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  • 1
    ISSN: 0942-0940
    Keywords: Head injury ; outcome ; Glasgow Coma Scale ; children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Patients defined as having a moderate head injury on the basis of Glasgow Coma Scale scores within the ranges of 9 to 13 after acute nonsurgical procedures were selected. Almost 1600 cases were hospitalized in the Neurosurgery Department. The cases were admitted through the Emergency Unit of Gaz University Medical School, Ankara, Turkey during the period between 1979 and 1992. The group studied consisted of 231 selected patients assessed separately in paediatric, adult and elderly age groups. Possible risk factors such as: GCS score, anisocoria, unilateral or bilateral fixed pupils, impaired oculocephalic reflexes, presence of multiple systemic injuries, aetiology of head trauma, presence of linear or depressed skull fractures, space occupying mass on CT or operation was also assessed. Subarachnoid haemorrhage turned out to be the only independent significant risk factor in predicting mortality. The data about the patients who have “talked and deteriorated” were also reported so as to assisst physicians charged with the care of trauma victims.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Endothelium derived relaxation factor ; aneurysm clip ; manipulations ; microvascular clip
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mechanically induced vasoconstriction observed throughout surgery and in the immediate postoperative period was investigated to assess the effects of various microsurgical manipulations. Factors such as the type of aneurysm clip, duration of temporary clipping and peri-adventitial tissue stripping were the variables in this study. Microsurgical clips were applied on guinea pig “cervical carotid arteries” in which peri-adventitia had been removed microsurgically. Arterial rings were removed immediately after surgery. Endothelium dependent relaxations were measured and morphological investigations were performed using light microscopy. It was observed that as the clip application period increased, relaxation responses decreased. Peri-adventitial tissue stripping caused a marked decrease in the relaxation responses in all types of the clips. Microvascular clips, in spite of their lower closing forces, had the greatest deleterious effect on relaxation responses of the vessel, in both normal and peri-adventitial tissue stripped. When the peri-adventitial tissue of the vessel had been stripped, convolutions of the lamina elastica interna were found to be lost in parallel with the decreased tonus of the artery. In the vessels subjected to clipping endothelial denudation and cracking took place. As a conclusion it can be stated that both peri-adventitial tissue stripping and microvascular clip application have deleterious effects in the early postoperative period. While choosing clips from minimal occlusion force tables, care must be taken to choose clips with less width; and while performing microvascular anastomosis, temporary clips with a lesser width must be used in place of microvascular clips. Adventitial stripping must not be unnecessarily generous during microvascular anastomosis.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 131 (1994), S. 211-214 
    ISSN: 0942-0940
    Keywords: White blood cell count ; leucocytosis ; head trauma ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective analysis of 153 cases of head trauma was conducted with respect to their white blood cell counts. A white blood cell count exceeding 20×106/l is associated with a poor clinical grade on admission and with a 96% mortality as opposed to that of a 23% mortality for those with slightly lower or slightly above normal white blood cell count. The sensitivity for this level is a mortality of 96% while the specificity is 77%.
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  • 4
    ISSN: 0942-0940
    Keywords: Keywords: Arachidonic acid; cerebral vasoconstriction; ultrastructure; vasoactive agents.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 2 -a potent vasoconstrictor and aggregating metabolite of arachidonic acid- or infusion of the stable analogues of prostacyclin -which is another cyclo-oxygenase metabolite of arachidonic acid- has been shown to be beneficial in cerebral vasoconstriction. Endothelin-1, a peptide derived from endothelial cells, has been shown to induce a long-lasting cerebral vasoconstriction both in vivo and in vitro. The purpose of this study was to investigate the role of a novel thromboxane A2-synthase inhibitor UK 38485 on the acute vascular and morphological effects of Endothelin-1 applied intra-arterially on rabbit basilar arteries.  The inguinal region of twenty four anaesthetized albino rabbits of both sexes were dissected and a catheter was inserted into the aorta via the femoral artery, for control angiography of the basilar artery and intra-arterial injection of ET-1 (0.25 ng total dose) and UK 38485 at a dose of 0.05 μg kg−1 min−1 for 20 min or saline. Angiographic vasoconstriction quantification and morphological investigations of both vessels and brain stem either by light microscopy or transmission electron microscopy were the techniques applied for the study.  We found out that, although the systemic administration of UK 38485 resulted in a potent antagonism of the acute vasoconstriction as visualized in angiographic studies, it did not affect the morphological changes induced by Endothelin-1 on the vessel wall. The results indicated that there might have been an interaction between Endothelin-1 and the prostaglandin synthesis mechanism in acute cerebral vasoconstriction.
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  • 5
    ISSN: 1439-0264
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Destruction and denervation atrophy in skeletal muscles caused by the injection of local anaesthetics was investigated by injecting lidocaine or bupivacaine around the rabbit facial nerve to produce facial paralysis. Animals were then sacrificed at 2, 4, 6, and 8 weeks post-injection, and changes in mimic muscle tissue were assessed at each stage by light microscopy and electron microscopy. Atrophic changes were observed at 2–6 weeks after injection, and regeneration started at 6–8 weeks. Compared to bupivacaine, lidocaine caused more dramatic atrophic changes and was associated with slower muscle regeneration.
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  • 6
    ISSN: 1439-0264
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The alterations due to the long-term degeneration and regeneration of the rabbit facial nerve were investigated. The facial nerve was blocked with conventional lidocaine and bupivacaine solutions. The rabbits were sacrificed and facial nerves were removed 2, 4, 6 and 8 weeks after the administration of normal saline, lidocaine and bupivacaine. The samples were then processed for electron microscopic observation.Degenerations were seen 2–4 weeks after the injection of normal saline, lidocaine and bupivacaine. In the normal saline group the regeneration process was observed after 6 weeks, whereas in the lidocaine and bupivacaine groups this process was first noticed after 8 weeks.In the lidocaine and bupivacaine groups, regeneration was not completed at the end of 8 weeks; however, it was faster in the bupivacaine group. Bupivacaine is therefore suggested as the drug of choice for neural blockade as it caused less damage and a faster regeneration.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 140 (1998), S. 619-620 
    ISSN: 0942-0940
    Keywords: Keywords: Bipolar coagulator; instrumentation; neurosurgical operations.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. Sometimes charring or popping occurs and the bipolar blades get stuck to the vessel.  Methods. The tips of one of the many commercially available bipolar forceps were coated in a striped manner with Teflon −50 μ in thickness.  Results. The new bipolar coagulator coated with Teflon reduced the incidence of tissue sticking.  Conclusions. Experience with this instrument was still quite limited, but preliminary results were promising.
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