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  • 1
    ISSN: 1432-1440
    Keywords: Extrazellulärwasser ; Ganzkörperwasser ; Plasmavolumen ; Ganzkörperkalium ; Lebercirrhose ; Extracellular space ; Body water ; Plasma volume ; Body potassium ; Cirrhosis of the liver
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Extracellular water (EWC; 82-bromide), total body water (TBW; 3-THO), intracellular water (ICW=TBW-ECW), plasma volume (PV; 51-Cr), and total body potassium (TBK; 40-K) were studied in patients with cirrhosis of the liver (n=12) and in controls (n=12). ECW (39%), TBW (28%), ICW (19%), and PV (24%) increased, TBK (28%) however, decreased in cirrhosis. The results indicate that it is less the lean body mass, but rather the intracellular potassium concentration that is lowered (cirrhosis: 84±21 mmol/l ICW; controls: 115±23 mmol/l ICW). Decreased potassium per cell (mmol) and increased intracellular water are discussed as possible reasons for this. The correlation between TBK (%) and serum potassium (mmol/l) was found to ber=0.56 (p〈0.002). Correlations between the biochemical parameters gamma-globulins, cholin esterase, serum sodium and serum albumin (g/l PV) and characteristic fluid disturbances in cirrhosis are highly significant whereas albumin (g/kg bodyweight) was the same in both groups. We can support the ‘overflow theory’ of ascites formation [19].
    Notes: Zusammenfassung Untersucht wurden die Flüssigkeitsräume Extrazellulärwasser (82-Bromid; ECW), Ganzkörperwasser (3-THO; TBW), Intrazellulärwasser (ICW=TBW-ECW) und Plasmavolumen (51-Chrom; PV), sowie das Ganzkörperkalium (40-K; TBK) bei Lebercirrhotikern (n=12) im Vergleich zu einer Kontrollgruppe (n=12). Die auf das Körpergewicht bezogenen Größen ECW (39%), TBW (28%), ICW (19%) und PV (24%) fanden wir bei den an Lebercirrhose Erkrankten vergrößert, das Ganzkörperkalium (% des Sollwertes) um 28% erniedrigt. Diese Ergebnisse weisen darauf hin, daß bei der Lebercirrhose weniger die sogenannte fettfreie Substanz (lean body mass; LBM) als vielmehr die intrazelluläre Kaliumkonzentration verringert ist. (Cirrhose: 84±21 mol/l ICW; Kontrolle: 115±23 mmol/l ICW). Als Ursachen werden ein vermindertes Kalium (mmol) pro Zelle und eine vergrößerte intrazelluläre Wasserkonzentration (ml/kg) diskutiert. Die Korrelation zwischen dem TBK (%) und dem Serum-Kalium (mmol/l) beträgtr=0,56 (p〈0,002). Die klinisch chemischen Parameter γ-Globuline, Cholinesterase, Serumnatrium und Albumine (g/l PV) korrelieren signifikant mit den charakteristischen Veränderungen der Flüssigkeitsräume und des Ganzkörperkaliums. Hierbei ist das auf das Körpergewicht bezogene Gesamtalbumin trotz der relativen Hypoalbuminämie nicht erniedrigt. Unsere Ergebnisse sprechen für die ‘overflow theory’ der Ascites-Pathogenese (Lieberman et al., 1970).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Osteoporosis ; Parathyroid hormone ; Bone metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In contrast to prevention, the therapy of manifest osteoporosis remains a clinically significant problem. So far all therapeutic attempts have yielded unsatisfying results. For this reason we have tried to achieve a positive bone balance by sequential stimulation and inhibition of the osseous metabolism. The therapy consisted of six 14-day courses with 400 units (1–38)hPTH per day and, in addition, starting with the 2nd week of PTH therapy, EHDP 5 mg per kg body weight per day for a total of 2 weeks. Already the initial therapeutic course resulted in a stimulation of decreased bone metabolism which could be documented by an increase in the calcium-47 accretion rate (six patients). An increase of the alkaline phosphatase could be noted (four patients); this, however, did not correlate with the calcium accretion. A positive calcium balance could, nonetheless, only be attained in four of eight patients within this period, while neither the alkaline phosphatase nor the kinetics would allow a prediction of this effect. Changes of the balance coincided with equal changes in the net calcium absorption. The urinary calcium excretion increased temporarily during the therapeutic phase. We were not able to detect an influence on the vitamin D metabolites. Histomorphometric studies did not demonstrate an increase in bone mass in the iliac creast after six therapeutic courses. Nevertheless, progressive deformations of vertebral bodies did not occur. We conclude that already after 2 weeks this therapeutic concept can lead to a stimulation of bone metabolism.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Medullary thyroid carcinoma ; Prognostic factors ; Sporadic and familial form ; Age ; Sex ; Tumor stage at diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective study of 741 patients with medullary thyroid carcinoma diagnosed between 1967 and 1991 was carried out by members of the German Medullary Thyroid Carcinoma Study Group to evaluate prognostic factors. A total of 559 patients (75%) were considered to have sporadic disease, and 182 (25%) had the familial type. The sex ratio (male to female) was 1:1.4 in sporadic disease patients, and the mean age at diagnosis was 45.9 years (range 5-81 years). For familial disease patients the sex ratio was 1:1.1, and the mean age at diagnosis was 33.4 (range 5–77 years). The follow-up time for 630 patients ranged from 1 month to 20.8 years (mean 13.0 years). The overall adjusted survival rate was 86.7% at 5 years and 64.2% at 10 years. In a univariate analysis the stage of disease at diagnosis, age, sex, and type of disease (sporadic, familial) were relevant prognostic factors, with a better prognosis for young female patients with familial disease and diagnosed at an early stage. In a multivariate proportional hazards analysis, the difference in the survival rate of patients with familial disease versus those with the sporadic form disappeared, while prognostic information provided by age and sex was still significant. The poorer prognosis of patients with sporadic medullary thyroid carcinoma may be related to the patients' older age at detection and more advanced tumor stage at diagnosis. There seems to be no difference in biological behavior between tumors of the sporadic and those of the familial type.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Psychiatry Research 29 (1989), S. 343-345 
    ISSN: 0165-1781
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 0165-1781
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Surface Science 40 (1973), S. 61-70 
    ISSN: 0039-6028
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1435-1285
    Keywords: Key words Transcoronary ablation of septal hypertrophy – TASH – hypertrophic obstructive cardiomyopathy – alcohol ablation – interventional cardiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 1991, our group started to develop a catheter interventional therapy for hypertrophic obstructive cardiomyopathy (HOCM). The new concept was proposed in 1994. It is based on the conventional PTCA technique with the aim of inducing an artificial myocardial infarction by instillation of 96% ethanol into the most proximally situated septal branch of the left anterior descending coronary artery. This leads to a subaortic contraction disorder with subsequent decrease of the intraventricular pressure gradient, shrinkage of the hypertrophied septal bulge and widening of the outflow tract (“therapeutic remodeling”). The subaortic defect is small and well demarcated as assessed by left ventricular angiography, transesophageal echocardiography and 18 F-glucose positron emission tomography. The term transcoronary ablation of septum hypertrophy (TASH) was suggested. Our patient cohort that now comprises 215 therapeutic procedures in 187 patients underwent a large variety of prospective studies (maximum follow-up 4.5 years) including invasive controls at regular intervals, investigation of hemodynamics at rest and at exercise, transesophageal and transthoracic echocardiography. Doppler echocardiography during bicycle exercise, electrophysiologic testing, Holter monitoring and measurement of myocardial metabolism and perfusion, assessment of microembolic events by transcranial Doppler sonography and histological examinations. This article gives an overview and reports our increasing experience in applying TASH. The following post-TASH findings were obtained: significant hemodynamic and clinical improvement at rest and at exercise, decrease of septum thickness, increase of outflow tract area and decrease of induced ventricular tachycardia. There were well-demarcated, histologically atypical subaortic myocardial defects, no microembolic events, abnormal early peak of infarct related enzymes, and no change of baroreflex sensitivity. Pre-/post-TASH evaluations of the patients should be based in particular on clinical symptoms correlated to the intraventricular gradient measured by bicycle exercise Doppler echocardiography and to outflow tract area as assessed by transesophageal echocardiography. Since 1994, as a roughly estimate, worldwide 1000 patients in 20 countries have been treated. According to published articles, abstract presentations and workshops, TASH consistently leads to a pronounced clinical and hemodynamic benefit for patients with HOCM. TASH has become an established technique. At least in centers with a high level of expertise, it is no longer experimental but a routinely performed alternative to surgical treatment for HOCM, i.e., the previous gold standard of therapy. Of course, patient outcome needs further careful clinical and prognostic evaluation. With respect to complications, TASH appears to be superior to surgery (transaortic septal myectomy) for HOCM. Like surgical treatment, TASH is currently indicated in critically ill patients with typical HOCM (subaortic form), who exhibit with drug refractory symptoms, including patients, who preferred DDD pacemaker therapy as a first therapeutic step but in whom this produced no subsequent clinical benefit.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 38 (1997), S. 917-923 
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Leberszintigraphie ; Lebertumor ; Lebermetastasen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Die nuklearmedizinische Diagnostik der Leber beruht im wesentlichen auf 3 Anreicherungsmechanismen: •*Speicherfähigkeit der von Kupfferschen Sternzellen des retikuloendothelialen Systems für Kolloide, •*Aufnahme, Umbau und Exkretion von Iminodiazetatverbindungen durch Hepatozyten, •*Darstellbarkeit des Blutpools mit markierten Erythrozyten Die verschiedenen szintigraphischen Methoden, die bei der Leberdiagnostik zur Anwendung kommen, werden mit ihren Indikationsstellungen hier eingehend dargestellt. Nuklearmedizinische ergänzen die morphologischen Methoden und tragen zur Differentialdiagnostik von Raumforderungen in der Leber bei. Sie liefern zugleich wichtige Informationen zur Leberfunktion.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 10 (1985), S. 93-94 
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 12 (1987), S. 631-632 
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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