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Biomedical subjects

I Vogel

Publications and source records attributed to I Vogel.

80 records · Page 5Linked to original sources
PubMedDate not supplied

Sepsis syndrome induced by tuberculous perforation of the esophagus.

Perforation of the esophagus induced by tuberculosis with no evidence of HIV infection is an extremely unusual presentation of the disease. We report on a 41-year-old man presenting with an esophageal perforation who developed a sepsis syndrome characterized by multiple organ dysfunction. The perforation was covered endoscopically with a tube, the patient recovered from cardiovascular, renal and pulmonary dysfunction under intensive care treatment, including antimycobacterial therapy. In response to endoscopic and medical treatment the size of the lesion decreased and disappeared 56 days after diagnosis. The patient could be discharged 2 months after admission and remained asymptomatic after a 12 month follow-up examination.

Adult↗
PubMedDate not supplied

Clinical usefulness, safety, and plasma concentration of ropivacaine 0.5% for inguinal hernia repair in regional anesthesia.

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the pharmacokinetics, feasibility, and clinical effects of ropivacaine in regional anesthesia (ilioinguinal-iliohypogastric blocks [IIB], genitofemoral block plus local infiltration) for inguinal hernia repair. METHODS: Following ethics committee approval and informed consent, 21 male adults received 60 mL ropivacaine 0.5% (without vasoconstrictor). In 11 patients, further injections of 5 to 10 mL were given while preparing the hernial sack. Plasma concentration of ropivacaine was determined in venous blood after 10, 20, 30, 45, 60, 90, 120, and 300 minutes using reversed-phase high pressure liquid chromatography (HPLC). RESULTS: Peak plasma concentrations of ropivacaine were 1.5 +/- 0.6 (0.7 to 2.6) microg/mL (mean +/- SD [range]). These maximum concentrations occurred after 45 (30 to 60) minutes (median [range]). No signs of central nervous or cardiovascular toxicity were observed. Twelve of 21 patients did not need any additional analgesics within 24 hours postoperatively. One patient had a femoral motor block lasting 6 hours, 5 patients reported sensory femoral block lasting 5 to 12 hours. Patients, as well as the surgeon, were very satisfied with the procedure, and all patients stated that they would like to have it performed again that way in case of an inguinal hernia on the opposite side. CONCLUSION: A ropivacaine dose of 60 to 70 mL of 0.5% appears adequate for regional anesthesia for inguinal hernia repair regarding conditions for surgery, safety, ambulation, and postoperative pain relief.

Adult↗
PubMedDate not supplied

Serum relaxin in the newborn is not a marker of neonatal hip instability.

It has been suggested that intrauterine exposure to high levels of relaxin causes hip instability in newborns. The aim of this work was to evaluate whether the serum relaxin concentration in umbilical vein blood is associated with hip instability in the newborn. Blood was collected by cordocentesis from 2,185 newborns, and serum relaxin levels were obtained by using a standard sandwich enzyme-linked immunosorbent assay (ELISA). Movement of the femoral head in the hip joint was determined for all 2,185 children by the anterior-dynamic ultrasound method. Hereby their status on neonatal hip instability was determined. Fifteen cases (12 girls, three boys) were found, and 106 controls were selected. Only six newborns had unstable hips to a degree requiring treatment. Ten newborns had Ortolani-positive hips. Only three specimens of the 121 samples measured had serum relaxin concentrations above the detection limit of 10 pg/ml. None of these were cases. This study does not show an association of serum relaxin with neonatal hip instability. It is suggested that detectable serum relaxin levels are found in samples from the umbilical cord only when these are contaminated with maternal blood.

Biomarkers↗
PubMedDate not supplied

Ductal adenocarcinoma of the pancreas head: survival after regional versus extended lymphadenectomy.

BACKGROUNDS/AIMS: The aim of the study was to evaluate the influence of regional versus extended lymphadenectomy on survival in patients with ductal adenocarcinoma of the head of the pancreas. From 1988 to 1996 we performed partial duodeno-pancreatectomies (Whipple procedure) combined with either regional (n = 20, group A) or extended retroperitoneal (n = 33, group B) lymphadenectomy in 53 patients with ductal adenocarcinoma of the pancreas head. METHODOLOGY: The outcome of the two groups was compared by constructing survival curves and evaluating demographic, intraoperative and histopathologic data from all patients (n = 44) with curative (R0) resections. RESULTS: For patients after R0 resection there was no significant difference in terms of survival between group A and B. Only tumor stage (p = 0.0258), portal vein invasion (p = 0.0190) and tumor grade (p = 0.0021) had a significant influence on survival, regardless of the type of operation. CONCLUSION: Our data suggest that no further improvement of the survival rate can be achieved by extended retroperitoneal lymphadenectomy, compared to regional lymphadenectomy.

Adenocarcinoma↗
PubMedDate not supplied

Intact tissue of gastrointestinal cancer specimen orthotopically transplanted into nude mice.

BACKGROUND/AIMS: A relevant animal model of human gastrointestinal cancer in nude mice, which can be adapted for repetitive investigations, could improve our understanding of carcinogenesis and cancer metastasis. Furthermore, it may support the development of new and effective therapeutic concepts. METHODOLOGY: We have established an orthotopic transplantation tumor model for human tumors in nude mice with intact tissues of colorectal, pancreatic, and gastric cancer. We investigated the biological characteristics of original and corresponding transplanted tumors, including routine pathological examination (HE staining), mucin production (PAS staining), and immunostaining. In addition, the lung and liver specimens were screened for micrometastases. RESULTS: 1) Overall, 10 out of 22 surgical specimens were growing in nude mice subcutaneously and/or orthotopically (4/6 colon, 5/10 pancreatic, and 1/6 gastric cancer). In the group of fresh tumor tissues with greater than 50% tumor cell content, the take rate was 100% (3/3 pancreatic, and 3/3 colon). 2) The orthotopically transplanted tumors resemble the original tumors morphologically and biologically, including local invasion, regional and distant metastases, and CEA production. 3) The detection of dissemination of cancer cells can be achieved by immunostaining. CONCLUSIONS: An orthotopic xenotransplantation model for human gastrointestinal carcinomas in nude mice was established. The comparative analysis by immunohistochemistry suggests that this study will be helpful for developing new diagnostic methods to monitor micrometastatic disease.

Adult↗