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Biomedical subjects

T Schmid

Publications and source records attributed to T Schmid.

At least 109 records · Page 6Linked to original sources
PubMed1989

Inhibition by loperamide of mucus secretion in the rat colon in vivo.

The effect of loperamide on mucus secretion and the net transport of fluid, sodium and potassium was investigated in the perfused rat colon in vivo. Prostaglandin E2 (PGE2, 1 mg/kg per h intraarterially) and deoxycholic acid (2 mM intraluminally) were used as secretagogues. Mucus secretion was determined as the total amount of protein-bound hexose in the effluent. Under basal conditions, loperamide (6 mg/kg subcutaneously) slightly decreased mucus secretion and increased the absorption of fluid and sodium. PGE2 and deoxycholic acid stimulated mucus secretion about 4- and 9-fold, respectively. Loperamide abolished the mucus secretory response to PGE2 and reduced the response to deoxycholic acid by 50%. It also reduced the fluid secretion following PGE2 but did not affect the diminished fluid absorption following deoxycholic acid. Potassium secretion was not significantly influenced by loperamide and therefore was independent of the secretion of mucus. The data suggest that loperamide is a potent inhibitor of colonic mucus secretion, a property that possibly contributes to the antidiarrheal effect of this opiate analogue.

Animals↗
PubMed1989

[Infectious complications in the early phase following kidney transplantation].

A retrospective analysis of 533 patients receiving kidney transplantation was performed to study the incidence of infection in the early postoperative period. Mostly localized in the lungs and renal system, bacterial complications arose in 133 patients. As compared with the unproblematic management of the urinary tract infections, 45 pulmonary infections were characterized by difficulties in diagnosis and treatment. Poor graft function was closely related to pulmonary infections: mean creatinine was 2.4 mg% (in patients without pneumonia - 1.5 mg%). Out of 45 patients with pneumonia, the graft failed in 16 patients. 6 patients died as a result of pneumonia. Rapid detection of the pathogenic organism is required, if necessary by invasive diagnosis. The administration of erythromycin before identification of the responsible pathogen may be indicated, in view of the fatal outcome in several patients subsequently diagnosed as having Legionella infection.

Adolescent↗
PubMed1989

[Regeneration of lymph drainage following transplantation of the small intestine].

Since the resorption of long-chained fatty acids proceeds exclusively via the lymphatics, the regeneration of lymphatic flow from small bowel grafts takes on a significant role. An isogene, heterotopic small bowel transplant was performed in a total of 54 Lewis rats, whereby 27 animals received no immunosuppression (group A) and the remaining 27 rats received cyclosporin A (group B). The lymphatic regeneration was determined by instilling dye into the mesenterial lymph nodes of the graft between day 1 and day 42 after transplantation and measuring the interval between instillation and appearance in the retroperitoneal lymph channels of the host. Additionally, the severity of the lymph edema was examined in histological slides, and the lymph vessels of the villi were examined for the presence of chylomicrons. In group A the passage of the dye into the lymphatic system first occurred on day 3 after transplantation, namely after a mean of 11.8 min, while in group B the lymph channels of the retroperitoneum first became visible on day 7 after transplantation (mean 8 min after instillation). Passage of the dye out of the lymphatic system of the graft was prompt and unhindered from day 10 in group A and from day 14 after transplantation in group B. In all grafts there was a marked interstitial lymph edema during the first week, and it was less severe in both groups up to day 14. Chylomicrons in the villi were observed in group A as of day 10 and after two weeks in group B. Regeneration of the lymphatics in small bowel grafts thus appears to be adequate for enteral nutrition only after 14 days.

Animals↗
PubMed1989

Vascular lesions after percutaneous biopsies of renal allografts.

On the basis of two arteriovenous fistulas, one arteriocaliceal fistula, and the literature concerning these complications, clinical symptoms, diagnostic measures, and therapeutic strategies are discussed. Decreased renal function, severe hypertension, and a bruit over the transplant site - particularly after core biopsy - are said to be indicative of an arteriovenous fistula, while persisting hematuria is seen as evidence of an arteriocaliceal fistula. In both cases, angiographic evaluation is indicated. Therapeutic possibilities include selective angiographic embolization and surgical repair. Large intraparenchymal fistulas may require wedge resection.

Adult↗
PubMed1989

Histologic pattern of small bowel allograft rejection in the rat. Mucosal biopsies do not provide sufficient information.

Accessory small bowel transplantation was performed in a rat model, and the histologic sequence of acute rejection with and without immunosuppression with cyclosporine defined. The first rejection episodes occurred on the fifth postoperative day, defined as phase I. The mucosa and submucosa of the grafts were infiltrated by mononuclear and polynuclear leukocytes, and lymphocytes were scattered along the myenteric ganglia. Three to five days later (phase II) the infiltrate intensified and was associated with villous flattening and sloughing of epithelial cells. The muscular layer was invaded by numerous lymphocytes and neutrophils. At the end of the rejection episode complete destruction of the mucosa and the muscular layer developed (phase III). As no lesion other than lymphocytic infiltration could be detected in the mucosa in phases I and II of rejection, which may be considered reversible, and this change is known to be unspecific, biopsies of the mucosa alone are inadequate for a purely histologic diagnosis of small bowel allograft rejection.

Animals↗
PubMed1989

Do donor age and cold-ischemia time have a detrimental effect on early pancreas-allograft function?

To study the impact of donor age and cold-ischemia time (CIT) on early graft function, we retrospectively divided the donors of 51 pancreas transplants performed between 1979 and 1987 at Innsbruck University Hospital into four groups according to donor age (greater than 45 yr and less than 15 yr) and CIT (greater than 8 h and less than 3 h). All organs were perfused with Eurocollins solution and stored at 4 degrees C. Fasting blood glucose levels and total amount of pancreatic juice produced over the first 3 postoperative days were recorded to assess graft function. No statistically significant difference was found between groups 1 and 2 and between groups 3 and 4. From these data, it is concluded that with the preservation method used, CIT can without a doubt be extended to at least 12 h, and a maximum donor age similar to that for the kidney can be adopted. This might not only enlarge the donor pool but also facilitate distant organ procurement.

Age Factors↗
PubMed1989

Rejection of kidney and pancreas after pancreas-kidney transplantation.

On the basis of 26 combined pancreas-kidney transplants we questioned whether both organs undergo rejection simultaneously. Reliable diagnosis of pancreas-graft rejection was made possible by monitoring exocrine graft function, including quantitative measurements of pancreatic juice, its amylase content, and pancreatic juice cytology. In addition, diagnosis of pancreas rejection was based on regular flow studies, daily urinary neopterin excretion, and a retrospective analysis of the clinical course. Clinical symptoms, blood chemistry, and, primarily, histology were used to assess rejection of the kidney allograft. In 18 cases the kidney and pancreas were rejected together; in 8 cases the kidney or the pancreas was rejected. Although both organs were rejected at the same time in most cases, either organ can be rejected alone. Thus, the kidney cannot be used to monitor the pancreas allograft in every case.

Adult↗
PubMed1988

[Oxygen saturation during sleep in chronic obstructive lung diseases before and after bronchodilator therapy. A controlled, prospective study in 36 patients].

In a study of nocturnal oxygen saturation by transcutaneous oximetry in 36 patients, 26 patients with chronic obstructive pulmonary disease (COPD) of varying degrees were compared with 10 patients without lung disease. The oxygen measurements were performed in all COPD patients before and after an 8-10 days' course of anti-obstructive therapy on an inpatient basis. COPD patients had more severe desaturation during night-time than those without lung disease. The severity of nocturnal desaturation correlates with severity of the obstructive lung disease. Anti-obstructive therapy significantly improves nocturnal oxygenation in patients with COPD. We conclude that strictly performed anti-obstructive therapy may diminish nocturnal oxygen desaturation and its negative sequelae, and therefore could have a positive effect on the prognosis of COPD patients.

Blood Gas Monitoring, Transcutaneous↗
PubMed1988

[Modified ureterocystostomy: a low rate of urological complications in kidney transplantation].

A total of 31 urological complications (4.6%) were noted between January 1974 and July 1987 among 670 renal transplantations: ureteral stenoses (n = 18), ureteral leaks (n = 8), vesicorenal reflux in the transplant with chronic urinary-tract infection (n = 1), and urolithiasis in the area of the transplant (n = 4). There were six ureteral leaks among 110 extravesical ureterocystoneostomies, while there were only two leaks among 560 anastomoses done by a modified method of Leadbetter and Politano. Restoration of urinary flow integrity was achieved without organ loss or functional impairment.

Constriction, Pathologic↗
PubMed1988

[Our therapy concept in nonresectable liver metastases].

Cytotoxic chemotherapy was performed in a total of 18 patients (12 men, 6 women): 5 patients with colonic carcinoma and 1 patient with unknown primary lesion received 5 x 1000 mg 5-Fluorouracil (5-FU) at 4 week interval. The 5 following patients primarily suffering from colonic carcinoma were treated with 0.5 mg/kg BW FUDR continuously at 2 week interval. 5 further patients with colonic carcinoma sequential received Mitomycin C (8 mg/m2) and 4 x 1000 mg 5-FU. 2 patients with breast cancer were treated with 500 mg/m2 Cyclophosphamide, the same amount of 5-FU and 40 mg/m2 Methotrexate every 4 weeks. Chemotherapy was well tolerated by all patients. A clinically significant response, however, was seen in only 2 patients with breast cancer. In 8 patients a liver transplantat was performed, which was followed in 3 cases by ultra-high dose Cyclosphosphamide, lethal total body irradiation and autologous bone marrow transplantation. 1 further patient received polychemotherapy. At the time of this analysis only 3 patients were still alive at 61, 30 and 26 months with only 1 perioperative death. All 3 had meanwhile developed recurrent or metastatic disease. Because of these sobering results, liver transplantation for the treatment of non-resectable liver metastases has been abandoned, and regional chemotherapy is now only applied in patients with liver metastases from breast cancer and after resection of metastases in an adjuvant setting.

Adult↗
PubMed1988

[Experiences with kidney transplantation in elderly patients].

Despite a significant increase in the number of elderly patients with end stage renal disease, these patients still represent a minority of renal transplant recipients in many countries. Roughly the recipients in the present study were older than 50 years of age. Infection was a more common complication in these patients than in the younger patients. However, the incidence of cerebrovascular and cardiovascular complications was found to be lower than expected. Patient-graft survival in 110 renal transplants in 106 patients aged 50 years or older were 87% and 76% respectively. These results suggest that cadaveric renal transplantation represents a relatively safe form of therapy also for older patients.

Aged↗
PubMed1987

[Realities in the diagnosis of bronchial carcinoma in clinical and general practice].

In 100 patients with lung cancer the diagnostic procedure, results of clinical staging and therapeutic sequelae were analysed retrospectively and compared to a similar group of patients 10 years previously. During the 10 years' interval there was a remarkable shortening of the time between the onset of symptoms and the diagnosis, from 20 weeks to the present 10 weeks. Despite this acceleration the number of patients undergoing curative surgical resection increased only from 15 to 17%. Inoperability was still due to general condition in 14%, impaired lung function in 7%, advanced tumor stages with metastasis in 52% and local inoperability in 10%. Of the 77 patients with specific tumor related symptoms only 18 were in the prognostically favourable stage I, whereas in the asymptomatic group early stage I was observed in 13 out of 23 patients. We conclude that an improvement in early detection of lung cancer may be achieved by periodical screening of the high risk population, rather than by focusing on the onset of the first symptoms.

Combined Modality Therapy↗