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  • 1
    Electronic Resource
    Electronic Resource
    Möglichkeiten und Grenzen des Simultaneingriffes (1973)
    Springer
    Langenbeck's archives of surgery 333 (1973), S. 109-122 
    Details
    ISSN: 1435-2451
    Keywords: Abdominal Surgery ; Combined Surgical Procedure ; Risks ; Complications ; Indications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 1. Der Simultaneingriff setzt die gemeinsame Abwägung von Dringlichkeit des Befundes und Operationstoleranz des Kranken voraus. 2. Erstere wird durch die beiden Befundgruppen der kurativen Indikation sowie der präventiven und der diagnostischen Indikation bestimmt. Hier hat sich die Berücksichtigung einer pragmatischen Abstufung bewährt. 3. Das zweite Kriterium ist die Operationstoleranz des Operierten. Sie wird letztlich bestimmt durch die Schwere der Erst- als auch des simultanen Zweiteingriffs; in erster Linie aber der Dauer des Eingriffs, des Indikationsgrades und der Lokalisation der Operationsfelder und schließlich nicht weniger vom Alter und den Begleitleiden des Operierten. 4. Die Eingriffsschwere läßt sich am modifizierten Schema der Schockklassifikation von Moore [15] ablesen. 5. Der Abschätzung der allgemeinen Disposition des Kranken dient die Einteilung der Operationsgrade entsprechend der von der Internationalen Gesellschaft für Anästhesiologie angegebenen Abstufung. 6. Engpässe der Indikation gibt es beim Zusammentreffen belastender Erst- und Zweitoperationen gleicher Dringlichkeit mit schlechter Ausgangssituation des Kranken. 7. Vermeidbar sind solche Notsituationen durch eine auf die unspezifische Symptomatik der Baucherkrankung rücksichtnehmende, breit angelegte präoperative Diagnostik. Für polytraumatische Abdominalbefunde sind Präventivempfehlungen nicht möglich. 8. Oberste Leitregel für den simultanen Zweiteingriff ist es, daß er nur angeraten und gerechtfertigt erscheint, wenn er unter den gleichen Sicherheitskriterien ausgeführt wird, wie sie für den Ersteingriff galten.
    Notes: Summary From the point of view of indication as well as operative technic the combined surgical procedure is defined as a separate secondary surgical operation. This analysis, based on 4128 patients (own cases and reports from the literature) concerns the special problems which accompany this procedure. Since there will be a rise of the risk factors in operations with an extended shock-stress (stomach and large intestine) one will have to take the following into consideration: 1. Assessment of the complications of both surgical procedures. 2. The separate risks of infection and operative trauma. 3. The duration of the operation. 4. The situation before the procedure (general health, age, accompanying illness). The main rule to be followed in combined surgical procedures is that one only undertakes such risks if the criteria are the same as for the single operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01261631
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  • 2
    Electronic Resource
    Electronic Resource
    Effects of flow-stop on the metabolism of noradrenaline released by nerve stimulation in the perfused spleen (1973)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 278 (1973), S. 179-194 
    Details
    ISSN: 1432-1912
    Keywords: Noradrenaline ; Noradrenaline Metabolites ; Perfused Spleen ; Nerve Stimulation ; Transmitter Overflow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The metabolic pathway of 3H-noradrenaline released spontaneously and by nerve stimulation was studied in the isolated perfused spleen of the cat. The deaminated glycol, DOPEG, (3,4 dihydroxyphenylglycol) was the main metabolite in spontaneous outflow, accounting for 62.5±1.6% of the total radioactivity (n=13). Of the total increase in radioactive products elicited by nerve stimulation at 5 Hz or 10 Hz around 30% was accounted for by the noradrenaline metabolites, particularly DOPEG and the O-methylated fraction. In the presence of 2.9×10−6 M of cocaine the total overflow of radioactivity induced by stimulation was unchanged but DOPEG formation from released noradrenaline was abolished. These findings indicate that DOPEG formation results from the recapture of the released transmitter by adrenergic nerve endings and subsequent intraneuronal deamination. The total overflow of noradrenaline was reduced by flow-stop while the metabolism of the released transmitter was increased significantly. Cocaine, 2.9×10−6 M, prevented the increase in DOPEG when stimulation was applied under flow-stop conditions. The decrease in noradrenaline overflow induced by flow-stop is partly due to the increase in the metabolism of the released transmitter.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00500649
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of the noradrenaline metabolites on the adrenergic receptors (1973)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 276 (1973), S. 71-88 
    Details
    ISSN: 1432-1912
    Keywords: Noradrenaline Metabolites ; Guinea-Pig Atria ; Nictitating Membrane ; Normetanephrine ; Metanephrine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of the five noradrenaline (NA) metabolites and of the O-methylated metabolite of adrenaline, metanephrine, were studied in a tissue with adrenergic beta-receptors (guinea-pig atria) and in a tissue with predominance of alpha-receptors (cat's nictitating membrane). In atria, normetanephrine and metanephrine elicited positive chronotrophic effects which were mediated through the beta-receptors. Both O-methylated metabolites had only 1/1000th of the potency of NA. In the normally innervated nictitating membrane normetanephrine and metanephrine elicited maximal responses of the same magnitude as NA. While normetanephrine had one half of the potency of NA, metanephrine was even more potent than NA. The effects of normetanephrine or metanephrine were mediated through the activation of the alpha-receptors and were not potentiated by either cocaine or denervation. Neither the deaminated nor the deaminated-O-methylated metabolites of NA had activity as agonists on alpha-or beta-receptors in concen-of up to 1×10−4M. These metabolites did not elicit alpha-or beta-receptor block in concentrations of up to 1×10−4M.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00500780
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of the noradrenaline metabolites on tyrosine hydroxylase activity in guinea-pig atria (1973)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 280 (1973), S. 315-330 
    Details
    ISSN: 1432-1912
    Keywords: Tyrosine Hydroxylase ; Noradrenaline ; Noradrenaline Metabolites ; Dopa Decarboxylase ; Guinea-pig Atria ; Noradrenaline Synthesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of noradrenaline, its five metabolites and metanephrine, were studied on tyrosine hydroxylase activity in guinea-pig atria. The deaminated metabolite, (±)-3,4-dihydroxyphenylglycol (DOPEG), was equipotent with (±)-noradrenaline in its inhibitory action on tyrosine hydroxylase activity in the homogenates of guinea-pig atria. The inhibition by DOPEG was competitive with the cofactor, reduced pteridine. The deaminated acid, 3,4-dihydroxymandelic acid (DOMA) and the O-methylated deaminated acid, 3-methoxy, 4-hydroxymandelic acid (VMA) had 1/50th and 1/30th, respectively, the potency of noradrenaline in inhibiting tyrosine hydroxylase. The rest of the metabolites did not inhibit tyrosine hydroxylase in homogenates in concentrations up to 1.0 mM. In intact guinea-pig atria noradrenaline was considerably more potent than DOPEG in inhibiting tyrosine hydroxylase. Normetanephrine 1.4×10−4 M inhibited tyrosine hydroxylase in the intact tissue but failed to inhibited the enzyme in the homogenate even in higher concentrations. The effect of normetanephrine in the intact tissue is related to the ability of this compound to release endogenous noradrenaline. A reserpine-like agent, Ro 4-1284, did not inhibit tyrosine hydroxylase activity in the homogenate but in the intact tissue the inhibition was more than 50%. This effect of Ro 4-1284 in the intact tissue appears to be related to the releasing effects of this agent and to an increase in the axoplasmic levels of DOPEG. Since the formation of the deaminated glycol, DOPEG, represents the main metabolic pathway for the neurotransmitter in adrenergic nerve endings, the present results are compatible with the view that, in addition to the pool of extravesicular noradrenaline, the cytoplasmic concentration of DOPEG could also participate in the regulation of the activity of tyrosine hydroxylase.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00501354
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  • 5
    Electronic Resource
    Electronic Resource
    Heterotopic heart transplant in the cat (1974)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 283 (1974), S. 389-407 
    Details
    ISSN: 1432-1912
    Keywords: Heterotopic heart transplant ; Cardiac denervation ; Noradrenaline ; Isoprenaline ; Supersensitivity of the allografted heart ; Cardiac Rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A technique for the heterotopic heart transplant into the abdominal cavity of the cat has been developed as an experimental model for studies of the development of sympathetic denervation and of allograft rejection. Under our experimental conditions and in the absence of immunosuppressive treatment the survival rate of the transplant was higher than that reported for dogs. Immediately after the operation the cardiac rate of the transplanted heart was reduced from 153±9 (n=36) to 131±9 beats/min (n=36). After the third postoperative day the rate of the graft increased steadily, reaching 185±8 beats/min (n=15) on the seventh day. The endogenous noradrenaline (NA) content in the right atrium was completely depleted 3 days after the operation (controls 2.07±0.45 μg NA/g; transplants 0.09±0.04 μg NA/g). In the ventricles a similar degree of depletion was obtained on the seventh postoperative day (controls 1.69±0.25 μg NA/g; transplants 0.06±0.02 μg NA/g). “In vitro” studies of strips of left atria revealed supersensitivity to the inotropic effect of (−)-noradrenaline 7 days after the surgical procedures. On the 7th day maximal responses of the atria to (−)-noradrenaline were significantly lower than those of the corresponding controls. There was no increase in sensitivity to (−)-isoprenaline 7 days after the operation. The results obtained demonstrate that the transplanted heart undergoes sympathetic denervation and develops supersensitivity to noradrenaline. The latter appears to be the reason for the tachycardia which develops between the third and the seventh day after the operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00501112
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