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  • 1
    Digitale Medien
    Digitale Medien
    s.l. : American Chemical Society
    Journal of chemical & engineering data 40 (1995), S. 1242-1248 
    ISSN: 1520-5134
    Quelle: ACS Legacy Archives
    Thema: Chemie und Pharmazie , Werkstoffwissenschaften, Fertigungsverfahren, Fertigung
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Diseases of the colon & rectum 37 (1994), S. 685-688 
    ISSN: 1530-0358
    Schlagwort(e): Colorectal cancer ; Colonic obstruction ; Emergency subtotal/total colectomy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract PURPOSE: The operation of choice for acutely obstructed carcinoma of the left colon is controversial. The aim of the study was to evaluate the results of its management by emergency subtotal/total colectomy with immediate anastomosis without diversion. METHODS: An emergency subtotal/total colectomy was performed in 44 patients (mean age, 72.4 years). Inclusion criteria were reasonable operative risk, resectable acutely obstructed carcinoma, massively distended colon of dubious viability and likely to contain ischemic lesions, signs of impending cecal perforation, and masses suggesting synchronous colonic cancers. RESULTS: Postoperative mortality was 6.8 percent. Two patients over 90 years of age died postoperatively as a result of cardiopulmunary complications. An 83-year-old female died as a result of an anastomotic dehiscence. Morbidity was 6.8 percent including one fistula which recovered without surgery. There were three synchronous colon cancers. Six months after surgery, the mean daily stool frequency was two following subtotal colectomy and three after total colectomy. CONCLUSION: Emergency subtotal colectomy achieves in one stage relief of bowel obstruction and tumor resection by encompassing a massively distended and fecal-loaded colon with ischemic lesions and serosal tears on the cecum, ensures restoration of gut contiguity via a “safe” ileocolonic anastomosis, and removes occasional lesions proximal to the index cancer. It is a safe procedure given that operative mortality rates are as low as with elective surgery.
    Materialart: Digitale Medien
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  • 3
    ISSN: 1530-0358
    Schlagwort(e): Glycine ; Hyponatremia ; Endoscopic transanal resection ; Rectal cancer ; Palliation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Purpose: This study was undertaken to evaluate the potential metabolic complications of 1.5 percent glycine irrigating solution during endoscopic transanal resection (ETAR) of rectal tumors. METHODS: Thirteen consecutive frail patients (mean age, 81 (range, 57–91) years) undergoing 18 ETAR were prospectively studied from July 1993 to January 1995. Indications for ETAR included palliation of advanced rectal cancer (12 patients) and an extensive villous tumor (1 patient). A 27-French two-way Iglesias resectoscope was used. Packed cell volume, blood glucose, and serum concentrations of sodium, potassium, and creatinine were measured before, during (at 45 minutes), and after (at 6 and 24 hours) ETAR. Plasma concentration of glycine and hemoglobin levels were both measured preoperatively and at 45 minutes and 24 hours, respectively. Variables studied included resection time, volume and rate of irrigating fluid, height of irrigating fluid bag above operating table, resectate weight, occurrence of intraperitoneal and extraperitoneal perforation, blood loss, and clinical symptoms. RESULTS: Two patients were excluded. Mean operating time was 456 minutes. A mean of 192.3 liters of irrigant was infused into the rectum. Mean irrigation rate was 43,330 ml/minutes. Mean height of irrigating fluid bag was 692 cm. Extraperitoneal perforation occurred in two patients. Blood loss exceeded 200 ml in four patients, one of whom complained of nausea (operating time, 110 minutes). Mean rise in p-glycine at 45 minutes (10,028 mol/l; 387 percent of preoperative values) was significant (P =0.006). Changes in packed cell volume, b-hemoglobin, b-glucose, s-sodium, and s-creatinine levels were not significant. There was significant correlation between p-glycine and s-creatinine levels at six hours (P =0.033), between p-glycine levels and fall in s-sodium at 24 hours (P =0.037), and between levels of b-hemoglobin and packed cell volume at 24 hours (P =0.0004). There was a positive linear correlation between p-glycine and operating time (r =0.7; P =0.0026) and between p-glycine and volume of irrigating fluid (r =0.5; P =0.0386). CONCLUSIONS: Operating time best predicts increase of p-glycine in ETAR.
    Materialart: Digitale Medien
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    Diseases of the colon & rectum 43 (2000), S. 771-774 
    ISSN: 1530-0358
    Schlagwort(e): Anastomosis ; Colectomy ; Diverticulitis ; Laparoscopic sigmoid resection
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract PURPOSE: Operating room time and anastomosis-related morbidity of laparoscopic-assisted sigmoid resection with anastomosis performed in an open fashion through a horizontal suprapubic incision or laparoscopically after re-establishing pneumoperitoneum were compared. METHODS: A randomized trial was performed on patients with recurrent uncomplicated diverticulitis of the sigmoid colon during a 14-month period. Inclusion criteria were persistence of symptoms despite medical treatment and two previous admissions. Exclusion criteria included complicated diverticulitis, suspected cancer, and previous extensive abdominal surgery. Because skin incisions were similar and patients were randomly assigned in the operating room, the trial was performed as double blind. RESULTS: There were no deaths. Two patients were excluded before randomization. Three patients were not treated as allocated because of conversion to open surgery. Aside from previous abdominal-surgery rates, 16 patients with laparoscopic-assisted sigmoid resections after re-establishing pneumoperitoneum and 15 patients with laparoscopic-assisted sigmoid resections with anastomosis performed in an open fashion through a horizontal suprapubic incision were well-matched for age, gender, weight, American Society of Anesthesiology class, previous admissions, skin-incision length, size of circular stapler, and mobilization of splenic flexure. There were no significant differences in morbidity rates (3/16vs. 3/15), complete doughnuts (16/16vs. 15/15), blood loss (300vs. 200 ml), flatus (4vs. 4 days), solid-food resumption (5vs. 6 days), stay (8.5vs. 9 days) in laparoscopic-assisted sigmoid resection after re-establishing pneumoperitoneum and laparoscopic-assisted sigmoid resection with anastomosis performed in an open fashion through a horizontal suprapubic incision groups, respectively. Patients with laparoscopic-assisted sigmoid resection after re-establishing pneumoperitoneum had statistically longer operating room time (295vs. 190 minutes;P〈0.01). Median follow-up was 12 and 10 months in 10 patients with laparoscopic-assisted sigmoid resection after reestablishing pneumoperitoneum and 11 patients with laparoscopic-assisted sigmoid resection with anastomosis performed in an open fashion through a horizontal suprapubic incision, respectively. One patient with laparoscopic-assisted sigmoid resection with anastomosis performed in an open fashion through a horizontal suprapubic incision had an anastomotic stenosis endoscopically dilated. CONCLUSIONS: Nonrestoration of pneumoperitoneum after laparoscopic-assisted sigmoid resection allows a decrease in operating room time and a similar outcome.
    Materialart: Digitale Medien
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  • 5
    Digitale Medien
    Digitale Medien
    Springer
    Annals of surgical oncology 3 (1996), S. 464-469 
    ISSN: 1534-4681
    Schlagwort(e): Colorectal cancer ; Follow-up ; Recurrences ; Diagnosis and treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: The main rationale for follow-up of colorectal cancer patients resected for “cure” is that early detection and treatment of recurrence and metachronous disease should result in improved survival. Our purpose was to assess in a prospective fashion the impact on survival of a follow-up program versus that of undergoing nonscheduled visits. Methods: Within the 14-year period from 1975 through 1988, a prospective study was carried out on 800 patients with colorectal adenocarcinoma radically resected with no evidence of synchronous cancers of the colon and rectum or in other organs, of whom 322 patients were to attend a 5-year follow-up, and 478 patients were free to make nonscheduled visits on account of symptoms. Results: Asymptomatic recurrence was found at follow-up in 92 (28%) of 322 patients, whereas 175 (36%) of 478 patients had a symptomatic recurrence detected at a nonscheduled visit. Diagnosis of resectable recurrence was established within a median time of 21.5 months. Surgical resection of recurrence was performed in 30 (32%) of 92 and in 13 (7%) of 175 patients (32 vs. 7%;p〈0.001). Resection was curative in 13 (14%) of 92 and in two (1%) of 175. Five-year survival of resected recurrence was 10% in 30 of 92 patients and 0.8% in 13 of 175 (10 vs. 0.8%;p〈0.01). Two patients are alive with no evidence of disease or two (2%) of 92. Metachronous colorectal lesions were treated for cure in 63 (19.5%) of 322 patients. The effectiveness of scheduled follow-up was 4% (13 of 322 patients). Conclusions: These results underline the rationale for a follow-up program in early detection and surgical treatment of recurrent disease in patients operated on for colorectal cancer.
    Materialart: Digitale Medien
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  • 6
    ISSN: 1572-8927
    Schlagwort(e): Acetonitrile ; γ-butyrolactone ; propylene carbonate ; 1,2-dimethoxyethane ; dielectric constant ; isothermal compressibility
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie
    Notizen: Abstract The dielectric constants ∈ of 1,2-dimethoxyethane, acetonitrile, γ-butyrolactone, and propylene carbonate were determined from capacitance measurements extrapolated to infinite frequency; ln ∈ are reported as a function of pressure up to 80 MPa at 15, 25, 35, 45°C and as a function of temperature in the range 10 to 50°C at 0.10133 MPa. The variation of ln ∈ with temperature or pressure can be expressed by a second order polynomial expression. The isothermal compressibilities β of the solvents were determined at 25°C from sound velocities, densities, and heat capacities. A simple correlation can be established between ∂ ln ∈/∂P and β for most aprotic solvent.
    Materialart: Digitale Medien
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  • 7
    Digitale Medien
    Digitale Medien
    Springer
    Applied microbiology and biotechnology 32 (1990), S. 403-408 
    ISSN: 1432-0614
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Werkstoffwissenschaften, Fertigungsverfahren, Fertigung
    Notizen: Summary Growing cells ofLactobacillus casei were entrapped inκ-carrageenan/locust bean gum (LBG) (2:1 or 2.75%:0.25% w/w respectively) mixed gel beads (two ranges of diameter: 0.5–1.0 and 1.0–2.0 mm) to fermentLactobacillus Selection (LBS) medium and produce biomass. The results showed significant influence of initial cell loading of the beads and bead size on the fermentation rate. The highest cell release rates were obtained with 2.75%:0.25%κ-carrageenan/LBG small diameter gel beads. However, 17 h fermentation of LBS medium with immobilized cells resulted in substantial softening of the gel matrix, prohibiting reuse of immobilized biocatalysts as inoculum in subsequent batch fermentation. A dynamic shear rheological study showed that the gel weakness was related to chemical interactions with the medium. Results indicated that part of the matrix-stabilizing K+ ions diffused back to the medium. Stabilization of the gel was obtained by adding potassium ions to the LBS medium;L. casei growth was not altered by this supplementation. Fermentation of LBS medium supplemented with KCl byL. casei showed higher cell counts in the broth medium with immobilized cells than with free cells, reaching 1010 cells/ml after about 10 h with entrapped cells in 0.5–1.0 mm diameter beads and 17 h with free cells. Counts in the gel beads after fermentation were higher than 1011 cells/ml and bead integrity was maintained throughout fermentation.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1432-234X
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie
    Beschreibung / Inhaltsverzeichnis: Résumé Ce travail porte sur 7 espèces de Copépodes Calanoides, choisies pour la variété de leur régime alimentaire: essentiellement herbivore (Calanus helgolandicus), très omnivore (Nannocalanus minor,Temora stylifera,Centropages typicus,Labidocera wollastoni,Acartia clausi) ou nettement carnivore (Candacia armata). Sur le plan topographique, le tube digestif de ces 7 Copépodes présente une homogénéité certaine, en particulier au niveau de l'intestin moyen, toujours formé par une succession de 3 zones caractéristiques: zone I à cellules à plateau strié; zone II à grandes cellules vacuolaires; zone III à cellules aplaties. Les principales différences relevées concernent le mode d'abouchement de l'oesophage avec l'intestin moyen, la présence ou l'absence d'un diverticule dans la région antérieure de l'intestin moyen, la position, dorsale ou ventrale, de la zone III. Un mésentère d'épaisseur très variable, souvent chargé de gouttelettes lipidiques, entoure l'intestin moyen dont il est seulement séparé, de façon discontinue, par une fine musculature. Au point de vue ultrastructural, nous avons mis en évidence 3 types fondamentaux de cellules: cellules R à grandes microvillosités et à réticulum endoplasmique lisse ou peu granulaire; cellules F à réticulum endoplasmique très granulaire et phagosomes souvent volumineux; cellules B renfermant un appareil vacuolaire avec 5 stades principaux d'évolution (B1 à B5). La structure fine de chacune des catégories cellulaires précitées offre une remarquable constance chez toutes les espèces considérées et, comme au niveau structural, aucune des variations mises en évidence ne peut être reliée à un mode de nutrition particulier. L'analyse détaillée de leurs caractères ultrastructuraux permet d'avancer un rôle d'absorption pour les cellules R, de digestion pour les cellules F et B et, peut-être, d'excrétion pour les cellules B.
    Notizen: Summary The present study deals with 7 species of Calanoid Copepods selected for alimentary diet variety: essentially herbivorous diet (Calanus helgolandicus), or very omnivorous diet (Nannocalanus minor, Temora stylifer a, Centropages typicus, Labidocera wollastoni, Acartia clausi), or extremely carnivorous diet (Candacia armatd). From the topographical point of view, the alimentary canal of the Calanoids presents a great homogeneity, especially on a level with the midgut which consists of three successive zones: zone I with striated border cells; zone II with large vacuolar cells; zone III with flattened cells. The major differences between species concern the junction mode between oesophagus and midgut, the presence or the absence of an anterior midgut diverticulum, the zone III in a dorsal or a ventral situation. A mesentery of greatly varying thickness, often filled with lipid droplets, surrounds the midgut of which it is discontinuously separated by a thin musculature. From the ultrastructural point of view three main cell types have been distinguished: R-cells are large microvillar and smooth or lightly granular reticulum-cells; F-cells are extremely granular reticulum and often large phagosomal cells; B-cells are vacuolar cells developing in five successive stages of evolution (Bl to B5). As on an optical microscopic level, the fine structure of each type presents an excellent degree of invariability in all the 7 species and none of the observed variations is to connect with a peculiar nutritional mode. From a cell ultrastructural detailed analysis we propose an absorptive function for R-cells, a digestive function for F- and B-cells and perhaps an excretory function for the B-cells also.
    Materialart: Digitale Medien
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  • 9
    ISSN: 1436-0691
    Schlagwort(e): Key words: pancreas, duodenopancreatectomy, renal cell carcinoma, metastase, survival
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: The pancreas is an uncommon site of metastasis from renal cell carcinoma. We present five patients with solitary pancreatic metastasis from renal cell carcinoma located in the head of the pancreas, treated by duodenopancreatectomy. There were no perioperative deaths. Mean survival was 48 months; three patients were alive at the end of the study (at 27, 46, and 88 months, respectively) and two patients died, at 13 and 70 months. The 3- and 5-year survival rates of our patients together with 22 previously reported patients were 86% and 68%, respectively. We advocate aggressive surgical treatment when the metastatic disease is limited to the pancreas.
    Materialart: Digitale Medien
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  • 10
    ISSN: 1436-0691
    Schlagwort(e): Key words: pancreaticobiliary maljunction ; gallbladder cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: A rare case of pancreaticobiliary maljunction (PBM) without dilatation of the biliary tract (DBT) associated with gallbladder carcinoma is described herein. A 62-year-old European woman with a long history of right upper abdominal pain was diagnosed as having PBM without DBT by endoscopic retrograde cholangiopancreatography and other examinations. Excision of the gallbladder and biliary duct with a Roux-en-Y hepaticojejunostomy was performed, and subsequent pathological examination of the surgical specimen showed a well differentiated adenocarcinoma of the gallbladder. She had no clinical symptoms for 58 months postoperatively. PBM allows reflux of pancreatic juice into the biliary tract. Recent findings support the idea that epithelial hyperplasia plays an important role in gallbladder carcinogenesis with PBM, and also support the concept that gene mutations are involved in the carcinogenesis of biliary epithelium in patients with PBM. For these reasons, we advocate that resection of the extrahepatic biliary tract in PBM patients without bile duct dilatation, rather than cholecystectomy alone, is the treatment of choice for preventing bile duct carcinoma.
    Materialart: Digitale Medien
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