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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Magnetic resonance ; Brain ; Brain tumors ; Echo planar imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to assess the potential of high-speed interleaved echo-planar imaging (EPI) to achieve diagnostic image quality comparable to T2-weighted imaging in patients with brain tumors. Seventeen patients with intra-axial, supratentorial tumors (10 untreated gliomas, 7 radiated gliomas) were investigated on a 1.5-T scanner. The conventional scan (SE, TR/TE = 2200/80 ms, 18 slices) was acquired in 8 min, 4 s, and EPI (TR/TE = 3000/80 ms, 18 slices) was completed in 25 s. The films were compared in a blinded trail by three radiologists. On the general impression and anatomic display, both sequences were rated to be of similar quality. Artifacts were slightly more pronounced at the skull base and around surgical clips using EPI. Tumor delineation was nearly equivalent using EPI, compared with the T2-weighted sequence. Echo-planar imaging reached diagnostic quality in all patients. Interleaved high-resolution EPI yielded sufficient quality to depict intra-axial, supratentorial brain tumors. Since EPI can be obtained in a small fraction of the time needed for conventional spin echo, in addition to other indications it could be considered to study patients unable to cooperate.
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  • 2
    ISSN: 1433-0385
    Keywords: Key words: Total gastrectomy ; Treatment costs ; Decontamination ; Anastomotic leakage. ; Schlüsselwörter: Behandlungskosten ; Dekontamination ; Anastomoseninsuffizienz.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Es war Ziel der Untersuchung, den Einfluß der Dekontamination im Vergleich zu einer Placebomedikation auf die postoperativen Behandlungskosten nach Gastrektomie zu ermitteln. Die Ergebnisse einer prospektiv doppelblind angelegten und placebokontrollierten Multicenterstudie zeigen, daß eine perioperative i. v.-Prophylaxe mit Cefotaxim und eine topische Dekontamination mit Polymyxin B, Tobramycin, Vancomycin und Amphotericin B in der Prävention oesophagojejunaler Anastomoseninsuffizienzen höchst wirksam ist. Beim Kostenvergleich der beiden Gruppen wurden nur dem Studienprotokoll entsprechend dekontaminierte Patienten (n = 90) den mit Placebo behandelten (n = 103) gegenüber gestellt, weil der Einfluß der Dekontamination auf die Behandlungskosten ermittelt werden sollte. Die oesophagojejunale Nahtinsuffizienzrate betrug 10,6 % bei Placebopatienten (n = 103) und konnte unter Dekontamination (n = 90) hochsignifikant auf 1,1 % reduziert werden (p = 0,0061; Fisher-exact-Test, 2-tailed). Es konnte nur eine asymptomatische Anastomoseninsuffizienz im Gastrografinschluck nachgewiesen werden. Auch die Lungeninfektions- (p = 0,0173) und Gesamtkomplikationsrate (p = 0,0238) waren in der Gruppe der Dekontaminierten signifikant reduziert. Im Beobachtungszeitraum verstarben 9 (8,7 %) der Placebopatienten und 3 (3,3 %) der Dekontaminierten. Die Kostenermittlung umfaßte die orale Prophylaxe, Pflegekosten der Normal- und Intensivstation, Nachsorgeklinik, Antibiotica sowie Reoperationen und Interventionen. Sie beschränkte sich ausschließlich auf die ersten 42 postoperativen Tage. Die Gesamtkosten der Placebogruppe beliefen sich pro Patient auf 20 000,– DM. Die durchschnittlichen Gesamtkosten pro Patient betrugen in der Prophylaxengruppe dagegen nur 16 200,– DM, weil signifikant weniger Patienten für kürzere Zeiträume intensivmedizinisch behandelt werden mußten (p = 0,0082), signifikant weniger Patienten antibiotisch therapiert (p = 0,0232) wurden und die Anzahl der Patienten mit Reoperationen und Reinterventionen geringer war als in der Placebogruppe (p = 0,0909). Die Durchführung einer Prophylaxe zum Preis von 400,– DM senkte die postoperativen Behandlungskosten um 3800,– DM oder 19 %. Die Prophylaxe kann empfohlen werden, weil sie die Morbidität, die Letalität und die Kosten der Gastrektomie senkt.
    Notes: Summary. The aim of this study was to examine the effect of decontamination as compared to placebo medication on post-gastrectomy treatment costs. The results of a prospective double-blind placebo-controlled multicenter trial indicate that perioperative i. v. prophylaxis with cefotaxim and topical decontamination with polymyxin B, tobramycin, vancomycin and amphotericin B from the day before surgery until the 7th postoperative day is most effective in the prevention of esophagojejunal anastomotic leakage following total gastrectomy. For the cost analysis, only patients who had been decontaminated according to the study protocol (n = 90) were compared to the non-decontaminated patients (n = 103). The esophagojejunal leakage rate was 10.6 % in placebo patients (n = 103) and could be reduced significantly to 1.1 % in decontaminated patients (n = 90, P = 0.0061; two-tailed Fisher's exact test). There was only one asymptomatic leakage detected on Gastrografin swallow. The pulmonary infection (P = 0.0173) and overall complication rates (p = 0.0238) were significantly reduced in the decontamination group as well. During the observation period, 9 (8.7 %) patients in the placebo group and 3 (3.3 %) in the decontaminated group died (P = n. s.). Patients were followed up for the initial 42 postoperative days and treatment costs were calculated for this time period only. The parameters compiled in the study pertaining to use of medical resources formed the basis for the determination of the postoperative treatment costs. These were the costs for decontaminating drugs, intravenous antibiotics, reoperations and non-surgical reinterventions as well as daily treatment costs of the general ward, the intensive care unit (ICU) and rehabilitation. The average costs per patient in the placebo group amounted to DM 20 000 while the costs for decontaminated patients were only DM 16 200, which was due to a significantly lower number of patients requiring treatment in the ICU (P = 0.0082), significantly fewer patients requiring i. v. antibiotics (P = 0.0232) and fewer patients with reoperations (P = 0.0909). The prophylaxis employing decontaminating drugs in the amount of DM 400 lowered post-gastrectomy treatment costs by DM 3800 or 19 %. The prophylaxis can be recommended, because it lowers morbidity, mortality and the costs of total gastrectomy.
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  • 3
    ISSN: 1365-2842
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Mandibular movement may be assessed by measuring maximum mouth opening. This is a linear measurement from the maxillary to the mandibular incisal edge and is affected by gender, age and ramus length. It cannot be used to classify patients. The temporomandibular opening index (TOI) appears to be independent of these variables and has been shown to differ for different categories of patients with temporomandibular disorders (TMD). This study examined the TOI in a group of 11 patients with closed lock and a control group of 11 individuals with no signs or symptoms of TMD. The group with closed lock had a significantly different TOI from that of the control group (P〈0·001) according to the Mann–Whitney U-test. This suggests that the TOI may have greater diagnostic value than linear mouth opening.
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  • 4
    ISSN: 1365-2842
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Limited mandibular movement is one of the cardinal signs of temporomandibular disorders, and is usually assessed by measurement of mouth opening. Linear measurement of mouth opening does not discriminate between diagnostic groups and has been shown to be influenced by gender, age and ramus length. A new temporomandibular opening index, however, can differentiate between diagnostic groups and is not influenced by the above variables. When patients with a myogenous temporomandibular disorder were examined, the temporomandibular opening index distinguished two subgroups, the first with values about the lower quartile and the second with values about the upper quartile. A similar identification of two subgroups was seen in electromyographic studies of myogenous temporomandibular disorder patients (Visser, A., Kroon, G.W., Naeije, M. & Hansson, T.L. (1995) Journal of Oral Rehabilitation, 22, 429)
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  • 5
    ISSN: 1432-1912
    Keywords: 1-(m-Chlorophenyl)-biguanide ; 2-Methyl5-hydroxytryptamine ; 5-Carboxamidotryptamine ; 5-HT3 receptors ; α2-Adrenoceptors ; Noradrenaline release ; 3H-Rauwolscine binding ; Rodent brain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We analyzed the facilitatory effect of the 5-HT3 receptor agonist 1-(m-chlorophenyl)-biguanide (mCPBG) on the electrically evoked noradrenaline release in superfused mouse brain tissue. In addition, we determined the affinities of mCPBG and two other 5-HT receptor ligands, namely, 2-methyl-5-hydroxytryptamine (2-methyl-5-HT; also a 5-HT3 receptor agonist) and 5-carboxamidotryptamine (5-CT; a 5-HT1 receptor agonist) for α2 binding sites. The latter two 5-HT receptor agonists were included because of the claimed involvement of α2-adrenoceptors in their effects on noradrenaline release. In superfusion experiments on mouse brain cortex slices preincubated with 3H-noradrenaline, tritium overflow evoked by 2-min periods of electrical field stimula tion (3 Hz) was facilitated by mCPBG and, in addition, by rauwolscine (α2-adrenoceptor antagonist) and tetraethylammonium (K+ channel blocker) (which were examined for comparison). The effect of mCPBG was not affected by the 5-HT3 receptor antagonist tropisetron or by desipramine but was abolished by rauwolscine. In slices superfused with medium containing desipramine, the concentration-response curve of unlabelled noradrenaline for its inhibitory effect on the electrically (0.3 Hz) evoked overflow was shifted to the right by mCPBG and rauwolscine (apparent pA2 5.35 and 7.88, respectively). In another series of superfusion experiments, 4 electrical pulses, administered at 100 Hz, were used to evoke tritium overflow. Tritium overflow evoked by this stimulation procedure (under which an endogenous tone of noradrenaline does not develop) was not affected by mCPBG and rauwolscine but still increased by tetraethylammonium. The specific binding of 3H-rauwolscine to rat brain cortex homogenates was displaced monophasically by unlabelled rauwolscine, mCPBG, 2-methyl-5-HT and 5-CT (pKi 8.59, 5.84, 5.05 and 5.86, respectively). In conclusion the present results indicate that mCPBG acts as a low-affinity antagonist at α2-adrenoceptors. This property has to be considered in functional studies of 5-HT3 receptor-mediated effects in tissues containing α2-adrenoceptors as well.
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  • 6
    ISSN: 1432-1912
    Keywords: Histamine H3 receptors ; Intraneuronal Ca2+ concentration ; Voltage-sensitive K+ channels ; ATP-dependent K+ channels ; G proteins ; Adenylate cyclase ; Noradrenaline release ; Mouse brain cortex
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study was aimed at the identification of mechanisms following the activation of histamine H3 receptors. Mouse brain cortex slices preincubated with 3H-noradrenaline were superfused and the (H3 receptor-mediated) effect of histamine on the electrically evoked tritium overflow was studied under a variety of conditions. The extent of inhibition produced by histamine was inversely related to the frequency of stimulation used to evoke tritium overflow and to the Ca2+ concentration in the superfusion medium. An activator (levcromakalim) and blocker (glibenclamide) of ATP-dependent K+ channels did not affect the electrically evoked tritium overflow and its inhibition by histamine. A blocker of voltage-sensitive K+ channels, tetraethylammonium (TEA), increased the evoked overflow and attenuated the inhibitory effect of histamine. TEA also reduced the inhibitory effect of noradrenaline and prostaglandin E2 on the evoked overflow. When the facilitatory effect of TEA on the evoked overflow was compensated for by reducing the Ca 2+ concentration in the superfusion medium, TEA did no longer attenuate the effect of histamine. Exposure of the slices to the SH group-alkylating agent N-ethylmaleimide increased the evoked overflow and attenuated the inhibitory effect of histamine; both effects were counteracted by the SH group-protecting agent dithiothreitol, which, by itself, did not affect the evoked overflow and its inhibition by histamine. Mouse brain cortex membranes were used to study the effect of the H3 receptor agonist R-(−)α-methylhistamine on the basal cAMP accumulation and on the accumulation stimulated by forskolin or noradrenaline. R-(−)-α-Methylhistamine did not affect basal cAMP accumulation but, at high concentrations, inhibited the forskolin- and noradrenaline-stimulated cAMP accumulation. S-(+)-α-Methylhistamine (which is 100 times less potent than R-(−)-α-methylhistamine at H3 receptors) was equipotent with the R-(−)-enantiomer in inhibiting the forskolin-stimulated CAMP accumulation. The inhibition by R-(−)-α-methylhistamine was not affected by the H3 receptor antagonist clobenpropit but was counteracted by the α2-adrenoceptor antagonist rauwolscine. The present results suggest that the histamine-induced inhibition of noradrenaline release depends on the availability of extracellular Ca2+ ions for stimulus-release coupling; in particular, a decrease in Ca 2+ influx into the varicosities may contribute to this inhibition. The H3 receptors (which may be coupled to a G protein) do not appear to be coupled to adenylate cyclase, to ATP-dependent K+ channels or to (TEA-sensitive) voltage-regulated K+ channels. α-Methylhistamine, in addition to its main action as a stereoselective H3 receptor agonist, proved to be weakly potent as an α2-adrenoceptor agonist.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Naturwissenschaften 39 (1952), S. 159-160 
    ISSN: 1432-1904
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Natural Sciences in General
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  • 8
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Chemie Ingenieur Technik - CIT 70 (1998), S. 1205-1205 
    ISSN: 0009-286X
    Keywords: Chemistry ; Industrial Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology , Process Engineering, Biotechnology, Nutrition Technology
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Chemie Ingenieur Technik - CIT 71 (1999), S. 1035-1035 
    ISSN: 0009-286X
    Keywords: Chemistry ; Industrial Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology , Process Engineering, Biotechnology, Nutrition Technology
    Type of Medium: Electronic Resource
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