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J Kübler

Publications and source records attributed to J Kübler.

At least 19 recordsLinked to original sources
PubMed2006

[Data sources in epidemiology].

The use of large databases has a high potential for future epidemiological research. Databases consisting of primary data as well as routine data that are mainly collected for administrative purposes will be of interest. This paper presents some large databases and some that are most relevant for epidemiological research, respectively, and shows how they might be exploited for research purposes. To make better use of large databases there are new requirements and challenges that we have to face regarding appropriate methods for their analysis. Some examples of such methods are given. An example of pharmaco-epidemiology illustrates linkage of several administrative databases and specific problems that have to be solved in this context. Finally, future challenges are discussed that have to be overcome on the way towards establishment, maintenance and analysis of large databases, especially regarding data protection, data quality and regular updates.

Computer Security↗
PubMed2006

Laparoscopic nephroureterectomy in children: a prospective study on Ligasure versus Clip/Ligation.

PURPOSE: The present study was performed to compare dissection of the renal hilar vessels in laparoscopic transabdominal nephrectomy in children using the Endo-Ligasure vessel sealing system versus clip/ligation. PATIENTS AND METHODS: In a prospective and comparative study carried out from February 2003 to April 2004, 10 consecutive patients (group 1) underwent laparoscopic transabdominal nephroureterectomy using clips or intracorporeally performed ligations, respectively. From April 2004 to April 2005, 10 consecutive patients (group 2) underwent the same procedure using the Endo-Ligasure vessel sealing system. Indications for surgery were confirmed non-functioning kidneys secondary to benign unilateral renal disease and no prior surgery. The age and underlying disease distribution and the affected side were not significantly different between the two groups. RESULTS: The operating time was significantly lower in the Endo-Ligasure group (group 1: median 167 vs. group 2: 108 min, p < 0.05). Bleeding of the renal artery occurred due to dislocation of a suture ligation, which was treated laparoscopically with an intracorporeal suture ligation. Blood loss was negligible in all patients. All procedures were completed laparoscopically and recovery was uneventful. CONCLUSIONS: Endo-Ligasure is a beneficial tool in laparoscopic transabdominal nephrectomy. It is safe, effective, and reduces operating times compared to clip application and intracorporeal suturing.

Blood Loss, Surgical↗
PubMed2005

Anuria during pneumoperitoneum in infants and children: a prospective study.

INTRODUCTION: Transient oliguria during laparoscopic surgery is a known phenomenon. Currently, no data on the impact of pneumoperitoneum on renal function in children are available. PATIENTS AND METHODS: Thirty children with normal kidney function, who underwent laparoscopic surgery, were included in a prospective study. A transurethral catheter was placed to measure urine output during and 6 hours after operation. Renal blood flow (resistive index) was evaluated by Doppler ultrasound of a segmental renal artery before surgery, every 15 minutes during laparoscopy, and after 24 hours. Blood and urine samples were studied before and 24 hours after surgery. Hemodynamic parameters were monitored continuously during standardized anesthesia, including a standardized intravenous infusion regimen. RESULTS: Urine output decreased within 45 minutes of pneumoperitoneum in all patients. Of 8 children younger than 1 year, 7 (88%) developed anuria vs 3 of 22 (14%) children aged 1 to 15 years (P < .001). Nine children 1 year and older (32%) developed oliguria. There was a significant recovering in the mean urine output until 5 to 6 hours after pneumoperitoneum in both age groups. No significant alterations of the renal blood flow (resistive index) and the serum and urine levels of cystatin C, creatinine, and urea nitrogen were evident until 24 hours postoperatively. The volume of infusion during pneumoperitoneum did not correlate with urine output. CONCLUSION: Pneumoperitoneum leads to anuria in most children younger than 1 year and to oliguria in about one third of older children. This is a completely reversible phenomenon. Urine output should not be taken into consideration for calculating intravenous fluid administration during pneumoperitoneum in children.

Age Factors↗
PubMed2000

Structure of the lipopolysaccharide core region of Hafnia alvei strains 1185 and 1204.

Sugar and methylation analyses using gas chromatography/mass spectrometry and NMR spectroscopy proved that the core oligosaccharides of Hafnia alvei strains 1185 and 1204 have the following formula: carbohydrate sequence [see text] where Kdo = 3-deoxy-oct-2-ulosonic acid and P-PEtN = diphosphorylethanolamine. The structure shown above is a slight modification of the typical core region of H. alvei lipopolysaccharides. The difference refers to one sugar only: terminal galactose is present in the core of strains of 1185 and 1204, while terminal glucose in the typical core.

Carbohydrate Conformation↗
PubMed1998

[Selective bradykinin B1 receptor block in ischemia/reperfusion of the rat pancreas].

The selective bradykinin B1-receptor-antagonist CP-0298 reduces ischemia/reperfusion induced enhanced leukocyte adherence in postcapillary venules of the pancreas, but has no influence on the microvascular perfusion failure. The postischemic enzyme release will effectively attenuated by the antagonist. Wether the activation of the B1-receptor under pathophysiological conditions exerts protective effects to maintain the integrity of the pancreas, has to be evaluated in further experiments.

Acute Disease↗
PubMed1998

[Extracellular polysaccharides of coagulase-negative staphylococci and their role in pathogenicity].

Coagulase-negative staphylococci have been recognised as important pathogens in biomaterial-associated infections and a number of studies have been carried out to identify virulence factors for these microorganisms. Among them bacterial slime has been most extensively investigated, since it is considered to participate in the staphylococcal adherence and growth on polymer surfaces. It has been shown that on the surface of infected biomaterial bacteria are embedded in a heavy slime layer, that allows them to escape host defence and resist to the antimicrobial action of antibiotics. In this review article the reasons for the growing pathogenicity of coagulase-negative staphylococci are discussed. Also the methods for studying bacterial adherence and slime production are presented and the latest data on chemical composition of coagulase-negative extracellular polysaccharides are reported.

Animals↗
PubMed1997

Immunochemical characterization of lipopolysaccharide from glucose-nonfermenting gram-negative clinical bacterial isolate.

A glucose-nonfermenting Gram-negative bacterial strain isolated from bronchofiberoscope used for examination of the patients suffering from pulmonary diseases was subjected to phenol-water extraction. Lipopolysaccharides (LPS) isolated from the water and the phenol phase differed in fatty acid composition. Both contained xylose, glucose, glucosamine and components typical for LPS, namely heptose, 3-deoxyoctulosonic acid (Kdo) and 3-hydroxymyristic acid. The presence of sphingosine in all LPS preparations classifies the strain to the genus Sphingomonas.

Animals↗
PubMed1996

Structural study and serological characterisation of the O-specific polysaccharide of Hafnia alvei PCM 1185, another Hafnia O-antigen that contains 3,6-dideoxy-3-[(R)-3-hydroxybutyramido]-D-glucose.

The O-specific polysaccharide of H. alvei strain PCM 1185 contains D-glucose, D-glucuronic acid, 2-acetamido-2-deoxy-D-glucose, and 3,6-dideoxy-3-[(R)-3-hydroxybutyramido]-D-glucose (Qui3NAcyl) in the ratios 2:1:1:1 as well as O-acetyl groups. On the basis of sugar and methylation analyses of the polysaccharide before and after chemical modifications (O-deacetylation, carboxyl reduction, Smith degradation), as well as 1H and 13C NMR spectroscopy, including 1D sequential, selective spin-decoupling, 2D homonuclear and 13C,1H heteronuclear correlation spectroscopy (COSY), and 2D rotating-frame NOE spectroscopy, it was found that the polysaccharide has a pentasaccharide repeating unit with the following structure: [formula: see text] with O-acetyl groups present in nonstoichiometric amounts, mainly at position 2 of GlcA and position 6 of GlcNAc or lateral Glc. Serological study showed that H. alvei strain PCM 1185 can be placed in a new serotype D and that an O-acetyl group can be a part of its epitope.

Carbohydrate Conformation↗
PubMed1996

[Bradykinin antagonism in ischemia and reperfusion of the pancreas].

INTRODUCTION: Acute pancreatitis is characterized by two different courses of the disease, edematous and hemorrhagic-necrotizing pancreatitis. The pathogenesis and causes for the progression of pancreatitis are unknown. Ischemia/reperfusion with formation of oxygen free radicals, activation of leukocytes and consecutive failure of the microcirculation has gained attention as a causative factor. Furthermore, the degree of microcirculatory injury correlates with the severity of pancreatitis. The aim of the study was to investigate the influence of long term reperfusion after ischemia of the pancreas for 2 hours on morphological changes and enzyme release of the pancreas in rats. Since the characteristic features of postischemic pancreatic reperfusion injury are kinin-mediated we employed the bradykinin B2-receptor antagonist HOE 140 to inhibit the progression of postischemic changes of the pancreas. METHODS: Under ether anesthesia Sprague-Dawley rats (n = 28) were laparotomized, the 4 supplying arteries of the pancreas were isolated (gastroduodenal artery, left gastric artery, splenic artery and caudal pancreaticoduodenal artery) and occluded with microvascular clips for 2 hours. At the end of ischemia the abdomen was closed and the animals were allowed to awake. 15 minutes before end of ischemia an osmotic minipump filled with NaCl (ischemia group NaCl), phosphate buffer (ischemia group phosphate buffer) or HOE 140 dissolved in phosphate buffer (ischemia group HOE 140) was placed intraperitoneally. Control animals underwent sham operation without vessel occlusion; the osmotic minipump was filled with 0.9 % NaCl. Five days after ischemia the animals were sacrificed for histology. Amylase concentration and peripheral leukocyte count were determined at baseline and daily after operation. RESULTS: After ischemia of 2 hours during reperfusion of 5 days all 14 animals developed histopathological changes as seen in hemorrhagic-necrotizing pancreatitis with a mortality rate of 50 %. These morphological changes were associated with a significant increase (p < 0.05) of pancreas amylase concentration from 1850 +/- 149 U/L before ischemia to a maximum of 3934 +/- 435 U/L at 1st postoperative day and decreased to 1518 +/- 399 U/L at 4th postoperative day. Leukocyte count increased significantly (p < 0.05) from 10 x 10(12)/L to 31 x 10(12)/L. In control animals as well as in animals receiving HOE 140, morphological and enzyme changes typical for acute pancreatitis were absent, leukocyte count increased only slightly. CONCLUSION: Ischemia of the pancreas of 2 hours with ensuing reperfusion of 5 days induces morphological and biochemical changes as observed in hemorrhagic-necrotizing pancreatitis. Organ dysfunction after ischemia/ reperfusion can be effectively inhibited by administration of the bradykinin-antagonist HOE 140.

Amylases↗