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  • Laparoscopic cholecystectomy  (3)
  • Locomotion  (2)
  • 63Ni  (1)
  • AC-ECD  (1)
  • Springer  (7)
  • Munksgaard International Publishers
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  • Springer  (7)
  • Munksgaard International Publishers
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  • 1
    ISSN: 1432-2218
    Keywords: Laparoscopic cholecystectomy ; Bile leak ; Cholelithiasis ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Laparoscopic cholecystectomy (LC) is now the treatment of choice for gallstones, but there has been concern that bile leakage with LC is more frequent than after open cholecystectomy (OC). We have analyzed our experience of this complication with regard to both its incidence and management. From a consecutive series of 500 LC, in which both operative cholangiography and drainage of the gallbladder bed were routine, bile leakage was identified in ten patients (2%). There was no bile duct injury. Nine of the ten patients presented with bile in the drain within 24 h of operation and one patient presented 1 week after operation with a subphrenic collection. Of the ten patients, five settled spontaneously. Of the five remaining patients, two needed laparotomy—one for a subphrenic collection not responding to percutaneous drainage and one for biliary peritonitis. One patient was treated by relaparoscopy and suture of a duct of Luschka and one patient had successful percutaneous drainage of an infected collection; the fifth patient who presented with a late subphrenic collection of bile was shown at endoscopic retrograde cholangiopancreatography (ERCP) to have a cystic duct stump leak and was treated with an endoscopic stent. Bile leakage is seen more frequently after LC than OC for reasons that are currently unclear. We believe that the use of routine gallbladder bed drainage is justified for this reason alone. The majority of bile leaks settle either spontaneously or with minimally invasive intervention.
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  • 2
    ISSN: 1432-2218
    Keywords: Laparoscopic cholecystectomy ; Liver retraction ; Fundus-first
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Removal of the gallbladder with commencement of dissection at the fundus is well recognized as a safe technique during difficult “open” cholecystectomy because it minimizes the risks of damage to the structures in or around Calot's triangle. We report here the routine employment of liver retractors and fundus-first dissection during laparoscopic cholecystectomy (LC) as an alternative to techniques previously described. Retraction of the liver and “fundus-first” dissection was used in 53 patients who underwent laparoscopic cholecytectomy. There were 16 male and 37 female patients. Seven were operations performed during an acute admission and 20 had moderate or severe adhesions involving the gallbladder. Thirteen patients had a preexisting abdominal incision. The procedure was successful in 52 patients (98%), but in one patient it was converted to open operation because of dense adhesions. Median duration of operation was 90 min (range 35–240 min). There was no mortality and two complications (persistent right upper quadrant pain for 2 weeks after operation and bile leakage from the gallbladder bed). The facility to retract the liver and carry out a fundus-first dissection extends techniques developed for “open” surgery into the laparoscopic arena. It offers the surgeon the safety and versatility during laparoscopic cholecystectomy that it confers during conventional open surgery.
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  • 3
    ISSN: 1432-2072
    Keywords: Key words Dopamine ; Microdialysis ; Nucleus accumbens ; Feeding ; Locomotion ; Area under the curve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The intent of the present study was to determine the effects of systemic injections of the sympathomimetic agent ephedrine (EPH) on extracellular dopamine (DA) levels within the rat nucleus accumbens (NAC) and to compare these effects with those of EPH on locomotion and on feeding. In experiment 1, adult male rats were prepared with an indwelling 3 mm microdialysis probe positioned within the NAC. The rats were injected (IP) with vehicle, 5, 10, or 20 mg/kg (–)-EPH with dialysates collected every 20 min for 100 min after drug injection. Systemic injections of 5, 10 or 20 mg/kg (–)-EPH significantly enhanced extracellular levels of NAC DA over baseline by 79%, 130%, and 400%. Systemic injection of 20 mg/kg EPH significantly reduced NAC levels of DOPAC and HVA by 37% and 31%. The effects of EPH on brain dopamine activity were stereospecific given that an additional group of rats injected with 20 mg/kg (+)-EPH exhibited smaller changes in NAC DA (〈25%), DOPAC (〈10%), and HVA levels (〈20%) than did rats injected with 20 mg/kg (–)-EPH. In experiment 2, adult male rats were injected (IP) with 0, 5, 10, or 20 mg/kg (–)-EPH prior to placement in automated activity chambers. Total distance traveled was significantly increased by 10 and 20 mg/kg (–)-EPH, but not by 5 mg/kg (–)-EPH. In experiment 3, adult male rats were injected (IP) with 0, 2.5, 5, or 10 mg/kg (–)-EPH or with 0, 2.5, 5, or 10 mg/kg (+)-EPH prior to a 30-min feeding test. Although each EPH enantiomer decreased feeding, (–)-EPH was more potent in feeding suppression than was (+)-EPH. The present results suggest that EPH may alter locomotion and feeding via an indirect action on brain dopamine activity.
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  • 4
    ISSN: 1432-2072
    Keywords: Key words Cocaine ; Dopamine ; Ephedrine ; Locomotion ; Rat ; Sensitization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Systemic injection of the sympathomimetic agent ephedrine (EPH) stimulates locomotion in drug-naive rats, an effect that may be dependent on the enantiomer of EPH employed [(–)-EPH or (+)-EPH]. The present experiments examined the effects of repeated EPH exposure on locomotion in rats to assess whether these treatments result in drug tolerance or sensitization. In experiment 1, adult male rats were injected once daily with 0, 10, 20, or 40 mg/kg (–)-EPH (IP) on each of 11 days. Locomotor activity was assessed for 60 min after drug injection. Acute exposure to (–)-EPH treatment increased locomotion for animals receiving 20 or 40 mg/kg, and this effect was augmented after 11 days of drug administration. A vehicle-only injection was given to all animals on day 12 to determine the influence of environmental cues on sensitization. On day 13, all rats were injected with 10 mg/kg cocaine HCl to assess whether repeated (–)-EPH exposure produced a cross-sensitization to cocaine (10 mg/kg, IP). Only rats treated repeatedly with 40 mg/kg (–)-EPH exhibited increases in cocaine-stimulated locomotion relative to saline-treated rats. In experiment 2, repeated exposure to (+)-EPH, 40 mg/kg, but not 20 mg/kg, increased activity and demonstrated the development of sensitization. Cross-sensitization to cocaine (10 mg/kg, IP) was not evident following treatment with either concentration of (+)-EPH. There was no evidence that contextual events alone played a role in the effects observed here.
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  • 5
    ISSN: 1432-2218
    Keywords: Laparoscopic cholecystectomy ; Pregnancy ; Second-trimester pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic cholecystectomy is now the standard treatment for symptomatic gallstones; while symptomatic gallstones during pregnancy are not frequent they are by no means rare. The role of laparoscopic cholecystectomy during pregnancy is controversial but initial reports suggest it is both safe and feasible. Methods: During a consecutive series of 500 laparoscopic cholecystectomies, 3 patients have undergone laparoscopic cholecystectomy during pregnancy. The 3 patients were 16–27 weeks pregnant with an average age of 32 years. The indication for laparoscopic cholecystectomy was severe pain in two patients and gallstone pancreatitis in one patient. Following standard obstetric anesthesia, laparoscopic cholecystectomy was performed. Open cannulation was used to establish peritoneal access, following which “standard,” four-port laparoscopic cholecystectomy was performed without complication. The insufflation pressure used was 8–10 mmHg CO2 and a liver retractor was employed to facilitate access. Results: In each case the postoperative recovery was rapid and uneventful for both mother and fetus. The patients were discharged on the first or second postoperative day. Conclusions: Laparoscopic cholecystectomy during the second trimester of pregnancy is both safe and feasible provided both suitable surgical and anesthetic expertise are available. Even up to the end of the second trimester there is sufficient access for the technique to be employed.
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  • 6
    ISSN: 1436-5073
    Keywords: ionization topography ; 3H ; 63Ni ; electron capture detector
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract The ion-pair generation rate (ionization topography) in plasmas from63Ni and particularly Ti3H4 foils, as used in electron capture detectors, was measured at room temperature using large, parallel plates of low backscattering ability in nitrogen gas of varying density. For one atmosphere pressure, the fall-off of ion pair formation as calculated from the exponential region equalsN 0·e −0.19d for63Ni andN 0·e −1.4d for3H (whereN 0 is the initial ionization rate immediately adjacent to the foil andd is the distance from the foil in mm). The experimentally measured half ranges (distances from the foil within which 50% of all possible ion pairs are created) are 2.7 mm for63Ni and 0.27 mm for3H. The half ranges calculated from the exponential region where there is less interference from electron backscattering, are 3.7 and 0.5 mm, respectively. The latter values are considered closer to the “true”, unimpeded ionization topography near planar63Ni and3H foils.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Microchimica acta 96 (1988), S. 11-26 
    ISSN: 1436-5073
    Keywords: electron capture detector (ECD) ; electron oscillation ; AC-ECD ; argon-methane ; non-homogeneous ECD kinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract The oscillation of electrons—as driven by AC polarization—can be used to extract a high-sensitivity signal from a conventional electron capture detector. For example, hexachloroethane was detected at a hypercoulometric ratio of 2.0 F/mol, down to ca. 60 fg/s (S/N=3) and with a linear range in excess of two orders of magnitude. The change in carrier gas from nitrogen to argon-methane produced the expected order-of-magnitude increase in optimum oscillation frequency. Anab initio simulation of potentials and ion populations in a heterogeneous electron capture system under a high-frequency AC regime provided further insight into the detector's mechanism: Hypercoulometric response is mainly caused by increased cation-electron recombination in the plasma region, owing to a decreased field gradient and an increased cation concentration.
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