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  • 1
    ISSN: 1432-1440
    Keywords: Standard operations ; anaesthesia ; blood transfusion ; plasma histamine ; Standardoperationen ; Anästhesie ; Bluttransfusion ; Plasmahistaminspiegel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine prospektive kontrollierte klinische Studie wurde über Veränderungen des Plasmahistamin- und Katecholaminspiegels bei 5 Standardoperationen durchgeführt. Diese Mitteilung, als erster Teil der Studie, zeigt nur die Möglichkeiten auf, eine solche Studie durchzuführen und Veränderungen des Plasmahistaminspiegels nachzuweisen. Erhöhte Plasmahistaminkonzentrationen, die einer Histaminfreisetzungsreaktion von 〉1 ng/ml entsprechen, kamen bei 8 von 25 Operationen vor. In einer explorativen statistischen Analyse wurden diese Reaktionen mit bestimmten Phasen der Anästhesie oder des chirurgischen Eingriffs in Verbindung gebracht. Bluttransfusionen tragen das Risiko in sich, „freies Histamin“ in den Patienten zu infundieren — zumal bei Filterpassage, wenn es unter erhöhtem Druck angewandt wird. Da während Operationen recht häufig „freies Histamin“ in die Zirkulation gelangt und möglicherweise schädigende Wirkungen entfaltet, ist möglicherweise eine Prämedikation mit H1- und H2-Rezeptorantagonisten ratsam.
    Notes: Summary A prospective controlled clinical trial was conducted on changes in plasma histamine and catecholamine levels during 5 standard operations. This communication, as the first part of the trial, deals only with the feasibility of such a trial and the changes in plasma histamine levels. Elevated histamine concentrations corresponding to histamine-release responses of 〉1 ng/ml occurred in 8 of 25 operations. In an explorative analysis these reponses were associated with distinct phases of anaesthesia or the surgical procedure. Blood transfusion carried the risk of infusion of “free histamine” into the patient — especially when administered under pressure. Since during operations “free histamine” enters the circulation with a rather high incidence and may cause harmful effects, premedication with H1-+H2-receptor antagonists seems worth consideration.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 68 (1997), S. 1041-1042 
    ISSN: 1433-0385
    Keywords: Key words: N. laryngeus inferior ; Thyroid gland ; Parathyroidea. ; Schlüsselwörter: N. laryngeus inferior ; Schilddrüse ; Nebenschilddrüse.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-0385
    Keywords: Key words: Conjoint longitudinal muscle ; Anal canal ; Continence ; Ganglionic cells ; Vater-Pacinian corpuscles. ; Schlüsselwörter: Longitudinaler Muskel ; Analkanal ; Kontinenz ; Ganglienzellen ; Vater-Pacini-Tastkörperchen.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Der longitudinale Muskel stellt eine kräftige musculäre Struktur des Analkanals zwischen M. sphincter ani internus und externus dar. Fasern dieses Muskels finden sich als M. canalis ani in der Submukosa des Analkanals und als M. corrugator ani durchdringen sie den subcutanen Anteil des M. sphincter ani externus. Somit verbindet dieser Muskel die willkürlichen und unwillkürlichen Anteile des analen Kontinenzorgans. Histologisch finden sich Ganglienzellen und Vater-Pacini-Tastkörperchen. Die hierdurch nachgewiesene Innervation des Muskels sichert seine funktionelle Bedeutung im Zusammenspiel des analen Schlußapparats. Morphologie, Histologie und Topographie des Muskels legen eine zentrale Bedeutung für die anorectale Kontinenz nahe. Zum Verständnis der Physiologie und Pathophysiologie des analen Kontinenzorgans ist eine Erarbeitung der funktionellen Bedeutung des longitudinalen Muskels unumgänglich.
    Notes: Summary. The longitudinal muscle (LM) represents a strong muscular structure of the anal canal situated between the internal (IAS) and the external anal sphincter (EAS). Terminal fibres of this muscle insert at the submucosa of the anal canal, representing the m. canalis ani. Others cross the subcutaneous part of the EAS to become the m. corrugator ani. Thus, the LM connects the visceral and somatic parts of the anal sphincter complex. Histologically ganglionic cells and as Vater-Pacinian corpuscles can be identified inside the LM. Morphology, topography and histology of the LM suggest that this muscle participates in maintaining anorectal continence. It is mandatory that the exact functions of this muscular structure be to elaborated upon, if we are to understand the mechanism of anorectal continence.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 986-990 
    ISSN: 1432-2218
    Keywords: Key words: Anal endosonography — Longitudinal muscle — External anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: Anal endosonography is an imaging modality new to the diagnostic workup of incontinence. Interpretations even of normal endosonomorphologic findings now vary considerably. The conjoined longitudinal muscle (LM), a widely ignored structure, has until recently not been fully recognized by anal endosonography. The aim of this study, therefore, was to accurately determine the normal anatomy of the anal canal and correlate it with the findings obtained by anal endosonography. Methods: Eight postmortem specimens of the anal canal were examined by endosonography. The findings were correlated with macroscopical dissection and gross sectional histology of the same specimens. Results: The external echogenic ring is composed of two anatomical structures: the LM and the external anal sphincter (EAS). However, during anal endosonography the LM cannot always be differentiated from the EAS. Histologically, the relation of the diameters of the LM and the EAS ranged from 0.45:1 to 1.25:1. The narrow hyperechogenic ring between the inner hypoechoic layer and the external hyperechoic ring is an artificial finding that cannot be related to a distinct anatomical structure and most likely represents a sonographic interface. Conclusions: This study exactly outlines the relation of diameters of the conjoined longitudinal muscle and external anal sphincter for the first time. Until now, the LM has been underestimated in its dimensions. The role of such a thick muscular structure should be included in the conception of anal continence in the future. Especially in view of the fact that anal endosonography is increasingly used in the diagnostic workup of incontinence and fistula in ano, it is essential to understand the anatomical basis of endosonography. This study accurately delineates the sonomorphology of the anal muscles. When viewed in light findings reported here, endosonographic findings in diseases of the anal canal are now based on a correct idea of the correlation between endosonomorphology and anal anatomy.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1401-1404 
    ISSN: 1432-2218
    Keywords: Key words: Adenoma — Rectal cancer — Pelvic peritoneal reflection — Endorectal ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Large adenomas and low-risk rectal carcinomas (T1) that are localized distal of the pelvic peritoneal reflection (PPR) are treated by transanal excision. However, the location of the PPR varies widely and cannot be detected reliably by preoperative methods. Therefore, we evaluated the value of endorectal ultrasound (EUS) for the prediction of an intraperitoneal location of rectal tumors. Methods: Fourteen patients with rectal tumors measuring ≤15 cm from the anal verge were examined by EUS. If peristalsis beyond the rectal wall or any intraperitoneal fluid was seen at the proximal tumor edge, the lesion was classified as localized above or in the level of the PPR. During the operation, the surgeon determined whether the upper end of the tumor reached the PPR. Results: In each of our 14 patients, the prediction by EUS was correct. In two patients, a small rectal tumor was excised with an electric sling during rectoscopy, but the polyp bases were not free of dysplastic epithelial tissue. The point where these two polyps were removed could be visualized by endoscopy but not by EUS. Once the relevant area was marked with a titanic endoclip, EUS was able to predict the resection place in relation to the PPR in these two patients as well. Conclusions: Although this knowledge would be very important for the therapeutic strategy of small rectal tumors, it is impossible to determine the location of a rectal tumor with regard to the PPR either clinically or by endoscopy. EUS provides this information with high reliability. Thus, we recommend EUS as the method of choice for predicting the location of the PPR.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 379 (1994), S. 131-136 
    ISSN: 1435-2451
    Keywords: Rectal endosonography ; Pelvis ; Abscess ; Ascites ; Tumour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die rektale Endosonographie wurde bei 35 Patienten unter dem Verdacht eines pathologischen Prozesses im kleinen Becken durchgeführt. In dieser Arbeit werden kasuistisch pathologische Befunde vorgestellt. Es wird gezeigt, daß die endorektale Sonographie weiterführende Informationen gegenüber den etablierten Schnittbildverfahren wie z. B. abdominelle Sonographie und Computertomographie liefern kann. Möglicherweise ist die Indikationsbreite der transrektalen Endosonographie über den bisher gesicherten Einsatz bei Rektumtumoren und Erkrankungen des Beckenbodens auszudehnen. Weitergehende systematische Untersuchungen sind erforderlich.
    Notes: Abstract Rectal endosonography was performed in 35 patients in whom a pathologic process in the pelvis was suspected. Pathologic findings were shown in various cases: abscess, tumours, ascites. It was shown that rectal endosonography can provide information that is not revealed by such established examinations as abdominal sonography and computed tomography. We recommend that the indications for transrectal endosonography can be extended beyond the established use in rectal tumours and diseases of the pelvic floor. Further systematic examinations are required.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Fresenius' Zeitschrift für analytische Chemie 28 (1889), S. 683-685 
    ISSN: 1618-2650
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Fresenius' Zeitschrift für analytische Chemie 37 (1898), S. 319-320 
    ISSN: 1618-2650
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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