Model Studies on the Antioxidative Effect of Polyphenols in Thermally Treated D-Glucose/L-Alanine Solutions with Added Metal Ions.

The influence of different polyphenolic compounds (PPs) on the Maillard reaction in a d-glucose/l-alanine model system with or without metal ions was studied under various reaction conditions. At temperatures up to 100 °C the PPs showed pro-oxidative effects due to their reducing effects on metal ions. This can be explained by a combined redox cycling mechanism of metals and PPs that promotes oxidation in the Maillard reaction.

[Treatment of complications in adjacent organs in chronic pancreatitis by duodenum saving resection of the head of the pancreas].

Chronic pancreatitis frequently generates complications through involvement of adjacent organs. Distal common bile duct stenosis or segmental duodenal stenosis, the most frequent complications, are usually treated by resective or by-passing procedures. This study presents the experience with an organ and functionality sparing procedure in the treatment of chronic pancreatitis with predominant involvement of the pancreatic head and coexisting organ complications.

[Laparoscopic ligamentum teres-plasty].

Report on 40 patients suffering from a therapy resistant gastroesophageal reflux disease. Conventional ligamentum-teres-plastic was performed on 18 patients, while 22 patients were treated laparoscopically as minimal invasive procedure. Both techniques are described and the advantages of the laparoscopy versus the conventional laparotomy are explained.

Complications of adjacent organs in chronic pancreatitis managed by duodenum-preserving resection of the head of the pancreas.

Chronic pancreatitis frequently generates complications through involvement of adjacent organs. Distal common bile duct stenosis and segmental duodenal stenosis, the most frequent complications, are usually treated by resection or bypass procedures. This study presents experience with duodenum-preserving resection of the head of the pancreas in the treatment of patients with chronic pancreatitis with predominant involvement of the pancreatic head and coexisting complications involving adjacent organs.

Accuracy of computed tomographic scan and surgical assessment for staging of bronchial carcinoma. A prospective study.

There is an increasing demand for accurate preoperative and intraoperative staging of bronchial carcinoma with respect to neoadjuvant therapy protocols and parenchyma-sparing operations. This study prospectively evaluated accuracy of computed tomographic scan and surgical assessment for staging of bronchial carcinoma in 108 consecutive patients. The stage of the primary tumor (T stage) was correctly determined in 85% of the patients, and surgical evaluation correctly determined the T stage in 92%.

Is aggressive surgical palliation of proximal bile duct cancer with involvement of both main hepatic ducts worthwhile?

The only curative treatment for proximal bile duct cancer with involvement of both main hepatic ducts is liver transplantation. Most patients do not fulfill the requirements for liver transplantation. Our treatment strategy in appropriate cases is palliative tumor resection and reconstruction of the biliary passage by sutureless bilioenteric anastomosis.

Accurate diagnosis of acute appendicitis: a retrospective and prospective analysis of 686 patients.

Objective: To formulate a score system that would make the preoperative diagnosis of acute appendicitis more accurate.

Design: Retrospective then prospective study.

Setting: City University Hospital.

Establishment of a pneumococcal septicemia model in the miniature swine.

Human pneumococcal septicemia, the prominent postsplenectomy complication, was as yet difficult to study in the porcine model, since this species appeared to be fairly resistant against pneumococcal infections. We have used two strains of pneumococci (serotype 1 and 6B) both of which had been isolated from patients with systemic infection and both of which were maintained in a virulent state by regular mouse passage. After challenge with 10(9) type 1 pneumococci, however, only one of the 5 pigs developed fever, none showed profound hematological alterations and each animal exhibited a rapid clearance of bacteria from peripheral blood.

[The value of computerized tomography and of the surgical assessment for lymph node staging in bronchial carcinoma. A prospective study].

We evaluated the accuracy of computed tomography (CT) and of surgical assessment for lymph node staging prospectively in 108 patients with bronchogenic carcinoma. For CT/surgical assessment a sensitivity of 29/90%, a specificity of 93/63%, a positive predictive value of 49/39% and a negative predictive value of 85/96% were calculated on a node-by-node basis. Sensitivity and specificity of CT were highly influenced by the lymph node region studied and by typing of the tumor.

[Fibrin-coated collagen fleece in thoracic surgery. Initial clinical experience].

After resecting procedures to the parenchyma of the lung the resection site was sealed with a collagen vleece combined with fibrin glue in 26 patients. No patient exhibited rebleeding. An air leak was present up to the first postoperative day in 19 patients, up to the third postoperative day in 5 patients.

[Injuries of the pelvis and retroperitoneal organs].

About 50% of all patients with pelvic fractures present with associated injuries. Diagnostic and therapeutic guidelines follow the step-by-step regimen used in polytraumatized patients. Whereas lifesaving emergency operations are rarely necessary, most associated injuries are operated on after completion of the first diagnostic phase in order to preserve organ function.

[Studies on post-splenectomy infection and immune activation by muramyl peptide. A new concept in the prevention of severe infections].

The existence of the overwhelming postsplenectomy infection syndrome in adults after traumatic splenectomy is discussed controversially. In this study the effects of splenectomy and spleen-preserving operations on outcome of experimental pneumococcemia of the pig were analyzed. Furthermore, the effect of the monocyte activator MTP-PE was assessed.

Splenectomy does not influence outcome of pneumococcal septicemia in a porcine model.

The existence of the overwhelming postsplenectomy infection syndrome in adults after traumatic splenectomy is controversial. Due to the similarity of the porcine immune system to man we chose the pig to study subsets of peripheral mononuclear cells after splenectomy and resistance to experimental Pneumococcal infection after splenic surgery and specific immunization. Female miniature pigs were assigned to four operative groups: sham operation, splenectomy, splenic resection, and heterotopic splenic autotransplantation.

Beneficial effect of liposome-encapsulated muramyl tripeptide in experimental septicemia in a porcine model.

In a porcine model of pneumococcal septicemia, animals were pretreated with 1 mg of liposome-encapsulated muramyl tripeptide phosphatidylethanolamine (MTP-PE) or with liposomes alone. After 24 h each animal received an injection of either 10(9) or 10(10) pneumococcal serotype 6B cells. MTP-PE pretreatment resulted in less pronounced leukocytopenia, with a nadir of 6,700 (versus 4,100) leukocytes per mm3 after injection of 10(9) bacteria and a nadir of 4,400 (versus 3,800) leukocytes per mm3 after injection of 10(10) bacteria.

[Retro- and prospective studies on the value of clinical and laboratory chemical data in acute appendicitis].

In a retrospective study 536 appendicectomized patients were analyzed, in order to identify anamnestic, clinical and laboratory findings which allow the differentiation between acute and non-acute appendicitis. 150 consecutive patients were studied prospectively, which were referred to our department with a presumptive diagnosis of acute appendicitis. Eight single criteria were found, which exhibited a significantly different frequency in acute and non-acute appendicitis.

The effects of sex steroids on colon carcinogenesis.

Numerous reports on colon carcinogenesis reveal gender differences in the incidence and location of tumors. A large number of the presented studies suggest that sex-steroids have a considerable effect on tumorigenesis of the large bowel. To clarify the, so far, not fully understood mechanisms and somewhat conflicting information about the possible hormone action, it is important to discuss two points: first, the reliability of the currently used experimental animal models; and second, what is known concerning the role of sex steroids in colon carcinogenesis.

Duodenum-preserving resection of the head of the pancreas in treatment of chronic pancreatitis.

Twenty-four patients underwent duodenum-preserving resection of the head of the pancreas for chronic pancreatitis of the head. All patients were reassessed in our follow-up clinic. Comparison with partial duodenopancreatectomy showed that both procedures can alleviate the majority of symptoms.

[A combination surgical-radiological approach for the treatment of carcinoma of the hepatic duct bifurcation with involvement of both hepatic duct trunks].

The only curative treatment to proximal bile duct cancers with involvement of both hepatic ducts is liver transplantation. A curative resection with wide lateral clearance is limited due to the neighbourhood of vital anatomic structures in the liver hilum. The majority of patients with bile duct cancers is over 60 years of age and due to concomitant disease, they do not fulfill the requirements for liver transplantation.

Effects of androgen manipulations on chemically induced colonic tumours and on macroscopically normal colonic mucosa in male Sprague-Dawley rats.

Epidemiological and experimental studies suggest that androgens influence colonic carcinogenesis. We investigated the effects of hormonal manipulations (surgical and chemical castration, hormone substitution) on colonic tumour development, tumour and mucosal histopathology, and epithelial proliferation in macroscopically normal colonic mucosa in male rats, after induction of chemical colon carcinogenesis by subcutaneous injections of azoxymethane (AOM). Chemical castration with cyproterone acetate, but not surgical castration, resulted in increased colonic tumorigenesis, which was accompanied by decreased crypt length, decreased number of cells per crypt, and increased crypt epithelial mitotic index in the right colon.

[Therapeutic concept in incidentaloma of the adrenal gland].

The operative approach to adrenal incidentalomas depends on the subclinical hormoneactivity and the risk of malignancy. In our 18 patients there were two pheochromocytomas (3 and 5 diameter), one with subclinical hormoneactivity and three malignancies, an adrenocortical carcinoma, a metastasis without primary and a lymphoma. The malignant tumors were larger than 5 cm.