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  • Angioplasty  (2)
  • Human  (2)
  • 2000-2004
  • 1995-1999  (4)
  • 1980-1984
  • 1997  (4)
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  • 2000-2004
  • 1995-1999  (4)
  • 1980-1984
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  • 1
    ISSN: 1432-1106
    Keywords: Key words Vision ; Locomotion ; Optic Flow Adaptation ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effect of an optic flow pattern on human locomotion was studied in subjects walking on a self-driven treadmill. During walking an optic flow pattern was presented, which gave subjects the illusion of walking in a tunnel. Visual stimulation was achieved by a closed-loop system in which optic flow and treadmill velocity were automatically adjusted to the intended walking velocity (WV). Subjects were instructed to keep their WV constant. The presented optic flow velocity was sinusoidally varied relative to the WV with a cycle period of 2 min. The independent variable was the relative optic flow (rOF), ranging from −1, i.e., forward flow of equal velocity as the WV, and 3, i.e., backward flow 3 times faster than WV. All subjects were affected by rOF in a similar way. The results showed, firstly, an increase in stride-cycle variability that suggests a larger instability of the walking pattern than in treadmill walking without optic flow; and, secondly, a significant modulating effect of rOF on the self-chosen WV. Backward flow resulted in a decrease, whereas forward flow induced an increase of WV. Within the analyzed range, a linear relationship was found between rOF and WV. Thirdly, WV-related modulations in stride length (SL) and stride frequency (SF) were different from normal walking: whereas in the latter a change in WV is characterized by a stable linear relationship between SL and SF (i.e., an approximately constant SL to SF ratio), optic flow-induced changes in WV are closely related to a modulation of SL (i.e., a change of SL-SF ratio). Fourthly, this effect of rOF diminished by about 45% over the entire walking distance of 800 m. The results suggest that the adjustment of WV is the result of a summation of visual and leg-proprioceptive velocity informations. Visual information about ego-motion leads to an unintentional modulation of WV by affecting specifically the relationship between SL and SF. It is hypothesized that the space-related parameter (SL) is influenced by visually perceived motion information, whereas the temporal parameter (SF) remains stable. The adaptation over the entire walking distance suggests that a shift from visual to leg-proprioceptive control takes place.
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lebertransplantation ; Postoperative Komplikationen ; Interventionelle Radiologie ; Angioplastie ; Stents ; Drainage ; Key words Liver transplantation ; Vascular and biliary complications ; Angioplasty ; Stents ; Drainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Postoperative complications contribute significantly to the morbidity and mortality of liver transplant patients. The management of these complications requires a multidisciplinary approach in which interventional radiology plays an integral role. Indications, techniques, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent radiological interventions, including angioplasty (n = 20), embolization (n = 2), percutaneous drainage (n = 11), and biliary interventions (n = 19). Results: Nine out of ten arterial stenoses located at the anastomoses (n = 8), within the liver (n = 1) and in the coeliac trunk (n = 1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n = 5) provided long-term success only in combination with stent implantation. Portal vein stenoses and chronic thrombosis were treated by balloon dilatation and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante- or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is poor. Conclusion: Interventional radiological procedures are very useful in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, and thus, surgical interventions may be avoided in selected cases.
    Notes: Zusammenfassung Die komplexe chirurgisch-technische Operation sowie immunologische und ischämieverursachte Probleme tragen zur relativ hohen Komplikationsrate nach Lebertransplantation bei, die grundsätzlich organ- bzw. lebensbedrohlich für den Patienten sind. Interventionelle radiologische Techniken sind aufgrund ihres minimal-invasiven Charakters in der klinischen Versorgung dieser Komplikationen akzeptiert. Über 10 % der lebertransplantierten Patienten im Klinikum Großhadern sind im Verlauf mit vaskulären (n = 22) oder biliären (n = 19) postoperativen Komplikationen einer interventionellen radiologischen Behandlung zugeführt worden. Wichtigste Verfahren sind die Angioplastie (n = 20), die Katheterembolisation (n = 2), die perkutanen Drainageverfahren (n = 11) und Gallengangsinterventionen (n = 19). 20 von 22 vaskulären Interventionen wurden technisch erfolgreich durchgeführt. Für die Langzeitprognose des Organs bzw. der Patienten ist die aktuelle Organfunktion zum Zeitpunkt der Intervention entscheidend; dies entspricht weitgehend den Ergebnissen nach operativen Revisionen. Bei biliär-septischen Komplikationen ist die Organprognose als deutlich eingeschränkt anzusehen. Interventionelle Eingriffe bei Problemen der biliären Anastomosen sind als erster Therapieschritt akzeptiert und können auch in der Langzeitbeobachtung eine zufriedenstellende Problemlösung durch Ballondilatation und Prothesenimplantation gewährleisten. Interventionelle radiologische Techniken spielen in differentialtherapeutischen Überlegungen zur Behandlung postoperativer Komplikationen eine wichtige Rolle. Bei entsprechender Patientenselektion sind sie als erster Therapieschritt einzusetzen.
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  • 3
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lungentransplantation ; Anastomosenkomplikation ; Angioplastie ; Bronchialstent ; Key words Lung transplantation ; Anastomotic complications ; Angioplasty ; Bronchial stenting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Bronchial and arterial anastomotic stenoses are major complications after lung transplantation. Interventional techniques provide a definitive cure in certain cases. Material and methods: Three out of four patients had ischemia-related stenoses of the bronchial anastomoses postoperatively; one patient developed malacia of the bronchus main stem 1 year after transplantation. Four patients had stenoses of the arterial anastomoses, which resulted in hemodynamic instability and reduced perfusion of the graft. Results: Stent implantation in the bronchial anastomoses (n = 3) and in the main stem (n = 1) improved ventilation and oxygen saturation in all patients. The stents were incorporated by mucosal overgrowth, as demonstrated by endoscopy, as early as 6 weeks after implantation. Balloon dilatation (n = 3) and stent implantation (n = 1) were successfully performed in 4 patients with stenoses of the arterial anastomoses. The mean transstenotic pressure gradient of 9.5 mm Hg was reduced to 2.2 mm Hg after angioplasty. Lung perfusion shifted towards the grafts, as shown by 99mTc perfusion scans. Conclusion: The minimally invasive techniques of interventional radiology are very effective in the treatment of anastomotic complications after lung transplantation and may avoid surgery in certain cases.
    Notes: Zusammenfassung Komplikationen nach Lungentransplantation betreffen in erster Linie die Bronchusanastomose und die Pulmonalarterienanastomose. Sie sind ischämieinduziert oder auf chirurgisch-technische Probleme zurückzuführen. Bei 8 von 66 transplantierten Patienten traten postoperative Stenosen an der arteriellen Anastomose (n = 4) und an der Bronchusanastomose (n = 4) auf, die jeweils zu einem organ- bzw. lebensbedrohlichen Zustand der Patienten geführt hatten. Die interventionelle Behandlung war bei allen Patienten erfolgreich; 4 Patienten wurden bei Anastomosenstenose bzw. Malazie der Bronchusanastomose mit Metallstent versorgt, 4 Patienten mit Stenosierung an der Pulmonalarterienanastomose wurden einer Ballondilatation bzw. zusätzlicher Stentimplantation zugeführt. Die Indikation zur Behandlung und die Überprüfung des Dilatationsergebnisses wurde anhand der Stenosegradienten ermittelt, zur ausreichenden Erweiterung war eine Ballonkaliberstärke von 15 bis 20 mm erforderlich. Indikation zur Stentimplantation war eine elastische Instabilität bei einem Patienten. Der minimal-invasive Eingriff bei schwerkranken Patienten, die effiziente und komplikationslose Therapie und der erfolgreiche Langzeitverlauf sprechen dafür, bei Anastomosenproblemen nach Lungentransplantation interventionelle radiologische Verfahren primär einzusetzen.
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  • 4
    ISSN: 1432-0878
    Keywords: Key words: Interleukin-6 ; Interleukin-1β ; Tenidap ; Astrocytes ; Alzheimer’s disease ; Therapy ; Cell culture ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. Tenidap is a structurally novel antirheumatic agent with anti-inflammatory and analgesic properties. Previous studies have shown that tenidap is able to inhibit the production and action of cytokines such as interleukin-1, interleukin-6 (IL-6) and tumour necrosis factor α. However, the mechanisms by which tenidap inhibits cytokine synthesis are not yet known. We investigated in the human astrocytoma cell line U373 whether tenidap inhibits IL-6 synthesis by inhibition of certain signal transduction processes leading to IL-6 synthesis. Cells were stimulated with different substances which have previously been shown to activate protein kinase A or C, reactive oxygen intermediates as well as transcription factors such as nuclear factor kappa B and AP-1 and which all result in IL-6 synthesis. Tenidap was a very potent inhibitor of IL-6 synthesis independent of the stimuli used, suggesting an inhibitory mechanism other than inhibition of a certain signal transduction pathway. Since IL-6 has been shown to be involved in the etiopathology of Alzheimer’s disease and since the use of nonsteroidal anti-inflammatory drugs appears to be of therapeutical benefit, it is concluded that tenidap should be tested in clinical trials in order to determine whether it may be useful for the treatment of Alzheimer’s disease.
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