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Biomedical subjects

R Grundmann

Publications and source records attributed to R Grundmann.

At least 91 records · Page 5Linked to original sources
PubMed1982

Dopamine treatment of human cadaver kidney graft recipients: a prospectively randomized trial.

In a prospectively randomized trial, 50 human cadaver kidney graft recipients were tested for the effect of dopamine infusion on kidney function after transplantation. The kidneys were taken from beating-heart donors under optimal conditions. The dopamine infusion did not affect the dialysis frequency in the 1st week after transplantation, in the dopamine group only slightly better creatinine clearances could be detected. However, the diuresis increased significantly when dopamine was given and this resulted in the fact that in the dopamine group 47.4% of the patients were dialyzed although the diuresis amounted to more than 11/day as compared to 15.7% of such patients in the nondopamine group. These findings correspond to experimental data, which showed that the dopamine infusion of the recipient mainly ameliorated renal function in those cases where kidneys were taken after hypotensive injury of the donor.

Cadaver↗
PubMed1982

The significance of colloid osmotic pressure measurement after crystalloid and colloid infusions.

Colloid osmotic pressure (COP) was followed postoperatively in 55 randomized patients. After minor operations and short-term infusion therapy only small changes of the COP could be observed and it was concluded that after such operations COP measurement is unnecessary. After major surgical interventions, however, COP measurement gave valuable hints. It was shown that even in the case of moderate blood loss replaced by crystalloids an abnormally low COP did not occur. The same applied also to preoperative hemodilution. It was unnecessary to substitute the withdrawn blood with a colloid solution. In addition, COP measurement helped to avoid expensive albumin administrations, and indicated colloid overload in cases of pulmonary edema.

Adult↗
PubMed1982

Successful treatment of streptozotocin diabetes of the rat by transplantation of the islets from a single donor pancreas.

A new digestion chamber was developed which made it possible to isolate 500 islets from the pancreas of one adult rat. The mesh chamber enabled us to remove islets out of the collagenase solution as soon as they are separated from pancreatic tissue. The islet injury due to collagenase was diminished, and the time of warm ischemia during digestion was considerably reduced. With this method it was possible to treat the diabetes successfully in eight of 14 rats. The condition of the remaining six rats was considerably improved, and no animal died due to diabetes during 90 days of surveillance as compared to a 50% death rate in the diabetic control group. A cataract did not occur in any transplanted rat, whereas it was observed in all surviving animals of the diabetic control group. If the complete separation of endocrine and exocrine tissue in a density gradient was abandoned the transplantation results improved significantly.

Animals↗
PubMed1982

[Diagnosis, treatment and prognosis of malignant tumors of the liver and extrahepatic bile ducts in the last 20 years].

188 patients with primary malignant tumors of the liver, gallbladder and extrahepatic bile ducts are reported. Changes in diagnostics, treatment and survival were analyzed in comparing three periods: 1959-1966, 1967-1974, 1975-1980. A significant improvement of the patient's prognosis could be observed, but this was only based on a decrease of hospital mortality. Radical tumor resection offers the only hope for long-term survival in patients with primary liver tumor. In contrast the carcinoma of the extrahepatic bile duct should be rather treated by palliative surgery. In the case of gallbladder carcinoma the prognosis was already hopeless if the tumor was detected macroscopically during surgery.

Adolescent↗
PubMed1982

[Frequency and causes of wound infection and pneumonia rate following various surgical operations].

753 patients who underwent general surgery were prospectively analysed with respect to postoperative wound infection and the pulmonary infection rate. A clear distinction was made between the real infection rate and those infections that were not combined with other complications and were therefore called "isoated" infections. It could be demonstrated that operations concerned with colon and perforated viscera had an increased isolated wound sepsis rate, the gastric resection, however, could be counted as a clean operation. Furthermore, the would sepsis rate after colonic surgery was also very low in those cases where an adequate operative techique was used. The pulmonary infection rate showed the opposite behaviour, since patients with gastric resection were particularly endangered. The reasons for that are discussed and target groups for use of prophylactic antibiotic therapy are named.

Age Factors↗
PubMed1981

[Choice of donor and the results of renal grafting (author's transl)].

For the calculation of the donor influence on the results of renal grafting, all non-renal causes of transplant failure must be excluded. The following criteria for the selection of a suitable kidney donor were found: the urine production of the donor in the last hour before nephrectomy should amount to at least 200 ml and the age difference between donor and recipient should be not more than 20 years. Proteinuria, a high serum creatinine level, vascular anomalies and a long operation time for vascular anastomosis were unfavourable. The preservation time, the warm ischemia time and the sex of the donor have little effect. If no rejection crises occurred within the first 3 weeks after transplantation, the transplant survival rate increased from 45% to 71%.

Adult↗
PubMed1981

[Results of renal transplantation 1968-1979 (author's transl)].

173 renal transplantations were done over a period of 12 years. Among these were 162 first, 10 second and one third transplantation. The one year survival rate of transplanted kidneys (all cases) was around 50%, patient survival was 81.6%. Survival rates did not depend statistically on tissue compatibility, immediate function of kidney, duration of kidney conservation, donor age, commencement of graft versus host reaction, and duration of preoperative dialysis. Although the number of HLA identity has increased during the observation period, there was no increase of transplant survival rate. This may possibly be explained by the negative influence of the steady increase of conservation time during the same period.

Adolescent↗
PubMed1981

Effect of hypotension on the results of kidney storage and the use of dopamine under these conditions.

The influence of the length and severity of hypotension on the results of kidney preservation was examined in dogs. Successful 24-hr hypothermic kidney storage was possible, if the donor animal was subjected to hypovolemic hypotension (mean blood pressure 60 mm Hg) for a duration 1 to 4 hr. If the blood pressure was lowered to 50 mm Hg, successful kidney preservation could not be obtained. It was concluded that the level of hypotension was of more importance than its duration. After 24 hr of cold ischemia, the function of kidneys from hypotensive donors could be improved significantly if dopamine was given to the recipient. The preservation injury itself could not be counteracted by dopamine because dopamine did not improve the function of kidneys which were removed from normotensive donors but were stored for 24 hr under hypothermia.

Animals↗
PubMed1981

[Indications for the various surgical procedures in hepatic echinococcosis].

This report deals with 38 patients suffering from hydatid disease of the liver. The most frequently performed operative procedures were hepatic resection (n = 16), filling the cavity with normal saline solution (n = 16), filling the cavity with normal saline solution (n = 8), and total cystectomy (n = 6). Hepatic resection is mainly indicated in patients with alveolar echinococcosis of the liver lobe have to be removed. In patients with only one hydatid cyst of the liver the simple method of saline filling should be preferred. The prerequisite of saline filling is that no biliary fistula exists. If the remaining cavity of the hydatid cyst fills with bile, it can be easily drained under local anaesthesia with computertomographic control. Mebendazole was given in two cases with alveolar echinococcosis of the liver that could not be treated surgically. In both cases this treatment proved to be effective.

Adult↗
PubMed1980

[Liver resection in focal nodular hyperplasia and liver cell adenoma (author's transl)].

Focal nodular hyperplasia of the liver was found in 3 women, and liver cell adenoma in a 4th woman. There is a possible association with the use of oral contraceptives. The indication for operation in these cases depends on the size of the tumour (danger of rupture of tumour and haemorrhage). It is also present when a malignant tumour cannot be excluded. Resection of the liver was performed predominantly with good results so far. Three of the patients described underwent the same surgical procedure. For the future one should aim at tumour enucleation alone.

Adenoma↗
PubMed1980

[Problems in the management of liver trauma (author's transl)].

In the last ten years 43 patients with blunt liver trauma and 11 with penetrating liver wounds have been treated. The mortality rate after blunt liver trauma was close to 63%; all penetrating wounds were survived. The prognosis after trauma depended significantly on the number of additional wounds, the extent of blood loss, and the age of the patients. Management of liver trauma was performed in most of the cases (n = 41) by suture and drainage. Packing of the wounds and resection were performed in four cases each. In nine cases, the bleeding did not stop sufficiently after suture, debridement, or packing of the wounds. It is concluded that in those cases hepatic resection or hepatic artery ligation - depending on the extent of trauma - should be done in future.

Adolescent↗
PubMed1980

[Surgical consequences of anomalous arterial blood supply and aneurysms in the epigastric region (authors' translation)].

Abdominal angiography was performed in patients with occlusive disease of the iliofemoral arteries. In 85 of 389 patients, the anomalous arterial blood supply of the upper abdomen was detected accidentally: 81% of the variations were related to the hepatic artery, 19% to the celiac artery. The possible surgical consequences are discussed if these variations are disregarded. Four patients with aneurysms of the visceral arteries (three aneurysms of the hepatic artery, one aneurysm of the superior mesenteric artery) and one patient with a celiac artery compression syndrome were also detected. The latter diseases represent clear indication for operation with high chances of success if treated in time.

Abdomen↗
PubMed1980

Kidney storage at subzero temperatures using a hyperosmolar perfusate.

32 dog kidneys were stored in a hyperosmolar perfusate (770 mosm/kg) at minus2 and plus4 degrees C, respectively, for 12-48 h and thereafter autotransplanted. 18 kidneys of the control group were stored in Collins solution at plus4 degrees C. The immediate function of the kidneys after transplantation was measured by p-aminohippuric acid and inulin clearances. Successful 24-hour preservation was possible by use of the hyperosmolar perfusate. Kidneys stored in the hyperosmolar perfusate at minus2 degrees C were better preserved than kidneys stored in Collins solution at plus4 degrees C. The addition of human albumin to the hyperosmolar perfusate did not improve the preservation results.

Albumins↗
PubMed1980

[Influence of surgery and hemodilution on the colloid osmotic pressure].

Colloid osmotic pressure was measured pre- and postoperatively in 75 patients. It could be demonstrated that the level of the colloid osmotic pressure inaccurately corresponded to the serum protein concentration. This fact can be neglected in those patients that are infused for short-term periods. However, many patients receive large amounts of colloids during long-term parenteral nutrition and in those cases an abnormal increase of plasma volume has to be expected. This might be harmful to the cardiopulmonary function and can be avoided by infusing colloids according to the level of the colloid osmotic pressure.

Adult↗