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Biomedical subjects

O Abri

Publications and source records attributed to O Abri.

At least 19 recordsLinked to original sources
PubMed1995

[Prostacyclin (iloprost) as an adjuvant in local surgical therapy of stage IV arterial occlusive disease--is quantification of the therapeutic effect possible with tcPO2 measurements?].

The effect of intravenous therapy with iloprost (average duration 6 weeks) on the prognosis of leg-preserving local surgical treatment and on the transcutaneously measured oxygen pressure (tcPO2) in patients with ischaemic lesions was investigated in a prospective, open, controlled, randomized study. All of the 30 patients recruited to the study suffered from a peripheral arterial occlusive disease Fontaine stage IV with progressive symptoms and arterial occlusions below the knee. 15 patients received iloprost intravenously for 6 hours per day in an individual tolerable dose (mean dose: 1.7 ng/kg/min). 15 patients in the control group received no trial therapy. During the treatment period each patient underwent minor amputation or skin grafting. Wound healing after surgery and tcPO2 were assessed. The long-term efficacy of iloprost was assessed by following the patients for one year. The iloprost treatment was in general well tolerated and all patients completed the study in accordance with the trial protocol. Primary postoperative wound healing as the responder-criterion was observed in 9 patients (60%) of the iloprost group and in 4 patients (27%) of the control group. Patients with iloprost therapy were especially likely to show wound healing if they received the operation approximately in the mid of the treatment phase. The effect of therapy lasted for one year after the end of the treatment in 7 of 9 classified responders of the iloprost group. After one year the responder rate of 47% in the iloprost group was still 20% higher than in the control group. Surgical revisions were necessary in 7 patients (47%) of each group. 2 patients (13%) treated with iloprost and 4 control patients (27%) underwent major amputation. The mortality was 13% = 2 of 15 patients (iloprost) and 7% = 1 of 15 patients (control). Transcutaneous PO2-measurements were very reproducible over a long-term period under standardized conditions. A significant effect of iloprost on the tcPO2 was shown. There was a mean increase of 8.1 mmHg +/- 11.2 (mean +/- SD) in the foot of the affected limb after an average 6-week therapy (p < 0.05). At the same time a significant difference in the tcPO2-changes between responders and nonresponders was demonstrated (p < 0.05). Patients with primary wound healing had a greater increase in tcPO2 than patients whose wounds did not heal. An increase of at least 10 mmHg (6 patients) in tcPO2 during the infusion after 3 weeks of therapy predicted primary post-operative wound healing.

Aged↗
PubMed1993

[Use of laparoscopic surgical methods in mechanical ileus of the small intestine and in stomach perforation].

We report on the application of laparoscopic operative methods in ten patients with mechanical bowel obstruction and in seven patients with gastric perforation. From these experiences conclusions were drawn concerning the principles of trocar positioning as well as tactical and strategical considerations in acute abdominal surgery with known and unknown target regions.

Follow-Up Studies↗
PubMed1992

[Comparative analysis of mezlocillin/metronidazole and amoxicillin/clavulanic acid as "one shot" preventive antibiotic administration in colorectal interventions].

The prophylactic effect of intraoperative "one shot" antibiotic application in colorectal surgery was investigated. Patients were randomised and the antibiotic combination Mezlocillin/Metronidazole (group A) or Amoxicillin/Clavulamid acid (group B) was applicated in 160 patients. 111 patients were selected for the study (group A: 59; group B: 52 patients). In the postoperative course 53% (group A) and 67% (group B) of the patients developed bacterial infections. Abdominal wound healing was complicated by infection in 15% (A) and 12% (B) of the patients. A significant difference between the two groups could not be proven, 24% of all patients with documented intraoperative bacterial contamination and 10% of the patients with negative findings developed wound infections. In colorectal surgery patients are still at high risk for infectious complications. Applicated antibiotics should basically cover aerobic and anaerobic germs.

Adult↗
PubMed1990

[Iloprost in the treatment of ischemic tissue lesions in diabetics. Results of a placebo-controlled multicenter study with a stable prostacyclin derivative].

The efficacy of iloprost, a stable prostacyclin analog, was investigated in a placebo-controlled trial in 109 diabetics with ischemic lesions. 56 patients were randomly allocated to iloprost and 53 patients to placebo. Iloprost was intravenously applied for 6 hours daily on 28 consecutive days at an individually tolerated dose up to 2 ng/kg/min. The control group received identical solvent volumes. In addition all patients had an intensive basic, mainly local, therapy. At the end of the treatment in the iloprost group 31 of 50 patients (62%) showed partial (greater than 30%) or total healing of the lesion(s). In the placebo group this was the case in 12 of 51 patients (22.5%). The difference of 38.5% was statistically significant (p less than 0.05, chi 2-test, alpha = 0.05, beta = 0.1). The percentage of patients who were free of pain increased from 23% to 42% (+19%) in the iloprost group and from 38% to 48% (+10%) in the placebo group. After dose-titration iloprost was well tolerated. Flush, headache and abdominal complaints were the most frequent side effects. Heart rate and blood pressure were not influenced and the control of diabetes was not altered.

Adult↗
PubMed1990

Accumulation characteristics of human colon carcinomas after monoclonal antibody ex vivo perfusion.

Human colon carcinomas were operatively resected and the tumour-bearing segments interposed into an oxygenised ex vivo perfusion system. Pressure, flow, temperature, pH and metabolic parameters were controlled. Over a period of 45 min the 131I-labelled monoclonal antibody AUA1 was administered and its distribution in the tumour tissue analysed scintigraphically. The accumulated activity was determined in different tissues. The results showed that the AUA1 uptake increased with the degree of histological tumour differentiation. The main tumour:non-tumour ratio reached 0.8 in poorly, 4.1 in moderately and 5.9 in highly differentiated adenocarcinomas. Introducing the oxygenised erythrocyte-enriched perfusion media significantly increased the viability of the colon tissue. The ex vivo perfusion system will help to analyse factors determining monoclonal antibody accumulation in human colon carcinomas.

Adenocarcinoma↗
PubMed1989

[Iloprost, a stable prostacyclin derivative, in stage 4 arterial occlusive disease. A placebo-controlled multicenter study].

The effectiveness of iloprost, a prostacyclin derivative, was assessed in a placebo-controlled multicentre trial on 101 patients with chronic arterial disease, stage IV. All patients were on a basic local treatment, 53 randomly being assigned to the iloprost group, 48 to the placebo one. Both groups received identical saline infusions, one with the other without iloprost. Infusions were given on 28 consecutive days, iloprost being added at a dose of up to 2 ng/kg.min over six hours. At the end of the treatment period, 32 of 52 patients (61.5%) of the iloprost group and eight of the 47 in the placebo group (17%) had partial or complete healing of ulcers (P less than 0.05), the treatment effect persisting in both groups for a mean duration of at least one year. Iloprost was well tolerated, once individual dosages had been appropriately adjusted. Facial flushes, headache and nausea were the most common side effects. Heart rate and blood-pressure variations did not differ between the two groups.

Adult↗
PubMed1988

[Results and critical analysis of the treatment of obesity with the intragastric balloon].

UNLABELLED: In 54 patients with excessive obesity a silicone balloon was implanted endoscopically into the stomach. The overweight amounted to 76% (median) by Broca's formula. The therapeutical plan included balloon-implantation, dietary treatment, psychotherapeutical guidance, kineto-therapy and balloon-extraction. According to their therapeutical compliance there were three different groups of patients: G1 - maintenance of therapy; G2 - discontinuation of therapy; G3 - no additional therapy at all after balloon implantation. Up to the sixth week a weight reduction of 9.5-20.5 kg could be demonstrated in all groups. Only in the first group a further weight reduction by a mean of 20 kg after 20 weeks was noted. Patients in group 2 and 3 - in some the balloon was still implanted - had a renewed weight increase sometimes surmounting the original weight. COMPLICATIONS: 3 gastric respectively duodenal ulcers, one subileus. The long-term success can only be obtained by a multi-component therapy plan.

Adult↗
PubMed1988

[Assessment of specific indicators for determining postoperative infectious complications].

The acute-phase proteins CRP, haptoglobin, and sialic acid of 312 surgical patients (159 females and 153 males), aged between 18 and 95 years, were examined with a view to finding parameters for early prediction of perioperative septic complications. Laboratory tests were additionally applied to 39 patients for activated lymphocytes as well as for OKT3-, OKT4-, and OKT8-labelled T-lymphocytes. Straight forward postoperative decline in absolute numbers of OKT3- and OKT4-labelled T-lymphocytes was recordable from patients with septic complications, in contrast to patients with uneventful clinical courses. However, the OKT4 and OKT8 ratio did not yield any correlation with the clinical course. In acute-phase protein testing, a correlation was found to exist between CRP and clinical course. CRP levels in patients without septic complications (Group I) were found to depend clearly on the anatomic site of surgery. Normalisation of CRP levels was recordable from patients with primary septic disease and complete surgical management of the focus (Group II/1). Postoperative decline of CRP values was much less in patients with primary septic disease and incomplete surgical treatment (Group II/2). They had not even reached normality towards the end of observation. On average, unambiguously increased values were recordable as early as three days prior to clinical manifestation from patients with postoperative septic complications (Group III). Septic complications were found to occur along with re-increase or delayed decrease of CRP levels, after the fourth postoperative day. Sensitivity amounted to 78 per cent and specificity to 89 per cent.

Acute-Phase Proteins↗
PubMed1988

Biodistribution of 131I-labelled monoclonal antibodies in human colon tumours by an ex vivo perfusion model.

We describe a model for the evaluation of anti-tumour antibody specificity, using a human carcinoma-bearing colon segment. After resection of the human colon tumour, the supplying artery was cannulated and perfused with fresh frozen plasma and heparin. Continuous control of pressure, flow, temperature, pH and various metabolic parameters were performed after administration of 131I-labelled anti-CEA antibody. Highly differentiated adenocarcinomas of the colon showed a much higher antibody uptake than undifferentiated tumours. Between 3 and 7% of the injected antibody was found in the tumour tissue. Autoradiography showed non-homogeneous binding in the tumour tissue. The non-specific antibody perfusion showed no tumour binding. We conclude that the ex vivo perfusion of resected colon carcinomas can be used to measure the kinetics of binding and clearance of MAbs in tumour tissue by direct scintigraphy. The cellular biodistribution of the antibody can be documented by means of autoradiography.

Antibodies, Monoclonal↗
PubMed1988

[Accomplishments of tumor surgery in tumors of the skin].

Skin tumours are classified by potential for causing disease and skin layer involvement. Primary diagnosis of skin tumours is established by escision biopsy, i.e. narrow excision of the tumour-adjacent tissue. Depending on the histological results, a secondary excision may be required. In this procedure a malignant tumour is assumed during the primary excision, which is performed according to "relaxed skin tension lines." Besides the fundamental interconnection of diagnostic and therapeutic principles the cosmetic-aesthetic aspects of skin tumour treatment are of utmost importance. Every operation performed for skin tumour follows the rules of plastic surgery.

Basal Cell Carcinoma↗
PubMed1986

[Autologous heterotopic partial transplantation of the pancreas in the dogs with reference to different drainage methods].

Pancreatic autotransplantation is a necessary requirement for studies on the technical aspects of pancreatic grafting. In the allograft model immunological problems influences the graft survival. In 25 mongrel dogs the left limb of the pancreas was transplanted into the grain with end to side vascular anastomosis. The body and right limb of the pancreas was removed and discarded. We have compared various technique for management the exocrine pancreas section (Neoprene-injected duct; open duct technique). Currently the rate of complications in segmental pancreas autotransplantation was high especially in Neoprene injected dogs. Reasons for this result from technical failures like venous thrombosis and pancreatitis. In every case it was possible to ameliorate the diabetes mellitus up to the 7th day. Histological we found dilated interlobe space up to 7 days after transplantation with open ducts and there were no signs of disturbance in the endocrine tissue. In the Neoprene-injected group we found a severe intraacinous oedema and 5 days after transplantation already a beginning fibrosis with destroyed islets of Langerhans.

Animals↗
PubMed1986

[Arterial reconstructions spanning the knee joint].

Knee-joint crossing arterial repair is an alternative solution for patients whose extremities otherwise might have to be amputated. Indications are according to Fontaine for Stages III and IV. Specialised angiographic preparatory examination and knowledge of microsurgical techniques are required. Reference is made to peculiarities of surgical access routes, vascular substitute materials, and specific surgical techniques. The use of this approach to peripheral vascular repair appears to be justified against the background of international achievements and the authors' own results.

Angiography↗
PubMed1986

[Results of therapy of rectal cancer following anterior resection and abdominoperineal rectum amputation].

Since 1979, 174 patients with histopathologically proven adenocarcinoma of the rectum have undergone abdomino-perineal extirpation (Quenu) or anterior resection for cure. In 86% patients in Dukes stage B were undergone anterior resection and in 92.2% patients in Dukes stage C undergone extirpation. The recurrence rate was lower than 7%, 25% of them were local recurrences and 75% recurrence of the tumor in general. Anastomoic leak was not found after anterior resection. The three-years-survival rate was significantly higher in patients with adeno carcinoma of the rectum in the middle and upper part of the rectum. The three-years-survival rate was after anterior resection 87.6%. After abdominal extirpation, in most cases Dukes C, the three-years-survival time was 58.6%. For curative surgery a "curative" cancer resection involves resection of the cancer bearing rectal segment with its adjacent fat, blood vessels, nerves and lymph nodes. Specially in cases of mid rectal cancer involves resection of mesentery and utilizing high ligation of the inferior mesenteric artery and vein.

Abdomen↗