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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Hyperglykämie ; Hypoglykämie ; regionale Organdurchblutung ; Microspheres ; kardiopulmonale Reanimation (CPR) ; Key words Hyperglycaemia ; Hypoglycaemia ; Regional organ blood flow ; Microspheres ; Cardiopulmonary resuscitation (CPR)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Blood glucose alterations prior to cerebral ischaemia are associated with poor neurologic outcome, possibly due to extensive lactic acidosis or energy failure. Cerebral effects of hyper- or hypoglycaemia during cardiopulmonary resuscitation (CPR) are less well known. In addition, little information is available concerning cardiac effects of blood glucose alterations. The aim of this study was to evaluate the effects of pre-cardiac-arrest hypo- or hyperglycaemia compared to normoglycaemia upon haemodynamics, cerebral blood flow (CBF) and metabolism (CMRO2), and regional cardiac blood flow during CPR subsequent to 3 min of cardiac and respiratory arrest and after restoration of spontaneous circulation. Methods. After approval by the State Animal Investigation Committee, 29 mechanically ventilated, anaesthetised pigs were instrumented for haemodynamic monitoring and blood flow determination by the radiolabeled microsphere technique. The animals were randomly assigned to one of three groups: in group I (n=9) blood glucose was not manipulated; in group II (n=10) blood glucose was increased by slow infusion of 40% glucose to 319±13 mg/dl; in group III (n=10) blood glucose was lowered by careful titration with insulin to 34±2 mg/dl. After 3 min of untreated ventricular fibrillation and respiratory arrest, CPR (chest compressor/ventilator (Thumper®) and epinephrine infusion) was commenced and continued for 8 min. Thereafter, defibrillation was attempted, and if successful, the animals were observed for another 240 min. Cerebral perfusion pressure (CPP), CBF, CMRO2, coronary perfusion pressure (CorPP), and regional cardiac blood flow were determined at control, after 3 min of CPR, and at 10, 30, and 240 min post-CPR. Results. In group I, 4/9 animals (44%) could be successfully resuscitated; in group II 4/10 (40%); and in group III 0/10 (0%). Prior to cardiac arrest, mean arterial pressure, CPP, and CorPP in group III were significantly lower compared to groups I and II. In group I, CPP during CPR was 26±6 mmHg; CBF 31±9 ml/min/100 g CMRO2 3.8±1.2 ml/min/100 g; CorPP 18±5 mmHg; and left ventricular (LV) flow 35±15 ml/min/100 g. In group II: CPP=21±5; CBF 21±7; CMRO2 1.8±0.8; CorPP 16±6; and LV flow 22±9; and in group III: CPP 15±3; CBF 11±8; CMRO2 1.5±1.1; CorPP 4±2; and LV flow 19±10. During the 240-min post-resuscitation period, there were no differences in CBF, CMRO2, or LV flow between groups I and II. Conclusion. Hypoglycaemia prior to cardiac arrest appears to be predictive for a poor cardiac outcome, whereas hyperglycaemia does not impair resuscitability compared to normoglycaemia. In addition, hyperglycaemia did not affect LV flow, CBF, or CMRO2. However, it has to be kept in mind that haemodynamics and organ blood flow do not permit conclusions with respect to functional neurologic recovery or histopathologic damage to the brain, which is very likely to be associated with hyperglycaemia.
    Notes: Zusammenfassung Gegenstand der vorliegenden Untersuchung im Schweinemodell ist der Einfluß einer prä-ischämischen Normo-, Hyper- oder Hypoglykämie auf Hämodynamik, regionale Organdurchblutung und Reanimierbarkeit nach 3minüti-gem unbehandelten Herz-Kreislauf-Stillstand und anschließender kardiopulmonalen Reanimation (CPR). Hypoglykämie (Blutzuckerkonzentration von 34±2 mg/dl) war bereits vor der Reanimation mit einer deutlichen Beeinträchtigung hämodynamischer Parameter assoziiert. Keines der hypoglykämischen Tiere konnte erfolgreich reanimiert werden, im Gegensatz zu den hyper- (Blutzucker 319±13 mg/dl) bzw. normoglykämischen Tieren, die keinen Unterschied hinsichtlich der Erfolgsrate der Reanimation aufwiesen. Weder vor noch während oder nach Reanimation unterschieden sich hyper- und normoglykämische Tiere in bezug auf Hämodynamik oder regionale kardiale oder zerebrale Durchblutung. Somit bleibt festzuhalten, daß Hypoglykämie bei CPR mit einer schlechten kardialen Prognose assoziiert ist, während Hyperglykämie die kardiale Reanimation offenbar nicht beeinträchtigt.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Mineralium deposita 16 (1981), S. 459-465 
    ISSN: 1432-1866
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geosciences
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 127 (1977), S. 15-19 
    ISSN: 1432-1076
    Keywords: HGH secretion ; L-Dopa ; L-Carbidopa ; Arginine test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The stimulatory effect of Nacom® (250 mg L-Dopa and 25 mg L-Carbidopa) on the HGH secretion was evaluated in 75 short stature patients. The number of blood samples was restricted to only three (0, 45 and 90 min). 63 patients reached adequate HGH concentrations after the ingestion of 1 tablet Nacom (84%). Somatotropin levels increased from 2.08 (S x 0.28) to a maximal HGH value of 14.22 (S x 0.87) ng/ml. When the stimulatory effect of Nacom was compared with the standard method of arginine infusion in children with normal stature the arginine test was not superior to the Nacom-test. The Nacom-test appears to be a simple and reliable screening method for HGH deficiency, particularly in outpatients.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 135 (1981), S. 245-253 
    ISSN: 1432-1076
    Keywords: Transient hypothyroidism ; Prophylactic thyroid hormone substitution ; Neonatal intensive care ; Preterm infants ; Respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our previous examinations had shown that 9 of 13 premature infants with severe respiratory distress had hypothyroid T4-values. On the basis of these results a prospective study was initiated. Every second neonate born after less than 37 weeks gestation or weighing less than 2200 g and admitted to our intensive care unit since Janary 1979 received a prophylactic dose of 25 μg l-Thyroxine and 5 μg Tri-iodothyronine daily. Five of the patients inadvertently did not receive the drug and were included in the non-treated group which thus numbered 55. Both groups were nearly identical with regard to gestational age, birth weight and Apgar score. In the treated group of 45 infants three (=6.6%) died. In the untreated group of 55 infants 16 (=29%) died. The probability that the different mortality in the two groups was due to chance alone is less than 0.5% (χ2-test: P〈0.005). In 14 of the 55 non-treated patients transient hypothyroidism developed. Five patients with transient hypothyroidism and 2 patients with low T4-values without a TSH-increase were treated with thyroid hormone after ascertainment of their serum thyroxine levels and six survived. The analysis of the prophylactically treated cases showed that the dosage of 25 μg l-Thyroxine and 5 μg Tri-iodothyronine in critically ill infants (i.e., those who were mechanically ventilated or had sepsis) was rarely sufficient to produce normal serum thyroxine levels. In these children thyroxine usually rose to normal levels only when they had passed the acute stage of the disease. It therefore seems advisable to double the dose of thyroid hormone during the acute stage of the disease.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 122 (1976), S. 195-200 
    ISSN: 1432-1076
    Keywords: HGH secretion ; l-Dopa ; l-Carbidopa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei Kindern ohne Minderwuchs im Alter von 6–14 Jahren wurde nach oraler Gabe von 250 mg Levodopa und 25 mg l-Carbidopa (Nacom, ein Kombinations-präparat) die Wachstumshormonkonzentration im Serum bestimmt. Alle Probanden zeigten einen ausreichenden Wachstumshormonanstieg. Der Mittelwert betrug 19,6 ng/ml. Nach dem Maximum der HGH-Konzentration ließen sich zwei Gruppen unterscheiden. Die eine Gruppe erreichte zum Zeitpunkt 20 bzw. 40 min, die andere nach 60 bzw. 90 min den stärksten HGH-Anstieg. Aufgrund des Verlaufs der Mittelwertskurve werden 2 Blutentnahmen, 40 und 90 min nach Einnahme des Präparates, zum Ausschluß eines Wachstumshormonmangels für ausreichend gehalten. Das wahrscheinlich zugrundeliegende Wirkungsprinzip der HGH-Sekretion durch l-Dopa und l-Carbidopa wird anhand der Literatur diskutiert.
    Notes: Abstract The stimulatory effect of l-Dopa and l-Carbidopa (Nacom) on HGH secretion was determined in 12 children of normal height aged from 6 to 14 years. Each child received a standard dose of 250 mg l-Dopa and 25 mg l-Carbidopa p.o. HGH concentration in the serum was determined at standard intervals. All subjects showed a sufficient increase of HGH. The mean value was 19.6 ng/ml. According to the maximum values of the HGH concentration the sample can be divided into two groups; the first group reached the highest values after 20–40 min, the second one after 60–90 min. On evaluation of the curve of the mean values it appears that 2 blood samples taken 40 and 90 min after the ingestion of l-Dopa and l-Carbidopa are sufficient in order to exclude HGH deficiency. The theoretical background for HGH secretion after stimulation by l-Dopa and l-Carbidopa is discussed.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 132 (1979), S. 85-92 
    ISSN: 1432-1076
    Keywords: Transient hypothyroidism ; Neonatal intensive care ; Preterm infants ; Respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial TSH and T4 determinations were performed in sixty neonates admitted to our hospital for neonatal intensive care within a period of three months. Seven patients (12%) showed transient hypothyroidism on the basis of low T4 and high TSH values. Only one of these patients, who had meconium aspiration and pneumonia, did not have the respiratory distress syndrome. In addition, 4 of these patients had sepsis. All of the patients were born before 37 gestational weeks and had birth weight under 2200 g. In addition, two patients of this gestational age and birth weight group had a progressive fall of T4 to extremely hypothyroid values without simultaneous elevation of TSH. Two of the 5 patients who died had histological studies of their thyroids. These revealed colloid-depleted vesicles, desquamated epithelium, and prominent vascularisation of the thyroid. The results of this study show that early recognition and therapy of transient hypothyroidism may be live saving.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Dental traumatology 11 (1995), S. 0 
    ISSN: 1600-0595
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract - A case of a transdental fixation planned on the basis of ultrafast computed tomography is reported. This method allows to gain an insight in the osseous structures required for the operative procedure. Ultrafast computed tomography is superior to the convential radiographs in obtaining accurate information about the vertical bone supply and the extension of the facial osseous sinus wall. A set of axial CT-images with an extension of 3 mm was acquired in the region of the alveolar bone. By means of frontal reconstructions and data processing methods the thickness of the bone layer in transverse direction was accurately determined. The calculated bone thickness allowed to anchor a transdental self-tapping titanium screw.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Spectrochimica Acta Part B: Atomic Spectroscopy 23 (1968), S. 443-454 
    ISSN: 0584-8547
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Magnetism and Magnetic Materials 31-34 (1983), S. 1599-1600 
    ISSN: 0304-8853
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 0010-4655
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Computer Science , Physics
    Type of Medium: Electronic Resource
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