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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 4 (1981), S. 3-10 
    ISSN: 1437-2320
    Keywords: Tentorial notch ; Brain stem ; Microsurgery ; Cranial nerves ; Tentoriumschlitz ; Hirnstamm ; Mikrochirurgie ; Hirnnerven
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Nach Darstellung der topographischen Anatomie werden die verschiedenen operativen Zugangswege zum Tentoriumschlitz und ihre technische Ausführung anhand einiger Beispiele erläutert. Durch den pterionalen Zugang können Prozesse im supratentoriellen Bereich des vorderen und mittleren Drittels der Inzisura tentorii angegangen werden. Hierbei kann der Zugang zum infratentoriellen Raum durch Einschneiden und Hochnähen des Tentoriumrandes erweitert werden. Der mediale occipitale Zugang ist geeignet für die medial gelegenen raumfordernden Prozesse im aufsteigenden Abschnitt, d.h. im hinteren Drittel des Tentoriumrandes. Die infratentoriellen Geschwülste des Kleinhirnbrückenwinkels und des präpontinen Raumes mit Ausdehnung in den Tentoriumschlitz werden von lateral suboccipital angegangen. Ein subfrontales infrachiasmatisches Vorgehen kann bei suprasellären Prozessen mit parasellärer Ausdehnung in den Tentoriumschlitz angezeigt erscheinen, wenn es die Lage des Chiasma opticum erlaubt. Darüber hinaus kann die Lokalisation des Prozesses eine Kombination einzelner Zugänge erfordern.
    Notes: Summary After a description of the topographic anatomy, the different approaches to the tentorial notch and the details of technique are illustrated by a few examples. The pterional approach permits surgical treatment of lesions in the supratentorial region of the anterior and middle third of the tentorial opening. Any approach to the infratentorial region can be enlarged and improved by incising and stitching back the free margin of the tentorium. The medial occipital approach is appropriate for space-occupying lesions situated medially in the ascending portion, that is in the posterior third of the free margin of the tentorium. Infratentorial tumours in the cerebello-pontine angle and in the prepontine region, with extension into the tentorial notch, are best treated through the lateral suboccipital approach. A subfrontal infrachiasmatic procedure is indicated in the case of suprasellar lesions with parasellar extension into the tentorial notch, if the anatomy of the optic chiasm allows it. The location of any particular lesion may call for a combination of different approaches.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 54 (1999), S. 843-845 
    ISSN: 1432-1041
    Keywords: Key words Piritramide ; Protein binding ; Acute phase response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Piritramide is a lipophilic opioid, which is widely used for postoperative analgesia and analgosedation in Europe. In this study we investigated the influence of various protein concentrations (total protein, 1-acid glycoprotein, albumin) and the postoperative acute phase response on the protein binding of piritramide. Methods: The influence of various protein concentrations on the protein binding of piritramide was investigated by either diluting the serum samples of five volunteers with isotonic saline or by adding different amounts of 1-acid glycoprotein. Albumin binding was measured in a 5% human albumin solution. The impact of the postoperative acute phase response was investigated by obtaining daily serum samples from 18 surgical patients until the third postoperative day, and measuring piritramide protein binding, 1-acid glycoprotein, total protein and albumin. Results: There was a significant relationship between piritramide protein binding and the concentrations of total protein and 1-acid glycoprotein. The binding to albumin was 88%. During the postoperative acute phase response, the protein binding of piritramide did not change. Serum concentrations of 1-acid glycoprotein increased, whereas total protein and albumin decreased. Conclusion: Although there were significant changes in the piritramide-binding proteins, 1-acid glycoprotein and albumin, during the postoperative acute phase response, the protein binding of piritramide did not change. Therefore, a change in protein binding, which might be one factor to be considered in determining piritramide dosage in the postoperative period, does not have to be taken into account.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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