Surgical management of major pancreatic injury in children.     

J Snajdauf  M Rygl  J Kalousová  A Kucera  O Petr?  K Pycha  V Mixa  R Keil  Z Hríbal 《Zeitschrift für Kinderchirurgie》2007,17(5):317-321

INTRODUCTION: Major or complicated pancreatic trauma in children is uncommon and management strategies remain controversial. The aim of this study was to evaluate our experience with both early and delayed surgery in these pediatric cases. METHODS: We carried out a retrospective analysis of data of pediatric patients with major or complicated pancreatic injury operated on between January 1994 and December 2005 in our pediatric trauma center. RESULTS: Thirteen children (9 boys and 4 girls) with a mean age of 8.5 years (range 3 - 16 years) were operated for major or complicated pancreatic injury. The extent of injury was: grade II (major contusion without duct injury or tissue loss) in 4 children; grade III (distal transection) in 5 children and grade IV injury (proximal transection) in four patients. Pseudocyst developed in 8 children: 4 with grade II injury, 2 with grade III injury and 2 with grade IV injury (one with abdominal pseudocyst and one with an abdominal and a mediastinal pseudocyst). Early diagnosis and operation was achieved in 5 cases, while delayed diagnosis and operation occurred in 8. Three children underwent cystogastrostomy; 6 had a spleen-sparing distal pancreatectomy and 4 had resection with Roux-en-Y jejunostomy drainage. Endoscopic retrograde cholangiopancreaticography (ERCP) was the most useful diagnostic tool in assessing ductal injury. There were no deaths or long-term morbidity in our group of patients. CONCLUSIONS: Our results support the view that early operation is important in ductal pancreatic injury. We recommend transferring children with a suspected ductal injury to a tertiary center with experience in both pediatric ERCP and pancreatic surgery.  相似文献   

Thyroid diseases in advanced age     

H Schambach  I Keil  D Gottschild 《Zeitschrift für die gesamte innere Medizin und ihre Grenzgebiete》1988,43(6):156-159

Nearly all diseases of the thyroid, such as nodular goitre, thyroid carcinoma, non-immunogenic hyperthyroidism and idiopathic hypothyroidism, exhibit an increase in frequency with age. Their recognition is rendered more difficult by the often oligosymptomatic, ambiguous clinical picture, but it is the timely treatment that is of particular prognostic importance to an organism weakened due to polymorbidity. In all hard nodular alterations, a malignoma must be ruled out by sonography, scintigraphy and cytopuncture. In all iodine-deficient regions such as the GDR, a frequent occurrence of thyroid autonomy with manifestation of hyperthyroidism following iodine contamination has to be taken into account. Hypothyroidism is often misinterpreted as age-related changes. By employing adequately modern in vitro methods and imaging procedures it will be possible to further improve diagnosis and prognosis of the thyreopathy in the old age ranges.  相似文献   

Central effects of aldosterone infused into the rat subcommissural organ region     

R L Dundore  J N Wurpel  C D Balaban  L C Keil  W B Severs 《Neuroscience research》1984,1(5):341-351

D-Aldosterone (5 ng/microliter/h) was infused for 6 days into the region of the subcommissural organ (SCO) of conscious, adult male Sprague-Dawley rats. Aldosterone increased urinary sodium loss and the sodium/potassium ratio. Although probably central in origin, these effects still occurred when cannulae were displaced up to 1 mm from the targeted SCO placement. Aldosterone decreased adrenal medullary cross-sectional area without affecting cell density. This effect was highly dependent on proper cannula placement and was not observed when the cannula tip was not in contact with the cerebrospinal fluid of the pineal recess over the rostral two-thirds of the SCO. We conclude that aldosterone increases sodium excretion by an action in the SCO and/or adjacent structures. We also postulate a negative trophic relationship between mineralocorticoids and the adrenal medulla mediated by the SCO.  相似文献   

Papierelektrophoretische Untersuchungen über die löslichen Proteine des Nervus obturatorius des Rindes     

A. W. Keil 《Pflügers Archiv : European journal of physiology》1954,259(2):146-151

Zusammenfassung 1. Die Papierelektrophorese alkalischer Extrakte des N. obturatorius vom Rind führt zur Trennung in 4 Komponenten.2. Nach Abtrennung einer elektrophoretisch einheitlichen globulinartigen Fraktion finden sich noch 4 Komponenten, jedoch ist diejenige Bande des Elektropherogrammes, die der am langsamsten wandernden Proteinkomponente entspricht, weniger stark ausgeprägt als bei der Papierelektrophorese der Gesamtextrakte.Mit 4 Textabbildungen.  相似文献   

Effect of theophylline on ischemically induced hippocampal damage in Mongolian gerbils: a behavioral and histopathological study   总被引：8，自引：0，他引：8  

K A Rudolphi  M Keil  H J Hinze 《Journal of cerebral blood flow and metabolism》1987,7(1):74-81

We investigated the influence of the adenosine antagonist theophylline on the degree of hippocampal cell damage in the Mongolian gerbil following brief periods of forebrain ischemia. Male gerbils were randomly divided into nine groups. Ten minutes before surgery, four groups, which were later subjected to 1, 2, 3, or 5 min of bilateral carotid occlusion under halothane anesthesia, received theophylline (30 mg/kg, p.o.). Four groups served as nontreated ischemic controls; the ninth group was used to measure theophylline serum concentration. Neurological symptoms were classified by using a behavioral score. Fourteen days after ischemia, the brains were removed, and the hippocampus was histologically examined "blind" for the degree of cell damage in the CA1 sector, which was expressed as a semiquantitative histopathological score. There were no behavioral or histological abnormalities in either the control or theophylline group with 1 min of ischemia. With increasing duration of ischemia, the neurological symptoms worsened and the number of necrotic pyramidal cells increased significantly. The pretreatment with theophylline only moderately aggravated the neurological symptoms, whereas it enhanced the ischemic cell damage significantly. The results are discussed with respect to recent findings that theophylline may block putatively protective effects of endogenous adenosine, whose concentration in the brain is known to rise significantly during ischemia.  相似文献   

Is the Gauer-Henry reflex important for immersion diuresis in men?   总被引：4，自引：0，他引：4  

Greenleaf JE  Shiraki K  Sagawa S  Miki K  Wada F  Nagaya K  Torii R  Keil LC 《Aviation, space, and environmental medicine》1999,70(12):1201-1205

BACKGROUND: This study examines the relationship between the threshold for plasma vasopressin concentration [PVP] responses and diuresis (Gauer-Henry reflex), and tests the hypothesis that water intake would not influence diuresis. METHODS: Eight men (19-25 yr) underwent four treatments: euhydration in air (Eu-air), euhydration in water immersion (Eu-H2O), and with prior 3.6% hypohydration in air (Hypo-air), and hypohydration in immersion (Hypo-H2O). Ad libitum drinking was allowed during the 3-h experimental and 1-h recovery periods. RESULTS: Drinking was greatest during the first 10 min: 3.5 ml x kg(-1) with Hypo-air (450 ml x 3 h(-1)) and only 1.7 ml x kg(-1) (p < 0.05) with Hypo-H2O (235 ml x 3 h(-1)). At 1 h, concomitant [PVP] decreased from a control level of 6.6+/-1.5 to 4.0+/-1 .0 pg x ml(-1) (delta = 2.6 pg x ml(-1), p < 0.05) with Hypo-air, and from 5.9+/-0.6 to 2.3+/-0.2 pg x ml(-1) (delta = 3.6 pg x ml(-1), p < 0.05) with Hypo-H2O. Urine flow was unchanged from control level (<1.0 ml x min(-1)) with Hypo-air, Hypo-H2O, and Eu-air, but increased to 4-5 ml x min(-1) with Eu-H2O. Neither water intake volume nor urine flow was related to the magnitude of [PVP] depression. Regression of Uosm/Posm ratio on [PVP] and urine flow indicated that [PVP] above 2 pg x ml(-1) did not affect urine flow. Thus, ad libitum water intake in previously hypohydrated subjects did not affect urine flow or the decrease in [PVP]. The threshold [PVP] to initiate significant diuresis was about 2 pg x ml(-1), and significant diuresis can occur with no change in [PVP] maintained at about 1 pg x ml(-1) during immersion in euhydrated subjects. CONCLUSIONS: Thus, it appears that the Gauer-Henry reflex is not the major mechanism for immersion-induced diuresis. Clearly, other diuretic factors are also involved.  相似文献   

"Agenda for change"     

Keil OR 《Journal of clinical engineering》1993,18(4):296, 298

  相似文献   

Glutamic acid concentration in human semen--its origin and significance   总被引：1，自引：0，他引：1  

M Keil  U Wetterauer  H J Heite 《Andrologia》1979,11(5):385-391

Glutamic acid content of semen was determined photometrically in over 400 semen specimens. Glutamatic acid content was found to increase proportionately to temperature in the first few hours post ejaculation. The glutamate estimation should therefore be performed on semen at 30 min. after ejaculation. The frequency distribution of glutamic acid concentration with 400 unselected specimens, 50 "normozoospermias" as well as 42 azoospermias is shown. The mean value of normozoospermias was 10.6 mg% (+/- 4.6 mg%) that of azoospermias 7.7 mg% (+/- 4.7 mg%). There was no correlation found between glutamic acid content and pH value. A correlation however, was demonstrated between glutamic acid and following: sperm count, citrate concentration, gamma-GT and carnitine. No correlation to fructose content was detectable. That suggests that glutamate gets to the ejaculate with the secretions from the prostate gland and epididymis whereas the seminal vesicles do not play a role in the level in the total semen.  相似文献   

Prevalence and risk factors of RLS in an elderly population: the MEMO study. Memory and Morbidity in Augsburg Elderly   总被引：16，自引：0，他引：16  

Rothdach AJ  Trenkwalder C  Haberstock J  Keil U  Berger K 《Neurology》2000,54(5):1064-1068

OBJECTIVE: To evaluate prevalence, sociodemographic characteristics, and risk factors of restless legs syndrome (RLS) in a population-based survey of the elderly, using standard diagnostic criteria. BACKGROUND: Population-based studies of RLS are rare and have not yet used standard definition criteria. METHODS: The Memory and Morbidity in Augsburg Elderly (MEMO) Study is a follow-up project of the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Survey-Augsburg, Germany, 1989-1990, evaluating neurologic diseases and their risk factors in a German population 65 to 83 years of age. Two RLS-trained physicians assessed the prevalence of RLS based on the four minimal standard criteria (International Restless Legs Syndrome Study Group, 1995) using standardized questions in face-to-face interviews. They also obtained information on medical history, medications, depression (Center of Epidemiologic Studies Depression Scale), and quality of life (Short Form 36) and performed a standardized neurologic examination for each participant. RESULTS: The study population included 369 participants (173 women and 196 men). The overall prevalence of RLS was 9.8% (n = 36) and higher in women (13.9% versus 6.1%; p = 0.02). In women, the prevalence did not change with age, whereas men showed a nonsignificant inverse trend with increasing age. RLS-positive individuals took more benzodiazepines and estrogen compared with non-RLS cases, but the differences were not statistically significant. Participants with RLS had higher incidence of depression (p = 0.012) and lower self-reported mental health scores (p = 0.029) than did non-RLS cases. CONCLUSIONS: RLS is a frequent syndrome in the elderly with considerable impact on self-perceived mental health, affecting women about twice as often as men.  相似文献   

Surgical treatment of complications associated with the Angio-Seal vascular closure device     

Cikirikcioglu M  Cherian S  Keil V  Manzano N  Gemayel G  Theologou T  Kalangos A 《Annals of vascular surgery》2011,25(4):557-557.e4

Vascular closure devices are used to provide quick hemostasis and early ambulation after percutaneous interventions. The Angio-Seal (AS) vascular closure device forms a mechanical seal by closing the puncture site located between a bioabsorbable anchor within the lumen and a collagen sponge on the adventitia. Although morbidities associated with AS are reportedly infrequent, even the slightest inaccuracy in device implantation may result in displacement of these device components, leading to sudden and severe complications. We report the surgical treatment of complications associated with the use of AS in four patients, including acute limb ischemia, pseudoaneurysm formation, significant hemorrhage, and hypovolemic shock. A common factor in all these cases was that the components of the AS device were displaced from their original site of implantation, stressing the importance of proper device placement. All patients underwent successful surgical vascular repair. Our report highlights the need for exercising extreme care during device implantation, and also the requirement for vigilant inspection for any associated vascular complications commencing immediately after device implantation. It is vital that these device components are actively looked for and removed during surgical exploration so as to prevent future complications.  相似文献