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Biomedical subjects

E Kraas

Publications and source records attributed to E Kraas.

At least 55 records · Page 3Linked to original sources
PubMed1978

[Surgery of gastric cancer in patients older than 70 years (author's transl)].

In this study it is reported about operative mortality and long-term results of surgery of gastric carcinoma in patients over the age of 70 years. The operative mortality in 50 patients with a distal partial gastrectomy was 16%, the mortality in 24 patients with total gastrectomy was 33.3% and in 14 patients with a proximal gastrectomy the mortality was 28%. The main cause of death (40%) was a pneumonia. There was no correlation between frequency of pneumonia and preoperative results of measurement of lung function. Only advanced arteriosclerotic disease in the heart and brain has a fatal influence on mortality rate. In the old patients the long-term results are determined by the staging of the tumor at the time of operation, too. In the 60 patients, who had left the hospital and who are in our control, the half year survival rate was 78.3%, the 1-year survival rate was 58.3% and the 2-years survival rate is exceeding 41.6%. 14 patients of the 17, who are still alive and who are after 2 1/2 years again explored, are in a very good condition. In comparison with the literature it is to conclude that for the indication to surgery of gastric carcinoma there is important not only the real age of the patient but rather the biological and mental condition of the patient.

Age Factors↗
PubMed1977

[Isolated stenoses and occlusion of the coeliac artery--a comparative angiographic and clinical study (author's transl)].

14 patients with occlusion (7 patients) or extreme stenosis (7 patients) of the arteria coeliaca underwent operation because of heavy abdominal complaints. The constriction of the arteria coeliaca was caused by arteriosclerosis (2 patients), ligamentum arcuatum medianum (8 patients), ligamentum arcuatum medianum and ganglion tissue (2 patients). For the restitution of a normal blood circulation in the epigastric organs the following was necessary: in 10 patients a decompression, in 3 patients an aortocoeliacal bypass and in 1 patients an enlargement plastic with vein patch. The angiographic findings indicate a connection between the arteria coeliaca occlusion or extreme stenosis and the extent of the collateral blood supply. High pressure gradients between aorta and arteria coeliaca, significantly decreased medium pressures in the arteria hepatica communis and noticably frequent morphologic changes in the epigastric organs could be seen intraoperatively.

Adult↗
PubMed1977

[Risk and postoperative complications in abdominal surgery in elderly patients (author;s transl)].

1005 case histories of patients, older than 70 years, were studied retrospectively: 496 abdominal interventions (lethality - 29%), 509 extraabdominal interventions (lethality - 14%). In each patient 75 preoperative data are compared to 50 data of the intraoperative and postoperative period. There is a correlation between preoperative findings and postoperative complications and lethality. The main factors of risk are: Hb less than 10 g%, Creatinine greater than 1,5 mg%. The analysis implies the necessity of intensive preoperative therapy as well as the immediate correction of even slight post-operative deviations of the "norm".

Abdomen↗
PubMed1976

On the transport of tripeptide antibiotics in bacteria.

The two tripeptide antibiotics L-2-amino-4-methylphosphinobutyryl-alanyl-alanyl-alanine (L-phosphinothricyl-alanyl-alanine) and L-(N5-phosphono)methionine-S-sulfoximinyl-alanyl-alanine, both inhibitors of the glutamine synthetase, are transported into the cell of Escherichia coli K 12 via the oligopeptide transport system. The uptake by this system is proved first of all by cross-resistance with tri-L-ornithine using oligopeptide-transport-deficient mutants, and secondly by antagonism tests demonstrating competitive reversal of the action of the antibiotic by several peptides which have been shown to be transported via the oligopeptide transport system, e.g. tri-L-alanine, tetra-L-alanine, tri-L-lysine, tri-L-serine, tri-glycine, glycyl-glycyl-L-alanine and the synthetic tripeptide L-azadenyl-aminohexanoyl-alanyl-alanine. On the other hand, there is no effect on the action of the antibiotic in antagonism tests with compounds which use different transport systems, such as L-alanyl-alanine, L-lysyl-lysine, glutathione and the synthetic amino acid azaadenylaminohexanoic acid, i.e. 2-amino-6-(7-amino-3H-v-triazolo-[4,5-d]-pyrimidin-3-yl)hexanoic acid. Another inhibitor of the glutamine synthetase, L-methionine-S-dioxide (methioninesulfone) could be converted into a tripeptide form by linkage to L-alanyl-alanine analogously to the tripeptide antibiotics described above. Whereas the free L-methionine-S-dioxide seems to be transported via the methionine transport system, the tripeptide form is transported via the oligopeptide transport system. Thus, this glutamine synthetase inhibitor can be taken up by the cell via two different transport mechanisms. Our results indicate that this could provide a synergistic effect. The syntheses of the new tripeptides L-azaadenylaminohexanoyl-alanyl-alanine and L-methionine-S-dioxidyl-alanyl-alanine were performed by dicyclohexylcarbodiimide couplings of the unusual N-protected L-alpha-amino acids azaadenylaminohexanoic acid and L-methionine-S-dioxide to L-alanyl-alanine-tert-butyl ester followed by common deprotection steps. Tri-L-ornithine was synthesized without carboxyl protection via two successive couplings of hydroxybenzotriazol esters of Nalpha-butoxycarbonyl-Ndelta-benzyloxycarbonyl-L-ornithine.

Anti-Bacterial Agents↗
PubMed1976

Effects of selective gastric vagotomy and pyloroplasty on oral and intravenous glucose tolerance and insulin secretion.

In peripheral and portal venous blood, the immunoreactive insulin (IRI) and glucose levels in response to orally and intravenously administered glucose were measured in 14 patients with selective gastric vagotomy and pyloroplasty (SGV+P) and in 17 control subjects with other abdominal surgery. After intravenously administered glucose, the insulin and the glucose levels were nearly identical in both groups. After orally administered glucose, there were remarkable differences. Despite their early postoperative situations, and in contrast to the control patients, the SGV+P subjects showed no hyperglycemia. The measurements of IRI in the portal vein suggested that in SGV+P patients, the response of the islet cells is accelerated. In patients with SGV+P, the release of an insulinotropic intestinal factor and the preserved vagal innervation of the pancreas may be responsible for the accelerated insulin response of the undisturbed glucose tolerance.

Administration, Oral↗
PubMed1976

Insulin response and portal-peripheral insulin difference during the oral glucose tolerance test in patients after abdominal operations.

Following abdominal surgery, insulin and glucose concentrations in the portal vein, and a peripheral vein are compared in patients during control periods and after oral administration of glucose. During the control period, the glucose concentrations are identical in both veins. After glucose loads with the prompt increase of portal glucose concentration the portal-peripheral difference also increases (p less than 0.01). During the control period the insulin concentration in the portal vein is double as compared to peripheral blood (p less than 0.005). After glucose load the increasing portal insulin as well as the peripheral and portal glucose correlate with the portal-peripheral insulin difference (p less than 0.001). Furthermore, there is a significant positive correlation between the peripheral glucose area as a parameter of glucose tolerance and the portal insulin area as a semiquantitative parameter of insulin secretory capacity (p less than 0.001). It can be concluded that in the early postoperative period in patients with a diminished oral glucose tolerance (large glucose areas) there is an even greater insulin response in comparison to patients with normal oral glucose tolerance. On the other hand, however, in those patients with diminished glucose tolerance, the insulin response is essentially delayed.

Abdomen↗
PubMed1976

[Clinical experiences with autologous blood transfusion in vascular surgery].

In a prospective study 30 patients with high operative risk in vascular surgery underwent preoperative phlebotomy. Blood loss during operation could be replaced by bank autologous blood. The clinical data during and after operation are compared with the data of a control group. The use of banked autologous blood does not even endanger patients with poor cardiorespiratory function. As a clinical procedure it is easily performed and reduces the cost of medical care. The method of preoperative phlebotomy reduces the need of homologous blood by 75%. The number of patients receiving homologous blood is reduced by 50%. Banked autologous blood is an important help for the anesthetist. The basic physiologic principles of the method are discussed as well as advantage and disadvantage of preoperative hemodilution. The authors suggest to withdrawal of 800 ml autologous blood before every operation in which the blood loss will be higher than 500 ml.

Blood Banks↗
PubMed1975

[Glucose-assimilation and dynamics of insulin secretion. Measurements after intra-abdominal operations (author's transl)].

Insulin concentrations in peripheral venous blood and portal venous blood were measured in 18 patients after intraabdominal operations during 20 standardised glucose-infusion-tests (GIT). The conclusion is as follows: 1. In spite of similar preoperative situations and operative traumatisation the islets reactivity to a constant hyperglycemia and the glucose assimilation is individually ver different. 2. Measurements of insulin concentrations in the portal venous blood in man show a significant correlation between the profile of the insulin concentration curve and the k-value; the measurement of the insulin concentrations in peripheral venous blood fails to demonstrate a significant difference. 3. In patients with a pathologic glucose assimilation it is not the insulin secretion that is delayed but the insulin regression (disappearance rate) in portal venous blood. 4. In patients with a normal glucose assimilation the insulin concentrations curve in portal venous blood shows an oscillating course during the first 30 min. These oscillations registered for the first time in humans indicate an insulin-induced feedback mechanism of insulin secretion.

Abdomen↗
PubMed1975

[Diagnosis and operative treatment of coelic-artery compression].

Stenosis of the coeliac artery by compression occurs predominantly in youngish patients and three times more frequently in women than men. It gives rise to abdominal symptoms, due to chronic disturbance of intestinal arterial supply. In eight patients, operated on for this condition, the characteristic symptoms were of abdominal pain, epigastric vascular sounds, loss of weight, nausea and vomiting. Diagnosis could only be made by angiography of the coeliac and (or) mesenteric arteries, and lateral aortography. Analysis of 240 cases reported in the literature indicates that the condition is caused by compression of the coeliac artery by the medial arcuate ligament of the diaphragm, and only in a few instances by nerve tissue of the mesenteric ganglion of the coeliac plexus. Operative treatment (decompression of the artery) removes symptoms in 83% of cases.

Adult↗