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  • 1
    Electronic Resource
    Electronic Resource
    Sonographische Verlaufsbeobachtungen von Bauchaortenaneurysmen (1984)
    Springer
    Journal of molecular medicine 62 (1984), S. 1120-1125 
    Details
    ISSN: 1432-1440
    Keywords: The natural course of abdominal aortic aneurysms ; Ultrasonic follow-up studies of asymptomatic, small abdominal aortic aneurysms ; Prognosis of aortic aneurysms ; Risk of rupture ; Growth rate of abdominal aneurysms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Forty-two patients with an abdominal aortic aneurysm that had not been treated surgically were repeatedly examined by ultrasonography. The average observation time of all patients was 3.1 years. The total observation period including follow-up times of all patients adds up to 129 “patient years”. Within this time none of the 35 asymptomatic abdominal aneurysms with transversal diameters of maximally 5 cm ruptured. Three patients of seven with larger and symptomatic aneurysms died in consequence of a rupture. Small asymptomatic abdominal aortic aneurysms seem to have a better prognosis than previously supposed. The question whether all abdominal aneurysms should be operated on needs reconsideration, especially in the elderly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01782469
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  • 2
    Electronic Resource
    Electronic Resource
    Stepwise development of a clinical expert system in rheumatology (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 139-144 
    Details
    ISSN: 1432-1440
    Keywords: Expert systems ; Computer-assisted diagnosis ; Decision support systems ; Evaluation studies ; Rheumatology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The evaluation of computer expert systems, a promising diagnostic tool for future application in clinical medicine, is of great importance. We present here the evaluation of our expert system, “RHEUMA”. It is stressed, that repeated retrospective testing and updating of an expert system and its subsequent repeated assessment in clinical use and surroundings is mandatory. This increases the diagnostic accuracy of the system. For our system this is demonstrated under three separate conditions. In the first study the information available for the computer system (mainframe) came from medical histories only. Here an error rate of about 25% — similar to that of physicians themselves using the same information — was observed in 358 outpatients, compared to the final diagnoses of physicians also relying solely on information from medical histories. In a second step a completely new system on a personal computer was developed with all relevant diagnostic information. The error rate of this system (0.4%) was much too optimistic because the knowledge base was changed during the study, affecting about 30% of the 282 prospectively recruited outpatients. In a third step the efficacy of the expert system was tested in an additional hospital without the diagnostic involvement of the first testing clinic. The error rate of the system without changing the knowledge base reached 11% in 51 outpatients in this rheumatology clinic. This result reflects the diagnostic accuracy of the system today. Its ability to specify the same diagnoses which clinical experts reached approached 90%. Considerable time is needed for such prospective testing, with repeated updating of the knowledge base — in our case for both the two systems and field studies of 2 years each. Further prospective field testing with physicians not specialized in rheumatology and with a larger number of patients is necessary before the system can be used in clinical routine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179995
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Femoral venous flow dynamics during intraperitoneal and preperitoneal laparoscopic insufflation (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1213-1216 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Inguinal hernia repair — Deep vein thrombosis — Femoral vein — Preperitoneal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic herniorrhaphy may be performed using an intraperitoneal or a preperitoneal approach. Anecdotal and experimental evidence indicates that alterations in lower extremity venous flow, which occur during intraperitoneal laparoscopic insufflation, may be associated with an increased risk of deep vein thrombosis. However, no study has directly compared femoral venous flow during intraperitoneal insufflation with that during preperitoneal insufflation. Method: In eight consecutive patients undergoing laparoscopic herniorrhaphy under general anesthesia, flow through the common femoral vein was evaluated with B-mode and color flow duplex. Pre- and intraperitoneal pressures were standardized to 10 mm Hg, and respiratory tidal volumes were standardized to 10 cc/kg. Flow measurements were taken at end expiration. Flow through the common femoral vein was measured after induction of anesthesia, during intraperitoneal insufflation, during preperitoneal insufflation, and between insufflations to ensure return to baseline. Results: All patients in the study were males. Their mean age was 59 years. Mean flow in the common femoral vein was essentially identical at baseline (138 ml/min) and during preperitoneal insufflation (135 ml/min). Alternatively, mean flow in the common femoral vein was significantly reduced during intraperitoneal insufflation (65 ml/min, p= 0.02). Conclusions: Flow in the common femoral vein is significantly reduced during intraperitoneal insufflation. However, flow in the common femoral vein is not affected by preperitoneal insufflation. These data suggest that laparoscopic preperitoneal inguinal hernia repair may pose as less a risk of thromboembolic complications than laparoscopic intraperitoneal inguinal hernia repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900823
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  • 4
    Electronic Resource
    Electronic Resource
    Expansion of activated T lymphocytes (CD3+HLA/DR+) detectable in early stages of HIV-1 infection (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 393-396 
    Details
    ISSN: 1432-1440
    Keywords: T lymphocytes ; T lymphocytes, activated ; T lymphocytes, cytotoxic ; HIV ; AIDS ; Flow cytometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The phenotypic characterization of lymphocyte subsets in relation to different clinical stages of HIV infection has mainly focussed on CD4 and CD8 cells. Some reports focus on expansion of activated T lymphocytes in AIDS patients. Yet there is no detailed knowledge whether such changes occur also in earlier stages of HIV infection. In order to describe the kinetics and possible pathogenetic meaning of this subset when related to all distinct chronologic stages, we performed two-color flow cytometric lymphocyte differentiation in 173 HIV-infected patients and 30 healthy controls. All subjects were classified according to the Walter Reed (WR) system. Our results show that a significant increase of activated T lymphocytes (CD3+HLA/DR+) occurs early, in WR1 and WR2, thus preceding the clinically relevant CD4 depletion. This increase is paralleled by an expansion of CD 8+Leu7+cytotoxic cells. We conclude, thatearly changes of lymphocyte subsets are detectable in addition to inversion of the CD4/ CD8 ratio. The possible pathogenetic meaning including the question of possible autoimmune mechanisms is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01648577
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Ambulante indirekte Blutdrucklangzeitmessung bei primärer und sekundärer Hypertonie (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 713-716 
    Details
    ISSN: 1432-1440
    Keywords: Ambulatory blood pressure measurement ; Secondary hypertension ; Primary hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Ambulatory 24 hour blood pressure measurements were performed in 21 patients with various forms of secondary hypertension and were compared with the blood pressure profile of a matched group of patients with primary hypertension. Patients with renovascular (n=8) and renoparechymal hypertension (n=8), and with primary hyperaldosteronism (n=4) showed no significant fall in systolic blood pressure during the sleeping period (00-03 a.m.) and in systolic and diastolic blood pressure in the early morning (06 a.m.) as compared with essential hypertensives. However, in a single case of hypertension due to coarctation of the aorta the 24 hour blood pressure profile is not different from essential hypertension. Thus, ambulatory 24 hour blood pressure recording is a good method for screening secondary forms of hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01721289
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  • 6
    Electronic Resource
    Electronic Resource
    Immunsuppression durch Vitamin B6-Antagonisten (1979)
    Springer
    Research in experimental medicine 175 (1979), S. 169-180 
    Details
    ISSN: 1433-8580
    Keywords: Vitamin B6-Antagonists ; Immunosuppression ; Renal transplantation ; Vitamin B6-Antagonisten ; Immunsuppression ; Nierentransplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In mehreren Versuchsserien wurde an 84 Inzuchtratten die Wirkung eines kombiniert-pharmakologisch-diätetischen Vitamin B6-Mangels auf die Abstoßung von Nierentransplantaten geprüft. Während bei den Kontrolltieren ohne Vitamin B6-Mangel über 90% der Tiere zwischen 7. und 13. Tag an einer abstoßungsbedingten Urämie eingingen, zeigten die behandelten und erfolgreich nierentransplantierten Ratten eine deutliche Verlängerung der Überlebenszeit. 17 von 38 Tieren (45%) lebten länger als 35 Tage. Pharmakologisch (Desoxipyridoxin) — in Kombination mit einer Vitamin B6-armen Diät — induzierter Vitamin B6-Mangel bietet somit die Möglichkeit einer — reversiblen — Immunsuppression.
    Notes: Summary The combined effect of Vitamin B6 free diet and 4-Desoxipyridoxin (a potent Vitamin B6-Antagonist) on the rejection reaction of inbred rats after renal transplantation was investigated. More than 90% of the control animals without Vitamin B6-deficiency died between 7 and 13 days with uremia due to an acute transplant rejection, where as the Vitamin deficient and successfully transplanted animals (n = 38) showed a significantly prolonged survival time. In 17/38 rats survival was longer than 35 days. Vitamin B6-deficiency, induced by Desoxipyridoxin and Vitamin B6-deficient diet offers the possibility of an effective and reversible immunosuppression in renal transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01851824
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