S Ludwig's research while affiliated with Universitätsklinikum Carl Gustav Carus Dresden and other places
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Publications (48)
Background
Cell transplantation provides the unique possibility to preoperatively optimize organ function or to re-establish organ function after oncological resection. Transplantation of autologous islets of Langerhans after pancreatic resection and transplantation of hematopoietic stem cells (HSC) or mesenchymal stromal cells (MSC) to optimize li...
INTRODUCTION
Hereditary pancreatitis in children is rare. The indications for surgery in these children are complications and severe pain that cannot be managed by conservative treatment. Surgical treatment options are duodenum preserving resections as well as drainage procedures. Recurrences are common following theses surgical procedures, because...
Introduction: Anastomotic insufficiency after upper gastrointestinal tract surgery is associated with high morbidity and mortality. Complete pancreatectomy is representing a bail out procedure if major complications at a pancreatojejunostomy or duodenal anastomosis occured or will be expected and the patient is in a condition that does not allow fo...
For the majority of patients with type 1 diabetes intensive insulin therapy is effective and safe for maintaining glycemia and minimizing diabetes-associated complications. However, a rare number of patients show highly labile metabolic control and experience repeated and unpredictable hypoglycemic episodes. Such condition is often caused by defect...
Objective:
The transplantation of a cadaveric donor pancreas represents a therapeutic option for the type 1 diabetic. A precondition is the proof of negative serum C-peptide after glucagon stimulation (< 0.02 ng/ml) as it is found in the typical patient with type 1 or a pancreoprive diabetes. The pancreas can be transplanted alone (PTA) or after a...
Objective:
The treatment of thoracoabdominal aortic aneurysms remains an ongoing challenge in vascular surgery and has been associated with high periprocedural mortality. Since the introduction of endovascular procedures in the treatment of aortic pathologies during the last decade, new therapeutic options have arisen. We report here some technica...
Islet transplantation as a biological β-cell replacement therapy has emerged as a promising option for achieving restoration of metabolic control in type 1 diabetes patients. However, partial or complete loss of islet graft function occurs in relatively short time (months to few years) after implantation. The high rate of early transplant dysfuncti...
Die Entwicklung eines Diabetes mellitus stellt eine häufige Komplikation von Erkrankungen des Pankreas dar. Wenngleich die
Therapie der Primärerkrankung im Vordergrund steht, ist die Behandlung des sekundären Diabetes häufig eine große Herausforderung
in der täglichen Praxis und hat entscheidende Bedeutung für die Lebensqualität der Betroffenen. Im...
Das männliche Mammakarzinom stellt eine seltene Tumorentität dar, steht jedoch trotz steigender Inzidenz nicht im Mittelpunkt von Forschungsaktivitäten. Es erfolgte die retrospektive Auswertung von Tumorregisterdaten bei 67 Männern aus dem Großraum Leipzig, die zwischen 1985 und 2005 mit der Diagnose Mammakarzinom behandelt wurden. Das mediane Alte...
Das männliche Mammakarzinom stellt eine seltene Tumorentität dar, steht jedoch trotz steigender Inzidenz nicht im Mittelpunkt von Forschungsaktivitäten. Es erfolgte die retrospektive Auswertung von Tumorregisterdaten bei 67 Männern aus dem Großraum Leipzig, die zwischen 1985 und 2005 mit der Diagnose Mammakarzinom behandelt wurden. Das mediane Alte...
Male breast carcinoma represents a rare tumor entity and is not the focus of major research activities although an increasing incidence has to be noticed. Registry data on 67 males diagnosed and treated for breast carcinoma during the period 1985-2005 in the metropolitan area of Leipzig were retrospectively analyzed. The median age at diagnosis was...
Ischemia and reperfusion injury remains a relevant problem in clinical pancreas transplantation. We investigated the effect of sirolimus (SRL) in a rodent model of 90-min warm pancreatic ischemia. Four groups were studied: (1) sham surgery and vehicle; (2) sham surgery and SRL; (3) warm ischemia and vehicle; (4) warm ischemia and SRL. SRL (1.5 mg/k...
There is no consensus in the surgical management of chronic pancreatitis (cP) as to whether techniques preserving the duodenum are superior to pancreatoduodenectomy. This prospective study compared the outcome of standard pancreatoduodenectomy (PD) and duodenum-preserving pancreatic head resection (DPPHR) in treatment of selected patients with cP....
Der Ischämie/Reperfusionsschaden bei Leberresektionen als Folge der vaskulären Exklusion trägt wesentlich zur Mortalität und Morbidität bei. Endothelin (ET) ist ein potenter Mediator der auftretenden MikroZirkulationsstörungen. Ziel dieser Studie war eine Verringerung des Ischämie/Reperfusionsschadens (IRS) durch einen selektiven ET-A-Rezeptor-Anta...
Die Transplantatpankreatitis nach Pankreastransplantation als Folge des Ischämie/Reperfusionsschadens (IRS) ist für ca. 7% der Organverluste verantwortlich. Endothelin (ET) ist ein potenter Mediator der auftretenden Mikrozirkulationsstörungen. Fragestellung: Kann ein selektiver ET-A-Rezeptorantagonist (ET-A-RA) durch Verringerung der Mikrozirkulati...
In der chirurgischen Therapie der chronischen Pankreatitis werden in zunehmendem Umfang Resektionen des Pankreaskopfes eingesetzt. Ziel:Prospektive Untersuchung der endokrinen und exokrinen Funktion und des Ernährungsstatus nach duodenumerhaltender Pankreaskopfresektion nach Beger (DEPKR) und nach klassischer Kausch-Whipple Operation (KW) bei Patie...
Hintergrund: Die Remanifestation eines Typ 1 Diabetes mellitus (DM) nach Pankreastransplantation ist schwer von einer chronischen Abstoßungsreaktion zu unterscheiden. Fragestellung: Wie häufig sind Insellzell-spezifische Autoimmunphänomene bei Patienten mit Langzeit-DM? Wie beeinflußt die Pankreastransplantation diese Autoimmunphänomene? Sind die A...
Pancreatic microvascular control is a complex physiological process which is incompletely understood. Blood flow in the pancreas is altered by a large number of endogenous and exogenous factors in the context of acute and chronic pancreatitis. The frequency of progression from acute pancreatitis to a chronic form is a controversial question. In acu...
At least 50 % of all patients with chronic pancreatitis require surgical treatment in the course of their disease. Indications for surgery are intractable pain, intra- and extrapancreatic complications and the suspicion of a carcinoma. The basic principles of surgery are resection and drainage. The choice of the surgical procedure depends on the mo...
Mindestens 50 % aller Patienten mit chronischer Pankreatitis werden im Krankheitsverlauf operiert. Indikationen zur Operation sind Schmerzen, intra- und extrapankreatische Komplikationen und der Verdacht auf ein Karzinom. Resektion und Drainage sind die Grundprinzipien der chirurgischen Therapie. Die Wahl des chirurgischen Verfahrens hängt von der...
Aim: About 80 neuroendocrine tumours (NTs) of the ampulla of Vater have been reported. Ampullary NTs should be discussed sep-arately because they differ clinically, histologically and immunohistochemically from NTs elsewhere in the duodenum. Patients and Methods: The medical records of 6 pat. (4 men, 2 women) were reviewed retrospectively to examin...
There is no study comparing quality of life (QoL) using a standardized and valid QoL index in patients with chronic pancreatitis, who underwent Kausch-Whipple procedure (PD) and duodenum-preserving pancreatic head resection (DPPHR) respectively. In 32 patients after PD and 37 patients after DPPHR the EORTC-QoL index was evaluated prospectively preo...
Citations
... Organ preservation is the goal; nevertheless, total pancreatectomy with islet autotransplant can be contemplated in carefully selected cases. 33,34 The main limitation of the study is its retrospective and single-centre design. ...
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... After the concept of islet macroencapsulation had been successfully proven in different transplant models in large animals (biocompatibility, efficacy, immune-protection) [52] and in a first trial of macroencapsulated allogeneic islet transplantation in man [51@BULLET] , a study of porcine islet xenotransplantation in diabetic NHP was initiated. The first promising results were reported at the IPITA-IXA-CTS Conference 2015 in Melbourne [53]. ...
... 8 The inherent limitations of ICT-low islet survival rates, the loss of function of the transplanted cells due to poor vascularization at the implantation site, development of antibodies against the donor cells, graft rejection and post-surgical complications that come with the requirements of lifelong immunosuppression. [9][10][11] -are the main reasons why islet transplantation is still considered an experimental procedure by the US Food and Drug Administration (FDA). ...
... El resultado se presentará en las sesiones multidisciplinarias mensuales del equipo de trasplante, se emitirá un informe definitivo y en caso de ser considerado el paciente como elegible se firmará el documento de Consentimiento Informado. Se comunicará a la persona afectada su inclusión o no en la lista de espera de trasplantes de páncreas y en caso negativo se explicitarán las causas 79 . ...
... Such rooms can incorporate more sophisticated image guidance capabilities than do traditional surgical procedure rooms, and they can provide a greater degree of sterility control and anesthesia utilization than do traditional interventional rooms. Most of the studies conclude with an evaluation that states that improvement of the facilities, equipment, technologies, and processes is mandatory (5,(9)(10)(11)(12). However, there are several limitations that apply (12). ...
... Macroencapsulation strategies, which provide both immune isolation and retrievability, are among the most actively pursued transplantation approaches. Numerous porous membranes and macrobeads have been investigated, with select systems advancing to clinical evaluation [16][17][18][19][20][21][22][23][24] . While encapsulation provides a beneficial physical barrier against host immune cell entry, this immunoprotective barrier also impedes the movement of insulin [25][26][27] . ...
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... Effects in organ transplantation: Ambrisentan has protective effects on the transplanted liver and this could be due to its ability to counteract the ischemic/reperfusion tissue damage that often occurs after transplantation. Analogously, ambrisentan was shown to decrease endothelin-1 and IL-6 synthesis in grafted pancreases in minipigs (Gäbel et al., 2003) and to protect these transplanted organs from graft pancreatitis, a devastating complication whose genesis is partly due to endothelinA receptor activation (Uhlmann et al., 2001). ...
Reference: Ambrisentan
... Embora geralmente assintomáticos, podem se expandir causando dor abdominal e compressão vascular ou formar fístulas, além de ser causa de infecção espontânea com formação de abscessos. 20 No atestado de óbito desse paciente constava pseudocisto pancreático, pancreatite necro-hemorrágica evoluindo para choque séptico de foco abdominal. ...
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... Ähnliche Ergebnisse ließen sich ebenfalls für das Radikal Stickstoffmonoxid (NO) nachweisen [47]. Aufgrund der relaxierenden Wirkung von NO auf die glatte Gefäßmuskulatur bewirkt ein systemischer NO-Anstieg zusätzlich zu den oben beschriebenen Auswirkungen eine Vasodilatation des venösen Systems, was die renale Kongestion verstärkt [10,48]. ...
... A beneficial effect of ambrisentan with a significant decrease in the synthesis of proinflammatory cytokines was demonstrated also in hepatic damage induced by ischemia/reperfusion Uhlmann et al., 2004aUhlmann et al., , b, 2005Uhlmann et al., , 2006Witzigmann et al., 2002). This could be explained by the evidence that upon ischemia/reperfusion endothelin-1 synthesis and release does increase leading to vasoconstriction and inflammation. ...
Reference: Ambrisentan
