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  • 1
    Electronic Resource
    Electronic Resource
    Microsurgery of deep-seated cavernous angiomas: Report of 26 cases (1991)
    Springer
    Acta neurochirurgica 108 (1991), S. 91-99 
    Details
    ISSN: 0942-0940
    Keywords: Cavernous angioma ; complications ; indications for surgery ; vascular malformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors review 26 patients with deep-seated cavernous angiomas which were removed by microsurgery. Ten of the angiomas were located in the insula and basal ganglia, 2 in the thalamus, 5 in the midbrain, 8 in the pons, and 1 in the brachium pontis. The patients were among 73 consecutive cases operated on between August 1983 and December 1989 for symptomatic cavernous angiomas in various locations. In 11 cases total excision of the cavernoma was achieved without producing additional neurological deficits. Postoperative neurological recovery was delayed in 7 patients. In the remaining 8, the complicated postoperative course was caused by bleeding from residual parts of the malformation or damage to long-tract pathways in two cases, respectively, vascular injury during dissection in three cases, and paradoxical air embolism in one case. In order to achieve a satisfactory surgical result, it is stressed that particular attention has to be paid to the operative approach, to careful dissection and complete removal of the malformation, to perforating arteries, and to anomalous venous drainage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01418515
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  • 2
    Electronic Resource
    Electronic Resource
    Protektiver Effekt der antioxidativ wirksamen Chromanstruktur des Tocopherols auf die Folgen stimulierter Arachidonsäure-Freisetzung in der pulmonalen Strombahn (1981)
    Springer
    Journal of molecular medicine 59 (1981), S. 463-465 
    Details
    ISSN: 1432-1440
    Keywords: Arachidonic acid metabolism ; Pulmonary vascular resistance ; Pulmonary vascular permeability ; Tocopherol ; Antioxidative therapy ; Arachidonsäure-Metabolismus ; pulmonaler Strömungswiderstand ; pulmonale Gefäßpermeabilität ; Tocopherol ; antioxidative Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Am Modell der isolierten, ventilierten und mit Krebs-Henseleit-Albumin-Puffer-Lösung rezirkulierend perfundierten Kaninchenlunge kann nach Arachidonsäure-Liberierung die Gefäßwiderstandszunahme den Metaboliten des Cyclooxygenase-Weges, die Erhöhung der Gefäßpermeabilität denjenigen des Lipoxygenase-Weges zugeordnet werden. Der Effekt von α-Tocopherol auf die Widerstands- und Permeabilitätszunahme in der pulmonalen Strombahn nach Zusatz von Arachidonsäure zum Perfusionsmedium und nach Stimulation der Arachidonsäure-Freisetzung mit dem Calcium-Ionophor A 23187 wurde untersucht. Dabei lassen sich eine Membranwirkung der Phytol-Seitenkette und eine antioxidative Wirkung der Chromanstruktur unterscheiden: während durch den Phytolrest sowohl die Widerstands- als auch die Permeabilitätszunahme verstärkt werden, vermindert die Chromanstruktur des Tocopherols allein beide Reaktionen weitgehend. Diskutiert wird die Möglichkeit antioxidativer Therapie pulmonaler Permeabilitätsstörungen.
    Notes: Summary In the model of isolated, ventilated and perfused rabbit lungs release of arachidonic acid results in an increase of pulmonary vascular resistance and pereability. The former can be ascribed to cyclooxygenase products, the latter to lipoxygenase products of arachidonic acid. The effect of α-tocopherol on the increase of pulmonary vascular resistance and permeability either after the addition of arachidonic acid to the perfusion fluid or after stimulation of arachidonic acid liberation by Ca-ionophore A 23187 was investigated. It is possible to distinguish a membrane effect of the phytol side chain of α-tocopherol and an antioxidative effect of its chromane structure: Phytol augments the increase of pulmonary vascular resistance and permeability, whereas the chromane-structure decreases both to a large degree. The possibility of antioxidative therapy in disturbances of pulmonary vascular permeability is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695901
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  • 3
    Electronic Resource
    Electronic Resource
    Zunahme des Strömungswiderstandes und der Gefäßpermeabilität in der pulmonalen Strombahn als Folge des Metabolismus freier Arachidonsäure (1981)
    Springer
    Journal of molecular medicine 59 (1981), S. 459-461 
    Details
    ISSN: 1432-1440
    Keywords: Arachidonic acid metabolism ; Pulmonary vascular resistance ; Pulmonary vascular permeability ; Indometacin ; Acetylsalicylic acid ; Arachidonsäure-Metabolismus ; pulmonaler Strömungswiderstand ; pulmonale Gefäßpermeabilität ; Indometacin ; Acetylsalicylsäure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Freisetzung von Arachidonsäure und deren Metabolismus werden als mögliche gemeinsame Endstrecke verschiedener Reize auf das Endothel der Lungenstrombahn angesehen. Die Beeinflussung des Gefäßwiderstandes und der Permeabilität durch eine vermehrte Bereitstellung freier Arachidonsäure wurde am Modell der isolierten, ventilierten und mit Krebs-Henseleit-Albumin-Puffer-Lösung rezirkulierend perfundierten Kaninchenlunge untersucht. Die Zugabe von Arachidonsäure zum Perfusionsmedium oder die Liberierung von Arachidonsäure durch den Calcium-Ionophor A 23187 löst regelmäßig eine charakteristische biphasische Erhöhung des Gefäßwiderstandes sowie eine kontinuierliche Zunahme der Gefäßpermeabilität mit Ausbildung eines Ödems aus. Die Hemmung der Cyclooxygenase mit Indometacin verhindert den Widerstandsanstieg, verstärkt dagegen die Permeabilitätszunahme. Somit läßt sich die Zunahme des pulmonalen Gefäßwiderstandes Cyclooxygenase-Produkten, die erhöhte Gefäßpermeabilität dagegen Lipoxygenase-Produkten der Arachidonsäure zuordnen.
    Notes: Summary Release and metabolism of arachidonic acid are supposed to form the common final pathway of different stimuli on the pulmonary vascular endothelium. In a model of isolated, ventilated and perfused rabbit lungs we investigated the influence of increased availability of free arachidonic acid on pulmonary vascular resistance and permeability. Addition of arachidonic acid to the perfusion fluid or release of arachidonic acid by Ca-ionophore A 23187 regularly produces a characteristic biphasic increase of the pulmonary vascular resistance as well as a continuous increase in permeability, followed by pulmonary edema. Inhibition of cyclooxygenase by indometacin prevents the augmentation of vascular resistance, the increase of vascular permeability however is enhanced. Thus the raise in pulmonary vascular resistance can be ascribed to cyclooxygenase products, the increased pulmonary vascular permeability to lipoxygenase products of arachidonic acid.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695900
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  • 4
    Electronic Resource
    Electronic Resource
    A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 634-643 
    Details
    ISSN: 1432-1440
    Keywords: Psoriasis ; Lipid infusion ; n-3 fatty acids ; Neutrophil leukotriene generation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty patients hospitalized for acute psoriasis guttata with a minimum 10% of body surface area involvement (range 10–90%) completed a 10-day trial in which they were randomly allocated to receive daily infusions with either an n-3 fatty acid based lipid emulsion [100 ml/day with 2.1 g eicosapentaenoic (EPA) and 21 g docosahexaenoic acid (DHA)] or a conventional n-6 lipid emulsion (EPA+DHA〈0.1 g/100 ml). The severity of disease was evaluated by scoring daily erythema, infiltration, and desquamation and by a subjective scoring of clinical manifestations offered by the patients. Leukotriene (LT) and platelet-activating factor (PAF) generation were investigated in ionophore-stimulated neutrophils obtained on days 0, 1, 3, 5, 10, and 40. Moderate improvement in clinical manifestations was noted in the n-6 group (changes in score systems between 16–25% from baseline within 10 days). In contrast, the severity of disease markedly decreased in all patients of the n-3 group, with improvements in all score systems ranging between 45% and 76% within 10 days (P〈0.05 for each variable). The difference in response to the two regimens was evident within 4–7 days after onset of lipid infusion. A more than ten fold increase in neutrophil EPA-derived 5-1ipoxygenase product formation (LTB5, its omega-oxidation products, non-enzymatic degradation products of LTA5 and 5-hydroxyeicosapentaenoic acid) was noted in the n-3 group but not in the n-6 group. Neutrophil PAF generation increased in the n-6 group but decreased in the n-3 group. In conclusion, modulation of eicosanoid metabolism by intravenous n-3 fatty acid supplementation appears to exert a rapid beneficial effect on inflammatory skin lesions in acute guttate psoriasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184491
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  • 5
    Electronic Resource
    Electronic Resource
    Alveolar surfactant and adult respiratory distress syndrome (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 177-190 
    Details
    ISSN: 1432-1440
    Keywords: Adult respiratory distress syndrome ; Alveolar surfactant ; Surfactant phospholipids ; Surfactant apoproteins ; Surfactant inhibition ; Hyaline membranes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The adult respiratory distress syndrome (ARDS) is characterized by extended inflammatory processes in the lung microvascular, interstitial, and alveolar compartments, resulting in vasomotor disturbances, plasma leakage, cell injury, and complex gas exchange disturbances. Abnormalities in the alveolar surfactant system have long been implicated in the pathogenetic sequelae of this life-threatening syndrome. This hypothesis is supported by similarities in pulmonary failure between patients with ARDS and preterm babies with infant respiratory distress syndrome, known to be triggered primarily by lack of surfactant material. Mechanisms of surfactant alterations in ARDS include: (a) lack of surface-active compounds (phospholipids, apoproteins) due to reduced generation/release by diseased pneumocytes or to increased loss of material (this feature includes changes in the relative composition of the surfactant phospholipid and/or apoprotein profiles); (b) inhibition of surfactant function by plasma protein leakage (inhibitory potencies of different plasma proteins have been defined); (c) “incorporation” of surfactant phospholipids and apoproteins into polymerizing fibrin upon hyaline membrane formation; and (d) damage/inhibition of surfactant compounds by inflammatory mediators (proteases, oxidants, nonsurfactant lipids). Alterations in alveolar surfactant function may well contribute to a variety of pathophysiological key events encountered in ARDS. These include decrease in compliance, ventilation-perfusion mismatch including shunt flow due to altered gas flow distribution (atelectasis, partial alveolar collapse, small airway collapse), and lung edema formation. Moreover, more speculative at the present time, surfactant abnormalities may add to a reduction in alveolar host defense competence and an upregulation of inflammatory events under conditions of ARDS. Persistent atelectasis of surfactant-deficient and in particular fibrin-loaded alveoli may represent a key event to trigger fibroblast proliferation and fibrosis in late ARDS (“collapse induration”). Overall, the presently available data on surfactant abnormalities in ARDS lend credit to therapeutic trials with transbronchial surfactant administration. In addition to the classical goals of replacement therapy defined for preterm infants (rapid improvement in lung compliance and gas exchange), this approach will have to consider its impact on host defense competence and inflammatory and proliferative processes when applied in adults with respiratory failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180100
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  • 6
    Electronic Resource
    Electronic Resource
    Advantage of buffered solutions or automated capnometry in air-filled balloons for use in gastric tonometry (1997)
    Springer
    Intensive care medicine 23 (1997), S. 423-427 
    Details
    ISSN: 1432-1238
    Keywords: Key words Intramucosal pH ; Gastric tonometry ; Blood gas analyzer ; Automated capnometry ; Carbon dioxide ; Steady-state equilibration time
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To test accuracy, reproducibility and time constants of pCO2 measurement with the tonometric technique, using different media for filling the silastic balloon (saline, phosphate buffer, citrate buffer, air) and employing different analyzer devices (ABL3, ABL330, Nova Stat 5, automated capnometry). Design: Comparative laboratory study of different tonometric techniques, measuring test solutions with known pCO2 values due to pre-equilibration with three different pCO2 concentrations. Setting: Clinical laboratory of a university hospital intensive care unit. Measurements and results: The use of saline, as suggested for routine tonometry, led to negative bias values throughout, i. e. underestimation of pCO2 values, the extent of which depended on the blood gas analyzer device employed. Registration of the equilibration kinetics showed that full equilibration demanded 90 min regardless of the environmental pCO2 level. Replacing saline by buffered electrolyte solutions resulted in a significant improvement of bias, but did not change the kinetics of pCO2 equilibration. The employment of air-filled balloons, combined with automated capnometry, led to very low bias values, approaching zero, for all pCO2 levels, along with excellent precision. Time constants of equilibration were dramatically reduced, with full equilibration being achieved within 12.5 min. Conclusions: Buffered electrolyte solutions are preferable to saline for achieving reliable pCO2 measurements in gastric tonometry. Air-filled balloons, combined with automated capnometry, present excellent accuracy and reproducibility together with short equilibration times, thus offering “on-line” monitoring of even rapid changes in environmental pCO2.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050351
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  • 7
    Electronic Resource
    Electronic Resource
    Diagnostische Möglichkeiten der positiven Ventrikulographie (1975)
    Springer
    Acta neurochirurgica 31 (1975), S. 227-243 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A comparison has been made of the relative merits of air, Conray 60, and Dimer X ventriculography in 100 cases. The great virtue of positive contrast ventriculography is its superior ability to demonstrate abnormalities in the midline and in the posterior cranial fossa. Tomoventriculography using a multiple layer cassette permits exact localization of intraventricular lesions without causing additional discomfort to the patient. The subtraction technique confers additional benefits. Positive contrast ventriculography has its limitations when there are large extraventricular masses.
    Notes: Zusammenfassung Es werden hinsichtlich Beurteilbarkeit und Nebenerscheinungen die Ergebnisse von je 100 Luft-, Conray 60- und DIMER-X-Ventrikulographien verglichen. Die Stärke der positiven Ventrikulographie liegt in der ungleich besseren Verträglichkeit und erheblich besseren Beurteilbarkeit bei Prozessen der Mittellinie und der hinteren Schädelgrube. Die Tomoventrikulographie mit mehrschichtiger Simultankassette erlaubt eine exakte Lokalisation intraventrikulärer Prozesse ohne weitere Belastung des Patienten. Ebenso ergibt das Subtraktionsverfahren einen besseren Überblick über Einzelheiten, ebenfalls ohne weitere Belastung des Patienten. Ihre Grenzen findet die positive Ventrikulographie bei Mißbildungen des Ventrikelsystems infolge Überlagerungseffekten und der notwendigen großen Kontrastmittelmengen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406295
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  • 8
    Electronic Resource
    Electronic Resource
    Intraselläres Epidermoid mit außergewöhnlichem Gesichtsfeldbefund (1960)
    Springer
    Acta neurochirurgica 8 (1960), S. 81-87 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary An intrasellar expanding Epidermoid was described which was indistinguishable clinically and radiologically from a pituitary adenoma and which was recognised by means of unusual visual field changes. The diagnosis was proved by operation and histology. The differential diagnosis, treatment and prognosis were discussed.
    Abstract: Résumé Description d'une tumeur intrasellaire épidermoide sans caractères cliniques et radiologiques différents de ceux d'un adénome pituitaire caractérisée par l'existence de modification du champ visuel. Le diagnostic fut fait par opération et l'histologie. La diagnostic différentiel, le traitement et le pronostic sont discutés.
    Notes: Zusammenfassung Es wurde über ein intrasellär wachsendes Epidermoid berichtet, welches klinisch und röntgenologisch von einem Hypophysenadenom nicht zu trennen war und durch einen ungewöhnlichen Gesichtsfeldbefund auffiel. Die Diagnose wurde operativ und histologisch gesichert. Differentialdiagnose, Behandlung und Prognose wurden erörtert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405596
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  • 9
    Electronic Resource
    Electronic Resource
    Secondary manifestation of medulloblastoma: Metastases and local recurrences in 66 patients (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 117-126 
    Details
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; recurrence ; metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although primary treatment of medulloblastoma is now successful in a high percentage of patients, its secondary manifestations still bear a poor prognosis. Thorough studies of secondary manifestations are therefore pivotal to plan therapeutic approaches for the long-term management of medulloblastoma. Here we describe the incidence of secondary tumour manifestations in 66 patients of a single centre who underwent surgery for medulloblastoma between 1975 and 1990. No patient was excluded due to a poor postoperative course. Thirty-five patients showed evidence of secondary tumour growth. Of these, 17 suffered from local recurrence, and 27 developed metastastatic disease. The median latencies for secondary manifestations were 25 months for local recurrence (n = 17), 11 months for spinal metastases (n = 10), 15 months for supratentorial metastases (n = 8), 8 months for subleptomeningeal dissemination (n = 6), and 23 months for systemic metastases (n = 8). Two patients developed primary metastatic spread to the posterior fossa. Of 8 patients with supratentorial metastases, 6 developed fronto-basal lesions. In our patients, 89% of secondary lesions occurred within less than 3 years after primary diagnosis. 85% of patients with extra-axial tumour spread had been treated with a permanent shunt. Radical tumour resection and radiotherapy with 30 Gy to the neuraxis and 20 Gy boost to the posterior fossa was an important prognostic factor in this series. Patients with additional chemotherapy did not benefit significantly from this treatment. We conclude that optimal management of the primary lesions should aim at (i) total resection, (ii) avoid permanent shunting, and (iii) completion of the radiotherapy with inclusion of the medial frontobasal cisterns in the radiotherapeutic regimen. Our analysis suggests that adequate postoperative screening programmes should consist of 3-monthly scans of the neuraxis in the first three postoperative years and 6-monthly scans thereafter.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01410612
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  • 10
    Electronic Resource
    Electronic Resource
    Microsurgery of tumours of the frontal white matter (1978)
    Springer
    Acta neurochirurgica 44 (1978), S. 11-47 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Seventy eight microsurgical extirpations of tumours located in the frontal white matter led to adjustment of the normal anatomy of the frontal brain according to microsurgical requirements, and also to relation with modern diagnostic procedures, especially computerized tomography (CT-scanning). The advantages of microsurgical treatment have been demonstrated. Thus, only exact comprehension of topographical anatomy allows a methodical, careful, and radical procedure. As vessels were commonly saved, postoperative courses were relatively benign because of less tendency to oedema. Out of 78 patients, 3 died while in hospital, and two recurrences were observed in the following 23 months. Postoperatively 51 patients improved, 18 stayed unchanged neurologically, and 9 patients deteriorated permanently. The usual microsurgical instruments were employed. Vascular problems were dealt with by the routine techniques used at our hospital.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401629
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