126
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Deltz E, Schroeder P, Schweizer E, Gundlach M, Gebhardt H, Hansmann ML. [Small intestine transplantation--a causal therapy in short bowel syndrome]. SCHWEIZERISCHE RUNDSCHAU FUR MEDIZIN PRAXIS = REVUE SUISSE DE MEDECINE PRAXIS 1990; 79:1586-8. [PMID: 2270384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The problems of surgical technique, graft physiology and immunological reactions in small-bowel transplantation have been investigated in extended animal experiments. In these experiments, the fundamentals of a successful clinical application of small-bowel transplantation could be laid. A successful human small-bowel transplantation could be carried out by the Kiel Group for the first time in 1988. A graft which had been removed from a related donor showed a complete adaptation after 22 months, so that the patient became completely independent from parenteral nutrition. After that, in several cases small-bowel and combined liver and small-bowel transplantation have been carried out. Thus, the clinical small-bowel transplantation represents the causal therapy of short-bowel syndrome and should be developed in further clinical trials.
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127
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Deltz E, Schroeder P, Gundlach M, Hansmann ML, Leimenstoll G. Successful clinical small-bowel transplantation. Transplant Proc 1990; 22:2501. [PMID: 2264126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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128
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Schindler R, Gundlach M, Dörner K, Siemer HW, Schroeder P, Deltz E. Effect of orthotopic small-bowel transplantation on vitamin A and zinc metabolism. Transplant Proc 1990; 22:2453. [PMID: 2264103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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129
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Hell K, Gundlach M, Schmidt P, Hansmann ML, Schroeder P, Deltz E. Immunohistochemical analysis of immunocompetent cells involved in small-bowel rejection in the rat. Transplant Proc 1990; 22:2461-2. [PMID: 2264108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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130
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Gundlach M, Schmidt P, Hell K, Schroeder P, Hansmann ML, Deltz E. The influence of major histocompatibility complex subloci differences on graft rejection in small-bowel transplantation. Transplant Proc 1990; 22:2474-5. [PMID: 2264115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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131
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Schroeder P, Gundlach M, Siermer HW, Hoffmann K, Schindler R, Deltz E. Metabolic changes and liver function after orthotopic small-bowel transplantation. Transplant Proc 1990; 22:2452. [PMID: 2264102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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132
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Schroeder P, Gundlach M, Quaroni A, Hansmann ML, Schweizer E, Deltz E. Follow-up of small-bowel transplantation by monoclonal antibodies against brush-border membranes. Transplant Proc 1990; 22:2476. [PMID: 2264116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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133
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Abstract
605 upper gastrointestinal endoscopies were performed at a student health centre on university students under the age of 35. Some abnormality, and sometimes more than one, was found in 291 (48.0%) patients. 93 (15.4%) had chronic superficial gastritis, 36 (5.9%) acute gastritis, three had atrophic gastritis, and two eosinophilic gastritis. 53 patients (8.7%) had an oesophageal abnormality. Coeliac disease was found in 16 (2.6%) and new cases of duodenal ulcer in 14 (2.3%). 19 patients (3.1%) had gastric polyps. It is concluded that upper gastrointestinal endoscopy is a procedure well suited for primary health care, and that a significant proportion of young adults examined for abdominal complaints in such a setting will be found to have some abnormality.
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134
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Hansmann ML, Hell K, Gundlach M, Deltz E, Schroeder P. Immunohistochemical investigation of biopsies in a successful small-bowel transplantation. Transplant Proc 1990; 22:2502-3. [PMID: 2264127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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135
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Schroeder P, Gebhardt H, Gundlach M, Hell K, Schweizer E, Hansmann ML, Deltz E. Diagnosis and treatment of graft rejection in experimental and clinical small bowel transplantation. Transplant Proc 1990; 22:2326. [PMID: 2219390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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136
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137
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Abstract
Small intestinal transplantation has had several clinical attempts based on extensive experimental work during the past two decades. Several models, such as auxiliary (heterotopic) or orthotopic models, have been developed in regard to problems with graft immunology and function. The question of mesenteric-portal or mesenteric-caval graft drainage was raised, and the answer seems to be open. Concerning lipid absorption, interest was directed to the reconstitution of lymphatic vessels, because orally administered cyclosporine A is absorbed by the lipid mechanism. Carbohydrate digestion and absorption are used for determination of graft function and for monitoring graft rejection. This article summarizes these problems and deals with the surgical procedure of small bowel transplantation in the rat.
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138
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Hansmann ML, Deltz E, Gundlach M, Schroeder P, Radzun HJ. Small bowel transplantation in a child. Morphologic, immunohistochemical, and clinical results. Am J Clin Pathol 1989; 92:686-92. [PMID: 2816825 DOI: 10.1093/ajcp/92.5.686] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A small bowel transplant was performed on a five-year-old boy with a short bowel syndrome. The donor was the child's mother. Despite immunosuppressive therapy, the transplant was acutely rejected and had to be explanted on the twelfth day. Morphologic and immunohistochemical investigations on subsequent biopsies taken from the small bowel transplant were carried out. Besides typical changes in epithelial cells and the presence of T-cell infiltrates and Ig-deposits in vessels, many macrophages were seen. The submucosa in particular was invaded before rejection by numerous macrophages with positive results of antimonocyte/macrophage antibodies Ki-M6 and Ki-M7. The number of the macrophage antibodies Ki-M6 and Ki-M7. The number of the monocyte/macrophage cells and the immunohistochemical characteristics of the same may be important parameters for monitoring small bowel transplantations.
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139
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Schroeder P. Quality assurance activities. JOURNAL OF NURSING QUALITY ASSURANCE 1989; 3:viii-ix. [PMID: 2639137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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140
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Deltz E, Schroeder P, Gundlach M, Gebhardt H, Schindler R, Sandforth F. [Functional and structural adaptation following transplantation of the small intestine]. ZEITSCHRIFT FUR GASTROENTEROLOGIE. VERHANDLUNGSBAND 1989; 24:225-9. [PMID: 2474963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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141
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Schroeder P, Deltz E. [Parenteral nutrition in short bowel syndrome]. KRANKENPFLEGE JOURNAL 1989; 27:54-7. [PMID: 2502660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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142
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Marker CG, Schroeder P. QA Forum. Unit-based nursing quality assurance. JOURNAL OF NURSING QUALITY ASSURANCE 1989; 3:84-6. [PMID: 2768430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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143
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Deltz E, Schroeder P, Gebhardt H, Gundlach M, Engemann R, Timmermann W. [First successful clinical small intestine transplantation. Tactics and surgical technic]. Chirurg 1989; 60:235-9. [PMID: 2656129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of successful clinical small bowel transplantation is demonstrated. A segment of 60 cm of jejunum and ileum has been harvested from the sister of the recipient and has been brought in heterotopic position in the first operative step. It was anastomosed to the recipient's GI-tract 6 weeks later. This procedure has the advantage that the graft can recover from ischemic damage in heterotopic position and that an immunological steady state can be achieved. This case of successful clinical small bowel transplantation offers a new causal therapy for patients with short gut syndrome.
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144
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Schroeder P, Sandforth F, Gundlach M, Deltz E, Thiede A. Functional adaptation of small intestinal mucosa after syngeneic and allogeneic orthotopic small bowel transplantation. Transplant Proc 1989; 21:2887-9. [PMID: 2565062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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145
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Deltz E, Albers U, Schroeder P, Beske C, Hamelmann H. [Surgical indications status in ileus using a simple clinical index]. Chirurg 1989; 60:99-103. [PMID: 2707098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Based on a retrospective analysis of a group of patients with ileus disease in regard of the indication for operative intervention an "ileus index" was created which is derived from simple clinical and radiological findings and laboratory data. Prospective evaluation of this index showed its effectiveness in separating patients who had to undergo an emergency operation from those who could be operated electively after preceding diagnostic procedures or could be treated conservatively.
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146
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Gundlach M, Schroeder P, Hansmann ML, Zwingers T, Deltz E. Graft manipulation prior to small intestinal transplantation. Transplant Proc 1989; 21:2894-5. [PMID: 2784919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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147
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Schroeder P. Directions and dilemmas in nursing quality assurance. Nurs Clin North Am 1988; 23:657-64. [PMID: 3047697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Effects of the health care environment have been a catalyst for the evolution of nursing quality assurance programs. Changes can be summarized as an increased focus on actual clinical practice, an increased participation by professional nurses, and an increased sophistication in the methods used to monitor and evaluate. Much work remains to be done in creating environments that assure quality of care.
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148
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149
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Gundlach M, Schroeder P, Schindler R, Deltz E. Absorption of vitamin A after orthotopic small bowel transplantation: evidence for the development of graft adaptation to lipid metabolism. Transplant Proc 1987; 19:3965-7. [PMID: 3672612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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150
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Schroeder P, Schang T, Engemann R, Jessen P, Mengel W. [The Hickman catheter as a permanent access in hemodialysis in the child]. Chirurg 1987; 58:179-81. [PMID: 3581987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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