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  • 1
    Electronic Resource
    Electronic Resource
    Comparison of FEV1 and specific airway conductance in assessing airway response to occupational agents (2003)
    Oxford, UK : Munksgaard International Publishers
    Allergy 58 (2003), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  There is theoretical evidence that specific airway conductance (SGaw) could be more reliable than forced expiratory volume in 1 s (FEV1) for assessing changes in airway calibre. We investigated the changes in FEV1 and SGaw when assessing bronchial responses to occupational agents.Methods:  SGaw and FEV1 were measured during inhalation challenges with various occupational agents in 174 consecutive subjects investigated for possible occupational asthma.Results:  A decline in SGaw of 50% or greater was documented in 77 of 90 subjects (86%) who showed a ≥20% fall in FEV1 and in 11 of 84 subjects (13%) who failed to demonstrate such a fall in FEV1. Among subjects who developed a ≥20% fall in FEV1, those who failed to develop a ≥50% decline in SGaw had a lower baseline SGaw than those who did. Among the group without a ≥20% fall in FEV1, a ≥50% decrease in SGaw was associated with either an ‘intermediate’ fall in FEV1 (between 15 and 17% from baseline value) (n = 4), a significant postchallenge increase in nonspecific bronchial hyper-responsiveness to histamine (n = 2), or both features (n = 3).Conclusions:  A decline in SGaw of 50% or greater may provide useful complementary evidence of a bronchial response during challenges that produce equivocal results in FEV1.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1398-9995.2003.00313.x
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  • 2
    Electronic Resource
    Electronic Resource
    Is a Cooled Tip Catheter the Solution for the Ablation of the Cavotricuspid Isthmus? (2003)
    350 Main Street , Malden , MA 02148-5018 , USA . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SCAVÉE, C., et al.: Is a Cooled Tip Catheter the Solution for the Ablation of the Cavotricuspid Isthmus? To test the theoretical superiority of irrigated tip catheters to achieve complete cavotricuspid isthmus block, a 4-mm cooled tip catheter was compared to a conventional 8-mm tip catheter with a double temperature sensor in the cavotricuspid isthmus (CTI) ablation. The study prospectively enrolled 60 patients (47 men, mean 65 ± 10 years) with common flutter divided in group 1 (n = 30) assigned to an 8-mm tip catheter versus group 2 (n = 30) , assigned to an internal circuit, irrigated tip catheter. Linear radiofrequency applications were performed in a point-by-point protocol to achieve complete CTI block. Complete CTI block was achieved in 29 patients in each group. Mean durations of procedure and fluoroscopy were 91 versus 90 and 40 versus 33 minutes in group 1 versus 2, respectively, (NS). The mean number/patient of RF pulses to interrupt atrial flutter was four in group 1 and eight in group 2 (P = 0.034) , and 11 and 13, respectively, to interrupt CTI conduction (NS). The total energy delivered was similar in both groups (29,237 vs 23,236 W/s, NS). CTI ablation with a conventional 8-mm tip catheter versus an irrigated tip catheter was associated with similar success rates, procedure duration, and fluoroscopic exposure. The technical complexity of the cooled tip catheter renders it less competitive. (PACE 2003; 26[Pt. II]:328–331)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00043.x
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  • 3
    Electronic Resource
    Electronic Resource
    Sexual isolation betweenDrosophila melanogaster females andD. simulans males. Male mating propensities versus success in hybridization (1993)
    Springer
    Cellular and molecular life sciences 49 (1993), S. 596-598 
    Details
    ISSN: 1420-9071
    Keywords: Drosophila ; hybridization ; male vigour ; male mating speed
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Genetic variation has been found in males of aD. simulans population for their eagerness to hybridize withD. melanogaster females. In a search for traits involved in this hybridization, males ofD. simulans were tested for mating speed and sexual vigour. Between-male differences were detected in both sexual traits, but no relationship was noticed between them, nor with the frequency of hybridization. Thus male mating propensities appear to be unrelated to the breakdown of sexual isolation between these sibling species.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01955171
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  • 4
    Electronic Resource
    Electronic Resource
    Primary Prevention of Glucocorticoid-Induced Osteoporosis with Intermittent Intravenous Pamidronate: A Randomized Trial (1997)
    Springer
    Calcified tissue international 61 (1997), S. 266-271 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Osteoporosis — Bisphosphonates — Pamidronate — Glucocorticoids — Bone mineral density.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. The aim of this study was to assess whether early intermittent I.V. administration of disodium pamidronate can effectively achieve primary prevention of glucocorticoid-induced osteoporosis (GIOP). A total of 27 in- or outpatients who required first-time, long-term corticosteroid therapy at a daily dose of at least 10 mg prednisolone were studied. Patients were randomly selected to receive either pamidronate and calcium or calcium alone. Patients allocated to pamidronate treatment (pamidronate group) received a first intravenous infusion of 90 mg pamidronate simultaneously with the initiation of their steroid treatment. Subsequently, they received 30 mg pamidronate, intravenously, every 3 months, for as long as steroid therapy was continued. As with the control patients (calcium group), they were put on a daily 800-mg elemental calcium supplement given as calcium carbonate. Lumbar spine and hip (total and subregions) bone mineral densities (BMDs) were measured at the start and every 3-months by dual-energy X-ray absorptiometry (Hologic® QDR-2000). Over 1 year, the pamidronate group showed a significant BMD increase in the lumbar spine (3.6%), and at all sites of the hip (2.2% at the femoral neck). In the calcium group, a significant BMD reduction was registered at the lumbar spine (−5.3%) and at the femoral neck (−5.3%). Differences between the groups were significant at all sites measured. Intermittent intravenous pamidronate effectively achieves primary prevention of GIOP, as assessed by BMD measurements over 1 year.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900334
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  • 5
    Electronic Resource
    Electronic Resource
    Gastric acidity and duodenogastric reflux during nasojejunal tube feeding in mechanically ventilated patients (1999)
    Springer
    Intensive care medicine 25 (1999), S. 574-580 
    Details
    ISSN: 1432-1238
    Keywords: Key words Critically ill ; Enteral feeding ; Gut dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: In order to prevent gastric microbial overgrowth, which may complicate nasogastric feeding, administration of nutrients more distally into the gut has been advocated in intensive care patients, as it offers the advantage of keeping the stomach empty and acid. In this study, we assessed the impact of jejunal feeding upon gastic pH in a group of mechanically ventilated, critically ill patients, with special focus on duodenogastric reflux as a possible cause of gastric alkalinization during jejunal nutrition. Design: Prospective experimental study. Setting: Multidisciplinary intensive care unit of a university hospital. Patients and methods: Gastric pH was recorded by continuous pHmetry over a 4-h period of fasting followed by a 4-h period of nasojejunal feeding at 100 kcal/h in 21 mechanically ventilated, critically ill patients. To determine the contribution of duodenogastric reflux to modifications of gastric acidity, the diet was traced with [111In] DTPA (pentetic acid) in 11 of these 21 patients; gastric contents were aspirated every 30 min, then analysed for measurement of radioactivity, glucose, and bile acid concentration. Measurements and results: Median intragastric pH increased slightly from 1.59 (1.20–2.73; interquartile range) (fasting) to 2.33 (1.65–4.64) (feeding) (p = 0.013), and the length of time that the pH was 4 or above increased from 1 (0–24) to 9 (0–142) min (p = 0.026). The variability of pH values and the number of acute alkalinization episodes did not change between the two phases. In 10 of 11 patients in which the diet was labeled with [111In] DTPA, reflux was documented at a given time of the feeding period. Bile acid concentrations in the stomach increased from 392 (61–1076) (fasting) to 1446 (320–2770) μmol/l (feeding) (p = 0.010) and mean glucose concentration increased from 59 (28–95) to 164 (104–449) mg/dl (p = 0.006). Conclusion: Duodenogastric reflux is common in mechanically ventilated critically ill patients with nasojejunal feeding tubes. It occurs both during fasting and during nasojejunal feeding. During nasojejunal feeding, moderate alkalinization of the gastric contents occurs as a result of bile and nutrient reflux.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050905
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  • 6
    Electronic Resource
    Electronic Resource
    Effect of dopamine on gastrointestinal motility during critical illness (2000)
    Springer
    Intensive care medicine 26 (2000), S. 901-907 
    Details
    ISSN: 1432-1238
    Keywords: Key words Gastrointestinal motility ; Critical care ; Dopamine ; Gastric emptying ; Enteral nutrition ; Ventilation, mechanical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To document the action of dopamine on gastrointestinal motility in mechanically ventilated patients. Design: Crossover, randomized, placebo-controlled study. Setting: General intensive care unit (ICU) in a university hospital. Patients: Twelve mechanically ventilated patients in a stable hemodynamic condition, with no contraindication to enteral feeding.¶Interventions: Dopamine (4 μg/kg per minute) and placebo were infused over 8 h (4 h fasting, followed immediately by 4 h nasogastric feeding at 100 kcal per hour) on two consecutive days, in a random order. Pressure changes in the gastric antrum (four sites) and in the duodenum (two sites) were recorded by perfused catheter manometry. Each session started with the institution of dopamine or placebo infusion.¶Measurements and results: The migrating motor complex and its three successive phases were identified (phase I, period of quiescence; phase II, period of irregular contractile activity; phase III or activity front, period of high-frequency, regular contractions). Contractions and activity fronts at each site were quantified during fasting and feeding. The mean duration of the fasting migrating motor complex was determined in the duodenum, as well as the contribution of each phase (phases I, II, III) to the length of the complete cycle. The propagation characteristics of each activity front were assessed visually. The number of contractions was lower in the antrum (p = 0.024) and phase III motor activity higher in the duodenum [incidence of activity fronts (p = 0.008); number of phase III contractions (p = 0.009)] during dopamine infusion than with placebo. These modifications observed under dopamine were related to decreased antral contractions during fasting (p = 0.050), increased incidence of activity fronts during feeding (p = 0.031), and increased number of phase III contractions during fasting (p = 0.037). In both groups (placebo and dopamine) activity fronts rarely started in the antrum, and abnormally propagated activity fronts were found in the duodenum in some patients. Conclusions: Low-dose dopamine adversely affects gastroduodenal motility in mechanically ventilated critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051279
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  • 7
    Electronic Resource
    Electronic Resource
    Total colectomy with ileorectal anastomosis in surgical management of toxic megacolon (1983)
    Springer
    Langenbeck's archives of surgery 360 (1983), S. 159-165 
    Details
    ISSN: 1435-2451
    Keywords: Colektomie ; Ileorectale Anastomose ; Toxiches Megacolon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Twenty-five patients with toxic megacolon are reported. The most frequent etiology of this syndrome was ulcerative colitis and the main complication colonic perforation. Toxic dilatation generally involved the transverse colon. Twenty patients were treated by a surgical procedure, namely two enterostomies and eighteen colectomies. A total colectomy with ileorectal anastomosis was performed in ten patients. Mortality for the whole series was 32 %, but was reduced to 14 % in the last 4 years. There were no deaths and no complications needing surgical management in the group of patients treated by total colectomy with ileorectal anastomosis. However, the method resulted in Schlüsselwörter: Colektomie - Ileorectale Anastomose - Toxisches Megacolon. one failure. The satisfactory results obtained with this procedure must be emphasized. Despite the small number of so-treated patients reported in world literature, it is suggested that total colectomy with ileorectal anastomosis must be regarded as the procedure of choice for toxic megacolon without peritonitis.
    Notes: Zusammenfassung Es wird über 25 Patienten mit toxischem Megacolon berichtet. Die häufigste Ätiologie dieses Syndroms war ulceröse Colitis und die Hauptkomplikation Colonperforation. Toxische Dilatation greift gewöhnlich das transverse Colon an. 20 Patienten wurden chirurgisch behandelt, d.h. zwei Enterostomien und achtzehn Colektomien. Eine totale Colektomie mit ileorectaler Anastomose wurde bei 10 Patienten durchgeführt. Die Gesamtletalität war 32 %, wurde aber in den letzten 4 Jahren auf 14 %. reduziert. In der Patientengruppe, die mit einer totalen Colektomie mit ileorectaler Anastomose behandelt wurden, gab es weder einen Todesfall noch Komplikationen, die einen chirurgischen Eingriff notwendig gemacht hätten. Die zufriedenstellenden Ergebnisse, die mit dieser Methode erzielt wurden, müssen gewürdigt werden. Obwohl nur wenige derartige behandelte Patienten in der Weltliteratur erwähnt werden, sollte die totale Colektomie mit ileorectaler Anastomose als die Methode der Wahl für das toxische Megacolon ohne Peritonitis angesehen werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01259232
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  • 8
    Electronic Resource
    Electronic Resource
    Expression of E-cadherin adhesion molecule in vocal cord carcinomas (1997)
    Springer
    European archives of oto-rhino-laryngology and head & neck 254 (1997), S. 417-421 
    Details
    ISSN: 1434-4726
    Keywords: Laryngeal carcinomas ; Tumor suppressor gene ; Cell adhesion molecule ; E-cadherin ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract E-cadherin is a 120 kDa transmembrane protein that plays a major role in the maintenance of cell-cell adhesion in epithelial tissues. In the present study its expression was examined immunohistochemically for the first time using paraffin-embedded archival tissues of 38 vocal cord carcinomas. Ten cases of vocal cord polyps were used as positive controls. According to our criteria, results showed that all but one of the polyps, in which staining was lost, had strong or moderate E-cadherin expression, whereas 32% of the cases with tumors showed preserved staining, and 68% of cases showed a reduced staining. E-cadherin expression was significantly correlated with histological stages, with a greater expression in carcinoma in situ and microinvasive carcinoma than in invasive carcinoma (P = 0.010). A significant correlation was also found between E-cadherin expression and the degree of tumor differentiation (P = 0.018). Some of these findings were consistent with previously published data using fresh tissues. Our study provides evidence that E-cadherin may be linked to progression and differentiation of laryngeal cancer and could play a role as a tumor-suppressor gene in this cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02439971
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  • 9
    Electronic Resource
    Electronic Resource
    CO2 laser in the diagnosis and treatment of early cancer of the vocal fold (1997)
    Springer
    European archives of oto-rhino-laryngology and head & neck 254 (1997), S. 169-176 
    Details
    ISSN: 1434-4726
    Keywords: Glottic carcinoma ; Laser cordectomy ; Quality of voice ; Acoustic voice analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 74 patients underwent cordectomy using CO2 laser for either diagnosis or treatment of an early cancer of the vocal fold. Type I cordectomy consisted in the resection of the entire epithelium, while leaving the vocal ligament intact. Type II cordectomy involved removal of the vocal fold from the vocal process to the anterior commissure and passing through the inferior thyroarytenoid muscle. Type IIIA required vocal fold resection along the internal side of the thyroid ala, while type IIIB included removal of the anterior commissure. Type I cordectomies were carried out with an Acuspot micromanipulator, which provided a 250-μm-diameter beam for a working distance of 400 mm, and in the shot-by-shot cutting mode with 3 W power superpulse. This cordectomy was carried out in 39 patients and a dysplasia or an early carcinoma were detected in 45.9% of cases. Type II and type III procedures were performed with the Microslad micromanipulator having a 700-μm-diameter beam in the continuous cutting mode, 7 W power superpulse. Fifteen cases were treated by type II cordectomy, of which 3 T1aN0M0 cases underwent postoperative radiotherapy due to insufficient resections and 2 cases with T1bN0M0 tumors later underwent reconstructive laryngectomy. A type III cordectomy was used for 14 cases of TlaNOMO carcinomas and 3 cases of severe dysplasia. The margins of resection were found to be positive histologically in 23.5% of these cases, making frozen section examinations mandatory at time of surgery. Results of all procedures showed that voice was best after a type I cordectomy where only the epithelium was resected. In the type II and type III cordectomies, the quality of voice depended on the development of a fibrous fold and the absence of anterior synechia in the healed larynx.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00879268
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