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  • 11
    ISSN: 1432-1246
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Culture on Löwenstein medium shows that lungs, hilar lymph nodes and spleens from female albino rats injected intravenously with BCG, and then killed after observation periods up to 12 months, contain viable BCG. These organisms induced granulomatous tissue reactions in rat lungs, indicating that the resistance of rats to tubercle bacilli is only relative.
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  • 12
    ISSN: 1432-1076
    Keywords: Wiedemann-Beckwith syndrome ; IGF-II ; Disomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In Wiedemann-Beckwith syndrome (WBS) a putative disease gene resides at the tip of the short arm of chromosome 11 in the region of the insulin growth like factor II (IGF-II) gene. Whilst changes in gene dosage in this area do not appear to be common in the syndrome, in familial cases the lesion appears to be dominant only when inherited through the female line. We undertook to examine the parental origin of the copies of chromosome 11 in a large group of WBS patients using a series of restriction fragment length polymorphisms (RFLPs) on 11p, and report here that in one sporadic case of WBS out of 14 both copies of chromosome 11 are derived from the father and are present in a normal dosage. This suggests that at least one mode of expression of the lesion is modified by genomic imprinting.
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  • 13
    ISSN: 1432-1076
    Keywords: Wiedemann-Beckwith syndrome ; Chromosome 11
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Wiedemann-Beckwith syndrome (WBS) is characterised by a specific group of congenital malformations associated with an increased concurrent risk for development of a defined group of childhood neoplasms. The mode of inheritance is complex, but recently compiled family data suggest that it is an autosomal dominant trait of varying expression. It has previously been suggested that major rearrangements on the short arm of chromosome 11 may be involved in the aetiology of the disease, particularly in the region of the insulin like growth factor II (IGF-II) gene (11p15.5). This gene is thought to be parentally imprinted in the mouse and it has been suggested that in the human, duplication of the non-imprinted locus in WBS patient might lead to diploid expression of the gene and consequent general hyperplasia. This model predicts that there should be both frequent and parental origin specific duplication of the IGF-II gene in the patients. It was the aim of this study to examine the IGF-II locus and its surrounding chromosomal environment for such lesions in a large number of WBS patients. Using restriction fragment length polymorphism analysis for four linked markers on 11p and genomic clones internal to the IGF-II locus we could find no evidence of alteration or amplification of this area in any of the 11 patients investigated. In one patient who developed a Wilms tumour we could find no evidence for loss of any material on the short arm of chromosome 11 as reported previously. We conclude that amplification of genes on the short arm of chromosome 11 is not a frequent occurrence in WBS and certainly not a prerequisite, leaving open the possibility that mutations in unknown transacting factors might affect the expression of IGF-II in these patients in the absence of lesions in the gene itself.
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  • 14
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In-hospital observation with repeated clinical examinations is commonly used in patients with an equivocal diagnosis of appendicitis. It is not known if repeated measurements of temperature and laboratory examinations have any diagnostic importance in this situation. The importance of repeated measurements of the body temperature, white blood cell (WBC) and differential cell counts, C-reactive protein concentration (CRP) and of the surgeon's repeated assessments was prospectively analyzed in 420 patients with an equivocal diagnosis of appendicitis at admission who were reexamined after a median of 6 hours of observation. The final diagnosis was appendicitis in 137 patients. After observation the inflammatory response was increasing among patients with appendicitis and decreasing among patients without appendicitis. The variables discriminating power for appendicitis consequently increased, from an area under the receiver operating characteristic (ROC) curve of 0.56 to 0.77 at admission, to 0.75 to 0.85 after observation. The ROC area of the surgeons' clinical assessment increased from 0.69 to 0.89. The WBC and differential cell counts were the best discriminators at the repeat examination. The change in the variables between the observations had weak discriminating power and had no additional importance in addition to the actual level at the repeat examination. To conclude, the diagnostic information of the temperature and laboratory examinations increased after observation. Repeated controls of the body temperature and laboratory examinations are therefore useful in the management of patients with equivocal signs of appendicitis, but the result of the examinations must be integrated with the clinical assessment.
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 399 (1983), S. 177-189 
    ISSN: 1432-2307
    Keywords: Achilles tendon ; Tendon injuries ; Muscles ; Myofibrils ; Ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Unilateral tenotomy of the Achilles tendon was carried out in 60 rabbits. The limb was then either mobilized directly or immobilized for 10 to 35 days using a plaster usually after tendon suture. In certain cases the plaster was removed early (on the 7th or 16th day) and the animals were than allowed to use this leg. Separation between tendon ends was apparent from steel markers, placed close to each cut end of the tendon and examined by X-ray. The separation curve was biphasic and both the first and the inactive phase reflected the degree of tension over the tendon suture. However, during the second separation phase, which began between the 17th and 21st day, the separation gradually reached the same level in all groups. Enzyme histochemistry and electron microscopy revealed severe degenerative changes in immobilized and in shortened muscles. Furthermore, a gradual shift in fibre type characteristics from type 1 slow-twitch fibres towards type 2 fast-twitch fibres occurred. Rapid recovery followed removal of the plaster. The findings indicated that both degenerative and regenerative processes and adaptive processes had been initiated in all experimental muscles when the tendon continuity was broken. The adaptive processes progressed gradually during the five-week post-operative period and might have been responsible for the second phase of the tendon end separation. The fibre adaptation, i.e. the transformation, may be accounted for by changes in structure of the myofibrils and composition of the myosin molecules.
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  • 16
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'analyse des différentes études scientifiques sur les infections intra-abdominales a montré que les problèmes d'interprétation et de comparabilité relèvent de critiques diagnostiques variables, et de l'absence d'évaluation de la sévérité de la maladie, et de son évolution. Un système de définitions a été développé pour pallier ces déficiences. L'infection intra-abdominale se définit comme péritonite clinique exigeant la confirmation opératoire et microbiologique de l'infection. Le score APACHE II est proposé pour classer l'infection selon sa sévérité et prévoir le risque de mortalité. Mortalité et délai avant la mort, guérison st délai avant la guérison sont proposés comme critères d'évolution. On espére que le fait d'adopter ces règles permettra de comparer les études et fera progresser notre compréhension de l'infection intra-abdominale et son traitement.
    Abstract: Resumen El análisis de los resultados de investigaciones científicas en pacientes con infección intraabdominal secundaria ha revelado que los problemas de interpretación y comparabilidad entre los diversos estudios se relacionan con criterios diagnósticos variables, con gravedad no definida de la enfermedad, y con parámetras indeterminados de desenlace. Se ha establecido un Sistema consistente de definiciones con el objeto de eliminar tales deficiencias. La infección intraabdominal es definida como una peritonitis clfnica que requiere confirmación, tanto operatoria como microbiológica como prueba de la infección. Se propone el sistema APACHE II para determinar el grado de gravedad de la infección y para la estratificación del riesgo de mortalidad. La mortalidad y el período hasta la muerte del paciente por un lado, y la recuperación y el perfodo hasta la recuperación por otro, son propuestos como los parámetras principales de desenlace, ambos definidos en forma independiente y positiva. Se espera que este sistema de reglas mínimas habrá de producir estudios que sean comparables, lo cual acelere la adquisición de nuevos conocimientos y la mejor comprensión de la infección intraabdominal y de su tratamiento.
    Notes: Abstract Analysis of the experience with scientific studies on patients with secondary intraabdominal infection has revealed that problems of interpretation and comparability between studies exist as they relate to variable diagnostic criteria, unmeasured severity of disease, and unclear outcome measures. A consistent system of definitions has been developed to address these deficiencies. Intraabdominal infection is defined as clinical peritonitis requiring both operative and microbiological confirmation for proof of infection. The APACHE II system is proposed for grading the severity of the infection and for stratification of patient risk of mortality. Mortality and time until death, on one hand, and recovery and time until recovery, on the other, are proposed as the main outcome measures, both being independently and positively defined. It is anticipated that this system of minimum rules will produce studies that can be compared, hence, accelerating knowledge and understanding about intraabdominal infection and its best treatment.
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  • 17
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 18
    ISSN: 1433-3058
    Keywords: Key words: Case-based reasoning; Heat-exchange equipment; Mixing equipment selection; Neural networks; Process design
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Mathematics
    Notes: The early stages of design are characterised by imprecise and incomplete information about the features and properties of targeted product or process. Equipment selection is one of the decisions to be taken in an initial phase of design. Mixing is an example of process where the selection of the equipment is practically realised ‘by hand’. An application of rule-based or object-oriented tools in the selection of mixing equipment encounters many problems. The main reasons are the lack of well-structured knowledge and the great diversity of mixing problems. Case-based reasoning constitutes a good tool to handle the problems of mixing equipment selection. An instance generator for case-based reasoning system is described in this work. A fuzzy neural network system has been used to produce the cases. The following types of the equipment for heat exchange in stirred vessels have been considered: plain jacket, plain jacket with agitation nozzles, plain jacket with spiral baffles, dimple jacket, halfpipe jacket, helical coil, vertical coil and vertical plate coil.
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  • 19
    ISSN: 1433-7339
    Keywords: Acyclovir ; Bacteraemia ; Leukaemia induction treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively tested the hypothesis that prevention of herpes simplex virus infection with acyclovir might also reduce the incidence of bacterial infections in adult patients with acute leukaemia. During the first induction therapy a double-blind, randomized and placebo-controlled study was undertaken. Fifty-two patients were treated with 200 mg acyclovir orally four times daily throughout the induction period, whereas 55 patients received placebo. The groups were comparable with regard to age, cytotoxic chemotherapy and duration of neutropenia. Bacteraemias were significantly fewer in the acyclovir group (20 versus 41 episodes; P=0.007). The number of isolated microorganisms causing bacterial or fungal infections was also lower during acyclovir prophylaxis (52 isolates, versus 93 isolates; P=0.02). There was no significant differenc between the groups with regard to the number of clinically documented infections or fevers of unknown origin. Herpes simplex virus isolations occurred only in the placebo group (P=0.001). Thus, oral acyclovir prophylaxis was associated with reductions of all microbiologically documented infections suggesting that prevention of herpes simplex virus reactivation in acute leukaemia patients may reduce the occurrence of other infections.
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  • 20
    Electronic Resource
    Electronic Resource
    Springer
    Acta neuropathologica 16 (1970), S. 64-72 
    ISSN: 1432-0533
    Keywords: Intracranial Aneurysm ; Microradiography ; Calcification ; Fatty Plaque
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Häufigkeit von Verkalkungen und Fettplaques wurde an 70 Autopsiefällen mit 85 intrakraniellen Aneurysmen untersucht. 70 Aneurysmen waren rupturiert. Es wurden stereomikroskopische, mikroradiographische und histopathologische Methoden verwendet. Anomalien des Circulus arteriosus Willisii fanden sich in 55%, was den Befunden früherer Aneurysmaserien entspricht. Fettplaques und/oder Verkalkungen der Aorta und Carotiden fanden sich in 60% und waren weitgehend generalisiert in 24% der Fälle. Einige Patienten waren verhältnismäßig jung. Fettige Infiltration fand sich in der Wand aller Aneurysmen. Nahe den Plaques war die Aneurysmenwand dünn und oft vorgewölbt. Leere, dünne Ausbuchtungen waren nachweisbar. Die Fettplaques werden als Vorstufen der Verkalkungen angesehen. Verkalkungen fanden sich in der Wand von 25 Aneurysmen. Bei älteren Patienten waren die atheromatösen Lipidplaques und Verkalkungen größer und näher dem Aneurysmenhals; bei jüngeren Patienten waren sie näher der Kuppe und oft im weitesten Durchmesser des Aneurysmas. Die Rupturstellen waren nahe den Fettplaques oder Verkalkungen und meist distal davon. Die Bedeutung der Verwendung eines Mikroskops bei der Operation wird hervorgehoben.
    Notes: Summary The incidence of calcification and of fatty plaques was investigated in 70 autopsy cases with 85 intracranial aneurysms. Seventy aneurysms had ruptured. Stereomicroscopic microradiographic and histopathological methods were utilized. Anomalies of the circle of Willis were observed in 55%, corresponding to what is usually found in previous aneurysm series. Fatty plaques and/or calcifications were observed in the aorta and carotid arteries in 60% and were more widely generalized in 24% of the cases. Several of the patients were relatively young. Fatty infiltration was found in the walls of all aneurysms. Adjacent to the plaques the walls of the aneurysms were thin and frequently bulging. Empty thin outpouchings were also found. The sites of rupture were related to the outpouchings. The fatty plaques were considered to be prestages of calcifications. Calcification was found in the walls of 25 aneurysms. In older patients fatty atheromatous plaques and calcifications were larger and situated nearer the necks of the aneurysms; in younger patients they were nearer the domes, often at the widest diameter of the aneurysms. The sites of rupture were close to the fatty plaques of calcifications and generally distal to them. The importance of using a microscope at operation is stressed.
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