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Biomedical subjects

K Kraft

Publications and source records attributed to K Kraft.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Endoscopic hernia surgery (TAPP)--gold standard in management of recurrent hernias?].

From April 1993 to December 1995 210 TAPP procedures were performed because of recurrent hernia. With the TAPP method there is no difference between primary and recurrent repair. All procedures in this study were done with general anaesthesia by senior surgeons. The learning curve shows a reduction of operation time (60 to 55 min) with increasing experience and a reduction in complications as well (total 4.3%). Recurrence was observed in two cases. The reasons for these recurrences were technical failures during the previous repair. In both cases a second TAPP repair was carried out successfully. The main advantage of TAPP in recurrent hernia is that this method gives possibilities to avoid anterior scar tissue. Secondly tension-free repair can be combined with the benefit of the minimal access technique. For this reason, the TAPP procedure must be considered the method of choice in recurrent hernia repair.

Adult↗
PubMed1996

Studies on nutritional status in general surgery patients by clinical, anthropometric, and laboratory parameters.

We assessed the nutritional status of general surgery patients with and without cancer from a western European population in this prospective study. Anamnestic (weight development, abdominal complaints) and anthropometric (fat tissue measurements) data were collected on six groups of patients: cancer of the stomach (n = 13), pancreas (n = 13), colorectal (n = 23), breast (n = 12), and two control groups with benign diseases, ages 20-45 and 50-75 y. From these data, body mass index and ideal body weight were calculated. Concentrations of albumin, transferrin, retinol-binding protein, prealbumin, and creatinine height index were determined by biochemical tests. A weight loss of more than 10% was found in only 31% of gastric and 61% of pancreatic cancer patients. Significant values from anthropometric data were also found only in these groups. In biochemical tests, only the creatinine height index was reduced in all patients with pancreatic cancer. The remaining laboratory changes were so unspecific in all other parameters that no conclusions could be drawn as to the status of the patient's nutritional condition. For the evaluation of nutritional status, only relatively simple and inexpensive anamnestic and anthropometric measurements are necessary.

Adult↗
PubMed1996

[Laparoscopic hernioplasty (TAPP)--complications and recurrences in 900 operations].

A prospective study of 900 patients with inguinal hernia who underwent transabdominal preperitoneal laparoscopic hernia repair (TAPP) was performed. The median operation time was 50 minutes (range 20-155); overall 44 complications (4.8%) were recorded. 8 patients (0.9%) required reoperation, in 6 cases because of postoperative bleeding or haematoma formation respectively, in one case because of testicular tenderness and in one case because of a mesh infection. Now, with the maximum follow-up of 26 months, 12 recurrences have been noted, giving a 1.33% recurrence rate. Return to work was 21 days (range 4-47 days). One year postoperatively about 83% of patients were without any complaints. A strict correlation between the complication and recurrence rate and the learning curve was found. It is concluded, that laparoscopic hernia repair (TAPP) is a safe and effective procedure. Complications and hernia recurrences diminish with experience.

Adolescent↗
PubMed1995

Age is a major determinant of the divergent blood pressure responses to varying salt intake in essential hypertension.

Blood pressure responses to 1 week of low (20 mmol sodium/day) and high (300 mmol sodium/day) salt intake were investigated in a double-blind, randomized study in 46 white, nonobese subjects with essential hypertension (13 women, 33 men; mean age 45.3 +/- 2.2 years, age range 25 to 80 years). The individuals were classified as salt-sensitive when mean arterial blood pressure rose by at least 5 mm Hg during high salt intake, as salt-resistant when mean arterial blood pressure changed by less than 5 mm Hg, and as "counter-regulators" when mean arterial blood pressure fell by at least 5 mm Hg during the high salt diet. Mean arterial blood pressure of all subjects taken together increased from 101.9 +/- 1.4 mm Hg during salt restriction to 103.7 +/- 1.5 mm Hg (P < .05) during salt loading. Eleven subjects (23.9%) were classified as salt-sensitive, 27 (58.7%) as salt-resistant, and 8 (17.4%) as counter-regulators. Multiple regression analysis revealed that age, but not baseline blood pressure, sex, body mass index, or family history of hypertension contributed significantly to the change in blood pressure following the diets. Ten of the 11 salt-sensitive subjects were older than the median age of 45 years. In salt-sensitive, as compared to salt-resistant, hypertensive subjects, creatinine clearance was lower and plasma renin activity was suppressed at baseline as well as during low and high salt intake. In contrast, plasma concentrations of norepinephrine and atrial natriuretic peptide were elevated in salt-sensitive subjects. These differences between the groups appeared, at least partially, to be age-related.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Adenocarcinoma arising from ectopic gastric pancreas: two case reports with a review of the literature.

Adenocarcinoma is a common histological diagnosis of gastric neoplasias. Only if typical elements of pancreatic structures are found nearby or in the tumor, this particular origin can be proven. The development of a carcinoma within ectopic (or heterotopic) pancreas is extremely rare. Because of the accidental observation of two of such cases this topic is discussed in the present report. There are only sporadic cases available in literature and these mostly refer to pancreatic ectopy localized in the stomach or duodenum. Due to their origin and spread, the tumors form an intramural mass with relatively late mucosal invasion. Therefore malignancy is difficult to prove by endoscopic biopsy. In general the patients' prognosis is poor, survival varying between months and many years.

Adenocarcinoma↗
PubMed1994

[The effect of endogenous opioids in blood pressure regulation and arterial hypertension].

There are numerous hints to the participation of endogenous opioids in the tonic regulation of blood pressure and in pathogenesis and maintenance of essential hypertension. Endogenous mu- and delta-receptor agonists of the central nervous system seem to regulate long-term control of the sympathetic tone in essential hypertension. In the initial stage of hypertension, altered responses to opioid agonists and antagonists could be demonstrated in young spontaneously hypertensive rats. In young, but not in old hypertensive patients alterations of plasma concentrations of endogenous opioids were found. Reactivity and reagibility of blood pressure seem to be regulated rather independently from endogenous opioids, but they may modulate the influence of psychosocial stress on blood pressure.

Animals↗
PubMed1994

Pancreatoblastoma in an adult: its separation from acinar cell carcinoma.

Pancreatoblastomas are rare tumours, which usually occur in childhood. Here we describe a pancreatoblastoma in a 39-year-old woman. The tumour was located in the tail of the pancreas and consisted of cells forming well-differentiated acinar structures and scattered solid components ("squamoid corpuscles"). Immunocytochemically, the acinar components were positive for pancreatic enzymes and pancreatic stone protein, while the cells of the "squamoid corpuscles" lacked these markers. There was no p53 overexpression nor any mutation at codon 12 of the Ki-ras oncogene. The main differential diagnosis of this tumour was acinar cell carcinoma, because both tumours have a number of features in common (scattered solid components, positivity for pancreatic enzymes, lack of p53 overexpression and of Ki-ras mutation). Findings which distinguished the pancreatoblastoma and separated it from acinar cell carcinoma were the negativity of the solid components ("squamoid corpuscles") for neuroendocrine markers and their very weak keratin positivity. As the patient is alive and well 30 months after tumour resection, this pancreatoblastoma also differs in biology from the usual acinar cell carcinoma.

Adult↗
PubMed1994

Plasma lipids and lipoproteins and essential hypertension.

In recent years there have been many studies demonstrating a correlation between increased arterial blood pressure and altered lipid profiles, and there has been an especially positive correlation between high cholesterol levels and blood pressure. There are differences between the various reports that are important. In our study the lipid distribution in 105 hypertensive patients with mild or moderate arterial hypertension according to WHO criteria without clinically or ultrasonographically apparent atherosclerosis was compared to the lipid distribution in 65 age-matched healthy persons. On the epidemiological level a significant, positive association was found between LDL serum levels (P < or = 0.001), Apo B serum levels (P < or = 0.001), serum triglyceride levels (P < or = 0.05) and VLDL serum levels (P < or = 0.01) and arterial hypertension. However, in contrast to recent reports, no significant difference was found between total serum cholesterol levels in normotensives and hypertensives, and there was no difference in HDL serum levels. No evidence could be found for a significant increase in lipoprotein (a) serum levels in hypertensives.

Adult↗
PubMed1994

Twenty-four-hour blood pressure profiles in patients with mild-to-moderate hypertension: moxonidine versus captopril.

In 26 patients with mild-to-moderate hypertension, 80.8% of whom had a history of concomitant diseases, the effect of moxonidine (0.2 mg b.i.d.) on the 24-h ambulatory blood pressure profile (ABPM) was compared with captopril (25 mg b.i.d.) in a double-blind, parallel-group study. After 4 weeks of treatment with placebo, ABPM was performed and the patients were treated with moxonidine (n = 14) or captopril (n = 12) for a further 4 weeks. ABPM was then repeated. Both moxonidine and captopril reduced systolic and diastolic blood pressure sufficiently and to the same extent. Mean 24-h pulse rate and standard laboratory parameters were not changed by active treatment. After drug withdrawal for 5 days, sitting blood pressure did not differ from baseline values in both groups. Serious adverse events did not occur, the most frequent complaints were nausea (2 of 14 patients receiving moxonidine) and dizziness (3 of 12 patients receiving captopril). We concluded that the blood pressure-lowering effects of moxonidine (0.2 mg b.i.d.) and captopril (25 mg b.i.d.) are comparable in patients with mild-to-moderate hypertension.

Adolescent↗
PubMed1994

Effects of severe and moderate salt restriction on serum lipids in nonobese normotensive adults.

The effects of severe and moderate sodium restriction on blood pressure and serum lipids were studied in nonobese normotensive adults. Subjects (n = 163) were given a low (20 mmol Na/d) and high (300 mmol Na/d) salt diet for 1 week each in random order. Of these subjects, 25 were selected to participate in a second study with moderate salt restriction (85 mmol na/d) or "normal" sodium diet (200 mmol Na/d) given for 4 weeks each in random order. After severe salt restriction, 19% of the 163 subjects had a significant decrease in blood pressure (salt-sensitive), 15% showed a significant rise (counter-regulator), and 66% exhibited no change (salt-resistant). Severe sodium restriction increased serum total and low density lipoprotein (LDL) cholesterol and triglycerides. After correction for hematocrit, the changes in blood lipids remained significant in the counter regulators only. After moderate salt restriction, serum lipid concentrations and blood pressure did not change.

Adult↗
PubMed1994

[The lost gallstone--complication after laparoscopic cholecystectomy].

In this case report a persisting fistula between the right flexure of the colon and the abdominal wall was observed after a laparoscopic cholecystectomy. This was caused by a lost gallstone and eventually resulted in the resection of a colon segment. As a consequence of this case it can be said that intra-abdominally lost gallstones--especially larger ones--have to be recovered completely. In risky cholecystectomies we should consider the use of a laparoscopic bag or the installation of additional working cannulas.

Biliary Fistula↗
PubMed1993

Determination of ascorbic acid by isotachophoresis with regard to its potential in neuroblastoma therapy.

Analytical capillary isotachophoresis was used to determine ascorbic acid (AA) in different matrices (cell-free system, neuroblastoma cell extracts and urine). The system for purging bone marrow of neuroblastoma cells, including 6-hydroxydopamine (6-OHDA) and AA, was analysed with regard to the interaction of AA with 6-OHDA and its autoxidation product, hydrogen peroxide. Furthermore, analyses concerning the uptake of AA into neuroblastoma cells as well as its excretion in urine after uptake of large amounts were carried out.

Ascorbic Acid↗
PubMed1993

[Are home blood pressure measurements and 24-hour ambulatory recordings superior to office measurements? Comparison of 3 blood pressure recording methods in a study of cilazapril versus atenolol].

Self-assessment of blood pressure and ambulatory blood pressure monitoring (ABPM) are being more widely used in the diagnosis and therapy of hypertension, in addition to office blood pressure measurement. The present multicenter double-blind study compared cilazapril 2.5 to 5 mg (n = 26) to atenolol 50 to 100 mg (n = 27) over a period course of eight weeks. Office blood pressures in the morning before medication, ABPM over 24 h and self assessment of the blood pressure in the morning and evening were taken. The aim of the study was to find out if the results of ABPM and self assessment of blood pressure are similar when compared to office blood pressure measurement. After four weeks of therapy both cilazapril and atenolol achieved a significant and comparable reduction of blood pressure, which did not change significantly afterwards. Both medications showed a comparable blood pressure control over 24 h. with a once-a-day regimen. The comparison of the three techniques of blood pressure measurement demonstrates that ABPM results in significantly lower average daily values than office blood pressure measurement and that the self-assessed blood pressure values in most cases lie in-between. Although the diastolic ambulatory daily values were on the average 9 mmHg lower than the corresponding office values, it was not possible for an individual patient to accurately predict the ambulatory value obtained by to his office blood pressure value. Similar results were found for the values according to self assessment of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

The behaviour of neurogenic tumours of the maxillofacial region.

In 37 patients with neurogenic tumours of the maxillofacial region, epidemiology, clinical, sonographical and computer tomographical findings as well as the results of fine needle aspiration cytology (FNAC), histopathological evaluation of biopsies and flow cytometric determination of DNA ploidy, were analyzed in order to detect characteristics distinguishing the behaviour of the neoplasm prior to resection. Simultaneous histopathological and flow cytometric evaluation of biopsies is recommended to avoid the danger of mistaking ancient schwannomas for malignancies and vice versa. FNAC proved to be unreliable in these cases. The retromaxillary/pterygomandibular region appeared to be the most likely site for malignant schwannoma. Von Recklinghausen's neurofibromatosis in the patient or in their family should lead to immediate investigation of any mass developing in the vicinity of the facial or trigeminal nerves.

Adult↗
PubMed1993

Neurohormonal and metabolic effects of severe and moderate salt restriction in non-obese normotensive adults.

OBJECTIVE: The effects of severe and moderate sodium restriction on blood pressure, neurohormonal activity and serum lipids were studied in non-obese normotensive adults. METHODS: In the first part of the study, 163 subjects were randomly assigned to a diet of 20 or 300 mmol/day sodium for 1 week each. In the second part, 25 subjects were given a diet of 85 or 200 mmol/day sodium for 4 weeks each in random order. RESULTS: After severe salt restriction 19% of the subjects had a significant decline (salt-sensitive group), 15% showed a significant rise (counter-regulator group) and 66% exhibited no change in blood pressure (salt-resistant group). Severe sodium restriction increased plasma renin activity and noradrenaline concentration, as well as serum total and low-density lipoprotein-cholesterol and triglycerides. After correction for haematocrit, only the changes in total and low-density lipoprotein-cholesterol remained significant. The rise in plasma renin activity during salt restriction was steeper in the counter-regulator group than in the other groups, whereas the changes in plasma noradrenaline concentrations were similar in all groups. During moderate salt restriction, plasma renin activity and noradrenaline concentration were significantly increased, but serum lipid concentrations and blood pressure did not change. CONCLUSION: In non-obese normotensive adults, severe and moderate salt restriction stimulates neurohormonal activity. In contrast to severe salt restriction, a moderate reduction in dietary salt intake does not influence blood lipids in normotensive subjects.

Adult↗
PubMed1993

Divergent hemodynamic and hormonal responses to varying salt intake in normotensive subjects.

Blood pressure responses to 1 week of low-salt (20 mmol sodium/d) and high-salt (300 mmol sodium/d) intake were investigated in a single-blind randomized study in 163 white, nonobese normotensive subjects (65 women and 98 men; mean age, 38 +/- 1.2 years). The individuals were classified as salt sensitive when mean arterial blood pressure rose by at least 5 mm Hg during high-salt intake, as salt resistant when mean arterial blood pressure changed by less than 5 mm Hg, and as "counterregulator" when mean arterial blood pressure fell by at least 5 mm Hg during the high-salt diet. Reexamination of 31 subjects showed that this approach to the testing of salt sensitivity was reliable and reproducible. Thirty subjects (18.4%) were classified as salt sensitive, 108 (66.3%) as salt resistant, and 25 (15.3%) as counterregulators. Multiple regression analysis revealed that age, body weight, and family history of hypertension contributed significantly to the change in blood pressure after the diets. Salt sensitivity was more frequent in older subjects and in those with a positive family history of hypertension. An increase in blood pressure after salt restriction was more likely in younger individuals and in those with a negative family history of hypertension. Plasma renin activity and plasma aldosterone concentrations were lower in salt-sensitive compared with salt-resistant and counterregulating subjects. The rise in plasma renin activity during salt restriction was most pronounced in counterregulating subjects. Plasma norepinephrine concentrations were not different among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗