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  • 1
    Electronic Resource
    Electronic Resource
    Chester : International Union of Crystallography (IUCr)
    Journal of synchrotron radiation 6 (1999), S. 630-632 
    ISSN: 1600-5775
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Geosciences , Physics
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 1180-1183 
    ISSN: 1432-2218
    Keywords: Key words: Antireflux surgery—Dysphagia—Esophageal stricture—Gastroesophageal reflux disease—Laparoscopy—Nissen fundoplication—Outcomes—Postoperative complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Persistent postoperative dysphagia occurs in up to 24% of patients who undergo a laparoscopic Nissen fundoplication for reflux disease [7]. We hypothesized that patient history, pH testing, and esophageal manometry could be used to preoperatively identify patients at risk for this complication. Methods: Of 156 laparoscopic Nissen fundoplications performed over a 27-month period, we identified 19 patients (12%) who suffered from postoperative dysphagia longer than 3 months. The presenting complaint of preoperative swallowing difficulty was noted as was the presence of a known esophageal stricture. Preoperative pH testing and esophageal manometry were performed for all subjects. We compared the following parameters to an age and gender-matched control group: history of esophageal stricture, presence of preoperative dysphagia, DeMeester reflux score, upper esophageal sphincter pressure and relaxation, esophageal body motility, location of respiratory inversion point, and lower esophageal sphincter length, resting pressure, and relaxation. Data were compared via t-test and Fisher's exact test. Results: Patients who presented before surgery with complaints of difficulty swallowing were more likely to suffer from postoperative dysphagia (p= 0.029). Incidence of stricture, DeMeester score, and manometric measurements did not differ between the dysphagia and control groups (p 〉 0.05 for all parameters). Conclusions: Although preoperative studies are not helpful in identifying patients at risk for persistent dysphagia after laparoscopic Nissen fundoplication, patients presenting with the preoperative complaint of difficulty swallowing are at increased risk for this complication.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Bulletin of environmental contamination and toxicology 62 (1999), S. 608-615 
    ISSN: 1432-0800
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 1080-1083 
    ISSN: 1432-2218
    Keywords: Key words: Toupet — Fundoplication — Laparoscopic — Gastroesophageal reflux disease — Antireflux surgery — Prospective
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This prospective study assesses the outcome results in 100 consecutive patients with gastroesophageal reflux disease (GERD) treated with a laparoscopic Toupet fundoplication. Methods: GERD was confirmed by 24-h pH study and/or esophagogastroduodenoscopy (EGD). Pre- and postoperative symptoms, operative times, and perioperative complications were recorded on standardized data forms. Early follow-up was at 3 months and late follow-up, including 24-h pH, manometry, and EGD was at 22 months. Results: Preoperative symptoms included heartburn (92%), regurgitation (58%), water brash (39%), and dysphagia (39%). Mean operative time was 3.2 hours. There were no conversions to celiotomy and there were no mortalities. The perioperative complication rate was 14%; 6% (5/83) of patients reported heartburn at 3 months and 20% (15/74) at 22 months. Early and late dysphagia was 20% (17/83) and 9% (7/74), respectively; 24-h pH testing was abnormal in 90% of symptomatic patients (9/10), 39% of asymptomatic patients (12/31), and 51% overall. Conclusions: Despite early improvement in reflux symptoms following laparoscopic Toupet fundoplications, there is a high incidence of recurrent GERD. Symptomatic follow-up underestimates the true incidence of 24-h pH-documented reflux. Based on these results we cannot recommend the laparoscopic Toupet repair for GERD patients with normal esophageal motility.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Experimental brain research 73 (1988), S. 627-636 
    ISSN: 1432-1106
    Keywords: Posture ; Adaptation ; Long-latency response ; Sensory integration ; Startle reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The experimental goal was to investigate discrepancies in the literature concerning postural adaptation and to determine if the prior presentation of horizontal perturbations affected the amplitude of responses to rotational perturbations. Surface EMG recordings from lower leg muscles (gastrocnemius (GAS) and tibialis anterior (TA)) were recorded in twelve subjects, and the amplitudes of the responses were statistically analyzed. We did not find differences between the responses to rotational perturbations which preceded or followed horizontal perturbations. This finding did not support the hypothesis that differences in the order of presentation of the different types of perturbations accounted for the discrepancies in the literature. Furthermore, our design did not show the progressive elimination of the GAS response within three to five sequential trials. Instead, we found a slow but significant response amplitude reduction over ten trials without yielding a permanent disappearance of the response. When analyzing the GAS responses to the rotational perturbations only, we found two components that contributed to the response reduction: 1) an initial reduction between trials one and subsequent trials, which could be due to habituation of a startle-like response; and 2) a second reduction which was more gradual. Our results also showed an immediate change in the response amplitude on the first trial, when the type of perturbation was changed. This is inconsistent with the view that ankle musculature stretch and joint movement are the primary inputs driving the postural responses. Since small ankle dorsiflexing rotations produced by the platform translations caused large GAS responses while large ankle dorsiflexing rotations produced by direct platform rotations caused small GAS responses, this suggests that multiple sensory inputs contribute to the responses. We propose that an initial compensation to a new perturbation type occurs within the first trial by the integration of these divergent sensory inputs.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1438-3888
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1438-3888
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1438-3888
    Keywords: Key words Bioindicators ; Spatial pattern ; Temporal pattern ; North Sea
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract  A comprehensive database, containing biological and chemical information, collected in the framework of the bilateral interdisciplinary MARS project (”biological indicators of natural and man-made changes in marine and coastal waters”) during the years 1995–1997 in the coastal environment of the North Sea, was subjected to a multivariate statistical evaluation. The MARS project was designated to combine a variety of approaches and to develop a set of methods for the employment of biological indicators in pollution monitoring and environmental quality assessment. In total, nine ship cruises to four coastal sampling sites were conducted; 765 fish and 384 mussel samples were analysed for biological and chemical parameters. Additional information on the chemical background at the sampling sites was derived from sediment samples, collected at each of the four sampling sites. Based on the available chemical data in sediments and black mussel (Mytilus edulis) a pollution gradient between the selected sites, was established. The chemical body burden of flounder (Platichthys flesus) from these sites, though, did not reflect this gradient equally clear. In contrast, the biological information derived from measurements in fish samples displayed significant a regional as well as a temporal pattern. A multivariate bioindicator data matrix was evaluated employing a factor analysis model to identify relations between selected biological indicators, and to improve the understanding of a regional and temporal component in the parameter response. In a second approach, applying the k-means algorithm on the data matrix, two significantly different clusters of samples, characterised by the current health status of the fish, were extracted. Using this classification a temporal, and in the second order, a less pronounced spatial effect was evident. In particular, during July 1996, a clear sign of deteriorating environmental conditions was extracted from the biological data matrix.
    Type of Medium: Electronic Resource
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