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Biomedical subjects

G Klima

Publications and source records attributed to G Klima.

At least 91 records · Page 5Linked to original sources
PubMed1990

[A technique for pancreatic juice collection in the rat].

Monitoring of exocrine graft function and pancreatic juice cytology have proved to be a reliable method of detection of pancreas allograft rejection. In order to confirm these clinical findings and to define further parameters, experimental work is still needed. The rat was chosen for these experiments and a technique of pancreatic juice procurement developed. In five animals a fully implantable closed reservoir-catheter system was used. For the prevention of bacterial contamination it was necessary to install a mixture of antibiotics and culture medium into the reservoir. Pancreatic juice was procured daily under general anaesthesia. During the observation time of 14 days no further complications were encountered with the exception of one catheter dislocation. The mean amount of juice of 1 cc per day has proved to be sufficient for various enzyme estimations as well as for juice cytology.

Anesthesia, General↗
PubMed1989

[Metastatic thyroid cancer: sudden death following aclarubicin therapy].

We report on a 62-year-old patient with a metastasising, only poorly differentiated follicular thyroid carcinoma, who was subjected postoperatively to chemotherapy with Aclarubicin. Aclarubicin (Aclaplastin) is a new cytostatic agent, from the group of anthracyclines, with fewer side effects and clearly diminished cardiotoxicity. The patient died suddenly after two treatment cycles with clinical symptoms of cardiac insufficiency; the post-mortem examination, however, revealed that two metastases in the myocardium might have been the cause of death; toxic myocardial damage could be excluded histologically. Upon occurrence of cardial symptoms and signs during therapy with cytostatic agents of thyroid carcinoma with Aclarubicin, whose cardiotoxic side effects are known, the possibility of metastatic spread in the myocardium should, nevertheless, also always be considered in the differential diagnosis.

Aclarubicin↗
PubMed1989

[Microcirculation in parenteral Ginkgo biloba extract therapy].

15 patients with arteriosclerotic lesions in the extracranial brain arteries, randomly selected, were treated with an infusion of 250 ml physiological NaCl and 25 ml Ginkgo biloba extract (Tebonin). A second group (n = 15) received 250 ml NaCl without drugs stimulating blood flow. The skin microcirculation was measured in vivo by means of a helium-neon laser at one of the 4 extremities. Perfusion increased significantly (p less than or equal to 0.01) in response to Ginkgo biloba extract als composed with the response in the control group. The results justify the administration of Ginkgo biloba extract in vascular diseases.

Aged↗
PubMed1989

[Regeneration of lymph drainage following transplantation of the small intestine].

Since the resorption of long-chained fatty acids proceeds exclusively via the lymphatics, the regeneration of lymphatic flow from small bowel grafts takes on a significant role. An isogene, heterotopic small bowel transplant was performed in a total of 54 Lewis rats, whereby 27 animals received no immunosuppression (group A) and the remaining 27 rats received cyclosporin A (group B). The lymphatic regeneration was determined by instilling dye into the mesenterial lymph nodes of the graft between day 1 and day 42 after transplantation and measuring the interval between instillation and appearance in the retroperitoneal lymph channels of the host. Additionally, the severity of the lymph edema was examined in histological slides, and the lymph vessels of the villi were examined for the presence of chylomicrons. In group A the passage of the dye into the lymphatic system first occurred on day 3 after transplantation, namely after a mean of 11.8 min, while in group B the lymph channels of the retroperitoneum first became visible on day 7 after transplantation (mean 8 min after instillation). Passage of the dye out of the lymphatic system of the graft was prompt and unhindered from day 10 in group A and from day 14 after transplantation in group B. In all grafts there was a marked interstitial lymph edema during the first week, and it was less severe in both groups up to day 14. Chylomicrons in the villi were observed in group A as of day 10 and after two weeks in group B. Regeneration of the lymphatics in small bowel grafts thus appears to be adequate for enteral nutrition only after 14 days.

Animals↗
PubMed1989

Histologic pattern of small bowel allograft rejection in the rat. Mucosal biopsies do not provide sufficient information.

Accessory small bowel transplantation was performed in a rat model, and the histologic sequence of acute rejection with and without immunosuppression with cyclosporine defined. The first rejection episodes occurred on the fifth postoperative day, defined as phase I. The mucosa and submucosa of the grafts were infiltrated by mononuclear and polynuclear leukocytes, and lymphocytes were scattered along the myenteric ganglia. Three to five days later (phase II) the infiltrate intensified and was associated with villous flattening and sloughing of epithelial cells. The muscular layer was invaded by numerous lymphocytes and neutrophils. At the end of the rejection episode complete destruction of the mucosa and the muscular layer developed (phase III). As no lesion other than lymphocytic infiltration could be detected in the mucosa in phases I and II of rejection, which may be considered reversible, and this change is known to be unspecific, biopsies of the mucosa alone are inadequate for a purely histologic diagnosis of small bowel allograft rejection.

Animals↗
PubMed1989

Influence of high frequency ventilation at different end-expiratory lung volumes on the development of lung damage during lung lavage in rabbits.

The effects of high frequency ventilation in combination with sustained inflations was studied in the surfactant-deficient lungs of 18 New Zealand White rabbits (weight 1.9-2.1 kg) during anaesthesia with urethane and neuromuscular block with pancuronium. Lung damage was induced by repeated lung lavage. In nine rabbits (group I) baseline ventilator settings were maintained constant throughout the study and airway pressure was readjusted to achieve a constant tidal volume. In the other nine rabbits (group II), ventilation was reinstituted after lung lavage with one period of four sustained inflations followed immediately by high frequency ventilation. In group I there was a significant decrease in gas exchange for oxygen and deterioration in pulmonary mechanics, whereas in group II there was little change in baseline blood-gas values or pulmonary mechanics. These data suggest that, with adequate ventilatory management during the period of lung lavage, the lung damage produced by this manoeuvre may be obviated.

Anesthesia, Intravenous↗
PubMed1989

Pancreatic juice cytology in the monitoring of pancreas allografts.

A technique for preparation of pancreatic juice for cytological examination, which was applied in 35 consecutive recipients of a pancreas allograft, is described. Pancreatic juice cytology (PJC) was performed daily, giving a total of 1116 cytological specimens. In these 35 pancreas grafts, 26 acute cellular and two vascular rejections were diagnosed on the basis of exocrine and endocrine graft function, perfusion scans, and clinical course and outcome, and were retrospectively compared with PJC findings. Histology was available only for vascular-type rejections. In uncomplicated cases, mainly neutrophil granulocytes with some ductal epithelial cells and 2-3% lymphocytes were seen. During 96% of acute cellular rejections an increase of lymphocytes was detected to more than 5% of all cells counted. In two-thirds of these episodes, eosinophil granulocytes and/or necrotic epithelial cells were found. The total number of cells was significantly increased in 60% of the cases. A minimum of two of these criteria was necessary for diagnosis of rejection. Rejections were correctly diagnosed in 234 slides (23 episodes) and missed in 36 (three episodes), PJC gave a false-positive result in 27 examinations (three rejections), but a correct negative result in the remaining 819 examinations. This gives a sensitivity of 86.6% and a specificity of 96.8%. With the exception of viral pancreatitis, where no specific changes were seen, PJC also proved very helpful in diagnosing other complications after pancreas transplantation, such as pancreatitis, bacterial or fungal contamination of the juice, and even cyclosporine toxicity. PJC facilitated the detection of isolated rejection episodes of the pancreas graft in recipients of a combined renal pancreatic graft, which happened in six instances. PJC has proved to be a simple but most helpful method for the detection of cellular rejection of pancreas allografts, as well as other complications.

Cyclosporins↗
PubMed1989

Rejection of kidney and pancreas after pancreas-kidney transplantation.

On the basis of 26 combined pancreas-kidney transplants we questioned whether both organs undergo rejection simultaneously. Reliable diagnosis of pancreas-graft rejection was made possible by monitoring exocrine graft function, including quantitative measurements of pancreatic juice, its amylase content, and pancreatic juice cytology. In addition, diagnosis of pancreas rejection was based on regular flow studies, daily urinary neopterin excretion, and a retrospective analysis of the clinical course. Clinical symptoms, blood chemistry, and, primarily, histology were used to assess rejection of the kidney allograft. In 18 cases the kidney and pancreas were rejected together; in 8 cases the kidney or the pancreas was rejected. Although both organs were rejected at the same time in most cases, either organ can be rejected alone. Thus, the kidney cannot be used to monitor the pancreas allograft in every case.

Adult↗
PubMed1989

[Treatment of purulent meningitis in childhood].

Treatment of bacterial meningitis in children requires the choice of the optimal antimicrobial substance: besides the in vitro susceptibility also pharmacokinetic parameters (CSF penetration and elimination) have to be considered. A careful medical history and a few laboratory tests (gram-stain and antigen determination) provide a preliminary bacterial diagnosis within less than one hour. In addition to the identification of the causative organism also the determination of the number of colony forming units per milliliter CSF is of crucial importance. A rapid bacterial cell kill of high numbers of pneumococci, meningococci and streptococci group B overwhelms the CSF with endotoxins with rapidly increasing cerebral edema. Applying a slowly increasing dosage regimen proved effective in preventing this detrimental effects. Supportive therapy e.g. treatment of septic shock, disseminated intravascular coagulation, cerebral edema and anticonvulsive therapy is of paramount importance. Inadequate ADH secretion in the majority of patients requires a restricted fluid and electrolyte supplementation. By this combined therapeutic approach a remarkable low lethality rate and a low number of patients with late sequelae was seen.

Anti-Bacterial Agents↗
PubMed1989

[Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy].

10 patients suffering from neuropathies caused by various diseases and with an autonomic disregulation of skin were treated intravenously with a new combination of 87.5 mg Ginkgo-biloba-extract standardized to 21.0 mg Flavonglycosids and 3 mg folic acid during 14 days. The autonomic nerve-function was measured immediately before onset and after the end of therapy with the hyperthermal laser-Doppler-Flowmetry. Additionally pain, superficial and deep sensibility were described. After the end of treatment the autonomic nerve-function was improved in a significant manner (p less than 0.01). An improvement of the described parameters for pain and for perception could be observed too. Therefore this new combination seems to be suited for treatment of polyneuropathies.

Adult↗
PubMed1989

[Experimental and histologic studies on fetal membrane tensility and membrane rupture].

The collagen microfibrils of the amniotic connective tissue are irregularly textured. In all a preference for a meridional orientation perpendicular to the placental-rim can be observed. There are randomly dispersed weak spots between dense bundles of collagen fibres. The chorion connective tissue consists also of fibril bundles in a meridional main orientation. Within the bundles or bands there is an unmistakable pattern of latticed arranged fibrils. The framework receives its stability from the bundles that run perpendicular or inclined to the previously mentioned bundles. There are randomly dispersed weak areas between the dense fibril aggregates. In general the amniotic and chorionic connective tissues are both of variable strength. The tensile strength of both membranes is regionally varying due to the irregular texture. At times it varies within the same fetal membrane or from fetal membrane to fetal membrane considerably, where by the variation in membrane thickness also is of influence. It is to be observed that in general the resistance perpendicular to the meridian direction is smaller than along the meridian direction. During the rupture of the membranes the latticed arranged fibres from the bundles of the chorionic connective tissue give way and tear in an arbitrary weak spot. In the amniotic tissue the tearing also begins in a weak spot and continues to tear in a non predictable direction between the irregular pattern of bundles.

Amnion↗
PubMed1989

[The microtexture of amnion and chorion connective tissue].

On microscopical, stereo-scan and TEM observations the microtexture of the connective tissue of amnion and chorion have been analysed. The "compact layer" of the amnion-connective tissue consists of single collagen fibrils, which are arranged felt-like in parallel layers. In the "fibroblast layer" the fibrils are mostly arranged in bundles, forming a network. Single fibrils and bundles of fibrils in both layers are arranged surface parallel. The superficial layer of the chorion's connective tissue is predominated by wave-like bundles of fibrils in parallel and latticed arrangements, which are consolidated by transversely and diagonally running fibres. In the inferior layer the fibres leave their formation, run diagonally in the direction of the trophoblast and interweave with each other to a mat of fibrils at the border to the trophoblast. The tensile strength of the amnion connective tissue is due to the felt-like fibril texture of the "compact-layer" and the special arrangement of surface-parallel collagen fibres and fibrils.

Amnion↗