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  • 1
    Electronic Resource
    Electronic Resource
    Influence of Two Blood Conservation Techniques (Cardiotomy Reservoir Versus Cell-Saver) on Biocompatibility of the Heparin Coated Cardiopulmonary Bypass Circuit During Coronary Revascularization Surgery (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 12 (1997), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Blood conservation during cardiac surgery is critically important because of the inherent risks in homologous blood transfusions. Two techniques for the intraoperative conservation of blood—retransfusion of the red cells using a cell-saver (CS), or retransfusion of the blood using a cardiotomy suction (CTR) system—were compared using biocompatibility markers, granulocyte activation, and production of oxygen-free radicals (OFR). In the CTR group, heparin coated circuits with an uncoated cardiotomy reservoir were used. For the CS group, identical heparin coated cardiopulmonary bypass (CPB) sets, without a cardiotomy reservoir but with a CS, were used. In each group, eight patients had coronary artery bypass grafting performed. The capacity of the whole blood and the granulocytes to produce OFR was estimated by a chemiluminescence, and granulocyte activation was measured as release of the granulocyte granule proteins myeloperoxidase (MPO) and lactoferrin. A significantly reduced capacity to produce OFR by the whole blood was noted at 45 minutes of CPB in the CTR group (68%± 17% vs 94%± 16% in the CS group). MPO release was higher after 3 hours (p = 0.05) and 20 hours (p 〈 0.05), postoperatively, in the CTR group (417 ± 77 μg/L and 257 ± 31 μg/L vs 246 ± 25 μg/L and 164 ± 12 ng/L, respectively, in the CS group). We conclude that the heparin coated CPB circuit with the uncoated cardiotomy reservoir may be less biocompatible than the identical CPB set used together with the CS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1997.tb00122.x
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  • 2
    Electronic Resource
    Electronic Resource
    Predictive value of serum S100B for monitoring patients with metastatic melanoma during chemotherapy and/or immunotherapy (1999)
    Oxford BSL : Blackwell Science Ltd
    British journal of dermatology 140 (1999), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In the immunohistology of malignant melanoma the use of polyclonal antibodies against protein S100 is well established. Recently, it was shown that S100B, a subunit of the S100 protein family, is detectable in the serum of melanoma patients and correlates with the stage of the disease in patients with metastatic melanoma. In the present study, the first evaluation of a large number of treatment observations (n = 77) in 64 different patients during chemotherapy and/or immunotherapy for advanced metastatic melanoma (stage IV) is presented. All patients received treatment according to standardized protocols comprising 8 weeks of treatment followed by routine staging procedures to evaluate therapeutic outcome. In 13 patients with tumour enlargement after first-line therapy, a second-line treatment was subsequently given. S100B immunoradiometric assay (IRMA) tests were performed before, during and after treatment at scheduled time points. In the interim analysis at 4 weeks 29 of 37 (78%) patients with tumour progression during treatment showed a raised S100B level. In the final analysis at 8 weeks, 31 of these 37 patients (84%) demonstrated rising S100B values (P 〈 0.001). Patients who responded to treatment (stable or regressing metastatic disease) showed constant or declining S100B levels in 38 of 40 patients (95%) at the interim analysis, at 8 weeks this was further increased to 39 of 40 patients (98%; P 〈 0.001). Thus, the use of S100B for monitoring treatment is adequate in the majority of cases. Our observations are of great interest for therapeutic trials of adjuvant and palliative therapies as the rise of S100B levels might indicate that re-staging and/or changes in therapy strategies should be chosen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1999.02905.x
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  • 3
    Electronic Resource
    Electronic Resource
    Characterization of MexE–MexF–OprN, a positively regulated multidrug efflux system of Pseudomonas aeruginosa (1997)
    Oxford BSL : Blackwell Science Ltd
    Molecular microbiology 23 (1997), S. 0 
    Details
    ISSN: 1365-2958
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Medicine
    Notes: Antibiotic-resistant mutants of Pseudomonas aeruginosa were generated using chloramphenicol and ciprofloxacin as selective agents. These mutants displayed a multidrug phenotype and overexpressed an outer membrane protein of 50kDa, which was shown by Western blot analysis to correspond to OprN. A cosmid clone harbouring the oprN gene was isolated by partial complementation of a mutant deficient in OprM, the outer membrane component of the mexAB–oprM efflux operon. Antibiotic-accumulation studies indicated that OprN was part of an energy-dependent antibiotic-efflux system. Sequencing of a 6180bp fragment from the complementing cosmid revealed the presence of three open reading frames (ORFs), which exhibited amino acid similarity to the components of the mexAB–oprM and mexCD–oprJ efflux operons of P. aeruginosa. The ORFs were designated MexE, MexF and OprN. Mutation of the mexE gene eliminated the multidrug-resistance phenotype in an OprN-overexpressing strain, but did not affect the susceptibility profile of the wild-type strain. Expression of the mexEF–oprN operon was shown to be positively regulated by a protein encoded on a 1.5 kb DNA fragment located upstream of mexE and belonging to the LysR family of transcriptional activators. The presence of a plasmid containing this DNA fragment was sufficient to confer a multidrug phenotype onto the wild-type strain but not onto the mexE mutant. Evidence is provided to show that the mexEF–oprN operon may be involved in the excretion of intermediates for the biosynthesis of pyocyanin, a typical secondary metabolite of P. aeruginosa.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2958.1997.2281594.x
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  • 4
    Electronic Resource
    Electronic Resource
    Immunotherapy of acute lymphoblastic leukemia by vaccination with autologous leukemic cells transfected with a cDNA expression plasmid coding for an allogeneic HLA class I antigen combined with interleukin-2 treatment (1998)
    Springer
    Journal of molecular medicine 76 (1998), S. 215-221 
    Details
    ISSN: 1432-1440
    Keywords: Abbreviations ALL Acute lymphoblastic leukemia ; BMT Bone marrow transplantation ; CTL Cytotoxic T-lymphocytes ; IL Interleukin ; MHC Major histocompatibility ; MRD Minimal residual diseaseIntroductionObjective ; The purpose of this protocol is to induce a specific cellular immune reaction after autologous bone marrow transplantation (BMT) by vaccination with human leukocyte antigen (HLA) B13 transfected autologous leukemic cells in children with high-risk relapse of acute lymphoblastic leukemia (ALL). Specific cytotoxic T-lymphocytes (CTL) will be expanded in vivo by low-dose interleukin-2 (IL-2). The expression vector used is the pcDNA3 HLA-B13 plasmid ; driven by a cytomegalovirus promoter. Leukemic cells are transfected by electroporation/ballistomagnetic transfer.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001090050211
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  • 5
    Electronic Resource
    Electronic Resource
    Infektion mit Ancylostoma duodenale im Kindesalter (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 15-18 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Ferntourismus ; Ancylostoma duodenale ; Eosinophilie ; Hypochrome Anämie ; Stuhldiagnostik ; Key words International tourism ; Ancylostoma duodenale ; Eosinophilia ; Hypochromic anemia ; Examination of stool smears
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background: Worldwide 400 to 800 Mio people are infected with hookworms. In tropical and subtropical areas an infection with hookworms is the most common reason of eosinophilia and hypochromic anemia. Depending on patients’ weight, age, status of health and nutrition severe medical problems are possible. Case report: In our hospital a 13 year old boy was admitted to clear up an eosinophilia. Atopic, malign, different infectious or drug induced diseases could be excluded. Finally an infection with Ancyclostoma duodenale could be detected in the fourth direct microscopic examination of fecal smears for parasits and worm eggs. A therapy with mebendazole eradicated the hookworm successfully. Discussion: Because of increasing international tourism it is mandatory to include hookworm infections in the differential diagnosis of eosinophilia and hypochromic anemia also in Northern Europe. It must be considered that a sufficient substitution with iron may compensate the anemia and will cover the disease. Therefore sometimes several stool smears have to be examined to detect the infection.
    Notes: Zusammenfassung Hintergrund: Weltweit sind 400–800 Mio. Menschen mit Hakenwürmern infiziert. In den tropischen/subtropischen Gebieten gehört der Befall zu den häufigsten Ursachen einer Eosinophilie sowie hypochromen Anämie. Abhängig von Gewicht, Alter, Gesundheits- und Ernährungszustand sowie Intensität der Infektion können schwere gesundheitliche Schäden auftreten. Fallbericht: Wir berichten über einen 13jährigen Knaben, der zur Diagnostik einer unklaren Eosinophilie eingewiesen wurde. Als Ursache der Eosinophilie konnten Atopien, maligne und verschiedene infektiöse Erkrankungen sowie medikamentös induzierte Formen ausgeschlossen werden. Erst bei der 4. Untersuchung frischer Stuhlproben auf Parasiten und Wurmeier ließ sich eine Infektion mit Ancylostoma duodenale nachweisen, die erfolgreich mit Mebendazol behandelt wurde. Diskussion: Aufgrund des ansteigenden internationalen Reiseverkehrs muß eine Hakenwurminfektion bei unklarer Eosinophilie und hypochromer Anämie auch in unseren Breiten unbedingt differentialdiagnostisch einbezogen werden. Der Nachweis erfordert häufig mehrere Stuhluntersuchungen. Bei guter Eisenversorgung kann die Anämie kompensiert und das Krankheitsbild maskiert werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050388
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  • 6
    Electronic Resource
    Electronic Resource
    Intraokulare Tumoren im Kindesalter (1999)
    Springer
    Der Onkologe 5 (1999), S. 920-928 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Raumfordernde intraokulare Prozesse sind im Kindesalter ein extrem seltenes Ereignis. Alle bekannten intraokularen Tumoren können auch im Kindesalter auftreten, jedoch ist das Retinoblastom der mit Abstand häufigste maligne Tumor in dieser Altersgruppe.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050551
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  • 7
    Electronic Resource
    Electronic Resource
    Validating of a transoesophageal ultrasonic-Doppler-probe to the detection of air in the venous blood (1998)
    Springer
    Der Anaesthesist 47 (1998), S. 406-408 
    Details
    ISSN: 1432-055X
    Keywords: Key words Venous air embolism ; Neurosurgery ; Doppler sensor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: The aim of this study was to compare the sensitivity of a newly applied transoesophageal ultrasonic Doppler sensor for detection of air with the traditional precordial ultrasonic Doppler sensor in clinical use. Methods: We studied 16 patients undergoing neurosurgical procedures in a sitting position. Two ultrasonic Doppler devices were compared as to their ability to detect venous air embolisms (VAE): transoesophageal (ODM II, co. Abbott) versus a precordial ultrasonic Doppler sensor (Parks Medical Electronics Inc.). After establishing general anaesthesia and endotracheal intubation, we applied an ultrasonic Doppler sensor to the right sternal border of the patient’s chest and inserted an ultrasonic Doppler probe into the oesophagus. With the patient in the sitting position, microparticularly d-galactose was injected to verify the efficacy of both ultrasonic Doppler devices. Results: Using ODM II by positioning the probe toward the azygos vein, a dosage of 1 ml microparticularly d-galactose was dedected in every patient. When adjusting the ODM II-probe on the right myocardial wall or using the precordial ultrasonic Doppler sensor, the administration of microparticularly d-galactose was detected by the devices in only 11 patients. Conclusions: This study demonstrates that a transoesophageal ultrasonic Doppler sensor (ODM II) is more efficient than the precordial ultrasonic Doppler sensor for monitoring patients who are at risk of VAE by sonification of the azygos vein.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050577
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  • 8
    Electronic Resource
    Electronic Resource
    Atemgasklimatisierung mit leistungsfähigen HME (Heat and Moisture Exchanger) – eine effektive und kostengünstige Alternative zu aktiven Befeuchtern bei beatmeten Patienten (1996)
    Springer
    Der Anaesthesist 45 (1996), S. 518-525 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Atemgasklimatisierung ; Aktive Befeuchtungssysteme ; HME ; Heat and Moisture Exchanger ; Künstliche Nasen ; Wärme- und Feuchtigkeitstauscher ; Key words Air-conditioning ; Artificial nose ; Heat and moisture exchanger ; Heated humidifier ; HME
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Heat and moisture exchangers (HME) are used as artificial noses for intubated patients to prevent damage resulting from dry and cold inspired gases. HME collect a large fraction of the heat and moisture of the expired air, adding them to the subsequent inspired breath. In a prospective clinical study the air-conditioning capacity of a heated humidifier was compared with a hygroscopic HME. Methods. The water content of the ventilated air of 49 intensive care patients requiring artificial ventilation with tidal volumes between 440 and 1,190 ml (mean 658±148 ml) was examined. Each patient was ventilated in sequence with an HME (DAR Hygrobac S) and a heated humidifier (Fisher & Paykel MR 630 B). The temperature of the air in the inspiratory limb was maintained at 34 °C. The water content of the ventilated air was determined under steady-state conditions directly at the tracheal tube or between tracheal tube and HME using a new, high-resolution humidity meter. The results were compared with the absolute water loss of the exhaled air at the gas outlet of the ventilator as an expression of the water loss from the lower airways. Airway resistance was calculated by a standard formula. The daily running costs for both HME and heated humidifier were estimated. Results and discussion. Moisture retention was equivalent in both the HME and the heated humidifier (33.7±1.85 bzw. 34.1±2.62 mgH2O/l). These data show that modern HMEs are able to maintain physiological air-conditioning even in long-term ventilated patients. The small increase in airway resistance associated with HMEs (3.1±2.5 mbar/l·s) has to be noted in difficult weaning procedures. Both labour and costs per day are significantly less with HMEs (8.60 vs. 21.70 DM).
    Notes: Zusammenfassung In einer prospektiven klinischen Studie an 49 intubierten und kontrolliert beatmeten Patienten wurde gezeigt, daß die inspiratorischen Befeuchtungsleistungen des HME DAR Hygrobac S und des aktiven Befeuchters Fisher & Paykel MR 630 B äquivalent sind (33,7± 1,85 vs. 34,1±2,62 mgH 2 O/l). Bei bestimmungsgemäßem Einsatz (tubusnahe Plazierung bzw. inspiratorische Atemgastemperatur von 34 °C) und Tidalvolumina zwischen 440 und 1190 ml (Mittel 658±148 ml) gewährleisteten beide Systeme eine physiologische Klimatisierung der Atemluft. Die geringgradige Erhöhung der inspiratorischen Resistance durch die HME (3,1±2,5 mbar/l/s) muß ggf. bei der schwierigen Respiratorentwöhnung mit berücksichtigt werden. Die Verwendung von HME ist erheblich kostengünstiger und weniger personalintensiv als der Einsatz von aktiven Befeuchtungssystemen. Leistungsstarke HME stellen damit eine gute Alternative zu aktiven Befeuchtungssystemen in der Intensivbeatmung dar.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050285
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  • 9
    Electronic Resource
    Electronic Resource
    An experimental investigation of the ELAC 1 configuration at supersonic speeds (1999)
    Springer
    Experiments in fluids 26 (1999), S. 423-436 
    Details
    ISSN: 1432-1114
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: Abstract  Supersonic flight of aerospace planes is of marked interest since several flow regimes characterized by different local flow structures have to be flown through. This problem was investigated experimentally for the hypersonic research configuration ELAC 1. The aim of the study was to detect the influence of the rounded leading edge, of the thickness distribution prescribed, and of the Reynolds number, especially on the flow on the leeward side of the configuration. The experiments were carried out in the transonic wind tunnel of Aerodynamisches Institut of RWTH Aachen, at a freestream Mach number Ma ∞=2, a unit Reynolds number of Re ∞=13×106, angles of attack between −3°?α?10°, and in a wind tunnel of the Institute for Theoretical and Applied Mechanics of the Russian Academy of Sciences in Novosibirsk. The freestream Mach numbers covered in these experiments were varied between 2?Ma ∞?4, freestream Reynolds numbers per unit length between 25×106?Re ∞?56×106 and angles of attack between −3°?α?10°. Flow visualization studies, measurements of surface pressure distributions and of aerodynamic forces were used to analyze the flow. The results, which will also be compared with numerical data, clearly indicate marked differences in the location of the separation and reattachment lines, and the formation of the primary, secondary and tertiary vortices, for the flow regimes investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003480050306
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  • 10
    Electronic Resource
    Electronic Resource
    Sensitive and selective determination of metabolically formed trans-dihydrodiols and phenols of benzo[a]pyrene in water and urine samples by HPLC with amperometric detection (1998)
    Springer
    Fresenius' journal of analytical chemistry 360 (1998), S. 95-99 
    Details
    ISSN: 1432-1130
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract A method has been developed to separate hydroxylated metabolites of the carcinogenic polycyclic aromatic hydrocarbon benzo[a]pyrene, i. e. trans-4,5-, 7,8-, 9,10-dihydrodiol and 1-, 3-, 7-, and 9-phenol, by HPLC with amperometric detection employing an isocratic methanol/water eluent (70:30, v/v) containing 0.5 g/L sulfuric acid and 1 g/L lithium perchlorate. Compared with the usually applied fluorescence (λex = 265 nm, λem = 460 nm) and ultraviolet (λ = 265 nm) detection, the amperometric technique is about 2–12 times more sensitive for the determination of all metabolites investigated. The method was applied to the determination of the seven metabolites of benzo[a]pyrene in different water samples and in urine after solid-phase extraction (SPE). The results obtained by HPLC with amperometric detection after SPE enrichment from an aqueous extract of a soil sample and from the urine of a rat intragastrically treated with benzo[a]pyrene agreed well with the values determined with fluorescence and/or UV detection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002160050649
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