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1.
J Plast Reconstr Aesthet Surg ; 65(12): 1684-91, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22841770

RESUMO

BACKGROUND: Composite tissue allotransplantation (CTA) is a newly emerging field of transplantation. Immunological research in CTA has been intensified due to the recent clinical success of hand and face transplantation. Establishing immunological tolerance by adoptive transfer of ex vivo cultured tolerance-inducing cell types is of growing interest. Transplant acceptance-inducing cells (TAICs) are a type of deactivated immunoregulatory macrophages. METHODS: A total of 36 allogeneic hind limb transplantations in the rat were performed in six groups. Group A (Lewis (LW) â†’ Brown-Norway (BN)) received Lewis-donor-derived TAICs locally (i.m.). Group B (LW â†’ BN) received Lewis-donor-derived TAICs systemically (i.v.) and group C (Sprague Dawley (Sp-D) â†’ BN) served as a control group receiving Lewis-donor-derived TAICs systemically (i.v.). Groups D (LW â†’ BN), E (LW â†’ BN), and F (BN â†’ BN) also served as control groups with group D receiving no immunosuppression, group E receiving FK506 and prednisolone and group F receiving no immunosuppression with isograft transplantations (BN â†’ BN). The timing of rejection was assessed by clinical observation and histological findings. RESULTS: Rejection of the allogeneic hind limb occurred on average 7.7 days after transplantation in group A and 7.4 days in group B. Rejection was significantly delayed (Log-rank test, p < 0.01) compared to groups C and D, where rejection of the allogeneic hind limb occurred on average 5.8 days and 5.6 days after transplantation. No rejection was seen in groups E and F. CONCLUSION: For the first time, TAICs have been applied in a CTA model and demonstrated a significant immunosuppressive effect. Even though the immunomodulatory effect is relatively modest, the results of this study justify subsequent research on TAIC therapy to improve experimental and clinical outcome after CTA.


Assuntos
Membro Posterior/transplante , Macrófagos/imunologia , Transplante Homólogo/métodos , Transferência Adotiva , Animais , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Tolerância Imunológica , Terapia de Imunossupressão/métodos , Ratos , Ratos Endogâmicos Lew , Ratos Sprague-Dawley , Estatísticas não Paramétricas , Imunologia de Transplantes
2.
Zentralbl Chir ; 131(3): 230-4, 2006 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-16739064

RESUMO

OBJECTIVE: Review of the literature (Medline) based on a clinical case. CASE: A twenty one year old lady presented with a one day history of acute right sided lower abdominal pain associated with leucocytosis and the clinical signs of an acute abdomen. Sonography showed fluid coincident with cocardal formation in the right lower abdomen. Incidentally a cystic formation in projection to the caudal pancreas was seen. A CT scan confirmed a cystic mass, 5 cm in diameter. An appendectomy was performed immediately after admission. After an interval of ten days an upper laparotomy leading to a left sided resection of the pancreas was performed. Histological findings showed a solid-pseudo-papillary tumor of the pancreas without any signs of metastatic spreading. Four years after the operation the patient is subjectively well and shows no signs of diabetes or of insufficiency of the exocrine pancreas nor of any recurrence. -- Characteristic findings in solid-pseudo-papillary pancreatic tumors (SPPT) are remarkable size at the time of diagnosis, low risk of malignancy, predominance in young female (10 female symbol : 1 male symbol, M = 27 a), association with oral anticonceptive drugs and mostly incidentally detection. Usually the definitive diagnosis is only found after complete radical resection which in 95 % of cases is curative. CONCLUSION: Abdominal sonography should be performed very thoroughly in any diagnostic query even if, clinically, the diagnosis seems to be obvious.


Assuntos
Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Achados Incidentais , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/cirurgia , Adulto , Apendicectomia , Carcinoma Papilar/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pâncreas/patologia , Pancreatectomia , Neoplasias Pancreáticas/patologia , Reoperação , Esplenectomia , Ultrassonografia
3.
Dtsch Med Wochenschr ; 129(39): 2032-4, 2004 Sep 24.
Artigo em Alemão | MEDLINE | ID: mdl-15386205

RESUMO

HISTORY AND ADMISSION FINDINGS: An 86-year-old patient presented to our clinic with increasing redness and swelling of the right scrotum and inguinal lymphadenopathy. Five and a half years before admission carcinoma of the bladder (pT1,G2) had been diagnosed and was treated with several transurethral endoscopic resections as well as repeated instillations of Bacille Calmette-Guérin (BCG) into the bladder. INVESTIGATIONS: Orchiectomy on the right side was performed. Histological analysis revealed a granulomatous inflammation consistent with a mycobacteriosis. Mycobacterium bovis BCG could be isolated from several sputum and urine specimens of the patient. DIAGNOSIS, TREATMENT AND COURSE: Tuberculostatic therapy was started soon after surgery. After seven weeks of treatment no more mycobacteria could be detected in sputum and urine control specimens. At a follow up after twelve months there was no evidence of recurrent disease. CONCLUSION: We describe the late manifestation of a BCG infection including the lungs and the urogenital tract. This is a rare complication with potentially serious consequences and requires rapid diagnosis and urgent treatment by a multidisciplinary team.


Assuntos
Abscesso/etiologia , Vacina BCG/efeitos adversos , Doenças Linfáticas/etiologia , Mycobacterium bovis/isolamento & purificação , Doenças Testiculares/etiologia , Tuberculose dos Genitais Masculinos/etiologia , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Vacina BCG/administração & dosagem , Bacteriúria/microbiologia , Virilha , Humanos , Linfonodos/patologia , Doenças Linfáticas/tratamento farmacológico , Doenças Linfáticas/cirurgia , Masculino , Orquiectomia , Escarro/microbiologia , Doenças Testiculares/tratamento farmacológico , Doenças Testiculares/cirurgia , Testículo/microbiologia , Testículo/patologia , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Tuberculose dos Genitais Masculinos/cirurgia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/etiologia , Neoplasias da Bexiga Urinária/terapia
4.
Z Gastroenterol ; 41(2): 171-4, 2003 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-12592598

RESUMO

Wireless capsule endoscopy is a new diagnostic procedure to detect diseases of the small bowel, in particular in patients with obscure gastrointestinal bleeding. We report on a 76-year-old patient who presented at our hospital with signs of gastrointestinal bleeding and hypochromic anaemia. Bidirectional endoscopy, push enteroscopy, angiography as well as small bowel barium enema rendered no pathologic findings. Wireless capsule endoscopy demonstrated a polypous space in the cantral area of the small bowel. Subsequent intraoperative endoscopy revealed a subtotal stenosing tumour of the upper jejunum which was resected. Based on the histology a high-grade B-Cell lymphoma was diagnosed. The postoperative staging examinations did not indicate any further extranodal involvement.


Assuntos
Anemia Ferropriva/etiologia , Endoscópios Gastrointestinais , Hemorragia Gastrointestinal/etiologia , Pólipos Intestinais/diagnóstico , Neoplasias do Jejuno/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma não Hodgkin/diagnóstico , Idoso , Cápsulas , Desenho de Equipamento , Humanos , Mucosa Intestinal/patologia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/patologia , Pólipos Intestinais/patologia , Neoplasias do Jejuno/patologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma não Hodgkin/patologia , Masculino
5.
Knee Surg Sports Traumatol Arthrosc ; 9(5): 272-81, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11685358

RESUMO

Two studies were carried out after anterior cruciate ligament (ACL) reconstruction to determine the effect of a knee brace on coordination (test 1) and electromyographic muscle activity in drop jumps (test 2). Test 1 studied 25 patients with ACL reconstruction under three test conditions (one-leg static, two-legged static, two-legged dynamic) compared with a control (n=30). The results showed highly significant improvements in all braced conditions. In test 2 ten patients with ACL reconstruction and ten healthy subjects performed a two-legged drop-jump; this was repeated 15 times and again 15 times with a knee brace worn on the reconstructed limb. Changes in electromyographically determined muscle activity (vastus medialis, vastus lateralis, biceps femoris, gastrocnemius) were observed, but they were significant in only few cases because of high variability. Drop-jumps with knee brace improved jumping height, increased the maximum knee angle in the ground contact phase, and reduced the maximum knee angle in the landing phase. Patients thus develop an increased confidence in the stability of their knees. We conclude that the benefits of the knee brace are due to the mechanical action, an enhanced coordination, and a psychological effect.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Braquetes , Traumatismos do Joelho/fisiopatologia , Articulação do Joelho/fisiopatologia , Músculo Esquelético/fisiopatologia , Adulto , Lesões do Ligamento Cruzado Anterior , Fenômenos Biomecânicos , Eletromiografia , Humanos , Traumatismos do Joelho/cirurgia , Período Pós-Operatório
6.
Sportverletz Sportschaden ; 15(1): 16-21, 2001 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-11338659

RESUMO

In 25 test persons with Anterior-Cruciate-Ligament (ACL)-Operation the sensomotory capabilities of the affected and the unaffected side were examined by KAT 2000 (BREG Inc., Vista, C.A., USA) with and without knee-brace (Hypex knee-brace/Fa. Aircast-Europa GmbH). The results were compared with those of a control group. In all cases of test variations (both leg-static/both leg-dynamic/one leg-static) there were significant differences between testing with and without knee brace. In the one leg-static test there was an improvement of 30% (p < 0.01), in the both leg-static test an improvement of 24% (p < 0.01). The both leg-dynamic showed a similar result (23.8%; p < 0.01). These noticed adaptations may be mediated by improvements of proprioceptive and exteroceptive capabilities and a positive impact on the anticipative control of behavior. The results of the control group differ in only a few cases from the results in the group of patients. This may be judged as indicator for the variety of sensomotory capabilities in the general population.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Braquetes , Articulação do Joelho/fisiologia , Propriocepção , Desempenho Psicomotor , Adaptação Fisiológica , Adulto , Feminino , Humanos , Cinestesia , Perna (Membro)/fisiologia , Masculino
7.
Endoscopy ; 32(7): 546-8, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10917189

RESUMO

On colonoscopy, the macroscopic aspect of a lesion is an important criterion for the differential diagnosis. We present a case of an apparently malignant tumor in the sigmoid. Histological investigation failed to support the diagnosis made from the gross appearance seen on colonoscopy. After surgical resection, the lesion turned out to be a reactive pseudotumor caused by fibroepithelial hyperplasia related to a severe diverticulitis with perforation of the intestinal wall.


Assuntos
Colonoscopia , Doença Diverticular do Colo/diagnóstico , Granuloma de Células Plasmáticas/diagnóstico , Perfuração Intestinal/diagnóstico , Doenças do Colo Sigmoide/diagnóstico , Neoplasias do Colo Sigmoide/diagnóstico , Idoso , Colo Sigmoide/patologia , Diagnóstico Diferencial , Doença Diverticular do Colo/patologia , Epitélio/patologia , Granuloma de Células Plasmáticas/patologia , Humanos , Hiperplasia , Perfuração Intestinal/patologia , Masculino , Doenças do Colo Sigmoide/patologia , Neoplasias do Colo Sigmoide/patologia
8.
Sportverletz Sportschaden ; 14(1): 12-9, 2000 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-10859789

RESUMO

Many studies have shown that ACL-surgery leads to a decrease of proprioception abilities. In spite of the resulting high importance of coordinative exercise, there is nothing like a phase specific concept for coordinative training after ACL-operations going along with rehabilitation. Following a model, including all coordinative abilities, and a current after-care concept of ACL-surgery, the presented method is based on different categories of coordinative demands.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Traumatismos em Atletas/reabilitação , Terapia por Exercício/métodos , Traumatismos do Joelho/reabilitação , Traumatismos em Atletas/cirurgia , Fenômenos Biomecânicos , Humanos , Traumatismos do Joelho/cirurgia , Modelos Teóricos , Debilidade Muscular/reabilitação , Equilíbrio Postural , Propriocepção
9.
Ned Tijdschr Geneeskd ; 139(48): 2487-91, 1995 Dec 02.
Artigo em Holandês | MEDLINE | ID: mdl-8532085

RESUMO

OBJECTIVE: To determine whether increased alertness regarding multiple pulmonary embolism in geriatric patients increases the number of cases diagnosed. DESIGN: Retrospective descriptive study. SETTING: Dutch nursing homes Mariënhaven (psychogeriatric) in Warmond and De Wilbert (somatic and psychogeriatric) in Katwijk aan den Rijn, the Netherlands. METHOD: In the period 1989-1991, the diagnosis of multiple pulmonary embolism was suspected in 15 patients with an 'unclear' or 'aspecific' complex of symptoms, who subsequently underwent ventilation perfusion scintigraphy. RESULTS: In 11/15 patients the diagnosis of multiple pulmonary embolism was confirmed. These patients were treated with anticoagulants resulting in complete recovery in 9 patients. Aspecific symptoms suggestive of pulmonary embolism include subfebrile temperature, respiratory and sensory disturbances and a clinical picture mimicking airway infection. If lung scintigraphy is only performed if a positive diagnosis will have the therapeutical consequences for the patients concerned, and assuming that refraining from treatment would lead to death, it was calculated that on a yearly basis mortality in subjects in nursing homes could be reduced by more than 2% when appropriate diagnosis is made and treatment given. Comparison of the data from SIG Health Information (Utrecht) with the present results suggests that the prevalence of (multiple) pulmonary embolism in the Dutch nursing homes is insufficiently recognized. CONCLUSION: More alertness regarding multiple pulmonary embolism in nursing home patients will establish the diagnosis more frequently and proper treatment of this condition will lead to a decrease in mortality.


Assuntos
Embolia Pulmonar/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Casas de Saúde , Pneumonia/diagnóstico , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/tratamento farmacológico , Cintilografia , Estudos Retrospectivos , Relação Ventilação-Perfusão
10.
Hum Reprod ; 10(2): 470-4, 1995 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7769081

RESUMO

Cumulative pregnancy rates and pregnancy outcome analysis are useful methods for advising an infertile couple of the probability of in-vitro fertilization (IVF) success. All 5209 IVF cycles in 2391 couples at University Hospital, London, Ontario, Canada, over 10 years were studied. Cumulative pregnancy rates were estimated using life table analysis. The Cox proportional hazards model was used to estimate the influence of covariates. Oocyte retrieval and embryo transfer were achieved in 84 and 64% of cycles initiated respectively. There were 644 intra-uterine and 24 ectopic pregnancies (13%/cycle initiated, 15%/oocyte retrieval and 20%/embryo transfer). Cumulative pregnancy rates following six cycles were: tubal 55%, idiopathic 65%, endometriosis 60%, multifactorial 63% and male 40%. There were 68 spontaneous abortions (10.6%) and three induced abortions for congenital anomalies. The multiple gestation rate was 22%. Caesarean section and preterm delivery rates were 35 and 20% respectively, due in part to the high proportion of multiple gestations. Of 15 deliveries which resulted in stillbirths and/or neonatal deaths, 12 were multiple gestations; 18 pregnancies (3.3%) were complicated by congenital malformations. No increases in congenital malformations or spontaneous abortions were identified. Cumulative pregnancy rates were lower in cases of male infertility. Success rates did not decline with successive IVF cycles. IVF is an evolving infertility treatment.


Assuntos
Fertilização in vitro , Resultado da Gravidez , Gravidez , Coeficiente de Natalidade , Cesárea , Transferência Embrionária , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Gravidez Múltipla , Modelos de Riscos Proporcionais
11.
Behav Res Ther ; 31(1): 25-35, 1993 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8417725

RESUMO

Up to now, no experimental studies have inquired into the possible role of performance demand in female sexuality. The objective of this study is to investigate the effects of performance demand on sexual arousal in functional women, using explicit instructions. Forty-eight female subjects were asked to respond with maximum sexual arousal within 2 min, both during sexual fantasy and while watching an erotic film excerpt. Photoplethysmographic pulse amplitude was continuously recorded and self-report ratings of sexual arousal and affective reactions were collected after each erotic condition. Subjects were also instructed to continuously indicate their subjective sexual excitement during the conditions by means of a lever. Performance demand resulted in higher genital responses and was most effective in the fantasy condition. These results corroborate the findings for functional men. Although for both measures of subjective experience of sexual arousal performance demand yielded significantly higher ratings, this was conditioned by the order in which subjects were exposed to conditions. Women who masturbate with a mean frequency of 4 times a month reported higher subjective sexual arousal during performance demand conditions as compared with women who masturbate substantially more or who do not masturbate. Genital vasocogestion did not differ between masturbation-groups. Continuous subjective monitoring yielded lower correlations with vasocongestion than discrete ratings of sexual arousal and appears to be more sensitive to order effects.


Assuntos
Atenção , Fantasia , Medo , Libido , Comportamento Sexual , Adulto , Nível de Alerta , Conscientização , Feminino , Humanos , Masturbação/psicologia
12.
J Clin Pathol ; 28(1): 29-32, 1975 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1123436

RESUMO

During investigations of the microbial flora of the skin over haemodialysis shunt sites it has not proved possible to predict clinical infection by a preceding colonization of the shunt site with a pathogenic organism. The normal non-pathogenic flora of the sites is not specifically related to the flora of other sites on the body though Staphylococcus aureus on a shunt site appeared to be acquired principally from the nose when the shunt was in the arm or from the perineum when the shunt was in the leg. Cimino shunt sites had a greater density of organisms than did Scribner shunt sites; this may be related to the disinfection procedures.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Diálise Renal , Infecção da Ferida Cirúrgica/microbiologia , Ágar , Braço/microbiologia , Enterobacteriaceae/isolamento & purificação , Feminino , Humanos , Klebsiella/isolamento & purificação , Perna (Membro)/microbiologia , Masculino , Nariz/microbiologia , Períneo/microbiologia , Pele/microbiologia , Staphylococcus/isolamento & purificação
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