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  • 1
    Electronic Resource
    Electronic Resource
    Differentialdiagnose der orthostatischen Dysregulationen (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 1044-1051 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Orthostatische Dysregulation ; Hypoadrenerge orthostatische Hypotension ; Posturales Tachykardiesyndrom ; Neurokardiogene Synkope ; Differentialdiagnose ; Key words Orthostatic dysregulation ; Hypoadrenergic orthostatic hypotension ; Postural tachycardia syndrome ; Neurocardiogenic syncope ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Orthostatic circulatory disorders are frequently the cause of orthostatic intolerance, syncope or dangerous falls. A sufficient therapy should be based on a differential diagnosis by means of an active standing test or a tilt-table test. Three typical pathological reactions of blood pressure and heart rate can be differentiated. The hypoadrenergic orthostatic hypotension is characterised by an immediate drop in blood pressure (systolic drop 〉20 mmHg below base line within 3 min) with or without compensatory tachycardia. It is caused by peripheral or central sympathetic dysfunction. Tachycardia (〉30 beats per minute above base line within 10 min) without significant blood pressure drop but with a fall of cerebral blood flow indicates a postural tachycardia syndrome. In general, there is no further somatic dysfunction. Increased venous pooling is thought to be the assumed pathomechanism. A reflex mechanism evokes the neurocardiogenic syncope after a certain time of standing: sympathetic inhibition yields a strong blood pressure drop and vagal activation bradycardia. Proved therapies include use of the mineralocorticoide fludrocortison (hypoadrenergic orthostatic hypotension), of the a-agonist midodrin (postural tachycardia syndrome) and of b-blockers (neurocardiogenic syncope).
    Notes: Zusammenfassung Orthostatische Kreislaufregulationsstörungen sind oft die Ursache für orthostatische Intoleranz, Synkopen und gefährliche Stürze. Grundlage für eine geeignete Therapie sollte eine genaue Differentialdiagnose sein, die durch den Schellong- oder Kipptischtest ermöglicht wird. Aus den Blutdruck- und Herzratenveränderungen nach dem Hinstellen können drei unterschiedliche pathologische Orthostasereaktionen differenziert werden. Die hypoadrenerge orthostatische Hypotension ist durch eine rasch einsetzende Hypotension (systolischer Blutdruckabfall 〉20 mmHg innerhalb von 3 min) mit oder ohne kompensatorischen Herzratenanstieg gekennzeichnet und meist Ausdruck einer peripheren oder zentralen Sympathikusstörung. Das Leitsymptom des posturalen Tachykardiesyndroms stellt ein Herzfrequenzanstieg um mehr als 30 Schläge pro Minute innerhalb von 10 min dar, das ohne signifikanten Blutdruckabfall aber mit einem deutlichen Abfall im zerebralen Blutfluß einhergeht. Weitere organpathologische Befunde liegen dabei meistens nicht vor. Ein übermäßiges venöses Pooling im Stehen wird als Pathomechanismus angenommen. Zur orthostatischen neurokardiogenen Synkope kommt es nach längerem Stehen durch einen Reflexmechanismus: Sympathikusinhibition führt zu einem Blutdruckabfall und Vagusaktivierung zu Bradykardie. Bewährt hat sich in der medikamentösen Behandlungen der Einsatz des Mineralokortikoids Fludrocortison (hypoadrenerge orthostatische Hypotension), des a-Agonisten Midodrin (posturales Tachykardie-Syndrom) und von b-Blockern (neurokardiogene Synkopen).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050538
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  • 2
    Electronic Resource
    Electronic Resource
    Pseudotumor cerebri: Clinical and neuroradiological findings (1987)
    Springer
    European archives of psychiatry and clinical neuroscience 237 (1987), S. 54-60 
    Details
    ISSN: 1433-8491
    Keywords: Pseudotumor cerebri ; Computerized tomography ; Empty sella ; Disturbed CSF circulation ; CSF pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Pseudotumor cerebri (PTC) is a diagnosis per exclusionem applied to a condition of increased intracranial pressure in the absence of an intracranial infection, a space-occupying lesion, or hydrocephalus. Diagnostic criteria should include the evaluation of possibly disturbed cerebral venous outflow, which may result in similar clinical findings. Disturbed venous drainage should be separated from the syndrome of PTC because it represents a condition of well-defined origin and therapeutic regimen. Course and prognosis of PTC are not related to the increased intracranial pressure, the degree of papilledema, or to the duration of the disease. Functional cerebral disorders and EEG abnormalities are rare, indicating that brain tissue is not primarily affected. Correspondingly, computerized tomography (CT) scans with respect to the cerebrum are normal in about 90% of the cases; but enlarged optic nerve sheaths (46.7%) and empty sella (45.7%) are frequent findings on CT-scans. They most likely represent a direct consequence of long-term increased pressure within CSF spaces. This observation favors the assumption of disturbed CSF pressure regulation either by increased production of CSF or its decreased rate of absorption. Brain edema (slit ventricles) as assessed by CT is a rare finding (11.4% of our cases). It may be a hint towards a different pathogenetic entity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00385667
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  • 3
    Electronic Resource
    Electronic Resource
    Nitrogen-tillage-residue management (1985)
    Springer
    Plant and soil 84 (1985), S. 67-77 
    Details
    ISSN: 1573-5036
    Keywords: Maize (Zea mays L.) ; 15N ; N budget ; N fertilizer ; Potentially mineralizable N(N0)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Summary NCSWAP (nitrogen and carbon cycling in soil, water and plant) is a simulation model of the soil-crop-water system which integrates water flow dynamics, crop growth, N transformations, tillage and residue effects, soil temperature, and solute transport. A small plot field study was initiated in May of 1980 to determine the effects of N rate (2 or 20 g N/m2), tillage (rototill or no-till), and residue management system (residue return or noresidue) on soil parameters, and maize (Zea mays L.) production. Significant differences due to treatments (N rate, tillage, and residue) were not detected in 1981 for the measured soil-plant parameters including soil moisture, yield, and N uptake. Therefore, two representative treatment combinations (N rates of 2 or 20 g N/m2-tilled-no residue) characterized the field research data. Calculated and observed data sets were compared for several parameters including: (1) soluble NO3−N, (2) N leaching losses (3) plant total-N and15N, (4) root growth, (5) soil moisture, and (6) fertilizer efficiency. The objectives of this study were to initiate the validation process of the model NCSWAP, and to illustrate how NCSWAP can be used as a research tool to infer operational characteristics of the N cycle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02197868
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    Paper (German National Licenses)
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