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Biomedical subjects

M Dürig

Publications and source records attributed to M Dürig.

At least 37 records · Page 2Linked to original sources

[Value of subtotal stomach resection in stomach cancer].

The controversy about the extent of resection of gastric cancer has been lasting for decennies. The extreme viewpoints may have become less divergent recently although controlled data are still lacking. As gastrectomy has generally become safer, a somewhat broader indication for it is justified. Subtotal resection is still justified for cancer of the antrum of the intestinal type (Laurén-classification) without evidently involved distant nodes and as long as a clear margin can be expected, furthermore in some advanced disease situations and finally in high risk patients, especially with severe cardiopulmonary handicaps.

Gastrectomy↗

[Splenectomy: surgical indications in malignant hematologic diseases].

Indications for splenectomy in malignant hematological diseases are discussed for relief of symptoms (splenomegaly, cytopenias), for staging (M. Hodgkin) or improvement of survival (hairy cell leukemia). The role of splenectomies is also evaluated for Non-Hodgkin lymphomas, chronic lymphatic leukemia, myelofibrosis and for chronic myeloic leukemia.

Hematologic Diseases↗

[Rectal prolapse].

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Fecal Incontinence↗

[Autologous spongiosa as an antibiotic carrier in the treatment of osteitis].

The treatment of osteomyelitis essentially depends on a bactericidal concentration of antibiotic in bone tissue with an appropriate spectrum. Ciprofloxacin is effective against the main organisms causing osteomyelitis (staphylococcus aureus, pseudomonas aeruginosa) at low MIC. We investigated the concentration of ciprofloxacin in human bone. After a single dose (200 mg ciprofloxacin i.v., preoperatively) the concentration in cortical bone was 6.9 +/- 0.8 mcg/g and 9.7 +/- 0.8 mcg/g in cancellous bone. In any case the concentration of ciprofloxacin exceeded the MIC for staph. aureus and pseudomonas aeruginosa. For the treatment of osteomyelitis we transferred the antibiotic bound to autologous cancellous bone grafts to the site of inflammation after surgical debridement. First clinical results are documented.

Administration, Topical↗

The effect of surgery and anesthetic agents on granulocyte-chemiluminescence in whole blood.

The effect of anesthesia and major abdominal surgery on zymosan-induced chemiluminescence (CL) of neutrophil granulocytes was evaluated. CL was measured in diluted whole blood taken at distinct intervals within the perioperative period. In addition, blood samples from healthy volunteers were supplemented with ether and halothane to investigate the in vitro effect of these agents. The phagocytosis-induced CL was not found to be depressed by anesthesia and surgery. Only at supranarcotic concentrations was CL reduced. Surgery and anesthesia, therefore, do not appear to impair this defense system significantly under the conditions of this investigation.

Abdomen↗

Impaired antipneumococcal antibody production in patients without spleens.

Fifteen splenectomised and 15 normal subjects were studied, in absence of any intentional immunisation, for pokeweed mitogen induced synthesis of antipneumococcal capsular polysaccharide antibodies in vitro by peripheral blood mononuclear cells. Results showed that removal of the spleen had caused a persistent immune deficiency of circulating B cells capable of synthesising IgM antipneumococcal capsular polysaccharide. In vitro synthesis of polyclonal IgM and IgG by peripheral blood mononuclear cells of subjects without spleens was also depressed. These defects were due to an abnormality of the B cell compartment. These data are evidence of the major role of the spleen in the control and production of a consistent part of pokeweed mitogen responsive circulating B cells and add another facet to the complex immune dysfunction of splenectomised subjects. The findings, moreover, may help in understanding the susceptibility of splenectomised people to pneumococcal sepsis and the delayed and impaired antibody response to pneumococcal vaccine.

Adult↗

Beta-adrenergic regulation of the blood lymphocyte phenotype distribution in normal subjects and splenectomized patients.

The beta-adrenergic effect on the release of immunoregulatory cells from the spleen was investigated by physical stress testing (bicycle ergometry up to submaximal work capacity) in 19 normal subjects (15 males, median 21 years) and in 10 male patients splenectomized for trauma (median 29 years). It was repeated in 6 subjects of each group during beta-blockade with 80 mg oxprenolol. Blood samples for leucocyte analysis were taken before and at the end of the test. Leucocyte subpopulations were analyzed in a cytofluorograph after staining of buffy coat cells by direct (B cells) or indirect immunofluorescence with monoclonal antibodies directed against the phenotypes of T- (Leu-1), T helper- (Leu-3a), T suppressor/cytotoxic (Leu-2a) cells and natural killer (OKM1+ lymphocytes) cells. In the controls all leucocyte subsets increased at ergometry, but B-, Leu-2a- and OKM1-cells increased more than Leu-3a cells. During beta-blockade the leucocyte changes reached only 50% of the value without treatment; the B- and Leu-2a cell mobilization was reduced more than the Leu-3a-, OKM1 cell- and monocyte changes. In splenectomized patients the proportional cellular changes were only half of those found in normal subjects, except for the Leu-3a cells which were not released. Beta-blockade during ergometry had no effect on Leu-3a cells, a similar effect on B- and Leu-2a cells as in normal subjects and a stronger effect on granulocytes, monocytes and OKM1 cells than in controls. In conclusion, the B- and Leu-2a cell mobilization from the spleen (50%) was beta-adrenoceptor dependent, while the one from other lymphoid organs was beta-adrenoceptor independent. The strongly spleen dependent Leu-3a cell changes were not beta-adrenoceptor mediated. Granulocyte-, monocyte- and OKM1 cell changes were only partly spleen dependent. The spleen independent changes however were strongly beta-adrenoceptor dependent.

Adolescent↗