Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Sevofluran ; Enfluran ; Fluorid ; Nierenfunktion ; Key words Sevoflurane ; Enflurane ; Fluoride ; Renal function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Sevoflurane is a “new” volatile inhaled anaesthetic. Owing to its lower blood-gas solubility coefficient, emergence from anaesthesia is faster with sevoflurane than with isoflurane, enflurane, or halothane. Sevoflurane undergoes metabolic biodegradation, releasing inorganic fluoride ions that could produce nephrotoxicity. In this study, we compared serum inorganic fluoride concentrations (IFCs) in patients receiving either sevoflurane or enflurane. Furthermore, indices of renal function were evaluated until the 3rd postoperative day. Methods. Thirty patients with no history of renal or hepatic disease and with an anticipated duration of anaesthesia of at least 3 h were studied in an open, prospective, randomised clinical trial. Anaesthesia was induced with fentanyl, thiopentone, and vecuronium for facilitating endotracheal intubation. Anaesthesia was maintained with sevoflurane or enflurane, 60% nitrous oxide in oxygen, and additional doses of fentanyl. Blood samples for serum IFCs were obtained preoperatively and 2 and, if possible, 4 and 6 h after starting sevoflurane or enflurane, at the end of anaesthesia, and 1, 2, 4, 8, 12, 24, 48 and 72 h post-anaesthesia. Fluoride analysis was performed using an ion-selective electrode. Indices of renal function (serum sodium, osmolality, creatinine, urea, and uric acid, urine specific gravity, osmolality, and pH) were evaluated preoperatively, at the end of anaesthesia, and 24, 48, and 72 h post-anaesthesia. Results. The duration of anaesthetic exposure was approximately 1.65 MAC-h for both inhaled anaesthetics. Peak serum IFCs were higher with sevoflurane (34.5 μmol/l) than with enflurane (19.4 μmol/l). Fluoride levels decreased more rapidly with sevoflurane: 24 h post-anaesthesia there was no difference between sevoflurane and enflurane (Fig. 1). The area under the curve (AUC) was greater with sevoflurane (688 μmol/l·h) than with enflurane (591 μmol/l·h). For both groups correlation coefficients were higher for MAC-h and AUC than for MAC-h and peak serum IFC (Figs. 2 and 3). Indices of renal function did not change in either group. Discussion. In our study 1.69 MAC-h sevoflurane produced peak serum IFCs of 34.5 μmol/l. This is in accordance with the investigation of Frink et al. [4], who reported approximately 30 μmol/l after 1.4 MAC-h sevoflurane. Peak serum IFCs with sevoflurane were twice those with enflurane. Within the first 24 h post-anaesthesia, fluoride levels decreased more rapidly after sevoflurane. AUC may be more important than peak serum IFC in evaluating patients who are at risk for renal concentrating defects. In our study there was no evidence of renal dysfunction in either group.
    Notes: Zusammenfassung In einer offenen, randomisierten, prospektiven und vergleichenden Studie zwischen Sevofluran und Enfluran wurden bei 30 nierengesunden Patienten die Serumfluoridkonzentrationen und die exokrine Nierenfunktion bis zum 3. postoperativen Tag untersucht. Die applizierte Dosis betrug in beiden Gruppen ca. 1,65 MAC-Stunden. Die maximale Serumfluoridkonzentration war mit 34,5 μmol/l nach Sevofluran fast doppelt so hoch wie nach Enfluran (19,4 μmol/l). 24 h nach Anästhesieende war die Serumfluoridkonzentration in der Sevoflurangruppe auf ca. 25% des Maximalwerts abgefallen, in der Enflurangruppe auf ca. 40% des Maximalwerts. Ab diesem Zeitpunkt war kein Unterschied mehr zwischen den beiden Gruppen nachweisbar. Die Fluoridbelastung (Area under the curve, AUC) war nach Sevofluran (688 μmol/l·h) etwas größer als nach Enfluran (591 μmol/l·h). Die Korrelation von MAC-Stunden (applizierte Dosis) und AUC war in beiden Gruppen besser als die von MAC-Stunden und maximaler Serumfluoridkonzentration. Veränderungen von Laborvariablen (Natrium, Osmolalität, Kreatinin, Harnstoff und Harnsäure i.S., spez. Gewicht, Osmolalität und pH-Wert i.U.), die auf eine Nierenschädigung hinweisen würden, wurden nicht nachgewiesen.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neuropathologica 85 (1993), S. 199-204 
    ISSN: 1432-0533
    Keywords: Desmoplastic infantile ganglioglioma ; Ganglioglioma ; Desmoplasia ; Gliofibroma ; Neurofilament polypeptides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two supratentorial desmoplastic gangliogliomas arising in a 15-year-old boy and a 25-year-old man are reported. Both tumors reached the brain surface and exhibited large cysts. They showed intense desmoplasia and tumor cells of astrocytic and ganglionic differentiation. In one case the ganglionic nature was only demonstrable by immunohistochemistry. Such neoplasms can no longer be regarded as exclusively infantile brain tumors.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 54 (1999), S. 843-845 
    ISSN: 1432-1041
    Keywords: Key words Piritramide ; Protein binding ; Acute phase response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Piritramide is a lipophilic opioid, which is widely used for postoperative analgesia and analgosedation in Europe. In this study we investigated the influence of various protein concentrations (total protein, 1-acid glycoprotein, albumin) and the postoperative acute phase response on the protein binding of piritramide. Methods: The influence of various protein concentrations on the protein binding of piritramide was investigated by either diluting the serum samples of five volunteers with isotonic saline or by adding different amounts of 1-acid glycoprotein. Albumin binding was measured in a 5% human albumin solution. The impact of the postoperative acute phase response was investigated by obtaining daily serum samples from 18 surgical patients until the third postoperative day, and measuring piritramide protein binding, 1-acid glycoprotein, total protein and albumin. Results: There was a significant relationship between piritramide protein binding and the concentrations of total protein and 1-acid glycoprotein. The binding to albumin was 88%. During the postoperative acute phase response, the protein binding of piritramide did not change. Serum concentrations of 1-acid glycoprotein increased, whereas total protein and albumin decreased. Conclusion: Although there were significant changes in the piritramide-binding proteins, 1-acid glycoprotein and albumin, during the postoperative acute phase response, the protein binding of piritramide did not change. Therefore, a change in protein binding, which might be one factor to be considered in determining piritramide dosage in the postoperative period, does not have to be taken into account.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 54 (1980), S. 181-189 
    ISSN: 0942-0940
    Keywords: Percutaneous needle trephination ; twist drill trephination ; CSF ; hydrocephalus ; ICP monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 56 neurosurgical patients 70 percutaneous needle trephinations were performed. This method was mostly used in patients with acute increase of ICP due to occlusive hydrocephalus of various aetiologies. Thanks to the accuracy and exhaustiveness of CT information, and thanks to the simplicity and safety of percutaneous needle trephination, this latter could be more and more used in daily clinical practice as a diagnostic and therapeutic procedure, for example for the study of adult hydrocephalus, for provisional external ventricular drainage, for treatment of CSF infections, and for ventricular bleedings (also in newborns and premature infants). No serious complication was seen even after prolonged CSF drainage over a period of 41 days. The method of PNT, as described in detail, can be used under sterile conditions at the bedside, on the stretcher in the emergency room, or in the CT or X-ray laboratory. It fulfils the criteria for clinical acceptance: simplicity, low risk, reliability, exactness, and effectiveness.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 33 (1976), S. 249-264 
    ISSN: 0942-0940
    Keywords: Sella turcica ; Pituitary neoplasms ; Meningiomas ; Tumour Recurrence ; CT-scan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Different methods of postoperative radiological examination of space occupying lesions of the sellar region are discussed with regard to early diagnosis of recurrences. The important role of regular controls by lateral radiographs of the skull is stressed in this follow up survey of 164 eases over a period of 23 years. Comparisons of radiographs over a period showed in 80% of our cases whether there was a tumour recurrence or not. Radiological changes in the area of the sella can be demonstrated more clearly by the use of magnified lateral radiographs and a centimetre rule. With regard to frequency and time of recurrence, 40% of first recurrences were found after 5 years, so periodic radiographic follow up X-ray examinations should be carried out six monthly initially, and later at twelve month intervals. Examples are demonstrated. Intraoperative marking of the diaphragm and dorsum sellae with gold foil for later control radiography is evaluated. Today, space occupying lesions, including intrasellar pituitary tumours, can be clearly demonstrated with the CT scan after i.v. injection of contrast medium to intensify the shadow of the tumour tissue.
    Notes: Zusammenfassung Die Möglichkeiten postoperativer Röntgenkontrolle bei raumfordernden Prozessen der Sellaregion werden an 164 nachuntersuchten Fällen des eigenen Krankenguts besprochen. Hierfür wurden, bei einem Beobachtungszeitraum bis zu 23 Jahren, die Befunde von 110 Hypophysenadenomen, 24 Kraniopharyngeomen, 17 Sellameningeomen, 7 anderen Sellatumoren und von 6 Fällen einer zystischen Arachnitis ausgewertet. Seitliche Schädelübersichtsaufnahmen erlaubten in etwa 80% der nachuntersuchten Fälle eine sichere Aussage bezüglich eines Rezidivs. Eine noch bessere Beurteilung ist mit der von uns vorgeschlagenen seitlichen Vergrößerungsaufnahme (V 3∶1) mit Zentimetermaßstab möglich. Tumorrezidive sind häufig. Etwa 40% der Erstrezidive wurden erst nach 5 und mehr Jahren objektiviert. Routinemäßige Röntgenkontrollen der Sellaregion sind daher in zunächst 6monatigen, später jährlichen Abständen durchzuführen. So lassen sich lokalisierte Umbauprozesse gut vergleichen. Sie geben einen frühen Hinweis auf ein neuerliches Tumorwachstum, wie an Beispielen gezeigt wird. Auf die Vorteile einer intraoperativen Markierung des Diaphragma und Dorsum sellae mit Goldfolie für spätere Röntgenkontrollen zur Früherkennung von Rezidiven wird hingewiesen. Die außerordentliche Bedeutung des CT-scan auch für die Diagnose raumfordernder sellärer Prozesse wird aufgezeigt. Mit der Tomometrie lassen sich nach i.v.-Kontrastmittelinjektion auch intraselläre Tumoren sicher nachweisen.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 47 patients with various pituitary tumours plasma cortisol, LH, FSH, prolactin, and GH were measured by radioimmunoassays to investigate anterior pituitary function. In 14 subjects LH-RH and TRH stimulation tests were performed to assess pituitary reserve before, during, and after surgical therapy. The mean cortisol levels were raised during and after the operative procedures until the 14th postoperative days. In patients with functionless tumours the other hormone concentrations remained nearly unchanged and in the normal ranges. After the removal of the tumour a rapid decrease in hormone levels, as might be expected, was rare, with the exception of the GH and prolactin levels in patients with hypersecretion. The postoperative stimulation tests showed a maintained secretory pituitary reserve due to active tissue left behind after operative removal of the tumour.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 0165-0327
    Keywords: Cell-mediated immunity ; Glucocorticoid receptor ; Glucocorticoids ; Lymphocyte transformation test ; Major depression
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Computers and Electronics in Agriculture 11 (1994), S. 53-68 
    ISSN: 0168-1699
    Keywords: Combine ; DGPS ; GPS ; Yield mapping ; Yield measurement
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Computer Science , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Electronic Resource
    Electronic Resource
    Cambridge : Cambridge University Press
    Philosophy 14 (1939), S. 326-340 
    ISSN: 0031-8191
    Source: Cambridge Journals Digital Archives
    Topics: Philosophy
    Notes: It has been said that in Plato the intuitive mode of receiving knowledge is accepted implicitly, and that it is left to Aristotle to make a clear-cut distinction between Intuition and Reason.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...