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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20031111-20031116; Berlin; DOC03dguF11-5 /20031111/
    Publication Date: 2003-11-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Mit Hilfe einer Apparatur, die eine Perfusion auf beiden Seiten der Placentamembran erlaubt, wurde die pharmakodynamische Wirkung von Serotonin, Deseril, Lysergsäurediäthylamid, Adrenalin und Papaverin an Nabelschnur und Placenta des Meerschweinchens geprüft. Serotonin führt schon bei Konzentrationen von 0,1–0,5μg/ml an den Umbilicalgefäßen zu einer Vasoconstriction, auf die placentaren Gefäße hat es keinen Einfluß. Als wirksamer Antagonist hat sich Deseril (Methyllysergsäurebutanolamid) in einer ca. 4mal höheren Konzentration als Serotonin erwiesen. Dagegen konnte durch LSD (Lysergsäurediäthylamid) der gefäßverengernde Effekt des Amins nicht aufgehoben werden. Inwieweit der Effekt dosisabhängig ist, bleibt noch zu klären. Adrenalin, das wie Serotonin die Placentaschranke in Richtung Mutter — Fet nicht zu penetrieren vermag, führte sowohl im fetalen als auch im maternen Kreislauf bei Konzentrationen zwischen 5 und 20μg/ml zu einer Flußreduktion. Papaverin erwies sich auch an den Nabelschnurgefäßen als wirksames Spasmolyticum.
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  • 3
    ISSN: 1434-601X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract In plasmas produced by microwave power the electron density displays a dependence on the magnetic field strength obviously asymmetric with respect to the harmonics of the electron cyclotron frequency. In regions of the magnetic field strength just above the harmonics there are extremely high values of electron density, the density values dropping sharply off towards the other wing of the harmonics. Absorption experiments near the second harmonic at low microwave power — the plasma being produced by different means — reveal a resonant absorption structure in the magnetic field region above the harmonic. This can be attributed to excitation of geometrical eigenmodes of electrostatic. waves propagating perpendicular to the magnetic field (Bernstein waves).
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Techniques in coloproctology 4 (2000), S. 79-81 
    ISSN: 1128-045X
    Keywords: Key words Anal stenosis ; Sphincter spasm ; Radical hemorrhoidectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Used in the treatment of gross circumferential hemorrhoidal prolapse. Whitehead hemorrhoidectomy is technically more demanding and has slightly more complications than four-quadrant hemorrhoidectomy. The former, however, offers a radical cure and is the better operation whereas the latter is often associated with considerable remaining skin tags and areas of residual hemorrhoidal tissue. Following the Whitehead operation, we have observed fewer complications in older patients compared to younger patients. Case notes and follow-up data of all patients who underwent a Whitehead hemorrhoidectomy in the period October 1995 to November 1999 were reviewed, and clinical presentation and outcome were analyzed. The study group consisted of 11 patients (8 males, 3 females), of median age 58 years (range, 41–,75 years). The median operation time was 30 min (range, 15–40 min). The median hospital stay was 3 days (range, 2–15 days). There was only early and one late complication, both with minimal related morbidity. In both these patients, appropriate treatment resulted in complete recovery. All othera patients had an uneventful course with no residual symptoms at the last visit. Elderly patients may be less prone to developing significant sphicter spasm due to a generally more lax sphincter tone. Therefore, they may be at less risk of suture line ischemia, breakdown and stenosis.
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  • 5
    ISSN: 1128-045X
    Keywords: Key words Surgical technique ; Functional end-to-end anastomosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The use of staplers for ileostomy closure may facilitate the procedure and improve outcome by creating a wide, functional end-to-end anastomosis. We retrospectively compared 136 sutured ileostomy closures with 152 stapled closures. Perioperative data and outcome parameters were analyzed. Patient characteristics were similar in both groups. Highly significant reduction was found in operating time (p 〈 0.001) and hospitalization (p = 0.001) in the stapled group compared to the sutured group. Recovery of intestinal function and complication rates showed no differences. Our results show that both techniques are comparably safe but stapling is considerably faster to perform. The higher expenses of using a stapling device may be economically compensated by the shorter operation time under certain circumstances.
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  • 6
    ISSN: 1591-9528
    Keywords: Hepatic arterial flow ; Total liver bloodflow ; Catecholamines ; Angiotensin ; Vasopressin ; Arterielle Leberdurchblutung ; Lebergesamtdurchblutung ; Katecholamine ; Hypertensin ; Vasopressin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 33 Hunden wurde der Einfluß pressorischer Pharmaka auf die arterielle Leberdurchblutung (mit dem elektromagnetischen Flowmeter gemessen) und die Lebergesamtdurchblutung (Outflowmethode) untersucht: 1. Adrenalin, Noradrenalin, Effortil und Novadral bewirken bei Dosen bis zu 10γ/kg einen Anstieg, bei Dosen über 10γ/kg einen Abfall der Lebergesamtdurchblutung. Die arterielle Leberdurchblutung verhält sich nach Injektion dieser Pharmaka weitgehend abhängig vom arteriellen Ausgangsdruck, sie steigt dabei nur im unteren Druckbereich (unter 80 mm Hg) parallel mit dem Systemdruck an. 2. Hypertensin steigert in kleinen Dosen die Leberdurchblutung, reduziert sie in gleicher Weise wie Adrenalin und Noradrenalin jedoch bei hohen Dosen. Die A.hep.-Durchblutung steigt bei Dosen bis zu 10γ/kgunabhängig vom arteriellen Ausgangsdruck an. 3. Durch Vasopressin (0,7–3,5 E/kg) wird die A.hep.-Durchblutung erhöht, jedoch wird gleichzeitig die Lebergesamtdurchblutung parallel mit dem Pfortaderdruck reduziert. Auf Grund der depressorisohen Wirkung auf das Herzzeitvolumen, des antidiuretischen Effektes und der Gefahr einer hypoxischen Schädigung des Magen-Darm-Traktes ist bei der kontinuierlichen Vasopressintherapie zur Behandlung blutender Oesophagusvaricen größte Vorsicht geboten.
    Notes: Summary By means of electromagnetic flowmeter and bypass technique hepatic artery flow as well as hepatic venous outflow has been investigated in 33 dogs after application of pressor substances. 1. Intravenous injection of epinephrine and norepinephrine at a dosage up to 10γ/kg is followed by an increase of total liver flow; doses exceeding 10 γ/kg however lead to a decrease of total liver blood flow. After injection of these drugs the hepatic artery flow is dependent on the initial artery blood pressure to a great extend; an increase parallel to the systemic pressure can be observed only after application of catecholamines at a low initial pressure up to 80 mm Hg. 2. Injection of small doses of angiotensin was followed by an increase of liver blood flow whereas larger doses had a diminishing effect like that caused by catecholamines. The hepatic artery flow is increased by doses up to 10γ/kg independent of the initial arterial pressure. 3. After intravenous injection of vasopressin (0.7–3.5 E/kg) the hepatic artery flow rises, while at the same time total liver flow is reduced in a parallel way to portal pressure. Because of the depressor effect on cardiac output, antidiuretic effect and danger of hypoxical damage to the intestinal tract, utmost attention is recommended in respect to the treatment of bleeding oesophageal varices by continuous vasopressin therapy.
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  • 7
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Venom immunotherapy (VIT) is regarded as an established and efficient treatment of Hymenoptera venom allergy. Different frequencies of side-effects have been reported in the literature, depending on the hyposensitization regimen (conventional outpatient programme, rush immunotherapy, ultra rush immunotherapy) and the venom preparation. Aim of this study was to evaluate safety and tolerance of rush VIT in patients treated with a 7-day protocol in our department.Methods: VIT protocols of 178 patients treated at the Department of Dermatology and Allergy of the University of Bonn were analysed retrospectively. All patients had been treated with a standardized venom preparations (ALK-SQTM). We used a modified VIT-protocol with a 2-day break to reduce systemic side-effects.Results: During the course of VIT in 15 patients (8.4%) systemic reactions grade I (Mueller scale) were observed, in seven (3.9%) grade II, in six (3.4%) grade III and in four (2.2%) grade IV. A total of 146 patients (82.1%) had no or only local reactions.Conclusions: The rate of systemic adverse reactions Mueller Grade I–IV of 17.9% of the ‘Bonn rush VIT protocol’ appears to be relatively low compared with the data in the literature.
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  • 8
    ISSN: 1432-2218
    Keywords: Key words: Abdominal pain — Appendicitis — negative appendicectomy rate — Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Healthy-looking appendixes are often removed at laparoscopy for suspected appendicitis. This practice may have adverse secondary effects. Methods: We reviewed the literature for the years 1978 to 1998 to analyze the negative appendectomy rates, complication rates, the accuracy of laparoscopic appendix assessment, and the incidence of false negative diagnosis of appendicitis at surgical and gynecological laparoscopy. Results: The respective negative appendectomy rates were 22% and 15% in studies that compared laparoscopic with open appendectomy. The appendix was left in situ in 37% of 4,281 surgical diagnostic laparoscopies. There were instances of missed appendicitis among the 3,367 gynecological diagnostic laparoscopies performed on women for lower abdominal pain, and there were 188 appendectomies in this group. Studies comparing the macroscopic appearance of the appendix at operation with microscopic findings from the excised specimen had a false negative error rate of 3%. Conclusions: Contrary to general opinion, there is no substantial evidence to support the assumption that the macroscopic diagnosis of appendicitis is unreliable. High rates of conflicting diagnoses of excision specimens suggest that endoappendicitis has little clinical significance. At present, negative appendectomy rates are considerably higher for laparoscopic appendectomy than for the open approach. The role of diagnostic laparoscopy in suspected appendicitis should be reconsidered. It may be useful in particular subgroups of patients, but it is no substitute for good clinical judgment. Furthermore, it is not always necessary to perform an incidental appendectomy.
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  • 9
    ISSN: 1432-2013
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 42 Hunden wurde das Stromvolumen der A. hep. mittels elektromagnetischem Flowmeter und der venöse Leberausstrom mittels Bypass-Verfahren fortlaufend registriert. Die Pfortaderdurchblutung wurde durch Subtraktion ermittelt. Am unnarkotisierten und narkotisierten Tier betrugen die Normalwerte für die A. hep.-Durchblutung 5,8±1,5 ml/kg min; für die Lebergesamt-durchblutung am narkotisierten Tier 18,9±5,1 ml/kg min (Körpergewicht). Bei hypo- und normovolämischer Drucksenkung auf Aortendruckwerte bis 30 mm Hg bestand für die A. hep. in den meisten Fällen eine abszissenkonkave Druck-Stromstärke-Beziehung. Auch die Lebergesamtdurchblutung und — in Grenzen — die Pfortaderdurchblutung ließen bei Senkung des Systemdrucks ein aktives Verhalten erkennen, welches durch Ganglienblockade unbeeinflußt blieb, nach Applikation von Endotoxin jedoch nicht mehr zu beobachten war. Für die Regulation der A. hep.-Durchblutung wird ein myogener Entstehungsmodus angenommen; das Verhalten von Pfortader- und Gesamtdurchblutung dürfte weitgehend von der blutdruckabhängigen Regulation des Mesenterialkreislaufs bestimmt sein.
    Notes: Summary In 42 dogs arterial hepatic flow was determined by electromagnetic flowmeter, venous liver-outflow by means of a bypass procedure and portal venous flow by subtraction. Normal data obtained were as follows: Arterial hepatic flow 5,8±1,5 ml/kg · min body weight (in the anaesthetized as well as unanaesthetized animal). Total liver flow 18,9±5,1 ml/kg · min in the anaesthetized dog. During hypo- and normovolaemic hypotension to aortic pressure values of 30 mm Hg pressure-flow relationship of arterial flow had been concave to the pressure-axis. Total liver flow and—within limits—portal venous liver flow as well showed some sort of active behaviour during acute systemic hypotension. This proved to be unaltered by ganglionic blockage, whereas was not being observed after administration of Endotoxin. The hepatic arterial flow reaction, being described here is probably of a myogenic nature. In contrary to that pressure flow relationship of portal venous flow and total liver flow presumably is being dependant to response of the mesenteric circulation to peripherial systemic blood pressure.
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  • 10
    ISSN: 1434-6079
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract. We discuss the Bloch-state solutions of the stationary Gross-Pitaevskii equation and of the Bogoliubov equations for a Bose-Einstein condensate in the presence of a one-dimensional optical lattice. The results for the compressibility, effective mass and velocity of sound are analysed as a function of the lattice depth and of the strength of the two-body interaction. The band structure of the spectrum of elementary excitations is compared with the one exhibited by the stationary solutions (“Bloch bands”). Moreover, the numerical calculations are compared with the analytic predictions of the tight binding approximation. We also discuss the role of quantum fluctuations and show that the condensate exhibits 3D, 2D or 1D features depending on the lattice depth and on the number of particles occupying each potential well. We finally show how, using a local density approximation, our results can be applied to study the behaviour of the gas in the presence of harmonic trapping.
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