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  • Articles  (64)
  • Springer  (62)
  • German Medical Science; Düsseldorf, Köln  (1)
  • The American Association for Clinical Chemistry (AACC)  (1)
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  • Articles  (64)
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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  51. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie; 20060910-20060914; Leipzig; DOC06gmds056 /20060901/
    Publication Date: 2006-09-25
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    ISSN: 1432-1211
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract To define the polymorphism and extent of the mouse immunoglobulin kappa (Igk) gene complex, we have analyzed restriction-enzyme digested genomic DNA from 33 inbred strains of mice with labeled DNA probes corresponding to 16 V x protein groups (1 of them previously undescribed) and the J k/C K region (V, variable; J, joining; C, constant). These probes detected between 1 and 25 distinct restriction enzyme fragments (REF) that appeared in up to eight polymorphic patterns, thus defining eight mouse Jgk haplotypes. The investigated portion of the V A repertoire was estimated to encompass between 60 and 120 discernable V k gene-containing REFs. In contrast to mouse V H gene families, several V k gene families defined by these probes appeared to overlap. This observation has implications for V k gene analyses by nucleic acid hybridization and raises the possibility that the V A gene complex is a continuum of related sequences.
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  • 3
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Probands from 26 PKU-affected families of the Berlin area were analyzed with respect to the allele frequency distribution of six RFLPs in linkage with the normal and the PKU alleles of the phenylalanine hydroxylase gene. These investigations confirm most of the RFLP haplotypes observed by Güttler and colleagues in the Danish population and describe two additional ones. They detect no significant differences in the single RFLP or RFLP haplotype distribution on the normal chromosomes in comparison with the Danish families and confirm a prevalent association of the RFLP haplotypes 1,4 and 7 with the normal PAH allele. In contrast to the Danish investigations, in our study the PKU allele is found most frequently linked to haplotype 2, rather then to haplotype 3. In one of our patients we found a substitution of the normal 19-kb MspI fragment by a 13.5- and a 5.5-kb fragment, reported up to now only in one other German family.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 3 (1997), S. 99-104 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 5 (1981), S. 293-294 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2277
    Keywords: Experimental liver transplantation ; Living donor ; Heterotopic graft ; Primates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The need for liver grafts is critical in countries where brain death is not accepted as a legal criterion for organ retrieval. This experimental study was conducted with nonhuman primates in order to evaluate the feasibility of liver transplantation using a living donor. An original technique was employed to remove the left part of the liver from the donor: transection of the parenchyma was done while the blood flow was kept to the left part of the liver. In the recipients, the graft was placed heterotopically. No blood transfusions were administered to donors or recipients. In spite of a few failures, due to consequences of intraoperative bleeding, several donor operations using this original technique were successful, in the immediate postoperative period as well as several months later. Among the recipients, the large number of early failures suggests that the heterotopic position is probably not the appropriate one and that orthotopic transplantation should be preferred.
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  • 7
    ISSN: 1432-2196
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 8
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Neuromonitoring ; SSEP ; NIRS ; Transkonjunktivale Sauerstoffspannung ; Selektive Shunteinlage ; Key words NIRS ; Selective shunting ; Neuromonitoring ; SSEP ; Conjunctival oxygen tension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The principle of, “selective shunting” during carotid endarterectomy requires a special concept to monitor neuronal function. The valence of the oxymetric methods, “near-infrared” spectroscopy (NIRS) and conjunctival oxygen tension (pcjO2) was determined with the reference method somatosensory evoked potentials (SEP). Methods. In 41 patients undergoing reconstructive surgery on the internal carotid artery, recordings of the different methods were obtained under control, during carotid occlusion and during reperfusion. Cerebral ischemia was assumed if a complete loss of SEP appeared and an intraluminal shunt was placed. Conjunctival oxygen tension was measured continuously and simultaneously on the ipsi- and contralateral eye. Results. In comparison to the reference method (SEP) the sensitivity and specificity of NIRS was 80% and 94%, respectively. The occlusion induced reduction of NIRS appeared 6.5±3.2 min earlier than the corresponding loss of SEP. Biocular determination of conjunctival oxygen tension was not able to detect hypoperfusion dependent ischemia during carotid occlusion. Conclusion. During carotid endarterectomy the measurement of conjunctival oxygen tension is not useful to detect cerebral ischemia. The use of NIRS as a single neuronal monitor is not appropriate to perform, “selective shunting”. In contrast to SEP, however, NIRS is characterized by its rapid changes immediately following carotid occlusion. This non invasive method is likely to complete the standard method SEP in a modified monitoring concept of neuronal function during carotid endarterectomy.
    Notes: Zusamenfassung Ziel der Arbeit. Das Prinzip der selektiven Shunteinlage bei Karotisendarterektomien erfordert ein differenziertes Neuromonitoringkonzept. Die Wertigkeit der oxymetrischen Verfahren “near-infrared” Spektroskopie (NIRS) sowie des transkonjunktivalen Sauerstoffpartialdrucks (pcjO2) wurden anhand der Referenzmethode SSEP bestimmt. Methodik. Bei 41 Patienten mit elektiver Karotis-TEA wurden diese Neuromonitoringparameter unter Kontrollbedingungen, während Karotisokklusion und in der Reperfusionsphase bestimmt. Der vollständige Verlust der SSEP-Amplitude war das Kriterium zur Shunteinlage. Die Messung des transkonjunktivalen Sauerstoffpartialdrucks erfolgte zeitgleich auf dem ipsi- und kontralateralen Auge. Ergebnisse. Im Vergleich zur Referenzmethode SSEP zeigte NIRS eine Sensitivität und Spezifität von 80% und 94%. Die okklusionsbedingte Reduktion von NIRS zeigte sich im Mittel 6,5±3,2 min früher als die entsprechenden Veränderungen der SSEP-Werte. Die biokulare Bestimmung des transkonjunktivalen Sauerstoffpartialdrucks konnte die hypoperfusionsbedingte Ischämie nicht detektieren. Schlußfolgerung. Die transkonjunktivale Sauerstoffspannung ist bei Karotisendarterektomien als Neuromonitoringverfahren ungeeignet. Die alleinige Indikation zur Shunteinlage ist mittels NIRS nicht möglich. NIRS ist jedoch im Unterschied zu den SSEP durch eine rasche Änderung nach Karotisokklusion charakterisiert. NIRS ist als nicht invasive Methode geeignet, das Standardverfahren SSEP in einem modifizierten Neuromonitoringkonzept zu ergänzen.
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  • 9
    ISSN: 1432-0509
    Keywords: Foreign bodies ; Sponges, towels ; Surgery, complications ; Abdomen. abscess ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The diagnosis of retained sponges and towels a year or more after surgery is often very difficult. We describe the computed tomographic (CT) findings in 4 patients with this complication; 2 cases of retained sponges and 2 cases of retained towels. While the CT appearance of the retained sponges was not specific, the particular appearance of the retained towels had not been previously described. This appearance is characteristic enough to suggest the correct diagnosis before reoperation.
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  • 10
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Tagesklinik ; Anästhesie-Informations-Management-System (AIMS) ; Dokumentation ; Unvorhergesehene stationäre Aufnahme ; Ambulantes Operieren ; Keywords Day care unit ; Anesthesia information management system (AIMS) ; Documentation ; Unanticipated admission ; Ambulatory surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract From January 1997 until June 1999, the complete durations of stay of 3152 outpatients were entered into a computerized documentation system. The scope of the data entry went from patient admission to patient release. The objective was to determine the usefulness of the anaesthesia information management system (AIMS) in producing complete and high-quality documentation in the field of outpatient operations. Some aspects and results from routine work are presented here. Method. The system was installed in eight bedside computers, in addition to a further client connected to the existing AIMS via Ethernet. Patient medical courses were documented both preoperatively and postoperatively in outpatient bedsides until their discharge or admission. The online documentation software NarkoData (Version 4, Imeso GmbH, Hüttenberg, Germany) was used to document and store patient data in a database. This program contains all relevant information concerning the course of anaesthesia and outpatient duration of stay, including application of drugs, vital signs, observation times, and medical findings as well as the data sets of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI), ICD, and ICPM. Data was analyzed by exporting from the database into a statistical program using “structured query language.” Results. Data sets of 3152 outpatients were entered into the online documentation software. Most (54.2%) of the ambulatory surgical procedures were performed by the Department of Traumatology. General Surgery followed with 16.0%, and Urology managed 9.5% of the cases. The most frequent ambulatory surgical procedures were: diagnostic arthroscopy (923, 31.2%), removal of osteosynthetic material (410, 13.8%), and circumcision (250, 8.4%). Anesthesia procedures consisted of inhalative (38.6%, n=1218) and intravenous anesthesia (IVA) (29.9%, n=938). In 22.6% (713) of the cases, regional anaesthesia was performed. The average postoperative observation time was 289.2±140.1 minutes. One hundred sixty-nine patients (5.4%) were unexpectedly admitted to overnight care. The decision to admit patients to normal wards took place within the first 3 postoperative hours in 51.9% of the cases. Conclusion. The AIMS described above is sufficient in documenting the entire care process of patients in a day care unit. Integration into the existing AIMS was an important prerequisite for the integrity of the documentation chain. This allowed for a sensitive communication with other clinical data processing systems. The quality of documentation and flow of information at the workplaces in the day care unit were increased, similarly to other anaesthesiological workplaces in the hospital. Medical and administrative data and information for analyses of clinical processes are possible with such tools.
    Notes: Zusammenfassung Von Januar 1997 bis Juni 1999 wurde der komplette Aufenthalt aller tageschirurgischen Patienten, von der Aufnahme bis zur Entlassung, mit einem computergestützten Dokumentationssystem erfasst. Einzelne Aspekte und Ergebnisse aus dem Routinebetrieb sollen mit der Fragestellung vorgestellt werden, ob ein Anästhesie-Informations-Management-System (AIMS) geeignet ist, auch im Bereich des “Ambulanten Operierens” eine umfassende und qualitativ hochwertige Dokumentation zu gewährleisten. Methodik. Die Installation des Systems erfolgte durch Einbindung von 8 Bettplatz-Computern und eines weiteren Clients über das Intranet in das bestehende AIMS. An den tagesstationären Bettplätzen wurden Patientendaten prä- und postoperativ bis zur Entlassung oder Verlegung der Patienten mit der Online-Dokumentationssoftware NarkoData® Version 4 (Imeso GmbH, Hüttenberg) dokumentiert und in einer Datenbank gespeichert. Dieses Programm erfasst sämtliche für den Narkoseverlauf und tagesstationären Aufenthalt relevanten Informationen, u. a. Medikamentenapplikationen, Vitaldaten, Überwachungszeiten, Befunde sowie den Kerndatensatz der DGAI, ICD 9 und ICPM. Zur Auswertung wurden die Daten mittels der “Structured Query Language” (SQL) aus der Datenbank in ein Statistikprogramm exportiert. Ergebnisse. Die Datensätze von 3.152 tagesstationären Patienten wurden mit der Online-Dokumentationssoftware erfasst. Die häufigsten tageschirurgischen Operationen führte mit 54,2% der Fälle die operierende Fachabteilung Unfallchirurgie durch, gefolgt von der Allgemeinchirurgie mit 16,0% und der Urologie mit 9,5%. Die häufigsten tageschirurgischen Eingriffe waren diagnostische Arthroskopie (923, 31,2%), Entfernung von Osteosynthesematerial (410, 13,8%) und die Zirkumzision (250, 8,4%). Von anästhesiologischer Seite kamen zumeist die Inhalationsnarkose (38,6%, n=1218) und die intravenöse Anästhesie (IVA; 29,9%, n=938) zum Einsatz. Eine Regionalanästhesie wurde in 22,6% der Fälle (n=713) durchgeführt. Die durchschnittliche postoperative Überwachungszeit betrug 289,2±140,1 min. 169 Patienten (5,4%) wurden ungeplant stationär aufgenommen. Die Entscheidung zu einer stationären Aufnahme wurde bei 50,9% der stationär aufgenommenen Patienten intraoperativ oder in den ersten drei postoperativen Stunden gefällt. Schlussfolgerung. Das beschriebene AIMS ist geeignet, den gesamten Behandlungsprozess eines Patienten in einer operativen Tagesklinik zu dokumentieren. Die Integration in das bestehende System stellte sich als wesentliche Voraussetzung für die Integrität der Dokumentationskette heraus und ermöglicht eine sinnvolle Kommunikation mit anderen klinischen Datenverarbeitungssystemen. Wie auch im Bereich der Anästhesie konnten die Dokumentationsqualität und der Informationsfluss am Narkosearbeitsplatz gesteigert werden. Neben medizinischen und administrativen Daten stehen Informationen für die Analyse klinischer Prozesse zur Verfügung.
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