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  • Key words: Colon perforation — Colonscopy — Laparoscopic treatment  (1)
  • Tension  (1)
  • 1
    ISSN: 1432-2013
    Keywords: Vascular Smooth Muscle ; Thermoelastic Properties ; Noradrenaline ; Dose-Response Curves ; Temperature ; Tension ; Propanolol ; Escape Phenomenon ; Gefäßmuskel ; Thermoelastische Eigenschaften ; Noradrenalin ; Dosis-Wirkungs-Kurven ; Temperatur ; Spannung ; Propanolol ; Escape-Phänomen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Registrierung von Dosis-Wirkungskurven an isolierten Spiralstreifen aus der Rattenaorta im Konzentrationsbereich von 3·10−10 bis 5·10−6 g NA/ml führte zu folgenden Ergebnissen: 1. Im Bereich von 10−8 bis 10−6 g NA/ml besteht eine positiv logarithmische Beziehung zwischen Noradrenalinmenge und isometrisch entwickelter Spannung. Bei weiter ansteigenden Noradrenalindosen nimmt die Kontraktionsamplitude des Gefäßmuskels konzentrationsabhängig und signifikant ab (Abb. 2). 2. Der bei 37° C und 6000–7000 mg/mm2 Faserdehnung (=2000 mg Belastung) besonders deutliche Gipfel der Dosis-Wirkungskurve liegt mit 1·10−6 g NA/ml in der bei Nervenreiz lokal in situ aufgebauten Größenordnung. 3. Die Veränderung der Ruhespannung auf Grund der passiven thermoelastischen Eigenschaften beträgt bei unserer Versuchsanordnung durchschnittlich 15,4 mg/o C (Abb. 1). 4. Eine Erniedrigung der Badtemperatur auf 30° C führt ebenso wie eine Steigerung der Faserdehnung von 500 auf 2000 mg zur deutlichen Verschiebung des Maximums der Dosis-Wirkungskurve zu niedrigeren Werten, wobei die negative Korrelation zwischen Noradrenalin-Menge und entwickelter Spannung im hohen Konzentrationsbereich ausgeprägter wird (Abb. 2 und 3). 5. Propanolol führt zur Verlagerung des Gipfels der Dosis-Wirkungskurve in Richtung höherer Konzentrationen (Abb. 4). 6. Bei einmaliger, nicht kumulativer Gabe von Noradrenalin wird die Dosis-Wirkungskurve bis zur entsprechenden Konzentration durchlaufen. Größere Dosen können dabei zu einer biphasischen Spannungsänderung führen (“Escape-Phänomen”), die unter Propanolol verschwindet (Abb. 5).
    Notes: Summary In isolated helical strips of the rat aorta, dose-response curves of noradrenaline were tested in concentrations ranging between 3×10−10 and 5×10−6g NA/ml. The following results were obtained: 1. There was a positive logarithmical correlation with increasing doses of noradrenaline between 10−8 and 10−6 g NA/ml. Further increases of noradrenaline resulted in a significant decrease of the isometric tension of the vascular smooth muscle, this being also concentration-dependend (Fig. 2). 2. At 37° C and 6000–7000 mg/mm2 tension/cross section (or 2000 mg basic tension of the strip), the peak of the dose-response curve was found at 1×10−6 g NA/ml; this corresponding to the local concentration at the nerve endings by electrical stimulation. 3. The passive thermoelastic properties of the tissue changed the basic tension about 15,4 mg/o C (Fig. 1). 4. Reducing the bath temperature to 30° C, as well as enhancing the tension from 500 to 2000 mg, the maximum of the dose-response curve was displaced to lower concentrations. The negative correlation between noradrenaline-concentrations and tension developed became more pronounced (Fig. 2 and 3). 5. Propanolol shifted the peak of the dose-response curve to higher noradrenaline-concentrations (Fig. 4). 6. If noradrenaline was added in a single dose instead of cumulatively, the doseresponse curve was passed until the corresponding concentration was reached. At higher noradrenaline-concentrations the tension could be changed biphasically (“escape phenomenon”). This effect disappeared following propanolol (Fig. 5).
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 484-487 
    ISSN: 1432-2218
    Keywords: Key words: Colon perforation — Colonscopy — Laparoscopic treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Colonic perforations associated with colonoscopy are rare but major complications. Conservative treatment is less invasive than major surgery, but any case of failure leads to more extensive surgical procedures with a higher morbidity and mortality than the immediate operative repair. To reduce the invasiveness of major surgery and avoid the risk of failure, we introduced laparoscopic techniques to deal with iatrogenic colonic perforations. Methods: Each colonic perforation was identified by diagnostic laparoscopy. The perforation was then characterized by size and extent of thermal damage into one of three types, followed by type-dependent treatment (suture, tangential resection, segmental resection, or open procedure). Operative time, complications, clinical outcome, and patient satisfaction were recorded. Results: Seven patients underwent diagnostic laparoscopy for colonic perforations. Laparoscopic treatment was performed on five patients (one simple closure by suture, three tangential resections, and one segmental resection). Two cases required open procedures. There was one intraoperative complication that necessitated conversion. There were no postoperative complications. All laparoscopically treated patients were satisfied with their clinical outcome and cosmetic results. Conclusions: Laparoscopic treatment seems to reduce the invasiveness and morbidity of major surgery. At the same time, it is more definitive than conservative treatment, so that we now prefer to use laparoscopic techniques to treat colonic perforations related to colonoscopy.
    Type of Medium: Electronic Resource
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