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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 71 (2000), S. 1530-1551 
    ISSN: 1433-0385
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Das Gallensteinleiden gehört mit einer Prävalenz von 15–30% zu den häufigsten Erkrankungen in den westlichen Industriestaaten. Gallensteine entstehen durch eine Verschiebung des Lösungsgleichgewichts. Risikofaktoren für das Gallenleiden sind die “6F” (female, fair, forty, fat, fertile, flatulent dyspesia). Weitere Ursachen der Steinentstehung sind Motilitätsstörungen der Gallenwege, Hämolyse, Leberzirrhose und chronische Gallenwegsinfektionen.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 7 (1983), S. 80-87 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le traitement des polytraumatisés subdivise en 2 étapes: avant l'hospitalisation et lors de l'hospitalisation. L'étape initiale d'hospitalisation est ellemême subdivisée en fonction du diagnostic et du traitement en 4 périodes: aiguë, immédiate, secondaire, tardive. Du cours de la première période les blessures mettant la vie en jeu sont traitées ainsi en est-il des lésions abdominales hémmoragiques. Lors de la deuxième période est pris en considération le traitement des ruptures intestinales, des fractures avec lésions vasculaires associées des fractures ouvertes, des fractures articulaires ouvertes, des fractures du fémur. Le traitement secondaire s'applique aux fractures articulaires fermés, aux fractures fermés de l'avant bras. Le traitement tardif répond à la chirurgie reconstructive (griffe osseuse retardée). En se pliant a ces règles, chez le polytraumatisé, il est non seulement possible de sauver le blessé dont la vie est menacée mais aussi d'aboutir à de bons résultats fonctionnels.
    Notes: Abstract The treatment of multiple trauma patients is subdivided into pre-hospital and hospital periods. The hospital period is divided according to diagnostic and therapeutic measures into acute, primary, secondary, and tertiary periods. In the acute period, all life-threatening injuries, e.g., severe abdominal bleeding, are treated. In the primary period, visceral injuries such as bowel rupture and fractures with vessel injuries, open fractures, open joints, severe compartment syndromes, and closed femoral fractures require surgery. In the secondary period, prolonged joint reconstructions, closed fractures of the forearm, and partially reconstructive surgery are performed. In the tertiary period, reconstructive surgery is done (e.g., cancellous bone grafts). Using this regimen in multiple trauma patients, we not only obtain restoration of vital function, but also good restoration of the extremities is achieved.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 102 (1999), S. 906-908 
    ISSN: 1433-044X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 4
    ISSN: 1432-0630
    Keywords: PACS: 78.40; 78.30; 73.60; 78.65
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics , Physics
    Notes: Abstract.  Optical properties in the spectral range from 0.06 to 5.5 eV of fullerite films on different substrates, C60 powder, and dissolved fullerene material are investigated by spectroscopic ellipsometry and optical transmission and reflection measurements. Depolarization effects are taken into account during determination of the dielectric function of fullerite films by ellipsometry. The optical gap for C60 films is found to be 1.63 eV. Three optical absorption bands are observed at 2.69, 3.53, and 4.49 eV. The dielectric function in the infrared shows the four characteristic infrared vibrational modes. The interference pattern seen in UV/VIS reflection measurements are used for high-precision thickness determination of the films. The Clausius-Mossotti formula is successfully applied to reproduce the experimental optical data measured in C60/dichlormethane solutions. Deviations between theory and experiments provide interesting information about the intermolecular interaction of the C60 molecules. A tentative interpretation of the measured absorption bands is presented.
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  • 5
    ISSN: 1432-0630
    Keywords: 78.40 ; 78.30 ; 73.60 ; 78.65
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics , Physics
    Notes: Abstract Optical properties in the spectral range from 0.06 to 5.5 eV of fullerite films on different substrates, C60 powder, and dissolved fullerene material are investigated by spectroscopic ellipsometry and optical transmission and reflection measurements. Depolarization effects are taken into account during determination of the dielectric function of fullerite films by ellipsometry. The optical gap for C60 films is found to be 1.63 eV. Three optical absorption bands are observed at 2.69, 3.53, and 4.49 eV. The dielectric function in the infrared shows the four characteristic infrared vibrational modes. The interference pattern seen in UV/VIS reflection measurements are used for high-precision thickness determination of the films. The Clausius-Mossotti formula is successfully applied to reproduce the experimental optical data measured in C60/dichlormethane solutions. Deviations between theory and experiments provide interesting information about the intermolecular interaction of the C60 molecules. A tentative interpretation of the measured absorption bands is presented.
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  • 6
    ISSN: 1434-6036
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract In the electrostatic approximation inhomogeneous samples with characteristic scale of inhomogeneities much smaller than the wavelength of light can be characterized by an effective dielectric function εeff. This paper analyzes in which cases simple mixing formulas can be used to calculate εeff from the dielectric functions of the consituents. These considerations are compared with reflectance measurements of alkali halide composites in the far infrared. In many cases it turns out that it is essential to employ the general ansatz of the Bergman spectral representation in order to describe all effects due to the geometrical arrangement of the phases in a proper manner. It is necessary to adjust Bergman's spectral density to measurements. This can be done by use of a Monte-Carlolike algorithm. Further on we try to answer the question how to extract the dielectric function of one of the constituents from measurements of the effective dielectric function.
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  • 7
    ISSN: 1434-6036
    Keywords: 77.90
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract The effective dielectric function of a heterogeneous medium can be calculated according to the Bergman-representation. It is a general approach to calculate the effective material properties of a two-phase composite. In this article a parameterization of the effective dielectric function on the basis of the Bergman representation is suggested and fits to measured data are presented.
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  • 8
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Continuous infusion of 15O-labeled water allows a quantitative measurement of the total water pool in the chest region by positron emission tomography (PET). By subsequent inhalation of 11CO the intravascular space (blood pool) can be quantitated as well. After a suitable normalization of the intravascular activities the extravascular water can be determined by subtraction of the blood pool from the water pool. The regional extravascular lung water distribution can be visualized in tomographic slices. The method was validated in an animal experiment using five dogs. They were measured before and after induction of a lung edema by IV injection of oleic acid. The increase of extravascular lung water was monitored by the thermodye-dilution method (TDD). The correlation of extravascular lung water as measured by TDD with PET measurements is good (r=0.94). The PET values agree also with gravimetric lung water determinations. An absolute quantitation of regional extravascular lung water is possible after absorption correction of the PET data via transmission measurements and calibration of the camera system. The uncertainty in the absolute quantification is±20%. In the experiments described here the mean extravascular lung water was 0.13 g/cm3 before and 0.25 g/cm3 after induction of lung edema.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 11 (1985), S. 227-230 
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusions A great deal has been learned about fluid resuscitation in the last several decades. The choice of an appropriate fluid for resuscitation in every given clinical situation has not yet been definitively determined but we can make some conclusions based on currently available data. It should again be emphasized that the goal of resuscitation of hypovolemic shock is quite clear regardless of the choice of fluid; to resuscitate the shock state as quickly as possible while at the same time minimizing the deleterious effects of fluid resuscitation on the pulmonary, renal, immunological and other systems. Animal experimental work reveals that use of colloid solutions to minimize pulmonary edema formation is ineffective, especially in instances where pulmonary capillary permeability is increased. Further, there are suggestions that colloid solutions may actually exacerbate pulmonary dysfunction following resuscitation by changing the characteristics of the pulmonary interstitium and the dynamics of fluid flux in the lung. This is entirely consistent with Starling's theory of a balance of hydrostatic and osmotic pressure, given what we now understand about the “other” or interstitial side of the Starling equation. Aside from the lungs, there are known side effects of various colloid solutions on other organs and body systems. In addition, questions remain about other possible associated short-term and long-term renal, coagulation, and immunological effects. Clinical studies using extravascular lung water as an objective parameter of pulmonary dysfunction show no correlation with fluid balance and no deleterious effects of crystalloid resuscitation. The relative cost of various resuscitation fluids should be a minor point when making therapeutic decisions. These relative costs, however, argue strongly for crystalloid therapy unless advantages for colloid fluids can be proved. Such proof is lacking to date. This is not to say that colloid solutions might never be called for. An occasional situation may arise in which sudden acute hypovolemia is associated with difficulties in obtaining good intravenous access. An example would be the victim of an automobile accident trapped for a prolonged period in a vehicle. Such situations impose practical limits on the amount of volume that can be infused. The use of colloid solutions to provide maximal intravascular volume restoration may be justified in such instances. In the vast majority of cases of hypovolemia, however, the balance of experimental, clinical, and practical considerations convincingly favor the use of a crystalloid solution for resuscitation in association with blood and clotting factors as needed.
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  • 10
    ISSN: 1432-2218
    Keywords: Blunt chest trauma ; Lung contusion ; Bronchopleural fistulae ; Bronchoalveolar lavage ; Pneumonia ; Acute respiratory distress syndrome (ARDS)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Extended lesions of the lung parenchyma are often seen in association with blunt chest trauma. Blood aspiration, atelectasis and the formation of bronchopleural fistulae can lead to early respiratory deterioration and the development of severe post-traumatic complications (pneumonia, acute respiratory distress syndrome). Diagnostic and therapeutic bronchoscopy is essential on admission. This procedure helps to estimate the severity and extent of parenchymal lesions even before chest X-ray signs are noted. Bronchoalveolar lavage is needed for removal of aspirates. In our study bronchoalveolar lavage on admission reduced bacterial contamination and pneumonia in comparison to patients not lavaged. A new method for closure of bronchopleural fistulae is described. Fibrin instillation after balloon catheter occlusion leads to a significant reduction of tidal volume loss (greater than 50% in average).
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