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  • 1
    ISSN: 1248-9204
    Schlagwort(e): Incisional hernia ; Preperitoneal prosthesis ; Absorbable mesh ; Postoperative complications
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The surgical approach for the treatment of abdominal incisional hernias is a difficult problem. Only the use of prosthetic materials can provide a solution, yet their use in case of abundant loss of peritoneum can involve complications due to direct contact between the mesh and the intestine. The use of prosthetic materials in reconstruction of the abdominal wall highlights two closely connected problems: the kind of mesh to be used and the best implant site The prosthesis should be positioned only in the pre-peritoneal space or in the retromuscular prefascial plane. We report our experience with a surgical technique in which the peritoneum is integrated with an absorbable prosthesis and the nonabsorbable prosthesis is positioned in the neo-preperitoneal plane. From January 1992 to January 2000 65 patients underwent surgery for large incisional hernias. The follow-up period ranged from 6 to 60 months. There were 15 (23.1%) early complications (seromas, hematomas and infections) and 2 (3.1%) late complications: a fistula between the skin and the prosthesis and a subacute infection of the abdominal wall. No recurrence was noted. In patients with abundant loss of substance there is no real pre-peritoneal space; therefore a new one must be created to restore the mechanical and functional structure of the peritoneum. The prosthetic Vicryl® mesh permits good tissue repair with almost no involvement of the intestinal loop. Follow-up studies confirm the efficacy of this method.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1248-9204
    Schlagwort(e): Hernioplasty ; Outpatient surgery ; Prosthetic materials
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Since the first hernioplasty performed by Edoardo Bassini in 1884, all surgical reconstruction techniques have suffered from a common defect: tension on the suture line. This represents the main etiologic factor for recurrent hernia. With the introduction of modern prosthetic materials (meshes and plugs) it is possible to perform all hernia repairs without altering the normal anatomy, as well as avoiding undesired suture line tensions. Between January 1992 and December 1998 1405 open sutureless tension-free repairs were performed for primary inguinal hernia in 1317 patients. The number of patients treated with local anesthesia was 1235 (93.8%), with 63 (4.8%) treated under general anesthesia, and 19 (1.4%) with epidural anesthesia. In this series only 4 (0.3%) cases of intra-operative complication occurred (vagal crisis without consequences for the patients). Nine (0.6%) cases of early postoperative complications were noted, of which 8 involved vagal crisis and 1 hemorrhage. Forty six (3.4%) late postoperative complications occurred: 32 seromas accompanied by 3 massive inguino-scrotal edemas, 4 hematomas, and 10 wound infections without the necessity to remove the mesh in all cases. Six recurrences (0.4%) were noted after primary surgical repair. Mean follow-up time was 4 years (range 1–7 years). The proposed technique is simple, safe, and characterized by a rapid performing procedure giving an excellent outcome. The data presented confirms the experience of others reported in the world literature, with a low complication rate and lower cost for the community.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 0009-8981
    Schlagwort(e): Electrothermal atomic absorption spectroscopy ; Solvent extraction ; Urine ; Vanadium determination
    Quelle: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 0009-8981
    Schlagwort(e): Aluminium determination ; Biological fluid ; Electrothermal atomic-absorption spectroscopy ; Solvent extraction
    Quelle: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    Digitale Medien
    Digitale Medien
    Springer
    International archives of occupational and environmental health 54 (1984), S. 155-161 
    ISSN: 1432-1246
    Schlagwort(e): Aluminium ; Biological monitoring ; Indicators of dose ; Prevention
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Aluminium in urine (A1U) and in plasma (AlP) was determined in seven subjects occupationally exposed to environmental concentrations of aluminium below or equal to the TWA (5 mg/m3). The AlU levels in these workers were markedly higher than those found in the control group. The levels of the indicator were definitely higher at the end of the shift than at the beginning of the same working day; also, the AlU levels were higher on Friday morning than on Monday morning. After an interruption in work of two weeks, the values of the indicator underwent a marked reduction and were then only slightly higher than those of the control group. Occupational exposure to fumes produced higher AlU levels than exposure to dusts, and in the subjects exposed to fumes the AlU levels were clearly influenced by the degree of exposure. The levels of aluminium in plasma in the exposed workers on the other hand, hardly differed from the levels found in the control group. These data appear to indicate that, whereas AlU allows daily and weekly exposure to be evaluated, AlP cannot be used as an indicator of occupational exposure, at least in the case of brief exposures to environmental concentrations below or equal to the TWA.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    International archives of occupational and environmental health 40 (1977), S. 283-292 
    ISSN: 1432-1246
    Schlagwort(e): Lead ; Lead in blood-protoporphyrin in erythrocytes ; ALAD ; Urinary ALA ; Urinary coproporphyrin ; Validity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The relationships between certain indicators of internal dose and of biological effect were studied in 93 adult women with varying degrees of exposure to lead (PbB levels ranging from 8 to 74 μg/ 100 ml). The results were compared with those obtained in a group of 95 males with more of less similar exposure. In both groups a good correlation was found between PbB and ALAD, EP, CPU taken singularly and the trend of the indicators of effect, depending on PbB levels, was similar: the decrease in ALAD values was already clear at PbB levels which do not cause an elevation of EP and the erythrocyte metabolite increased earlier than CPU. Considering the same levels of internal lead load (measured by both PbB and PbU-EDTA) in women, EP values were higher than in the men. No significant difference was established between the two sexes regarding ALAD and CPU values, when considered at the same PbB levels. Validity of ALAD and EP in the females, as already shown in our previous studies on males, was moderate in predicting PbB levels ⩾ 40 μg/100 ml, while it clearly improved at PbB levels ⩾ 50–60 μg/ 100 ml. This indicates that for screening women of child-bearing age the two indicators of effect must be used with caution, since a value of 40 μg/100 ml has been proposed as the „permissible” PbB limit.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 7
    Digitale Medien
    Digitale Medien
    Springer
    International archives of occupational and environmental health 73 (2000), S. 389-396 
    ISSN: 1432-1246
    Schlagwort(e): Key words Toluene ; Exposure ; Biological monitoring ; Urine ; Blood
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: To compare blood toluene (TOL-B) and urinary toluene (TOL-U) as biomarkers of occupational exposure to toluene, and to set a suitable procedure for collection and handling of specimens. Method: An assay based on headspace solid-phase microextraction (SPME) was used both for the determination of toluene urine/air partition coefficient (λurine/air) and for the biological monitoring of exposure to toluene in 31 workers (group A) and in 116 non-occupationally exposed subjects (group B). Environmental toluene (TOL-A) was sampled during the work shift (group A) or during the 24 h before specimen collection (group B). Blood and urine specimens were collected at the end of the shift (group A) or in the morning (group B) and toluene was measured. Results: Toluene λurine/air was 3.3 ± 0.9. Based on the specimen/air partition coefficient, it was calculated that the vial in which the sample is collected had to be filled up to 85% of its volume with urine and 50% with blood in order to limit the loss of toluene in the air above the specimen to less than 5%. Environmental and biological monitoring of workers showed that the median personal exposure to toluene (TOL-A) during the work-shift was 80 mg/m3, the corresponding TOL-B was 82 μg/l and TOL-U was 13 μg/l. Personal exposure to toluene in environmentally exposed subjects was 0.05 mg/m3, TOL-B was 0.36 μg/l and TOL-U was 0.20 μg/l. A significant correlation (P 〈 0.05) was observed between TOL-B or TOL-U and TOL-A (Pearson's r=0.782 and 0.754) in workers, but not in controls. A significant correlation was found between TOL-U and TOL-B both in workers and in controls (r=0.845 and 0.681). Conclusion: The comparative evaluation of TOL-B and TOL-U showed that they can be considered to be equivalent biomarkers as regards their capacity to distinguish workers and controls and to correlate with exposure. However, considering that TOL-U does not require an invasive specimen collection, it appears to be a more convenient tool for the biological monitoring of exposure to toluene.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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