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  • 1
    ISSN: 1432-1238
    Keywords: Key words Weaning ; CPAP ; BiPAP ; Extravascular lung water ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the effects of continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) on extravascular lung water during weaning from mechanical ventilation in patients following coronary artery bypass grafting. Design; Prospective, randomized clinical study. Setting; Intensive care unit at a university hospital. Patients; Seventy-five patients following coronary artery bypass grafting. Interventions; After extubation of the trachea, patients were treated for 30 min with CPAP via face mask (n=25), with nasal BiPAP (n=25), or with oxygen administration via nasal cannula combined with routine chest physiotherapy (RCP) for 10 min (n=25). Measurements and results: Extravascular lung water (EVLW), pulmonary blood volume index (PBVI) and cardiac index (CI) were obtained during mechanical ventilation (T1), T-piece breathing (T2), interventions (T3), spontaneous breathing 60 min (T4) and 90 min (T5) after extubation of the trachea using a combined dye-thermal dilution method. Changing from mechanical ventilation to T-piece breathing did not show any significant differences in EVLW between the three groups, but a significant increase in PBVI from 155±5 ml/m2 to 170±4 ml/m2 could be observed in all groups (p〈0.05). After extubation of the trachea and treatment with BiPAP, PBVI decreased significantly to 134±6 ml/m2 (p〈0.05). After treatment with CPAP or BiPAP, EVLW did not change significantly in these groups (5.5±0.3 ml/kg vs 5.0±0.4 ml/kg and 5.1±0.4 ml/kg vs 5.7±0.4 ml/kg). In the RCP-treated group, however, EVLW increased significantly from 5.8±0.3 ml/kg to 7.1±0.4 ml/kg (p〈0.05). Sixty and 90 min after extubation, EVLW stayed at a significantly higher level in the RCP-treated group (7.5±0.5 ml/kg and 7.4±0.5 ml/kg) than in the CPAP-(5.6±0.3 ml/kg and 5.9±0.4 ml/kg) or BiPAP-treated groups (5.2±0.4 ml/kg and 5.2±0.4 ml/kg). No significant differences in CI could be observed within the three groups during the time period from mechanical ventilation to 90 min after extubation of the trachea. Conclusions: Mask CPAP and nasal BiPAP after extubation of the trachea prevent the increase in extravascular lung water during x weaning from mechanical ventilation. This effect is seen for at least 1 h after the discontinuation of CPAP or BiPAP treatment.Further studies have to evaluate the clinical relevance of this phenomenon.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Weaning CPAP ; BiPAP ; Extravascular lung water ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the effects of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) on extravascular lung water during weaning from mechanical ventilation in patients following coronary artery bypass grafting. Design Prospective, randomized clinical study. Setting Intensive care unit at a university hospital. Patients Seventy-five patients following coronary artery bypass grafting. Interventions After extubation of the trachea, patients were treated for 30 min with CPAP via face mask (n=25), with nasal BiPAP (n=25), or with oxygen administration via nasal cannula combined with routine chest physiotherapy (RCP) for 10 min (n=25). Measurements and results Extravascular lung water (EVLW), pulmonary blood volume index (PBVI) and cardiac index (CI) were obtained during mechanical ventilation (T1), T-piece breathing (T2), interventions (T3), spontaneous breathing 60 min (T4) and 90 min (T5) after extubation of the trachea using a combined dye-thermal dilution method. Changing from mechanical ventilation to T-piece breathing did not show any significant differences in EVLW between the three groups, but a significant increase in PBVI from 155±5 ml/m2 to 170±4 ml/m2 could be observed in all groups (p〈0.05). After extubation of the trachea and treatment with BiPAP, PBVI decreased significantly to 134±6 ml/m2 (p〈0.05). After treatment with CPAP or BiPAP, EVLW did not change significantly in these groups (5.5±0.3 ml/kg vs 5.0±0.4 ml/kg and 5.1±0.4 ml/kg vs 5.7±0.4 ml/kg). In the RCP-treated group, however, EVLW increased significantly from 5.8±0.3 ml/kg to 7.1±0.4 ml/kg (p〈0.05). Sixty and 90 min after extubation, EVLW stayed at a significantly higher level in the RCP-treated group (7.5±0.5 ml/kg and 7.4±0.5 ml/kg) than in the CPAP-(5.6±0.3 ml/kg and 5.9±0.4 ml/kg). No significant differences in CI could be observed within the three groups during the time period from mechanical ventilation to 90 min after extubation of the trachea. Conclusions Mask CPAP and nasal BiPAP after extubation of the trachea prevent the increase in extravascular lung water during weaning from mechanical ventilation. This effect is seen for at least 1 h after the discontinuation of CPAP or BiPAP treatment. Fuether studies have to evaluate the clinical relavance of this phenomenon.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0899-0042
    Keywords: enantiomers ; diastereoisomeric ureas ; high-performance liquid chromatography (HPLC) ; fluorophores ; inversion of optical rotation ; antiarrhythmics ; propranolol ; plasma ; Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: The synthesis and analytical testing of two new fluorescent chiral derivatizing agents (-)-(S)-flunoxaprofen and (-)-(S)-naproxen isocyanate, is described. In a few simple steps the free carboxylic acids [(S)-flunoxaprofen and (S)-naproxen] are activated with ethyl chloroformate/sodium azide and transformed to the corresponding isocyanates. The crystalline reaction products display high enantiomeric and chemical purity and stability. The direction of the optical rotation of both substances is inverse to that of the corresponding carboxylic acids. At ambient temperature the reagents swiftly react with primary and secondary amines, yielding highly fluorescent ureas. The applicability of the two reagents for the resolution of racemic amines was tested with a number of pharmaceuticals (antiarrhythmics, β-adrenergic antagonists, calcium channel blockers, centrally acting antidepressants). The diastereoisomeric derivatives were efficiently resolved and separated from side-products by means of normal and reversed-phase high-performance liquid chromatography (HPLC). The use and sufficient sensitivity of the two reagents for pharmacokinetic studies were demonstrated with a determination of plasma levels of propranolol enantiomers after oral administration of the racemic drug [80 mg (R,S)-propranolol-HCl] to two volunteers.
    Additional Material: 7 Ill.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    New York, NY : Wiley-Blackwell
    Journal für Praktische Chemie/Chemiker-Zeitung 340 (1998), S. 656-661 
    ISSN: 0941-1216
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Starting from the benzylidene lactone 3 of D-(-)-quinic acid the cyclohexyl fragment 15 (C-28-C-34 part) of the immunosuppressant FK506 was synthesized. Key steps include homolytic deoxygenation reactions on compounds 4 and 6 as well as a regioselective opening of the benzylidene acetal 5. Opening of the lactone 7 to provide the methyl ester 8 was followed by methylation of the hydroxy group to give 9. Further steps provided the aldehyde 12 which was elongated to the alkyne 15. This sequence provides 15 in gram quantities.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    New York, NY : Wiley-Blackwell
    Journal für Praktische Chemie/Chemiker-Zeitung 340 (1998), S. 175-177 
    ISSN: 0941-1216
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Bromination of the disubstituted 4,5-dimethyl-1,3-cyclohexanedione (6) followed by oxidation of the resulting 3-bromo-5,6-dimethyl-2-cyclohexen-1-ones (7) gave 5-bromo-2,3-dimethylphenol (1) together with its constitutional isomer 3. The structure of 1 was secured by a x-ray analysis of its tosyl derivative 8.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0947-3440
    Keywords: Enediynes ; [2 + 2] Cycloaddition ; Bicyclo[3.2.0]heptanes ; Fragmentation ; Ring closing metathesis ; Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Two routes to 1,4-difunctionalized cycloheptenes are described. The first one is based on a fluoride-induced fragmentation reaction of the bicyclic [3.2.0]heptanesilyl monosulfate 10. This compound in turn was prepared by a ketene-cyclopentene cycloaddition route. An alternative strategy took advantage of a ring-closing metathesis (RCM) reaction of the diolefin 18 with the ruthenium catalyst 21. This reaction proved to be reliable even on a larger scale and allowed the isolation of the cycloheptene 19a in reasonably good yield.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Liebigs Annalen 1997 (1997), S. 2043-2046 
    ISSN: 0947-3440
    Keywords: Dihydroxylation ; Tetrol ; Oxirane ; Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Double asymmetric dihydroxylation of 1,5-hexadiene gave in one step a mixture of the d,l/meso tetrols 6 in a ratio of 3.4:1. From this ratio a facial selectivity of 6.65:1 for each double bond can be calculated. As a consequence of the double reaction the d/l ratio can be estimated to be 44:1. Compound 6 served then as starting material for the preparation of the bis-epoxide 12 and the 2,5-dihydroxyhexane (13). While the separation of the diastereomers was not possible so far, this route for the preparation of 6, 12 and 13 might still be useful because it is very short and products derived from them might allow the crucial separation.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Monomeric 3′-deoxyadenosine (cordycepin) was modified at the 2′-O- (13-18) and 5′-O-position (25-29) by the vitamins E, D2, and A and by the two lipids 1,2-di-O-palmitoylglycerol and 1,2-di-O-hexadecylglycerol via succinate or carbonate linkages. The base-labile conjugates afforded protection groups like the 2-(4-nitro-phenyl)ethoxycarbonyl (npeoc) and monomethoxytrityl group (MeOTr) that are cleavable without harming the ester and carbonate bonds, respectively. Monomeric conjugates of cordycepin and vitamin E, vitamin D2, 1,2-di-O-palmitoylglycerol, and 1,2-di-O-hexadecylglycerol (see 13, 14, 17, 18, 25, 26, 28, and 29) inhibited HIV-1-induced syncytia formation 1.7 to 6.2 fold compared to 1.5-fold for cordycepin (see Table); IC50 values for 25 and 28 were 257 and 267 m̈M, respectively. In addition, the monomeric cordycepin-vitamin and -lipid conjugates inhibited HIV-1 RT activity 28-49% which compares with a 13% inhibition of HIV-1 RT observed for cordycepin. The minimal inhibition of HIV-1-induced syncytia formation and HIV-1 RT activity did not proceed by the activation of RNase L. The monomeric conjugates tested (13, 14) increased PKR expression.
    Additional Material: 1 Tab.
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  • 9
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: The syntheses of biodegradable 2′- and 5′ -ester and 2′- and 5′ -carbonate conjugates of the antivirally active 3′-deoxyadenylyl-(2′-5′)-3′-deoxyadenylyl-(2′-5′)-3′-deoxyadenosine (cordycepin-trimer core) with the vitamins, E, D2, and A and the lipids 1,2-di-O-palmitoylglycerol and 1,2-di-O-hexadecylglycerol were achieved first by preparation of the trimeric educts 19-21 (Scheme 1). Secondly, these substances were condensed with the lipophilic residues via a succinate or carbonate linker and then deprotected by β-elimination of the npeoc and npe protecting groups and acid treatment for detritylation without harming the ester and carbonate functions, respectively (Scheme 2). Metabolically stable cordycepin-trimer-vitamin and -lipid conjugates are a new class of bioconjugates that inhibit HIV-1-induced syncytia formation with IC50 values of 7, 18, and 24 m̈M for 39, 29, and 42, respectively, and inhibit HIV-1 reverse transcriptase (RT) activity from 14 to 96% (see Table). Of the nine conjugates tested, inhibition of HIV-1 replication by 28, 29, 32, 40, and 42 may be attributed in part to the activation of the RNase L/PKR antiviral pathways. Trimer conjugate 42 showed the greatest inhibition of HIV-1 replication, i.e., a 120-fold decrease in HIV-1-induced syncytia formation and an 88% inhibition of HIV-1 reverse transcriptase (RT). This inhibition of replication of HIV-1 by 42 can be attributed in part to the activation of recombinant, human RNase L. The inhibition of HIV-1 replication by the cordycepin-trimer-vitamin and -lipid conjugates is significantly greater than that observed for the (2′-5′) A-trimer core or cordycepin-trimer core.
    Additional Material: 1 Tab.
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  • 10
    Electronic Resource
    Electronic Resource
    New York, NY : Wiley-Blackwell
    Helvetica Chimica Acta 76 (1993), S. 441-450 
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Fumaramides 3b and 3c bearing the C2-symmetrical pyrrolidine moieties (2R,5R)-2,5-bis(methoxymethyl)pyrrolidine (2b) or 1,3:4,6-di-O-benzylidene-2,5-dideoxy-2,5-imino-L-idit (2c), respectively, as a chiral auxiliary lead to high diastereoselectivities in radical reactions (‘tin method’;Scheme 1). Removal of the chiral auxiliaries affords the corresponding alkylated fumaric acids Scheme 2. Single-crystal X-ray structures of 3b and 3c support arguments that lead to the model of 1,4-stereoinduction.
    Additional Material: 2 Ill.
    Type of Medium: Electronic Resource
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