Langenbecks Archiv fur Chirurgie最新文献_第5页

[Adjuvant therapy of peritonitis with taurolidine. Modulation of mediator liberation]. 牛罗列丁辅助治疗腹膜炎。调节介质释放]。

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/pl00014640

K H Staubach

{"title":"[Adjuvant therapy of peritonitis with taurolidine. Modulation of mediator liberation].","authors":"K H Staubach","doi":"10.1007/pl00014640","DOIUrl":"https://doi.org/10.1007/pl00014640","url":null,"abstract":"Despite aggressive surgical treatment, prompt antibiotic therapy, and modern intensive care, up to one half of patients still die of diffuse peritonitis. There must be a distinction between infection as a microbiological phenomenon and sepsis as a complex, deleterious, inflammatory host response. Physiologic and metabolic changes during the latter process by taxonomically different organisms or different sources of infection are often clinically indistinguishable. Taurolidine, an amino acid derivate, seems to cover a variety of effects in peritonitis. As secondary peritonitis is associated with a significant cytokine release that is compartementalized in the peritoneal cavity, taurolidine is bactericidal, antiendotoxic, and antiadherent locally and, on the other hand, may modulate the systemic cytokine-mediated inflammatory response after being adsorbed systemically by the peritoneum. Current management of peritonitis can clear the peritoneal cavity of microorganisms and their products but patients continue to die of uncontrolled cytokine-induced systemic inflammation. In patients that undergo daily staged, planned relaparotomies they should not only be treated locally by taurolidine but also systemically by intravenous administration. The latter should, as a sort of sequential therapy, be continued, especially when the peritoneal cavity has been closed after a series of relaparotomies.","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 4 Suppl 1","pages":"S26-30"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/pl00014640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20267722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

[Systemic release of prostanoids after surgically-induced injury of lung tissue]. [手术所致肺组织损伤后前列腺素的全身释放]。

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01

F Gebhard, M Marzinzig, W Hartel, U B Brückner

{"title":"[Systemic release of prostanoids after surgically-induced injury of lung tissue].","authors":"F Gebhard, M Marzinzig, W Hartel, U B Brückner","doi":"","DOIUrl":"","url":null,"abstract":"In a prospective study, the systemic inflammatory consequences of surgery-induced lung tissue injury were evaluated using biochemical markers. The aim was to examine whether this type of injury produces a specific pattern of prostanoid plasma levels (prostacyclin, thromboxane, PGE2, PGF2 alpha, and PGM). We, therefore, compared 18 patients (group 1) who underwent thoracotomy without injury to the lung with 26 patients (group 2) that had a resection of pulmonary tissue due to benign diseases. Group 2 patients clearly revealed increased plasma levels of C-reactive protein as well as of the granulocyte-specific PMN-elastase. In particular, there was a pronounced release of prostacyclin and its antagonist thromboxane A2 following lung tissue resection. In contrast to group 1 patients, lung tissue damage resulted in immediately elevated plasma levels of PGF2 alpha and PGE2. When, however, taking into account the time course of PGM, the stable cleavage product of PGF2 alpha, there was no hint of an altered pulmonary metabolic capacity. Presumably, this pattern of elevated prostanoid levels in group 2 is the result of the surgical damage to the lung tissue. Therefore, it can be suggested to be specific for that type of injury. Thus, the release of prostanoids following surgery-induced lung tissue damage may indicate the importance of these mediators, particularly in thoracic injuries associated with lung damage since those may lead to post-traumatic pulmonary dysfunction. These substances may also be useful in evaluating both the severity and the extent of lung tissue damage following major trauma.","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 5","pages":"243-51"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20338475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Waiting for the crisis]. (等待危机发生)。

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01

G D Giebel, M Doehn, M Müller-Gorges, R Stuttmann

{"title":"[Waiting for the crisis].","authors":"G D Giebel, M Doehn, M Müller-Gorges, R Stuttmann","doi":"","DOIUrl":"","url":null,"abstract":"Aim of the study: Experience in daily routine reveals that most of ICU patients usually go through \"crisis\" within 14 days of admission. Only few patients need remarkable more time to get to this point and it seems there is hardly anything to be done therapeutically to change the course of it. We therefore examined a large group of ICU patients in order to find reasons for this course or to spot them as an \"entity of their own\".Methods: 1,861 ICU patients all being on IPPV for more than three days were included in the study. Every day 18 variables were taken down in a standardised way until the day IPPV was finished. We extracted 170 patients who were artificially ventilated for more than 40 days. For these patients we established mean values for each of the 18 variables during the first and the last 40 days of ventilation. In both groups we compared survivors to non-survivors.Results: Mortality was almost the same in both groups (IPPV < 40 days vs. IPPV > 40 days). Survivors and non-survivors showed remarkable differences regarding extrapulmonary factors-in terms of total fluid amount and transfusion, state of abdomen, brain, liver and kidney function and circulation problems. Pulmonary factors revealed major differences only towards the end of the observation period.Conclusions: There seems to be an \"entity of ist own\", a small population of patients who arrive at the crucial turning point later. Pulmonary complications (pneumonia, ARDS) is not the reason but the expression of cause for prolonged ventilation. The key to the extrapulmonary origin of the crisis remains unknown, the only thing we can do is alleviate its manifestations.","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 4","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20372594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Does the extent of lymph node dissection have an effect on morbidity and prognosis after resection of the head of the pancreas for ductal or periampullary pancreatic carcinoma?]. [淋巴结清扫程度对胰头切除术后导管或壶腹周围胰腺癌的发病率和预后有影响吗?]

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01

T Böttger, J Boddin, R Küchle, T Junginger

引用次数: 0

[Concealed perforated aneurysm of an aberrant right hepatic artery: papillary bleeding. Case report and review of the literature]. 隐藏的肝右动脉穿孔动脉瘤:乳头状出血。病例报告及文献回顾]。

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01

A Hoffmann, K Günther, H Rupprecht

引用次数: 0

[Angiosarcoma of the spleen. Case report and review of the literature]. 脾脏血管肉瘤。病例报告及文献回顾]。

Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01

B Geissler, R Fleischmann, T Wagner, W Wohlgemuth, F Lindemann