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  • 1
    ISSN: 1420-908X
    Keywords: Key words: Human - Trauma - Antiinflammation - Cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Objective: Besides interleukin (IL)-10, accumulating evidence from in vitro studies has indicated a strong antiinflammatory capacity for IL-13. A prospective clinical study was undertaken to assess the influence of additional brain injury on systemic IL-10 and IL-13 levels as markers for the antiinflammatory state in trauma patients.¶Material and methods: The course of IL-10 and IL-13 plasma levels from 32 patients with an isolated severe head trauma (SHT), 50 patients with multiple injuries and additional SHT and 39 patients with multiple injuries without SHT was detected using ELISA-technique. Blood samples from 37 healthy blood donors were analysed for control.¶Results: IL-10 levels were significantly elevated in all 3 injury groups within 3 h after trauma. The lowest initial release was detected in patients with an isolated SHT (Injury severity score; ISS: 18.1 ± 5.6). No difference could be demonstrated for the IL-10 levels from multiple injured patients with (ISS: 35.3 ± 9.6) or without additional SHT (ISS: 25.5 ± 11.7), though there were relevant differences in the ISS. In contrast, the IL-13 plasma levels were not elevated systemically after trauma.¶Conclusions: IL-10 but not IL-13 is a detectable antiinflammatory marker in trauma patients with or without brain injury and to a minor degree in patients with an isolated SHT.¶
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    s.l. ; Stafa-Zurich, Switzerland
    Materials science forum Vol. 77 (Jan. 1991), p. 257-268 
    ISSN: 1662-9752
    Source: Scientific.Net: Materials Science & Technology / Trans Tech Publications Archiv 1984-2008
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Thermochimica Acta 218 (1993), S. 445-453 
    ISSN: 0040-6031
    Keywords: Levitation ; Liquid Metals ; Nickel ; Surface Tension
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-0385
    Keywords: Key words: Postoperative pain ; Pain therapy ; Pain measurement ; Survey. ; Schlüsselwörter: Postoperativer Schmerz ; Schmerztherapie ; Schmerzmessung ; Umfrage.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Mittels einer anonymen Umfrage wurde der Status der perioperativen Schmerztherapie in Deutschland untersucht. Von insgesamt 2254 chirurgischen Abteilungen antworteten 1000 (Rücklaufquote 44,4 %). Die strukturierten Fragen bezogen sich auf Organisationsstruktur und Zuständigkeit in der Schmerzbehandlung, Bedeutung, Methoden der Schmerzmessung/-dokumentation und die Verwendung verschiedener Analgetica/Analgesieverfahren. In 47 % waren Chirurg und Anaesthesist gemeinsam für die Schmerztherapie zuständig, in 33 bzw. 14 % war es der Chirurg bzw. der Anaesthesist allein. Nur 41 % kannten die Vereinbarung zur postoperativen Schmerztherapie, die 1992 durch die Berufsverbände der Deutschen Chirurgen und Anaesthesisten erstellt wurde. Obwohl die Bedeutung postoperativer Schmerzen als hoch angesehen wurde (für den Arzt 77,6 %, für den Patient 94 %), verfügen nur 19,1 % über ein schriftlich fixiertes Therapiekonzept. Schmerzmessungen führen nur 11 % überwiegend mittels der „Visuellen Analog-Scala“ durch. Die medikamentöse Schmerztherapie besteht bevorzugt aus der systemischen Pharmakotherapie; nur 18 % verwenden regionale Analgesieverfahren. 51 % der Chirurgen entscheiden erst auf der Station über die Wahl und Dosierung von Schmerzmedikation. 33 % gestanden ein, erst bei Klagen des Patienten die Therapie zu beginnen. 70 % der Chirurgen haben noch nie an einem Schmerzkongreß teilgenommen. In der Schlußfolgerung erscheint daher die Schmerztherapie vieler chirurgischer Kliniken in Deutschland als ineffektiv, inadäquat und ohne den nötigen organisatorischen und wissenschaftlichen Hintergrund.
    Notes: Summary. To evaluate the status of perioperative pain management we mailed a anonymous postal survey to all 2,254 surgical departments in Germany. We received answers from 1,000 clinics (44.4 %) which were representative related to their regional distribution. We asked the responsible surgeons to report their organizational structure and responsibilities for treating pain patients, the significance of the problem, their methods of measuring pain, and the usage of different analgesic drugs and methods. In 47 % the surgeon and the anesthesist together had responsibility for adequate postoperative pain treatment; in 33 % and 14 %, respectively, it was the surgeon and anesthesist alone. Only 41 % knew the interdisciplinary statement on pain therapy of the Professional Societies of German Surgeons and Anaesthesists from 1992. Although the importance of postoperative pain is globally acknowledged, only 19.1 % of all departments had a written concept for pain treatment. Pain was measured in only 11 % of the clinics mainly by using the visual analogue scale. Most surgeons relieve pain solely with systemic drugs. Regional analgesia was used by 18 % only. 51 % of the surgeons decide on the choice and dosage of analgesic therapy on the ward; 33 % admit that pain therapy often starts after complaints of the patient. 70 % of all surgeons never participated in a congress on pain. We conclude that postoperative pain management in most German surgical departments still lacks effectiveness, adequacy, and organizational and scientific background.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2218
    Keywords: Key words: Consensus development conference — Diverticulitis — Contrast enema — Hartmann resection — Laparoscopic colectomy — Intraabdominal infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: With the aim of resolving the current controversy over the diagnosis and treatment of diverticular disease, this consensus development conference set out to summarize the actual state of the art. Methods: A multidisciplinary panel of international experts (n= 16) was selected to take part in the consensus process. Prior to the conference, all experts were asked to answer a series of questions on diverticular disease. The consensus statement compiled out of these evaluations was modified during a joint meeting of the panel members, then presented for discussion in a public session, and finally revised by the expert panel. The finalized statement was mailed to all panel members for approval (Delphi method). Results: Asymptomatic diverticulosis, diverticular disease (with actual or recurrent symptoms), and complicated diverticular disease were defined separately. No agreement was reached on whether barium enema or colonoscopy is the better choice as an initial diagnostic tool in uncomplicated cases. In complicated cases, computed tomography is recommended for diagnosis. After two attacks of diverticular disease, elective resection should be considered. For patients in whom a concomitant carcinoma cannot be excluded and those with chronic complications (fistula, stenosis, or bleeding) surgery is also indicated. Laparoscopic sigmoid colectomy is recommended only for uncomplicated and, after percutaneous drainage of abscesses, Hinchey stage I and II cases. Conclusions: Laparoscopic surgery has already begun to influence the management of diverticular disease, but the randomized controlled trials needed to support therapy decisions are largely missing.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 908 -910 
    ISSN: 1432-2218
    Keywords: Key words: Clinical practice guidelines — Consensus development conference — Literature search — Publication bias — Retrieval bias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Ideally, a consensus panel combines expert knowledge with external evidence derived from the literature. To date, many consensus conferences do not use a structured approach to search the literature, but simply compile an add-on reference list from all papers cited by the panelists. This study examined how well such panelists retrieved the relevant literature. Methods: We used the reference lists of nine surgeons who took part in a consensus conference on common bile duct stones. We included all papers that were referred to as randomized controlled trials (RCTs). We then compared this list with a database search in order to calculate sensitivity and specificity. Results: The nine experts cited between 35 and 518 papers, but only eight papers on average were RCTs. Of the 49 papers that the experts believed to be RCTs, only 23 actually were RCTs. The sensitivity resp. specificity for correctly identifying an RCT was 0.21 (95% Cl, 0.11–0.30) resp. 0.80 (95% Cl; 0.64–0.95). RCTs that included the word ``randomized'' in their title were significantly more likely to be identified (relative risk, 1.31; 95% Cl, 1.18–1.45). Conclusion: Our data indicate that consensus panelists usually do not perform systematic literature searches, but simply use their favorite papers to back up their arguments. Because this may lead to a biased selection of the evidence base on which the consensus statements are founded, a systematic search of all relevant articles should become a mandatory task in any consensus or guideline process.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-2218
    Keywords: Key words: Common bile duct stones — Gallbladder — Bile duct calculi — Laparoscopic cholecystectomy — Endoscopic retrograde cholangiopancreaticography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Common bile duct stones (CBDS) are a frequent problem (10–15%) in patients with symptomatic cholecystolithiasis. Over the last decade, new diagnostic and surgical techniques have expanded the options for their management. This report of the Consensus Development Conference is intended to summarize the current state of the art, including principal guidelines and an extensive review of the literature. Methods: An international panel of 12 experts met under the auspices of the European Association of Endoscopic Surgery (EAES) to investigate the diagnostic and therapeutic alternatives for gallstone disease. Prior to the conference, all the experts were asked to submit their arguments in the form of published results. All papers received were weighted according to their scientific quality and relevance. The preconsensus document compiled out of this correspondence was altered following a discussion of the external evidence made available by the panel members and presented at the public conference session. The personal experiences of the participants and other aspects of individualized therapy were also considered. Results: Our panel of experts agreed that the presence of common bile duct stones should be investigated in all patients with symptomatic cholecystolithiasis. Based on preoperative noninvasive diagnostics, either endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiography should be employed for detecting CBDS. Eight of the 12 panelists recommended treating any diagnosed CBDS. For patients with no other extenuating circumstances, several treatment options exist. Stones can be extracted during ERCP, or either before or (in exceptional cases) after laparoscopic or open surgery. Bile duct clearance should always be combined with cholecystectomy. Evidence for further special aspects of CBDS treatment is equivocal and drawn from nonrandomized trials only. Conclusions: The management of common bile duct stones is currently undergoing some major changes. Many diagnostic and therapeutic strategies need further study.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1912
    Keywords: Thromboxane A2 (TXA2) ; Prostacyclin (PGI2) ; Human platelets ; Bovine coronary artery ; Non-steroidal antiinflammatory drugs ; Prostaglandin-cyclooxygenase ; Bioassay ; RCS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The action of the non-steroidal antiinflammatory drugs indomethacin, tiaprofenic acid, diclofenac and meclofenamate on vascular and plateletcyclooxygenases was studied by measuring the arachidonic acid-induced thromboxane A2 (TXA2)-formation of washed human platelets and prostacyclin (PGI2)-formation of bovine coronary artery rings. TXA2 was bioassayed as RCS on rabbit aorta strips, PGI2 in terms of its antiaggregatory activity on ADP-induced aggregation of human platelet-rich plasma. All of the substances studied produced concentration-dependent inhibition of PGI2- and RCS-release. The IC50 [μM] in inhibition of RCS-formation was 0.019 for indomethacin, 0.070 for tiaprofenic acid but 44.9 for meclofenamate and 63.2 for diclofenac. The IC50 [μM] in inhibition of PGI2-release was 0.42 for diclofenac, 0.63 for indomethacin and 0.99 for tiaprofenic acid. The data suggest (1) high sensitivity of human platelet-cyclooxygenase against indomethacin and tiaprofenic acid, (2) different sequence of the substances studied in inhibiting arachidonic acid-induced TXA2- and PGI2-formation. The possible therapeutic value of selective inhibition of platelets and vascular cyclooxygenases in discussed.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    International journal of thermophysics 13 (1992), S. 65-74 
    ISSN: 1572-9567
    Keywords: image processing ; levitation ; microgravity ; metals ; surfacetension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract An improved method for measuring the surface tension of liquid metals is proposed. It makes use of the electromagnetic levitation technique for levitating a liquid metal droplet and of digital image processing to evaluate the surface oscillations of the droplet. The oscillation frequencies determine the surface tension. This paper contains a discussion of the theoretical background and a description of the experimental setup. In addition, preliminary results on FeNi samples in 1g and microgravity are presented.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    International journal of thermophysics 14 (1993), S. 573-584 
    ISSN: 1572-9567
    Keywords: density ; electrical conductivity ; electromagnetic levitation ; emissivity ; liquid metals ; microgravity ; specific heat ; surface tension ; undercooling ; viscosity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract With the advent of containerless processing techniques such as electromagnetic levitation, it is now possible to study the properties of high-temperature liquid metalsin situ by applying sophisticated noncontact diagnostics, such as pyrometry and high-speed videography. Thermophysical properties of interest are, e.g., specific heat, thermal conductivity, and viscosity. Applying containerless processing, it is also possible to undercool the melt because of the lack of container-induced nucleation sites. This gives access to a metastable region of the phase diagram. The knowledge of thermophysical data in this region is very important, because undercooling plays a major role in any solidification process. The degree of undercooling not only determines the growth velocity, but also is crucial in selecting the eventually obtained metastable solid phase. In this paper, some recent developments are surveyed relating to the noncontact measurements of emissivity, specific heat, electrical conductivity, density, surface tension, and viscosity, as well as a discussion of possible experiments in microgravity.
    Type of Medium: Electronic Resource
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