Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Tumor necrosis factor-alpha (TNF-alpha) gene polymorphism in surgical intensive care patients with SIRS].
Biallelic polymorphism in the promotor region of the TNF-alpha gene have been associated with variation in TNF-alpha production. We determined the TNFA polymorphism (position--308) and related these data to plasma cytokine levels of TNF alpha, IL6, IL6R and IL8 in patients with SIRS and sepsis. Although there seems to be a different cytokine secretion pattern for both allelic groups (TNFA1 and TNFA2), a clear risk group could not be determined. It still remains unclear whether there is a genetic factor that influences the development of sepsis and multi organ failure.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Video-assisted thoracoscopy for effective palliation of malignant pleural effusion. Pleurodesis--pleuroperitoneal shunt].
Dyspnea and reduced physical capability mean a significant reduction in quality of life of patients with advanced tumor disease. Video-assisted thoracoscopic talc poudrage or alternatively placement of pleuroperitoneal shunts were retrospectively evaluated as procedures for definitive palliation.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Ambulatory co-disciplinary risk-adjusted preoperative care].
Routine preoperative studies in asymptomatic patients are not helpful for perioperative risk evaluation, and the cost is considerable. The decision regarding the status of a patient for elective surgery can be accurately predicted in 95% of cases on the basis of a complete history and physical examination alone; selective testing should be preferred. Interdisciplinary outpatient premedication is suitable for an individual risk evaluation, and a significant reduction in cost and inpatient treatment.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Minimal invasive, percutaneous ventriculostomy in therapy of severe craniocerebral trauma].
From May 1996 until April 1997 percutaneous CT-controlled ventriculostomy (PCV) was performed in 19 patients with severe traumatic brain injury and no indication for decompressive craniotomy. There was a significant reduction in the duration of the procedure compared to burr-hole ventriculostomy with no complications. Because of further advantage of PCV CT-controlling is the possibility of puncturing even very narrow ventricles.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Systemic effect of extremity-ischemia reperfusion surgical trauma. Assessment of tourniquet ischemia induced activation of poplymorphonuclear neutrophic granulocytes].
Ischemia-reperfusion-injury represents a fundamental common pathway of tissue damage in a wide variety of disease processes, i.e. myocardial infarction, septic or hemorrhagic shock, multiple organ failure, trauma and organ transplantation. Ischemia-reperfusion-injury is said to be initiated by leukocyte accumulation and adhesion to vascular endothelium as well as oxygen free radicals playing a pivotal role in the pathogenesis of ischemia-reperfusion-injury. However, only few data exist for measuring influence of tourniquet-ischemia on the activation of granulocytes in humans. ⋯ The tourniquet-ischemia of the upper limb without any operation (n = 10) induced an increase of the CD 11b-expression too (systemic, 149 +/- 76% and local 131 +/- 90%, both: p < 0.05 vs. bl). Furthermore there was a spontaneous release of free radical oxygen to 129.2 +/- 26.2% (systemic) und 154.8 +/- 35.9% (local: p < 0.01 vs. bl:) After stimulation by Phorbol-Myristat-Acetat (PMA) we demonstrated a decrease to 67.6 +/- 23.2% (systemic, p < 0.01 vs. bl) and to 68.3 +/- 15.6% (local, p < 0.01 vs. bl). These results indicate that ischemia-reperfusion-injury in humans induces a early measurable local and systemic activation of circulating PMN-granulocytes.