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  • 1
    ISSN: 1432-1041
    Keywords: Terbutaline ; ibuterol ; dose response curves ; forced expiratory volume ; side effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The selectivity of the recently developed β-stimulating drug ibuterol, a terbutaline ester which is rapidly hydrolyzed to terbutaline in vivo, was tested by comparing it with terbutaline after intravenous infusion. Dose-response curves for both drugs for FEV*1, heart rate, blood pressure, and tremor were recorded. The two drugs had equal bronchodilator effect. Ibuterol caused significantly less increase in heart rate, tremor ratio, and pulse amplitude when doses causing equal bronchodilation were infused. This is probably due to inequality of distribution. The lower tremorogenic activity of ibuterol can also be caused by differences in the concentration of tissue esterases in lung and skeletal muscle. It is concluded that ibuterol is more selective for the bronchi than terbutaline.
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Hodgkin's disease ; Positron emission tomography ; Sweat glands ; Fluoro deoxyglucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin's disease demonstrated bilateral uptake of [2-18F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes.
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Open MRI ; Shoulder instability ; Gadolinium ; Apprehension test position ; Bankart lesion ; Hill-Sachs lesion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to describe and evaluate an alternative MR assessment procedure for analysis of unstable shoulders. Twelve patients with unilateral recurrent anterior shoulder dislocation had both shoulders examined. Magnetic resonance imaging was performed with an open-MR system in the apprehension position with the shoulder in 90 ° of abduction and maximum tolerable external rotation. Contrast enhancement was achieved with intravenous gadolinium. Correlations were made to the findings at operation. In 10 of 12 unstable shoulders the inferior glenohumeral ligament labral complex (IGHLLC) was detached from the glenoid as seen on MR and later verified during surgery. In one shoulder MR was unable to show a capsulolabral detachment that was verified at surgery, whereas in one shoulder both MR and surgical assessment revealed no soft tissue detachment (accuracy 92 %). A Hill-Sachs lesion was visualized and verified in all unstable shoulders, whereas the stable controls revealed normal IGHLLC and no Hill-Sachs lesion. Open-MRI evaluation of the shoulder in the apprehension test position may become a useful tool for the evaluation of anterior shoulder instability.
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  • 4
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'hémophilie et la maladie de Willebrand représentent les affections congénitales les plus fréquentes caractérisées par des troubles du saignement et de la coagulation. La situation des malades atteints de ces affections s'est modifiée considérablement au cours des 2 ou 3 dernières années. Le propos de cet article est de faire le point sur la démographie et la mortalité de l'hémophilie puis, ensuite, de passer en revue les problèmes thérapeutiques de base posés par l'hémophilie et la maladie de Willebrand lors de la chirurgie en insistant sur l'emploi des constituants sanguins.
    Abstract: Resumen La hemofilia y la enfermedad de von Willebrand son las alteraciones congénitas de la coagulación de mayor incidencia. La situacion de estos pacientes ha cambiado en forma drástica en las últimas 2 a 3 décadas. El propósito de este artículo es, primero, suministrar cifras demográficas y de mortalidad en la hemofilia y, luego, revisar los problemas de tratamiento, especialmente en relación a la cirugía en la hemofilia y en la enfermedad de von Willebrand con énfasis en el uso de componentes sanguíneos. Actualmente, el riesgo mayor en los hemofílicos candidatos a un procedimiento operatorio no es el procedimiento quirúrgico de por sí. Los problemas de hemostasis en pacientes carentes de inhibidores pueden ser manejados en forma casi totalmente rutinaria. Es el problema de la terapia de sustitución el que constituye una amenaza, por el riesgo de hepatitis e infección por HTLV-III. La solución puede ser hallada en la tecnología genética. Hoy se conocen los códigos genéticos para los factores IX y VIII. Esto presenta el primer paso hacia la producción de concentrados “estériles” de factores capaces de remediar los efectos colaterales del uso de componentes sanguíneos en el tratamiento de desórdenes congénitos de la coagulación.
    Notes: Abstract Hemophilia and von Willebrand's disease are the most common congenital coagulation and bleeding disorders. The situation for patients suffering from these conditions has changed drastically during the last 2 to 3 decades. It is the purpose of this article, first, to give data on demography and mortality in hemophilia and, then, to review basic problems of therapy, especially in connection with surgery in hemophilia and von Willebrand's disease with emphasis on the use of blood components.
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  • 5
    ISSN: 1433-7347
    Keywords: Key words Shoulder ; Primary ¶dislocation ; Arthroscopic lavage ; Nonoperative regime ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Recent studies have shown that arthroscopic lavage of the glenohumeral joint within 10 days following a primary anterior dislocation significantly lowers the recurrence rate when compared with a nonoperative regime. We hypothesize that the lavage reduces distension in the joint and thereby facilitates adaptation and healing of the soft tissue lesion. Using ultrasound, we assessed the hemarthrosis in the glenohumeral joint weekly in 16 consecutive patients after traumatic primary anterior shoulder dislocation. The patients were randomized into two groups for treatment with either arthroscopic lavage or a nonoperative regime. Except for the lavage the two groups followed an identical rehabilitation program. Transversal dorsal ultrasound of the glenohumeral joint was performed, in which the joint effusion was assessed as the distance between the humeral head and the glenoid. Prior to the lavage the two groups had a similar amount of excessive joint effusion. The effusion declined to a steady state level within 3–7 weeks. The joint effusion decreased more rapidly (33%) in the group treated with arthroscopic lavage (P = 0.02) than in the nonoperated group.
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  • 6
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Soixante-dix-sept (77) patients porteurs d'hémophylie A ou B furent soumis à un total de centhuit (108) opérations chirurgicales majeures relevant principalement de la chirurgie générale, de la chirurgie orthopédique ou de la neurochirurgie. L'article décrit les principes guidant le remplacement des facteurs anti-hémophyliques selon les différents types d'hémophylie et d'intervention ainsi que les indications opératoires et la technique chirurgicale. On y souligne l'importance de prolonger la thérapie de substitution durant la période post-opératoire pour éviter la formation d'hématome tardif, en particulier chez les cas d'hémophylie grave soumis à des interventions chirurgicales majeures. Grâce au traitement employé, on a évité les hemorragies peropératoires et quelques rares cas seulement d'hématomes post-opératoires ont été observés. En combinant le remplacement des facteurs anti-hémophyliques et l'immunosuppression, mÊme les patients porteurs d'inhibiteurs des facteurs VIII et IX ont pu Être opérés. Le taux de complication, en particulier l'incidence d'hépatite, est demeuré bas. En conclusion, l'hémophylie mÊme sévère est compatible avec la chirurgie majeure et ce, sans augmentation significative du risque opératoire. Cependant, l'application du traitement de substitution de mÊme que le jugement et la technique chirurgicale posent des problÊmes importants qui nécessitent la centralisation des cas électifs.
    Notes: Abstract Seventy-seven hemophilic patients of type A or type B were subjected to a total of 108 major surgical procedures mainly in the field of general surgery, orthopedic surgery, or neurosurgery. The principles for the substitution therapy in the different types of procedures and different types of hemophilic diseases are described, as well as the indications for surgery and the surgical technique. The importance of prolonged substitution therapy postoperatively to avoid late hematoma, particularly in patients with severe hemophilia undergoing major surgery, is stressed. With this type of management there has been no increased intraoperative hemorrhage, and very few cases of late hematoma formation. By combining the substitution therapy with immunosuppression, it has been possible to operate also on patients with inhibitors against factor VIII or IX. The rate of complications, particularly the incidence of hepatitis, has been low with the type of substitution given in this series of patients. It is concluded that major surgery can be carried out even in severe hemophilia without significantly increased risk. The handling of the substitution therapy, and the surgical judgment and technique, offers however, special problems, necessitating centralization of elective cases.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Calcified tissue international 2 (1968), S. 97-97 
    ISSN: 1432-0827
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
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  • 8
    ISSN: 1432-0851
    Keywords: Key words Epidermal growth factor ; Murine monoclonal antibody ; Glioma ; Immunotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Malignant glioblastoma may over-express the epidermal-growth-factor receptor (EGF-R). Normal brain cells show a low or no expression of EGF-R. A mouse monoclonal antibody (IgG2A) (mAb 425) (EMD55900) (Merck KGaA, Bernstadt, Germany) directed against EGF-R was produced for therapeutic use. Eight patients with primary or recurrent, EGF-R-positive glioblastomas entered the study, which was designed to evaluate the clinical effect of the mAb. In order to achieve a high tumor cell saturation, the mAb was injected intratumorally twice weekly through an implantable catheter. The total administered dose varied between 4 mg and 120 mg. In 3 patients with solid tumors, a massive tumor necrosis was noted, with infiltration of macrophages, granulocytes and T cells. A further 3 patients developed clinical and radiological signs of an intense, local, inflammatory reaction. There may be a relation between the mAb dosage and the antitumor effect, insofar as higher doses seemed to cause a more pronounced, inflammatory reaction. Of the 8 patients, 6 developed human, anti-(mouse Ig) antibodies. This anti-EGF-R mAb may induce an intense, inflammatory reaction and a considerable necrosis in glioblastoma. However, the planned schedule could not be completed, even after the dose level was re-adjusted, owing to inflammatory reactions, which were severe without prior tumor debulking.
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  • 9
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Einbau von Kalzium, Phosphat und Zink in den Kallus bei geschlossenen Tibiafrakturen wurde an erwachsenen Ratten untersucht, die mit einer standardisierten Diät ernährt wurden. Niedrige Dosen (60 ng/kg pro Tag) von 1,25(OH)2D3 an 5 Tagen pro Woche haben die frühzeitige Mineralisation des Kallus bemerkenswert erhöht. Dies stand nicht in Zusammenhang mit einem erhöhten molaren Kalzium-Phosphat-Produkt, sondern eher mit einem herabgesetzten Verhältnis. Der Einbau von Zink schien mit der Mineralisation in Zusammenhang zu stehen, jedoch nicht mit der Verabreichung von 1,25(OH)2D3 als solcher. Die Frage einer direkten, indirekten oder komplexen Bedeutung von 1,25(OH)2D3 bei der Knochenbildung und der Mineralisation wird diskutiert.
    Notes: Summary The incorporation of calcium, phosphate, and zinc into the callus of closed tibial fractures was studied in adult rats fed a standard diet. Low doses (60ng/kg per day) of 1,25(OH)2D3 5 days a week greatly increased early callus mineralization. This was not related to an increased serum calcium-phosphate molar product but rather to a decreased ratio. The incorporation of zinc into callus seemed to be correlated to the mineralization process but not to the 1,25(OH)2D3 administration as such. The question of a direct, indirect, or a complex role of 1,25(OH)2D3 in bone formation and mineralization is discussed.
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  • 10
    ISSN: 1434-601X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract A detailed analysis of the positive parity levels in odd iridium isotopes is carried out with an extended version of the Hecht and Satchler model. A satisfactory description of187–193Ir positive parity states and their electromagnetic properties is obtained by coupling several Nilsson particle configurations to an asymmetric rotor.
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