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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015); 20151020-20151023; Berlin; DOCPO21-918 /20151005/
    Publication Date: 2015-10-06
    Keywords: implant ; electric ; stimulation ; monopolar ; femur neck ; fracture ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  Hypertonie 2005; 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga; 20051123-20051125; Berlin; DOC05hochP22 /20060808/
    Publication Date: 2006-08-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  22. Jahrestagung der Retinologischen Gesellschaft; 20090626-20090627; Berlin; DOCRG2009-53 /20090629/
    Publication Date: 2009-07-07
    Keywords: ddc: 610
    Language: German
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  • 4
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Zerebrale Durchblutung ; Hirnvenöse Sättigung ; Arteriovenöse Sauerstoffgehaltsdifferenz ; Key words Cerebral blood flow ; Cerebral venous oxygen saturation ; Arteriovenous oxygen content difference
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The arteriovenous oxygen content difference (avDO2) of the brain is dependent on O2 consumption (CMRO2) and cerebral blood flow (CBF). With unchanging arterial O2 content, avDO2 is inversely related to cerebral venous O2 saturation (SO2). Measurement of SO2 in the jugular bulb not only provides information about the O2 balance of the brain, but may give an important estimation of CBF if a clinically useful correlation is proven. The aim of the present study was to verify this aspect. Methods. Sixty-two male patients undergoing coronary revascularisation were investigated. The study was approved by the local Ethical Committee and each patient gave written informed consent on the preoperative day. At four points during the perioperative course arterial and cerebral venous SO2 and CBF were measured. Cerebral venous blood was sampled from a catheter in the superior bulb of the right internal jugular vein. CBF was measured using the argon wash-in technique. All sampled data were pooled and evaluated. Results. As expected from theory, cerebral venous SO2 and avDO2 showed a close linear relationship (r=−0.892). However, only a weak hyperbolic relationship was found between cerebral venous SO2 and CBF. In addition, no direct correlation between CMRO2 and SO2 in the jugular bulb could be demonstrated. Conclusions. In this clinical study, a close relationship between cerebral venous SO2 and CBF was not found. This was primarily due to the high variability of cerebral O2 uptake. Changes in cerebral venous SO2 may therefore not be used as an estimate of perioperative changes in CBF.
    Notes: Zusammenfassung In der klinischen Routine stellt die Bestimmung der Hirndurchblutung häufig ein Problem dar. Leichter meßbar ist die arteriovenöse Sauerstoffgehaltsdifferenz (avDO 2 ) des Gehirns, die abhängig ist von dessen O 2 -Verbrauch (CMRO 2 ) und dem zerebralen Blutfluß (CBF). Bei gleichbleibendem Sauerstoffangebot ist die avDO 2 umgekehrt proportional zur hirnvenösen O 2 -Sättigung (ShvO 2 ). Damit erlaubt die Bestimmung der hirnvenösen Sättigung nicht nur eine Aussage über die Sauerstoffausschöpfung des Gehirns, sondern könnte bei einer konstanten O 2 -Aufnahme eine Einschätzung des CBF ermöglichen. In der vorliegenden Untersuchung wurde an 62 männlichen Patienten im Alter von 41–60 Jahren im Rahmen von aorto-koronaren Bypassoperationen dieser Zusammenhang untersucht. Zu vier definierten Meßpunkten wurden die arterielle und hirnvenöse Sauerstoffsättigung sowie die zerebrale Durchblutung gemessen. Die erhaltenen Werte wurden gepoolt. Es konnte eine lineare Abhängigkeit zwischen der avDO 2 und ShvO 2 bestätigt werden; eine hinreichend enge Verknüpfung zwischen ShvO 2 und CBF lag unter diesen klinischen Bedingungen jedoch nicht vor. Die Ursache lag in der hohen Variabilität des CMRO 2 . Ohne Kenntnis der CMRO 2 dürfen aus Sättigungsänderungen keine Rückschlüsse auf perioperative Veränderungen der Hirndurchblutung gezogen werden.
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  • 5
    ISSN: 1432-055X
    Keywords: Schlüsselwörter PDE-III-Hemmer ; Hämodynamik ; Koronare Herzkrankheit ; Key words PDE-III-inhibitors ; Haemodynamics ; Ischaemic heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract At present, phosphodiesterase III inhibitors are commonly used for the treatment of low cardiac output states. Despite their positive inotropic and lusitropic effects, these drugs are still under discussion because of certain adverse effects like thrombopaenia, elevation of transaminases, abdominal disregulation, and excessive periphereal vasodilatation. As a consequence, more cardioselective phosphodiesterase inhibitors were developed with the aim of reducing these adverse effects. One of them, enoximone (Marion Merrell Dow, Fig. 1), an imidazole derivative, has nearly no influence on platelets and abdominal organ function. In addition, in many studies vasodilatation was found to be absent. Recently a new substance, R80122 (Janssen, Belgium, Fig. 1), was developed. First experimental studies showed high cardioselectivity of this substance. The aim of this study was to compare the haemodynamic effects of enoximone and R80122 in patients with ischaemic heart disease. Methods. This study was thoroughly discussed and approved by the local Ethics Committee; all patients gave written informed consent. Twenty male patients (Table 1) with normal left ventricular function who were about to undergo elective coronary artery bypass surgery were randomly allocated to receive a bolus of either 1.0 mg/kg enoximone or 0.3 mg/kg R80122 after induction of anaesthesia. Premedication consisted of 2 mg flunitrazepam orally the evening before and in the morning 1 h before operation. Anaesthesia was induced with 0.007 mg/kg fentanyl, 0.2 mg/kg etomidate, and 0.1 mg/kg pancuronium bromide and maintained by a continuous infusion of 0.02 mg/min fentanyl and 0.3 mg/min midazolam. After induction of anaesthesia haemodynamic measurements were performed and blood gas samples were taken preoperatively under steady-state conditions before and 5, 30, and 60 min after drug administration. Results. The results of both groups are shown in Table 2 as mean values with standard deviations. Individual changes of cardiac index (CI), mean arterial pressure (MAP), and systemic vascular resistance (SVR) are depicted in Fig. 2. Peak percentage changes of the haemodynamic parameters are shown in Fig. 3. Both substances improved cardiac function; 5 min after drug administration CI increased by 31% and 26%, respectively. This was accompanied by increases in stroke volume (13% and 14%, respectively) and heart rate (15% and 10%, respectively). At the same time, there were declines in SVR (38% and 36%, respectively) and MAP (19% and 21%, respectively). Although mean values of pulmonary arterial and wedge pressure decreased after drug administration, these changes were inconsistent and not of clinical relevance. There were no statistically significant differences between the haemodynamic effects of both substances at any time in this study. Conclusions. Both enoximone and R80122 showed the expected inotropic effects. Nevertheless, both substances have a distinct vasodilative effect, which leads to a decline in MAP. R80122 does not have higher cardioselectivity than enoximone.
    Notes: Zusammenfassung In dieser Untersuchung wurden die hämodynamischen Effekte einer Bolusinjektion von 1,0 mg/kg KG Enoximon bzw. 0,3 mg/kg KG R80122 bei jeweils 10 Patienten mit koronarer Herzkrankheit und normaler linksventrikulärer Funktion gemessen und miteinander verglichen. Die einzelnen Messungen erfolgten präoperativ nach Narkoseeinleitung unter steady state-Bedingungen. Der Herzindex stieg bereits 5 min nach Gabe des jeweiligen PDE-III-Hemmers maximal an, in der Enoximongruppe im Mittel um 31%, in der R80122-Gruppe im Mittel um 26% über die jeweiligen Ausgangswerte. Der Anstieg des Herzindex basierte bei beiden Gruppen sowohl auf einem Anstieg des Schlagvolumens, nach Enoximongabe im Mittel um 13%, nach Gabe von R80122 im Mittel um 14%, wie auch der Herzfrequenz, nach Enoximongabe im Mittel um 15%, nach Gabe von R80122 im Mittel um 10%. Gleichzeitig kam es zu einem Abfall des arteriellen Mitteldrucks, nach Enoximongabe im Mittel um 19%, nach Gabe von R80122 im Mittel um 21%. Ursache für den Abfall des arteriellen Mitteldrucks war in beiden Gruppen die Erniedrigung des peripheren Gefäßwiderstands, in der Enoximongruppe im Mittel um 38%, in der R80122-Gruppe im Mittel um 36%. Ein signifikanter Unterschied zwischen den hämodynamischen Parametern beider Gruppen lag zu keinem Meßzeitpunkt vor. Beide Substanzen zeigen in der vorgegebenen Dosierung vergleichbare hämodynamische Effekte, einen Anstieg von Herzindex, Herzfrequenz und Schlagvolumen bei gleichzeitigem Abfall des peripheren Gefäßwiderstands. Die in tierexperimentellen Untersuchungen nachgewiesene höhere Kardioselektivität von R80122 konnte unter den klinischen Bedingungen dieser Studie nicht nachgewiesen werden.
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  • 6
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The cerebral haemodynamic effects of vasodilators are of clinical interest because a decrease in mean arterial pressure (MAP) might alter global cerebral blood flow (CBF). Luxury perfusion of the brain, in contrast, might be unfavourable in patients with reduced intracranial compliance. Despite the widespread use of nitroglycerine (NTG), little is known about the cerebral haemodynamic consequences of NTG infusions in humans. This prospective, controlled study was designed: (1) to investigate the effects of NTG on CBF and cerebrovascular CO2 reactivity and (2) to compare reference measurements o
    Notes: Zusammenfassung Ziel dieser prospektiven kontrollierten Studie war es, 1.) den Einfluß von Nitroglyzerin (NTG) auf den globalen zerebralen Blutfluß (CBF) und die zerebrovaskuläre CO2-Reaktivität zu untersuchen, und 2.) den Einfluß von NTG auf den Zusammenhang zwischen CBF und der Flußgeschwindigkeit in der A. cerebri media (VMCA) zu bestimmen. Bei 10 kardiochirurgischen Patienten wurde zunächst während einer Kontrollphase in randomisierter Reihenfolge eine Hypo- und Hyperkapnie (paCO2≈30 bzw. 50 mmHg) induziert. Anschließend wurden alle Messungen unter einer Infusion von 1,5·μg·kg−1·min−1 NTG bei identischen paCO2-Niveaus wiederholt. Die Bestimmung des CBF erfolgte mittels der Kety-Schmidt-Technik. Simultan wurde jeweils die VMCA mittels eines 2-MHz-Dopplersystems aufgezeichnet. Unter NTG-Infusion nahm der zerebrale Perfusionsdruck um 15–17% ab, dennoch zeigte sich aufgrund einer Reduktion des zerebrovaskulären Widerstands eine erhebliche Zunahme des CBF um 96 bzw. 69%, während die VMCA geringfügig abfiel. Die CO2-Reaktivität des CBF zeigte keine signifikante Änderung. Die Ergebnisse der vorliegenden Untersuchung zeigen zum einen, daß NTG zu einer ausgeprägten Zunahme der globalen Hirndurchblutung führt, sofern kein kritischer Abfall des zerebralen Perfusionsdrucks eintritt. Zum anderen legen die Ergebnisse des durchgeführten Methodenvergleichs nahe, daß auch die proximalen Segmente der A. cerebri media (MCA) unter dem Einfluß von NTG eine Vasodilatation aufweisen, die zu einer methodisch relevanten Diskrepanz zwischen relativen Änderungen der Hirndurchblutung und der MCA-Strömungsgeschwindigkeit führt.
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cerebral blood flow, cerebral oxygen and glucose consumption, and cerebral lactate and pyruvate release were measured; spectral analysis of the EEG was recorded in 10 male patients who had coronary artery bypass surgery. The measurements were taken to evaluate the effects of fentanyl–midazolam anaesthesia during normothermia and during hypothermic nonpulsatile cardiopulmonary bypass at 26°C venous blood temperature, when a temperature-corrected Paco2-value of 5.3 kPa was maintained. Anaesthesia with fentanyl 7 μg/kg and midazolam 200 μg/kg as induction doses, followed by infusions of fentanyl 0.15 μg/kg/minute and midazolam 3 μg/kg/minute, was characterised by a decrease in fast-wave activity and an increase in high-amplitude, slow-wave activity in the EEG. There was also a decrease in cerebral blood flow (38%), oxygen consumption (22%) and glucose consumption (25%), while lactate and pyruvate production remained unchanged. Hypothermia of 26°C venous blood temperature suppressed EEG almost completely and decreased oxygen and glucose consumption by a further 61% and 54%, respectively, with no changes in lactate and pyruvate production while cerebral blood flow increased by 145%. These results show that the effects of fentanyl–midazolam anaesthesia on cerebral metabolism are enhanced during hypothermic cardiopulmonary bypass while the influence of anaesthesia on cerebral blood flow is overshadowed by the practice of a temperature-corrected acid-base management.
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  • 8
    ISSN: 1588-2780
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Energy, Environment Protection, Nuclear Power Engineering
    Notes: Abstract Extraction of pertechnetate with bicyclic guanidinium compounds has been studied in the KTcO4-buffer-H2O/ligand-trichloromethane system. Extraction data of guanidinium ligands have been compared with trialkylmethylammonium (Aliquat 336), tetraphenylphosphonium and tetraphenylarsonium chloride. The lipophilicity of extractants investigated was determined by RP-HPLC. The efficiency of pertechnetate extraction correlates with the lipophilicity of the guanidinium compounds. 1:1 complex formation in the organic phase was observed. The influence of hydroxide, chloride and bicarbonate on the pertechnetate extraction has been investigated. Pertechnetate is extracted with great preference over OH−, Cl− and HCO3 −, ions.
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  • 9
    ISSN: 1615-6714
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In this account an investigation is presented of the nature of the centric and the habitual occlusion in those cases where a forward positioning of the lower jaw was achieved through treatment. After comparison with control cases, the results of treatment with functional orthodontic appliances show that the forweard development of the mandible is not combined with an enlargement of the field of occlusion beyond the normal limit.
    Abstract: Résumé Ce travail examine quelle différence il y a entre l'occlusion centrique et l'occlusion de convenance chez des patients où l'on a modifié avec succès l'occlusion par un traitement d'orthopédie dento-faciale. Le résultat démontre qu'avec l'emploi d'appareils fonctionnels cette différence n'excède pas la norme.
    Notes: Zusammenfassung In der vorliegenden Arbeit wird bei mit Erfolg durchgeführten Bißverschiebungsfällen untersucht, wie sich zentrale und habituelle Okklusion verhalten und welches Okklusionsfeld vorliegt. Die Untersuchungsergebnisse zeigen, daß die Bißverschiebung, durchgeführt mit funktionskieferorthopädischen Geräten, bei den hier nachuntersuchten Fällen nicht zu einer Vergrößerung des Okklusionsfeldes über die Norm hinausgeführt hat.
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  • 10
    ISSN: 0020-1693
    Keywords: Crystal structures ; Kinetics and mechanism ; Manganese complexes ; Metal thiolates
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
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