Biomedical subjects
Publications and source records attributed to E Moritz.
A case is described of delayed diagnosis of traumatic rupture of the diaphragm with herniation of the colon. The pathogenesis of late herniation is discussed.
In 72 patients, 80 circular stapler anastomoses have been performed in the whole gastrointestinal tract of them, 39 were created by means of the Russian SPTU stapler with a single row of staples and 41 were performed with the American Auto-Suture EEA stapler, which employs a double row of staples. Three patients died because of anastomotic leakage (4.17%) and one myocardial infarction (overall mortality: 5.56%). The use of circular staplers lowers the incidence of anastomotic dehiscence, shortens the operating time and enlarges the operative possibilities, particularly in esophageal and rectal surgery. Since application of these staplers may be difficult, this, like any other surgical technique, must be trained.
17 cases of tracheal stenosis following prolonged endotracheal intubation are reported. Resection of the stenotic segment and anastomosis were performed in all patients. The clinical result was classified as good in 15 patients and as satisfactory in one patient. One patient died from wound dehiscence and mediastinitis. Results of pre- and postoperative respiratory function tests are presented and the validity of these tests for objective evaluation of operative results is discussed. Diagnostically most informative is the quantitative and qualitative evaluation of airway resistance and MEFV curves.
A bioassay, based on tumorigenicity, has been developed to determine the mechanism whereby the blastocyst of the mouse controls malignant expression of embryonal carcinoma. The assay is based upon the incidence of tumors obtained when known numbers of cells of the 402AX strain of embryonal carcinoma are injected into strain 129 mice, compared to the incidence obtained when the same number of embryonal carcinoma cells are incorporated into Swiss-Webster blastocysts that are then injected in strain 129 animals. The results indicate that the blastocyst can regulate one embryonal carcinoma cell consistently; it may have a slight effect on three, but it cannot regulate four or five of them. The position of the embryonal carcinoma cell in the blastocyst is important. Regulation occurs if the embryonal carcinoma cell is placed in the blastocoele cavity, but enhancement of tumorigenicity is obtained if it is placed between the zona pellucida and the trophectoderm. By contrast, the blastocyst is unable to regulate a single B-16 melanoma cell placed in the blastocoele cavity, indicating a degree of specificity for the regulatory process.
Medium conditioned by human lung tissue was found to contain colony stimulating activity (CSA). This material was tested against mouse and human bone marrow as target system. Colony forming units (CFUc) from both species responded and gave rise to clonal growth in agar cultures. This colony formation was dose dependent and the relationship was a sigmoid one. Experiments to determine the molecular weight of human lung derived colony stimulating Factors brought evidence for four active molecular weight fractions with approximately 79000, 40000, 23000 and 2000 daltons. The 23000 dalton fraction activated human cells only, whereas the other fractions were active on both human and mouse bone marrow cells.
The most important points in preventing innominate artery erosions following tracheostomy are proper placement of the stoma and selection of flexible tubes with appropriate low pressure cuffs. In tracheal resections the risk of a tracheo-innominate artery fistula can be reduced by avoiding damage to the adventitia of the artery fibrosed to the stenotic tracheal segment and by interposing tissue between artery and anastomosis. If haemorrhage occurs this can be controlled by hyperinflation of a cuffed endotracheal tube in most cases. Permanent control of this complication can be achieved by resection of the artery without interposing a vascular graft. No cerebral damage will result. A great number of patients can be saved by the timely institution of proper measures.
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The plasma concentrations of substrates, together with transhepatic and transgut balances, have been studied in six control and eight septic awake fasted dogs. Four severely ill septic dogs (typically fluid in chest and/or abdomen, extensive peritonitis, respiratory difficulties) had high concentrations of threonine, glycine, tyrosine, lysine, histidine, tryptophan, and triglycerides (p less than or equal to 0.05). The other septic dogs (less severely ill) showed fewer and less pronounced alterations in the plasma substrates (aspartate and tryptophan were elevated, p less than or equal to 0.05). The infusion of glucose increased the concentration of glucose, lactate, and pyruvate and depressed the concentrations of most amino acids in both normal and septic dogs. Threonine, asparagine, glutamine, leucine, isoleucine, alpha-aminobutyrate, and tyrosine were significantly depressed in the severely ill septic dogs (p less than or equal to 0.05). In the normal dogs most amino acids were removed by the liver, with alanine accounting for approximately 40% of the total. Glutamine removal was negligible. In the septic dogs hepatic removal of amino acids was variable; livers of two severely ill septic dogs did not remove amino acids. In the control dogs glucose infusion (0.015--0.017 g/kg/min) tended to lower hepatic removal of amino acids. Hepatic dye removal in the septic dogs was always very poor. In the gut glutamine was removed and alanine, glutamate, glycine, and ammonia produced, but the overall sum of amino acid uptake was negligible in both the control and septic dogs. The ratio of tryptophan to the sum of valine, isoleucine, leucine, tyrosine, and phenylalanine concentrations was greatly elevated in all septic dogs in which it was measured. The free concentrations of amino acids in the liver, heart, and muscle tissues were grossly elevated in the low intravenous alimented septic state relative to the fasted normal state, whereas the tissue concentrative ability as measured by nonmetabolizable amino acids, alpha-aminoisobutyrate and cycloleucine, was not similarly increased. Sepsis clearly alters plasma and tissue concentrations, and in some instances hepatic uptake of amino acids.
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The paper reports on 11 patients with very advanced melanoma, who were treated with a modified version of multiple-stage cancer therapy. No improvement in the course of the illness resulted, but survival may have been slightly prolonged.
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The catabolism of glucose and amino acids has been studied in the normal, the fasted, and the fasted septic dog. The fasted septic dog oxidized more glucose and alanine, and had more gluconeogenesis from alanine and the five tritiated amino acids--glutamate, threonine, phenylalanine, leucine, and valine--as compared to the normal and equally fasted dog. Thus the total body protein catabolic state was characterized in biochemical terms. In contrast, following glucose infusion, the fasted septic animal responded much like the fasted animal in terms of decreased animo acid gluconeogenesis and decreased plasma concentrations of amino acids, fats and fat products, but considerably increased the oxidation of alanine. The increased alanine oxidation appeared to be primarily related to increased tissue clearance and increased plasma concentration. There was some suggestive evidence for enhanced oxidation of the tritiated amino acids including leucine and valine during glucose infusion. The protein catabolic state secondary to this sort of sepsis in dogs only on per os fluid support appears to be best characterized as a glucose catabolic state with alanine being oxidized directly. Such states are known to be ones of enhanced metabolic rate secondary to enhanced synthetic processes generally. This is probably related to enhanced sympathetic nervous system release of glucagon with insulin being normally responsive to glucose because of a normal plasma epinephrine.
A comparative study has been made of the assimilation and metabolism of rac-1 and 2-[9, 10(-3)H]-octadec-9-enylglycerol in a clone of epithelial-like cells isolated from rabbit liver. Based on cell protein content, the free glycerol ether isomers attained equal cellular concentrations. As shown by isolation and degradation experiments, however, the incorporation of radioactive 1-monether was appreciably higher than that of radioactive 2-monoether in both the triacylglycerol and phospholipid fractions. The 1-monoether, unlike the 2-monether, was also a significant source of esterified fatty acids in both lipid fractions. In addition, the 1-monoether, but not the 2-monoether, was an active precursor of plasmalogens, particularly ethanolamine plasmalogen. In contrast to the 1-monoether, the 2-monoether was a more active precursor of triacylglycerols than it was of phospholipids. The results indicate that in the rabbit liver cells the pathway of complex lipid synthesis from 1-monoether was via 1-alkyl-sn-glycerol-3-phosphoric acid and from 2-monoether via 1-alkyl-2-acyl-sn-glycerol.
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