The proteome microenvironment determines the protective effect of preconditioning in cisplatin-induced acute kidney injury

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Thymoma--a retrospective study of 48 cases

Of the 48 thymomas operated on between 1968 and 1985 50% were associated with myasthenia gravis, in 25% diagnosis was made due to accidental X-ray findings. In the staging according to Masaoka et al. [10] the following distribution was noted: I:22, II:5, III:18, IV:3. The 5-year survival rate of the 37 curatively resected patients was 78.5% (stage I: 88.6%, stage III: 55.6%). No stage III patient with residual tumor survived more than 2 years. Predominantly epithelial tumors had a significantly worse prognosis as compared to those with lymphocytic predominance. None of the 4 patients with category II thymoma survived more than 15 months. Association with myasthenia proved to have a negative prognostic influence in stage I and II patients. Frequency of local recurrences and metastases is documented. The value of irradiation and chemotherapy is discussed.     

Multicenter Randomized Comparison of Xenon and Isoflurane on Left Ventricular Function in Patients Undergoing Elective Surgery

Background: Volatile anesthetics are commonly used for general anesthesia. However, these can induce profound cardiovascular alterations. Xenon is a noble gas with potent anesthetic and analgesic properties. However, it is uncertain whether xenon alters myocardial function. The aim of this study was therefore to investigate left ventricular function during anesthesia with xenon compared with isoflurane.

Methods: The authors performed a randomized multicenter trial to compare xenon with isoflurane with respect to cardiovascular stability and adverse effects in patients without cardiac diseases scheduled for elective surgery. Two hundred fifty-nine patients were enrolled in this trial, of which 252 completed the study according to the protocol. Patients were anesthetized with xenon or isoflurane, respectively. Before administration of the study drugs and at four time points, the effects of both anesthetics on left ventricular function were investigated using transesophageal echocardiography.

Results: Global hemodynamic parameters were significantly altered using isoflurane (P < 0.05 vs. baseline), whereas xenon only decreased heart rate (P < 0.05 vs. baseline). In contrast to xenon, left ventricular end-systolic wall stress decreased significantly in the isoflurane group (P < 0.05 vs. baseline). Velocity of circumferential fiber shortening was decreased significantly in the xenon group but showed a more pronounced reduction during isoflurane administration (P < 0.05 vs. baseline). The contractile index (difference between expected and actually measured velocity of circumferential fiber shortening) as an independent parameter for left ventricular function was significantly decreased after isoflurane (P < 0.0001) but unchanged using xenon.     

Das Verhalten der Herzfrequenz unter pulsatiler Betamimetika- Applikation (Bolustokolyse)

Ohne Zusammenfassung     

Zur Behandlung der Luxationen und Luxationsfrakturen im Lisfrancschen Gelenk

Zusammenfassung Aus der Vielzahl der Verrenkungsbrüche desLisfrancschen Gelenkes werden einige besondere Formen herausgegriffen, die mit gleichzeitiger Verrenkung in anderen Fu?wurzelgelenken kombiniert sind. Die prim?re Fixierung dieser unstabilen Verrenkungsbrüche mit gekreuzten Bohrdr?hten wird empfohlen. Bei veralteten F?llen ist die Arthrodese oder Keilresektion des Gelenkes angezeigt.

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Summary Among the numerous types of fracture-dislocations in the tarso-metatarsal joints some special cases are described, associated with simultaneous dislocations of other tarsal joints. In these unstable fracture-dislocations primary osteosynthesis by means of crossed drill-wires is recommended. In old cases arthrodesis or wedgeosteotomy of the joint is indicated.