Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • Articles: DFG German National Licenses  (693)
  • 2000-2004  (693)
  • Chemistry  (481)
  • breast cancer  (140)
  • Complications  (72)
  • Engineering
  • Engineering General
Source
  • Articles: DFG German National Licenses  (693)
Material
Years
Year
Keywords
  • 1
    Electronic Resource
    Electronic Resource
    Laparoscopic colectomy compares favorably with colectomy by laparotomy for reduction of postoperative ileus (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 61-65 
    Details
    ISSN: 1530-0358
    Keywords: Laparoscopic colectomy ; Laparotomy ; Postoperative ileus ; Complications ; Nasogastric tube ; Colectomy ; Colorectal surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to compare the length of postoperative ileus in patients undergoing colectomy by either laparotomy or laparoscopy. METHODS: A total of 166 patients were studied. These patients were divided into two groups: Group 1, in which colectomy was done laparoscopically, and Group 2, consisting of patients undergoing laparotomy. Both groups contained 83 patients who were matched for disease severity, indications for surgery, and procedure. Indications for surgery included sigmoid diverticulitis in 12 (14 percent) patients, polyps in 22 (27 percent), Crohn's disease in 21 (25 percent), colorectal cancer in 11 (13 percent), stoma reversal in 8 (10 percent), rectal prolapse in 3 (4 percent), and other indications in 6 (7 percent) in each group. Operations were colectomy with anastomosis (42 ileocolic, 26 colorectal, 6 colocolic, 4 ileorectal, and 2 ileal J pouch) or without anastomosis (3 abdominoperineal resections) performed by the same surgeons during the same time period (January 1993 to October 1996). The nasogastric tube was removed from all patients immediately after surgery in both groups. All patients received a clear liquid diet on the first postoperative day, followed by a regular diet as tolerated. The nasogastric tube was reinserted if two or more episodes of emesis of more than 200 ml occurred in the absence of bowel movement. Patients were discharged from the hospital when tolerating a regular diet without evidence of ileus. Statistical analysis was performed using unpairedt-test and Fisher's exact probability test. RESULTS: The male-to-female ratio was 38 to 45 in both groups. A total of 10 (12 percent) and 23 (28 percent) patients in Group 1 and Group 2 had emesis (P=0.02), and the rate of nasogastric tube reinsertion was 5 (6 percent) and 13 (16 percent), respectively (P〉0.05). There were significant differences between Groups 1 and 2 relative to the lengths of ileus (3.5±1.3vs. 5.4±1.7 days, respectively;P〈0.001), hospitalization (6.6±3.3vs. 8.1±2.5 days, respectively;P〈0.002), and operative time (170±60vs. 114±46 minutes, respectively;P〈0.001). The morbidity rate was 16 (19.2 percent) and 18 (21.6 percent) in the laparoscopy and laparotomy groups, respectively. CONCLUSIONS: Although early oral intake is safe and can be tolerated by 84 percent of patients after colectomy by laparotomy, laparoscopic colectomy reduced the lengths of both postoperative ileus and hospitalization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237245
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Closedvs. open hemorrhoidectomy—Is there any difference? (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 31-34 
    Details
    ISSN: 1530-0358
    Keywords: Hemorrhoidectomy ; Postoperative pain ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to compare closed (Ferguson) hemorrhoidectomy to open (Milligan-Morgan) hemorrhoidectomy regarding postoperative conditions, complications, and long-term results. METHOD: This was a randomized study of 77 patients with second-degree or third-degree hemorrhoids suitable for hemorrhoidectomy. In 39 patients the Milligan-Morgan procedure was used, and in 38 patients the Ferguson procedure was used. Details of operations, postoperative complications, and length of postoperative stay were recorded. Pain was assessed from a visual analog scale and by registration of postoperative analgesic medication. Follow-up was done at three weeks, six weeks, and by visit or telephone interview after at least a year. RESULTS: No statistically significant differences were found between the two methods regarding complications, pain, or postoperative stay. There were four reoperations for bleeding, all after Milligan-Morgan operations. At follow-up after three weeks 86 percent of the Ferguson patients had completely healed wounds, and none had signs of infection. Of the Milligan-Morgan patients, only 18 percent had completely healed wounds, and symptoms of delayed wound healing were significantly more frequent. One patient had a superficial wound infection. After one year more than 10 percent in each group had recurrent hemorrhoids with symptoms. CONCLUSION: Both methods are fairly efficient treatment for hemorrhoids, without serious draw-backs. The closed method has no advantage in postoperative pain reduction, but wounds heal faster, and the risk of wound dehiscence seems exaggerated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237240
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Audit of single-stage proctocolectomy for Crohn's disease (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 249-256 
    Details
    ISSN: 1530-0358
    Keywords: Single-stage proctocolectomy ; Crohn's disease ; Complications ; Delayed perineal wound healing ; Stomal complications ; Long-term results ; Recurrence ; Risk factor for recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was undertaken to review our overall experience of single-stage proctocolectomy for Crohn's disease. METHODS: One hundred three patients who underwent single-stage proctocolectomy for Crohn's disease between 1958 and 1997 were reviewed. Factors affecting the incidence of recurrence were examined using a multivariate analysis. RESULTS: Principal indications for proctocolectomy were chronic colitis (49 percent), acute colitis (37 percent), and anorectal disease (14 percent). The commonest postoperative complication was delayed perineal wound healing (n=36; 35 percent), followed by intra-abdominal sepsis (17 percent) and stomal complications (15 percent). In 23 patients the perineal wound healed between three and six months after proctocolectomy, whereas in 13 patients the wound remained unhealed for more than six months. There were two hospital deaths (2 percent) caused by sepsis. The 5-year, 10-year, and 15-year cumulative reoperation rates for small-bowel recurrence were 13, 17, and 25 percent, respectively, after a median follow-up of 18.6 years. From a multivariate analysis, factors affecting reoperation rate for recurrence were gender (male; hazard ratio 2.4vs. female;P=0.03) and age at operation (≤30 years; hazard ratio 2.6vs. 〉30 years;P=0.04). The following factors did not affect the reoperation rate: duration of symptoms, smoking habits, associated perforating disease, coexisting small-bowel disease, postoperative complications, and medical treatment. CONCLUSIONS: Proctocolectomy for Crohn's disease is associated with a high incidence of complications, particularly delayed perineal wound healing. Proctocolectomy carries a low recurrence rate in the long term. However, young male patients are at high risk of recurrence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02236990
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Femoral neuropathy: An infrequently reported postoperative complication (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 419-422 
    Details
    ISSN: 1530-0358
    Keywords: Neuropathy ; Femoral nerve ; Colectomy ; Complications ; Retractors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Postoperative femoral neuropathy is an uncommon complication of abdominal surgery. We present four cases occurring after colectomy at our institution and discuss the diagnosis and treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02258312
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Safety and efficacy of dynamic graciloplasty for fecal incontinence (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 743-751 
    Details
    ISSN: 1530-0358
    Keywords: Fecal incontinence ; Dynamic graciloplasty ; Neurostimulation ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Dynamic graciloplasty has been used for intractable fecal incontinence, and good results have been reported. The aim of this study was to assess prospectively the safety and efficacy of dynamic graciloplasty for intractable fecal incontinence in a prospective, multicenter trial. METHODS: A total of 123 adults were treated with dynamic graciloplasty at 20 institutions. Continence was assessed preoperatively and postoperatively by use of 14-day diaries. RESULTS: There was one treatment-related death. One hundred eighty-nine adverse events occurred in 91 patients (74 percent). Forty-nine patients (40 percent) required one or more operations to treat complications. One hundred seventy (90 percent) events were resolved. Sixty-three percent of patients without pre-existing stomas recorded a 50 percent or greater decrease in incontinent events 12 months after dynamic graciloplasty, and an additional 11 percent experienced lesser degrees of improvement. Twenty-six percent were not improved, worsened, or exited. In patients with pre-existing stomas, 33 percent achieved successful outcomes at 12 months. This number increased to 60 percent at 18 months. Seventy-eight percent of patients had increased enema retention time, and mean anal canal pressures improved significantly at 12 months. Significant changes in quality of life were also observed. CONCLUSIONS: Objective improvement can be demonstrated in the majority of patients with end-stage fecal incontinence treated with dynamic graciloplasty. Reduction in incontinence episodes can be correlated with improved quality of life. Adverse events are frequently encountered, but most resolve with treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02238008
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    A Prospective Analysis of the Cephalic Vein Cutdown Approach for Chronic Indwelling Central Venous Access in 100 Consecutive Cancer Patients (2000)
    Springer
    Annals of surgical oncology 7 (2000), S. 496-502 
    Details
    ISSN: 1534-4681
    Keywords: Cephalic vein ; Subclavian vein ; Central venous access ; Implanted port ; Tunneled catheter ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Chronic indwelling central venous access devices (CICVAD) generally are placed by the percutaneous subclavian vein approach. The cephalic vein cutdown approach is used only infrequently. Although the technique has been well described, few prospective data are available on the cephalic vein cutdown approach. Methods: From September 9, 1998, to July 20, 1999, the cephalic vein cutdown approach was attempted in 100 consecutive cancer patients taken to the operating room with the intention of placing CICVAD. Median patient age was 54.5 years (range 18–88), with 46 men and 54 women. Twenty-five patients had gastrointestinal malignancies, 17 had breast cancer, 15 had lymphoma, 13 had lung cancer, 12 had leukemia, 5 had multiple myeloma, and 13 had other malignancies. Patients were followed prospectively for immediate and long-term outcome. Results: CICVAD placement via the cephalic vein cutdown approach was successful in 82 patients; the remaining 18 patients required conversion to a percutaneous subclavian vein approach. The reasons for inability to place CICVAD via cephalic vein cutdown approach were a cephalic vein that was too small (10 patients), an absent cephalic vein (7 patients), and inability to traverse the angle of insertion of the cephalic vein into the subclavian vein (1 patient). There were 56 subcutaneous ports and 26 tunneled catheters. Median operating time was 44 minutes (range, 26–79 minutes). No postoperative pneumothorax occurred. Median catheter duration was 198 days (range, 0–513 days). Long-term complications included catheter-related bacteremia (6%), site infection (2%), deep venous thrombosis (5%), port pocket hematoma (1%), and superior vena cava stricture (1%). Thirty-seven percent of patients have died since CICVAD placement. Twenty-nine percent of the CICVADs have been removed. Conclusions: The cephalic vein cutdown approach was successful in 82% of patients. This approach is a safe and useful alternative to the percutaneous subclavian vein approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-000-0496-9
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 7
    Electronic Resource
    Electronic Resource
    Use of a gracilis muscle flap to facilitate delayed ileal pouch-anal anastomosis (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 1628-1631 
    Details
    ISSN: 1530-0358
    Keywords: Gracilis muscle flap ; Ileal pouch-anal anastomosis ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Failure of an ileal pouch-anal anastomosis may result in unsuccessful completion of the anastomosis or removal of an ischemic pouch. We report a technique for preservation of the muscular wall of the rectum after mucosal dissection, which allowed a successful delayed pull-through.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02236752
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 8
    Electronic Resource
    Electronic Resource
    Effect of previous surgery on abdominal opening time (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 1749-1753 
    Details
    ISSN: 1530-0358
    Keywords: Adhesions ; Operative technique ; Complications ; Economics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The purpose of this study was to document prospectively the time required to gain access to the abdomen to perform a planned procedure in patients with and without previous surgery. METHODS: Patients were obtained from the consecutive cases of 11 surgeons at three colorectal surgery centers. Opening time (skin incision to retractor placement) was measured and recorded in the operating room by the circulating nurse or by an independent researcher. Demographic data including the number and type of previous operations and the presence and severity of adhesions were recorded by the staff surgeon. A comparison of opening times between patients with and without previous abdominal operations was conducted. RESULTS: One hundred ninety-eight patients had abdominal operations. Fifty-five percent had previous abdominal procedures. Patients with prior surgery required a mean of 21 minutes to open their abdomens, whereas patients without prior surgery required a mean of 6 minutes (P〈0.01). The median times were 17 and 6 minutes, respectively. Eighty-three percent of patients with prior surgery had adhesions, whereas only 7 percent of patients had adhesions on their initial operation. Patients with prior surgery also had higher grade adhesions (P〈0.001). Irrespective of previous surgery, comparing patients with adhesions with those without, patients with adhesions required a mean of 22 minutes to open, whereas the lack of adhesions resulted in a mean opening time of 6 minutes. CONCLUSIONS: Previous surgery and the presence of adhesions add significant time to opening the abdomen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02236862
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 9
    Electronic Resource
    Electronic Resource
    Lumbar osteomyelitis and epidural abscess complicating recurrent pilonidal cyst (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 1015-1017 
    Details
    ISSN: 1530-0358
    Keywords: Pilonidal cyst ; Lumbar osteomyelis ; Epidural abscess ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was conducted to report the rare presentation of lumbar osteomyelitis and epidural abscess as a complication of a pilonidal cyst. METHODS: A case report is presented. RESULTS: We describe the rare case of a male patient with diabetes with a recurring pilonidal cyst who developed a lumbar osteomyelitis and epidural abscess three weeks after pilonidal cyst excision with epidural anesthesia, with a fatal outcome despite emergency treatment. CONCLUSIONS: Life-threatening complications should be kept in mind in high-risk patients with repetitive surgery and neurologic involvement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237370
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 10
    Electronic Resource
    Electronic Resource
    Erfahrungen mit der Osteosynthese bei Fersenbeinfrakturen (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S442 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Intraartikuläre Fersenbeinfraktur ; Klassifikation ; Weichteilschaden ; Komplikationen ; Ergebnisse ; Keywords Intraarticular calcaneal fracture ; Classification ; Soft tissue lesions ; Complications ; Results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Even now, the diagnosis of a dislocated intraarticular calcaneal fracture means a handicap for many patients. A bilateral fracture usually means the end of professional life – especially in the case of any job involving physical work. Because the functional outcome after an intraarticular calcaneal fracture is determined by the degree to which restoration of the different articular surfaces, and of the height, length and width of the affected calcaneus is achieved, operative treatment has become much more frequent in recent years. Discussion continues on the operative treatment of high comminuted fractures. The available studies are not comparable, differing as they do in the classification systems and criteria of outcome used and the postoperative check-up schedules followed. Despite some progress towards standardization of the operative procedure in the last 10 years, especially with respect to soft tissue treatment and the types of implants used, several questions remain to be answered. Our own experience is reported.
    Notes: Zusammenfassung Die Diagnose einer intraartikulären dislozierten Fersenbeinfraktur bedeutet auch heute noch für viele Patienten eine Einschränkung der künftigen Belastbarkeit, bei beidseitiger Betroffenheit in der Regel das Ausscheiden aus einem körperlich belasteten Beruf. Da sich das funktionelle Ergebnis der Fersenbeinfraktur im Wesentlichen durch die Wiederherstellung der Gelenkflächen, Höhe, Länge und Breite sowie Achsen des Fersenbeins beeinflussen lässt, hat die operative Rekonstruktion in den letzten Jahren deutlich zugenommen. Die Diskussion über die operative Versorgung von Fersenbeinfrakturen ist insbesondere bei Trümmerfrakturen noch nicht als abgeschlossen zu betrachten. Die vorliegende Fülle von Studien ist bezüglich der Klassifikation, der Nachuntersuchungskriterien und der Nachuntersuchungszeiträume nur schwer zu vergleichen. Trotz einer seit nun mehr als über einem Jahrzehnt perfektionierten und zunehmend standardisierten Operationstechnik bleiben noch viele Fragen zu beantworten. Über Schwierigkeiten bei der operativen Versorgung wird berichtet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014967
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 11
    Electronic Resource
    Electronic Resource
    Aktuelle Behandlungsstrategien bei distalen Unterarmfrakturen (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S205 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Distale Unterarmfrakturen ; Konservative Therapie ; Operative Therapie ; Risiken ; Komplikationen ; Keywords Distal fractures of lower arm ; Conservative therapy ; Operative therapy ; Risks ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The treatment of distal fractures of the lower arm can be conservative or operative. The immediate aims of any treatment are anatomical realignment and the avoidance of trophic impairments, with the ultimate objective of unrestricted function of the hand and wrist. A graduated treatment scheme based on the ASIF classification is necessary to do justice to the different forms of fracture that can occur. The majority of injuries can still be successfully treated by conservative means; operative treatment becomes more important when there are signs of unusually high levels of instability or joint involvement. The authors’ own patient population is presented in this paper: in these patients fixation with Kirschner wires has proved to be the most successful of the operative procedures used, followed by palmar plate fixation with or without cancellous bone plasty, and for C-type fractures according to the ASIF classification or when there ¶is severe soft-tissue damage, application of ¶a fixateur externe spanning the joint has proved best. Treatment strategy, risks, complications and results are presented.
    Notes: Zusammenfassung Die Behandlung distaler Unterarmfrakturen kann konservativ oder operativ erfolgen. Ziel jeder Behandlung sind die anatomische Reposition und Retention sowie die Vermeidung trophischer Störungen mit dem Fernziel einer unbeeinträchtigten Funktion der Hand und des Handgelenks. In Anlehnung an die AO-Klassifikation ist ein stufenförmiges Behandlungsschema notwendig, um den verschiedenen Frakturformen gerecht zu werden. Ein Großteil der Verletzungen kann nach wie vor erfolgreich konservativ behandelt werden, bei Zeichen einer erhöhten Instabilität oder einer Gelenkbeteiligung rückt die operative Behandlung zunehmend in den Vordergrund. Im eigenen, dargestellten Krankengut hat sich bei den operativen Verfahren schwerpunktmäßig die Kirschner-Draht-Osteosynthese bewährt, nachfolgend die palmare Plattenosteosynthese mit oder ohne Spongiosaplastik und bei Frakturen der C-Typen nach AO und bei höhergradigem Weichteilschaden die gelenkübergreifende Fixateur-externe-Anordnung. Behandlungsstrategie, Risiken, Komplikationen und Ergebnisse werden dargestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014888
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 12
    Electronic Resource
    Electronic Resource
    Spezielle Probleme bei Wirbelfrakturen mit Querschnittlähmung (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S500 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Hoffnung ; Selbstständigkeit ; Komplikationen ; Gangschulung ; Keywords Hope ; Independence ; Complications ; Mobility training
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract In the treatment of paraplegic patients ¶there is a definite discrepancy between the ideas and wishes of the patients and the approaches and objectives of the physiotherapists. The greatest concern of the person affected is recovery of the ability to walk, while the main emphases of physiotherapy primarily involve avoiding complications of paralysis and achieving the highest possible degree of independence. One aid used in teaching partially paralysed patients to walk again is the walking belt, which complements the neurophysiological treatment methods very well. Mobility training with completely paralysed patients is obviously restricted owing to the lack of function. Sources of problems include relapsing shoulder pain and marked spasticity, which limit the results that can be achieved by way of rehabilitation medicine. With the support of an electronic measuring system the threat of pressure sores can be successfully combated.
    Notes: Zusammenfassung In der Behandlung Querschnittgelähmter besteht zwischen den Vorstellungen und Wünschen der Patienten und den Gesichtspunkten und Zielen der Physiotherapie eine deutliche Diskrepanz. Der Betroffene erhofft sich v. a. das Wiedererlangen seiner Gehfähigkeit, die Schwerpunkte der Physiotherapie liegen in erster Linie auf der Vermeidung lähmungsbedingter Komplikationen und dem Erreichen maximaler Selbstständigkeit. Gangschulung wird bei inkomplett Gelähmten u. a. mit Hilfe des Laufbands durchgeführt, das eine hervorragende Ergänzung der neurophysiologischen Behandlungstechniken darstellt. Das Gehtraining mit komplett Gelähmten reduziert sich naturgemäß aus Mangel an funktionellen Einsatzmöglichkeiten. Unter anderem können rezidivierende Schulterschmerzen und starke Spastik Probleme darstellen und sich limitierend auf das Rehabilitationsergebnis auswirken. Der Dekubitusgefahr wird, unterstützt durch ein elektronisches Messsystem, erfolgreich entgegengewirkt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014982
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 13
    Electronic Resource
    Electronic Resource
    Identification of High-Risk Breast Cancer Patients from Genetic Changes of Their Tumors (2000)
    Springer
    Surgery today 30 (2000), S. 516-522 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: genetic changes ; prognostic factor ; breast cancer ; amplification ; loss of heterozygosity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: ERBB2 , INT2, and MYC genes, in 131 patients with breast carcinoma, 49 of whom had lymph node involvement, but none of whom had distant metastases. Among the several chromosome arms tested, LOH at 17q was correlated with lymph node metastasis. Amplification of the ERBB2, MYC, and INT2 genes was found more frequently in tumors from patients with lymph node metastases than in tumors from those without lymph node metastases. Univariate analysis demonstrated that LOH at 17q and INT2 amplification were factors influencing disease-free survival (DFS). A multivariate analysis was performed on 89 tumors that were able to be evaluated for both LOH at 17q and INT2 amplification, and the results showed that patients who had tumors with these genetic changes were more likely to have a poor prognosis. The findings of this study suggest that investigating genetic changes, in addition to conventional clinicopathologic factors, may contribute to defining groups of breast cancer patients with differences in prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950070118
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 14
    Electronic Resource
    Electronic Resource
    Management intraoperativer Komplikationen bei der Applikation stentgestützter Aortenprothesen (2000)
    Springer
    Gefässchirurgie 5 (2000), S. 232-240 
    Details
    ISSN: 1434-3932
    Keywords: Schlüsselwörter Endovaskuläre Operationen ; Stents ; Aortenstentprothese ; Bauchaortenaneurysma ; Komplikationen ; Keywords Endovascular surgery ; Stents ; Aortic stent prostheses ; Aneurysm ; Abdominal aorta ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract  Intraoperative complications can be divided into three categories on the basis of the time of their occurrence: Group I – Problems associated with access; group II: introduction of the endovascular stent (a: release of the main segment, b: anchoring the second limb); and group III: incidence of primary endoleaks. The objective of the present study was to describe the management of these complications. In a group of 130 patients undergoing endovascular treatment of aneurysms of the abdominal aorta, a total of 31 complications occurred in 26 patients (20.0%). The most frequently encountered complication in each group and its respective management was as follows: Group I: Correction was performed using dilatation and retroperitoneal stretching as well as surgical shortening of the external iliac artery with interposition; group IIa: overstenting the renal arteries was corrected either by conversion or tugging at the endograft; group IIb: the guide wire or docking system could not be placed. Such cases were managed either through conversion or use of fresh systems; group III: such complications were treated with repeated stent placement, postoperative coil embolizations, or conversion. The endovascular therapy of aortic aneurysms is associated with intraoperative complications in 20% of cases. Adequate management helps to keep both morbidity and mortality rates low.
    Notes: Zusammenfassung  Intraoperative Komplikationen können je nach Zeitpunkt des Ereignisses in 3 Gruppen definiert werden: Gruppe I – Zugangsprobleme, Gruppe II – Einbringen des endovaskulären Stents (a: Absetzen des Hauptteils, b: Andocken des 2. Schenkels), Gruppe III – Inzidenz primärer Endoleaks. Zielsetzung dieser retrospektiven Studie war es, das Management zur Behebung dieser Komplikationen darzustellen. Von 130 Patienten mit endovaskulärer Ausschaltung eines Aortenaneurysmas traten bei 26 Patienten 31 intraoperative Komplikationen auf (20,0%). Die führenden Komplikationen in jeder Gruppe sowie das daraus resultierende Management waren: Gruppe I: Die Korrektur erfolgte durch Dilatation, retroperitoneale Streckung, Kürzungsoperation der A. iliaca externa und Interponat. Gruppe II a: Bei Überstentung der Nierenarterien erfolgte die Konversion oder Zug am Endograft. Gruppe II b: Führungsdraht oder Andocksystem können nicht platziert werden. Die Behebung erfolgte durch Konversion und Anwendung neuer Systeme. Gruppe III: Hier wurden erneute Stentplazierungen, postoperativer Coil-Embolisationen und Konversionen durchgeführt. Die endovaskuläre Therapie aortaler Aneurysmen birgt eine Rate intraoperativer Schwierigkeiten von 20%. In 3,8% der Fälle musste eine Konversion durchgeführt werden. Durch adäquates Management konnten die Letalität (1/26) und Morbidität jedoch gering gehalten werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010600
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 15
    Electronic Resource
    Electronic Resource
    Primary node negative breast cancer in BRCA1 mutation carriers has a poor outcome (2000)
    Springer
    Annals of oncology 11 (2000), S. 307-313 
    Details
    ISSN: 1569-8041
    Keywords: BRCA1 ; breast cancer ; p53 ; survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The association between BRCA1 germ-linemutations and breast cancer prognosis is controversial. A historical cohortstudy was designed to determine the prognosis for women with axillary lymphnode negative hereditary breast cancer. Patients and methods:We tested pathology blocks from 118Ashkenazi Jewish women with axillary lymph node negative breast cancer for thepresence of the two common BRCA1 founder mutations, 185delAG and5382insC. Patients were followed up for a median of 76 months. SomaticTP53mutations were screened for by immunohistochemistry, and directsequencing was performed in the BRCA1-positive tumours. Results:Sixteen breast cancer blocks (13.6%) carried aBRCA1 mutation. Young age of onset, high nuclear grade, negativeestrogen receptor status and over-expression of p53 were highly associatedwith BRCA1-positive status (P-values all 〈0.01).BRCA1 mutation carriers had a higher mortality than non-carriers(five-year overall survival, 50% and 89.6%, respectively,P = 0.0001). Young age of onset, estrogen receptor negative status,nuclear grade 3, and over-expression of p53 also predicted a poor outcome. Coxmultivariate analyses showed that only germ-line BRCA1 mutationstatus was an independent prognostic factor for overall survival (P= 0.01). Among nuclear grade 3 tumours, the BRCA1 mutation carrierstatus was a significant prognostic factor of death (risk ratio 5.8,95% confidence interval: 1.5–22, P = 0.009). Sequencingof BRCA1-related breast cancers revealed one TP53missensemutation not previously reported in breast cancer. Conclusions:Using a historical cohort approach, we haveidentified BRCA1 mutation status as an independent prognostic factorfor node negative breast cancer among the Ashkenazi Jewish women. Thosemanaging women carrying a BRCA1 mutation may need take these findingsinto consideration. Additionally, our preliminary results, taken together withthe work of others suggest a different carcinogenic pathway inBRCA1-related breast cancer, compared to non-hereditary cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008340723974
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 16
    Electronic Resource
    Electronic Resource
    The contribution of molecular markers to the prediction of response in the treatment of breast cancer: A review of the literature on HER-2, p53and BCL-2 (2000)
    Springer
    Annals of oncology 11 (2000), S. 647-663 
    Details
    ISSN: 1569-8041
    Keywords: BCL-2 ; breast cancer ; HER-2 ; p53 ; predictive factor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The selection of therapies for breast cancer is todaybased on prognostic features (chemotherapy, radiotherapy), hormone receptorstatus (hormonal therapy) and HER-2 status (trastuzumab therapy). HER-2,p53and BCL-2are tumour-related proteins that have thepotential to further improve individualisation of patient management, bypredicting response to chemotherapy, hormonal therapy and radiotherapy. Materials and methods:This paper reviews the rationale for theuse of these proteins as predictive factors, as well as the publishedliterature addressing the use of each one to predict response to hormonaltherapy, chemotherapy and radiotherapy. Results:HER-2, p53and BCL-2remaininadequately assessed as predictive factors in breast cancer. HER-2 evaluationis required for the selection of patients for trastuzumab (Herceptin®)therapy, as trials of this therapy have been limited to HER-2 overexpressors.HER-2 overexpression may be predictive of resistance to hormonal therapy.Anthracyclines are effective therapy for breast cancer regardless of HER-2status, but patients whose tumours overexpress HER-2 appear to receive thegreatest relative benefit from this therapy. Studies of HER-2 as a predictorof response to CMF and to radiotherapy are inconclusive at this time. No datayet exist to support the use of p53or BCL-2as predictivefactors in the therapy of breast cancer. Conclusions:At this point in time, there is inadequate evidenceto support the use of HER-2, p53or BCL-2to guide theselection of hormonal therapy, chemotherapy or radiotherapy for breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008390429428
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 17
    Electronic Resource
    Electronic Resource
    Activity and toxicity of GI147211 in breast, colorectal and non-small-cell lung cancer patients: An EORTC–ECSG phase II clinical study (2000)
    Springer
    Annals of oncology 11 (2000), S. 793-797 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; camptothecins ; colorectal cancer ; GI147211 ; non-small-cell lung cancer ; topoisomerase I
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:GI147211 is a water-soluble synthetic analogue ofcamptothecin showing promising in vivoand in vitroantitumor activity and an acceptable toxicity profile. Patients and methods:Between April 1995 and November 1996, 67eligible patients with pretreated breast cancer (25 patients) andchemo-naïve colorectal (19 patients) and non-small-cell lung cancer (23patients) were entered into three multicentric, non-randomized phase IItrials. Treatment schedule consisted of intravenous GI147211 administered ata dose of 1.2 mg/m2/day for five consecutive days every threeweeks. Results:Hematological toxicity was common with grade 3–4neutropenia in 54% of patients and neutropenic fever together or notassociated with infection in 14.5% of patients. Grade 3–4thrombocytopenia and grade 2–4 anemia were observed in 20% andin 68% of patients, respectively. Non-hematological toxicity wasgenerally mild to moderate and consisted mainly of gastrointestinal toxicity,asthenia and alopecia. A dose-escalation to 1.5 mg/m2/d wasfeasible in 17 (25%) patients. The antitumor activity of GI147211 wasmoderate in breast cancer patients (3 partial responses (PRs), response rate(RR) 13%) and minimal in non-small cell lung cancer patients (2 PRs,RR 9%). No objective responses were obtained in colorectal patients. Conclusions:GI147211, at the dose and schedule employed in thisstudy, showed an acceptable safety profile but a modest antitumor activity inthe examined tumor types.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008373031714
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 18
    Electronic Resource
    Electronic Resource
    An Analysis of Unicellular Mass Transfer Using a Microfabricated Experimental Technique (2000)
    Springer
    Biomedical microdevices 2 (2000), S. 305-316 
    Details
    ISSN: 1572-8781
    Keywords: membranes ; breast cancer ; oncology ; cell column regulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract Using microfabrication technology, we have developed a new experimental apparatus and technique which allow isolation of individual cells and which facilitate the study of kinetic volume changes and membrane permeability. The key component of the apparatus is a microdiffusion chamber which was constructed using silicon microfabrication technology and standard photolithography. The central unit of the chamber is a 1 μ m thick silicon nitride membrane with a center hole on the order of 2–3 μ m in diameter. The device is novel in its analysis of a single cell, instead of the traditional array of cells, and its avoidance of the damage artifacts and computational difficulties which are inherent in other, commonly used methods of cellular analysis. The device is used in conjunction with a predictive computer model which simulates the response of the entire membrane or a portion of the membrane to various permeant and impermeant concentrations. This study introduces the apparatus and the model, and illustrates the effectiveness of the new procedure by determining several membrane permeability coefficients for HBL-100 (healthy human breast line). The empirical data and theoretical data were combined to yield a water permability (L p) of 1.1 ± 0.5μ m/(min-atm) (mean ± 1 standard deviation) (N= 5) during the uncoupled transport of water at 22 ±C. In the presence of 6 M glycerol, the water permeability (L p), permeability coefficient (P S), and the reflection coefficient (σS) were determined to be 2.0 ± 0.63 μ m/(min-atm), 2.7E-5 ± 6.1E-6 cm-sec-1, and 0.76 ± 0.5 (N = 6). No previous values of these coefficients could be found for HBL-100 cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009959323022
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 19
    Electronic Resource
    Electronic Resource
    Comparative study of clinical, pathological and biological characteristics of symptomatic versus asymptomatic breast cancers (2000)
    Springer
    Annals of oncology 11 (2000), S. 581-586 
    Details
    ISSN: 1569-8041
    Keywords: biological/pathological characteristics ; breast cancer ; prognosis ; progression ; symptomatic/asymptomatic patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:It is well known that mammographic screening reducesbreast cancer mortality. One possible explanation for this effect is thatscreening makes it possible to detect smaller breast cancers with fewerinvolved nodes, but another hypothesis is that some screening-detected tumorsare in a pathologically and biologically different phase of evolution fromthose that are detected clinically. The aim of the present study was tocompare the biological, pathological and clinical characteristics ofsymptomatic vs. asymptomatic breast cancers. Patients and methods:The study considers a series of 1916consecutive patients who underwent surgery for stage I and II infiltratingbreast cancer at Verona hospitals after having undergone ultrasound andmammography (at least one of which was positive). They were divided into twogroups on the basis of why they decided to undergo the imaging examinations:group A refers to the 1247 patients with a palpable lump, and group B to the616 who were asymptomatic. Results:The patients in group A were older, and had larger tumorsand a higher percentage of positive nodes than those in group B; they also hadsignificantly higher grade tumors, higher Ki-67 levels, and a higherpercentage of ER and PgR negative and c-erbB-2 positive tumors (allof the P-values were significant). A logistic regression analysisadjusted for tumor diameter and age showed a reduction in the significance ofeach of the considered variables, but all of them remained significantlyassociated with the modality of diagnosis except ER, PgR andc-erbB-2. Conclusions:Our results suggest that asymptomatic tumors arebiologically different from their clinically presenting counterparts, thusconfirming the hypothesis that progression towards greater malignancy mayoccur during the natural history of breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008320317114
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 20
    Electronic Resource
    Electronic Resource
    Combined 4-hydroxy-ifosfamide and vinorelbine treatment in established and primary human breast cell cultures (2000)
    Springer
    Annals of oncology 11 (2000), S. 587-594 
    Details
    ISSN: 1569-8041
    Keywords: 4-OH-IF ; breast cancer ; drug combination ; human cell lines ; primary cultures ; VNB
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Vinorelbine and ifosfamide are active drugs againstbreast cancer, but the best treatment schedule has yet to be defined bypreclinical or clinical studies. The antitumor activity of4-hydroxy-ifosfamide (4-OH-IF), the active form of ifosfamide, and vinorelbine(VNB) and their interaction were investigated in two established breast cancercell lines (MCF-7 and BRC-230) and in 10 primary breast cancer cultures. Materials and methods:Cytotoxic activity was evaluated by ahighly efficient clonogenic assay (HECA). The median-effect principle wasapplied to evaluate synergistic and antagonistic interactions and thecorresponding combination index values were calculated. Cell cycleperturbations were analysed by flow cytometry. Results:In MCF-7 and BRC-230 cell lines the sequence VNB for 4hours followed by 4-OH-IF for 24 hours produced an antagonistic effect.Conversely, the inverse sequential scheme, 4-OH-IF → VNB providedsynergistic effects on both cell lines. The synergism was associated with astrong block in the G2-M phase. Synergistic activity of 4-OH-IF → VNBsequence was confirmed in 7 of 10 primary breast cancercultures. Conclusions:In conclusion, the sequence 4-OH-IF → VNBappeared to be the most effective scheme both in established cell lines andin primary breast cancer cultures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008340902093
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 21
    Electronic Resource
    Electronic Resource
    Delayed adjuvant tamoxifen: Ten-year results of a collaborative randomized controlled trial in early breast cancer (TAM-02 trial) (2000)
    Springer
    Annals of oncology 11 (2000), S. 515-519 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant treatment ; breast cancer ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aim:Immediate adjuvant tamoxifen reduces disease recurrence andimproves survival in patients with early breast cancer. However, is it toolate to administer tamoxifen to patients who have already undergone treatment,but were unable to benefit from this adjuvant therapy? The French NationalCancer Centers (FNCLCC) have investigated the efficacy of delayed tamoxifenadministration in a randomized controlled trial. Patients and methods:From September 1986 to October 1989, womenwith primary breast cancer, who had undergone surgery, radiotherapy, and/orreceived adjuvant chemotherapy but not hormone therapy more than two yearsearlier, were randomized to receive either 30 mg/day tamoxifen or notreatment. The 10-year disease-free and overall survival rates of the twogroups of patients and of various subgroups were determined according to theKaplan–Meyer method and compared by the log-rank test. Results:This intention-to-treat analysis comprised 250 women inthe tamoxifen group and 244 in the control group. Patient characteristics(age, T stage, number of positive nodes, receptor status, and interval sincetumor treatment) were comparable in both groups. Delayed adjuvant tamoxifensignificantly improved overall survival only in node-positive patients and inpatients with estrogen receptor-positive (ER+) or progesteronereceptor-positive (PR+) tumors. Disease-free survival, however, wassignificantly improved in the global population and in several patientsubgroups (node-positive, ER+, PR+). Patients in whom the interval betweenprimary treatment and delayed adjuvant tamoxifen was greater than five yearsalso had significantly improved disease-free survival. Conclusions:Overall and disease-free survival results indicatethat delayed adjuvant tamoxifen administration (30 mg/day) is justified inwomen with early breast cancer, even if this treatment is initiated two ormore years after primary treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008321415065
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 22
    Electronic Resource
    Electronic Resource
    Tumor lysis syndrome following hemi-body irradiation for metastatic breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 1349-1351 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; radiotherapy ; tumor lysis syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumor lysis syndrome (TLS) is a rare serious acute complication of cancertherapy, reported mainly following chemotherapy in patients with large tumorload and chemosensitive disease. These are mainly patients with non-Hodgkin'slymphoma, leukemia and rarely in solid tumors. It is less frequently describedafter radiotherapy for lymphoid and hematological malignancies. TLS followingradiotherapy for solid tumors is a very rare complication. In thisreport/review we describe a seventy-three-year-old male patient withprogressive metastatic carcinoma of the breast to the lungs, liver and bone.He was referred for radiotherapy because of generalized bony pains. Thepatient was planned for sequential hemi-body irradiation starting with themore symptomatic upper half body. After premedication, he was given 8.5 Gy tothe mid point at the maximum chest separation with anterior lung attenuatorlimiting uncorrected lung dose to 6.15 Gy. A further 3.5 Gy electron boost tothe fungating breast tumor was given to the 100%. Forty-eight hours after irradiation he developed hyperkalemia,hyperphosphatemia, hyperuricemia, hypocalcemia and renal failure. Theseclinical and biochemical changes are typical of tumor lysis syndrome (TLS).Despite hydration, and treating the hyperuricemia, the patient developed comaand died eight days after irradiation. The prophylaxis and management of TLS and in high-risk patients aredescribed to avoid this frequently fatal complication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008347226743
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 23
    Electronic Resource
    Electronic Resource
    ErbB2 status and the benefit from two or five years of adjuvant tamoxifen in postmenopausal early stage breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 1545-1550 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; erbB2 ; HER-2/neu ; tamoxifen ; therapy resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aim:We aimed to study the importance of erbB2 status in earlystage postmenopausal breast cancer for patients who participated in a trialof five vs. two years of adjuvant tamoxifen. Patients and methods:We analysed the erbB2 status of the tumoursfrom 577 patients participating in the trial, either by a DNA amplificationassay (n = 181) or by measurement of the protein level with flowcytometry (n = 396). Results:ErbB2 was overexpressed or gene amplified in 102 of thepatients (18%). Overall, erbB2-positive patients had a significantlylower recurrence-free probability than others, 62% at five years ascompared to 83%, and showed a significantly decreased breast cancersurvival rate (P = 0.0007). ErbB2 status was significantlyassociated with recurrence and death in Cox multivariate analysis, adjustingfor nodal status, tumour size and estrogen receptor status. The relative riskof recurrence (RR) for five vs. two years of tamoxifen was analysed inrelation to erbB2 status for patients still disease-free two years aftersurgery. Whereas erbB2-negative patients showed significant benefit fromprolonged treatment (RR = 0.62, 95% confidence interval (95%CI): 0.42–0.93), no benefit was evident for erbB2-positive patients (RR= 1.1, 95% CI: 0.41–3.2). When the same analysis was restrictedto ER-positive patients a similar difference in relative hazard was obtainedbut the difference was not strictly significant (P = 0.065). Conclusions:For early stage breast cancer patients treated withadjuvant tamoxifen, overexpression of erbB2 is an independent marker of poorprognosis. The results suggest that overexpression decreases the benefit fromprolonged tamoxifen treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008313310474
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 24
    Electronic Resource
    Electronic Resource
    Dose-finding study of oral idarubicin and cyclophosphamide in first-line treatment of elderly patients with metastatic breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 229-230 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; cyclophosphamide ; elderly ; idarubicin ; oral chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008384820279
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 25
    Electronic Resource
    Electronic Resource
    A feasibility study evaluating docetaxel-based sequential and combination regimens in the adjuvant therapy of node-positive breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 169-175 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant therapy ; breast cancer ; docetaxel ; feasibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background and purpose:Docetaxel is an active agent in thetreatment of metastatic breast cancer. We evaluated the feasibility ofdocetaxel-based sequential and combination regimens as adjuvant therapies forpatients with node-positive breast cancer. Patients and methods:Three consecutive groups of patients withnode-positive breast cancer or locally-advanced disease, aged ≤70 years,received one of the following regimens: a) sequential A → T → CMF:doxorubicin 75 mg/m2 q 3 weeks × 3, followed by docetaxel 100mg/m2 q 3 weeks × 3, followed by i.v. CMF days 1 + 8 q 4weeks × 3; b) sequential accelerated A → T → CMF: A and T wereadministered at the same doses q 2 weeks; c) combination therapy: doxorubicin50 mg/m2 + docetaxel 75 mg/m2 q 3 weeks × 4,followed by CMF × 4. When indicated, radiotherapy was administeredduring or after CMF, and tamoxifen started after the end of CMF. Results:Seventy-nine patients have been treated. Median age was48 years. A 30% rate of early treatment discontinuation was observedin patients receiving the sequential accelerated therapy (23% duringA → T), due principally to severe skin toxicity. Median relativedose-intensity was 100% in the three treatment arms. The incidence ofG3–G4 major toxicities by treated patients, was as follows: skintoxicity a: 5%; b: 27%; c: 0%; stomatitis a: 20%;b: 20%; c: 3%. The incidence of neutropenic fever was a:30%; b: 13%; c: 48%. After a median follow-up of 18months, no late toxicity has been reported. Conclusions:The accelerated sequential A → T → CMFtreatment is not feasible due to an excess of skin toxicity. The sequentialnon accelerated and the combination regimens are feasible and under evaluationin a phase III trial of adjuvant therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008345432342
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 26
    Electronic Resource
    Electronic Resource
    Risiken bei Sectio caesarea und vaginaler Geburt (2000)
    Springer
    Der Gynäkologe 33 (2000), S. 872-881 
    Details
    ISSN: 1433-0393
    Keywords: Schlüsselwörter Sectio caesarea ; Notsectio ; Geburt ; Schwangerschaft ; Müttersterblichkeit ; Letalität ; Morbidität ; Komplikationen ; Keywords Cesarean section ; Emergency cesarean ; Birth ; Pregnancy ; Maternal mortality ; Lethality ; Morbidity ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The rate of cesarean section now exceeds 20% and continues to increase. This effect is enhanced by the almost negligible surgery-dependent risks. Maternal mortality in Central Europe has evidenced a sharp decline to approximately 10–20 deaths per 100,000 live births. Cesarean mortality due solely to surgical and/or anesthesiological intervention has also decreased considerably in the past 20 years. Nevertheless, vaginal birth entails a lower risk per se for the mother. Thus, the letality rate for vaginal birth is lower by a factor of 5–10 excluding pregnancy-dependent risks. Primary cesarean section exhibits a 1.7-fold lower risk of letality in comparison to secondary cesarean section. The main causes of death continue to be hemorrhages and thromboembolism. The mortality rate due to cesarean section continues to remain higher than that for vaginal birth. The rate of severe blood loss is significantly higher. The risk of deep vein thrombosis is about ten times greater than for vaginal birth with concomitantly increased risk for a pulmonary embolism as well as post-thrombotic syndrome. Perioperative prophylactic treatment with antibiotics was able to reduce the morbidity rate due to infection by more than 50%, but endometritis and wound infection continues to occur 10–15 times more frequently than during vaginal birth. In summary, maternal risk during pregnancy and birth – be it vaginal or cesarean – has been further reduced considerably. Nevertheless, cesarean section constitutes a surgical intervention entailing significantly higher rates of morbidity and mortality in comparison to vaginal birth.
    Notes: Zusammenfassung Die Sectiorate hat die 20%-Grenze überschritten und steigt unvermindert an. Begünstigt wird dieser Effekt durch die schon fast vernachlässigbaren operationsbedingten Risiken; die maternale Mortalität verzeichnet in Mitteleuropa einen starken Rückgang auf ca. 10–20 Todesfälle bezogen auf 100.000 Lebendgeburten. Auch die reine operations- bzw. anästhesiebedingte Sectioletalität hat sich in den letzten 20 Jahren deutlich vermindert. Nichtsdestotrotz geht die vaginale Geburt mit einem für die Mutter per se niedrigeren Risiko einher. So liegt die Letalität bei vaginaler Geburt um den Faktor 5–10 niedriger bei Ausschluss gestationsbedingter Risiken. Die primäre Sectio weist gegenüber der sekundären Sectio ein 1,7fach vermindertes Letalitätsrisiko auf. Haupttodesursachen sind weiterhin die Hämorrhagie und Thrombembolien. Aber auch die sectiobedingte Morbidität liegt weiterhin über der einer vaginalen Geburt. Die Rate an stärkeren Blutverlusten ist signifikant höher. Das Risiko einer tiefen Venenthrombose liegt rund 10fach über dem einer vaginalen Geburt mit ebenfalls erhöhtem Risiko für eine Lungenembolie sowie einem postthrombotischen Syndrom. Zwar konnte durch die perioperative Antibiotikaprophylaxe die Infektmorbidität um mehr als 50% gesenkt werden, doch ist die Endometritis und die Wundinfektion nach Sectio noch rund 10- bis 15-mal häufiger als bei vaginaler Geburt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001290050656
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 27
    Electronic Resource
    Electronic Resource
    Doppelbilder durch Doppel-IOL (2000)
    Springer
    Der Ophthalmologe 97 (2000), S. 781-783 
    Details
    ISSN: 1433-0423
    Keywords: Schlüsselwörter Katarakt-Chirurgie ; Komplikationen ; IOL-Luxation ; Doppel IOL ; Doppelbilder ; Keywords Cataract surgery ; Complications ; Intraocular lens dislocation ; Double intraocular lens implant ; Double vision
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract An 80-year-old man had intraoperative loss of an intraocular lens (IOL) in the vitreous and simultaneous implantation of an anterior chamber lens. For the first 3 years his course was uncomplicated, but after this time he noted monocular double vision. The IOL in the vitreous had moved into the optic axis of the eye. The case presented here underlines the possibility of complications occurring even years after surgery due to an IOL left behind in the vitreous. The double IOL implant technique should be reserved for very few selected indications.
    Notes: Zusammenfassung Bei einem 80-jährigen Patienten war nach intraoperativer Luxation einer intraokularen Linse (IOL) in den Glaskörper (GK) eine zweite IOL in die Vorderkammer implantiert worden. Nach zunächst komplikationslosem Verlauf, bemerkte der Patient 3 Jahre später monokulare Doppelbilder, offensichtlich durch eine Mobilisierung der IOL im GK in die optische Achse. Der beschriebene Fall zeigt, dass Komplikationen einer in den GK luxierten IOL auch nach längerer Zeit noch auftreten können. Die Doppelimplantationstechnik sollte ganz wenigen Ausnahmefällen vorbehalten werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003470070028
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 28
    Electronic Resource
    Electronic Resource
    Bilaterale simultane LASIK Pro und Kontra (2000)
    Springer
    Der Ophthalmologe 97 (2000), S. 881-884 
    Details
    ISSN: 1433-0423
    Keywords: Schlüsselwörter LASIK ; einzeitige und zweizeitige Operation ; Kostenaspekt ; Komplikationen ; Keywords LASIK ; Simultaneous and sequential operation ; Cost effectiveness ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Until recently simultaneous bilateral laser in situ keratomileusis (LASIK) was regarded as contraindicated in Germany. However, the procedure was sporadically performed, because it offers patient comfort and is more cost effective than sequential LASIK. Even though the complication rate is below the calculated rate of 0.01%, bilateral complications may have catastrophic effects on the patient. In addition, there is the theoretical disadvantage that the results from the first eye cannot be used for the second eye. However, this effect has yet to be clinically proven.
    Notes: Zusammenfassung Seit September 2000 wird in Deutschland die bilaterale simultane Laser-in-situ-Keratomileusis (LASIK) nicht mehr als ungerechtfertigt angesehen. Bereits zuvor wurde sie vereinzelt durchgeführt, da sie dem Patienten einen höheren Komfort bietet und kostengünstiger ist als ein zweizeitiges Vorgehen. Auch wenn die Komplikationsrate sehr gering ist und sicherlich unter der rechnerischen Komplikationsrate von 0,01% liegt, können beidseitige Komplikationen katastrophale Auswirkungen für den Patienten haben. Zudem besteht der theoretische Nachteil der schlechteren Vorhersagbarkeit für das zweitbehandelte Auge. Dieser Effekt konnte bisher klinisch nicht nachgewiesen werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003470070014
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 29
    Electronic Resource
    Electronic Resource
    Operative Behandlung von Verletzungen des thorakolumbalen Übergangs Teil 2: Operation und röntgenologische Befunde (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 1032-1047 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Arbeitsgemeinschaft “Wirbelsäule” der DGU ; Prospektive multizentrische Studie ; Thorakolumbale Wirbelsäule ; Wirbelsäulenverletzung ; Operative Behandlung ; Operative Zugänge zur Wirbelsäule ; Dorsale Stabilisierung ; Kombinierte Stabilisierung ; Ventrale Stabilisierung ; Fusionsoperation ; Fixateur interne ; Spinalkanaldekompression ; Komplikationen ; Schraubenfehllagen ; Grund-Deckplatten-Winkel ; Segmentale Kyphose ; Körperwinkel ; Sagittaler Index ; CT der Wirbelsäule ; Keywords Working group “spine” of the German Trauma Society, prospective multicenter study ; Thoracolumbar spine ; Fractures and dislocations of the spine ; Injuries of the spine ; Operative treatment ; Posterior surgery ; Combined surgery ; Anterior surgery ; Spinal fusion ; Internal fixator ; Decompression of the spinal canal ; Complications ; Misplaced pedicle screws ; Segmental kyphosis angle ; Wedge angle ; Sagittal index ; Computertomography of the spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The authors report on a prospective multicenter study with regard to the operative treatment of acute fractures and dislocations of the thoracolumbar spine (T10–L2). The study should analyze the operative methods currently used and determine the results in a large representative collective. This investigation was realized by the working group “spine” of the German Trauma Society. Between September 1994 and December 1996, 682 patients treated in 18 different traumatology centers in Germany and Austria were included. Part 2 describes the details of the operative methods and measured data in standard radiographs and CT scans of the spine. Of the patients, 448 (65.7%) were treated with posterior, 197 (28.9%) with combined posterior-anterior, and 37 (5.4%) with anterior surgery alone. In 72% of the posterior operations, the instrumentation was combined with transpedicular bone grafting. The combined procedures were performed as one-stage operations in 38.1%. A significantly longer average operative time (4:14 h) was noted in combined cases compared to the posterior (P〈0.001) or anterior (P〈0.05) procedures. The average blood loss was comparable in both posterior and anterior groups. During combined surgery the blood loss was significantly higher (P〈0.001; P〈0.05). The longest intraoperative fluoroscopy time (average 4:08 min) was noticed in posterior surgery with a significant difference compared to the anterior group. In almost every case a “Fixateur interne” (eight different types of internal fixators) was used for posterior stabilization. For anterior instrumentation, fixed angle implants (plate or rod systems) were mainly preferred (n=22) compared to non-fixed angle plate systems (n=12). A decompression of the spinal canal (indirect by reduction or direct by surgical means) was performed in 70.8% of the neurologically intact patients (Frankel/ASIA E) and in 82.6% of those with neurologic deficit (Frankel/ASIA grade A–D). An intraoperative myelography was added in 22% of all patients. The authors found a significant correlation between the amount of canal compromise in preoperative CT scans and the neurologic deficit in Frankel/ASIA grades. The wedge angle and sagittal index measured on lateral radiographs improved from −17.0° and 0.63 (preoperative) to −6.3° and 0.86 (postoperative). A significantly (P〈0.01) stronger deformity was noted preoperatively in the combined group compared to the posterior one. The segmental kyphosis angle improved by 11.3° (8.8° with inclusion of the two adjacent intervertebral disc spaces). A significantly better operative correction of the kyphotic deformity was found in the combined group. In 101 (14.8%) patients, intra- or postoperative complications were noticed, 41 (6.0%) required reoperation. There was no significant difference between the three treatment groups. Of the 2264 pedicle screws, 139 (6.1%) were found to be misplaced. This number included all screws, which were judged to be not placed in an optimal direction or location. In seven (1.0%) patients the false placement of screws was judged as a complication, four (0.6%) of them required revision. The multicenter study determines the actual incidence of thoracolumbar fractures and dislocations with associated injuries and describes the current standard of operative treatment. The efforts and prospects of different surgical methods could be demonstrated considering certain related risks. The follow-up of the population is still in progress and the late results remain for future publication.
    Notes: Zusammenfassung Die Autoren berichten über eine prospektive multizentrische Studie zur operativen Behandlung frischer Verletzungen des thorakolumbalen Übergangs (Th10 bis L2). Die Studie soll die derzeitigen Behandlungsmethoden und ihre Ergebnisse an einem großen Kollektiv repräsentativ analysieren und wird von der Arbeitsgemeinschaft “Wirbelsäule” der Deutschen Gesellschaft für Unfallchirurgie (DGU) erarbeitet. An 18 unfallchirurgischen Kliniken in Deutschland und Österreich wurden von September 1994 bis Dezember 1996 insgesamt 682 Patienten prospektiv erfasst. Die Nachuntersuchung der Patienten ist z. Z. noch nicht abgeschlossen. Im Teil 1 (Epidemiologie) wurden Studiendesign und epidemiologische Daten des Kollektivs dargestellt. Der vorliegende Teil 2 schildert die Details der Operationen sowie Messdaten der konventionellen Röntgenuntersuchungen und Computertomographien (CT); 448 (65,7%) Patienten wurden von dorsal, 197 (28,9%) kombiniert dorsoventral und 37 (5,4%) isoliert von ventral operiert; 72% der 448 von dorsal stabilisierten Patienten erhielten eine transpedikuläre Spongiosaplastik. Die kombinierten dorsoventralen Eingriffe wurden bei 75 (38,1%) Verletzten einzeitig und bei 122 (61,9%) zweizeitig durchgeführt. Die durchschnittliche Operationszeit war bei kombiniertem Eingriff mit 4:14 h signifikant länger als bei dorsalem (p〈0,001) oder ventralem (p〈0,05). Der durchschnittliche Blutverlust war bei dorsalem und ventralen Vorgehen vergleichbar hoch und signifikant geringer als bei kombinierter Operation (p〈0,001 bzw 〈0,05). Die intraoperative Durchleuchtungszeit war mit 4:08 min bei dorsaler Behandlung am längsten und signifikant (p〈0,005) länger als bei ventraler. Als dorsales Implantat wurde fast ausnahmslos ein Fixateur interne verwendet (8 verschiedene Modelle). Bei den ventralen Eingriffen kamen überwiegend winkelstabile Platten- oder Stabsysteme (n=22) und seltener winkelinstabile Platten (n=12) zum Einsatz. Der Spinalkanal wurde bei 82,6% der Patienten mit neurologischem Defizit und bei 70,8% derjenigen ohne Ausfallserscheinungen direkt mit Eröffnung des Spinalkanals oder indirekt mit Hilfe des Instrumentariums dekomprimiert. Eine intraoperative Myelographie wurde bei 22% der Patienten für notwendig gehalten. Wir fanden eine statistisch signifikante Korrelation zwischen dem Ausmaß der neurologischen Beeinträchtigung und der Einengung des Spinalkanals im präoperativen CT. Der im seitlichen Röntgenbild ermittelte Körperwinkel des betroffenen Wirbels und der sagittale Index betrugen im Gesamtkollektiv präoperativ im Mittel −17,0° und 0,63; postoperativ lagen die Werte bei −6,3° und 0,86. Eine signifikant (p〈0,01) stärkere Verformung des Wirbelkörpers bestand präoperativ in der kombinierten gegenüber der dorsalen Gruppe. Der segmentale Kyphosewinkel GDW 1 wurde von prä- zu postoperativ durchschnittlich um 11,3° und der GDW 2 um 8,8° lordosiert. Die signifikant (p〈0,005) größte Korrektur wurde bei den kombiniert Behandelten erzielt. Bei insgesamt 101 (14,8%) Patienten wurden intra- oder postoperative Komplikationen beobachtet, davon 41 (6,0%) revisionspflichtige. Die 3 Behandlungsgruppen wiesen unterschiedliche Komplikationsraten auf, der Unterschied war jedoch nicht signifikant (χ2-Test). Die Rate von Fehllagen transpedikulärer Schrauben betrug 139 von 2264 (6,1%) Schrauben; jede nicht optimal plazierte Schraube wurde dabei als Fehllage dokumentiert. Bei 7 (1,0%) Patienten wurde eine Schraubenfehllage als Komplikation gewertet und 4 (0,6%) von diesen wurden deswegen revidiert. Die Sammelstudie ermöglicht eine aktuelle Standortbestimmung für Verletzungshäufigkeiten und -muster sowie die verschiedenen, heute angewendeten Operationsmethoden. Mit der multizentrischen Studie konnten erstmals der operative Aufwand sowie Möglichkeiten und Risiken der verschiedenen Behandlungsformen dargestellt werden. Weiterführende Ergebnisse sind von den noch andauernden klinischen und radiologischen Nachuntersuchungen zu erwarten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050667
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 30
    Electronic Resource
    Electronic Resource
    Zur Implantatpositionierung bei der Epiphysiolysis capitis femoris Folgen des schlechten Verlaufs und Konsequenzen (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 820-825 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Implantatpositionierung ; Epiphysiolysis capitis femoris ; Komplikationen ; Behandlungskonsequenzen ; Keywords Implant position ; Slipped capital femoral epiphysis ; Complications ; Consequences of treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Which consequences can be ascribed to the intraarticular position of devices in the operative treatment of a slipped capital femoral epiphysis? Which steps are to define as a standard of a careful procedure? The clinical and radiological results of five cases of a pin or nail penetration after the operative treatment of a slipped capital femoral epiphysis are described, a possible connection of causalities is investigated. The intraarticular position of devices in most cases goes along with an unfortunate clinical outcome and leads to a higher risk of developing chondrolysis. Because of the radiologic overprojection with the femoral head it is possible to oversee the malposition of the pin. Any operative treatment of a slipped capital femoral epiphysis requires a careful intraoperative X-ray examination combined with documentation. With this procedure the bad results of an intraarticular implant position must be ascribed to the reminding risk of a fateful development.
    Notes: Zusammenfassung Welche Folgen bei der operativen Behandlung der Epiphysioslysis capitis femoris sind einer intraartikulären Implantatlage zuzurechnen, und welche Maßnahmen sind als Sorgfaltsmaßstab zu definieren? Anhand von 5 Fällen mit intraartikulärer Implantatlage nach der operativen Behandlung einer Epiphysiolysis capitis femoris werden die klinischen und radiologischen Folgen aufgezeigt und ein möglicher Kausalzusammenhang anhand der Literatur untersucht. Die intraartikuläre Implantatlage geht meistens mit einem ungünstigen klinischen Ergebnis einher und führt zu einer erheblichen Risikoerhöhung für das Auftreten einer Chondrolyse. Durch Überlagerung mit dem Femurkopf kann sich die Fehlposition des Implantates der radiologischen Diagnostik entziehen. Jede operative Behandlung der Epiphysiolysis capitis femoris erfordert eine sorgfältige intraoperative Durchleuchtungskontrolle, eine entsprechende Dokumentation ist zu empfehlen. Bei einem solchen Vorgehen sind die Folgen einer intraartikulären Position des Implantats als Restrisiko dem schicksalshaften Verlauf zuzurechnen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050627
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 31
    Electronic Resource
    Electronic Resource
    Behandlungsergebnisse nach primärer und sekundärer Radiusköpfchenresektion (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 437-443 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Radiusköpfchenfraktur ; Primäre Resektion ; Osteosynthese ; Sekundäre Resektion ; Komplikationen ; Keywords Radial head fracture ; Primary resection ; Osteosynthesis ; Secondary resection ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Apart from comminuted fractures of the radial head the indication for resection of the radial head is discussed controversially. To evaluate our own results, the hospital notes of 113 patients treated between 1.1.1984–31.12.1994 in our clinic by posttraumatic primary or secondary radial head resection were examined retrospectively. 79 patients were controlled by clinical and radiological examination with an average follow-up of 37,8 months. We examined at 46 patients the influence of additional lesions of the elbow joint on the functional outcome. In 33 patients follow up was done with special regard to the time of resection. Poor results due to the score from Radin and Riseborough especially followed secondary radial head resection (〉14 days after trauma) and in case of additional elbow lesions. We could not observe problems of the wrist joint after radial head resection as described by other authors. According to our own experience primary resection is recommended in case of doubtful reconstruction of the radial head. In these fracture types radial head resection should not be seen as an alternative treatment because of the worse results following secondary resection.
    Notes: Zusammenfassung Abgesehen von Trümmerfrakturen wird die Indikationsstellung zur Radiusköpfchenresektion kontrovers diskutiert. Zur Evaluation eigener Ergebnisse führten wir eine retrospektive Untersuchung der 113 Patienten durch, die von 1.1.1984–31.12.1994 mittels primärer oder sekundärer posttraumatischer Radiusköpfchenresektion behandelt wurden. Nach einem durchschnittlichen postoperativen Intervall von 37,8 Monaten konnten insgesamt 79 Patienten klinisch und radiologisch nachuntersucht werden. Bei 46 Patienten wurde die Auswirkung der Begleitverletzungen auf das Endergebnis untersucht. Bei 33 Patienten erfolgte die Nachuntersuchung unter besonderer Berücksichtigung des Resektionszeitpunktes. Schlechte Behandlungsergebnisse nach den Kriterien des Scores von Radin und Riseborough resultierten besonders häufig nach sekundärer Radiusköpfchenresektion (〉 14 Tage nach Trauma) und bei Begleitverletzungen des Ellenbogengelenks. Die Berichte anderer Autoren über negative Langzeitfolgen auf das Handgelenk können wir nicht bestätigen. Nach unseren Erfahrungen sollte daher bei zweifelhaften Rekonstruktionsversuchen die primäre Radiusköpfchenresektion bevorzugt werden, die aufgrund der eindeutig schlechteren Resultate nach sekundärer Resektion nicht als Option für mißlungene Erhaltungsversuche des Radiusköpfchens betrachtet werden darf.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050563
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 32
    Electronic Resource
    Electronic Resource
    Perforation eines mucocelenartig transformierten Hartmannstumpfs (2000)
    Springer
    Der Chirurg 71 (2000), S. 572-574 
    Details
    ISSN: 1433-0385
    Keywords: Keywords: Mucocele ; Ileostomy ; Complications ; Hartmann procedure. ; Schlüsselwörter: Mucocele ; Ileostoma ; Komplikationen ; Hartmannstumpf.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Wir berichten über eine 53 jährige Patientin, bei der 22 Jahre nach Anlage eines Ileostomas wegen eines Morbus Crohn eine Stenose im distalen Colonsegment (Hartmannstumpf) zu einer mucocelenartigen Transformation und nachfolgenden Ruptur geführt hat. Über die Ruptur eines stillgelegten Colonabschnitts nach Anlage eines Ileostomas wurde bisher offenbar noch nicht berichtet.
    Notes: Abstract. We report an unusual complication in a 53-year-old woman following ileostomy for Crohn's disease 22 years previously. A stenosis of the distal colonic segment was the reason for the formation and subsequent rupture of a huge colonic mucocele. To our knowledge, this is the first report of a ruptured mucocele of colonic origin after ileostomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050859
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 33
    Electronic Resource
    Electronic Resource
    Patient reports of complications of bone marrow transplantation (2000)
    Springer
    Supportive care in cancer 8 (2000), S. 33-39 
    Details
    ISSN: 1433-7339
    Keywords: Key words Marrow transplantation ; Complications ; Oral mucositis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In recent years, significant improvements have been made in the management of neutropenia and thrombocytopenia and other potentially life-threatening complications of ablative chemotherapy. While these complications are of particular concern to physicians, patients receiving ablative therapy for bone marrow or blood stem cell transplants are often troubled by other side effects such as nausea, vomiting, diarrhea and mouth sores. The purpose of the study was to gain a better understanding of patients' experiences while undergoing a transplant. The same professional medical interviewer conducted in-depth interviews with 38 subjects (10 men, 28 women; mean age 46.9 years) who had received ablative therapy for bone marrow and/or peripheral blood stem cell transplants. Participants were consecutively identified through physician and patient referrals, cancer and BMT patient support groups, and newspaper advertisements. Twenty-eight patients (74%) received autologous stem cell transplants and 10 patients (26%) received allogeneic transplants. Participants reported mouth sores, nausea and vomiting, diarrhea, and fatigue as the most troubling side effects of their transplants. Mouth sores were selected as the single most debilitating side effect (42%), followed by nausea and vomiting (13%). Many patients mentioned that mouth sores made it difficult or impossible to eat (n=23), swallow (n=21), drink (n=17), and/or talk (n=8). Twenty patients reported pain in the mouth, throat, and/or esophagus. Two-thirds (66%) of patients reported receiving opioid analgesics, most frequently morphine, to relieve oral pain. For many, opioids caused incapacitating side effects, including hallucinations, a feeling of loss of control and a decrease in mental acuity. Patients receiving ablative chemotherapy identify oral mucositis as a significant cause of suffering and morbidity. Effective interventions to alleviate this complication are urgently needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005209900095
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 34
    Electronic Resource
    Electronic Resource
    Heilungsverlauf und Komplikationen nach Augenmuskeloperationen (2000)
    Springer
    Der Ophthalmologe 97 (2000), S. 22-26 
    Details
    ISSN: 1433-0423
    Keywords: Schlüsselwörter Augenmuskeloperation ; Komplikationen ; Heilungsverlauf ; Key words Eye muscle surgery ; Complications ; Healing process
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Background: Varying reports on the incidence of operative and postoperative complications following eye muscle surgery have been published. The purpose of this study was to quantify complications after various types of eye muscle surgery as well as minor pathological changes of the anterior and posterior segment. Patients and methods: This prospective study included all patients who underwent eye muscle surgery at the Department of Strabismology and Neuroophthalmology, Giessen, from January to May 1998. Five hundred eyes of 377 patients aged 2–82 years were included. The spectrum of procedures comprised: recessions, resections, tucks, R&R procedures, transpositions, bimedial retroequatorial myopexies, and revisions of rectus and oblique muscles. All patients were examined 1 day preoperatively and 1 day, 1 week, and 3 months postoperatively. Any complications and even minor pathological changes of the anterior and posterior segment were documented. Some changes were assessed by means of a score (0–3). Results: One day postoperatively, 30% of eyes had inflammatory pseudoptosis, most of them mild. Conjunctival swelling and injection were frequently mild and moderate, after 1 week mostly mild. Conjunctival irritation was more pronounced following resection than tucking. Punctate epithelial keratopathy was noted in 1.6% of cases (first postoperative day), dellen in 4.3% (first postoperative week). Three months postoperatively, 14.3% of eyes had biomicroscopically visible conjunctival folds and 91.3% had minimal conjunctival scars. None of the patients had a scleral perforation or other serious complication. Conclusions: Eye muscle surgery rarely entails complications. Revisions due to organic pathological changes are extremely rare. Possible development of dellen requires check-up 4–7 days postoperatively. Tucking of rectus muscles causes less conjunctival irritation than resection.
    Notes: Hintergrund: Zur Inzidenz operativer und postoperativer Komplikationen bei Augenmuskeloperationen liegen unterschiedliche Mitteilungen vor. Ziel der vorliegenden Studie war es, sowohl Komplikationen als auch geringfügige pathologische Veränderungen des vorderen und hinteren Augenabschnittes nach unterschiedlichen Augenmuskeloperationen zu quantifizieren. Patienten und Methode: Es wurden prospektiv alle Patienten erfaßt, bei denen im Zeitraum Januar bis Mai 1998 an der Augenklinik für Schielbehandlung und Neuroophthalmologie Gießen eine Augenmuskeloperation durchgeführt wurde. In die Studie konnten 500 Augen von 377 Patienten im Alter von 2 bis 82 Jahren einbezogen werden. Das Spektrum der durchgeführten Eingriffe umfaßte Rücklagerungen, Resektionen, Faltungen, kombinierte Operationen, Transpositionen, Fadenoperationen und Revisionsoperationen an allen geraden und schrägen Augenmuskeln. Die Patienten wurden am Tag vor der Operation und postoperativ am ersten Tag, nach einer Woche und nach drei Monaten untersucht. Alle Komplikationen des vorderen und hinteren Augenabschnittes wurden dokumentiert und quantitativ erfaßt, teilweise erfolgte eine Gradeinteilung (0–3). Ergebnisse: Am ersten postoperativen Tag war bei 30% der Augen eine zumeist diskrete Lidschwellung auffällig. Die Bindehautschwellung und -injektion waren meist gering bis mäßig, nach einer Woche häufig nur noch gering. Der Reizzustand der Bindehaut war geringer nach Faltung als nach Resektion eines horizontalen M. rectus. Bei den Hornhautveränderungen dominierte am ersten postoperativen Tag eine Epitheliopathie (1,6%), nach 1 Woche standen diskrete Fuchs'sche Dellen (4,3%) im Vordergrund, die unter lokaler Therapie abheilten. Mikroskopisch erkennbare Bindehautfalten wurden überwiegend zur 3-Monats-Kontrolle (14,3%) dokumentiert, ebenso Bindehautnarben (91,3%), die i.d.R. sehr gering waren. Perforationen oder schwerwiegende Komplikationen kamen nicht vor. Schlußfolgerungen: Eine Augenmuskeloperation ist ein komplikationsarmer Eingriff, der nur selten einen erneuten Eingriff wegen organischer pathologischer Veränderungen erfordert. Zur Erkennung von Fuchs'schen Dellen ist eine Kontrolluntersuchung 4–7 Tage postoperativ wichtig. Faltung eines horizontalen M. rectus führt zu weniger Bindehautreiz als Resektion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003470050005
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 35
    Electronic Resource
    Electronic Resource
    Okuläres vernarbendes Pemphigoid Retrospektive Analyse von Risikofaktoren und Komplikationen (2000)
    Springer
    Der Ophthalmologe 97 (2000), S. 113-120 
    Details
    ISSN: 1433-0423
    Keywords: Schlüsselwörter Okuläres vernarbendes Pemphigoid ; Therapie ; Komplikationen ; Glaukom ; Key words Ocular cicatricial pemphigoid ; Therapy ; Complications ; Glaucoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Cicatricial pemphigoid (CP) is a rare autoimmune disease characterized by subepidermal blistering and progressive cicatrization affecting the skin and mucosa. Ocular involvement occurs in approximately 70% of the patients. Methods: The course of the disease, complications and putative risk factors in patients with ocular cicatricial pemphigoid (OCP) treated at the Departments of Ophthalmology and Dermatology were analyzed retrospectively from 1986 to 1998. Results: Eighteen of 28 patients (64%) with CP demonstrated ocular involvement. The mean age of patients with OCP was 73 years; 61% were female. At the time of referral to our hospital, all patients had reached advanced stage III (83%) or IV (17%) of OCP. In 38% of patients vision was already reduced to 〈20/200 at first presentation. Twenty-eight percent of patients additionally suffered from glaucoma. Two patients exhibited life-threatening extraocular manifestations of CP (larynx stricture, esophagus stricture). Conjunctival or mucosal biopsies were performed in 15 patients with OCP and showed typical immunodeposits at the basement membrane zone in 12/15 patients. Therapy with dapsone (12 patients), oral steroids (11 patients), azathioprine (5 patients), cyclophosphamide (4 patients), colchicine (2 patients) and methotrexate (1 patient) was used concomitantly or consecutively. Complications of OCP including entropion, recurrent epithelial erosions, corneal ulcers, keratitis, and corneal perforations required multiple surgical interventions such as entropion surgery (8 patients), tarsorrhaphy (3 patients), mucous membrane grafting (1 patient), amniotic membrane transplantation (1 patient), tectonic keratoplasty (1 patient), keratoprosthesis (1 patient) and enucleation (1 patient). Despite control of the inflammatory process, further visual loss occurred in 53% of eyes. Reading visual acuity could only be maintained in 35% of eyes. Discussion: Early diagnosis and therapy can prevent ocular complications of OCP. This study indicates that advanced stages of the disease often result in irreversible visual loss despite institution of immunosuppressive therapy. Whether or not the high association of OCP with glaucoma and/or anti-glaucomatous treatment in our patients represents part of the underlying disease process or plays a role in the pathogenesis of OCP must still be clarified.
    Notes: Zusammenfassung Das vernarbende Pemphigoid (cicatricial pemphigoid, CP) ist eine seltene, mit subepidermaler Blasenbildung und Vernarbung einhergehende Autoimmunerkrankung, die sich an Haut und Schleimhaut manifestiert. Eine Augenbeteiligung liegt bei etwa 70% der Patienten vor. Methode: Retrospektiv wurden Krankheitsverlauf, klinische Komplikationen und mögliche Risikofaktoren von Patienten der Augen- und Hautklinik mit vernarbendem Pemphigoid von 1986–1998 untersucht. Ergebnisse: 18/28 Patienten (64%) mit CP hatten eine okuläre Beteiligung. Das Durchschnittsalter der Patienten mit okulärem vernarbendem Pemphigoid betrug 73 Jahre, 61% der Patienten waren weiblich. Bereits bei Erstvorstellung in unserer Klinik bestand bei allen Patienten ein Krankheitsstadium III (83%) oder IV (17%), mit einem Visus 〈0.1 in 38% der Augen. Bei 28% der Patienten wurde zusätzlich ein Glaukom diagnostiziert. Zwei Patienten zeigten eine lebensgefährliche extraokuläre Schleimhautbeteiligung (Larynx- bzw. Ösophagusstriktur). Bei 15 Patienten mit okulärem vernarbendem Pemphigoid wurde eine Bindehaut- bzw. Schleimhautbiopsie aus dem Mund oder Nasen-Rachen-Raum durchgeführt, welche die Verdachtsdiagnose bei 12/15 Patienten immunhistologisch sicherte. Eine Therapie mit Dapson (12 Patienten), oraler Kortikosteroidgabe (11 Patienten), Azathioprin (5 Patienten), Cyclophosphamid (4 Patienten), Colchizin (2 Patienten) und Methotrexat (1 Patient) wurde in Folge oder Kombination eingesetzt. Komplikationen wie Lidfehlstellungen, rezidivierende Epitheldefekte, Hornhautulzera, Keratitiden und Hornhaut-Perforationen erforderten multiple operative Eingriffe wie Entropium-Operation (8 Patienten), Tarsorrhaphie (3 Patienten), Kryoepilation (2 Patienten), Mundschleimhaut-Transplantat (1 Patient), Amniontransplantat (1 Patient), tektonische Keratoplastik (1 Patient), Keratoprothese (1 Patient) und Enukleation (1 Patient). Trotz befriedigender Kontrolle des okulären vernarbenden Pemphigoids kam es bei 53% der Augen zum weiteren Visusabfall. Ein Lesevisus konnte nur in 35% der Augen erhalten werden. Schlußfolgerung: Wahrscheinlich kann die Früherkennung und rechtzeitige Behandlung des okulären vernarbenden Pemphigoids okuläre Komplikationen verhindern. Diese Studie zeigt, daß trotz immunsuppressiver Therapie in Spätstadien häufig ein irreversibler Visusverlust resultiert. Es bleibt zu untersuchen, ob die auffällig hohe Assoziation von okulärem vernarbendem Pemphigoid zu Glaukom bzw. antiglaukomatöser Therapie in unserem Patientenkollektiv als Folge der Grunderkrankung oder als pathogenetischer Faktor zu werten ist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003470050021
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 36
    Electronic Resource
    Electronic Resource
    Qualitätssicherung in der gynäkologischen Endoskopie (2000)
    Springer
    Der Gynäkologe 33 (2000), S. 213-219 
    Details
    ISSN: 1433-0393
    Keywords: Schlüsselwörter Qualitätssicherung ; Endoskopie ; Komplikationen ; Key words Quality control ; Endoscopy ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Due to the expanding use of laparoscopic surgery in gynecology, the necessity for evaluation of results was raised. With the intention of quality control in gynecological endoscopy, the gynecological department of the Evangelisches Diakonie-Krankenhaus in Bremen has developed, in cooperation with the Institute for Artificial Intelligence at the University of Bremen and on behalf of the German Society for Gynecological Endoscopy, the quality control program “German Gynecological Endoscopy Complication Register”. In 1997, 20 German endoscopic centers took part in the prospective observational study. A total number of 17,745 cases were reported. Altogether 20,050 endoscopic procedures were performed, 8020 hysteroscopies and 12030 laparoscopies. The complication rate for hysteroscopies amounted to 7.0‰ and that of laparoscopies to 9.6‰. The quality control program of the German Society for Gynecological Endoscopy is a unique tool, comparable to the “German Perinatology Study”. It allows to compare individual hospital profiles, an option that is necessary to gain the best possible results in terms of quality in gynecological surgery in the long term.
    Notes: Zusammenfassung Mit dem Ziel der Qualitätsverbesserung in der gynäkologischen Endoskopie hat die Frauenklinik des Evangelischen Diakonie-Krankenhauses in Bremen im Auftrag der Arbeitsgemeinschaft der Gynäkologischen Endoskopie (AGE) zusammen mit dem KI-Labor der Universität Bremen das Qualitätssicherungs-Programm “Komplikationsregister gynäkologische Endoskopie” entwickelt. Es ermöglicht dem Anwender die differenzierte Betrachtung der durchgeführten Operationen von den Indikationsstellung bis zum Therapieerfolg. Im Jahre 1997 haben 20 endoskopisch tätige Institutionen an der prospektiven Dokumentation der gynäkologisch-endoskopischen Operationen teilgenommen. Bei insgesamt 17.745 Patientinnen wurden 20.050 Eingriffe erfasst, darunter 8020 Hysteroskopien und 12.030 Laparoskopien. Die Komplikationsrate der Hysteroskopien betrug 7,0‰, die der Laparoskopien 9,6‰. Mit dem Qualitätssicherungs-Programm der AGE steht heute ein Instrument zur Verfügung, das vergleichbar der Perinatologiestudie die Daten in Form von vergleichenden Klinikprofilen liefern kann, die notwendig sind, um im Zusammenhang mit endoskopischen Operationen langfristig die bestmögliche Ergebnisqualität zu erzielen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001290050537
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 37
    Electronic Resource
    Electronic Resource
    Neurologische Komplikationen nach Organtransplantation (2000)
    Springer
    Der Nervenarzt 71 (2000), S. 249-258 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Organtransplantation ; Immunsuppression ; Neurotoxizität ; ZNS-Infektionen ; Komplikationen ; Key words Organ transplantation ; Complications ; Immunosuppression ; Neurotoxicity ; CNS infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Following organ transplantation, 30–60% of patients develop neurologic complications which can be classified as pre-existing deficits due to the underlying disease, complications during surgery, metabolic encephalopathies, neurotoxicity of immunosuppressant agents, opportunistic CNS infections, and secondary malignomas as indirect side effects of immunosuppression. While encephalopathies, seizures, or CNS infection can occur in all types of transplantation, some specific neurological complications exist for different types of organ transplantation. In this review, the clinical symptoms and treatment of both the common neurological complications as well as the particular neurological syndromes after liver, heart, and bone marrow transplantation are discussed.
    Notes: Zusammenfassung Nach Organtransplantation entwicklen 30–60% der Patienten neurologische Komplikationen, die eingeteilt werden können in vorbestehende Störungen im Rahmen der Grunderkrankung, intraoperative Komplikationen, metabolische Enzephalopathien, neurotoxische Nebenwirkungen der verschiedenen Immunsuppressiva sowie opportunistische ZNS-Infektionen und sekundäre Malignome als indirekte Folge der Immunsuppression. Differentialdiagnostisch relevant ist, dass einerseits Enzephalopathien, Anfälle oder ZNS-Infektionen bei allen Transplantationen auftreten können, andererseits für einzelne Organtransplantationen bestimmte neurologische Komplikationen typisch sind. In dieser Übersicht werden die allgemeinen neurologischen Komplikationen mit klinischen Leitsymptomen und Therapie sowie die spezifischen neurologischen Krankheitsbilder nach Leber-, Herz- und Knochenmarktransplantation vorgestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050554
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 38
    Electronic Resource
    Electronic Resource
    Management von Komplikationen nach prothetischer Stimmrehabilitation (2000)
    Springer
    HNO 48 (2000), S. 508-516 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Stimmprothese ; Komplikationen ; Laryngektomie ; Tracheoösophageale Fistel ; Keywords Voice prosthesis ; Complications ; Total laryngectomy ; Tracheoesophageal fistula
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The growing popularity of prosthetic voice restoration after total laryngectomy confronts ENT specialists with an increasing number of prosthesis-related complications. The ENT specialist should be familiar with the management of these complications in order to maintain the patients speech and social rehabilitation. In a retrospective study on 108 consecutive patients, complications were encountered in 30%. The incidence was not related to the factors age or primary vs. secondary insertion of the prosthesis. Complications consisted of formation of granulation tissue (15,7%), shunt dilatation (5,5%), loss of prosthesis (3,7%), local cellulitis (2,8%), extrusion (1,9%), ingrowth of prosthesis (1,9%) and formation of excessive scar tissue with dislocation of prosthesis (0,9%). Permanent removal of the prosthesis due to complications was necessary in 3 cases (2,8%). Therapeutic measures for the management of complications are described and evaluated. The treatment of complications was well tolerated by all patients and led to satisfying results in most cases. Our observations show that prosthetic voice rehabilitation is associated with various difficulties and complications, but that these can be handled quite easily and successfully in the majority of cases.
    Notes: Zusammenfassung Die wachsende Beliebtheit der prothetischen Stimmrehabilitation nach Laryngektomie konfrontiert den HNO-Arzt immer häufiger mit stimmprothesenbedingten Komplikationen. Als solcher sollte man daher die Komplikationen der Stimmprothesenversorgung kennen und deren Management beherrschen, um die kommunikative und soziale Rehabilitation des Patienten nicht zu gefährden. Die retrospektive Untersuchung von 108 Stimmprothesenträgern erbrachte eine Komplikationshäufigkeit von 30%. Eine Abhängigkeit der Komplikationsinzidenz vom Alter des Patienten oder vom Faktor primäre / sekundäre Protheseneinlage gab es dabei nicht. Häufigste Komplikation war die Entwicklung von Granulationsgewebe (15.7%), gefolgt von Shunterweiterung (5,5%), Prothesenverlust (3,7%), lokalen Infektionen (2,8%), Abstoßung (1,9%), eingewachsener Prothese (1,9%), narbiger Shuntwandverdickung mit Prothesendislokation (0,9%). In nur 3 Fällen (2,8%) mußte die Stimmprothese aufgrund verschiedener Komplikationen wieder entfernt werden. Die erforderlichen therapeutischen Maßnahmen waren für die Patienten wenig belastend und führten in fast allen Fällen zu befriedigenden Ergebnissen. Diese Beobachtungen zeigen, daß die prothetische Stimmrehabilitation zwar nicht ohne Komplikationen und Schwierigkeiten ist, diese jedoch in weitaus der Mehrzahl der Fälle medizinisch leicht zu beherrschen und daher zumutbar sind.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050607
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 39
    Electronic Resource
    Electronic Resource
    Die stabile und instabile pertrochantäre Femurfraktur Differenzierte Indikationsstellung für die dynamische Hüftschraube (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 741-748 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Pertrochantäre Fraktur ; Dynamische Hüftschraube ; Instabile Frakturen ; Komplikationen ; Keywords Trochanteric fracture ; Dynamic hip screw (DHS) ; Instable fractures ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The aim of all surgical procedures in the treatment of trochanteric fractures in elderly and even geriatric patients is achievement of initial stability. We examined in a clinical trial whether primary stability was achieved in all types of trochanteric fractures following osteosynthesis with the Dynamic Hip Scres (DHS). From 1994 to 1996, 122 patients with trochanteric fractures had osteosynthesis by dynamic hip screw. Patient records were evaluated and all data got registered with a standardized protocoll; clinical and radiological outcome was analysed after an average period of 1,9 years after injury according to the Traumatic Hip Rating Score. 22% of all patients died meantimes, 51,6% of the remaining 95 patients could get examined. The average age was 75,5 years, the patient population showed an increased preoperative morbidity (2,5 points) according to ASA-Score. 81% showed progressive osteoporosis. According to the AO-classification 47% stable fractures (type A-1) and 53% instable trochanteric fractures (type A-2 and A-3) occured. Surgery lasted 77 minutes average in osteosynthesis of stable fractures. The duration of 108 minutes in instable fractures was significantly higher, as well as the blood loss was 43% increased in these complex fractures. Complications closely associated to the osteosynthesis appeared only in instable fractures (7%). Also common complications (24,6%) predominated with 15,6% in tpy A-2 and A-3 fractures versus 9% in type A-1 fractures; mortality was also different with 5,7% versus 1,6%. Assesment of the functional outcome according to THRS showed a significant deterioration of 20 points in 71% of all patients compared with the preoperative score. The results show that dynamic hip screw osteosynthesis in instable trochanteric fractures is associated to a higher incidence of complications. While the dynamic hip screw still represents the standard implant in stable fractures of the trochanteric regio, beeing aware of improved intramedullary implants regarding biomechanical features and surgical technique, the results justify to critical consider the use of DHS for osteosynthesis in instable fractures of the trochanteric region.
    Notes: Zusammenfassung Bei der operativen Versorgung petrochantärer Femurfrakturen im geriatrischen Krankengut stellt eine sofort übungs- und belastungsstabile Osteosynthese das Therapieziel dar. In einer klinischen Studie wurde vergleichend untersucht, ob dieses Ziel mit der DHS (dynamische Hüftschraube) bei allen pertrochantären Frakturtypen erreicht werden kann. Von 1994–1996 wurden 122 pertrochantäre Frakturen mit der DHS behandelt. Neben der Auswertung durch standardisierte Datenerhebungsprotokolle wurden die Patienten durchschnittlich 1,9 Jahre nach Trauma radiologisch und klinisch nach dem “Traumatic hip rating score” nachuntersucht; 22% waren verstorben, von den verbliebenen 95 Patienten konnten 51,6% nachkontrolliert werden. Bei einem Altersdurchschnitt von 75,5 Jahren lag mit dem ASA-Score von durchschnittlich 2,5 Punkten eine hohe präoperative Morbidität vor; 81% der Fälle wiesen eine fortgeschrittene Osteoporose auf. Nach der AO-Klassifikation handelte es sich um 47% stabile (Typ A1) und 53% instabile (Typ A2 und A3) Frakturen. Die mittlere Operationszeit war bei den instabilen im Vergleich zu den stabilen pertrochantären Frakturen mit 108 gegenüber 77 min signifikant höher, der Blutverlust um 43% größer. Direkt mit der Osteosynthese assoziierte Komplikationen betrafen ausschließlich instabile Frakturen (7%). Allgemeine Komplikationen (24,6%) überwogen ebenfalls mit 15,6% in der Gruppe der Typ A2 und A3 gegenüber der Typ-A1-Frakturen, was sich auch in einer entsprechend höheren Klinikletalität mit 5,7% gegenüber 1,6% ausdrückt. Bei der Bewertung des funktionellen Nachuntersuchungsergebnisses mit dem THRS wiesen 71% der Patienten im Vergleich zum präoperativen Ausgangswert eine deutliche Verschlechterung um durchschnittlich 20 Punkte auf. Die Osteosynthese instabiler pertrochantärer Femurfrakturen durch die DHS ist mit einer höheren Komplikationsrate belastet. Während die DHS für die stabilen Frakturen das Standardverfahren darstellt muss die Osteosynthese instabiler Frakturen vor dem Hintergrund neuerer, operationstechnisch und biomechanisch verbesserter intramedullärer Implantate kritisch betrachtet werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050613
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 40
    Electronic Resource
    Electronic Resource
    Unaufgebohrter Humerusnagel (UHN) (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 277-283 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Humerusschaftfraktur ; Intramedulläre Marknagelosteosynthese ; UHN ; Komplikationen ; Behandlungsergebnisse ; Keywords ; Fracture of the humeral diaphysis ; Humerus nail ; UHN ; Complications ; Results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: In a retrospective study, 115 fractures of the humeral diaphysis were evaluated, and 94 of the patients were treated by surgical operations. In 64 patients we used an unreamed humerus nail (UHN) to stabilize the fractures of the humerus diaphysis. All patients with an UHN were followed up. Having analysed the system-specific and general complications and the functional, subjective and radiological results we can recommend the UHN for the treatment of both fractures and pseudarthrosis of the humeral diaphysis.
    Notes: In einer retrospektiv durchgeführten Studie wurden 115 Humerusschaftfrakturen ausgewertet. Operativ wurden 94 Patienten, davon 64 mit einem unaufgebohrten Humerusnagel (UHN), versorgt. Die mit einem UHN behandelten Patienten wurden nachuntersucht. Nach Auswertung der systemspezifischen und allgemeinen Komplikationen sowie der funktionellen, subjektiven und radiologischen Ergebnisse kann der UHN sowohl zur Behandlung der frischen Humerusschaftfraktur als auch zur Versorgung von Humerusschaftpseudarthrosen empfohlen werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100390000318
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 41
    Electronic Resource
    Electronic Resource
    Wann ist die arthroskopische Diagnostik und Therapie am Ellbogengelenk beim Trauma angezeigt? (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S81 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Arthroskopie ; Ellbogengelenk ; Trauma ; Minimalinvasive Osteosynthese ; KomplikationenArthroscopy ; Elbow joint ; Injury ; Osteosynthesis ; Complications ; Key words ; Arthroskopie ; Ellbogengelenk ; Trauma ; Minimalinvasive Osteosynthese ; KomplikationenArthroscopy ; Elbow joint ; Injury ; Osteosynthesis ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Elbow arthroscopy, unlike arthroscopy of the knee or shoulder, is technically a very demanding procedure that is associated with a high risk of complications owing to the surrouding neurovascular structures. In the case of trauma the arthroscopic approach is even more difficult because of the altered anatomy. In addition, the time available for the performance of any surgical procedures is very much limited by the immediate onset of periarticular swelling with fluid loss caused by the damage to the joint capsule that is present in most cases. Arthroscopy of the elbow should not therefore be considered to be indicated in acute trauma except in isolated cases and after very careful consideration of the risks and benefits for the patient. This procedure cannot be generally recommended as a standard method of examining or treating freshly sustained injuries.On the other hand, elbow arthroscopy can be very helpful in the case of posttraumatic functional deficiencies or such pathologic findings as loose bodies after osteochondral fractures, adhesions and intraarticular scars, while little or no improvement can be expected for vague joint symptoms or posttraumatic arthrosis. As there is a relatively high risk of neurological complications the patient needs to be given quite comprehensive information in an intensive preoperative session. Diagnostic arthroscopy is hardly ever indicated in a trauma case because of the excellent results yielded by modern noninvasive imaging methods, such as ultrasound, X-ray, computed tomography and MRI.
    Notes: Zusammenfassung Im Gegensatz zur Arthroskopie des Knie- oder Schultergelenks ist die Arthroskopie des Ellbogengelenks mit erheblichen technischen Schwierigkeiten und entsprechend hohen Komplikationsrisiken verbunden. Beim Trauma ist die Arthroskopie zudem aufgrund der veränderten anatomischen Verhältnisse noch weit komplizierter. Die Operationszeit ist wegen der rasch auftretenden periartikulären Schwellung infolge der meist bestehenden Gelenkkapselläsionen deutlich limitiert. Die Indikation zur Arthroskopie sollte daher nur im Einzelfall unter sorgfältiger Abwägung der Risiken und der zu erwartenden Vorteile gestellt werden. Eine generelle Empfehlung für dieses Verfahren bei frischen Verletzungen kann nicht ausgesprochen werden. Sinnvoll ist der Einsatz dagegen bei einigen posttraumatischen Veränderungen, z. B. freien Gelenkkörpern nach osteochondralen Frakturen oder Arthrolysen bei intraartikulären Vernarbungen, während bei „unklaren Gelenkbeschwerden“ oder posttraumatischer Arthrose kaum Verbesserungen zu erwarten sind. Wegen des relativ hohen Risikos neurologischer Komplikationen ist eine intensive präoperative Aufklärung der Patienten erforderlich. Eine diagnostische Arthroskopie beim Trauma ist bei der Aussagekraft der modernen nichtinvasiven Untersuchungsverfahren kaum noch angezeigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014932
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 42
    Electronic Resource
    Electronic Resource
    Indikationsstellung und Verfahrenswahl bei Beckenringverletzungen (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 39-45 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Beckenringfrakturen ; Klassifikation ; Behandlungsverfahren ; Komplikationen ; Ergebnisse ; Keywords ; Pelvic ring fractures ; Classification ; Treatment ; Complications ; Results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Injuries of the pelvis are caused by high-energy trauma, and concomitant injuries are therefore often found. Many patients with such pelvic injuries have multiple injuries. Accurate diagnosis and classification are both fundamental to adequate therapy. Especially in the presence of complex pelvic trauma and in polytraumatised patients priority-oriented and fast procedures are essential. Type B and C instabilities require operative treatment. In emergency cases with unstable pelvic fractures external fixation has proved successful. For definitive treatment with internal stabilisation different internal fixation procedures with screws and plates selected with reference to the features of the injury are needed. The operative stabilisation of the pelvic ring demands particular care, because various main vessels and nerves are adjacent to the injury site. Ultimately, the results of treatment depend heavily on the quality of anatomical restoration of the pelvic ring.
    Notes: Beckenverletzungen entstehen aufgrund hoher lokaler Gewalteinwirkung und sind deswegen häufig mit Begleitverletzungen kombiniert. Bei vielen beckenverletzten Patienten liegt ein Polytrauma vor. Grundlage einer adäquaten Therapie von Verletzungen des Beckenrings sind eine exakte Diagnostik und Klassifikation. Vor allem beim komplexen Beckentrauma und beim Vorliegen eines Polytraumas ist ein rasches und an Prioritäten orientiertes Vorgehen entscheidend. Instabilitäten vom Typ B und C erfordern eine operative Stabilisierung. Dabei steht in der Notfallbehandlung des instabilen Beckenrings die externe Stabilisierung im Vordergrund. Beim Übergang auf interne Fixationsverfahren haben sich abhängig von der Verletzungsmorphologie verschiedene Schrauben- und Plattenmontagen bewährt. Die operative Stabilisierung des Beckenrings erfordert wegen der engen Nachbarschaft zu verschiedenen Gefäß- und Nervenbahnen besondere Sorgfalt. Das Endergebnis hängt dabei ganz wesentlich davon ab, wie gut die Wiederherstellung der anatomischen Form des Beckenrings gelungen ist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100390050089
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 43
    Electronic Resource
    Electronic Resource
    Verletzungen des thorakolumbalen Übergangs (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 162-166 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Thorakolumbale Frakturen ; Transpedikuläre Spondylodese ; Spongiosaplastik ; Komplikationen ; Keywords ; Thoracolumbar fractures ; Transpedicular spondylodesis ; Bone grafting ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Spinal fractures are located predominantly at the thoracolumbar junction. After conservative treatment, for unstable fractures operative procedures were established during the last 20 years. Using implants with angular stability, dorsal transpedicular fixation yields good clinical results even compared with those of combined dorsoventral procedures. Transpedicular bone grafting is controversial as resorption frequently occurs; it has given disappointing results in fracture types in which definitive segmental fusion is unavoidable, so that combined dorso-ventral stabilization is necessary in such cases. The most frequent complications of dorsal instrumentation are the result of badly positioned transpedicular screws.
    Notes: Die Verletzungen des thorakolumbalen Übergangs stellen die Mehrzahl der Frakturen der Wirbelsäule dar. Nach der konservativen Therapie hat sich in den letzten beiden Jahrzehnten die operative Versorgung instabiler Frakturen etabliert. Die dorsale transpedikuläre Spondylodese unter Verwendung winkelstabiler Implantate stellt ein Verfahren dar, mit dem sich auch im Vergleich zu aufwändigen dorsoventralen Rekonstruktionen bei den meisten Frakturen gute klinische Resultate erzielen lassen. Der additionellen transpedikulären intrakorporalen Spongiosaplastik wird aufgrund der zu beobachtenden Resorption des Transplantats zunehmend geringere Bedeutung beigemessen. Auch bei Frakturtypen, bei denen eine definitive Fusion angestrebt werden sollte, hat die transpedikuläre interkorporale Knochentransplantation enttäuscht, sodass in derartigen Fällen nach primärer dorsaler Stabilisierung sekundär die Fusion von ventral erfolgen sollte. Die häufigsten Komplikationen bei der dorsalen transpedikulären Spondylodese sind auf Fehllagen der transpedikulären Schrauben zurückzuführen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010931
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 44
    Electronic Resource
    Electronic Resource
    Infantile acute pancreatitis after mumps vaccination simulating an acute abdomen (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 488-489 
    Details
    ISSN: 1437-9813
    Keywords: Key words Pancreatitis ; Childhood ; Mumps vaccination ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe an extremely rare case of acute pancreatitis presenting as an acute abdomen that appeared as a complication of mumps vaccination in a young child. A laparotomy performed because of suspected perforated appendicitis proved unnecessary in retrospect. No similar case in infancy and early childhood has been reported to date.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830000417
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 45
    Electronic Resource
    Electronic Resource
    Patient perception of magnetic resonance arthrography (2000)
    Springer
    Skeletal radiology 29 (2000), S. 265-269 
    Details
    ISSN: 1432-2161
    Keywords: Key words MR arthrography ; Joint injection ; Gadolinium (intra-articular) ; Pain-rating scores ; Arthrogram ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. Magnetic resonance (MR) arthrography has been demonstrated to be more accurate than MR imaging alone in the identification of a variety of musculoskeletal pathology. While the complication rate of intra-articular gadolinium: saline injection has been shown to be relatively low, MR arthrography is more invasive, painful, and costly, and less convenient, than MR imaging alone. The purpose of this study was to evaluate patients’ perception of the fear and discomfort, and to assess their overall acceptance of the intra-articular gadolinium injection. Design and patients. Between October 1997 and January 1998, 113 outpatients who were referred to Yale-New Haven Hospital for MR arthrography of the ankle, elbow, hip, knee, shoulder, or wrist were asked to complete a questionnaire rating their fear of factors most commonly associated with the procedure including ”pain”, ”needles”, ”complications”, and ”discovery of results that would lead to surgery”. In addition, after having undergone the intra-articular gadolinium:saline injection, patients were asked to rate their perception of pain. Results. While many patients expressed fear of ”pain” and ”needles”, after having undergone the injection their overall pain rating score was low. Only 6% actually found gadolinium arthrography more painful than expected. Conclusion. Despite the fact that patients expressed apprehension about certain aspects of MR arthrography, subjects who underwent the intra-articular gadolinium injection considered the discomfort less than expected. Clinicians should not hesitate to order MR arthrography because the accuracy of the procedure is high enough that patients accept the discomfort.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050605
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 46
    Electronic Resource
    Electronic Resource
    Rapid chondrolysis after an intra-articular leak of bone cement in treatment of a benign acetabular subchondral cyst: an unusual complication of percutaneous injection of acrylic cement (2000)
    Springer
    Skeletal radiology 29 (2000), S. 275-278 
    Details
    ISSN: 1432-2161
    Keywords: Key words Bone subchondral cyst ; Acetabulum ; Interventional radiology ; Complications ; Methylmethacrylate ; Chondrolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Percutaneous injection of methylmethacrylate is now increasingly employed to treat bone lesions, both malignant and benign. However, the risks of this procedure are still to be fully established. In this report, we describe a case of rapid chondrolysis appearing after the intra-articular leakage of cement during injection of an acetabular subchondral cyst, resulting in hip replacement. Although the mechanism of such chondrolysis is unknown, this event suggests a chondrolytic effect of the acrylic cement. Thus, it is essential to systematically search for the presence of an intra-articular passage before injecting bone cement into a peri-articular cyst. This unusual complication highlights the need for rigorous evaluation of the benefits and risks of percutaneous injection of acrylic cement in the treatment of benign lesions, especially close to an articulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050607
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 47
    Electronic Resource
    Electronic Resource
    D3 Lymph Node Dissection in Gastric Cancer: Evaluation of Postoperative Mortality and Complications (2000)
    Springer
    Surgery today 30 (2000), S. 700-705 
    Details
    ISSN: 1436-2813
    Keywords: Key words Gastric cancer ; Lymph node dissection ; Mortality ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since November 1995 we have been performing a D3 lymph node dissection in patients undergoing an operation for gastric cancer with a curative intent. The aim of the present study was to evaluate whether this procedure results in an increased postoperative mortality or complication rate in a Western population. Between November 1995 and August 1997 the postoperative courses of 76 patients were retrospectively assessed (45.3 lymph nodes per patient, lymph node ratio: 0.16). The patient outcome was compared with data from a historic control group of patients (n = 383) in whom the newly established D2 dissection was studied in our department. Regarding the demographic, clinical, and tumor-pathologic data, and the choice of resection and reconstructive procedures, the two groups differed only slightly. The postoperative mortality of 1% was lower (vs 6.8%) while the overall complication rate of 34% (vs 32.1%) was identical. In particular, no anastomotic leakage (vs 9.4%) and fewer nonsurgical complications (17.1% vs 27.9%) occurred. The reoperation rate was 1% vs 9.7%. However, in 6% of the patients drainage tubes had to be inserted under computed tomographic guidance. The average hospital stay remained unchanged (21.9 vs 20.7 days). A D3 dissection was shown to be feasible while demonstrating no disadvantages in the patients when compared with the D2 procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950070080
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 48
    Electronic Resource
    Electronic Resource
    Differentialindikation zentraler und peripherer Leitungsanästhesien (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 495-504 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Regionalanästhesie ; Spinalanästhesie ; Epiduralanästhesie ; periphere Nervenblockaden ; Komplikationen ; Keywords Regional anesthesia ; Spinal anesthesia ; Epidural anesthesia ; Nerve blocks ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Serious neurological complications caused by spinal hematoma or abscess following central neuraxial block have been reported more often during the last years. In contrast, severe complications are extremely rare associated with peripheral nerve blocks. Concerned about the safety of spinal and epidural anesthesia, we encourage the use of peripheral regional techniques for procedures on the lower extremity and especially for postoperative regional analgesia. Motor block due to lumbar epidural anesthesia using high concentrations of local anesthetic makes spinal hematoma or abscess difficult to recognize. Therefore, low concentrations of local anesthestic should be used for postoperative epidural analgesia. Any increase in motor block following neuraxial blockade should raise the suspicion of a spinal compression (e.g. hematoma or abscess). Other symptoms are back pain, radicular pain or paresthesia and incontinence. Disastrous neurological injuries can only be prevented by immediate diagnosis (MR, CT or myelography) and therapy (surgical decompression).
    Notes: Zusammenfassung In den letzten Jahren wird vermehrt über schwerwiegende neurologische Komplikationen durch spinale Hämatome und Abszesse nach rückenmarksnahen Regionalanästhesien berichtet. Vor diesen Hintergrund werden die verschiedenen Regionalanästhesietechniken für die untere Extremität und ihre Komplikationen gegenübergestellt, denn die komplikationsärmeren peripheren Leitungsanästhesien bieten sich im Bereich der unteren Extremität als Alternative zur Spinal- oder Epiduralanästhesie an. Es wird empfohlen, zur postoperativen Schmerztherapie lumbale Epiduralanalgesien soweit möglich durch periphere Leitungsblockaden zu ersetzen. Kontinuierliche Blockaden, z.B. im Bereich des N. femoralis eignen sich auch zur postoperativen Schmerztherapie. Bei der postoperativen lumbalen Katheter-Epiduralanalgesie erschweren hohe Lokalanästhetika-Konzentrationen mit ausgeprägter motorischer Blockade die Diagnose intraspinaler Raumforderungen. Zur postoperativen Epiduralanalgesie sind Lokalanästhetika daher nur in niedriger Konzentration einzusetzen. Bis zum Ausschluss des Gegenteils begründet nach rückenmarksnaher Regionalanästhesie jede Zunahme der motorischen Blockade den Verdacht auf eine spinale Raumforderung (z.B. Hämatom oder Abszess). Weitere Kardinalsymptome sind Rückenschmerzen, Wurzelkompressionsschmerzen und Inkontinenz. Nur die sofortige Diagnose (MR, CT oder Myelographie) und Therapie (ggf. operative Entlastung) kann katastrophale neurologische Schäden verhindern.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070089
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 49
    Electronic Resource
    Electronic Resource
    Auswirkungen von Luftbläschen in der Infusionsspritze auf die Funktion von Spritzenpumpen (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 1018-1023 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Infusionssysteme ; Spritzenpumpen ; Luft ; Fehlerquellen ; Gefahren ; Keywords Syringe pumps ; Air ; Infusion line occlusion ; Drug delivery ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Application of highly concentrated short-acting vasoactive drugs in the critically ill patient requires precisely working syringe pump systems for continuous intravenous drug delivery. We performed a bench study to investigate the consequences of small amounts of air entrapped within a 50-ml infusion syringe. In particular we studied the effect of entrapped air on drug delivery after moderate vertical displacement of the pump by 50 cm (e. g. in preparation for transport) and the effect on the time required to trigger the pressure alarm after occlusion of the infusion line. At a flow rate of 1 ml/h, lowering the syringe pump prolonged the zero-drug delivery time from (mean±SD) 4.1±0.8 min (without air) to 6.2±0.9 (with 1 ml air) and to 13.1±0.9 min (with 2 ml of air, p〈0.001 for all comparisons). Entrapping of 2 ml of air within the syringe resulted in a 2.6-fold prolongation of the occlusion alarm time after accidental occlusion of the infusion line and a 3-fold increase of the resulting infusion bolus after occlusion. Enclosed air within infusion syringes considerably affects the syringe compliance. It increases the susceptibility of constant drug delivery to vertical displacement of syringe pumps and impairs the occlusion alarm function. Therefore, any air in syringe of infusion pump systems should be carefully removed. To avoid infusion boluses of short-acting vasoactive drugs after accidental occlusions, the occluded infusion line should be released to ambient pressure first.
    Notes: Zusammenfassung Werden hochdosierte kreislaufwirksame Pharmaka mit kurzer Halbwertszeit bei niedrigen Flussraten appliziert (z. B. bei Neugeborenen oder in der Kinder-Herzchirurgie), so ist eine konstante Zufuhr des Medikaments für die hämodynamische Stabilität eine unabdingbare Voraussetzung. Wir untersuchten in einem experimentellen Modell den Einfluss von geringen Luftmengen in 50-ml-Infusionsspritzen auf die Konstanz der Flussrate und die Alarmfunktion in 2 klinisch relevanten Situationen: relative Niveauänderungen zwischen Spritzenpumpe und Patient (etwa bei Transport oder Umlagern) und akzidentieller Verschluss (etwa Abknicken) einer Infusionsleitung. Nach Absenken der Spritzenpumpe um 50 cm gegenüber dem Ausgangsniveau verlängerte sich die Zeit unterbrochener Medikamentzufuhr (wegen hydrostatischer, retrograder Aspiration) von 4,1 min ohne Lufteinschluss auf 6,2 min bei 1 ml und auf 13,1 min bei 2 ml Lufteinschluss. Bei akzidentiellem Verschluss verlängerte sich die Zeit bis zum Okklusionsalarm bei 2 ml Lufteinschluss um das 2,6fache auf über 1 h, der resultierende Bolus nach Aufheben des Verschlusses verdreifachte sich. Daher sollten bei der Zufuhr hochkonzentrierter Vasoaktiva nicht nur relative Lageveränderungen zwischen System und Patient vermieden, sondern jegliche eingeschlossene Luft konsequent evakuiert werden. Dies gilt gleichermassen für alle über dasselbe Katheterlumen infundierenden Perfusoren. Bei Erkennen eines Verschlusses ist es sinnvoll, das okkludierte Infusionssystem vom Patienten zu trennen und den Druckentlastungsbolus zu verwerfen, bevor der Verschluss aufgehoben wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070016
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 50
    Electronic Resource
    Electronic Resource
    Ciaglia Blue Rhino: Ein weiterentwickeltes Verfahren der perkutanen Dilatationstracheotomie (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 202-206 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Perkutane Dilatationstracheotomie ; Ciaglia Blue Rhino ; Komplikationen ; Key words Percutaneous dilatational tracheostomy ; Ciaglia Blue Rhino ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Objective: Elective tracheostomy has become an established treatment modality in modern intensive care medicine, and the number of percutaneously performed tracheostomies is steadily increasing. The Ciaglia Blue Rhino (CBR) represents another percutaneous technique in which the tracheostoma is formed by one-step dilation. Our study presents the technique itself and the early clinical experiences. Methods: In 20 adult patients on long-term ventilation, CBR was done. After puncture of the trachea in typical manner, dilation of the tracheostoma was achieved in one single step by means of a curved dilator with a special hydrophilic coating. Then, the tracheostomy tube was inserted over a curved loading dilator. Practicability and safety were determined as well as gas exchange during the procedure by means of arterial blood gas samples. Results: As a result of the dilator’s hydrophilic coating, dilation of the tracheostoma was rapidly achieved within 152±22 s, virtually free from resistance of the trachea or the cervical tissues. Complications such as bleeding, aspiration or postoperative infection of the stoma were not noted in any of our patients. Fractures of isolated tracheal cartilage rings were seen in 5 patients, however, no therapeutic intervention was necessary. In terms of perioperative gas exchange, pre- and postoperative levels of FiO2, PaO2, PaCO2 and the oxygenation index (PaO2/FiO2) did not change significantly. Conclusions: Based on our early clinical experience, Ciaglia Blue Rhino represents a new method that may combine the typical advantages of each of the other techniques for percutaneous tracheostomy (i.e. Ciaglia, Griggs, Fantoni) in one single technique. This method is distinguished by a high level of safety and practicability. However, further comparative trials need to be done before a definitive judgement can be made.
    Notes: Zusammenfassung Fragestellung: Die elektive Tracheotomie stellt in der modernen Intensivmedizin einen festen Bestandteil der Beatmungstherapie dar und wird zunehmend perkutan durchgeführt. Mit der Ciaglia Blue Rhino (CBR) steht nunmehr eine weitere perkutane Technik zur Verfügung, bei der zur Anlage des Tracheostomas nur noch ein einziger Dilatationsschritt erforderlich ist. Ziel der vorliegenden Untersuchung war es, die Technik der CBR und erste klinische Ergebnisse vorzustellen. Methodik: Bei 20 langzeitbeatmeten, erwachsenen Intensivpatienten wurde eine CBR durchgeführt. Nach Punktion der Trachea in typischer Weise erfolgt die Dilatation des Tracheostomas in einem Schritt mittels eines gebogenen Dilatators, der über eine spezielle hydrophile Beschichtung verfügt. Anschließend wird die Trachealkanüle über einen Führungsstab eingeführt. Neben Praktikabilität und Komplikationen der Technik wurde deren Einfluß auf den perioperativen Gasaustausch mittels Blutgasanalysen untersucht. Ergebnisse: Aufgrund der hydrophilen Beschichtung des Dilatators und der damit verbundenen nahezu widerstandslosen Bougierung gelang die Anlage des Tracheostomas im Mittel in 152±22 s. Akut interventionsbedürftige Komplikationen wie Blutungen, Aspiration oder eine postoperative Infektion des Tracheostomas wurden nicht beobachtet. Bei 5 Patienten kam es zu einer Fraktur einzelner Trachealspangen, die jedoch keine therapeutische Konsequenz hatte. Hinsichtlich des perioperativen Gasaustauschs ergaben sich keine Signifikanzen hinsichtlich der prä- und postoperativen Höhen von FiO2, paO2, paCO2 und des Oxygenierungsindex (paO2/FiO2). Schlussfolgerung: Die Ciaglia Blue Rhino-Technik könnte aufgrund dieser ersten klinischen Erfahrungen ein Verfahren darstellen, das die jeweiligen Vorteile der anderen perkutanen Tracheotomietechniken nach Ciaglia, Griggs und Fantoni in sich vereint. Diese weiterentwickelte Technik zeichnet sich durch hohe Praktikabilität und eine sehr rasche und sichere Durchführbarkeit aus. Zur endgültigen Bewertung dieses Verfahrens auch im Hinblick auf Spätkomplikationen müssen jedoch detaillierte Vergleichsstudien folgen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050815
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 51
    Electronic Resource
    Electronic Resource
    Die Larynxmaske bei Adenotonsillektomie bei Kindern Gefährliche Spielerei oder medizinischer Fortschritt? (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 706-712 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter AT ; TE ; Larynxmaske ; Technik ; Komplikationen ; Keywords Adenotomy ; Tonsillectomy ; Laryngeal mask ; Technique ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Anaesthesia both for adenotomy (AT) and for tonsillectomy (TE) frequently presents a challenge. On one hand, children scheduled for adenotomy often have upper airway infections and are thus at risk of laryngo- and bronchospasm; on the other hand the ENT surgeon and the anaesthetist have to share the “workspace” in the patient's mouth. Since the succinyl choline debate in the early 1990s, the question of the best muscle relaxant has gone hand in hand with that of the most appropriate means of securing the airway. The concept of the laryngeal mask as airway was initially greeted with scepticism. Following several years' use of the mask for this purpose in AT and TE in young children, we report our experience and summarise the literature on this topic. The laryngeal mask represents a safe alternative to intubation, provided there is close cooperation with the ENT surgeon.
    Notes: Zusammenfassung Die Narkosen zur Adenotomie, aber auch zur Tonsillektomie stellen für Anästhesisten immer wieder große Herausforderungen dar. Zum einen haben die Kinder, die zur Adenotomie anstehen, häufig Infekte der oberen Luftwege und sind damit laryngo- und bronchospasmusgefährdet, zum anderen müssen sich HNO-Arzt und Anästhesist den “Arbeitsraum” im Mund teilen. Seit der Succinylcholindebatte der frühen 90er-Jahre stellte sich mit der Frage nach dem geeigneten Muskelrelaxans die Frage nach der geeigneten Atemwegssicherung. Der Anwendung der Larynxmaske als Airway bei AT und TE wurde zunächst mit Skepsis begegnet. Nach langjähriger Anwendung der Larynxmaske zur Atemwegssicherung bei AT und TE im Kleinkindesalter wird hier nicht nur über Ergebnisse und langjährige Erfahrungen berichtet, sondern auch die Literatur zu diesem Thema zusammengefasst. Daraus ergibt sich, dass die Larynxmaske bei AT und TE eine sichere Alternative zur Intubation darstellt. Voraussetzung dazu ist jedoch eine gute Kooperation mit dem HNO-Arzt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070064
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 52
    Electronic Resource
    Electronic Resource
    Pneumothorax bei der Vertikalen Infraklavikulären Blockade des Plexus brachialis Fallbericht einer seltenen Komplikation (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 901-904 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Vertikale Infraklavikuläre Blockade ; Pneumothorax ; Komplikation ; Plexus brachialis ; VIP ; Keywords Vertical infraclavicular blockade ; Pneumothorax ; Complications ; Brachial plexus ; VIP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract A 50 year old female patient received anaesthesia of the arm by the vertical infraclavicular blockade of the plexus brachialis (VIP). Postoperatively an ipsilateral pneumothorax occured complicated by pleural effusion and a contralateral bronchopneumonia, which resolved completely after treatment. The blockade of the plexus was performed correctly, failures in determining the correct point of needle insertion could be excluded. Therefore a pneumothorax has to be regarded as a specific complication of the VIP, which might occur despite correct technique, and requires that the patient be informed of this eventuality. Nevertheless, the VIP is an important method due to its high success rate concerning blockade of the musculocutaneous nerve and tolerance of tourniquet. The risk of a pneumothorax is about 0.2 to 0.7%.
    Notes: Zusammenfassung Bei einer 50-jährigen Patientin wurde im Rahmen einer elektiven Operation an der Hand die Anästhesie durch die Vertikale Infraklavikuläre Plexus-brachialis Blockade (VIP) nach Kilka durchgeführt. Postoperativ kam es zum Auftreten eines ipsilateralen Pneumothorax, welcher durch einen Pleuraerguss und eine kontralaterale Bronchopneumonie kompliziert wurde. Unter invasiver Behandlung der Patientin kam es bezüglich aller Komplikationen zur restitutio ad integrum. Die Durchführung der Anästhesie war lege artis entsprechend der Erstbeschreibung, Fehler bei der Bestimmung der Punktionsstelle konnten mit größtmöglicher Wahrscheinlichkeit ausgeschlossen werden. Ein Pneumothorax bei der Vertikalen Infraklavikulären Plexus-brachialis Blockade stellt auch bei korrekter Durchführung unter Vermeidung von beschriebenen Kardinalfehlern ein methodenspezifisches und somit aufklärungspflichtiges Risiko dar. Der VIP ist dennoch eine wichtige Ergänzung der herkömmlichen Methoden zur Blockade des Plexus brachialis, da er sich durch eine hohe Erfolgsrate speziell im Bereich des N. musculocutaneus und in der Toleranz eines Tourniquets auszeichnet. Nach den bisherigen Erfahrungen ist von einem Pneumothoraxrisiko von 0,2–0,7% auszugehen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070044
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 53
    Electronic Resource
    Electronic Resource
    Kombinierte Anästhesie mit Epiduralkatheter Eine retrospektive Analyse des perioperativen Verlaufs bei Patienten mit radikalen Prostatektomien (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 949-959 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Kombinierte Anästhesie ; Thorakale Epiduralanästhesie ; Lumbale Epiduralanästhesie ; Prostatektomie ; Schmerztherapie ; Komplikationen ; Keywords Combined anaesthesia ; Thoracic epidural anaesthesia ; Lumbar epidural anaesthesia ; Prostatectomy ; Pain management ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Patients requiring radical prostatectomy (rPE), including retroperitoneal lymphadenectomy are often aged and have coexisting cardiopulmonary diseases, increasing the risk of perioperative complications. The aim of the present study was to evaluate our perioperative anaesthesiologic regimen over the last five years, in terms of safety and patients comfort. Records of 433 patients who underwent rPE between 1994 and 1999 in our hospital were retrospectively reviewed. Patients were divided in those who received: 1. general anaesthesia (GA) alone, 2. a combination of lumbar epidural anaesthesia (LEA)+GA or, 3. thoracic epidural anaesthesia (TEA)+GA. General anaesthesia was performed as balanced anaesthesia, and epidural administered local anaesthetics were bupivacaine 0.25% or ropivacaine 0.2%, 8–12 ml/h. In terms of intra- and postoperative numbers of tachycardic and hypertensive episodes, a reduced stress response was observed under epidural anaesthesia (EA). Moreover, the weaning duration was shorter under EA and onset of gastrointestinal motility was found earlier ([h] GA: 50.6±11.1/ LEA: 39.3±13.6/ TEA:33.8±13.0). Furthermore, a trend to rarer phases of postoperative vomiting and a significant decrease of in hospital stay of about one day ([d] GA: 12.4±5.8/ LEA: 11.1±3.1/ TEA: 11.5±3.8) was observed. The duration of personnel binding in the OR did not differ significantly between GA and TEA ([min] GA: 222.9±43.5/ LEA: 238.2±41.8/ TEA: 227.0±46.2), but ICU stay was shortened under TEA. Besides this, TEA reduced the number of pathologic postoperative thorax-x-rays. Senso-motor blockades, decreases of SaO2 and cardiac complications were experienced more frequent under LEA as compared with TEA. Combination of GA and EA, especially TEA, appears to improve perioperative care of patients undergoing rPE, in terms of patients safety and comfort.
    Notes: Zusamenfassung Patienten, die sich einer radikalen Prostatektomie (rPE) einschließlich retroperitonealer Lymphadenektomie (rLA) unterziehen, haben aufgrund ihres Alters und ihrer Begleiterkrankungen ein erhöhtes perioperativen Risiko. Ziel dieser Untersuchung war es, den intra- und postoperativen Verlauf der standardisierten Operation rPE+rLA unter verschiedenen Anästhesieregimen zu analysieren. Krankenakten von 433 Patienten, die sich zwischen 1994 und 1999 in unserer Einrichtung einer rPE+rLA unterzogen, wurden retrospektiv ausgewertet. Die Patienten wurden nach dem durchgeführten Anästhesieverfahren eingeteilt: 1. Allgemeinanästhesie (AA), 2. Kombination lumbale Epiduralanästhesie (LEA)+AA, 3. thorakale Epiduralanästhesie (TEA)+AA. Für die intra- und postoperative Katheteranalgesie wurden Bupivacain 0,25% oder Ropivacain 0,2%, 8–12 ml/h verwendet. Die Allgemeinanästhesie wurde als balancierte Anästhesie durchgeführt. Diese retrospektive Erhebung zeigt unter epiduraler Analgesie, gemessen an Tachykardien und hypertensiven Episoden, eine reduzierte intra- und postoperative Stressantwort, kürzere Extubationszeiten, früheres Wiedereinsetzen der gastrointestinalen Motilität ([h] AA: 50,6±11,1/ LEA: 39,3±13,6/ TEA:33,8±13,0), tendenziell selteneres Erbrechen und eine um einen Tag verkürzte Krankenhausverweildauer ([d] AA: 12,4±5,8/ LEA: 11,1±3,1/ TEA: 11,5±3,8). Dabei war unter TEA die Dauer der Anästhesiepräsenz im OP-Bereich vergleichbar mit AA ([min] AA: 222,9±43,5/ LEA: 238,2±41,8/ TEA: 227,0±46,2), und der Wachstationsaufenthalt verkürzt. Daneben war unter TEA die Anzahl der auffälligen postoperativen Thoraxröntgenbefunde reduziert. Zum Erreichen einer der TEA vergleichbaren Analgesie mussten unter LEA häufiger sensomotorische Blockaden, saO2-Abfälle und tendenziell eine höhere Anzahl kardialer Komplikationen in Kauf genommen werden. Gemessen an den von uns erhobenen Parametern stellt damit die Kombination einer Allgemeinanästhesie, insbesondere mit thorakaler Epiduralanalgesie ein sicheres und auch betriebswirtschaftlich effizientes anästhesiologisches Vorgehen bei radikalen Prostatektomien dar.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070030
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 54
    Electronic Resource
    Electronic Resource
    The consequences of the mutual recognition of measurement standards for international metrology (2000)
    Springer
    Accreditation and quality assurance 5 (2000), S. 409-413 
    Details
    ISSN: 1432-0517
    Keywords: Key words Metrology ; Comparisons ; Chemistry ; Standards
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract  After stressing the importance in the modern world of accurate and reproducible measurements, the actions taken by the Bureau International des Poids et Mesures to set up, together with the regional metrology organizations, a series of key comparisons are described. They are the technical foundation of a mutual recognition of national measurement standards arrangement prepared in conjunction with the National Metrology Institutes (NMIs). This arrangement also includes the recognition of calibration and measurement certificates issued by these institutes. Then, the consequences of this arrangement for trade are described. The case of chemical analysis is illustrated by the application of the Kyoto protocol on the reduction of greenhouse gases. But the global workload to be taken up by the International Committee of Weights and Measures, its Consultative Committee for Amount of Substance and the NMIs is huge.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007690000228
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 55
    Electronic Resource
    Electronic Resource
    Lasertherapie in der Dermatologie und Ästhetischen Medizin Nebenwirkungen, Komplikationen und Behandlungsfehler (2000)
    Springer
    Der Hautarzt 51 (2000), S. 463-473 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Laser ; Nebenwirkungen ; Komplikationen ; Behandlungsfehler ; Keywords Laser ; Side effects ; Complications ; Treatment faults
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Many different laser systems are used in dermatology. To wisely choose the correct laser for a given problem, one must be aware of both the spectrum of disorders for which each laser is suited and the potential side effects. We compare the side effect and complication profiles of the common laser systems pointing out their possibilities and limitations. Typical treatment errors will be pointed out. Dermatological training, extensive experience in laser therapy and compliance with quality guidelines are prerequisites for safe and successful treatment.
    Notes: Zusammenfassung In der Dermatologie werden unterschiedliche Lasersysteme eingesetzt. Für die Anwender ist nicht nur das jeweilige Behandlungsspektrum von Bedeutung, sondern auch welche unerwünschten Reaktionen im Rahmen einer Laserbehandlung auftreten können. Das Nebenwirkungs- und Komplikationsprofil der gängigen Geräte wird in der vorliegenden Arbeit vorgestellt und verglichen, und deren Möglichkeiten und Grenzen werden dargestellt. Typische Behandlungsfehler werden aufgezeigt. Eine dermatologische Facharztausbildung, umfangreiche lasertherapeutische Erfahrungen sowie die Einhaltung und Erfüllung von definierten Qualitätsrichtlinien sind Voraussetzungen für ein sicheres Behandlungsergebnis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050051155
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 56
    Electronic Resource
    Electronic Resource
    Osteochondroma: MR imaging of tumor-related complications (2000)
    Springer
    European radiology 10 (2000), S. 832-840 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Osteochondroma ; Complications ; Chondrosarcoma ; Bone tumors ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Osteochondromas can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and postoperative recurrence. Magnetic resonance imaging represents the most valuable imaging modality in symptomatic cases, because it can demonstrate typical features of associated soft tissue pathology, which can be differentiated from malignant transformation. Reactive bursae formation presents as an overlying fluid collection with peripheral contrast enhancement. Dislocation, deformation, and signal alterations of adjacent soft tissue structures can be observed in different impingement syndromes caused by osteochondromas. Magnetic resonance imaging provides excellent demonstration of arterial and venous compromise and represents the method of choice in cases with compression of spinal cord, nerve roots, or peripheral nerves, depicting changes in size, position, and signal intensity of the affected neural structures. Malignant transformation as the most worrisome complication occurs in approximately 1 % of solitary and 5–25 % of multiple osteochondromas. Magnetic resonance imaging is the most accurate method in measuring cartilage cap thickness, which represents an important criterion for differentiation of osteochondromas and exostotic (low-grade) chondrosarcomas. Cartilage cap thickness exceeding 2 cm in adults and 3 cm in children should raise the suspicion for malignant transformation. Finally, MR imaging can detect postoperative recurrence by depiction of a recurrent mass presenting typical morphological features of a cartilage-forming lesion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300051014
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 57
    Electronic Resource
    Electronic Resource
    Implanted central venous catheter-related acute superior vena cava syndrome: management by metallic stent and endovascular repositioning of the catheter tip (2000)
    Springer
    European radiology 10 (2000), S. 1329-1331 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Central venous catheters ; Venous obstruction ; Vena cava ; Interventional procedure ; Catheters and catheterization ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We describe a case of a 49-year-old woman with stage-IIIB lung adenocarcinoma who experienced an acute superior vena cava syndrome related to an implanted central venous catheter without associated venous thrombosis. The catheter was surgically implanted for chemotherapy. Superior vena cava syndrome appeared after the procedure and was due to insertion of the catheter through a subclinical stenosis of the superior vena cava. Complete resolution of the patient's symptoms was obtained using stent placement and endovascular repositioning of the catheter tip.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300000361
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 58
    Electronic Resource
    Electronic Resource
    Risikofaktoren für das Auftreten von lokalen Komplikationen beim Erysipel (2000)
    Springer
    Der Hautarzt 51 (2000), S. 14-18 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter ; Erysipel ; Komplikationen ; Diabetes mellitus ; Hepatopathien ; Nephropathien ; Key words ; Erysipelas ; Complications ; Diabetes mellitus ; Hepatopathy ; Nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background and objective: A complicated course of erysipelas is not uncommon. Bullous, haemorrhagic, necrotic and purulent lesions may be encountered. Today no reliable data exist as to which constitutional factors renders a patient at risk for developing complicated erysipelas though several risk factors, particularly diabetes mellitus, are often suggested. Based on the analysis of patients with erysipelas at the Department of Dermatology in Graz, factors determining the risk for complicated erysipelas should be identified. Patients/Methods: In a retrospective case-control study clinical data sheets of 766 in- patients treated at the department were evaluated with respect to the course of the erysipelas and with respect to potential risk factors. Results: General risk factors for local complications were location at the lower extremities, pre-existing hepatic or renal disease, hyperuricaemia, and diabetes mellitus. Hepatic and renal disease and – to a lesser extent – diabetes particularly predisposed for bullous and haemorrhagic lesions, while vascular occlusive disease enhanced the risk for ne- crotic lesions. Conclusions: Location and hepatic and renal disease are the most important risk factors, while diabetes is probably of less significance than previously suggested.
    Notes: Zusammenfassung Hintergrund und Fragestellung: Im Zuge eines Erysipels treten immer wieder Lokalkomplikationen (Blasen, Hämorrhagien, Nekrosen, Abszesse) auf. Derzeit gibt es keine verlässlichen Daten darüber, aufgrund welcher Merkmale ein Patient als komplikationsgefährdet einzustufen ist, wobei aber verschiedene Risikofaktoren, insbesondere Diabetes mellitus, vermutet werden. Anhand des Patientenguts der Grazer Hautklinik sollten klinische Risikofaktoren für einen komplizierten Erysipelverlauf erhoben werden. Patienten/Methodik: In einer retrospektiven Fall-Kontroll-Studie wurden von 766 Patienten, die in den Jahren 1986–1995 wegen eines Erysipels stationär behandelt worden waren, klinische Daten hinsichtlich Erysipelverlauf und möglicher Risikofaktoren erhoben und statistisch ausgewertet. Ergebnisse: Das Risiko eines komplizierten Erysipelverlaufs wird allgemein durch Lokalisation am Bein, durch Leber- und Nierenerkrankungen, Hyperurikämie und durch einen Diabetes mellitus erhöht. Lebererkrankungen und – in geringerem Maße Diabetes – disponieren speziell zu bullösen und hämorrhagischen Verläufen, eine periphere arterielle Verschlusskrankheit zu nekrotischen Läsionen. Schlussfolgerungen: Betroffene Körperregion sowie Leber- und Nierenerkrankungen scheinen die wichtigsten Risikofaktoren zu sein, während der Diabetes mellitus möglicherweise eine geringere Rolle spielt, als bisher angenommen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050004
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 59
    Electronic Resource
    Electronic Resource
    Sleep-related breathing disorders following discharge from intensive care (2000)
    Springer
    Intensive care medicine 26 (2000), S. 426-433 
    Details
    ISSN: 1432-1238
    Keywords: Key words Outcomes ; Hypoxaemia ; Sleep-related breathing disorders ; Obstructive sleep apnoea ; Central sleep apnoea ; Mechanical ventilation ; Complications ; Intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To determine the incidence of sleep-related breathing disorders and nocturnal hypoxaemia in patients discharged from ICU following prolonged mechanical ventilation.¶Design: Prospective, consecutive patient observational study.¶Setting: The medical and surgical wards of a University Hospital.¶Patients and participants: Fifteen consecutive, adult patients discharged from the ICU who had received more than 48 h of mechanical ventilation were studied. Ten healthy volunteers acted as controls.¶Measurements and results: Overnight, multi-channel pneumographic studies were performed on all patients and controls. Chest and abdominal wall movement, air flow, oxygen saturation and snoring were continuously recorded. Data was analysed by both visual inspection of the traces and by computer-based algorithms. An apnoea/hypopnoea index was calculated for each patient and volunteer. Volunteers had an apnoea/hypopnoea index of less than 5 and had no episodes of nocturnal oxygen desaturation (SaO2 〈 90 %). Despite oxygen therapy 13/15 patients had episodes of desaturation and 9/15 spent more than 2 h with an SaO2 〈 90 %. Eleven patients had an abnormal apnoea/hypopnoea index (range 5–34 events/h). Four patients had predominantly obstructive events while 7 primarily had hypopnoeas.¶Conclusions: Significant overnight oxygen desaturation is common in patients discharged from ICU who have received prolonged mechanical ventilation. This group also has a significant incidence of sleep-related breathing disorders and this mechanism is likely to be important in the pathogenesis of the hypoxaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051177
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 60
    Electronic Resource
    Electronic Resource
    Translaryngeal tracheostomy: two modified techniques versus the basic technique – early experience in 75 critically ill adults (2000)
    Springer
    Intensive care medicine 26 (2000), S. 457-461 
    Details
    ISSN: 1432-1238
    Keywords: Key words Tracheostomy: percutaneous, translaryngeal ; Complications ; Oxygenation ; Intensive care medicine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Elective tracheostomy is an established procedure in the management of ICU patients on long-term ventilation. In addition, percutaneous tracheostomy techniques are increasingly being used. In 1997, Fantoni's translaryngeal technique (TLT), another minimally invasive procedure, was introduced. While clinical studies of TLT showed that the technique is safe and can be performed rapidly, technical difficulties which sometimes led to prolonged operating times were also noted. Our study compared the basic TLT technique to a modified TLT approach and to TLT performed with the manufacturer's new, improved “Straight Cannula” set. Twenty-five patients were enrolled in each group, and the advantages and disadvantages of the respective techniques were evaluated.¶Setting: Surgical ICU of a university hospital.¶Patients: Seventy-five adult, surgical intensive care patients.¶Measurements and results: Average operating times with the modified TLT techniques were significantly shorter, 4 and 5 min respectively, as compared to 11 min for the basic TLT technique. Initially, use of the new, improved TLT set resulted in a complete passage of the tracheal cannula in two patients; uneventful Griggs's tracheostomy was performed instead. Regardless of the technique used, no other perioperative complications were noted and the perioperative gas exchange remained unaffected by the tracheostomy procedure.¶Conclusions: The modified TLT procedures are safer and more readily performed than the basic technique. Difficulty in the retrograde passage of the guide wire was seen only occasionally with the modified techniques. Based on our data we conclude that the modified techniques are superior to the basic technique and represent significant progress in TLT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051181
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 61
    Electronic Resource
    Electronic Resource
    Delay of extubation in neonates and children after cardiac surgery: impact of ventilator-associated pneumonia (2000)
    Springer
    Intensive care medicine 26 (2000), S. 942-949 
    Details
    ISSN: 1432-1238
    Keywords: Key words Ventilator-associated pneumonia ; Cardiac surgery ; Children ; Pediatric intensive care ; Complications ; Extubation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children.¶Methods: Cohort study in a pediatric intensive care unit of a tertiary referral center. All patients who had cardiac operations during a 22-month period and who survived surgery were eligible (n = 272, median age 1.3 years). Primary outcome was time to successful extubation. Primary variable of interest was VAP. Surgical procedures were classified according to complexity. Cox proportional hazards models were calculated to adjust for confounding. Potential confounders comprised other known risk factors for delayed extubation.¶Results: Median time to extubation was 3 days. VAP occurred in 26 patients (9.6 %). The rate of VAP was not associated with complexity of surgery (P = 0.22), or cardiopulmonary bypass (P = 0.23). The adjusted analysis revealed as further factors associated with delayed extubation: other respiratory complications (n = 28, chylothorax, airway stenosis, diaphragm paresis), prolonged inotropic support (n = 48, 17.6 %), and the need for secondary surgery (n = 51, 18.8 %; e. g., re-operation, secondary closure of thorax). Older age promoted early extubation. The median delay of extubation attributable to VAP was 3.7 days (hazards ratio HR = 0.29, 95 % CI 0.18–0.49), exceeding the effect size of secondary surgery (HR = 0.48) and other respiratory complications (HR = 0.50).¶Conclusion: VAP accounts for a major delay of extubation in pediatric cardiac surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051285
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 62
    Electronic Resource
    Electronic Resource
    Operative or endovascular treatment of ruptured intracranial vertebral artery aneurysms? (2000)
    Springer
    Neuroradiology 42 (2000), S. 685-691 
    Details
    ISSN: 1432-1920
    Keywords: Key words Aneurysm, vertebral artery ; Haemorrhage, subarachnoid ; Surgery ; Embolisation ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to evaluate the surgical and endovascular treatment outcomes of ruptured intracranial vertebral artery aneurysms (RIVAA). The outcomes of 44 patients with RIVAA treated between 1983 and 1998 surgically (26), endovascularly (20) or both (2) were evaluated. The aneurysms were clipped in 24 patients, and clipped and wrapped in two. We treated 20 by the endovascular approach, 12 with Guglielmi detachable coils (GDC), and eight by parent-vessel occlusion using detachable balloons. Three patients had endovascular treatment after a failed or inadequate surgical attempt. Post-treatment follow-up was 17–183 months (mean 101 months) for surgically treated patients. For the GDC-treated group angiographic follow-up was carried at 8–49 months (mean 19 months). The condition of seven (27 %) of the surgically treated patients worsened due to procedure-related complications, compared with 10 % in the endovascular treatment group. Of the patients initially presenting with Hunt and Hess grade IV or V, three of five (60 %) died who were treated surgically and two of eight (25 %) who were treated endovascularly. A good outcome was achieved in 17 surgically treated patients (85 % of the survivors) and in 16 of the endovascular group (89 % of the survivors). This present “same-site” report on treatment of a specific abnormality, RIVAA, treated surgically or by an endovascular approach indicates that especially in poorer Hunt and Hess grade patients, the latter may offer a clinical outcome as good as that of surgery, although long-term efficacy of GDC treatment is still to be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000378
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 63
    Electronic Resource
    Electronic Resource
    Pediatric biopsy of a single native kidney (2000)
    Springer
    Pediatric nephrology 15 (2000), S. 66-69 
    Details
    ISSN: 1432-198X
    Keywords: Key words Biopsy ; Kidney ; Complications ; Percutaneous ; Internet ; e-mail
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Technological improvements have reduced the frequency of complications in children receiving a percutaneous renal biopsy. No study has systematically compared the safety of open and percutaneous kidney biopsy. Yet many nephrologists consider a single native kidney an absolute contraindication to percutaneous biopsy. We have established an international registry of single native kidney biopsies in children and we now report our early results. Eight biopsies are included. Seven patients had percutaneous biopsies and one an open biopsy. None of the patients had major complications, and adequate tissue was obtained from all. Our limited experience indicates that the presence of a single native kidney is not an absolute indication for an open approach. We encourage our colleagues to report to the international registry in order to further document the safety of percutaneous biopsy of the single native kidney in children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670000417
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 64
    Electronic Resource
    Electronic Resource
    Duodenal duplication cyst identified with MRCP (2000)
    Springer
    European radiology 10 (2000), S. 1277-1279 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Duodenum ; Congenital anomalies ; Duodenal duplication ; Imaging ; Duodenal duplication ; Complications ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of a stalked cystic duodenal duplication. The lesion, hyperintense on T2-weighted GRE images, maintained the signal intensity after oral administration of a negative contrast agent (Lumirem, Guerbet, Aulnay-Sous-Bois, France), confirming its independence from the duodenal lumen. To our knowledge, this is the first demonstration of duodenal duplication by means of MR cholangiopancreatography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003309900286
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 65
    Electronic Resource
    Electronic Resource
    Late complication following percutaneous cholecystostomy: retained abdominal wall gallstone (2000)
    Springer
    European radiology 10 (2000), S. 1284-1286 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Percutaneous cholecystostomy ; Complications ; Gallstone ; Abdominal wall imaging ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A case of recurrent abdominal wall abscess following percutaneous cholecystostomy (PC) is presented. Transperitoneal PC was performed in an 82-year-old female with calculous cholecystitis. Symptoms resolved and the catheter was removed 29 days later. The patient came back 5 months later with a superficial abscess that was drained and 8 months post PC with a fistula discharging clear fluid. Ultrasonography revealed the tract adjacent to an area of inflammation containing a calculus, whereas CT failed to depict the stone. Subsequent surgery confirmed US findings. To our knowledge, this is the first report of a dislodged bile stone following percutaneous cholecystostomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003309900309
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 66
    Electronic Resource
    Electronic Resource
    Complications following anterior approaches to the cervical spine (2000)
    Springer
    European journal of orthopaedic surgery & traumatology 10 (2000), S. 177-181 
    Details
    ISSN: 1432-1068
    Keywords: Cervical spine ; Anterior approach ; Complications ; Dysphagia ; hoarseness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors present a retrospective study of 535 consecutive anterior approaches to the cervical spine back to 5 years. The data were analyzed for post-operative complications. This surgical procedure has been commonly used for more than 40 years, but the post-operative complications due to the anterior approach itself were presented with few accompanying statistics, with various and contradictory results. Injury to nearly all of the structures has been reported in the literature, the more frequent problems are hoarseness and dysphagia; other complications include perforation of the oesophagus, hematomas, vascular injury⋯ Analysis of this data allows to understand better the specific problems related to this surgical approach, and to suggest precautions at each stage of the course of exposure of cervical vertebrae.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01682311
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 67
    Electronic Resource
    Electronic Resource
    Perinatal indomethacin treatment and neonatal complications in preterm infants (2000)
    Springer
    European journal of pediatrics 159 (2000), S. 153-155 
    Details
    ISSN: 1432-1076
    Keywords: Key words Indomethacin ; Premature infants ; Antenatal ; Postnatal ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the incidence of neonatal complications among infants exposed to indomethacin antenatally, postnatally or both ante-and postnatally (combined), the records of 240 infants of gestational ages between 23 to 32 weeks were analysed retrospectively. Antenatal indomethacin treatment for longer than 2 days with a daily or cumulative dosage ≥150 mg correlated with a significantly higher incidence of grade I-II intraventricular haemorrhage. Combined exposure, cumulative antenatal exposure ≥150 mg and duration of antenatal exposure of more than 2 days was associated with necrotising enterocolitis and a cumulative exposure with sepsis. There was no independent association between indomethacin exposure and pneumothorax, bronchopulmonary dysplasia or respiratory distress syndrome. Conclusion Preterm infants with exposure to antenatal indomethacin might be at increased risk of grade I and II intraventricular haemorrhage and those with both ante- and postnatal exposure at an increased risk of necrotising enterocolitis and sepsis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050040
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 68
    Electronic Resource
    Electronic Resource
    The results of anterior fusion and Cotrel-Dubousset-Hopf instrumentation in idiopathic scoliosis (2000)
    Springer
    European spine journal 9 (2000), S. 505-515 
    Details
    ISSN: 1432-0932
    Keywords: Key words Idiopathic scoliosis ; Anterior instrumentation ; Surgical treatment ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Anterior instrumentation for the correction of scoliotic curves has recently been gaining in popularity. The problems of high mortality and morbidity that were associated with the employment of anterior instrumentation in the first years it was used have now been overcome. Efforts are now being concentrated on increasing the correction rates in the frontal plane and decreasing the kyphotic effect in the sagittal plane. The anterior Cotrel-Dubousset-Hopf (CDH) system is a recently developed instrumentation that has been claimed to decrease the kyphotic effect through the use of double rods. This study aimed to investigate the impact of the anterior CDH system on idiopathic scoliotic curves in frontal and sagittal planes. To this end, 26 idiopathic scoliosis patients treated with the CDH system were followed for a mean period of 32.8 ± 5.3 months. In the frontal plane, Cobb angles of major and secondary curves were measured, and postoperative and final correction rates determined. In the sagittal plane, sagittal contours of both the instrumented region and the thoracic and lumbar regions were measured, and their preoperative, postoperative and final control values were determined. In addition to clinical examination, lateral trunk shift (LT), shift of head (SH) and shift of stable vertebra (SS) were measured in vertebral units (VU), on the preoperative and postoperative radiographs in order to evaluate the effect of the system on trunk balance. It was established that in patients with single flexible thoracolumbar and lumbar curves and those with rigid thoracic curves, the correction rates obtained in the frontal plane were respectively 79.4 ± 14.8%, 68.0 ± 9.4% and 61.5 ± 8.0%, with statistical significance. Their final corrections at the last control were 76.3 ± 17.4%, 56.9 ± 9.1% and 52.3 ± 8.3%, respectively. Although the corrections in the lumbar rigid curves were relatively low, they were still statistically significant. Taking all the patients together, the mean preoperative Cobb angle of the major curves of 67.2°± 20.2° improved to a mean of 28.6°± 21.0°, which was a statistically significant difference (P 〈 0.05), giving a mean correction rate of 61.2 ± 20.3%. The mean correction loss of major curves in the frontal plane in all patients was 6.0°± 3.8° and the mean final correction rate was 52.6 ± 23.2%. In the sagittal plane, there was a favorable kyphotic effect on the thoracic region of patients with hypokyphosis and lordosis pattern, whilst in patients with kyphotic pattern, this effect was minimal. In patients with a single flexible lumbar curve, kyphotic effect was not observed except in two patients. In these two patients, it was thought that excessive compression force may have been used. As to the patients with a rigid lumbar curve, there was a slight decrease in lumbar lordosis. No postoperative complaints were made about imbalance, and the mean overall correction in LT values was 60.1 ± 21.7%. While preoperatively, the SH and SS values of all patients were over 0.5 VU, postoperatively, 12 patients (46.2%) were completely balanced (SH = 0 VU, SS = 0 VU) and 8 patients (30.8%) were balanced (0 VU 〈 SH and SS 〈 0.5 VU). The remaining six patients, whose balance values were corrected with statistical significance but were still over 0.5 VU, were found to be the ones with rigid lumbar curves. Implant failure and systemic complications were not noted in the follow-up period. In view of these findings, it was determined that CDH instrumentation achieves significant correction rates in the frontal and sagittal planes, particularly in single flexible lumbar, thoracolumbar and thoracic rigid curves. It was found that the kyphotic effect was minimized with a double rod system. Significant clinical and radiological corrections were achieved in balance values, without any imbalance and decompensation problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005860000176
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 69
    Electronic Resource
    Electronic Resource
    Increasing chronic subdural hematoma after endoscopic III ventriculostomy (2000)
    Springer
    Child's nervous system 16 (2000), S. 402-405 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Endoscopic III ventriculostomy ; Overdrainage ; Chronic SDH ; Shunt ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Object: Endoscopic III ventriculostomy (ETV) is an effective and a rather safe treatment for noncommunicating hydrocephalus secondary to aqueductal stenosis and other obstructive pathologies. Though not devoid of risk, ETV is increasingly replacing shunt operations, and it prevents related complications, including overdrainage. Methods: We report a rare case of a large chronic subdural hematoma (ChSDH) after ETV in a patient with aqueductal stenosis. Three weeks after he was shunted elsewhere, he presented to us with clinical symptoms of intracranial hypotension and overdrainage. ETV was performed and the shunt removed uneventfully. On routine postoperative MRI a few weeks later, a large ChSDH was noted, the patient being totally asymptomatic. Since the ChSDH grew significantly, causing a mass effect on the follow-up MRI, it was finally drained. Large and increasing ChSDHs have previously been reported secondary to overdrainage after shunt placement, but not after ETV. Conclusions: We conclude that though rare, a ChSDH may evolve even after ETV, if there is a substantial decrease in previously elevated intracranial pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000298
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 70
    Electronic Resource
    Electronic Resource
    Evolution of living donor liver transplantation in adults: a single center experience (2000)
    Springer
    Transplant international 13 (2000), S. S134 
    Details
    ISSN: 1432-2277
    Keywords: Key words Liver transplantation ; Living donor ; Adult patient ; Right lobe graft ; Small-for-size graft ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050300
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 71
    Electronic Resource
    Electronic Resource
    Incidence and clinical characteristics of posttransplant lymphoproliferative disorders: report from a single center (2000)
    Springer
    Transplant international 13 (2000), S. S382 
    Details
    ISSN: 1432-2277
    Keywords: Key words Transplantation ; Complications ; PTLD
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the period 1973–1998, among 2 139 allograft recipients treated with standard immunosuppression, posttransplant lymphoproliferative disorders (PTLD) developed in 19 patients (0.9 %): one plasmacytic hyperplasia, two polymorphic PTLD, one myeloma, and 15 lymphomas. PTLD developed 1 year after transplantation (tx) in 14 patients. Five patients were diagnosed at autopsy, 2 were lost to follow up, 3 died before therapy could be instituted, and 1 patient has just started chemotherapy. Of the 8 evaluable patients, 2 received acyclovir and are alive in complete remission (CR) and 6 received chemotherapy ± surgery. Of these 6, 4 died of lymphoma and/or infection, 1 died of unrelated causes in CR, and 1 is alive in CR. PTLD is a severe complication of tx, usually running an aggressive course which may preclude prompt diagnosis and treatment. Nevertheless, therapy is feasible and must be tailored on the histologic subtype. Seventy-four percent of patients were diagnosed with late-onset PTLD stressing the need for long-term follow up.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050367
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 72
    Electronic Resource
    Electronic Resource
    Prevention of permanent arthrofibrosis after anterior cruciate ligament reconstruction alone or combined with associated procedures: a prospective study in 443 knees (2000)
    Springer
    Knee surgery, sports traumatology, arthroscopy 8 (2000), S. 196-206 
    Details
    ISSN: 1433-7347
    Keywords: Keywords Anterior cruciate ; ligament ; Immediate motion ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract We prospectively determined the effectiveness of an immediate knee motion and early intervention program to prevent permanent motion limitations in a consecutive series of patients who had anterior cruciate ligament autogenous patellar tendon reconstruction for isolated rupture (219 knees) or combined with other procedures (224 knees). The subjects were placed into either a progressive or delayed rehabilitation program and were followed for at least 12 months postoperatively. At follow-up a normal range of motion (0° to at least 135°) was found in 436 knees (98%), and mild losses of extension (–5°) were found in 7 knees. Twenty-three knees (5%) required interventions; 9 had extension casts, 9 had gentle manipulations under anesthesia, 3 had arthroscopic débridements, and 2 had continuous epidural anesthetic and inpatient therapy. All of these 23 knees regained full motion. The 7 patients with mild losses of extension had refused treatment intervention. The 0% incidence rate of permanent arthrofibrosis, and 0.7% reoperation rate for knee motion limitations, demonstrated the effectiveness of our program.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670000126
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 73
    Electronic Resource
    Electronic Resource
    Paclitaxel plus vinorelbine: An active regimen in metastatic breast cancer patients with prior anthracycline exposure (2000)
    Springer
    Annals of oncology 11 (2000), S. 85-89 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; combination therapy ; paclitaxel ; vinorelbine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:To evaluate the anti-tumour activity and tolerance of thecombination of paclitaxel plus vinorelbine in metastatic breast cancer (MBC)patients previously treated with anthracyclines. Patients and methods:Fifty-six MBC patients who have had at leastone previous anthracycline-containing chemotherapy regimen were enrolled inthis phase II trial. Patients received paclitaxel (135 mg/m2 overone-hour infusion) and vinorelbine (30 mg/m2) both on day 1 of eachthree-week course of therapy (maximum eight courses or until diseaseprogression was evident). Results:Six complete and nineteen partial responses were observedamong the fifty-four assessable patients (response rate of 46%,95% CI: 33%–60%). Responses were observed in alldisease sites and in all subsets of patients. The response rates whenpaclitaxel plus vinorelbine were used as first, second and third-linechemotherapy for metastases were 67%, 41% and 35%,respectively. The response rate among anthracycline-refractory patients was46% (6 of 13). Median time to progression in the overall patient groupwas 28 weeks. The main toxicities (CTC grade 2 or more) were alopecia,myelosuppression and peripheral neuropathy (85%, 46% and19% of patients, respectively). Nine patients (17%) hadneutropenic fever in fifteen of the three hundred twenty-eight coursesadministered (5%). Conclusions:The combination of paclitaxel and vinorelbine on day1 every three weeks is active in MBC patients with prior anthracyclineexposure. The regimen is safe, well tolerated and convenient for the patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008374425246
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 74
    Electronic Resource
    Electronic Resource
    Early secondary acute myelogenous leukemia in breast cancer patients after treatment with mitoxantrone, cyclophosphamide, fluorouracil and radiation therapy (2000)
    Springer
    Annals of oncology 11 (2000), S. 1289-1294 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; cyclophosphamide ; fluorouracil ; mitoxantrone ; radiation therapy ; secondary leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The topoisomerase II-targeted drugs,epipodophyllotoxins and anthracyclines, have been shown to inducetherapy-related AML (t-AML) characterized by a short latency period afterchemotherapy, the absence of prior myelodysplastic syndrome and stereotypedchromosome aberrations. Few reports have been published on patients treatedwith the anthracenedione mitoxantrone which also targets topoisomerase II. Weobserved 10 cases of such t-AML over a 7-year-period in breast cancer patientstreated with mitoxantrone combined with fluorouracil, cyclophosphamide andregional radiotherapy, and in three cases with vindesine. Patients and methods:We retrospectively analyzed patientsreferred to our hospital for AML with a past history of polychemotherapy forbreast cancer, including mitoxantrone, either as adjuvant (8patients)/neoadjuvant (1 patient) therapy or for metastatic disease (1patient). We studied the probability of developing t-AML in a prospectiveseries of 350 patients treated with an adjuvant FNC regimen (mitoxantrone,fluorouracil, cyclophosphamide) and radiation therapy. Results:The median age was 45 years (range 35–67). t-AMLdeveloped 13–36 months (median 16) after beginning chemotherapy forbreast cancer, and 4–28 months (median 10.5) after ending treatment. Asdescribed in t-AML following treatment with epipodophyllotoxins oranthracyclines, we found a majority of FAB M4, M5 and M3 phenotypes (7 of 10),and characteristic karyotype abnormalities that also can be found in denovoAML: breakpoint on chromosome 11q23 (3 patients), inv(16)(p13q22)(2 patients), t(15;17)(q22;q11) (1 patient), t(8;21)(q22;q22) (1 patient) anddel(20q)(q11) (1 patient). The prognosis was poor. All patients died of AMLshortly after diagnosis. Since two patients had been enrolled in a prospectivetrial for the treatment of breast cancer which included 350 patients, theprobability of developing t-AML was calculated to be 0.7% from25–40 months, using the Kaplan–Meier method (95% confidenceinterval (95% CI): 0.1–4.5). Conclusions:The combination of mitoxantrone withcyclophosphamide, fluorouracil, and radiation therapy can induce t-AML, aswith other topoisomerase II-targeted drugs. Despite a low incidence, theprognosis appears to be poor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008375016038
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 75
    Electronic Resource
    Electronic Resource
    Breast cancer in women ≤35 years: Review of 1002 cases from a single institution (2000)
    Springer
    Annals of oncology 11 (2000), S. 1255-1262 
    Details
    ISSN: 1569-8041
    Keywords: age ≤35 years ; breast cancer ; single institution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Early-onset breast cancer may differ with respect toetiology, clinical features and outcome compared with breast cancer in olderwomen. To gain further insight, we retrospectively reviewed the clinicalfeatures and outcome of women ≤35 years with primary breast cancer seen atour institution over a 30-year period. Patients and methods:Charts were reviewed for women with operablebreast cancer diagnosed ≤35 years of age seen at the Princess MargaretHospital (PMH), Toronto from 1965–1994. Results:One thousand eighty-six women with non-metastaticinvasive breast cancer, aged 18.3–35.6 years (median 32.1 years) werereferred to PMH. Symptoms at presentation included: self-detected breast lump(83%), other breast symptom (10%), physician diagnosis(4%) and unknown (3%). Tumor size was known in 936 (〉2 cm in61%) and nodal status in 888 (lymph node positive in 52%).Modified radical mastectomy was performed in 568 (57%) andbreast-conservation surgery (BCS) in 422 (42%). Five hundred sixteen(51%) patients received adjuvant radiotherapy and five hundredthirty-four (53%) adjuvant systemic therapy. Two hundred ninety-three(29%) patients had a family history of breast cancer (FH).Contralateral breast cancer (CBC) occurred more frequently in women with FH(Prange 0.042–0.008). Local recurrence (LR) was 37% and73% at 10 years in those treated by BCS with and without radiotherapy,respectively. At 10 years, disease-free survival (DFS) was 30% andoverall patient survival 48%. Conclusions:In this cohort, breast cancer was usuallyself-diagnosed and tumors were 〉2 cm at presentation in approximatelytwo-thirds of cases, suggesting the possibilities of a delay in diagnosis,more aggressive tumors or both. Our results are compatible with the knownassociation of breast cancer FH with increased CBC. Our data also corroboratesthe suggestion that positive genetic testing in this age group should lead toconsideration of more aggressive ipsilateral and contralateral breastmanagement. In those receiving adjuvant irradiation after BCS, the LR rate washigh, but did not impact on overall survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008391401404
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 76
    Electronic Resource
    Electronic Resource
    Infusional ECarboF in patients with advanced breast cancer: A very active and well-tolerated out-patient regimen (2000)
    Springer
    Annals of oncology 11 (2000), S. 1557-1561 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; carboplatinum ; chemotherapy ; continuous 5-fluorouracil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed a trial using the combination of epirubicin 50mg/m2/day 1, carboplatinum AUC 5/day 1 and continuous5-fluorouracil (5-FU) 200 mg/m2/day (every 4 weeks for6 months) to confirm the efficacy and low toxicity profile of thisregimen in breast cancer. In 51 patients with metastatic(n = 33) or locally advanced (n = 18)breast cancer the overall response rate was 86% (95% confidenceinterval (95% CI): 73%–94%): 94% in locallyadvanced and 81% metastatic disease. Grade 3–4 toxicity was low:4% of patients presented with febrile neutropenia, 16% withsevere palmar-plantar syndrome, 10% with Port-a-cath thrombosis. This study confirms the high efficacy of infusional 5-FU-based regimens andjustifies further research into novel promising oral 5-FU derivatives.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008378220547
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 77
    Electronic Resource
    Electronic Resource
    Doxorubicin-based adjuvant chemotherapy in elderly breast cancer patients: The M.D. Anderson experience, with long-term follow-up (2000)
    Springer
    Annals of oncology 11 (2000), S. 1597-1601 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; breast cancer ; doxorubicin ; elderly patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The purpose of this study was to evaluate the clinicaloutcome of doxorubicin-based adjuvant chemotherapy in elderly breast cancerpatients and to compare results in elderly patients with those in youngerpatients. Patients and methods:We retrospectively reviewed the records ofall patients aged 50 years or older treated in trials of doxorubicin-basedadjuvant chemotherapy between 1974 and 1988. Old age was not an exclusioncriterion for these trials. Patient characteristics, hematologic andnonhematologic side effects, patterns of recurrence, and causes of death weredetermined for patients aged 50–64 years and for patients aged 65 yearsor older, and results were compared between these two groups.Kaplan–Meier survival curves were plotted, and tested by the generalizedWilcoxon test. Results:A total of 390 patients aged 50 years or older weretreated with doxorubicin-based adjuvant chemotherapy during the study period.Of these, 325 were aged 50–64 years (group 1), and 65 were aged 65 yearsor older (group 2). The median follow-up period for group 1 was 185 months(range 29–272+ months), and the median follow-up period for group 2 was169 months (range 128–240+ months). There were no statisticallysignificant differences between the two groups with respect to performancestatus, hormone receptor profile, tumor size, nodal status, or type oflocoregional therapy. There also were no statistically significant differencesbetween the two groups in recurrence patterns, disease-free survival, oroverall survival. The granulocyte and platelet nadirs of cycles 1, 3, and 6were similar between the two groups. No cumulative hematologic side effectswere seen in either group. The occurrence of second malignancies was extremelylow in both groups. In both groups, the majority of deaths were due toprogression of disease. Conclusions:Adjuvant doxorubicin-based chemotherapy is welltolerated in elderly breast cancer patients who have good performance statusand normal cardiac ejection fraction. Adjuvant doxorubicin-based chemotherapyin these patients results in disease-free and overall survival rates similarto those seen in younger patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008315312795
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 78
    Electronic Resource
    Electronic Resource
    A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil®) in controlling hot flashes in breast cancer survivors (2000)
    Springer
    Annals of oncology 11 (2000), S. 17-22 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; hot flashes ; paroxetine ; serotonin uptake inhibitors ; survivors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Many breast cancer survivors suffer debilitating hotflashes. Estrogen, the drug of choice in perimenopausal women, is generallynot recommenced to breast cancer survivors. Nonhormonal treatments are mostlydisappointing. Anecdotal reports in our institution suggested that theselective serotonin-reuptake inhibitor, paroxetine hydrochloride, might beefficacious in alleviating hot flashes. Patients and methods:Thirty women with prior breast cancer whowere suffering at least two hot flashes a day entered a single institutionpilot trial to evaluate paroxetine's efficacy in reducing the frequency andseverity of hot flashes. After completing daily diaries for one week on notherapy, the women received open-label paroxetine, 10 mg daily for one week,followed by four weeks of paroxetine, 20 mg daily. The women completedhot-flash daily diaries throughout the study period, and a health-relatedsymptom-assessment questionnaire and a quality-of-life rating scale in thefirst and sixth week of the study. Results:Twenty-seven women completed the six-week study period.The mean reduction of hot flash frequency was 67% (95%confidence interval (95% CI): 56%–79%). The meanreduction in hot flash severity score was 75% (95% CI:66%–85%). There was a statistically significantimprovement in depression, sleep, anxiety, and quality of life scores.Furthermore, 25 (83%) of the study participants chose to continueparoxetine therapy at the end of study. The most common adverse effect wassomnolence, resulting in drug discontinuation in two women, and dose reductionin two women. One woman discontinued drug due to anxiety. Conclusions:Paroxetine hydrochloride is a promising new treatmentfor hot flashes in breast cancer survivors, and warrants further evaluationin a double-blind randomized placebo-controlled trial.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008382706068
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 79
    Electronic Resource
    Electronic Resource
    Socio-economic deprivation and stage of disease at presentation in women with breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 105-107 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; socio-economic status ; stage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:This study describes and compares the pathologicalprognostic factors and surgeon assessment of stage of breast cancer of womenliving in affluent and deprived areas to assess whether clinical stage atpresentation may explain the known poorer survival outcomes for deprivedwomen. Patients and methods:A population-based review of the caserecords of 417 women with breast cancer was carried out. Results:No difference in pathological criteria was found betweenthe 88% of women living in affluent and deprived areas for whom suchdata were available. Clinical assessment of the remaining 50 cases showed thatwomen living in deprived areas were more likely to present with locallyadvanced or metastatic disease. Conclusion:The poorer survival of women from deprived areas withbreast cancer may be explained by more deprived women presenting with advancedcancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008385321476
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 80
    Electronic Resource
    Electronic Resource
    Patient participation in medical decision-making: A French study in adjuvant radio-chemotherapy for early breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 39-45 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; choice ; decision-making process ; patient–physician relationship
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Shared decision-making is increasingly advocated asan ideal model. However, very few studies have tested the feasibility ofgiving patients the opportunity to participate in the choice of treatment. Patients and methods:Women, with non-metastatic breast cancer,eligible for non-intensified adjuvant chemotherapy attending our hospital wereproposed two administrations of chemotherapy and radiotherapy: a sequentialand a concomitant one. Two patient-questionnaires were used to elicitmotivations for their choice and their degree of comfort with the process ofdecision-making and one questionnaire to test physicians' ability to predictpatients' choice. Results:Participation rate in the study was 75.3%(n = 64). Majority (64%) of patients chose the concomitanttreatment. Multivariate analysis revealed that patients with a lower level ofeducation, who discussed the choice with social circle, and who most fearedside-effects were more likely to choose the sequential treatment. Physicianswere able to predict patients' choice in 66% of cases. 89% ofpatients declared that they were "fully satisfied" with having participatedin the choice of treatment and 79% supported shared decision-making. Conclusions:Results are in favour of promoting activeparticipation of cancer-patients in medical decision-making. The adequatedegree of such participation remains however to be elicited and tested fortherapeutic choices implying more difficult trade-offs between quantity andquality of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008390027720
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 81
    Electronic Resource
    Electronic Resource
    Second cancers after adjuvant tamoxifen therapy for breast cancer in Japan (2000)
    Springer
    Annals of oncology 11 (2000), S. 1539-1544 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant therapy ; breast cancer ; second cancer ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Women treated with tamoxifen for breast cancer are atincreased risk of endometrial cancer. We conducted a retrospective cohortstudy to evaluate the risk of second primary cancers after adjuvant tamoxifentherapy for breast cancer in Japan. Patients and methods:The subjects of the study were 6148 womenwho had been diagnosed with stage I, II, or IIIA unilateral primary breastcancer and had received surgical treatment during the period from January 1982through December 1990 at nine institutions in Japan. The information on eachpatient was obtained from medical records or a prospectively compiled computerdatabase at each institution. Results:Of the 6148 women, 3588 (58.4%) were administeredtamoxifen as an adjuvant treatment and 2560 (41.6%) were notadministered. Median follow-up periods were 7.64 years for tamoxifen-treatedpatients and 8.10 years for non-tamoxifen-treated patients, respectively. Theduration of tamoxifen treatment was mostly two years or less (80.7%),and few patients received tamoxifen for more than five years. The cumulativeincidence rates of all second cancers at 10 years were 4.61% and4.09% among tamoxifen-treated and non-tamoxifen-treated patients(P = 0.62), respectively, and the incidence rate ratio (IRR) forall second cancers was 1.06 (95% confidence interval (CI):0.77–1.47) after adjustment of several covariates. The numbers ofendometrial cancers was 9 and 3 among tamoxifen-treated andnon-tamoxifen-treated patients, respectively, and the IRR was 2.37 (95%CI: 0.64–8.77, P = 0.20). Of the 12 patients who developedendometrial cancer, 4 died of cancer (for 3 of them, the cause of death wasbreast cancer), and the other 8 patients were alive as of March 1996. Stomachcancer was the most frequent second cancer and the IRR was 1.34 (95%CI: 0.76–2.38, P = 0.31). There was no substantialincrease in any other type of gastrointestinal cancer such as colorectal andliver cancers among tamoxifen-treated patients. Conclusions:The incidence and risk of second primary cancersassociated with tamoxifen therapy is low. The potential benefit of adjuvanttamoxifen therapy in breast cancer patients outweighs the risk of secondprimary cancers for Japanese breast cancer patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008383804811
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 82
    Electronic Resource
    Electronic Resource
    Front-line treatment of advanced breast cancer with docetaxel and epirubicin: A multicenter phase II study (2000)
    Springer
    Annals of oncology 11 (2000), S. 1249-1254 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; docetaxel ; epirubicin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:In a previous phase I trial we evaluated the toxicity anddetermined the maximum tolerated doses of the docetaxel (D)–epirubicin(Epi) combination. We conducted a multicenter phase II study to evaluate theefficacy and tolerability of this regimen as front-line treatment in womenwith advanced breast cancer (ABC). Patients and methods:Fifty-four women with ABC stage IIIB (4patients) or IV (50 patients) received front-line treatment with Epi 70mg/m2 on day 1 and D 90 mg/m2 on day 2. The median agewas 55 years, performance status (WHO) was 0–1 in 49 patients andvisceral disease was present in 45 (83%). Results:All patients were evaluable for toxicity and 50 forresponse. In an intent-to-treat analysis complete remission was observed in5(9%) patients, partial remission in 31 (57%) (overall responserate 66%, 95% confidence interval: 54%–79%),stable disease in 9 (17%) and disease progression in 9 (17%).After a median follow-up of 11.5 months, the median duration of responses was8 months, the median time to disease progression 11.5 months and the mediansurvival has not yet been reached. The probability of one-year survival was65%. Three hundred six cycles of treatment were administered (median6 cycles per patient). Grade 3 and 4 neutropenia was observed in 8(15%) and 31 (57%) patients, respectively, and febrileneutropenia in 19 (35%). Prophylactic rh-G-CSF was used in 45(83%) patients or 226 (74%) cycles. Other hematologic ornon-hematologic toxicities were usually mild. In five (9%) patients theleft ventricular ejection fraction (LVEF) was decreased by more than10% with the treatment. Two patients died during the treatment ofrespiratory failure without associated neutropenia. Conclusions:The combination of docetaxel–epirubicin is aneffective and well tolerated front-line treatment in patients with ABC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008351310818
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 83
    Electronic Resource
    Electronic Resource
    p53 determination alongside classical prognostic factors in node-negative breast cancer: An evaluation at more than 10-year follow-up (2000)
    Springer
    Annals of oncology 11 (2000), S. 393-397 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; p53 ; prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:There is heterogeneity of methods and conflictingresults concerning the prognostic value of p53 in node-negativebreast cancer. The clinical value of a quantitative method for measuringtumoral p53 content still needs to be evaluated. Patients and methods: A long-term retrospective study wasconducted on 297 node-negative patients with a median follow-up greater than10 years (11 years, 101–172 months). Classic prognostic factors wereconsidered including age, tumor size, histoprognostic grade and estradiol (ER)and progesterone receptors (PR). In addition, the value of p53 determination (immunoluminometric assay in tumor cytosol) was assessed forthis long follow-up period. Results: p53 concentrations were significantly linked tothe histological grade (P = 0.001), to tumor size (P = 0.02)and ER status (P = 0.01). Higher p53 tumoral concentrationswere found in tumors with large size, pejorative histological grade andnegative ER status. In contrast, p53 tumoral concentrations were notinfluenced by menopausal or PR status. Multivariate Cox analysis demonstratesthat tumor size was the only significant predictor of disease-free survival(P = 0.049) with a risk factor at 1.38. As regards specific survival,univariate Cox analysis indicates that p53 taken as a continuousvariable is a significant predictor (P = 0.024) together withhistological grade, tumor size and ER status. In a multivariate Cox analysisthere were two significant and independent variables for predicting overallsurvival: tumor size (P = 0.031) and ER status (P = 0.015)with the highest risk factor (RR = 2.14). Conclusions:The present investigation points out that theprognostic power of p53 tumor determination evaluated at more than10 years median survival is not higher than the well-recognized classicprognostic factors in node-negative breast cancer. The present data highlightthe need to assess the prognostic value of potentially new biological factorsin node-negative breast cancer on cohorts of patients followed over periodsin excess of 10 years.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008359722254
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 84
    Electronic Resource
    Electronic Resource
    A comparison of methods currently used in clinical practice to estimate familial breast cancer risks (2000)
    Springer
    Annals of oncology 11 (2000), S. 451-454 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; genetic counselling ; risk assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:With the identification of genes predisposing tohereditary breast cancer, the accurate and consistent estimation of a woman'srisk of developing breast cancer based on her family history is of paramountimportance if national service guidelines are to be developed. Patients and methods:The residual lifetime risk of developingbreast cancer was estimated for 200 women attending a breast cancer geneticassessment clinic by three different methods currently in use in the UK. Riskswere computed on the basis of the Cancer and Steroid Hormone (CASH) study dataand were classified as ‘low/moderate’ (〈20%) or ‘high’(〉20%). These risk categories are representative of those currentlyused to allocate surveillance and genetic testing. Risks were then comparedto estimates derived by other methods used in current clinical practice,including those of Houlston and Murday. Results:The CASH data-based method ascribed 27% to thehigh risk category, as compared to 53% for the combined Houlston andMurday methods. A method based on the number of affected relatives aloneascribed only 14% to the high risk category. Overall, 108 (54%)women were placed in the same risk category by all three methods. Conclusions:This study demonstrates that there is a significantdegree of variability between methods currently used to estimate breast cancerrisk which has serious implications for individual patient management, serviceprovision and multicentre studies evaluating the benefits of genetic testingfor breast cancer susceptibility.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008396129543
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 85
    Electronic Resource
    Electronic Resource
    Gemcitabine and vinorelbine in pretreated advanced breast cancer: A pilot study (2000)
    Springer
    Annals of oncology 11 (2000), S. 495-496 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; gemcitabine ; metastases ; vinorelbine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:Gemcitabine (GEM) and vinorelbine (VNR) are both activeagainst advanced breast cancer (ABC), being able to induce a median ORR of25% and 40%, respectively. Because of their different mechanismof action and good tolerability, the combination of GEM and VNR has beentested in ABC. Patients and methods:Twenty-nine ABC patients pretreated withanthracycline-taxane were treated with GEM 1000 mg/m2 on day 1, 8,15, and VNR 25 mg/m2 on day 1 and 8 every twenty-eight days.Analysis of toxicity pattern, response rate, TTP and OS were carried out. Results:Twenty-nine patients were enrolled into the trial. TheORR was 48% (95% CI: 29–67): a CR was observed in threepatients (10%; 95% CI: 2–27), while eleven patients(38%; 95 CI: 21–58) achieved PR, eight (28%) had a SD, andseven (24%) progressed. Toxicity was mainly hematological and included:grade 3 leukopenia in 48% of cases without episodes of neutropenicfever, grade 3–4 thrombocytopenia in 10%, and grade 2 anemia in7%. Non-hematological toxicities were mild and rather infrequent. Conclusions:The GEM–VNR combination seems to be active inpretreated ABC with an acceptable toxicity pattern, and may well reppresentan interesting therapeutic choice after anthracycline/taxane regimens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008348704373
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 86
    Electronic Resource
    Electronic Resource
    Psychosocial predictors of survival: Metastatic breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 469-474 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; Prognostic factors ; psychosocial factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Research interest in psychosocial predictors of theonset and course of cancer has been active since the 1950s. Recently wereported associations between psychological factors and survival in patientswith metastatic melanoma. We now report a replication of this study in asample of women with metastatic breast cancer. Patients and methods:Ninety-nine patients with metastatic breastcancer completed questionnaires measuring cognitive appraisal of threat,coping, psychological adjustment, perceived aim of treatment, social supportand quality of life, approximately four months after diagnosis. Survival wasmeasured from date of study entry to date of death or censored at the date oflast follow-up for surviving patients. Results:In a multivariate analysis, four factors independentlypredicted outcome. Patients with metastases in the liver, lung or pleurasurvived for a shorter duration (P 〈 0.001); older patients(P 〈 0.001) and those with a better appetite (P 〈0.05) also lived for a shorter time. Patients who minimised the impact ofcancer survived longer (a median of 29.1 vs. 23.9 months after study entry,P 〈 0.01). Conclusions:Minimisation was also significantly associated withoutcome in patients with metastatic melanoma who participated in anidentically designed study, reported elsewhere. This suggests thatminimisation may have a general impact on cancer progression and deservescloser scrutiny in other cancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008396330433
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 87
    Electronic Resource
    Electronic Resource
    Combination chemotherapy with navelbine and continuous infusion of 5-fluorouracil in metastatic, chemotherapy refractory breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 1041-1043 
    Details
    ISSN: 1569-8041
    Keywords: 5-FU ; breast cancer ; metastatic ; navelbine ; protracted continuous infusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The protracted continuous infusion (PCI) of5-fluorouracil (5-FU) has proven in several studies an active and welltolerated treatment for advanced, pretreated breast cancer. Navelbine has alsoactivity in this setting. Patients and methods:Heavily pretreated patients with metastaticbreast carcinoma were eligible for the study. Treatment consisted of 5-FU 250mg/m2 given as a PCI by an elastomeric pump and navelbine 20mg/m2 on days 1 and 8, every four weeks. Eighty-three patients(median age 54 years; range 32–82 years) entered the study. The mediannumber of metastatic tumour sites was 2, with visceral involvement in 56patients. Apart from five patients with contraindications, all patients hadbeen pretreated with anthracyclines. Thirty-one patients had received taxanesand seventy-four bolus 5-FU. Results:A median of 5 cycles (range 1–14) per patient wasadministered. The median duration of 5-FU infusion was 17 weeks (range, 4-90).In the 80 evaluable patients (3 not yet evaluable) 12 complete remissions and24 partial remissions occurred (response rate, 45%). Median durationof response was 9 months. Toxicity was mild. Median survival was 20 months. Conclusions:PCI–5-FU combined with navelbine offers areasonable chance of tumour regression with modest side effects in patientswith heavily pretreated breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008333327500
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 88
    Electronic Resource
    Electronic Resource
    Adjuvant chemotherapy in node negative breast cancer: Patterns of use and oncologists' preferences (2000)
    Springer
    Annals of oncology 11 (2000), S. 631-633 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; attitudes ; breast cancer ; consensus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:A worldwide variation in policy is seen regardingadjuvant systemic treatment for node negative breast cancer (NNBC). After thefirst presentations of the 10-year EBCTCG results, a study was carried out inthe Netherlands to assess patterns of care and to obtain the views ofoncologists as to what constitutes a worthwhile benefit from treatment. Methods:A questionnaire regarding patterns of use of andpreferences for adjuvant chemotherapy in younger women was mailed to surgical,medical and radiation oncologists in the Netherlands. Results:Thirty-five percent stated that NNBC patients under 50in their hospital never received adjuvant chemotherapy. The majorityconsidered a 10-year survival gain of 6%–10% sufficientto warrant the use of chemotherapy in patients under 50. Surgical oncologistsrequired a larger benefit from treatment than radiotherapists and medicaloncologists. The more frequently oncologists treated patients in a researchcontext, the less benefit they required from treatment to make it worthwhile. Conclusions:Data such as these are valuable input into theprocess of guideline development, and may help discussion within theprofession as to what benefit offsets the burden of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008379628579
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 89
    Electronic Resource
    Electronic Resource
    Phase II study of docetaxel in patients with liver metastases from breast cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 541-546 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; clinical trial ; docetaxel ; hepatic metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Previous phase II studies of docetaxel have indicatedthat hepatic metastases from breast cancer respond well to first-linetreatment with docetaxel. The objective of this prospective, open label phaseII study therefore was specifically to evaluate the activity and safety ofdocetaxel in this indication. Patients and methods:The study recruited 47 women (mean age 50years, range 33–66 years) with hepatic metastases from breast cancer whofulfilled the eligibility criteria. After premedication with steroids,patients received a one-hour intravenous infusion of docetaxel 100mg/m2 at three-weekly intervals for up to eight cycles. Responseto treatment during medication was assessed after three, six and whereappropriate, eight cycles and every three month follow-up thereafter, untildisease progression or death. Results:The best overall response rate (ORR) for evaluablepatients was 64.3% (95% CI: 48.0%–78.5%).In terms of the primary efficacy parameters, the ORR at the sixth cycle oftreatment was 62% (95% CI: 45%–80%) with17% complete responses. The median duration of response was 139 days(95% CI: 111–216 days) and the median survival durationcalculated on an intent-to-treat basis was 335 days (227–568 days,95% CI). One (2%) toxic death was reported. Conclusions:Docetaxel is a highly effective cytotoxic agent inthe treatment of patients with liver metastases from breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008383707159
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 90
    Electronic Resource
    Electronic Resource
    Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: An approach to its validity (2000)
    Springer
    Annals of oncology 11 (2000), S. 701-705 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; lymph nodes ; sentinel lymph node biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Sentinel node biopsy (SNB) has been proposed as analternative to axillary lymph-node dissection (ALND) in breast cancer. Beforeimplementing SNB in our practice, we wished to test its validity by comparingit to the standard ALND, both in our hands and with other reported series. Patients and methods:One hundred thirty-two patients wereincluded prospectively. SNB and immediate ALND were performed. For SNB, atechnetium-colloid was used to produce preoperative lymphoscintigraphy andintraoperative gamma-probe search for the SN. Serial sectioning andimmunostains were used on the SN. A comprehensive review of the literature wasdone in order to run a meta-analysis of diagnostic tests using a summaryreceiver operating characteristic curve (SROC) to calculate the pooledparameters of sensitivity and associated 95% confidence interval(95% CI), including our own data. Results:Our technical success rate was 96%. Localsensitivity was 96%, with a 95% CI from85%–99%. Seven patients were upstaged by the SNB. Aliterature search identified 18 studies published from 1996–1999.Estimates of sensitivity ranged from 83%–100%. The pooleddata meta-analysis gave a global sensitivity of 91%, with a 95%CI from 89%–93%. The area under the global SROC curve was0.9967. Conclusions:The minimally invasive SNB was shown to be apractical alternative to ALND. We propose to use local as well as globalsensitivity and associated 95% CI to test the validity of SNB in theclinical setting. Due to limitations of ALND as the golden standard, SNB canin fact be considered a more accurate method for nodal staging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008377910967
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 91
    Electronic Resource
    Electronic Resource
    Weekly docetaxel plus gemcitabine or vinorelbine in refractory advanced breast cancer patients: A parallel dose-finding study (2000)
    Springer
    Annals of oncology 11 (2000), S. 367-371 
    Details
    ISSN: 1569-8041
    Keywords: docetaxel + gemcitabine ; docetaxel + vinorelbine ; phase I ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:The objective of this study was to determine thedocetaxel MTD when combined with gemcitabine or vinorelbine in advanced breastcancer patients who had received previous anthracycline-based chemotherapy foradvanced disease. Patients and methods:Advanced breast cancer patients aged between18 and 70 with ECOG PS 0–2 who had not responded to, or had relapsedafter, first-line anthracycline-based chemotherapy, were randomized to receiveeither gemcitabine 1000 mg/m2 or vinorelbine 25 mg/m2in combination with escalating doses of docetaxel (starting from 30mg/m2), all on days 1 and 8 every three weeks. Escalation wasstopped if 〉33% of patients treated at a given dose level showed DLTat the first cycle. Results:A total of 34 patients with locally advanced (8) ormetastatic disease (26) were treated, for a total of 94 cycles delivered.Nineteen patients received docetaxel in combination with gemcitabine and 15with vinorelbine. All patients had been pretreated with anthracyclines, and24 of 34 had also received weekly dose-dense paclitaxel. A docetaxel dose of40/m2 proved to be safe when combined on days 1 and 8 withgemcitabine, while a dose of 35 mg/m2 was tolerated in combinationwith vinorelbine. Overall, nine episodes of DLT, all of them neutropenia,occurred at the first cycle. Considering all 94 cyles, grades 3 or 4neutropenia and thrombocytopenia occurred in 15 (44%), and 7(20%) patients. Non-hematologic toxicity was mild, except for threecases of grade 2 peripheral neuropathy. All patients were assessed forresponse on an 'intent-to-treat' basis. Overall, five partial responses wererecorded (docetaxel + gemcitabine = 3 and docetaxel + vinorelbine = 2), fora 15% (95% CI: 5%–31%) overall responserate. Only 1 of 24 (4%) patients who had received weekly dose-densepaclitaxel responded to treatment. Conclusions:The weekly docetaxel administration in combinationwith either gemcitabine or vinorelbine is a well-tolerated treatment forheavily pretreated advanced breast cancer patients. This approach, althoughsometimes capable of achieving a major response, does not seem advisable inadvanced breast cancer patients refractory to both anthracyclines andpaclitaxel.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008346708604
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 92
    Electronic Resource
    Electronic Resource
    Response to primary chemotherapy in breast cancer patients with tumors not expressing estrogen and progesterone receptors (2000)
    Springer
    Annals of oncology 11 (2000), S. 1057-1059 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; estrogen receptor ; progesterone receptor ; preoperative chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:We recently demonstrated that in premenopausalpatients with estrogen receptors (ER)-absent tumors, early initiation ofsystemic chemotherapy after primary surgery might improve outcome. These dataindicate a different responsiveness to chemotherapy for tumors not expressinghormone receptors. To test this hypothesis we evaluated the responsiveness topreoperative chemotherapy in patients with ER and progesterone receptors(PgR)-absent tumors. Patients and methods:Patients with biopsy-provenT2–T3, N0–2 breast cancertreated at a single institution from January 1995 to August 1999 withpreoperative chemotherapy were retrospectively evaluated. ER and PgR weredetermined immunohistochemically and classified for this purpose as absent(0% of the cells positive) or positive (≥1% of the cells). Results:On 117 evaluable patients 72 had an objective response(61%). A significant difference in response was observed for patientswith ER and PgR absent compared with those with ER and/or PgR-positive tumors(82% vs. 57%,P = 0.03 Fishers's exact test).Pathological complete remission rates were also significantly different in thetwo groups (23% vs. 7%, respectively; P = 0.04). Conclusions:The different degree of response according to hormonereceptors expression supports the hypothesis that tumors not expressing bothER and PgR might represent a different clinical entity in terms ofchemotherapy responsiveness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008334404825
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 93
    Electronic Resource
    Electronic Resource
    Two Cases of Fulminant Mycoplasma pneumoniae Pneumonia within 4 Months (2000)
    Springer
    Infection 28 (2000), S. 180-183 
    Details
    ISSN: 1439-0973
    Keywords: Key WordsMycoplasma pneumoniae ; Pneumonia ; Complications ; Immunoblot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report the clinical course and diagnostic findings in two patients with life-threatening Mycoplasma pneumoniae (MP) pneumonia who were treated in the same hospital in the course of only 4 months. The patients were previously healthy adults, aged 31 and 37 years, respectively. In both of them severe complications occurred which coincided with the acute MP respiratory infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s150100050077
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 94
    Electronic Resource
    Electronic Resource
    Hospitalization for Primary Varicella-Zoster Virus Infection and Its Complications in Patients from Southern Israel (2000)
    Springer
    Infection 28 (2000), S. 200-204 
    Details
    ISSN: 1439-0973
    Keywords: Key Words Varicella ; Hospitalization ; Complications ; Bedouins ; Jews
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Background: We conducted this study to determine the impact of chickenpox on two different ethnic populations in southern Israel: Jews and Bedouins. Methods: Hospital records of 113 patients discharged from the Soroka Medical Center with the diagnosis of varicella during a 4.5-year period were reviewed. Results: Mean age was 9.2 years and the average hospital stay was 5.4 days. Bacterial skin or soft tissue infections were the most common complications (30%), followed by pneumonia (17%) and central nervous system complications (11.5%). There were no fatal cases throughout the study period. The calculated hospitalization rate for varicella was one in every 319 cases. Major differences between Jews and Bedouins included an older mean age of Bedouin patients (13.9 years versus 4.5 years); higher hospitalization rate (relative risk [R.R.]: 2.8, 95% confidence interval: 1.9–4.2), and higher risk for complicated varicella (R.R.: 2.1, 95% confidence interval: 1.3–3.4). Conclusion: Hospitalization of patients with varicella in southern Israel is common and varicella infection in Bedouins is associated with greater morbidity compared with that in Jews in southern Israel.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s150100070035
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 95
    Electronic Resource
    Electronic Resource
    Aktueller Einsatz und Stellenwert der intraaortalen Ballongegenpulsation in der kardiologischen Routine (2000)
    Springer
    Medizinische Klinik 95 (2000), S. 429-434 
    Details
    ISSN: 1615-6722
    Keywords: Schlüsselwörter Intraaortale Ballongegenpulsation ; Indikation ; Kardiogener Schock ; Akuter Myokardinfarkt ; Komplikationsrate ; Langzeitergebnisse ; Keywords Intraaortic balloon counterpulsation ; Indication ; Cardiogenic shock ; Acute myocardial infarction ; Complications ; Follow-up
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background: Intraaortic balloon counterpulsation (IABC) is an established technique for temporary support of the left ventricular function. However, less is known about the current use and outcome of IABC in daily clinical practice. Patients and Method: From July 1995 to May 1999 all patients receiving an IABC in the Department of Cardiology of the Heart Center Ludwigshafen were included in a consecutive registry and follow-up data were obtained. Results: Sixty-six patients (mean age 65 years, 64% male) received an IABC during the registration period. In 95% of cases the indication for IABC was the presence of cardiogenic shock. The shock was due to an acute myocardial infarction in 83%, other reasons were less frequent (≤ 5%). Total inhospital mortality was 48%. Patients in shock due to myocardial infarction (53%) showed the highest mortality. During follow-up (median 20 months) another 21% died. Complications occurred in 20% of patients under IABC, including vascular complications in 12%, infections in 5% and major bleedings in 3%. There was no difference between mortality among patients with complications and total mortality. Conclusion: Main indication for IABC in daily practice is the presence of cardiogenic shock (95%), dominantly due to myocardial infarction (83%). Despite IABC therapy, half of these patients die during the hospital stay. High mortality of cardiogenic shock in myocardial infarction with pharmacological therapy justifies IABC treatment with regard to a rate of complications of 20%.
    Notes: Zusammenfassung Hintergrund: Die intraaortale Ballongegenpulsion (IABP) ist ein etabliertes Verfahren zur passageren Linksherzunterstützung. Es gibt jedoch kaum Daten über den Stellenwert in der klinischen Routine sowie Früh-/Langzeitergebnisse. Patienten und Methodik: Von Juli 1995 bis Mai 1999 wurden alle Patienten, die in der Kardiologie des Herzzentrums Ludwigshafen eine IABP erhielten, in einem konsekutiven Register erfasst und ein Follow-up durchgeführt. Ergebnisse: 66 Patienten (mittleres Alter 65 Jahre, 64% Männer) erhielten im Untersuchungszeitraum eine IABP. Indikation war in 95% der Fälle ein kardiogener Schock, davon in 83% nach akutem Myokardinfarkt. Andere Indikationen waren selten (≤ 5%). Die Intrahospitalmortalität lag insgesamt bei 48%. Am höchsten war sie bei Infarktpatienten mit Schock (53%). Im Follow-up von im Median 20 Monaten verstarben weitere 21%. Die Komplikationsrate der IABP lag bei 20%, davon Gefäßkomplikationen in 12%, Infektionen in 5% und schwere Blutungen in 3%. Die Moralität dieser Patienten entsprach der im Gesamtkollektiv. Schlußfolgerung: Die Indikation zur IABP wird auch an einem interventionellen Zentrum selten gestellt (66 Fälle in vier Jahren). Die Hauptindikation ist der kardiogene Schock (95%), in erster Linie bei Myokardinfarkt (83%). Trotz IABP verstirbt die Hälfte der Patienten in der Klinik. Aufgrund der hohen Mortalität von Infarktpatienten mit medikamentöser Therapie des kardiogenen Schocks scheint ein liberaler IABP-Einsatz trotz einer Komplikationsrate von 20% gerechtfertigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000630050002
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 96
    Electronic Resource
    Electronic Resource
    Therapie der hypertensiven Krise (2000)
    Springer
    Medizinische Klinik 95 (2000), S. 286-292 
    Details
    ISSN: 1615-6722
    Keywords: Schlüsselwörter: Hypertensive Krise ; Hypertensiver Notfall ; Hypertensive Dringlichkeit ; Komplikationen ; Therapie ; Ursachen ; Key Words: Hypertensive emergency and urgency ; Etiology ; Complications ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Hypertensive crisis is defined as an extreme elevation of arterial blood pressure, with diastolic pressure 〉 120 mm Hg, and represents an imminent risk to the patient. In such cases, a rapid orientating diagnosis and adequate antihypertensive treatment to avoid sequelae are needed, sometimes even before diagnostic test are completed. Hypertensive emergencies and hypertensive urgencies can be distinguished. If the critical increase in blood pressure is associated with end-organ damage such as encephalopathy, acute left heart failure and pulmonary edema, angina pectoris, myocardial infarction or dissecting aortic aneurysm, a hypertensive emergency is presnet, that is an acute threat to the patient's life. A hypertensive emergency requires effective lowering of blood pressure within minutes, but not necessarily to normal range. The choice of suitable antihypertensive agents depends on clinical symptoms, contraindications, duration of pressure elevation and underlying conditions, prior cardiovascular, cerebrovascular and renal disorders. The risk of imminent end-organ damage must be weighed against the risk of rapid blood pressure lowering. In hypertensive urgencies without end-organ complications, blood pressure can be lowered more slowly over several hours, often with oral agents to avoid detrimental fall in blood pressure. The drugs of choice are mainly urapidil IV and nitroglycerine.
    Notes: Zusammenfassung Die hypertensive Krise stellt mit ihren kardialen, zerebralen und renalen Folgeerscheinungen eine potentiell lebensbedrohliche Komplikation der arteriellen Hypertonie dar. Bei einem hypertensiven Notfall (emergency), der den Patienten vital gefährdet, geht der kritische Blutdruckanstieg mit Organschä,den wie der Enzephalopathie, einer akuten Linksherzinsuffizienz, Angina pectoris, Herzinfarkt oder einem dissezierenden Aortenaneurysma einher. Der hypertensive Notfall erfordert eine umgehende effektive Blutdrucksenkung innerhalb von Minuten. Liegt eine Dringlichkeit (urgency) vor, bei der die oben genannten Folgeerscheinungen und Symptome bei stark erhöhten Blutdruckwerten fehlen, reicht eine langsame Absenkung des arteriellen Blutdrucks über mehrerer Stunden aus. Die Auswirkung der Hypertonie auf die Zielorganfunktion muß gegen das Risiko einer exzessiven Blutdrucksenkung abgewogen werden. Das Ausmaß der notwendigen Drucksenkung sowie die Wahl des geeigneten Antihypertensivums werden durch die klinische Symptomatik, Kontraindikationen, Dauer und Ausmaß der Blutdrucksteigerung und die zugrundeliegenden Vorerkrankungen des Patienten bestimmt. Eine zu langsame, aber auch eine zu rasche Blutdrucksenkung können zu schwerwiegenden Folgeschäden führen. Bei einer hypertensiven Dringlichkeit ohne Endorgankomplikationen ist meist eine allmähliche Blutdrucksenkung mir oral verabreichten Antihypertensiva ausreichend. Mittel der Wahl sind Urapidil intravenös und Nitroglycerin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00002123
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 97
    Electronic Resource
    Electronic Resource
    Behandlungsstrategien bei der akuten komplizierten Divertikulitis (2000)
    Springer
    Coloproctology 22 (2000), S. 205-210 
    Details
    ISSN: 1615-6730
    Keywords: Schlüsselwörter Akute Divertikulitis ; Komplikationen ; Chirurgische Behandlungsstrategien ; Key Words Acute diverticulitis ; Complications ; Surgical management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Interval single stage resection with primary anastomosis is the new strategy in management of acute complicated colonic diverticulitis. With increasing tendency localized complications are treated with minimally invasive techniques. Life threatening peritonitis with evidence of free perforation in old, multimorbid, bad conditioned patients should be further an indication for 2-stage resection. Laparoscopic assisted Hartmann reversal can be done with minimally invasive risk in experienced hands.
    Notes: Zusammenfassung Die möglichst einzeitige, elektive Resektion ist der Trend in der chirurgischen Behandlung der akuten komplizierten Divertikulitis. Lokalisierte Komplikationen werden nach Abklingen der akuten Entzündung zunehmend minimalinvasiv reseziert. Auch bei der vital bedrohlichen Perforationsperitonitis ist eine Tendenz zur primär einzeitigen Resektion erkennbar. Im Stadium der fortgeschrittenen Peritonitis hat bei multimorbiden Patienten in schlechtem Allgemeinzustand die Diskontinuitätsresektion weiterhin ihre Berechtigung. Die Hartmann-Wiederanschlussoperation kann heute risikoarm und zunehmend laparoskopisch assistiert durchgeführt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00001867
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 98
    Electronic Resource
    Electronic Resource
    Irreducible Displacement of Comminuted Metacarpal Head Fracture (2000)
    Springer
    European journal of trauma 26 (2000), S. 315-318 
    Details
    ISSN: 1615-3146
    Keywords: Key Words Metacarpal head fractures ; Irreducibility ; Complications ; Avascular necrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of a comminuted metacarpal head fracture of the index with distinct displacement and 180° longitudinal malrotation as well as irreducibility of head fragments due to entrapment in volar soft tissues is presented. Our case might illustrate the complications possibly encountered in these severe fractures, such as neural compromise and postoperative adhesions. Although the final functional outcome was good and the patient felt minimal pain, radiographic signs of avascular necrosis developed 12 months after injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00002458
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 99
    Electronic Resource
    Electronic Resource
    Complications amd Problems in Intramedullary Nailing of Children's Fractures (2000)
    Springer
    European journal of trauma 26 (2000), S. 287-293 
    Details
    ISSN: 1615-3146
    Keywords: Key Words Fracture ; Children ; Elastic stable intramedullary nailing (ESIN) ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Elastic stable intramedullary nailing (ESIN) is well established for stabilizing pediatric diaphyseal and special metaphyseal limb fractures. Expanding its application requires the evaluation of problems and complications to prevent uncritical use. Four pediatric surgical departments participated in a retrospective study. Between 1990 and 1998, 937 fractures were treated by ESIN. Major indications were forearm and femur fractures. Continuous documentation of treatment, postoperative course and follow-up formed the basis of evaluation. Analysis was subdivided into intraoperative problems, postoperative problems, and complications. Intraoperative problems (6.5%) were characterized by open reduction, cortical perforation by a nail tip with subsequent instability and by iatrogenic bursting of a third fragment. Postoperatively, 6.4% of patients showed soft tissue irritation due to nail ends or joint effusions. Complications (8.4%) included axial deviation 〉10° or instability of osteosynthesis in 5.3% and nerve injuries in 1.4%. Delayed healing, pseudarthrosis, osteomyelitis and synostosis were only observed in isolated cases, 5 children sustained a refracture. Severe complications are rare, problems arise from suboptimal technique and incorrect indication. Detailed knowledge of technical principles and procedural recommendations constitutes the mainstay in prevention.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00002453
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 100
    Electronic Resource
    Electronic Resource
    Expression of bone sialoprotein and osteopontin in breast cancer bone metastases (2000)
    Springer
    Clinical & experimental metastasis 18 (2000), S. 253-260 
    Details
    ISSN: 1573-7276
    Keywords: bone sialoprotein ; osteopontin ; breast cancer ; metastasis ; bone metastases ; immunohistochemistry ; in situ hybridization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bone sialoprotein (BSP) and osteopontin (OPN) are prominent, mineral-associated proteins in the extracellular matrix of bone that have been implicated in the metastatic activity of cancer cells. The expression of BSP, which is normally restricted to mineralizing tissues, has been observed in cancers with a high propensity for forming bone metastases. To investigate the relationship between BSP expression and the formation of bone metastases we have conducted an initial study of the expression of BSP in 10 intraductal breast carcinoma bone metastases using immunostaining and in situ hybridization, and compared the expression with OPN. The metastases were characterized by the infiltration of tumour cells into bone with extensive bone resorption evident. Moderate to strong staining for BSP was observed in all (100%) carcinomas, which also expressed BSP mRNA as determined by in situ hybridization. Variable staining for BSP was also observed in the mineralized bone and expression of BSP mRNA could be observed in osteoblastic cells on the bone surface and in some osteocytes at sites of bone remodelling. Contrary to a previous report, BSP expression could be demonstrated by PCR in three breast cancer cell lines, MCF-7, T47-D and MDA-MB-231. Moreover, in sub-cutaneous tumours formed by MDA-MB-231 breast cancer cells injected into athymic mice, higher immunostaining for BSP was seen in large ulcerating tumours in which mineral deposits were formed. In contrast to BSP, staining for OPN in bone metastases was generally restricted to the interface between tumor cells and bone surface of the carcinomas. While OPN staining was also observed in the cytoplasm of osteoclasts, which showed strong hybridization to a digoxygenin-labelled OPN cRNA probe, expression of OPN was not clearly detectable in the tumour cells. These studies provide the first demonstration of BSP expression by tumour cells in bone metastases and support the concept that BSP may have a role in targeting metastatic cells to bone. Expression of OPN in bone metastases appears to be related to increased bone resorptive activity by osteoclasts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006754605901
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...