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  • 1
    Electronic Resource
    Electronic Resource
    Aetiology of Delayed Facial Palsy after Vestibular Schwannoma Surgery: Clinical Data and Hypothesis (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 913-917 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Delayed facial palsy; herpes simplex virus; magnetic resonance image; vestibular schwannoma.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  A patient developed delayed facial nerve palsy at the level of House-Brackmann grade I to grade III 10 days after vestibular schwannoma surgery by the suboccipital transmeatal approach. The palsy had completely recovered after one month. Immunological study showed reactivation of herpes simplex and magnetic resonance (MR) imaging demonstrated an abnormal enhancement pattern of the facial nerve; intense enhancement of the distal intracanalicular segment and labyrinthine segment, similar to the MR findings for Bell's palsy. A prospective control study on the enhancement pattern of the functionally preserved facial nerve after vestibular schwannoma surgery in six cases showed a similar pattern to that of the normal facial nerve. Based on these findings, we propose the hypothesis that herpes simplex reactivation is an underlying cause of delayed facial palsy after vestibular schwannoma surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050193
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  • 2
    Electronic Resource
    Electronic Resource
    Surgical Outcome of Intramedullary Spinal Cord Ependymoma (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 341-347 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Spinal cord neoplasm; ependymoma; intramedullary tumour; surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Surgical outcome of intramedullary spinal cord ependymoma was investigated in order to define the treatment strategy. We have operated on 18 cases of intramedullary spinal cord ependymoma based on the principle of radical resection. The follow-up periods ranged from 10 months to 249 months with an average of 86.2 months. Postoperative neurological status in the long follow-up periods was compared to the pre-operative status and was correlated with the histological grade of malignancy. Total removal of the tumour was achieved in 17 cases, and subtotal removal followed by radiation therapy was conducted in 1 case. There was neither surgical mortality nor radiological evidence of recurrence in the long-term follow-up periods. The final outcome of the neurological condition was improved in 1 case, unchanged in 15 cases (including a case of subtotal removal) and deteriorated in 2 cases. The deterioration was in the form of gait disturbance due to the worsening of proprioception in 2 cases and dysaethesia in 1 case. Histological examination showed no evidence of anaplasia in 6 cases, evidence of early anaplasia in 10 cases, and moderate evidence of anaplasia in 2 cases. No relationship between the histological malignancy and clinical course was found. Intramedullary spinal cord ependymoma should be removed radically as early as possible while taking great care to avoid posterior column injury. Histologically malignant ependymoma might be a clinical exception.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050309
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  • 3
    Electronic Resource
    Electronic Resource
    Photo-oxidation of water in phospholipid bilayer membranes containing chlorophyll a (1977)
    [s.l.] : Nature Publishing Group
    Nature 265 (1977), S. 187-189 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] There have been several investigations of the photosensitivity of chlorophyll incorporated into phospholipid bilayers. For example, when chloroplast extracts were incorporated into the phospholipid bilayer separating two aqueous solutions of different redox potential, photocurrents through the ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/265187a0
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  • 4
    Electronic Resource
    Electronic Resource
    EAES ductal stone study (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1130-1135 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Ductal calculi—Endoscopic sphincterotomy— Laparoscopic Ductal Clearance—Randomized controlled clinical trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The current management of patients with ductal calculi and gallstone disease consists of endoscopic stone extraction (ESE) followed by laparoscopic cholecystectomy (LC). The advent of techniques of laparoscopic ductal stone clearance has introduced an alternative single stage laparoscopic treatment for these patients. The EAES ductal stone trial was set up to compare the relative efficacy and outcome of these two management options. Methods: The study consists of a prospective randomized controlled clinical trial comparing two management options of patients undergoing LC and suspected of harbouring common duct stones. Patients registered into the trial are randomized to one of two arms: (i) Group A—preoperative ERC with ESE followed by LC during the same hospital admission. (ii) Group B—single stage laparoscopic management consisting of LC and laparoscopic stone extraction either by the trans-cystic duct route or by direct supraduodenal common duct exploration. Results: This preliminary analysis was carried out on 207 randomized patients with comparisons being made on the intention to treat principle. The two groups (A = 106, B = 101) were comparable with respect to clinical features. ASA grade, serum biochemistry and ultrasound findings. Conclusions: These preliminary findings indicate equivalent success rates and patient morbidity between the two management options but a shorter hospital stay (cost benefit) with the single stage laparoscopic treatment. Trans-cystic duct extraction is a more benign procedure than laparoscopic supraduodenal CBD exploration and is accompanied by a significantly shorter hospital stay. The higher incidence of conversion in the single stage laparoscopic group compared to the two-stage arm is due to the preference for open common duct exploration when the laparoscopic attempt failed by the majority of participating surgeons. The results to-date suggest that in fit patients, single stage laparoscopic treatment is the better option and the role of ESE should change to selective use in those patients in whom laparoscopic ductal stone extraction has failed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900264
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  • 5
    Electronic Resource
    Electronic Resource
    Preoperative pneumatic dilatation represents a risk factor for laparoscopic Heller myotomy (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 359 -361 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Achalasia — Esophagomyotomy — Laparoscopy — Fundoplication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The development of minimally invasive surgery has renewed interest in the surgical therapy of achalasia. Methods: 21 patients with esophageal achalasia underwent Heller's laparoscopic myotomy with anterior fundoplication between August 1991 and March 1996. Results: There were two intraoperative perforations of the mucosa sutured laparoscopically with no postoperative sequelae; both complications occurred in patients previously treated with pneumatic dilatation; no perforations occurred in the 14 patients who had not been submitted to pneumatic dilatation (28% vs 0%). There were no surgical mortalities and no postoperative morbidities. Complete relief of dysphagia and modifications of radiological and manometric patterns were achieved in all patients. All patients remain asymptomatic at follow-ups ranging from 3 to 55 months after surgery. Conclusions: Laparoscopic Heller's myotomy is as effective as traditional surgery in treating symptoms and has all the advantages of pneumatic dilatation in terms of short hospital stay, quick recovery, and low cost; preoperative pneumatic dilatation is a risk factor for intraoperative mucosal perforation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900363
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  • 6
    Electronic Resource
    Electronic Resource
    Alterations in hepatic function during laparoscopic surgery (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 968-972 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic surgery — Laparoscopic cholecystectomy — Transaminases — Pneumoperitoneum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Very few studies have been done on the consequences of pneumoperitoneum on hepatic function. At present, there is no consensus on the physiopathological hepatic implications of pneumoperitoneum. The purpose of this clinical study was to evaluate the effects of pneumoperitoneum on hepatic function in 52 patients treated with laparoscopic procedures. Methods: Thirty-two laparoscopic cholecystectomies and 20 nonhepatobiliary laparoscopic procedures were performed in 52 patients (12 men and 40 women) with a mean age of 44 years (range, 15–74). All patients had normal values on preoperative liver function tests. The anesthesiologic protocol was uniform, with drugs at low hepatic metabolism. The 32 cholecystectomies were randomized into 22 performed with pneumoperitoneum at 14 mmHg and 10 performed at 10 mmHg. All nonhepatobiliary laparoscopic procedures were performed with a pneumoperitoneum of 14 mmHg. The postoperative serologic levels of AST, ALT, bilirubin, and prothrombin time were measured at 6, 24, 48, and 72 h. The serologic changes were related to the procedure, the duration, and the level of pneumoperitoneum. Results: Mortality and morbidity were nil. All 52 patients had a postoperative increase in AST, ALT, bilirubin, and lengthening in prothrombin time. Slow return to normality occurred 48 or 72 h after operation. The increase of AST and ALT was statistically significant and correlated both to the level (10 versus 14 mmHg) and the duration of pneumoperitoneum. Conclusions: The duration and level of intraabdominal pressure are responsible for changes of hepatic function during laparoscopic procedures. Although no symptom appears in patients with normal hepatic function, patients with severe hepatic failure should probably not be subjected to prolonged laparoscopic procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900758
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  • 7
    Electronic Resource
    Electronic Resource
    Extracorporeal shock wave lithotripsy and xanthine calculi in Lesch-Nyhan syndrome (1992)
    Springer
    Pediatric radiology 22 (1992), S. 304-304 
    Details
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of Lesch-Nyhan syndrome (LNS) with urinary xanthine calculi. At eight years of age calculi in the renal pelvis were successfully disintegrated by extracorporeal shock wave lithotripsy (ESWL) without any complications. Follow-up sonography is very useful for management of patients with LNS, particularly when they are on allopurinol therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02019872
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  • 8
    Electronic Resource
    Electronic Resource
    Solitary fibrous tumour of the adrenal gland associated with pregnancy (2000)
    Springer
    Virchows Archiv 437 (2000), S. 445-449 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Solitary fibrous tumour ; Adrenal gland ; Pregnancy ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Solitary fibrous tumour (SFT), first described as a pleural lesion, has been reported in several extrathoracic sites over the past 10 years. We describe a SFT of the left adrenal gland incidentally discovered in a 23-year-old, 22-week pregnant woman and characterised by a rapid growth during the third trimester of pregnancy. Elevated serum and urinary levels of cortisol and elevated blood levels of delta 4 androstendione and 17-OH progesterone were observed. After spontaneous delivery, the patient underwent laparoscopic resectioning of the mass and of the left adrenal gland from which the tumour was apparently originating. The kidney was not involved, and no other abdominal tumours were found. Histological and immunohistochemical features were typical of SFT of pleura and other locations. Only one case of adrenal SFT is on record, and the adrenal gland is to be added to the long list of extrathoracic locations of SFT. The association with pregnancy was a previously unrecognised event in SFT. The focal expression of progesterone receptors in the tumour cells may be related to pregnancy. This observation prompted an analysis of steroid hormone receptors in SFT of classical sites (pleura). Two of five cases had focal progesterone receptors too, a finding which deserves further investigations in a much larger series of SFTs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000268
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  • 9
    Electronic Resource
    Electronic Resource
    Laparoscopic colorectal resection (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 875-879 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic colorectal surgery — Minimally invasive surgery — Colorectal diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. The aim of the present study was to evaluate retrospectively the experience of six surgical units currently performing laparoscopic colorectal surgery. Methods. From November 1991 to January 1994, 200 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with locally advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I and IV adenocarcinoma. All surgeons considered obesity a relative contraindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resumption of gastrointestinal function, number of lymph nodes harvested, hospital stay. Results. Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedure (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90–480) for assisted resection and 275 min (54–550) for complete laparoscopic resection. The mortality rate was 1.7%; the overall morbidity was 19.6% (major complications 11.2%). All patients quickly became ambulatory and showed a prompt resumption of gastrointestinal functions, and less postoperative pain if compared with converted cases. The average number of lymph nodes was 12.1 (range 1–32). The mean hospital stay was 8.6 days (range 5–14.5). The mean follow-up was 16 months (range 6–24). The recurrence rate 11.7%. Conclusions: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-term follow-up is needed to evaluate the efficacy of laparoscopic surgery in the treatment of colorectal cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900187
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  • 10
    Electronic Resource
    Electronic Resource
    Laparoscopic colorectal resection (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 875-879 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopic colorectal surgery ; Minimally invasive surgery ; Colorectal diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. The aim of the present study was to evaluate retrospectively the experience of six surgical units currently performing laparoscopic colorectal surgery. Methods. From November 1991 to January 1994, 200 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with locally advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I and IV adenocarcinoma. All surgeons considered obesity a relative contraindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resumption of gastrointestinal function, number of lymph nodes harvested, hospital stay. Results. Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedure (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90–480) for assisted resection and 275 min (54–550) for complete laparoscopic resection. The mortality rate was 1.7%; the overall morbidity was 19.6% (major complications 11.2%). All patients quickly became ambulatory and showed a prompt resumption of gastrointestinal functions, and less postoperative pain if compared with converted cases. The average number of lymph nodes was 12.1 (range 1–32). The mean hospital stay was 8.6 days (range 5–14.5). The mean follow-up was 16 months (range 6–24). The recurrence rate 11.7%. Conclusions: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-term follow-up is needed to evaluate the efficacy of laparoscopic surgery in the treatment of colorectal cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00188473
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