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F Mosimann

Publications and source records attributed to F Mosimann.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Treatment of intimal hyperplasia by gene therapy: an update].

Injury to the vessel wall leads to smooth muscle cell (SMC) activation followed by intimal hyperplasia (IH). This process contributes to restenosis following balloon angioplasty--particularly with stenting--occlusion of vascular bypasses, and transplant arteriopathy. Genetic interventions affecting the cell cycle or early postinjury events have been successful in limiting SMC proliferation in vitro and in animal models. Gene therapy strategies have included the use of antisense oligonucleotides that block protein synthesis, transduced "suicide" genes that cause cytotoxicity, and cells engineered genetically to reduce the response to injury. The clinical application of gene therapy in vascular diseases should become a reality with the development of new delivery systems permitting efficient gene transfer to the injured vascular wall (J Mal Vasc 1999; 24: 349-355).

Angioplasty, Balloon, Coronary↗
PubMed1998

[Castleman disease: 2 unusual cases].

Castleman's disease is a localized, rare and benign hyperplasia of the lymph nodes, occurring mainly in the mediastinum. Three histologic types--hyalinvascular, plasmacellular and intermediate--have been recognized. We report on two patients with unusual locations of the disease, i.e. the pelvis and the retroperitoneum respectively. These observations show that diagnosis is difficult. They also indicate that, in selected patients, radiotherapy may induce tumor regression and allow the resection of apparently inoperable lesions.

Adult↗
PubMed1998

Are enemas given before abdominal operations useful? A prospective randomised trail.

OBJECTIVE: To assess the effect of preoperative enemas on the recovery of peristalsis after non-colonic abdominal operations. DESIGN: Prospective randomised trail. SETTING: University hospital, Switzerland. SUBJECTS: 116 adult patients (> 16 year old) about to undergo elective non-colonic abdominal operations under general anaesthaesia were considered. INTERVENTION: Two groups were randomised to receive a one litre water and glycerine enema the day before operation (n = 53) or no preoperative intestinal preparation (n = 53). MAIN OUTCOME MEASURES: Return of peristalsis after operation, assessed by auscultation of bowel sounds and time of the first spontaneous faeces. All participants were followed daily for 10 days or until discharge by the same observer. RESULTS: 110 patients gave informed consent, 6 refused to participate, and 4 had to be withdrawn after randomisation, leaving 106 for analysis. The patients without an enema recovered bowel sounds activity sooner (p = 0.02) and passed their first spontaneous faeces significantly earlier (p = 0.01). No subgroup of patients benefited from an enema. CONCLUSION: Preoperative enemas delay rather than improve the return of normal peristalsis after surgery. We recommend this practice should be abandoned.

Abdomen↗
PubMed1998

Leptin inhibits directly glucocorticoid secretion by normal human and rat adrenal gland.

Different interactions have been described between glucocorticoids and the product of the ob gene leptin. Leptin can inhibit the activation of the hypothalamo-pituitary-adrenal axis by stressful stimuli, whereas adrenal glucocorticoids stimulate leptin production by the adipocyte. The present study was designed to investigate the potential direct effects of leptin to modulate glucocorticoid production by the adrenal. Human adrenal glands from kidney transplant donors were dissociated, and isolated primary cells were studied in vitro. These cells were preincubated with recombinant leptin (10(-10)-10(-7) M) for 6 or 24 h, and basal or ACTH-stimulated cortisol secretion was subsequently measured. Basal cortisol secretion was unaffected by leptin, but a significant and dose-dependent inhibition of ACTH-stimulated cortisol secretion was observed [down by 29 +/- 0.1% of controls with the highest leptin dose, P < 0.01 vs. CT (unrelated positive control)]. This effect of leptin was also observed in rat primary adrenocortical cells, where leptin inhibited stimulated corticosterone secretion in a dose-dependent manner (down by 46 +/- 0.1% of controls with the highest leptin dose, P < 0.001 vs. CT). These effects of leptin in adrenal cells are likely mediated by the long isoform of the leptin receptor (OB-R), because its transcript was found to be expressed in the adrenal tissue and leptin had no inhibitory effect in adrenal glands obtained from db/db mice. Therefore, leptin inhibits directly stimulated cortisol secretion from human and rat adrenal glands, and this may represent an important mechanism to modulate glucocorticoid levels in various metabolic states.

Adrenal Glands↗
PubMed1997

[Surgery and cystic malformations of the bile ducts].

Bile duct cysts are usually diagnosed during infancy and childhood, although 20-30% become symptomatic in adults, sometimes as late as the seventh decade of life. The Todani modification of the Alonso-Lej classification is now generally accepted and has clarified a previously confusing literature. Treatment is surgical: resectional rather than the traditional drainage procedures are indicated. This aggressive approach decreases but does not abolish the risk of cancer in the hepato-bilio-pancreatic tree. The patients must therefore be followed up for life.

Adult↗
PubMed1997

Endogenous glucose production, gluconeogenesis and liver glycogen concentration in obese non-diabetic patients.

Resting, post-absorptive endogenous glucose production (EGP), fractional gluconeogenesis and liver glycogen concentration were assessed in 6 lean and 5 obese non-diabetic subjects undergoing elective abdominal surgery. During the 2 days preceding these measurements, 0.3 g/day U-13C glucose had been added to their usual diet to label their endogenous glycogen stores. On the morning of day 3, EGP was measured with 6,6-2H glucose. Their endogenous 13C glycogen enrichment was calculated from 13CO2 and respiratory gas exchanges. Fractional gluconeogenesis was assessed as 1-(13C glucose/13C glycogen)100. EGP was similar in lean subjects (113 +/- 5 mg/min) and in obese subjects (111 +/- 6). Fractional gluconeogenesis was higher in obese (59 +/- 10%) than in lean subjects (29 +/- 8%). However, overall EGP remained constant due to a decrease in glycogenolysis. Since an increased gluconeogenesis and a decreased glycogenolysis may both contribute to increase liver glycogen concentration in obesity, hepatic glycogen concentrations were assessed in hepatic needle biopsies obtained during surgery. Hepatic glycogen concentrations were increased in obese patients (515 +/- 38 mg/g protein) compared to lean subjects (308 +/- 58, p < 0.05). It is concluded that in obese patients: a) fractional gluconeogenesis is increased; b) overall EGP is unchanged due to a proportional inhibition of glycogenolysis; c) liver glycogen concentration is increased.

Adult↗
PubMed1997

Amoxycillin/clavulanic acid prophylaxis in elective colorectal surgery: a prospective randomized trial.

In a randomized trial of 440 patients undergoing elective colorectal surgery, the prophylactic efficacy and the safety of amoxycillin/clavulanic acid were compared with that of a control regimen of clindamycin and gentamicin. Surgical wound healing was assessed by the ASEPSIS points scale; it was normal in 86% of patients and the scores for both groups were not statistically different (amoxycillin/clavulanic acid: 11.1; clindamycin + gentamicin: 10.9). Intra-abdominal infections were more frequent in the clindamycin + gentamicin arm of the study (Fisher's exact test, P = 0.035). It is concluded that amoxycillin/clavulanic acid is as effective and safe as clindamycin + gentamicin in the prevention of wound infection and may provide better protection against intra-abdominal infections.

Adolescent↗
PubMed1996

[Heart-kidney transplantation of the same donor following failure of a first renal transplantation due to chronic rejection].

Combined heart and renal transplantation from the same donor is an uncommon procedure. We describe the case of a patient with prior kidney transplantation whose renal graft had to be removed a few years later because of chronic rejection. The patient then developed severe hypertensive and ischemic left ventricular dysfunction. Combined heart and kidney transplantation was performed several years after the first renal transplantation. This observation is the first description of a combined heart and kidney transplantation after removal of a former renal graft whose failure was due to chronic rejection. Great care was taken to avoid identical MHC antigens (HLA-A; -B; -DR) between the two donors, to prevent recurrent rejection of the grafted organs. After 18 months, no rejection was detected in either organ. This case report confirms the feasibility of this complex procedure, provided care is taken to avoid identical HLA groups between the two donors so as to reduce immunological complications.

Adult↗
PubMed1996

[Efficacy of organ exchange rules in a 7 million population nation].

The suitability of organ exchange rules were analysed retrospectively in a country with a population of 7 million not connected to international organ sharing organisations following the opening of a national coordination centre 2 years previously. The results demonstrate that the sharing rules work frictionless and efficiently, and that compulsory registration of every organ donor (cadaveric and living) guarantees entire transparency of organ source and exchange, therefore preventing any illegal activity. An unacceptably high mortality rate for patients awaiting a highly urgent organ (specifically heart or liver) shows that connection to an international organ exchange organisation is desirable in this respect.

Health Care Rationing↗
PubMed1995

Retransplantation of the liver after side-to-side caval anastomosis.

Caval reconstruction in orthotopic liver transplantation is generally performed by two end-to-end anastomoses, using a portal and caval-axillary bypass to sustain hemodynamic stability. In the "piggy-back" modification, the donor's suprahepatic inferior vena cava (IVC) is anastomosed end-to-side to the recipient's preserved IVC. We have used a recently described variant of the piggyback in 18 patients in whom both IVCs are anastomosed side-to-side. We report two patients who needed three retransplants after this reconstruction and conclude that regrafting can be performed in a quick and safe manner.

Aged↗
PubMed1995

Faecaloid breath heralding secondary aorto-enteric fistula.

A patient underwent simultaneous abdominal aortic prosthetic replacement and resection of a Meckel diverticulum. He then developed faecaloid breath. Later reoperation for aorto-enteric fistula cured halitosis. We conclude in retrospect that faecaloid breath may herald a secondary aorto-enteric fistula. A pathophysiological mechanism is suggested and discussed.

Aortic Aneurysm, Abdominal↗