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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of neurochemistry 27 (1976), S. 0 
    ISSN: 1471-4159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract— Tryptophan, 5-hydroxytryptamine and 5-hydroindoleacetic acid were found to be greatly increased in various parts of the brains of rats in acute hepatic failure following two stage hepatic devascularization. However, the increases in 5-hydroxytryptamine and 5-hydroxyindoleacetic acid varied by region and are not explicable solely in terms of increased concentrations of tryptophan. The results are discussed in terms of differences in the regional metabolism of 5-hydroxyindoleamines. Plasma free fatty acids, albumin, total tryptophan and free tryptophan were measured in plasma in hopes of elucidating the mechanism responsible for the cerebral elevation of tryptophan. Increased plasma free tryptophan appears sufficient to explain the rapid increase in brain tryptophan. The relationship between these results and recent observations in hepatic encephalopathy is discussed.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 36 (1993), S. 559-563 
    ISSN: 1530-0358
    Keywords: Fecal incontinence ; Dynamic graciloplasty ; Fast, slow-twitch skeletal muscle ; Electrical stimulation ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Dynamic graciloplasty for fecal incontinence includes gracilis muscle transposition around the anal canal as a new sphincter and subsequent electrical stimulation. The aim of electrical stimulation is to transform the gracilis fast-twitch, “fatigue-prone” fibers into slow-twitch, “fatigue-resistant” fibers to achieve a sustained tonic contraction. The latter is considered essential for sphincter function. Therefore, the following features of transposed gracilis muscle morphology were studied in nine patients before and after electrical stimulation: 1) the percentage of Type I fibers, 2) the lesser diameter of these fibers, and 3) the positive collagen staining area. Furthermore, the external anal sphincter and gracilis muscle histology was investigated in six autopsy cases. The mean percentage of Type I, slow-twitch, fatigue-resistant fibers in transposed gracilis muscle increased from 46 percent before electrical stimulation to 64 percent (P 〈0.01, paired Student's t-test) after electrical stimulation. The mean lesser diameter of these fibers did not change significantly (from 32 to 29 μm), and the mean percentage of collagen increased from 4 percent before electrical stimulation to 7 percent (P 〈0.01) afterward. The external sphincter in cadavers demonstrated a predominance of Type I fibers (80 percent) with a lesser diameter of 23 μ m and a high percentage (12 percent) of collagen. Gracilis muscle histology was uniform at six different sample sites in these cadaver dissections. We conclude that electrical stimulation induces histologic changes in transposed gracilis muscle, allowing this muscle to function as an external anal sphincter.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1530-0358
    Keywords: Stoma ; Fecal incontinence ; Fast-twitch and slow-twitch muscle fibers ; Electrical stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To develop surgical techniques to obtain stoma continence with a muscular sphincter, the anatomy (especially innervation and vascularization patterns) of the human abdominal wall muscles was studied in three cadaver dissections. It was found that transposed rectus abdominis muscle might be positioned as a new sphincter (sphincteroplasty). Next, the feasibility was assessed in six pigs, and the rectus muscle was positioned as a sphincter around a Thiry Vella loop. The use of three different surgical procedures has been assessed: 1) a muscular ring of the proximal rectus was constructed and partly denervated the muscle; 2) the distal end of the Thiry Vella loop was pulled through the middle of the rectus muscle, thereby also introducing partial muscle denervation; and 3) a sling was constructed using the distal muscle part. In four of these six pigs, identical procedures were performed also at the left side. These new sphincters were electrically stimulated (with implanted stimulation devices) to study the feasibility of prolonged sphincter contraction independent of will. Stimulation with a frequency of 25 Hz was used at the right and 2 Hz was used at the left sphincters. It was found that electrical stimulation with a frequency of 25 Hz as well as 2 Hz increased the percentage of Type I (relatively fatigue-resistant) muscle fibers significantly from 42 to 65 percent (n = 6) in the right and from 50 to 67 percent (n = 4) in the left rectus muscle into innervated muscle areas of the sphincters. This increase is considered essential for sustained sphincter function. Stoma continence was not achieved because constructing muscular rings (as a sphincter) caused partial atrophy. Construction of a sling using the distal part of the rectus did not cause substantial atrophy, but continence was not achieved because the dorsal side of the Thiry Vella loop was not completely covered with muscle fibers.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-739X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 364 (1984), S. 495-495 
    ISSN: 1435-2451
    Keywords: Esophagus varices ; Sclerotherapy ; Thrombin-sclerosanst therapy ; Oesophagusvaricenblutung ; Sklerotherapie ; Thrombinesklerosansmischung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 106 Patienten wurden mit Sklerotherapie wegen blutender Oesophagusvaricen behandelt. Für die Injektion unmittelbar in die Varicen wurde eine Mischung angewendet von einem Sklerosans und Thrombine. Um Komplikationen vorzubeugen wurde der Abfluß in die Vena azygos abgeschnürt mittels eines Ballons um die Spitze des Fiberendoskopes. 94% der akuten Blutungen kamen zum Stehen. Es gab einige Rezidivoesophagusblutungen, besonders während der ersten Monate. Bei Langzeitrezidivblutungen war eine hämorrhagische Gastritis die Hauptursache. Nach $${\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ Jahr waren noch 71% und nach 1 Jahr 66% der Patienten am Leben. Thrombine scheint die Behandlung günstig zu beeinflussen.
    Notes: Summary Sclerotherapy was used to treat 106 patients for bleeding esophagus varices. A sclerosanstthrombin combination was injected right into the varices. A flexible endoscope was used with a balloon around the tip to prevent the flow of thrombin directly into the azygos vein. There was immediate stop of the bleeding in 94% of the patients, although there were some cases of rebleeding in the first month. Late rebleeding was mostly caused by hemorrhagic gastritis. The survival rate was 71% after a half year and 66% after a year. The addition of thrombin seems to improve sclerotherapy.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 355 (1981), S. 539-539 
    ISSN: 1435-2451
    Keywords: Obstructive jaundice ; Choledochojejunostomy ; Ikterus ; Obstruktion ; Choledochojejunostomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Viele Kontroversen bestehen über die richtige biliodigestive Anastomose bei benignen oder malignen Gallenwegobstruktionen. Wir haben 94 Patienten mit einer Choledocho-, hepatojejunaler Anastomose mit Roux-Y-Technik nachuntersucht. Das Durchschnittsalter war 70 Jahre, 38 Patienten hatten ein Malignom, 56 Patienten eine benigne Erkrankung. Carcinome im Pankreaskopfbereich, Rest- oder Rezidivsteine, intrahepatische oder incarcerierte Steine waren die häufigsten Indikationen. Gesamtmorbidität war 19,5%, davon 9,1% Wundprobleme. Die Letalität betrug 10,5% in der malignomen und 2% in der benignen Gruppe. Das Follow-up nach einem modifizierten Visick-Schema ist 100 % Visick I und II.
    Notes: Summary For benign or malignant obstructive jaundice the kind of biliodigestive diversion still remains controversial. We studied retrospectively 94 patients with a choledocho- or hepaticojejunostomy with the limb fashioned by the Roux-en-Y technique. Mean age was 70 years; 38 patients had a malignancy, 56 a benign disorder. Cancer in the head of the pancreas or recurrent, residual, intrahepatic, or incarcerated stones were the most frequent indications for operation. Morbidity was 19.3% including 9.1% complications in wound healing. In the malignant group mortality was 10.5%, in the benign group 2%. Follow-up according to the modified Visick grade system scored 100% Visick grades I and II.
    Type of Medium: Electronic Resource
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