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Biomedical subjects

B Luther

Publications and source records attributed to B Luther.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Aortic aneurysm in horseshoe kidney--special diagnosis and therapy].

The co-existence of horseshoe kidney (HSK) and abdominal aortic aneurysm (AAA) is rare and demands a special diagnostic workup and a meticulous surgical procedure. Ten patients with HSK associated with AAA are reported. All underwent aortic replacement with successful preservation of multiple renal arteries. One patient died at the 7th postoperative day from myocardial infarction. HSK does not represent a contraindication for aortic repair. Angiography for identification of aberrant renal arteries and classification into three types for surgical management is mandatory. In type I and II we recommend a standard midline transperitoneal approach. Only in type III does a thoraco-abdominal approach seem favourable. The aortic reconstruction should be performed with tube grafts, if possible. Aberrant renal arteries are reattached directly to the prosthesis. Dissection of renal isthmus should be avoided. Temporary cold renal perfusion is indicated to extend the ischemic tolerance time. As repair of a ruptured AAA in patients with HSK may be quite difficult and time consuming, we recommend more liberal indications for aneurysm surgery in patients with HSK.

Adult↗
PubMed1996

[Perioperative intra-arterial irrigation perfusion for adjuvant therapy of acute intestinal circulatory disorders].

The extent of mesenteric infarctions caused by intestinal circulation disorders essentially depends on reactive vasoconstriction and oxygen radical induced lesions of enteric mucosa. Animal experiments indicated protective effects of an intraarterial flushing perfusion of mesenteric arteries with vasodilators and anti-oxidants. We carried out a transaortic perfusion of the superior mesenteric artery with lactated Ringer's-solution and vasodilators (papaverin, tolazolin, PGE1) in acute occlusion of mesenteric arteries in 12 patients (case reports). Three patients were treated successfully without reconstruction by conservative method alone. Only one patient (8.33%) died because of uncontrolled enteric ischemia. Angiological therapy is necessary in modern treatment of acute mesenteric ischemia. Surgical goals are elimination of central vascular occlusions and resection of necrobiotic areas of intestinal organs.

Aged↗
PubMed1996

[Pharmacologic modification of intestinal reperfusion injury in the animal experiment].

We evaluated experimentally (80 Lewis-rats) possible pharmacological strategies in the treatment of intestinal reperfusion injury in hypo- and normothermia. We used a specific perfusion solution containing PGI2 or radical scavengers (superoxide dismutase, oxypurinol, tocopherol, ascorbate). Decreased malondialdehyde (MDA) plasma release after reperfusion proved the antioxidative efficiency of the administered radical scavengers (normothermia-control group: MDA increase after 15 min of reperfusion to 160 +/- 30% compared to level at the end of ischemia, oxypurinol: 110 +/- 23%, tocopherol: 112 +/- 12%, ascorbate: 104 +/- 20%; p < 0.05). The ATP/ADP-ratio of the therapy groups was stable in contrast to the control group. Alkaline phosphatase release was significantly diminished under radical scavenger administration (normothermia/15 min reperfusion-control group: 7.7 +/- 0.9 mumol/ls, oxypurinol: 4.4 +/- 0.4 mumol/ls, tocopherol: 3.5 +/- 0.1 mumol/ls, ascorbate: 5.9 +/- 0.3 mumol/ls; p < 0.05). Histologically we observed a mucosa protective effect particularly in the ascorbate group. Other pharmacological strategies are discussed.

Animals↗
PubMed1996

[Vascular surgery operations in tumor diseases].

In a retrospective analysis covering 10 years, we examined 53 patients with malignant tumors, who had undergone 74 vascular reconstructive operations. The rate of all complications was 40%. Thirty-two patients died within a period of 3.1 years because their tumor progression; the survival rate after an average of 6.9 years was 65.6%.

Aortic Aneurysm, Abdominal↗
PubMed1995

Perioperative vascular flushing perfusion in acute mesenteric artery occlusion.

AIM: To evaluate in animals and patients a perioperative vascular flushing perfusion with antioxidants in order to improve postischaemic condition of the bowel and hence, to prolong the warm ischaemia tolerance time. MATERIALS: 40 rats and 10 patients with acute mesenteric artery occlusion. METHODS: Intestinal ischaemia was induced in 40 rats by clipping the superior mesenteric artery for 1 h. Thirty animals received a vascular flushing perfusion with oxygen radical scavengers (ascorbate, tocopherol or oxypurinol). Histology, ATP, ADP levels were examined in tissue biopsies and malondialdehyde, lactate dehydrogenase, alkaline phosphatase levels were measured in blood during ischaemia and 60 min after reperfusion. RESULTS: ATP restoration was particularly improved in the oxypurinol group (ATP/ADP-ratio = 2 vs. 1.2 in the control group). Malondialdehyde increase observed after reperfusion as a marker of radical induced lipid destruction was significantly attenuated (control group 160% of base level vs. 127% in the ascorbate group, 133% in the tocopherol group, 121% in the oxypurinol group). Histological alterations during ischaemia/reperfusion were markedly less extensive in the perfusion groups than in control. The patients treated perioperatively with arterial flushing perfusion had an overall mortality of 10%. CONCLUSION: Vascular flushing perfusion with oxygen radical scavengers prevents radical induced ischaemic damage and may prolong the warm ischaemic tolerance time of the intestine.

Acute Disease↗
PubMed1993

Monoclonal antibodies with in vitro borreliacidal activities define the outer surface proteins A and B of Borrelia burgdorferi.

Thirteen monoclonal antibodies (mAb) were produced against Borrelia burgdorferi strains B31 and PKa. Five mAb recognized the outer surface protein OspA (relative molecular mass (M(r)) 31,000) and four OspB with an M(r) of 34,000. Two of these mAb were directed against flagellin with an M(r) of 41,000, and the remaining two against the antigens of B. burgdorferi with M(r) values of 19,000 and 17,000. Immunoblot and immunofluorescence studies with these mAb on five isolates of B. burgdorferi revealed differences in the individual antigenic epitopes of OspA and OspB. OspA and OspB specific mAb showed a borreliacidal activity in vitro. These antibodies were additionally reactive in haemagglutination and immunofluorescence assays. Enzymatic digestion investigations on intact borreliae suggest that the antigenic determinants of mAb with borreliacidal activity are located in the peptide chain of OspA and OspB.

Animals↗
PubMed1993

[Successful embolectomy of the main branches of the celiac trunk and the superior mesenteric artery].

This is a case report of a female patient, 81 years old, with embolic occlusions of the celiac trunk and superior mesenteric artery. The surgical therapy was embolectomy of both vessels through a transversal arteriotomy. The peripheral mesenteric vascular bed was flushed with a special conservation solution in continuity. It is given a plentiful discussion about the details of this successful treated course of disease.

Aged↗