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  • 11
    ISSN: 1433-044X
    Keywords: Key words Tightening ACL ; Revision surgery ; ACL ; Reconstruction ; Schlüsselwörter Straffung vorderes Kreuzband ; Revisions-eingriffe ; Kreuzbandplastik
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Bei Elongationen des vorderen Kreuzbandes (VKB) schlagen wir als Alternative zu therapeutischen Nihilismus oder Bandplastik eine Straffung des Bandes vor. Diese wird ermöglicht durch die Mobilisierung des tibialen Kreuzbandansatzes. Der gesamte tibiale Ansatz wird ausgefräst und nach distal versetzt, womit das Band problemlos gestrafft werden kann. Somit bleiben Kreuzbandstrukturen und Propriorezeptionen erhalten. Die Mobilisierung des tibalen Ansatzes benutzen wir auch bei reinen proximalen Kreuzbandausrissen: hier wird das proximal ausgerissene Band mit dem tibialen Knochenblock entnommen. Ex vivo wird das Band mit Fäden durchflochten, um dann wieder eingezogen zu werden. Die Verkürzung durch die Nahtlegung wird ausgeglichen durch knappe Versetzung des tibialen Knochenblocks nach kranial.
    Notes: In patients with a significant elongation of the ACL we propose a new therapeutic regimen. After mobilisation of the tibial insertion of the ACL we pull the bone block with the attached ACL distally. Thus the ACL is easily tightened. In accordance with this method, we describe the treatment of a case of a strictly proximal rupture of the ACL: the tibial insertion is mobilised, the bone block with the attached ACL removed from the joint. Ex vivo sutures are placed into the ACL, the ligament is pulled back into the joint, and the shortening of the ligament caused by the sutures is compensated by slight proximal dislocation of the bone block.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intestinal stasis followed by mucosal barrier breakdown and the generation of locally produced cytokines has been proposed as the cause of systemic infection and multiple organ failure following hemorrhagic shock. The aim of this study was to investigate the underlying mechanisms of impaired intestinal muscle function leading to ileus following hemorrhagic shock. Rats were subjected to severe hemorrhagic shock (mean arterial pressure 40 mm Hg) followed by resuscitation and were killed early at 4 h or late at 24 h. Other groups consisted of control and sham animals. Intercellular adhesion molecule (ICAM-1) mRNA levels were significantly elevated in the muscularis but not in the mucosa using the semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR). There was a marked infiltration of neutrophils into the muscularis early and late after shock. Furthermore, smooth muscle contractility in response to bethanechol was significantly decreased, being more pronounced in the early group. Immunohistochemistry revealed signal for ICAM-1 in the muscularis microvasculature and on infiltrating cells. These results suggest that the expression of ICAM-1 within the muscularis vasculature after hemorrhagic shock promotes the local recruitment of leukocytes and that this inflammatory response is accompanied by a subsequent impairment of intestinal contractility.
    Type of Medium: Electronic Resource
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  • 13
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    Unknown
    Berlin, etc. : Periodicals Archive Online (PAO)
    Philologus. 50 (1891) 401 
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  • 14
    ISSN: 1432-0630
    Keywords: PACS: 68.55; 73.20
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics , Physics
    Type of Medium: Electronic Resource
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  • 15
    Electronic Resource
    Electronic Resource
    Oxford [u.a.] : International Union of Crystallography (IUCr)
    Acta crystallographica 51 (1995), S. 2030-2032 
    ISSN: 1600-5759
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Chemistry and Pharmacology , Geosciences , Physics
    Type of Medium: Electronic Resource
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 38 (1997), S. 299-306 
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Wissenschaftstheorie ; Methodologie ; Forschung ; Schulmedizin ; Alternativmedizin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Unterschiedliche epistemische Verfahren des Wissenserwerbs beruhen auf – zumindest partiell – miteinander nicht kompatiblen Axiomen, die ihrerseits nicht falsifizierbar sind. Die 4 Axiome des Erkenntnisgewinns in der Medizin sind: •*Axiom der Existenz von übernatürlichen Personen oder Kräften •*Axiom der Korrespondenz von Phänomenen (Analogieprinzip) •*Axiom des kausalgesetzlichen, mechanisch-deterministischen Ablaufs von Prozessen in der Natur (Grundlage der wissenschaftlichen Medizin) •*Axiom der Möglichkeit des intersubjektiven Verstehens von menschlichen Lebensäußerungen durch hermeneutische Interpretation verbaler und nonverbaler Zeichen. In der folgenden Übersicht werden diese Axiome erläutert. Unter dem letztgenannten Axiom betrachtet, sieht sich die Psychoanalyse einer epistemologischen Kritik ausgesetzt, die vor allem auf die konstruktivistischen Elemente dieser Lehre abzielt.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 1432-1084
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate the imaging properties and diagnostic potential of the novel polymeric ultrasound contrast agent SHU 563 A. After i. v. injection, the agent circulates in the blood pool for about 10 min and is then subsequently sequestered by the RES cells predominantly in the liver. The acoustic emission capabilities enable a very sensitive detection during the blood pool phase and after uptake in the RES cells, contributing to differential diagnosis as well as detection of liver lesions. During a multicenter study, 28 patients with liver lesions were examined. In all patients the results were compared to baseline ultrasound and Contrast enhanced Spiral CT. With respect to lesion size and location, very good agreement between SHU 563 A ultrasound and Spiral CT was achieved. Additional lesions could be shown in the RES phase by SHU 563 A enhanced ultrasound. 26 further patients were examined in other indications. The results in all 54 patients indicate good safety and tolerance of SHU 563 without limitations for diagnostic use. SHU 563 A enhanced ultrasound adds significantly to the detection and delineation of focal liver lesions by improving conspicuity due to RES based contrast after uptake.
    Type of Medium: Electronic Resource
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 36 (1996), S. 51-57 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Ultraschall ; Doppler ; Kontrastmittel ; Key words Ultrasound-Doppler-Contrast agent ; Signal enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Ultrasound contrast agents have recently proven to be clinically useful in many different areas and with many different ultrasound modalities. B-mode contrast echocardiography and delineation of cavities with ultrasound contrast agents are already accepted. Based on the contrast agent Echovist, assessment of tubal patency is possible with hysterosalpingo contrast sonography (HyCoSy). A new generation of transpulmonary, stable ultrasound contrast agents such as Levovist offer potential for various Doppler applications. Ultrasound contrast agents act as signal enhancers in Doppler examinations and therefore help to overcome the limitations of insufficient Doppler signal intensity. Recently, clinical studies have shown. Doppler examinations to have many clinical benefits. Contrast agents are useful in the assessment of high-grade stenosis or the delineation of small vessels and under difficult conditions. Ultrasound contrast agents also create new applications: analysis of tumor vascularization and delineation of the transcranial venous system are possible with contrast enhancement. Future developments in contrast-specific scanning (“harmonic imaging”) and new contrast agents, including organ-specific contrast agents, are expected to make a significant impact in the years to come.
    Notes: Zusammenfassung Ultraschallkontrastmittel stehen an der Schwelle zur klinischen Routineanwendung mit nahezu allen Ultraschallverfahren in vielfältigen klinischen Einsatzgebieten. Bereits am weitesten fortgeschritten sind B-Mode-Anwendungen wie Kontrastechokardiographie und die Darstellung von Hohlräumen mit Ultraschallkontrastmitteln. So wurde mit der auf dem ersten Echokontrastmittel Echovist® basierenden Hysterosalpingokontrastsonographie (HyCoSy) eine Alternativmethode zur Röntgen-HSG bzw. laparaskopischen Verfahren zur Darstellung der Eileiterdurchgängigkeit geschaffen. Durch neue lungenpassagestabile Ultraschallkontrastmittel wie Levovist® eröffnen sich viele Anwendungsgebiete mit Ultraschalldopplertechniken. Klinische Studien belegen, daß die Echosignalverstärkung durch Ultraschallkontrastmittel für eine Befundung unzureichende Dopplersignale darstellbar macht und so die Anwendbarkeit der Doppleruntersuchungen erweitert. Praktische klinische Vorteile sind so z. B. bei schwierigen Untersuchungsbedingungen, bei der Bewertung hochgradiger Stenosen, und bei der Darstellung kleiner Gefäße zu erzielen. Auch werden durch den Einsatz von Levovist® neue Anwendungen wie transkranielle Venendarstellung und Bewertung von Tumorvaskularisation ermöglicht. Zukünftige kontrastmittelspezifische Scanverfahren („harmonic imaging“) sowie neuartige, z. T. organspezifische Echokontrastmittel lassen eine Reihe von weiteren Innovationen erwarten.
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 38 (1998), S. 394-398 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Dreidimensionale Bildgebung ; Ultraschallkontrastmittel ; Transkranielle Duplexsonographie ; Power-Doppler ; Hirntumoren ; Key words Three-dimensional imaging ; Ultrasound contrast agents ; Transcranial duplex sonography ; Power Doppler ; Brain tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Echo-enhancing agents improve the signal intensity of transcranial Doppler signals, enabling a novel approach of three-dimensional transcranial vascular imaging by Doppler ultrasound. The basic principle, system requirements and early clinical results with a custom built system are described. Transcranial color Doppler imaging was performed through the temporal bone acoustic window. During IV administration of the transpulmonary stable, galactose-based echoenhancer Levovist® (Schering) the video output of the ultrasound scanner was digitized and the spatial position of the recorded frames was simultaneously registered using a mechanical position sensor. After automatic segmentation of the color information, the 3D datasets were reconstructed offline using a Unix-based workstation (Silicon Graphics). Visualization was achieved by maximum intensity projection or surface visualization techniques. Administration of Levovist® resulted in good enhancement of the vascular Doppler signal intensity, enabling acquisition of a 3D dataset of the complete circle of Willis with an imaging window of approximately 3–5 min for one IV injection. The vascularity of tumors could be recorded as a 3D dataset and further analyzed. The power Doppler technique with echoenhancement proved a valuable tool for 3D dataset recording. 3D datasets clearly facilitated the diagnosis of the vascular anatomy and lesion vascularity and provided additional information on localization of feeders, vascular displacement and extent of tumor vascularity.
    Notes: Zusammenfassung Echosignalverstärker verbessern die Signalintensität des transkraniellen Dopplersignals und ermöglichen damit die dreidimensionale Darstellung mittels transkraniellem Doppler-Ultraschall. Die grundlegenden Prinzipien, Systemvoraussetzungen und erste klinische Ergebnisse werden berichtet. Transkranielle Bildgebung erfolgte mit einem konventionellen Farbdopplersystem durch die intakte Schädelkalotte des Os temporale. Das Videosignal des Ultraschallgerätes wurde während der i.v. Applikation des galaktosebasierenden Echosignalverstärkers Levovist® (Schering) digitalisiert und die Position des jeweiligen Bildes mit einem mechanischen Sensorsystem erfaßt. Die Farbinformation wurde automatisch segmentiert und ein dreidimensionaler Datensatz daraus rekonstruiert, der auf einer Unix Workstation (Silicon Graphics) mittels Maximum-intensity-Projektion oder Oberflächendarstellung visualisiert wurde. Die Anwendung von Levovist® zeigte eine gute Signalverstärkung in einem Zeitraum von 3–5 min für eine i.v. Injektion, der eine Erfassung eines 3D-Datensatzes des kompletten Circulus Willisii bei allen Patienten ermöglichte. Zusätzlich konnte die Vaskularisation von Tumoren bei einigen Patienten dargestellt und weiter analysiert werden. Die angewandte Power-Doppler-Technik bildete zusammen mit Echosignalverstärkung die Basis für die Aufnahme bestmöglicher 3D-Datensätze. Die 3D-Visualisierung erleichterte die Darstellung komplexer Gefäßverläufe und zeigte zuführende Gefäße, Gefäßverlegungen und hochvaskularisierte Bereiche in Tumoren auf.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 1432-1084
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A novel ultrasonic imaging method, wideband harmonic imaging, for nonlinear imaging of microbubble contrast agents is evaluated. In wideband harmonic mode, two pulses of alternate phase are send out. The image is then processed from the sum of both pulses, resulting in an image of nonlinear scatterers such as microbubbles. A prototype ultrasound system, Siemens Elegra, was evaluated with in vitro investigations and animal trials, using conventional, harmonic and wideband harmonic settings with the galactose based ultrasound contrast agent Levovist. Wideband harmonic imaging offers superior sensitivity for ultrasound contrast agents compared to conventional imaging and harmonic imaging. At low transmit power settings (MI 0.1–0.5) the nonlinear response is already sufficient to generate a image of the blood pool distribution of Levovist in the rabbit kidney including the microvasculature, with clear delineation of vessels and perfused parenchyma. At high transmit amplitudes, nonlinear tissue response reduced the apparent image contrast between contrast agent and tissue. The results suggest that wideband harmonic imaging is currently the most sensitive contrast imaging technique, maintaining highest spatial resolution. This may add to image quality and offer new clinical potential for the use of ultrasound contrast agents such as Levovist.
    Type of Medium: Electronic Resource
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