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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  125. Kongress der Deutschen Gesellschaft für Chirurgie; 20080422-20080425; Berlin; DOC08dgch9863 /20080416/
    Publication Date: 2008-04-14
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  125. Kongress der Deutschen Gesellschaft für Chirurgie; 20080422-20080425; Berlin; DOC08dgch9564 /20080416/
    Publication Date: 2008-04-14
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  123. Kongress der Deutschen Gesellschaft für Chirurgie; 20060502-20060505; Berlin; DOC06dgch5541 /20060502/
    Publication Date: 2006-05-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science; Düsseldorf, Köln
    In:  123. Kongress der Deutschen Gesellschaft für Chirurgie; 20060502-20060505; Berlin; DOC06dgch5288 /20060502/
    Publication Date: 2006-05-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 5
    ISSN: 1434-3932
    Keywords: Schlüsselwörter Intraoperative Thrombolyse ⋅ Extremitätenischämie ⋅ Gewebe-Plasminogen-Aktivator (rt-PA) ; Key words Intraoperative thrombolysis ⋅ Limb ischemia ⋅ Tissue plasminogen activator
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose: Since its introduction in the 1980s, intraoperative thrombolysis in peripheral arterial occlusion as an additional procedure has been shown to be attractive and effective in reducing limb loss in severe lower-limb ischemia. Although the results are promising additional intraoperative intra-arterial thrombolysis has not been widely used according to the few papers published with approximately 300 patients that have been published from 1985 until now. Are vascular surgeons not acquainted with the intraoperative use of streptokinase, urokinase or tissue plasminogen activator (rt-PA)? We report our own experience, comparing our results with the data available in the literature. Patients and methods: Thirty patients (16 men, 14 women, mean age 71 years) with severe limb-threatening ischemia were treated with operative thromboembolectomy, local thrombendarterectomy or bypass-grafting and, simultaneously, with additional intraoperative thrombolysis. After clot removal or a revascularization procedure and after documentation by angiography, the procedure was accomplished by intra-arterial instillation of rt-PA (mean dose 10.5 mg Actilyse). Perioperatively, patients received systemic anticoagulation with heparin. Results: All but two combined revascularizations resulted in clinical and angiographically documentated restoration of perfusion to the affected limb. Four (13%) major amputations and two (7%) repeat operations due to bleeding complications were necessary during the 30-day postoperative period. Three (10%) patients died postoperatively, but not due to bleeding or operative complications. Conclusion: Intraoperative intra-arterial thrombolytic therapy with rt-PA is an attractive adjunct to catheter thromboembolectomy or to a revascularization procedure in limbthreatening ischemia. Salvage of the limb seems to be increased. We conclude that thrombolysis is effective and safe.
    Notes: Zusammenfassung Fragestellung: Seit Einführung der intraoperativen Thrombolyse im Rahmen von operativen Gefäßrekonstruktionen stellt sich dieses kombinierte Verfahren bei der Therapie der amputationsbedrohenden Extremitätenischämie als durchaus hilfreich und effektiv dar. Trotz der ermunternden Ergebnisse ist es bis heute zu keinem breiten Einsatz der simultanen intraoperativen Thrombolyse gekommen, betrachtet man die wenigen Publikationen mit knapp 300 Patienten in der Literatur. Liegt es vielleicht an einer Scheu des Gefäßchirurgen die Thrombolytika [Strepto-/Urokinase oder Gewebe-Plasminogen-Aktivator(rt-PA)] im Operationssaal einzusetzen? Die eigenen Erfahrungen mit der intraoperativen Anwendung von rt-PA sollen dargestellt und mit Ergebnissen in der Literatur verglichen werden. Patienten und Methode: 30 Patienten (16 Männer, 14 Frauen, mittleres Alter 71 Jahre) mit amputationsbedrohender Extremitätenischämie wurden operativ durch eine Thromboembolektomie, eine Thrombendarteriektomie oder durch ein Bypassverfahren mit zusätzlicher intraarterieller Thrombolyse der distalen Ausstrombahn behandelt. Nach chirurgischer Therapie erfolgte die intraoperative Kontrollangiographie und im Anschluß die intraarterielle Applikation von rt-PA (mittlere Dosis 10,5 mg Actilyse) zur Lyse der Ausstrombahn oder zur Demaskierung weiterer therapiebedürftiger Befunde. Zusätzlich erfolgte eine perioperative systemische Heparinisierung. Ergebnisse: Das kombinierte Therapiekonzept führte bei 28 von 30 Patienten zu einer angiographisch dokumentierten und klinisch primär ausreichenden Reperfusion der amputationsbedrohten Extremität. Aufgrund Reverschlüssen/ irreversibler Ischämien waren 4 Majoramputationen (13%) unabdingbar; 2 Reoperationen (7%) wegen Blutungskomplikationen waren postoperativ erforderlich. Drei Patienten (10%) verstarben nicht lyse- oder operationsbedingt innerhalb 30 Tagen postoperativ. Schlußfolgerung: Die intraoperative intraarterielle Thrombolyse mit rt-PA als additive Maßnahme zur Wiederherstellung der Reperfusion bei amputationsbedrohender Extremitätenischämie ist effektiv, die Beinerhaltung erscheint verbessert und in bezug auf Blutungskomplikationen ein sicheres Verfahren.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-7347
    Keywords: Key words Synovectomy ; Rheumatoid arthritis ; Photodynamic laser therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The introduction of arthroscopic techniques has improved the surgical therapy of rheumatoid arthritis. The additional application of the holmium:yttrium aluminum garnet (Ho:YAG) laser likewise holds great promise by providing complete hemorrhagic control. Unfortunately, a minimally invasive solution for use in smaller joints has not yet emerged. The present study describes the possible treatment of these joints by means of photodynamic laser therapy. Cell culture studies with human synovial fibroblasts obtained from patients with rheumatoid arthritis have demonstrated a cytotoxic effect after administration of Photosan-3 as a photosensitizer and subsequent laser irradiation at 630 nm. For the in vivo studies, IgG-induced arthritis in rabbits, which is histologically consistent with the proliferative phase of rheumatoid arthritis, was used as the animal model. The histologic picture following photodynamic laser therapy with Photosan-3 revealed complete synovial destruction which also extended to the border of the subjacent joint capsule. In contrast, bradytrophic structures, e.g. cartilage, menisci, and ligaments, remained unchanged at both the macroscopic and microscopic levels. Therefore, photodynamic laser therapy can be considered a new method in the surgical treatment of inflammatory disease of the synovial membrane. It has the advantage of being minimally invasive, while offering a high degree of efficacy and selectivity.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1434-3924
    Keywords: Schlüsselwörter PDT ; Laser ; Tiermodell ; Key words PDT ; Laser ; RA ; Animal model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: The principle of photodynamic therapy (PDT) for rheumatoid arthritis consists in specifically concentrating a drug (photosensitizer) in the synovium. Subsequent activation of the photosensitizer by means of a laser leads to a cytotoxic effect. The practicability of PDT was tested in an animal model of IgG-induced arthritis in rabbits. Photosan-3, 5-aminolevulinic acid and BPD-MA were administered intraarticularly or intravenously. In this model, concentration of the photosensitizer in the synovial lining cells, the lymphoid infiltrate, and the skin was seen. After laser irradiation a selective demarcation and destruction of the synovium by prior administration of Photosan-3, not constant by BPD-MA and without therapeutic effect by 5-aminolevulinic acid, was observed. In contrast, bradytrophic tissues such as cartilage, meniscus, and ligament structures were changed neither macroscopically nor microscopically in all series. PDT thus offers ideal preconditions for minimal invasive treatment of chronic inflammatory joint diseases because of its selectivity and efficacy. Photodynamic laser therapy can be considered a new method in the surgical treatment of inflammatory disease of the synovial membrane.
    Notes: Die rheumatische Entzündung nimmt ihren Ausgang vom entzündlichen Pannusgewebe, das die betroffenen Gelenke mit ihren Kapseln, Sehnen und Bändern zerstört. Bei der photodynamischen Lasertherapie (PDT) für die chronische Polyarthritis erfolgt in der Synovialis die selektive Anreicherung eines Medikaments (Photosensibilisator), dessen nachfolgende Laseraktivierung einen zytotoxischen Effekt bewirkt. Die Durchführbarkeit einer photodynamischen Therapie wurde am Tiermodell der IgG-induzierten Arthritis des Kaninchens erprobt. Dieses Tiermodell entspricht histologisch den proliferativen Phasen einer Rheumatoiden Arthritis. Als Photosensibilisatoren wurden 3 verschiedene Substanzen getestet (Photosan-3, 5-Aminolävulinsäure und das Benzoporphyrinderivat BPD-MA). Eine spezifische Anreicherung der Photosensibilisatoren in der Deckzellschicht und im lymphoplasmazellulären Infiltrat wurde beobachtet. Nach Laserbestrahlung des Gelenks zeigte sich eine vollständige Zerstörung der Synovialis bis zur darunter liegenden Gelenkkapsel mit 2 der 3 Photosensibilisatoren, Photosan-3 und BPD-MA. Im Gegensatz dazu waren die bradytrophen Strukturen von Knorpel, Meniskus und Ligamenten weder makroskopisch noch mikroskopisch verändert. Die photodynamische Lasertherapie stellt ein neues Verfahren zur Behandlung der Synovitis dar. Ihre Vorteile sind Effektivität und maximale Selektivität bei gleichzeitig minimaler Invasivität. Damit bietet die photodynamische Therapie eine neue Perspektive für die chirurgische Behandlung chronisch-entzündlicher Gelenkerkrankungen.
    Type of Medium: Electronic Resource
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  • 8
    Publication Date: 2018-07-17
    Description: Harnessing electro-optic correlations in an efficient mechanical converter Harnessing electro-optic correlations in an efficient mechanical converter, Published online: 16 July 2018; doi:10.1038/s41567-018-0210-0 A mechanical-mediated quantum-compatible microwave–optical converter achieves high efficiency through a feed-forward protocol that harnesses correlations in the output noise.
    Print ISSN: 1745-2473
    Electronic ISSN: 1745-2481
    Topics: Physics
    Published by Springer Nature
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