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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 26 (2000), S. 442-448 
    ISSN: 1432-1238
    Keywords: Key words Hyperbaric oxygen therapy ; Ventilator ; Airway resistance ; Gas density
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the function of four currently available, not specifically modified time-cycled ICU ventilators (EVITA 4, Oxylog 2000 HBO and Microvent from Drägerwerk, Germany and Servo 900C, Siemens-Elema, Sweden) under hyperbaric conditions using volume-controlled ventilation (VCV) and, if available, pressure-controlled ventilation (PCV).¶Design: All ventilators were studied on an electromechanical lung simulator consisting of a motor driven bellows (LS 1500, Drägerwerk, Germany) at normobaric (1 bar) and hyperbaric ambient pressures (1.3, 1.6, 1.9, 2.8 bar). Servo 900C and Microvent were additionally tested at 6 bar.¶Settings: Hyperbaric chamber.¶Measurements and results: During VCV the tidal volume (VT) was set at 750 ml at normobaric conditions prior to starting hyperbaric exposure. During PCV the same VT setting was achieved by adjusting the inspiratory pressure level. At each ambient pressure we registered airway pressure (measured inside the bellows) and flow (derived from the linear displacement of the bellows) for a period of 1 min. From these data we calculated off-line VT, inspiratory airway peak and plateau pressure (Ppeak and Pplateau) and, during PCV only, peak inspiratory flow (Vmax) and the time delay between onset of and peak inspiratory flow (Vdelay). During VCV inspiratory flow and, consequently, VT consistently decreased with increasing ambient pressure. In contrast, during PCV VT remained stable at each condition despite a slight decrease in Vmax.¶Conclusions: Whenever available, PCV should be preferentially used during hyperbaric oxygen therapy due to the stability of ventilator functioning. Based on the specific ventilator properties at increasing ambient pressures, appropriate corrections should be possible which will allow the safe use of ICU ventilators even during VCV.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 366-370 
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Abdominal gunshot wounds
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The role of laparoscopy in the selective management of gunshot wounds (GSW) of the abdomen was prospectively investigated in 38 patients. All the patients were hemodynamically stable and had equivocal evidence of intraabdominal penetration. Laparoscopy was performed in the operating room under anesthesia. The site of penetration was in the thoracoabdominal area in 13, epigastrium in 7, and lower quadrants in 18. Twenty-three (60.5%) had nonpenetration on laparoscopy and a laparotomy was avoided. The remaining patients had injuries to the liver (4 patients), spleen (two patients), diaphragm (3 patients), hemoperitoneum or retroperitoneal hematoma (6 patients), and hollow viscus injuries (5 patients). Laparoscopy was also helpful in determining the need for laparotomy vs thoracotomy in lower chest wounds. The negative laparoscopy group (no penetration) had a significantly lower hospital stay compared to hemodynamically stable patients who had negative laparotomy without laparoscopy for nonpenetrating GSW. There were no complications related to laparoscopy. Laparoscopy is a useful modality in the evaluation of hemodynamically stable patients with abdominal missile wounds.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Cell & tissue research 252 (1988), S. 435-447 
    ISSN: 1432-0878
    Keywords: Large intestine ; Cecum ; Colon ; Peristalsis ; Separation mechanism ; Nutritional strategy ; Nutria, Myocastor coypus (Caviomorpha)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Morphologically the large intestine of the nutria resembles that of other caviomorphs, notably the guinea pig. The cecum is voluminous: it contributes 8.6% of the total intestinal length and 12.7% of the total intestinal surface area (considering the surface enlargement factor). It contains 27–32% of the wet ingesta and 20–23% of the dry matter in the gastrointestinal tract. In the colon the corresponding figures are: 21.8% of length, 12.6% of surface area, 16–21% of wet ingesta, and 16–40% of dry matter. The colon can be subdivided both structurally and functionally into two sections, the proximal and the distal colon, the border between the two being the apical flexure of a long parallel loop. The proximal colon (42% of colonic length) displays on the mucosal surface of its mesenterial side a narrow furrow bordered by ridges, which is absent in the distal colon. The ridges contain subepithelial accumulations of coiled tubuloalveolar mucoid glands, entwined by bundles of muscle fibers. Determinations of nitrogen in the contents near the furrow suggest a concentration of bacteria in this part of the lumen. It is hypothesized that the structural differentiations of the proximal colon provide mechanisms for the transport of bacteria from the proximal colon back into the cecum to maintain the fermentation function. The slopes of the longitudinal profiles for dry matter and for concentrations of sodium, potassium and calcium in the luminal contents change at the tip of the parallel loop. The electrical potential difference “intestinal lumen — blood” is particularly large in the proximal colon, indicating active electrogenic ion transport in this region.
    Type of Medium: Electronic Resource
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