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  • 1
    ISSN: 1433-7339
    Keywords: Key words Central venous catheter ; Heparinization ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A phase I study to evaluate heparinization of tunnelled subclavian catheters (TSC) was conducted in 42 patients who each had a TSC for chemotherapy. They were enrolled in the study from August 1994 to December 1995. The inclusion criteria were: age 18–70, no general anticoagulant treatment, TSC used only for chemotherapy, informed consent. Heparinization was performed at the end of each cycle and then at increasing intervals: 11, 13, 15, 17, 19, and 21 days. A 21-day interval was intended to mimic the suppression of heparinization between cycles. Heparinization was performed with a 250 IU/ml heparin solution. Anti-Xa activity was studied before each heparinization. For each interval, at least 5 patients were followed up for two cycles. If no blockages were present progression to the next step was authorized. If one blockage was observed 5 additional patients were required to have their TSCs heparinized after the same interval. Two blockages (block) after the same interval meant that the previous interval was recorded as the longest tolerable. There were no blocks with the 11-day interval (6 patients), 1 block after 13 days (10 patients), 1 block after 15 days (10 patients), and no blocks after 17 days (5 patients), 19 days (6 patients), or 21 days (5 patients). The median anti-Xa activity (curative rate 0.2–0.6) was, respectively 11 days 6.74; 13 days 5.47; 15 days 4.71; 17 days 3.61; 19 days 3.67; 21 days 5.10 (NS). Heparinization between two cycles of chemotherapy is unnecessary. A high level of heparin activity persisted constantly inside the catheter lumen through the 3-week observation period.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 14 (1992), S. 203-208 
    ISSN: 1279-8517
    Keywords: Cervical spine ; Anterior approach ; Hypoglossal nerve ; Superior and inferior laryngeal nerves
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les suites de la chirurgie du rachis cervical par voie antérieure présternocléidomastoïdienne sont marquées dans un nombre de cas non négligeable par des troubles de la déglutition et de la phonation, et ce, d'autant que l'abord est étendu. 35 dissections sur cadavres ont été réalisées afin de préciser la topographie par rapport aux niveaux vertébraux, le trajet et les variations des éléments nerveux rencontrés lors de cet abord cervical : nerfs laryngés supérieur et récurrent, nerf hypoglosse et la racine supérieure de l'anse cervicale. A partir de cette étude morphologique, les auteurs suggèrent quelques points d' amélioration technique, à chacune des étapes de la dissection, en pratique chirurgicale.
    Notes: Summary The results of the surgical anterior approach to the cervical spine are marked in a number of cases by dysphagia and dysphonia, especially when the approach is extensive or performed at the upper cervical spine. 35 cadaver dissections were performed to define the topography of the nerve structures during operative exposure at various vertebral levels : superior and recurrent laryngeal nerves, hypoglossal nerve and its superior root of the ansa cervicalis. The authors suggest some technical improvements, for each stage of surgical dissection.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 171-176 
    ISSN: 1279-8517
    Keywords: Ligamentum flavum ; Anatomy ; Histology ; Innervation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le lig. jaune (ligamentum flavum), dont peu d'études sont rapportées dans la littérature, a plusieurs particularités mises en évidence dans ce travail. Sur le plan macroscopique, il a une disposition métamérique, il est composé de deux feuillets dont les fibres sont de direction opposée, il entretient des rapports étroits avec certains tendons d'insertion des mm. érecteurs du rachis. Sur le plan microscopique, sa structure est particulière pour un ligament, car y prédominent les fibres élastiques; une innervation lui est propre à chaque niveau vertébral, cette innervation s'appauvrit au fur et à mesure qu'augmente la dégénérescence ligamentaire. Le lig. jaune constitue un système ligamentaire actif, avec un rôle biomécanique essentiel. Le léser n'est sans doute pas sans conséquence, et cela pose des questions techniques concernant les abords chirurgicaux interlamaires.
    Notes: Summary The ligamentum flavum, of which there are only a few studies in the literature, has several features discussed in this work. On the macroscopic level, it has a metameric arrangement: it has two layers, superficial and deep, whose fibers are opposite, and it has close relations with the tendons of attachment of some spinal erector muscles. On the microscopic level, its structure is unique for a ligament, because of a predominance of elastic fibers, because of its intrinsic innervation at each level of the spine, and because this innervation grows poorer with increasing degeneration. The ligamentum flavum constitutes an active ligament, with an essential biomechanical role. Its injury is probably not without consequences, and therefore there are many technical problems about the surgical interlaminar approach.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 171-176 
    ISSN: 1279-8517
    Keywords: Ligamentum flavum ; Anatomy ; Histology ; Innervation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The ligamentum flavum, of which there are only a few studies in the literature, has several features discussed in this work. On the macroscopic level, it has a metameric arrangement it has two layers, superficial and deep, whose fibers are oppposite, and it has close relations with the tendons of attachment of some spinal erector muscles. On the microscopic level, its structure is unique for a ligament, because of a predominance of elastic fibers, because of its intrinsic innervation at each level of the spine, and because this innervation grows poorer with increasing degeneration. The ligamentum flavum constitutes an active ligament, with an essential biomechanical role. Its injury is probably not without consequences, and therefore there are many technical problems about the surgical interlaminar approach.
    Type of Medium: Electronic Resource
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