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Biomedical subjects

M Golling

Publications and source records attributed to M Golling.

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

Development of a computer based training program for liver transplantation.

The existence and future of every scientific area is directly and indirectly dependent on advanced education in that area and the quality of the work performed. Our aim in developing this program was to improve advanced education in liver transplant surgery and to ensure the quality of the work performed by every surgeon operating in this field. We developed a module that contains extensive information on the pathogenesis, symptoms, diagnosis, X-rays and treatment plans as well as operation-videos and case studies on the most common aspects in liver transplantation. This "teachware" is now on CD-ROM and can be installed on every personal computer without special computer knowledge. The expansion and updating of the material is technically facilitated with the help of an authoring tool.

CD-ROM↗
PubMed1998

[Development of a computer-assisted learning program for liver transplantation].

The German Society for Surgery recently decided to rename the "video library" as a "multimedia library", which will include also interactive, nonlinear computerised teachware in surgery. We report on the complex interaction of authors, editor, and the computer-based training laboratory, and the pitfalls with respect to data collection, structure, implementation, and technical aspects of the CD-ROM liver transplantation.

Computer-Assisted Instruction↗
PubMed1998

[Chronic liver immunologic factors in ischemic type biliary lesions (ITBL) --> reduced Th1 and increased Th2 response].

Compared to patients with a stable liver function, we found a decreased Th1 and increased Th2 response in patients presenting with ischemic type biliary lesions following liver transplantation. It remains open to speculation whether these immunological changes were induced by the damage of the bile ducts, occur as an additional damaging factor or are found as an epiphenomenon in patients with liver transplant dysfunction.

Bile Ducts↗
PubMed1997

[Prevention of hepatitis B--analysis of cost-effectiveness after liver transplantation].

HBV recurrence, despite immunoprophylaxis which occurred in 67% of our patients, remains the main problem following liver transplantation for HBV infection. Pretransplant viral replication (HBV-DNA) and probably viral mutation may account to some degree for the failures involved in hyperimmunoglobulin prophylaxis. In order to improve the cost/benefit relationship, only HBV-DNA and HBeAG-negative patients should be selected or preoperatively seroconverted by nucleosides (famciclovir, lamivudine); post-operatively a variable HIG prophylaxis should be administered.

2-Aminopurine↗
PubMed1996

Differential regulation of human T cell responsiveness by mucosal versus blood monocytes.

Human intestinal T lymphocytes are constantly exposed to a large number of foreign antigens without developing a systemic immune response. One crucial mechanisms leading to this intestinal hyporesponsiveness is based on impaired signal transduction through the T cell receptor/CD3 complex in lamina propria T lymphocytes (LP-T). In this study, we addressed the question whether a lack of co-stimulatory/progression signals might also contribute to LP-T hyporesponsiveness. To this end, isolated human monocyte populations from the intestinal lamina propria were obtained and their phenotypes as well as their capacity to promote T cell activation studied. Here, we demonstrate that lamina propria macrophages (LP-MO), in contrast to peripheral blood monocytes (PB-MO), do not support proliferation of either LP-T or PB-T. This may be due to the low expression of ligands (CD54, CD58, CD80) for the T cell accessory receptors CD11/18, CD2 and CD28/CTLA-4 on mucosal macrophages. Thus, down-regulation of both recognition/competence and co-stimulatory/progression signals contribute to intestinal hypo- or unresponsiveness.

Antigens↗
PubMed1996

The impact of disease pattern, surgical management, and individual surgeons on the risk for relaparotomy for recurrent Crohn's disease.

OBJECTIVE: The authors provide a multivariate analysis of a large single-center experience with limited surgery for Crohn's disease. SUMMARY BACKGROUND DATA: During the past decade, the aim of surgery for Crohn's disease has shifted from radical operation, achieving inflammation-free margins of resection, to "minimal surgery," intended to remove just grossly inflamed tissue or performing strictureplasties. METHODS: Seven hundred ninety-three cases of resection and/or strictureplasty in 689 individuals with histologically verified Crohn's disease were followed for a mean period of 50 months (range, 5-166 months). Two different end points were analyzed: 1) any relaparotomy for recurrent (or persistent) Crohn's disease and 2) relaparotomy for site-specific recurrence. More than 30 variables of patient/disease characteristics and surgical management were included in a proportional hazard model. RESULTS: Five parameters were associated independently with the risk for relaparotomy: increased risk coincided with young age at onset of disease, involvement of jejunum, enterocutaneous fistula, or performed strictureplasty, and decreased risk followed ileocecal resection. Site-specific risks of reoperation were calculated on the basis of 1260 intestinal resections or anastomoses performed in these patients. Young age at onset, duodenal and jejunal involvement, presence of enterocutaneous or perianal fistula, and a single surgeon (of 23) were associated significantly with increased risk of regional recurrence but not strictureplasty or inflammation at margins of resection. CONCLUSIONS: Limited surgery for Crohn's disease is not associated with increased risk of regional recurrence requiring reoperation. However, patients with juvenile onset, proximal small bowel disease, and some types of fistulae are at a considerable risk of experiencing early surgical recurrence.

Adolescent↗