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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 151 (1992), S. 652-654 
    ISSN: 1432-1076
    Keywords: Atrial myxoma ; Neurological complications ; Child ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Multiple embolizations were the hallmark of the disease in an 8-year-old boy with a left atrial myxoma. Embolizations occurred initially in both hands and legs, later in the brain with generalized seizures and hemiparesis, and finally in the left eye with occlusion of the central retinal artery and consecutive severe visual impairment. Echocardiography demonstrated the tumour which was removed without complications.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: Key words Amiodarone ; Myocardial tissue concentration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Background: Pharmacokinetics and tissue concentrations of amiodarone may vary considerably in end-stage heart failure, but may be crucial for treatment efficiency and antiarrhythmic drug therapy. Objective: This study was undertaken to determine plasma amiodarone and desethylamiodarone concentrations and to determine whether they correlate with myocardial concentrations in explanted hearts from patients with end-stage heart failure. Patients and methods: Eight patients with idiopathic dilated cardiomyopathy and normal coronary arteries were included in the present study. Myocardial tissue samples (seven sites) and epicardial fat were taken from each explanted heart, and drug concentrations of amiodarone and desethylamiodarone were determined. In addition, plasma drug levels were measured and compared with the myocardial amiodarone/desethylamiodarone concentrations. Results: The mean cumulative amiodarone dose was 91 g and the mean plasma concentrations of amiodarone and desethylamiodarone were 0.68 and 0.84 μg · ml−1, respectively. The tissue concentrations of amiodarone amounted to 13.2 and 28.3 μg · g−1, respectively, in the atria and to 13.0 and 40.8 μg · g−1, respectively, in the ventricles. The distribution of the drug and its metabolite were similar in the right and left ventricles. There was a good correlation between myocardial concentration of amiodarone and desethylamiodarone and the cumulative ingested dose of amiodarone. Tissue drug concentrations correlated only poorly with plasma amiodarone or desethylamiodarone levels. The highest drug levels were measured in the epicardial fat tissue, where the ratio of amiodarone 105 μg · g−1 to desethylamiodarone 32 μg · g−1 was reversed (3.3 compared with 0.29 in the ventricles). Thus, amiodarone concentrations in epicardial fat were approximately 10 times higher than myocardial and 150 times higher than plasma levels. Conclusions: Our data confirm the slow equilibrium of amiodarone and desethylamiodarone concentrations between plasma and myocardium. Myocardial tissue concentrations of desethylamiodarone and, to a lesser degree, amiodarone correlate with the cumulative ingested dose of amiodarone. Monitoring of the total cumulative dose may be more relevant clinically than monitoring plasma levels. These results support the clinical practice of reducing the maintenance dose of amiodarone in patients who are on long-term treatment.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Plant pathology 54 (2005), S. 0 
    ISSN: 1365-3059
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1365-3059
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Plant pathology 53 (2004), S. 0 
    ISSN: 1365-3059
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Plant pathology 53 (2004), S. 0 
    ISSN: 1365-3059
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1435-1285
    Keywords: Key words Aortic valves — aortic coarctation — aortic valve replacement — bicuspid valves — aortic stenosis — aortic regurgitation ; Schlüsselwörter Aortenisthmusstenose — Aortenstenose — Aorteninsuffizienz — bikuspide Klappen — Aortenklappenersatz
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Severe aortic valve disease is a rare complication of coarctation in adults. Between 1961 and 1990 aortic valve replacement was performed after or combined with the operation of coarctation in 24 adults (4% of entire population operated for coarctation). Bicuspid aortic valves were present in ⅔ of patients. In 10 patients (7/10 with aortic stenosis) coarctation was operated early (mean age 24 years) and aortic valve late (mean age 40 years): in 14 (10/14 with aortic regurgitation, mean age 40 years) aortic valve and coarctation were operated simultaneously (8 patients) or staged within 6 months (6 patients). Additional surgical interventions on the dilated aorta ascendens were performed in 8, mitral valve replacement in 2 and aorto-coronary bypass in 1 patients. Early mortality was 2/24 (8%) and was similar in simultaneously (1/8) and staged (1/14) operated cases: 10 year survival was lower than in an age-matched group of 72 patients with aortic valve disease of similar severity operated during the same period (70% vs 88%, p 〈 0.01): 6/7 late deaths were cardia; 5/5 pts with preoperatively severely increased end-diastolic (〉 199 ml/m2) and 4/4 with end-systolic (〉 90 ml/m2) left ventricular volumes and 2/2 with ejection fraction 〈 41 % died late postoperatively. Severe aortic valve disease arised in 4% of adults with coarctation or after coarctation resection. The results of valve replacement in these patients were less successful due to high late mortality in cases with severe preoperative left ventricular dilatation and/or decrease of ejection fraction. Thus, close surveillance of patients after coarctation surgery, especially those with bicuspid valves, is mandatory for early detection of valvular disease and appropriate timing of valve replacement before left ventricular function begins to deteriorate.
    Notes: Zusammenfassung Bei 24 Erwachsenen (mittleres Alter 41 Jahre), bei welchen eine Aortenisthmusstenose vorlag oder früher reseziert worden war, wurde zwischen 1961 und 1990 ein Aortenklappenersatz wegen eines schweren Aortenvitiums vorgenommen. Die Aortenisthmusstenose wurde bei 10 (7/10 mit einer Aortenstenose) 14 Jahre vorher und bei 14 (19/14 mit einer Aorteninsuffizienz) gleichzeitig (8) oder innerhalb eines halben Jahres (6) operiert (4% aller wegen einer Aortenisthmusstenose operierten Patienten). Bei ⅔ der Patienten lag eine bikuspide Aortenklappe vor. Zusätzlich zu den Aortenklappen wurden bei 8 Patienten die Operation eines Aneurysmas der Aorta ascendens, bei 2 ein Ersatz der Mitralklappe und bei einem ein aortokoronarer Bypass vorgenommen. Nach der Resektion der Aortenisthmusstenose lag bei keinem der Patienten ein hämodynamisch signifikanter Druckgradient vor (präoperativ 54 mmHg, postoperativ 3 mmHg). Die perioperative Mortalität der Aortenklappenoperation betrug 8%. Die 10-Jahre-Überlebensrate war niedriger als bei 72 gleichaltrigen Patienten der Kontrollgruppe, die während derselben Zeitperiode wegen eines Aortenvitiums ähnlichen Schweregrades operiert wurden (70% vs. 88 %, p 〈 0,01). 6/7 Todesfälle im Spätverlauf waren kardial bedingt. Alle 5/5 Patienten mit einem präoperativen linksventrikulären enddiastolischen Volumen 〉 299 ml/m2, 4/4 mit einem endsystolischen Volumen 〉 90 ml/m2 und 2/2 mit einer Auswurffraktion 〈 41 % verstarben im postoperativen Verlauf. Bei Erwachsenen traten schwere Aortenvitien im Verlauf einer Aortenisthmusstenose bei 4% der Fälle auf. Die postoperative Langzeitprognose dieser Patienten ist weniger günstig als nach isoliertem Aortenklappenersatz, wobei der präoperativen myokardialen Funktion die wesentliche prognostische Bedeutung zukommt. Die Operation des Aortenvitiums muß vor Auftreten einer wesentlichen Dilatation bzw. Abnahme der Auswurffraktion des linken Ventrikels vorgenommen werden. Das Risiko der Operation bleibt trotz häufiger zusätzlicher Eingriffe an der Aorta ascendens niedrig.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Pour essayer de réduire les doses d'antibiotiques, plusieurs essais prospectifs contrôlés et randomisés dans notre établissement ont montré que la prophylaxie antibiotique par la céfazaline pendant 4 jours était aussi efficace que la céfuroxime donnée pendant 2 jours et, la céfuroxime pendant 2 jours était aussi efficace que la ceftriaxone en 2 injections, pour la prophylaxie en chirurgie cardiovasculaire majeure. Dans cette étude randomisée et prospective, la prophylaxie apportée par la céfazoline (4×0.5 g en IV) pendant 24 heures a été comparée à celle de la ceftriaxone (2 g en IV) en une seule injection. Des 900 patients entrés dans l'étude, 17 ont été exclus. Des 883 patients restants, 439 étaient dans le groupe céfazoline, 444 dans le groupe ceftriaxone. Le taux d'infection globale était de 5.0% dans le groupe céfazoline, et de 4.5% dans le groupe recevant la ceftriaxone. Etant donné la similarité des résultats, nous pensons qu'une seule injection de ceftriaxone (2 g) fournit une prophylaxie antimicrobienne fiable. L'injection unique réduit le travail infirmier et le coût.
    Abstract: Resumen Con miras a una posible reducción de las dosis de antibióticos, varios estudios prospectivos fueron realizados en nuestra institución, los cuales demonstraron que el regimen profiláctico antimicrobiano de 4 días con cefazolina es tan efectivo como la profilaxis de 2 días con cefuraxine, y que el mejor de éstos es igualmente efectivo al regimen de dosis única de 2 g de ceftriaxona en cirugía cardiovascular mayor. En el presente estudio prospectivo y randomizado se hizo la comparación entre el regimen de profilaxis de un día con cefazolina (4×0.5 g IV) y la profilaxis mediante dosis única de ceftriaxona (2 g IV). Diecisiete de los 900 pacientes enrolados en el estudio fueron excluidos. De los 883 pacientes restantes, 439 quedaron ubicados en el grupo de cefazolina y 444 en el de ceftriaxona. La tasa global de infección postoperatoria fue 5.0% en el grupo de cefazolina y 4.5% en el grupo de ceftriaxona. En vista de las casi idénticas tasas de infección en los 2 grupos, consideramos que una dosis única de ceftriaxona ofrece al paciente profilaxis antimicrobiana confiable. La profilaxis mediante dosis única posee la ventaja adicional de reducir la dosificación y el costo del agente antibiótico.
    Notes: Abstract With a view of possible reduction in antibiotic dosage, several prospective randomized comparative trials performed in our institution showed that a 4-day prophylactic antimicrobial regimen with cefazolin was equally effective as a 2-day prophylaxis with cefuroxime and that the best regimen was equally as effective as a double dose of ceftriaxone prophylaxis in major cardiovascular surgery. In this prospective randomized comparative study, 1-day cefazolin prophylaxis (4×0.5 g intravenously) was compared with a single dose of ceftriaxone prophylaxis (2 g intravenously). Of the 900 patients enrolled in the study, 17 were subsequently excluded. Of the remaining 883 patients, 439 were in the cefazolin group and 444 were in the ceftriaxone group. The overall postoperative infection rate was 5.0% in the cefazolin group and 4.5% in the ceftriaxone group. In view of the almost identical infection rates in both groups, we considered that a single 2 g dose of ceftriaxone offers patients a reliable antimicrobial prophylaxis. The single-dose prophylaxis has the additional advantage of reducing the dosage administered and the costs of administration.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 325 (1969), S. 1179-1183 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei Hunden wurden nach Setzung eines AV-Blocks endokardiale Schrittmacherelektroden implantiert. Während der folgenden 47 Tage wurde das Verhalten der Reizschwelle und der myokardialen Impedanz an stimu lierten und nicht stimulierten Herzen gemessen. Der durchschnittliche Reizschwellenanstieg betrug das 4-5fache des Ausgangswertes und erreichte sein Maximum zwischen dem 7. und 10. postoperativen Tag. Im weiteren Verlauf kam es zu einem kleinen Abfall der Reizschwelle. Die Impedanz sank bis zum 3. postoperativen Tag im Mittel 35% des intraoperativen Wertes und blieb bei den weiteren Kontrollen unverändert. Dieses Verhalten konnte sowohl bei den stimulierenden als auch bei den nichtstimulierenden Elektroden beobachtet werden.
    Notes: Summary Endocardiac pacemaker electrodes were implanted into dogs after creating an AV-block. During the following 47 days the reaction of the stimulus threshold and of the myocardial resistance was measured in stimulated and unstimulated hearts. The mean increase of the stimulus threshold was 4 to 5 times that of the starting value and it reached its maximum from the 7th to the 10th postoperative day. During the subsequent course a mild decrease of the stimulus threshold occurred. Up to the third postoperative day the impedance showed a mean decrease of 35% of the intraoperative value and it remained unchanged during subsequent controls. This reaction could be observed in the stimulating electrodes as well as in the non-stimulating electrodes.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 349 (1979), S. 620-620 
    ISSN: 1435-2451
    Keywords: Ticlopidine ; Platelet-inhibition ; Dacron grafts ; Scanning electron microscopy ; Ticlopidine ; Rasterelektronenmikroskopie ; Thrombocytenaggregationshemmung ; Dacron-Graft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zur in vivo-Prüfung des Thrombocytenaggregationshemmers Ticlopidine (Ticlid) wurden bei 18 Hunden Dacron-Gefäßprothesen in beiden Aa. femorales implantiert. Nach verschiedenen Zeiten freien Blutdurchflusses (10s bis 7 Wochen) wurden Stücke derselben entnommen und rasterelektronenmikroskopisch untersucht. Die mit Ticlopidine behandelten Tiere zeigten eine Hemmung der Aggregation und der Pseudopodienbildung. Die Verschlußrate der implantierten Grafts nach 7 Wochen Versuchszeit war bei der mit Ticlopidine behandelten Gruppe (11%.) gegenüber der Kontrollgruppe (76%) signifikant niedriger.
    Notes: Summary To study the effects of Ticlopidine (Ticlid) as a platelet inhibiting drug, dacron grafts were implanted in arteries of 18 dogs. After different times of free blood-flow (10s to 7 weeks) pieces were taken out and observed by scanning electron microscopy. Those treated with the drug showed an inhibition of aggregation and pseudopods. The occlusion rate of the implanted grafts after 7 weeks had dropped from 76% to 11% under Ticlopidine.
    Type of Medium: Electronic Resource
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