[Contributions to microscopic anatomy and reproduction biology of Gyrodactylus wagneri v. Nordmann, 1832].
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Biomedical subjects
Publications and source records attributed to F Braun.
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BACKGROUND: In living donor liver transplantation (LDLTx) organ procurement is usually well controlled, and allows to assess liver preservation and graft function under standardized conditions. Because publications on histidine-tryptophan-ketoglutarate (HTK) solution are limited, we prospectively studied its safety and efficacy in a consecutive series of LDLTx. METHODS: Twenty-four patients received 22 right, 1 left, and 1 left lateral lobe graft. Liver preservation was done by gravity perfusion with HTK through portal vein, and hepatic artery, and flushing of bile ducts. Total ischemia time was 191 +/- 68 minutes. RESULTS: There was no primary nonfunction, and all partial liver grafts showed good recovery: peak aspartate aminotransferase 577 U/L, total bilirubin 15.15 mg/dL, and partial thromboplastin time 49.37 seconds. One graft was lost from parenchymal fracture secondary to portal hyperperfusion after 6 days, and the patient was salvaged with retransplantation. Thirty-day mortality, including sudden cardiac death, pancreatitis, and hepatic artery rupture, was not related to graft dysfunction. Eight of 24 recipients developed early biliary leakage. There was no late ischemic type biliary lesion. CONCLUSION: These results confirm that HTK solution is safe and effective when used in LDLTx. Potential advantages of HTK in comparison to other preservation solutions are low potassium concentration, low viscosity, no particles, in situ perfusion, no need to flush before reperfusion, improved biliary protection, better recovery of microcirculatory changes, ready to use, and lower costs. Because the risk-benefit ratio is of particular importance in LDLTx the use of HTK solution should be encouraged.
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In a retrospective study it was investigated in which a course the septicemia appears during the first year of life and which laborchemical and immunological findings are typical for the specific manifestation and can be used for the diagnosis. 27 sucklings with septicemia were admitted at our hospital during 1976-1982. As the clinical course we found: the acute septicemia with pronounced shocksymptoms (Septic-Toxic-Course, STC), the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem, namely in the brain (Meningoencephalitis), in the bone (Osteomyelitis) and in the soft tissue (Phlegmon), the septicemia with a tardy course and forms a septicopyemia with secundary dispersion of bacteria in multiple organsystems. Only STC and septicopyemia show the symptoms which are lead back with the dispersion of bacteria. By the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem the clinical symptoms are determined only in the infected organ. As the only course of septicemia the STZ shows laborchemically in the blood a damage to the livercells with a constant elevated levels of plasmaencyms GOT, GPT and LDH; this findings can be used for a diagnostic criterion. By septicopyemia, meningitis and osteomyelitis the findings of sepsis exist in the blood but are rare by phlegmon. By septicemia with a tardy course (2, 3) a humoral and/or cellular immundeficiency exist. This is a point of application for therapy to give biological antibody with a large spectrum.
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Collagenolytic enzymes, soluble and nonsoluble collagen were determined in skin specimens of 5 healthy volunteers, and 16 patients with rheumatoid arthritis, 7 RA-patients being on D-penicillamine, 9 without basic therapy. The following results were obtained: Collagenolytic enzymes were elevated in patients with RA compared with age matched controls. After administration of D-penicillamine the enzyme activity was found lower than values obtained in controls. Acid soluble collagen and nonsoluble collagen was not found statistically different in the three groups. These findings strongly suggest an inhibitory effect of D-penicillamine on the elevated collagenase activity in RA patients. Similar results in corneal tissue were reported by Francois and coworkers who treated corneal ulcers with D-penicillamine.