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Biomedical subjects

P M Sutter

Publications and source records attributed to P M Sutter.

17 recordsLinked to original sources
PubMed1997

Increased surface expression of CD18 and CD11b in leukocytes after tourniquet ischemia during elective hand surgery.

The surface expression of beta2-integrins was investigated in leukocytes from patients undergoing ischemia induced by tourniquet application for elective hand surgery. Blood samples were obtained before initiation, at the end of ischemia, and after 15 minutes of reperfusion from ischemic and contralateral arms of five patients. Comparable expression of CD18, CD11a, CD11b, and CD11c could be detected by immunofluorescence in leukocytes from samples drawn from either arm before tourniquet application. In contrast, a significant increase in the expression of CD18 was detectable in monocytes, granulocytes, and lymphocytes from the ischemic arm compared with that in the nonischemic contralateral control, at the end of the ischemia time (80 +/- 16 minutes). A significantly increased expression of CD11b, but not CD11a or CD11c, determinants was also observed in granulocytes and monocytes. Concomitantly, a significant reduction in the percentages of granulocytes in samples from ischemic areas was detectable. After 15 minutes of reperfusion, differences in the expression of these adhesion molecules were no longer significant. The expression of the genes encoding interleukins IL-1alpha, IL-1beta, and IL-6 and tumor necrosis factor alpha (TNFalpha) proinflammatory cytokines was also studied by reverse polymerase chain reaction (rPCR) in peripheral blood mononuclear cells (PBMCs) obtained from the same samples in three patients. IL-1beta or IL-6 gene expression was never observed. Expression of IL-1alpha and TNFalpha genes, as detected in two patients, was not related with induction of ischemia. However, in these patients expression of one or both these genes was observed in samples derived from the ischemic but not the control arm after 15 minutes of reperfusion. These data document that overexpression of adhesion molecules and sequestration of leukocytes take place following short ischemia times, as routinely applied clinically for minor surgical procedures.

Adult↗
PubMed1997

Muscle biopsy for malignant hyperthermia screening in children.

Malignant Hyperthermia (MH) remains a life-threatening event in anaesthetic practice. In paediatric patients, triggering agents such as volatile anaesthetics and other succinylcholine are widely used. For children with a positive family history or previous clinical signs of MH, muscle biopsy for the halothane and caffeine in vitro muscle contracture tests is the only reliable procedure for diagnosis of MH susceptibility. Here we investigated outcome and compliance of patients and parents involved in the test. Twenty-four children between 6 and 14 yrs of age were admitted to hospital for biopsy. Muscle withdrawal was performed at the upper leg from lateral vastus muscle using regional or trigger-free general anaesthesia. Outcome and compliance were controlled by a telephone interview or direct physical re-evaluation. Seventeen patients out of 24 were diagnosed as clinically MH-susceptible according to the protocol of the European MH Group. Seven children were excluded as MH-negative by the test. Twenty-one children were evaluated postoperatively. Minor side effects of wound healing occurred, but none of the patients showed any abnormalities of muscle contracture or movement performance. Considering the high risk of fatal complications in the presence of MH-susceptibility, muscle biopsy of the upper leg for in-vitro diagnosis is a justified procedure that is acceptable to children and their parents.

Adolescent↗
PubMed1997

[Carcinoid tumor in Meckel's diverticulum: case presentation and review of the literature].

Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. Neoplasms are extremely rare. We report a case of carcinoid tumor of Meckel's diverticulum in a patient with acute abdominal pain. So far, 111 cases have been reported. Review of the literature reveals that carcinoids are the most common malignant tumors of Meckel's diverticulum. Two thirds of the patients remain asymptomatic. Metastases are seen in 25% at diagnosis. The probability of metastases depends on the size of the primary tumor. Because of the early metastases rate even in small tumors, aggressive surgical management is justified.

Abdomen, Acute↗
PubMed1996

Ischemic preconditioning--a new concept in orthopedic and reconstructive surgery.

The duration of tourniquet-induced ischemia during orthopedic and reconstructive surgery is limited by the risk of ischemia and reperfusion injury to skeletal muscle. This study evaluated the potential of ischemic preconditioning (short periods of ischemia with intermittent reperfusion) to improve skeletal muscle function after ischemia and reperfusion in a rodent model. Preconditioning was found to improve force, contractility, and performance and to decrease fatigue of skeletal muscle. In contrast, energy-rich phosphates, measured concurrently, were not affected by preconditioning, suggesting mechanisms other than energy preservation to be involved. In summary, preconditioning may enable prolongation of orthopedic and reconstructive procedures.

Animals↗
PubMed1996

Effects of verapamil on skeletal muscle function following ischemia and reperfusion.

Verapamil (VRP) improves ischemic tolerance of different organs including brain, kidney, liver and heart. We report here on the effects of preischemic VRP treatment on skeletal muscle function following 3 h of tourniquet ischemia and 2 h of reperfusion using a rodent model. Postischemic and contralateral limbs were evaluated. Fast (musculi peronei)- and slow-twitch muscles (musculus soleus) of both limbs were excised and electrically stimulated in vitro. VRP pretreatment was found to significantly decrease tetanic peak tension of both contralateral nonischemic m. soleus and mm. peronei. Furthermore, VRP improved fatigability of slow-twitch muscles of both ischemic and contralateral limbs [increase of fatigue index from 0.04 +/- 0.009 (0 mg/kg) to 0.10 +/- 0.019 (4 mg/kg)], but not of fast-twitch muscles. These data indicate that the effects of VRP on postischemic skeletal muscle function depend on fiber composition.

Animals↗
PubMed1996

Ischemic preconditioning improves post-ischemic skeletal muscle function.

Ischemic preconditioning (IP), using one or more brief periods of ischemia before a sustained ischemia, represents a new approach to reduce tourniquet ischemia-induced skeletal muscle damage. The aim of this study was to investigate the effect of IP on skeletal muscle function and high-energy phosphate tissues levels in a rodent model. IP protocols using one, two, or three preconditioning cycles were compared. IP was found to significantly improve force, performance, endurance, and contractility of postischemic skeletal muscle. The efficacy of IP-induced protection was correlated with the number of preconditioning cycles. Preconditioning with three cycles resulted in a more effective protection as compared to one or two cycles. Three cycles of IP significantly improved force (409 +/- 63 versus 240 +/- 47 mN), performance (2546 +/- 481 versus 1081 +/- 242 mN*sec), endurance (46.7 +/- 5.0 versus 29.6 +/- 3.4 sec) and contractility (59.9 +/- 4.2 versus 38.7 +/- 5.1) in postischemic m.extensor dig. long. when compared to nonpreconditioned muscles. In contrast, high-energy phosphate tissue levels remained unchanged after three cycles of preconditioning. Altogether, this study describes, for the first time, the efficacy of IP to improve postischemic muscle function. The respective clinical potential warrants further exploration.

Animals↗
PubMed1995

[Ischemic preconditioning improves postischemic function, but not energy metabolism of skeletal muscles].

Ischemic preconditioning (IP) refers to a phenomenon whereby short periods of ischemia reduce tissue damage after a subsequent sustained ischemia. The effect of IP before tourniquet ischemia of the extremities has not yet been evaluated. We developed a rat model of skeletal muscle ischemia and measured the effect of IP on postischemic function and high-energy phosphate levels. IP consisted in three cycles of 10 min ischemia and 10 min reperfusion each. IP improved significantly skeletal muscle function after 3 hours of ischemia and 2 hours of reperfusion. High-energy phosphate levels, however, remained unchanged. This study is the first that shows a protective effect of IP in skeletal muscles. These results furthermore suggest that the protection of energy metabolism is not a mechanism of IP in this model. IP could be easily performed before surgery of the extremities under tourniquet ischemia. The protective effect on postischemic skeletal muscle has therefore to be further investigated.

Animals↗
PubMed1994

[Ruptured cystadenoma of the pancreas].

There are many potential reasons for an acute abdomen. Very rare is a rupture of a cystadenoma of the pancreas. We describe such a case of an 85-year old woman, who was treated with an internal drainage of the cyst with a Roux-Y-loop, as at the time of the emergency operation the histological diagnosis was not known. As for the age of the patient and her general condition a secondary procedure with total resection of the mucinous cyst was not carried out. The post-operative course was uneventful up to three months, when the patient died in a geriatric home due to a antibiotic-resistant urosepsis. Literature is reviewed and our case is discussed in respect to recent publications.

Abdomen, Acute↗
PubMed1993

[Developmental trends in cross-country skiing].

During the last 20 years we have treated 1,335 cross-country skiing injuries. Five percent of all winter sport injuries resulted from cross-country skiing. The peak percentage was 7.4% in winter 1989/90. Injuries of the upper extremity were found in 50.4%, followed by injuries of the lower extremity (25.8%). Injuries of the trunk were seen in 19%. Head trauma (1.1%) and skin laceration (3.7) are not frequent. We are analysing the statistical data of the last 20 years.

Adolescent↗
PubMed1993

[Modification of ischemia and reperfusion damage of skeletal muscles with allopurinol: in vivo 31P MR spectroscopy of the posterior limb of the rat].

The effect of Allopurinol on energy metabolism (re-utilisation of hypoxanthine) was studied in a in vivo skeletal muscle ischemia rat model by 31-P-MR spectroscopy. Allopurinol-treatment showed no benefit to the kinetics of PCr/(Pi + PCr) and ATP/(Pi + PCr). The role of re-utilisation of hypoxanthine has to be further investigated.

Adenosine Triphosphate↗
PubMed1991

[Early and long-term results following ileum-anal pouch anastomosis].

Between 1984 and 1989 21 patients underwent proctocolectomy and were reconstructed with ileal-pouch-anal anastomosis using a J-pouch. 18 patients had ulcerative colitis and 3 adenoma of the colon. In 16 of 21 patients the operation was performed in a three-stage way: (1.) total colectomy; (2.) proctomucosectomy, ileal-pouch-anal anastomosis and protective ileostomy; (3.) ileostomy closure. 5 patients had a two-stage operation (3 patients with adenoma of the colon, 2 patients with low or no steroid medication). Operative mortality was 0%. Complications were seen in 4 of 21 patients after colectomy (sepsis, pelvic abscess in 2 instances, ileus), in 4 of 21 patients after ileal-pouch-anal anastomosis (pouch-vaginal fistula, pelvic abscess, anastomotic stricture, ileus) and in 2 of 19 patients after closure of ileostomy (pouch-vaginal fistula). In 19 of 21 patients the ileostomy is closed. All of these patients are fully continent during the day and only 2 patients are slightly incontinent at night. The average stool evacuation is 4 to 5 during the day and once to twice at night. All patients are very satisfied with the result.

Adenomatous Polyposis Coli↗
PubMed1988

Beneficial effect of thyroxin in the treatment of ischemic acute renal failure.

To evaluate the effect of thyroxin (T4) on recovery from ischemic acute renal failure, rats were treated with T4 (10 or 20 micrograms/100 g body wt.) or normal saline (NS) either immediately prior to, immediately after or 24 h after 45 min of renal ischemia. Animals given T4 prior to ischemia had no significant increase in Inulin clearance (Cin) (377 +/- 40 microliters/min per 100 g body wt.) as compared with saline-treated ischemic controls (306 +/- 54). In contrast, animals treated immediately after ischemia with either dose of T4 demonstrated significantly better kidney function (Cin 515 +/- 59 microliters/min per 100 g body wt., Uosm 842 +/- 88 mosmol/kg, FENa 0.52% +/- 0.12% and Cin 543 +/- 71, Uosm 939 +/- 103, FENa 0.48 +/- 0.12, for 10 and 20 micrograms/100 g body wt., respectively). Moreover, the improvement in renal function was sustained and Cin was significantly better at day 3 (748 +/- 70) and day 7 (990 +/- 75) compared with saline controls (560 +/- 30 and 732 +/- 45, respectively). Animals which received T4 24 h after ischemia showed significantly higher Cin when compared with ischemic controls. To assess the impact of T4 on recovery of renal ATP, 31P-NMR was used. T4-treated rats demonstrated 90% +/- 5% recovery of renal ATP by 120 min of reflow, whereas NS animals had only 64% +/- 1%. In addition, cellular morphology was better preserved in T4 animals. These data indicate that animals treated postischemically with T4 showed accelerated and sustained recovery from acute renal failure. This beneficial effect appears to be related to cellular mechanisms which are essential for the restoration of sublethally injured cells.

Acute Kidney Injury↗
PubMed1983

Cyclosporin A: pharmacologic activity on the immune system and effects in clinical organ transplantation.

The recently discovered fungal metabolite cyclosporin A (CsA) is a potent immunosuppressant that is effective in preventing transplantation rejection due to allografts and even xenografts. Due to its influence on the biological activity of T-helper lymphocytes CsA's mechanism of action includes inhibition of cell-mediated cytolysis and delayed-type hypersensitivity (DTH) reaction. In addition to studies of the molecular mechanism of action, data on the pharmacokinetics of CsA are given. CsA does not cause anti-mitotic and/or cytotoxic effects. The side effects of the agent are relatively mild and appear to be reversible. CsA has been successfully used clinically in renal, bone-marrow, heart, heart-lung, liver, and pancreas transplantation. The application of the compound in organ transplantation appears to be superior to conventional immunosuppressive therapy.

Biological Availability↗
PubMedDate not supplied

[Effects of allopurinol on damage caused by ischemia and reperfusion of skeletal muscles: an in vivo spectroscopic analysis (31P-MR) in rats].

The effect of allopurinol on energetic metabolism (reutilization of hypoxanthine) has been studied in vivo by mean of 31P-RM spectroscopy on skeletal muscle in the rat in conditions of ischemia and reperfusion. The treatment with allopurinol demonstrates of on benefit or phosphocreatine and ATP kinetics. These results outline that reutilization of hypoxanthine doesn't represent a protective mechanism of allopurinol on skeletal muscles. The role of hypoxanthine reutilization has to be investigated with further researches.

Allopurinol↗
PubMedDate not supplied

[Ischemic preconditioning improves post-ischemic function but not energy metabolism of skeletal muscles].

Ischemic preconditioning (IP) refers to a phenomenon whereby short periods of ischemia reduce tissue damage after a subsequent sustained ischemia. The effect of IP before tourniquet ischemia of the extremities has not yet been evaluated. We developed a rat model of skeletal muscle ischemia and measured the effect of IP on postischemic function and high-energy phosphate levels. IP consisted in three cycles of 10 min ischemia and 10 min reperfusion each. IP improved significantly skeletal muscle function after 3 hours of ischemia and 2 hours of reperfusion. High-energy phosphate levels, however, remained unchanged. This study shows a protective effect of IP in skeletal muscles. These results furthermore suggest that the protection of energy metabolism is not a mechanism of IP in this model. IP could be easily performed before surgery of the extremities under tourniquet ischemia. The protective effect on postischemic skeletal muscle has therefore to be further investigated.

Animals↗