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Biomedical subjects

G Uhlschmid

Publications and source records attributed to G Uhlschmid.

At least 73 records · Page 4Linked to original sources
PubMed1978

[Replacement of Bauhin's valve with an end-to-end telescope anastomosis between the ileum and transverse colon. Experimental study in dogs].

A method of a telescope anastomosis for prevention of reflux was developed experimentally in dogs. After the resection of 40 cm of ileum and colon ascendens the ileal part was intussuscepted into the colon and fixed by seromuscular stiches. The vessels were left untouched. The intussuscepted part measured 3-4 cm. No ileus was observed in the 24 weeks. Glass balls of 1.2 cm diameter could pass through. Barium enema as well as air insufflation of different pressures showed no reflux. The serosa was covered pretty soon by a granular tissue and later on by normal mucosa.

Animals↗
PubMed1978

[A new use for the freely transplanted omentum. Management of a late radiation injury of the brachial plexus using freely transplanted omentum and neurolysis].

A short review of the structural characteristics and the function of the greater omentum is presented. The results of treatment of secondary lymphedema by free transplantation of the omentum with microvascular anastomoses in the canine model and their relevance for clinical application are discussed. Clinical indications, operative technique, and results of omental transplantation and exoneurolysis of the brachial plexus in seven patients with constrictive, radiation induced brachial plexus paralysis, with and without secondary lymphedema, are reviewed. No effect of the grafted omentum on arm-lymphedema was observed over the entire observation period of 1 1/2--4 years. Minor degree reversion of neurodegenerative changes was found in two patients, in all other patients, these changes stopped. The most impressing result was the immediate and permanent disappearance of pain in all patients.

Adult↗
PubMed1976

[Arterial stenoses after kidney transplantation].

After 268 kidney allotransplants, 7 cases of renal artery stenosis were observed. An additional 3 patients were referred to use from another center. The outstanding symptom of all 10 patients was hypertension refractory to medical treatment, beginning not later then 10 months after transplantation. In 9 cases there was a murmur over the transplant. In 6 patients hypertension was accompanied by a deterioration of renal function which was resistant to antirejection therapy. The tentative diagnosis was confirmed by selective renal arteriography of the transplant. Two main types of stenoses could be diagnosed: Segmental stenoses, 0.5-2 cm distal to the anastomosis, which were due to intimal lesions caused during removal of the kidney or by the perfusion canula; and kinking stenoses due to a technically inadequate implantation. Hypertension was controlled in all but 1 patient with reconstruction of the artery. Therefore, hypertension after kidney transplantation refractory to medical treatment should be further investigated with selective renal arteriography of the transplant. Stenoses with clinical symptoms which are confirmed by arteriography should be surgically corrected.

Adult↗
PubMed1976

Studies on the effect of angiotensin II and of Des -angiotensin II on blood pressure, plasma renin activity and plasma aldosterone in the dog.

1. The effect of infusions of equimolar doses of angiotensin II (AII) and of Des -angiotensin II (heptapeptide) on plasma renin activity, blood pressure and plasma aldosterone were compared in normal anaesthetized dexamethasone-suppressed dogs. 2. Plasma renin activity was equally suppressed by both compounds. The increase in blood pressure induced by the heptapeptide averaged 43-62% of the increase during AII infusions. No significant differences in aldosterone increase were observed between AII and the heptapeptide. Plasma aldosterone, however, dropped significantly faster in heptapeptide-treated dogs after the end of the infusions. 3. Sar -Ala -angiotensin II (saralasin, 400 pmol min-1 kg-1) suppressed plasma aldosterone that was stimulated by heptapeptide (20 pmol min-1 kg-1) completely. The same angiotensin antagonist had only a moderate effect on plasma aldosterone stimulated by AII. After stopping the antagonist infusion, plasma aldosterone rose significantly higher in dogs infused with AII than in those receiving the heptapeptide. 4. The results demonstrate differences between the effects of AII and the heptapeptide both on blood pressure and on plasma aldosterone. They do not support the hypothesis that the heptapeptide may be the main mediator of aldosterone secretion.

Aldosterone↗
PubMed1976

[Urological complications following renal transplantation (author's transl)].

Between December 1964 and April 1974, 216 renal transplants were performed on 200 recipients at the University Clinic of the Cantonal Hospital at Zürich. The ureteroneocystostomy was performed in most cases, a pyeloureterostomy being done only five times. 12% of all recipients (24 patients) developed serious urological postoperative complications involving 27 (14.3%) of the transplants, with four cases being fatal. Not considered as a serious complication were urinary infections and retention due to clotting, both of which could be treated conservatively with success. Of the more serious cases, 8 involved stenosis of the ureter, 4 compression of the ureter, 2 obstruction of the ureter, and 4 bladder fistulation. In 10 of these cases the complication can be related to imperfect operative technique in respect to transplanting the donor kidney. Preserving sufficient ureter vascularization is of paramount importance, and consideration must be given to increased vulnerability to infection as a result of the immunosuppressive therapy. Extreme stripping of the pyelon and ureter can result in stenosis and necrosis of the ureter. The treatment of urinary passage complications has not been standardized. However, fistula closure and operative correction of ureter obstruction must be carried out quickly.

Humans↗
PubMed1976

[Lymphocele following renal transplantation].

Lymphoceles as seen after renal transplantation are cystic swellings filled with lymph, situated beneath the lower end of the transplant on the iliac vessels. It seems that the lymph originates from lymphatics cut during operation. 5 such cases have been seen in our series of 268 renal allotransplantations. Symptoms arose 1 to 6 months after transplantation. According to our own experience and to 39 cases of the literature, deterioration of renal function because of compression of the ureter is the most common symptom. Therefore, intravenous pyelography is the main diagnostic means. Some cysts can be visualized by lymphangiography. Marsupialisation to the peritoneal cavity is the treatment of choice.

Adult↗
PubMed1976

Control of plasma aldosterone in terminal renal failure before and after nephrectomy and after renal transplantation.

In two patients with terminal renal failure the night-day rhythm of plasma aldosterone (PA) renin activity (PRA) and plasma cortisol (PC) were examined before and after bilateral nephrectomy and after renal transplantation. Before nephrectomy changes in abnormally high PA coincided with PC whereas no significant correlation was observed between PA and PRA. In the anephric state secretory episodes of PA occurred independent from those of PC while PRA was undetectable. After renal transplantation a lack of night-day variation in renin secretion was observed in both patients; only one of the two patients showed episodic secretion of PA while PC was suppressed in both patients probably due to the chronic administration of prednisone. Our results indicate, that before nephrectomy under the conditions described in this study plasma aldosterone was predominantly controlled by ACTH. In the anephric state and after renal transplantation other (yet unidentified) factors might have caused episodic secretion of aldosterone. Finally, the lack of night-day variation and secretory episodes in renin secretion after transplantation points to an important role of the sympathetic nervous system in the control of circadian and episodic renal renin release.

Aldosterone↗
PubMed1976

[Results with the second kidney transplantation].

330 kidneyallotransplantations were performed between 1965-1975 at the Surgical Clinic A of Zurich University Hospital, thereof 31 second set grafts. The one-year-survival rate of the second set recipients was 67% and that of the second set grafts 54%. From our more recent cases we can conclude, that even better results were possible, if retransplantation were planed and attempted an earlier state of graft failure.

Adult↗
PubMed1975

In vivo effects of angiotensin antagonists on plasma aldosterone in the dog.

The effects of infusions of equimolar doses of Sar1-Ile8-angiotensin II and of Sar1-Ala8-angiotensin II on plasma aldosterone, plasma renin activity and arterial blood pressure were compared in normal dogs. Plasma aldosterone increased significantly after Sar1-Ile8-angiotensin II whereas it was unaffected by Sar1-Ala8-angiotensin II. Changes in blood pressure and renin activity were small without marked differences between both groups of animals. The experiments demonstrate a clear steroidogenic potency of Sar1-Ile8-angiotensin II. Therefore, Sar1-Ala8-angiotensin II should be preferred as antagonist of the action of angiotensin II in the adrenal gland.

Adrenal Cortex Hormones↗
PubMed1975

Effect of angiotensin II and of an angiotensin II analogue (Sar1-Ile8-angiotensin II) on blood pressure, plasma aldosterone and plasma renin activity in the dog.

1. The effect of infusions of equimolar doses of angiotensin II (AII) and of the angiotensin analogue Sar1-Ile8-angiotensin II on arterial blood pressure, plasma aldosterone and plasma renin activity were compared in normal anaesthetized dexamethasone suppressed dogs. 2. Angiotensin II induced a significant increase of blood pressure and of plasma aldosterone whereas plasma renin activity decreased. The blood pressure was only slightly affected by large doses of the analogue. Plasma aldosterone, however, increased and plasma renin activity decreased. These changes were significant but less pronounced than after the infusions of angiotensin II. Plasma aldosterone remained high and renin activity low for 40 min after the infusions of the analogue. 3. The results suggest a strong agonistic potency of Sar1-Ile8-angiotensin II at the adrenal and renal angiotensin receptors, and that it is almost ineffective at the vascular receptors. The inhibition of renin secretion by angiotensin seems not be related to its vasoconstrictive activity.

Aldosterone↗
PubMed1975

[Cryosurgery of lung metastases (author's transl)].

Cryosurgery achieves a local tumor destruction and at least in many experimental models it also produces an antitumor immunity. Cryosurgery was therefore applied to 15 patients with multiple lung metastases. In 2 cases a good palliation with a temporary standstill of tumor growth and in 3 cases of positive effect with a decrease and disappearance of metastases was noted. In two of these cases metastases of the contralateral lung also decreased or varnished. This can be explained by an immune mechanism. Big tumors and fibrosarcomas are not suited for cryosurgery, whereas hypernephroid renal carcinomas and malignant teratomas give more promising results.

Adult↗
PubMed1975

Circadian rhythm of plasma renin activity and plasma aldosterone in normal man and in renal allograft recipients.

In normal supine man, a marked circadian rhythm was found in plasma renin activity (PRA) and in plasma aldosterone concentration, with highest levels in the morning and lowest in the evening. Short-term suppression of ACTH by dexamethasone did not eliminate the circadian variation of plasma aldosterone. In patients with a transplanted and thus denervated kidney, no such rhythm of PRA could be observed. From our data it is suggested that the normal circadian rhythm of PRA depends on intact renal innervation and is controlled by the central nervous system.

Adrenocorticotropic Hormone↗