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Biomedical subjects

H Pernthaler

Publications and source records attributed to H Pernthaler.

At least 37 records · Page 2Linked to original sources
PubMed1993

Regeneration of sympathetic activities in small bowel transplants.

In order to study the activity of noradrenergic nerve fibres along mesenteric arteries in small-intestinal grafts, the entire jejunoileum was transplanted heterotopically in an isogeneic rat model (group I, n = 12). To assess their influence on graft motility, 9 cm of jejunum were transplanted in an orthotopic position and three bipolar electrodes sutured to the seromuscular layer of the graft (group II, n = 10). Fasting motility was recorded up to postoperative day 42. Animals of group I were sacrificed from day 7 on at weekly intervals and mesenteries were analysed histochemically by fluorescence microscopy. After the 1st and 2nd week, grafts were found to be completely depleted of noradrenaline. At the end of the 3rd week, fluorescence became detectable along graft mesenteric arteries and showed normal intensity from the end of week 4. Migrating myoelectric complexes (MMCs) were present in all animals of group II. The variability of the MMC period (mean 12.6 min; SD 6.2 min) expressed as variation coefficient (median 36.5; 14.6-74) did not change during the observation period. From these findings it is concluded that there are no extrinsic noradrenergic activities in rat small-intestinal transplants for the first 3 postoperative weeks but they do recover there after. Their influence on graft function remains unclear: MMC periodicity, however, was no influenced.

Animals↗
PubMed1993

[Pregnancy after kidney transplantation].

11 women gave birth to 13 live-born infants after a mean period of 39.6 months following transplantation, whereby one of these women had two successful pregnancies and one patient had a twin pregnancy. The highly premature twins, born after a complicated pregnancy with impaired renal graft function in the mother, died of respiratory insufficiency on the 13th day. All of these renal allograft recipients had to be delivered by caesarean section, either for nephrological or obstetric reasons. All graft with stable function prior to conception suffered no damage as a result of the pregnancy. In two women with already impaired function, pregnancy led to further deterioration and, eventually, graft loss. Because of the small numbers in this series no conclusions can be drawn with regard to the incidence of malformation of premature delivery. It is concluded that women with normal and stable renal graft function should be allowed to become pregnant. The risk for the graft as well as for the child does not seem to be increased under these circumstances. However, due to the complexity of the situation these patients should be cared for at specialized centres.

Adult↗
PubMed1993

[Is selective use of intraoperative cholangiography in elective cholecystectomy justified?].

Operative cholangiography (IC) represents the most reliable investigation for common bile duct stones even during laparoscopic cholecystectomy (CHE). To reduce operating time, safety of selective IC was analysed in the last 308 consecutive patients undergoing conventional elective CHE. Obvious indication for common bile duct investigation excluded, IC was performed only in case of elevated liver function tests (n = 83, 26.9%), in 12 cases (14.5%) with positive in 2 cases (2.4%) with false positive result. In 255 (73.9%) patients IC was omitted. All patients were controlled after 4 months: no retained duct stone became evident in any case. Selective IC is safe and cuts time.

Adolescent↗
PubMed1992

[Model of electromyographic study of small intestinal transplants in the rat].

Adequate motility of a small bowel transplant is a prerequisite for its resorptive function as well as its self-purging capacity. The literature contains some reports on changes in motility following denervation or transplantation, but none on the impact of acute rejection on motility of small bowel grafts. Therefore an experimental model was established to meet the following criteria: orthotopic position of graft, adequate nutritional status even when graft is functionally impaired, chronically implantable electrodes attached to graft and corresponding segment of native bowel, isogeneic or allogeneic set-up. 10 cm of proximal jejunum were transplanted from Lewis donors to five Lewis recipients in an orthotopic position just distal of the ligament of Treitz without resection of native small bowel. Three bipolar electrodes were sutured to the graft and the same number to the subsequent recipient bowel. Serial myoelectric measurements were taken until the end of week 3. From day 5 on, migratory myoelectric complexes independent of myoelectric activities of native bowel were recorded. Pacemaker frequency of the graft was found to be the same as that of the transsected native small bowel. This early reappearance of myoelectric activities makes this model suitable for comparative studies of small bowel transplant motility and in particular its changes during rejection, since even in strongly allogeneic combinations Lewis small bowel does not show histological signs of rejection before day 6.

Animals↗
PubMed1990

[Intestinal angiodysplasia as a cause of severe intestinal hemorrhage--report of 4 cases].

Angiodysplasia of the small intestine alone cannot be differentiated histologically from hereditary hemorrhagic telangiectasia (Morbus Rendu-Osler-Weber). Isolated localisation in the small intestine is rare and requires surgery in the event of massive bleeding. Four cases of bleeding from angiodysplasias of the small intestine in patients having undergone surgery at our institution over a ten-year period are presented. In three patients the particular intestine was resected. Two of these patients had an uneventful follow-up of even and ten years, one patient relapsed and was rehospitalized for surgical treatment. The fourth patient, who showed angiodysplasias scattered over the entire small intestine, had no further bleeding over a three-year period after transmural ligations of the lesions found by intraoperative endoscopical diaphany.

Adult↗
PubMed1989

[Endoscopic sclerotherapy of bleeding Mallory-Weiss mucosal tear].

Based on a review of 66 patients with the Mallory-Weiss syndrome, the problems of diagnosis and treatment in general, and the application of sclerotherapy in particular in patients with bleeding tears is discussed. At emergency endoscopy 32 patients (48.4%) had an acute bleeding episode which could be stopped by sclerotherapy in 26 of 27 cases. The importance of control endoscopy after 48 hours and its influence on prognosis are emphasized.

Adolescent↗
PubMed1989

[Peptic ulcer with a visible non-bleeding vascular wall--early elective surgery or endoscopic therapy?].

The records of 71 patients with the endoscopic finding of a peptic ulcer with a non-bleeding visible vessel, treated between 1982 and 1987 were retrospectively analysed. 16 patients underwent early surgical treatment (group I), 15 patients were treated conservatively (group II) and 40 patients by endoscopic haemostasis (group III). Recurrent bleeding was observed in 6.25% patients in group I, in 53.3% in group II and in 25% in group III, in which case endoscopy was performed again. The patients with arterial bleeding underwent early elective operation after endoscopic haemostasis. Deaths occurred only in the postoperative period: group I 6.25%, group II 13%, and group III 5%. These findings indicate that primary endoscopic treatment in selected patients leads to results equal to those achieved with early surgery. Conservative therapy cannot, however, be recommended.

Adult↗
PubMed1989

[Infectious complications in the early phase following kidney transplantation].

A retrospective analysis of 533 patients receiving kidney transplantation was performed to study the incidence of infection in the early postoperative period. Mostly localized in the lungs and renal system, bacterial complications arose in 133 patients. As compared with the unproblematic management of the urinary tract infections, 45 pulmonary infections were characterized by difficulties in diagnosis and treatment. Poor graft function was closely related to pulmonary infections: mean creatinine was 2.4 mg% (in patients without pneumonia - 1.5 mg%). Out of 45 patients with pneumonia, the graft failed in 16 patients. 6 patients died as a result of pneumonia. Rapid detection of the pathogenic organism is required, if necessary by invasive diagnosis. The administration of erythromycin before identification of the responsible pathogen may be indicated, in view of the fatal outcome in several patients subsequently diagnosed as having Legionella infection.

Adolescent↗
PubMed1989

Vascular lesions after percutaneous biopsies of renal allografts.

On the basis of two arteriovenous fistulas, one arteriocaliceal fistula, and the literature concerning these complications, clinical symptoms, diagnostic measures, and therapeutic strategies are discussed. Decreased renal function, severe hypertension, and a bruit over the transplant site - particularly after core biopsy - are said to be indicative of an arteriovenous fistula, while persisting hematuria is seen as evidence of an arteriocaliceal fistula. In both cases, angiographic evaluation is indicated. Therapeutic possibilities include selective angiographic embolization and surgical repair. Large intraparenchymal fistulas may require wedge resection.

Adult↗