Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine.

Objective: Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations.

Methods: Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( = 12).

Hyperhomocysteinemia and the risk for vascular disease in hemodialysis patients.

The objective of this study was to examine if hyperhomocysteinemia is associated with occlusive vascular disease in hemodialysis patients. The study design included risk factor analysis and determination of serum homocysteine in hemodialysis patients. Fifty chronic uremic patients on regular hemodialysis treatment were studied.

A new central supply system as alternative source for bicarbonate dialysate.

Bicarbonate dialysis is mandatory for high efficiency treatment. In most cases bicarbonate is delivered either as prepacked powder or as a stable liquid concentrate in 6-10 I plastic containers. With a newly designed central supply system (CSS) using 800 I tanks of custom-made sterile and pyrogen free concentrates, we investigated the risk of bacterial contamination of dialysate in a 30-bed dialysis unit.

[Parathyroid sonography in long-term dialysis].

In a prospective study the prevalence of sonographically enlarged parathyroid glands in patients on maintenance hemodialysis was investigated and correlated with clinical and laboratory findings of secondary hyperparathyroidism. We examined 97 unselected patients with a 5 MHz probe. In 34% (33/97) a total of 69 parathyroid glands were detected with a statistically significant correlation between the period of dialysis and the incidence of parathyroid enlargement; 47.

Blood pressure elevation during the night in chronic renal failure, hemodialysis and after renal transplantation.

Diurnal blood pressure variation was studied by ambulatory 24-hour monitoring in patients with advanced chronic renal failure (n = 20), on chronic hemodialysis (n = 20), after renal transplantation (n = 21) and in matched control groups without renal disease. Nocturnal blood pressure reductions were significantly blunted in all patient groups as compared with the respective control groups. In almost none of the 61 controls did the mean values during nighttime (8 p.

[Long-term results following kidney transplantation. An empirical analysis of 467 allogeneic kidney transplants concerning the effect of clinical and immunological variables on graft function].

In a homogeneous group of 467 cadaver kidney transplants performed within one single center between 1979 and 1987, we analysed the influence of main risk factors on long-term survival up to 72 months. Calculating survival rates by Kaplan-Meier actuarial methods the overall graft survival exceeded 71%. The corresponding patient survival was higher than 90%.

[Incidence of conjunctival and corneal changes in dialysis patients].

Deposits of calcium salts in the conjunctivas and corneas of 72 patients showed a statistically significant correlation to the duration of hemodialysis. The deposition of calcium salts is not influenced by other signs of disturbed calcium metabolism (Ca-PO4 product, alkalic phosphatase) or the patient's age.

How to detect bacterial contamination prior to transplantation.

The mortality of kidney transplantation generally amounts to 10% due to infections and GIT complications. Once grafting a Staphylococcus aureus and Streptococcus contaminated kidney the recipient had to undergo emergency surgery four times. Hence it has become our routine to sample the perfusate on blood culture media.

[Glomerular proteinuria in pregnancy hypertension].

In view of the lack of reliable diagnostic parameters for predicting pregnancy-induced hypertension (PIH) the aim of this study was to test the prognostic value of electrophoretic urinary protein patterns. Based on experience with this method in nephrology, molecular weight related polyacrylamide-gel-electrophoresis (PAGE) of urinary proteins was used to distinguish between the different kinds of renal lesions (glomerular, tubular, combination, extrarenal). The analysis was carried out in two independent groups: urines of 126 non-selected pregnant women (1st group) were analysed at regular intervals.

[In vitro studies of cells in histiocytosis X].

In a female patient with histiologically ensured histiocytosis X, cell cultures modified according to NEZELOF were performed in methylcellulosis and Eagle's medium. From the 5th to the 15th day of incubation the cells were daily observed natively through a normal microscope and taken for histochemical examinations and for checking their capacity of phagocytosis. Two cell types could be distinguished: spindle-shaped fibroblasts as well as round cells of changing form and size, the alpha-naphthylacetate esterase response of which proved to be positive.

[Isolation and characterisation of two main metabolites of ifosfamide from human urine (author's transl)].

Two main metabolites of the cytostatic agent 1,3,2-oxazaphosphorine-3(2-chloroethyl)-2-[(2-chloroethyl)-amino]-tetrahydro-2-oxide (ifosfamidd as two different dechloroethylated derivatives. They both can also be derived from ifosfamide in vitro by means of KMnO4-oxidation. The metabolites are stable in organic solutions and they show no cytotoxic activity in biological test systems.

Side chain oxidation of ifosfamide in man.

Ifosfamide as well as its stable alkylating metabolites namely carboxy-Ifosfamide and two dechloroethylated compounds were determined in the urine of a patient with progredient lung carcinoma who had been treated with 6 g of the drug. Quantitative measurements were carried out using a colorimetric procedure which consists of TL-spectrophotometric determinations on sheets which had previously been sprayed with 4-pyridinaldehyde-2-benzothiazolylhydrazone. In the case investigated the Ifosfamide was found to have been converted largely into two dechloroethylated compounds (48%) and only a small portion of carboxy-Ifosfamide (2.

Instantaneous intensity distribution in a focused laser beam at 0.63 microm and 10.6microm propagating through the atmosphere.

Experimental results from investigations of instantaneous intensity distributions in focused laser beams at 0.63 microm and 10.6 microm at a distance of approximately 5 km are presented and discussed.

[Quantitative determination of cyclophosphamide, ifosfamide, and trofosfamide and their stable metabolites on TLC-plates with the aid of 4-pyridine-aldehyde-2-benzothiazolyl-hydrazone (PBH) (author's transl)].

Cyclophosphamide, ifosfamide, and trofosfamide can be analysed quantitatively together with their stable alkylating urine metabolites on TL-plates by means of the PBH-reagent (4-pyridine-aldehyde-2-benzothiazolyl-hydrazone). The method requires only 0.01 ml urine, but a careful standardisation is necessary by using reference substances.