[Biomechanical and histological studies on the function of the human arterial wall following thromendarterectomy].
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
P Kujath
Publications and source records attributed to P Kujath.
[Functional studies of the cardia muscles in achalasia].
1. The mechanical properties - extension behaviour and ability to contract per muscle cross-section - were the same for healthy and aganglionic cardiac sphincter. 2. The acetyl choline threshold is higher in aganglionic muscle strips. The maximum effective acetyl choline dose (2 microgram/ml) remained the same. 3. Achalasia is characterized by a considerable reduction of adrenergic beta-receptor activity and alpha-receptor predominance.
Acetylcholine↗
Secondary mycosis in surgery: treatment with fluconazole.
Together with the severity of the underlying disease, mycotic infections are assuming increasing significance in surgical patients under intensive care. 26 patients with severe internal mycotic infections were treated with fluconazole in an open clinical trial. The pathogens isolated were Candida albicans in 22 cases, Candida tropicalis in four, Torulopsis glabrata in three, Candida parapsilosis in two and Aspergillus fumigatus in one. Mixed infections were found in five cases. Most of this series of surgical patients had a severe, life-threatening post-operative condition. Their mean classification by the Apache score was 15.35. The most frequent risk factors were previous injuries to intraabdominal hollow organs and extensive antibiotic therapy; and the peritoneum was, therefore, the commonest site of infection. Antimycotic therapy was with fluconazole at a dose of 200-400 mg daily for at least ten days. The mycosis was cured in 22 of the 26 patients, one of these being a case of severe mycotic peritonitis. Nine patients died of the underlying disease within four weeks of the beginning of treatment. Fluconazole was effective and well tolerated in the treatment of severe life-threatening infections in surgical patients.
Adult↗
Comparative study of the efficacy of fluconazole versus amphotericin B/flucytosine in surgical patients with systemic mycoses.
In an open, prospective, randomized study, the efficacy of fluconazole was compared with that of the combination amphotericin B/flucytosine. Forty surgical patients with deep-seated mycoses were included in the study. Absolute inclusion criteria were histological finding of fungi in a tissue sample taken during surgery from e.g. peritoneum, pancreas, lungs or trachea, a positive blood culture or candida lesion of the eye. According to the random list 20 patients received up to 0.5 mg amphotericin B per kg body weight in combination with 3 x 2.5 g flucytosine (5-FC) daily and 20 patients received fluconazole, 400 mg on the first day and then 300 mg daily. The two therapy groups were comparable in terms of age, sex and underlying diseases. Gastrointestinal perforations (27 times) were the most frequent underlying diseases. Candida albicans was the fungus most frequently detected microbiologically (34 times). The pathogens were eliminated from 12 patients in the fluconazole group and 14 patients in the combination group. The median elimination time was 8.5 days in the fluconazole group and 5.5 days in the amphotericin B/5-FC group. Six patients died in the fluconazole group, whereas five patients died in the comparison group. Side effects which necessitated switching of therapy occurred twice in the combination group. In deep-seated candida mycoses, surgical patients receiving the combination therapy with amphotericin B/5-FC showed an earlier elimination than patients on monotherapy with fluconazole. With respect to cure rates there was no difference between these two regimens.
Adult↗
Study of cefotaxime twice daily for the therapy of postoperative pneumonia. The German Cefotaxime Study Group.
A total of 548 patients with postoperative pneumonia were treated with 1 or 2 g cefotaxime twice daily. Of the 88 patients without serious underlying diseases who received the 1-g 12-h dosage regimen, all were considered to be clinically cured, and all 54 isolated pathogens were eradicated or presumed to be eradicated. In the group with severe infection or severe underlying disease receiving 2 g 12-h cefotaxime, the overall clinical success rate (cured plus improved) was 98.4%. Results from this study support the use of cefotaxime as an alternative to empiric monotherapy for nosocomial pneumonia in surgical-service patients who are not neutropenic or on long-term artificial ventilation.
Aged↗
Fungal infections in surgical patients.
Deep fungal infection was diagnosed in 42 patients (a rate of four per 1000) treated during a one-year period between 1988 and 1989 at the Surgical Clinic in Würzburg. Most occurred in association with damage to intra-abdominal hollow organs. Diagnosis of deep fungal infections is difficult and only histological identification provides definite proof. However, often the decision to treat has to be made on the basis of the clinical picture and the physician's subjective assessment. Combination treatment with amphotericin B and 5-fluorocytosine is still the current recommendation but the introduction of the azole antifungal agents appears likely to bring about a change. A trial of fluconazole showed it to have clear advantages over combination treatment, being effective, well tolerated and easily administered.
Humans↗
Fluconazole monitoring in Candida peritonitis based on histological control.
Between May 1, 1988 and January 1, 1990, 10 patients were treated for Candida peritonitis. Origins of the infections were lesions and perforations of the gastrointestinal tract. Risk factors promoting the disease were tumours, diabetes mellitus and extensive antibiotic therapy. The mean classification by the APACHE score 2 was 19.0. All patients underwent the programmed peritoneal lavage for diffuse peritonitis. Daily relaparotomy and lavage of all quadrants of the abdomen was performed. The diagnosis of Candida peritonitis had been established by microbiological investigation, increasing serologic titres, histologic demonstration of a deep mycosis and clinical picture. All patients were treated with 300 mg fluconazole daily. Five of the ten patients died from their severe primary diseases in spite of control of fungal peritonitis. Daily relaparotomies allowed to follow up the microbiologic and histologic course of the disease. Within 2 to 4 days after administration of fluconazole, hydrous swelling and reduction of fungal elements could be demonstrated histologically. On the 4th day after onset of antifungal therapy, fungal mycelia were markedly reduced and distendedly decayed. Fluconazole clearly leads to a destruction of deeply invading Candida elements within 4 days.
Adult↗
Primary epithelioid angiosarcoma of the adrenal gland case report and review of the literature.
Primary angiosarcoma of the adrenal gland is extremely rare. Here, we report on a 70-year-old man with an angiosarcoma of the right adrenal gland who died 3 weeks after tumor resection due to intestinal infarction and acute renal failure. No metastases were found at autopsy. Histologically, the tumor showed a predominantly epithelioid differentiation. Immunohistochemical examination revealed positive reactivity for cytokeratin, epithelial membrane antigen, vimentin, factor VIII-related antigen, CD31, CD34 and Ulex europaeus agglutinin-I. Features of endothelial origin were also demonstrable by electron microscopy. The differential diagnosis of this uncommon neoplasm is discussed. The present case emphasizes problems in differential diagnosis that arise from its epithelioid differentiation. A review of the literature underlines the poor clinical outcome of adrenal angiosarcoma.
Adrenal Gland Neoplasms↗
[Thoracic trauma--clinical aspects and therapy].
Explore the source record for details and available documents.
Flail Chest↗