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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Acta neurochirurgica 138 (1996), S. 1050-1056 
    ISSN: 0942-0940
    Schlagwort(e): Dehydration therapy ; early surgery ; patients management ; severe subarachnoid haemorrhage ; vasospasm
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary We prospectively analysed treatment results in patients with severe subarachnoid haemorrhage (SAH) who underwent early aneurysm surgery, and were managed by dehydration therapy. We studied a total of 31 patients with poor-grade SAH including 18 in grade IV, and 13 in grade V according to the WFNS classification system. Patients who were older than 70 years of age, or those with an intracerebral haemorrhage or absent brainstem response were excluded from this study. At surgery, clot evacuation from the peribrainstem cisterns with/without external decompression was performed following obliteration of the aneurysmal neck. In the early postoperative period, patients were maintained in negative water balance using osmotic diuretics. When delayed ischaemic deficits had manifested themselves, the pulmonary wedge pressure and/or central venous pressure was immediately increased by the rapid injection of albumin until hypovolaemia reverted to normovolaemia with the continuous administration of dobutamine. The outcome at 3 months was good recovery in 16 (52%) patients, moderate disability in 3 (10%), severe disability in 5 (16%), a vegetative state in 1 (3%), and death in 6 (19%). We thought that early aneurysm surgery and postoperative dehydration therapy in the acute stages of brain oedema resulting from primary brain damage are effective in the treatment of patients with severe SAH but reversilbe primary brain damage.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-0630
    Schlagwort(e): 71.25.Hc ; 74.72.Hs ; 79.60.Bm
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Maschinenbau , Physik
    Notizen: Abstract Core-level X-ray photoelectron-diffraction patterns have been measured from cleaved Bi2Sr2CaCu2O8+δ (001) surfaces for all elements present in this compound. The incommensurate modulation alongb ([010]) leads to a strong inequivalence ofa- andb-directions for Bi, Sr and Cu photoelectrons, while Ca and O emission show less effect. Ultraviolet-photoemission experiments recording the emission intensity at the Fermi energy over a large solid angle are also presented, providing a direct mapping of the Fermi surface. Ac(2×2) superstructure is observed on the Fermi surface suggesting antiferromagnetic correlations within the Cu−O planes. The effects of the lattice modulation are clearly observable at the Fermi energy, and they are enhanced for binding energies higher than a few tens of meV.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    Pharmacy world & science 11 (1989), S. 87-91 
    ISSN: 1573-739X
    Schlagwort(e): Albumin ; Clearance ; Distribution ; Midazolam ; Models, theoretical ; Pharmacokinetics ; Protein binding
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie
    Notizen: Abstract The effects of altered albumin distribution on the apparent volume of distribution (V) and the apparent elimination rate constant (k) of drugs were investigated by a simulation analysis. The Equations derived by Øieet al. were modified for this purpose. Within the range observed in normal healthy subjects and patients, the change in albumin distribution significantly affectedV of drugs but, in general, notk. For drugs with more than 90% plasma-protein binding,V changed by more than 100%. The change in plasma-protein binding caused by an altered albumin distribution produced a greater effect onV than that caused by an altered albumin amount. These results suggest that albumin distribution is an important factor in controlling the kinetics of drugs which are highly bound to plasma protein. This is illustrated using midazolam as an example.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1573-739X
    Schlagwort(e): Chromatography, high pressure liquid ; Clearance ; Metabolism ; Pharmacokinetics ; Protein binding ; Sulfadimethoxine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie
    Notizen: Abstract Sulfadimethoxine is metabolized byO-dealkylation, N4-acetylation and N1-glucuronidation. In man, only N1-glucuronidation and N4-acetylation takes place, leading to the final double conjugate N4-acetylsulfadimethoxine-N1-glucuronide. The N1-glucuronides are directly measured by high pressure liquid chromatography. When N4-acetylsulfadimethoxine is administered as parent drug, 30% of the dose is N1-glucuronidated and excreted. Fast acetylators show a shorter half-life for sulfadimethoxine than slow acetylators (27.8±4.2 h versus 36.3±5.4 h; P=0.013), similarly the half-life of the N4-acetyl conjugate is also shorter in fast acetylators (41.3±5.2 h versus 53.5±8.5 h, P=0.036). No measurable plasma concentrations of the N1-glucuronides from sulfadimethoxine are found in plasma. N1-glucuronidation results in a 75% decrease in protein binding of sulfadimethoxine. N4-acetylsulfadimethoxine and its N1-glucuronide showed the same high protein binding of 99%. Approximately 50–60% of the oral dose of sulfadimethoxine is excreted in the urine, leaving 40–50% for excretion into bile and faeces.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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