[Organ-specific in vivo dipeptide (alanylglutamine, glycylglutamine) values in catabolic dogs].
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Animals↗
Biomedical subjects
J Funovics
Publications and source records attributed to J Funovics.
[Adjuvant chemotherapy in patients with radical resection of stomach cancer: 5-year results of a prospective randomized study].
102 patients with operable gastric carcinoma were randomly allocated to untreated control, polychemotherapy, chemoimmunotherapy. At a median follow-up of 5 years, chemotherapy did not improve the overall survival rate. However, in certain subgroups, patients with lymphnode metastases and intestinal tumor type showed a significant survival benefit when treated with adjuvant chemotherapy. Furthermore, we found the site of first recurrence very closely related to the type of tumor histology. Regardless of the positive effect of chemotherapy in retrospective subset-analysis, we do not generally recommend the use of polychemotherapy in operable gastric carcinoma.
Aged↗
[Measuring cyclosporin in immunosuppressive treatment following liver and heart transplantation].
Selective suppression of the immune system in graft recipients is now achieved in most cases by treatment with cyclosporine A. Due to large individual differences in absorption, utilization and metabolisation of this drug, therapeutic blood levels (immunosuppression/toxicity) can be maintained only by frequent measurements of the cyclosporine concentrations in blood samples and dosage readjustments. In the present study, we measured cyclosporine in whole blood samples from 37 patients (23 liver and 14 heart transplant recipients) using an high pressure liquid chromatographic method for native cyclosporine A which has been developed in our laboratory and a radioimmunoassay method (cyclosporine A + metabolites). By comparison of the results of HPLC and RIA-measurements (n = 520) we found a relatively stable metabolization rate (RIA/HPLC-ratio) of 4.23 +/- 1.30 for heart transplant recipients. In contrast RIA/HPLC ratios were highly variable in liver graft recipients ranging from 1.3-9 for the same patient in the posttransplant period. The liver recipients could be classified into two groups according to their mean RIA/HPLC-ratios: for 11 patients we observed a mean ratio of 2.65 +/- 0.35, for another 12 patients one of 4.35 +/- 0.75. Lower metabolisation rates seem to be associated with low donor age. No direct correlation was found between changes in RIA/HPLC-ratios and liver function, rejection and infection periods. Rejection treatment with high doses of methylprednisolone had no systematic influence on cyclosporine metabolisation in our patients. Since cyclosporine metabolites, at least those ones which are most abundant, have less immunosuppressive and toxic effects we recommend measurements of cyclosporine blood concentrations with any HPLC-method specific for the unchanged drug.(ABSTRACT TRUNCATED AT 250 WORDS)
Chromatography, High Pressure Liquid↗
[Liver transplantation--indications and postoperative course].
54 liver transplantations on 53 patients are analysed. Tumor disease was found in 57%, cirrhotic liver disease in 43%. 9 patients had metastatic liver tumors after distal colon surgery. The fatal technical failure rate was 3%, the postoperative mortality for the first 3 month and for 1 year 40% and 52% respectively. Very often jaundice and rejection in the graft were found, independent from the crossmatch (pos. in 16%). There is only one child with 3 years. The main reason for postoperative death are lung and heart diseases, which were not diagnosed preoperatively in 10 patients. We conclude that the postoperative complication rate is to be lowered by applying rigorous selection criteria, raising the replantation rate and improving the donor organisation.
Follow-Up Studies↗
Metabolic changes of patients with acute necrotizing pancreatitis.
We carried out metabolic investigations of 26 patients with severe forms of acute pancreatitis which were evaluated by an organ score. We formed six groups from this data: survivors and deceased in the first week, the second week, and after a further two weeks of illness. The amino acid patterns in plasma and muscles deviated considerably from normal at all times in both the surviving and the deceased patients. In particular, changes in the concentrations of branched-chain amino acids and glutamine in the muscle tissue have a prognostic value. In the range two to four (normal range: above 20), the factor glutamine/VAL+LEU+ILE characterizes a prefinal condition in non-survivors. This factor increased in patients recovering from the illness from 6 to values over 20. Non-survivors (NS) had higher plasma levels of glucose and glucagon compared to surviving patients. Plasma glucagon concentrations in NS reached levels up to 4,000 pg/mL at admission, which declined gradually to normal range during the course of the illness.
Acute Disease↗
[Regional results of human liver transplantation in Vienna].
21 cases of transplantation of the liver are analysed for indication, anaesthesia, operative management, anhepatic period, immunological therapy and specific post-operative problems (jaundice and rejection episodes). Causes of death are noted and prediction of survival gives a rate of 55%/1st year in the 17 patients operated on since 1982 under a standardised management schedule. The transplantation programme in Vienna provides routine treatment for otherwise untreatable primary (57% cases) and secondary metastatic (14%) tumours of the liver, and, in the second place, for end-stage hepatic cirrhosis (14%) and certain rare liver diseases (14%).
Adult↗
[The concept of therapy in liver metastases].
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Antineoplastic Combined Chemotherapy Protocols↗
[Problems of blood replacement in liver transplantation].
Liver transplantation often is accompanied with massive bleeding-blood losses up to 125 I have been reported. A survey of 21 transplantations describes the management for substitution of blood components. After an initial series of 18 patients including 4 cases with blood losses exceeding 100 units of blood, an attempt was made to optimize coagulation in 5 cases with NT-values below 40% by preoperative plasmapheresis. Platelet transfusion was performed in all cases with platelet values below 120 000. These measures led to a significant reduction in blood units substituted during the last 9 transplantations.
Adult↗
Liver amino acids in sepsis.
The metabolic derangement of sepsis leads to changes of the plasma and muscle amino acid (AA) pattern. In this study the influence of a septic process on liver AA pattern was investigated. In seven patients with abdominal sepsis, liver AA concentrations were determined during surgery and compared with those of four patients who had undergone cholecystectomy. In sepsis lowered AA levels were found for most of the AAs. Outstanding decreases exhibited the levels of the gluconeogenetic AAs (especially threonine and alanine), the branched chain AAs, lysine, and taurine. In the patients who did not survive the septic process, the depletion of these AAs was even amplified. Slightly increased AA levels were analyzed for P-ethanolamine, cystathionine, citrulline, beta-alanine, tyrosine, and phenylalanine. The results indicate a disturbed free AA pattern of the septic liver. Despite the increased flux of gluconeogenetic AA from muscle to liver in sepsis, as reported by several authors, no accumulation of these AAs occurs in the liver.
Adolescent↗
Amino acid concentrations in plasma and skeletal muscle of patients with acute hemorrhagic necrotizing pancreatitis.
We measured amino acid concentrations in plasma and skeletal muscle of three groups of patients with acute hemorrhagic pancreatitis: (a) patients without secondary organ lesions, (b) patients also suffering from kidney damage, and (c) patients in whom the pancreatitis was accompanied by sepsis and multiple organ failure. In all three groups, especially the third group, the amino acid concentrations in both plasma and muscle were below normal. Glutamine was only 14% of normal in muscle tissue of the third group. Onset of renal insufficiency was indicated by increasing values for 3-methylhistidine and cystathionine; multiple organ failure, by increased concentrations of methionine and phenylalanine in plasma. The low amino acid concentrations of patients with acute pancreatitis can be explained as a combined effect of semistarvation and hypercatabolism. Changes in the plasma concentrations of amino acids did not reflect necessarily the concentrations in muscle tissue.
Acute Disease↗
[Liver abscesses--clinical aspects and surgical therapy].
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Adolescent↗
[Chronic pancreatitis--when is a drainage operation worthwhile?].
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Chronic Disease↗
[The effect of p-bromophenacylbromide, a phospholipase A inhibitor, in experimental acute pancreatitis in rats].
In this study the effect of p-bromophenacylbromide (p-BPAB), an inhibitor of phospholipase A, was studied in acute pancreatitis in an experimental rat model. Acute pancreatitis was produced by instillation of 0.4 ml bile into the pancreatic duct. p-BPAB was injected i.p. in a dosage of 0.25 micrograms/g b.wt. 30 min before, 30 min after, or 4h after the onset of pancreatitis. Prophylactic and early administration of p-BPAB inhibited severe morphological changes, such as necrosis and hemorrhages. Moreover, during administration of the inhibitor, decreased plasma concentrations of serum lipase and amylase (P less than 0.001) were monitored and compared with untreated animals. These therapeutic effects of p-BPAB were not seen in rats in which the inhibitor was injected 4 h after the onset of pancreatitis. As a result the phospholipase inhibitor, p-BPAB, reduces the clinical and morphological manifestations of acute pancreatitis. The effect of p-BPAB is dependent on the time of administration.
Acetophenones↗
Effects of burns on amino acid levels in rat plasma, liver and muscle.
In this study the influence of a severe catabolic situation (scalding and nitrogen deprivation) on amino acid (AA) metabolism was investigated in an experimental rat model. Scalding of 25 per cent of the total body surface area (TBSA) and hypocaloric alimentation (5.6 kcal per 100 g rat per day, no nitrogen) resulted in mean daily nitrogen losses of -0.27 +/- 0.3 g. Compared to anabolic growing rats this nitrogen catabolism significantly reduced the total free AA content of muscle (-47 per cent, P less than 0.001) and liver (-39 per cent, P less than 0.001). The total plasma AA concentrations were slightly increased in catabolic rats (+10 per cent). In catabolic rats muscle glycine concentrations dropped significantly (-79 per cent, P less than 0.001), while glutamine concentrations decreased by 22 per cent, which was not significant. Branched chain AA and phenylalanine were significantly elevated both in muscle and in plasma. Scalding and nitrogen depletion in rats leads to characteristic changes in plasma, muscle and liver AA concentrations, which are comparable to the results obtained in catabolic patients. However, the low muscle glycine concentrations in burned rats differ from the clinical observations where glutamine rather than glycine concentrations in muscle tissue are reduced. The rat model seems to be well suited for studying the influence of various therapeutic approaches such as different forms of parenteral nutrition or hormonal substitution on nitrogen catabolism.
Amino Acids↗
[Tumors of the endocrine pancreas].
37 patients suffering from apudomas of the pancreas are reported (18 insulinomas, 6 isletcell-hyperplasias, 9 Zollinger-Ellison syndroms, 1 glucagonoma, 3 without hormone production). In preoperative localization computerized tomography and angiography were the best with 65% positive findings. Insulinomas were enucleated, all free of recidives. 50% of operated isletcell hyperplasias had a postoperative resisting hyperinsulinism. Either gastrectomy or tumour enucleation was performed in the Zollinger-Ellison syndrome. The five-years survival rate was 43%.
Adenoma, Islet Cell↗
[In vitro evaluation of the chemosensitivity of malignant gastrointestinal tumors by stem cell assay].
The Human Tumor Stem Cell Assay, originally described by Hamburger and Salmon, was shown to be a useful in-vitro technique for predicting response or lack of response in individual patients' tumors. In the present study 34 GI-tumors were assayed for evaluation of in-vitro growth characteristics and sensitivity-patterns to standard chemotherapeutic drugs as well as to recombinant interferon alpha-2(rIF). Sufficient growth for evaluation of anticancer drug activity (greater than 30 colonies/control plate) was obtained in 56% of specimens: 2/9 colorectal, 0/3 stomach, 0/3 pancreatic tumors and 1/4 hepatomas revealed a 50% (or more) decrease of TCFUs, that was considered the minimum for in-vitro efficacy. Our results suggest a very limited overall activity of rIF in gastrointestinal malignancies. Only 1 pancreatic cancer (of 18 evaluable specimens) showed a significant decrease of colony formation (70%), when 100 U of interferon/ml were added to the culture system.
Antineoplastic Agents↗
[Clinical aspects and therapy of congenital cystic livers].
Thirty patients with congenital cystic disease of the liver are reported. Expansion with pain, jaundice, cholangitis and suspicion of malignancy are indications for surgical intervention. Operation is chosen according to localization, size, quantity of cysts and their fluid content. Resection, fenestration, punction, anastomosis and hemihepatectomy were performed. Postoperative mortality was about 3%, prognosis is well, but worsened by associated diseases like polycystic kidneys or intramural aneurysms.
Cysts↗