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G Lexer

Publications and source records attributed to G Lexer.

22 records · Page 2Linked to original sources

[Massive pulmonary embolism: case report of successful embolectomy with transatrial vena cava blockade].

Massive pulmonary embolism occurred in a 42-year-old man 7 days after repair of a torn patellar ligament. Because of progressive deterioration in spite of full heparinization and supportive measures, and more than 60% occlusion of the pulmonary vascular bed on angiogram, partial cardiopulmonary bypass was instituted under local anesthesia by femoral artery and vein canulation. After improvement of hemodynamics and tissue oxygenation, general anesthesia was induced, the patient intubated and a longitudinal sternotomy carried out. The superior vena cava was canulated, the inferior vena cava occluded with a tourniquet and the pulmonary artery incised during temporary aortic occlusion. The left main pulmonary artery and its branches were nearly completely occluded, in addition, a large embolus was expressed into the right pulmonary artery by massaging the right lung. Finally, transatrial infrarenal caval interruption with a Mobin-Uddin umbrella filter was carried out. After 48 hours of mechanical ventilation, the patient was extubated; he made an essentially uneventful recovery.

Adult↗

[Administration of anxiolit retard before strumectomy (author's transl)].

With the aid of v. Zerssen's emotional scores the emotional condition of patients with toxic or cold thyroid adenomas was tested before operation with and without administration of oxazepam (Anxiolit retard). There was a significant improvement of the general condition not only in patients with toxic adenoma but also in patients with cold adenoma. Thus the preoperative application of Oxazepam is indicated before strumectomy to avoid stress symptoms and anxiety fits.

Adenoma↗

Effects of cyclosporine and antibody adsorption on pig cardiac xenograft survival in the baboon.

The problem of donor heart supply would be solved if hearts could be transplanted from readily available animals such as the pig or sheep. We have investigated heterotopic heart transplantation (in the neck) with the pig as donor and baboon as recipient. Five experimental groups were studied. Control hearts (group 1, n = 4) were rejected within 4 minutes to 8 hours. Splenectomy done before transplantation (group 2, n = 3) did not extend survival significantly (30 minutes to 8 hours). Donor heart survival in baboons receiving immunosuppressive therapy of cyclosporine and methylprednisolone (group 3, n = 5) was from 15 to 75 minutes only in four animals and for 5 days in one animal. Anti-pig antibody adsorption from baboon blood by pretransplant donor-specific kidney hemoperfusion (group 4, n = 7) resulted in cardiac function for 6 to 12 hours in three cases and from 4 to 5 days in four cases (p less than 0.02). A combination of pretransplant antibody adsorption and immunosuppression (group 5, n = 4) resulted in graft survival of 8 to 20 hours in three cases and of 4 days in one case (p less than 0.03). Histopathologic features of vascular (hyperacute) rejection were seen in all hearts except one (the 5-day survivor in group 3). Pretransplant adsorption of antibody clearly prolonged survival of discordant cardiac xenografts in some cases. Further exploration of this technique appears justified.

Adsorption↗

Hyperacute rejection in a discordant (pig to baboon) cardiac xenograft model.

Eight freshly excised pig hearts were hemoperfused by baboons in vivo. Cardiac function ceased in six hearts after a mean period of 90 minutes of perfusion (range 30 to 190 minutes). Two hearts continued functioning for the 4-hour study period. On microscopic examination, seven hearts, including one that continued beating, showed histopathologic features of hyperacute rejection. IgG, IgM, and C3 were strongly present on the myocardium in all cases. Hemoperfusion was associated with significant increases in heart mass (p less than 0.002) and circulating polymorphonuclear leukocytes (p less than 0.03) and reductions in coronary blood flow (p less than 0.0001), circulating lymphocytes (p less than 0.03), and C4 (p less than 0.03). Preformed circulating anti-pig antibodies disappeared in all but one baboon. Hyperacute rejection in this discordant xenograft model that used a nonhuman primate as "recipient" differs in few aspects from that seen in other experimental models. Possible methods of prolonging xenograft survival are discussed.

Animals↗