GLORIA — GEOMAR Library Ocean Research Information Access

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Optimierung heterogener, paketbasierter Telekommunikationsnetze unter besonderer Berücksichtigung von Mobilitätsunterstützung sowie Sicherheit und Datenschutz : Schlussbericht (2005)

Trick, Ulrich ; El Bouarfati, Soulaimane ; Weber, Frank ; [et al.]

Frankfurt am Main

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Keywords: Forschungsbericht

Type of Medium: Online Resource

Pages: Online-Ressource (65 S., 594 KB) , graph. Darst

URL: https://edocs.tib.eu/files/e01fb06/511081014.pdf

URL: https://doi.org/10.2314/GBV:511081014

URL: https://edocs.tib.eu/files/e01fb06/511081014l.pdf

DOI: 10.2314/GBV:511081014

Language: German

Note: Literaturverz. - Förderkennzeichen BMBF 1711403 , Unterschiede zwischen der gedruckten und der elektronischen Dokumentversion sind möglich , Auch als gedr. Ausg. vorh , Systemvoraussetzungen: Acrobat reader.

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Emergency Stent-Graft Placement in Thoracic Aortic Dissection and Evolving Rupture (2003)

Nienaber, Christoph A. ; Ince, Hüseyin ; Weber, Frank ; [et al.]

135 Bedford Road, PO Box 418 , Armonk , NY 10504-0418 USA . : Blackwell Science Inc

Journal of cardiac surgery 18 (2003), S. 0

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ISSN: 1540-8191

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Abstract Background: Even with rapid diagnosis and effective medical treatment mortality in type B aortic dissection with evidence of extraaortic leakage of blood remains high. Considering a mortality rate of 29% to 50% associated with emergency surgical repair, the concept of endovascular stent-graft placement may become a life-saving option in impending or evolving rupture by endovascular sealing of the entry tear and subsequent abortion of leakage. Methods: The concept was tested by comparing short-term and 1-year outcomes of 11 patients after emergency endovascular stent-graft placement with historic-matched control patients subjected to conventional therapy. All patients had acute type B dissection complicated by loss of blood into periaortic spaces. Results: Emergency stent-graft placement was successful without periprocedural morbidity, aborted leakage, and ensured reconstruction of the dissected aorta; at a mean follow-up of 15 ± 6 months no death had occurred in the stent-graft group whereas four patients had died with conventional treatment (p 〈 0.05). Conclusion: With appropriate logistics and expertise, type B aortic dissection with leakage and evolving rupture may benefit from nonsurgical reconstruction of the dissected segment by endovascular stent grafts.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1540-8191.2003.02082.x

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3

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Interventional Closure with Amplatzer PFO Occluder of Patent Foramen Ovale in Patients with Paradoxical Cerebral Embolism (2005)

CHATTERJEE, TUSHAR ; PETZSCH, MICHAEL ; INCE, HÜSEYIN ; [et al.]

350 Main Street , Malden , MA 02148-5020 , USA , and P.O. Box 1354, Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc

Journal of interventional cardiology 18 (2005), S. 0

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ISSN: 1540-8183

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Percutaneous transcatheter closure has been proposed as an alternative to surgical closure or long-term anticoagulation in patients with presumed paradoxical embolism and patent foramen ovale (PFO). We report our mid-term results of 55 consecutive symptomatic patients (mean age: 47 years, range: 20–79) who underwent percutaneous transcatheter closure of PFO after at least one event of cerebral ischemia; 16 (29%) patients had at least one transient ischemic attack and 39 (71%) patients at least one embolic stroke. Multiple embolic events had occurred in 6 (11%) patients. Percutaneous transcatheter closure was technically successful in all 55 patients (100%). For the majority of patients, an Amplatzer PFO occluder measuring 25 mm in diameter (n = 49) or an Amplatzer PFO occluder measuring 35 mm in diameter (n = 6) was used. Complete occlusion by color Doppler and transesophageal contrast echocardiography investigation was achieved in 96% at follow-up 3-6 months after implantation; only 2 patients had a trivial residual shunt at follow-up. Mean fluoroscopy time was 6.7 minutes (range: 1.7–47.1), and in-hospital follow-up was uneventful except for 1 patient who developed a cardiac tamponade requiring uneventful and successful needle pericardiocentesis. At a mean follow-up of 19 months (range: 3–32) no recurrent embolic neurological events was observed. Transcatheter closure of PFO with Amplatzer PFO occluder devices is a safe and effective therapy for patients with previous paradoxical embolism and aneurysmatic or nonaneurysmatic PFO. Percutaneous closure is associated with a high success rate, low incidence of hospital complications, and freedom of cerebral ischemia events.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1540-8183.2005.04050.x

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Caudal bupivacaine and s(+)-ketamine for postoperative analgesia in children (2003)

Weber, Frank ; Wulf, Hinnerk

Oxford, UK : Blackwell Science Ltd

Pediatric anesthesia 13 (2003), S. 0

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ISSN: 1460-9592

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Summary Background: The aim of this study was to evaluate whether caudal s-ketamine would prolong analgesia together with caudal bupivacaine. Methods: Thirty children, ASA I–II, 1 month−9 years, scheduled for minor inguinal or penile surgery, were randomly assigned in a prospective, double-blind fashion to receive single shot caudal blockade by either bupivacaine 0.125% 1 ml·kg−1 (group B, n = 15) or a mixture of bupivacaine 0.125% 1 ml·kg−1 and preservative-free s-ketamine 0.5 mg·kg−1 (group K, n = 15). Postoperative pain was assessed by means of an observational 10-point scoring system and analgesia was administered if the pain score exceeded a value of 3. Results: Within 24 h after caudal block 10 patients (67%) in group K and three patients in group B (20%) did not require additional analgesic medication (P 〈 0.01). There were no significant differences between the groups for incidence of haemodynamic changes. We did not observe any negative side-effects attributable to the caudal block or s-ketamine. Conclusions: Addition of preservative-free s-ketamine 0.5 mg·kg−1 to caudal bupivacaine 0.125% 1 ml·kg−1 provides significant prolongation of analgesia without producing negative side-effects.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1460-9592.2003.01018.x

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The correlation of the Narcotrend Index with endtidal sevoflurane concentrations and hemodynamic parameters in children (2005)

WEBER, FRANK ; HOLLNBERGER, HARALD ; GRUBER, MICHAEL ; [et al.]

Oxford, UK : Blackwell Science Ltd

Pediatric anesthesia 15 (2005), S. 0

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ISSN: 1460-9592

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background: The Narcotrend Index (NI) of anesthetic depth is potentially a pharmacodynamic measure of the effects of sevoflurane on the brain.Methods: In this prospective observational study of 30 pediatric surgical patients (1–11 years), we investigated the correlation between nonsteady-state endtidal sevoflurane (eTSevo), NI, mean arterial pressure (MAP), and heart rate (HR). The performance of the Narcotrend for differentiation between consciousness and unconsciousness was evaluated using prediction probability (PK).Results: Spearman correlation analysis showed significant correlations (P 〈 0.01) between eTSevo and NI (r = −0.85) and MAP (r = −0.43). PK-values for differentiation between consciousness and unconsciousness were 1.0 for NI and 〈0.85 for MAP and HR. During the surgical procedure, NI-values showed a constant rise with each 0.5% step of lowering eTSevo (P 〈 0.03), whereas MAP remained unaltered and HR showed a constant decline (P 〈 0.03), except between 1.5 and 1%.Conclusions: In children, nonsteady-state eTSevo concentrations are more closely related with NI than with MAP or HR. In this study, only NI reliably differentiated consciousness from unconsciousness.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1460-9592.2004.01546.x

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The correlation of the Narcotrend® Index and classical electroencephalographic parameters with endtidal desflurane concentrations and hemodynamic parameters in different age groups (2005)

WEBER, FRANK ; GRUBER, MICHAEL ; TAEGER, KAI

Oxford, UK : Blackwell Science Ltd

Pediatric anesthesia 15 (2005), S. 0

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ISSN: 1460-9592

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background : The Narcotrend® Index (NI) for assessment of depth of anesthesia by analysis of the electroencephalogram (EEG), is potentially a pharmacodynamic measure of the effects of desflurane on the brain.Methods : In this prospective study of 30 pediatric and adult patients (group 1: 3–6 years, n = 10; group 2: 〉 6 〈 12 years; group 3: 12–40 years), undergoing ophthalmological surgery, we investigated the pharmacodynamic relationship between nonsteady state endtidal desflurane concentrations (eTDes), NI, classical EEG parameters (cEEG), heart rate (HR) and mean arterial pressure (MAP). The performance of the Narcotrend for differentiation between consciousness and unconsciousness was evaluated using prediction probability (PK).Results : Spearman correlation analysis showed significant negative correlations (P 〈 0.001) between eTDes and NI (group 1: r = −0.93, group 2: r = −0.86, group 3: r = −0.66). Correlations between eTDes and MAP or HR were either only weak negative (r 〈 −0.5) or not significant. Desflurane EC50 (eTDes with half maximal effect on NI) was 7.18% for group 1, 7.34% for group 2, and 4.15% for group 3 (P 〈 0.001 Vs groups 1 and 2). Overall awake NI values (96.7 ± 1.4) were significantly higher (P 〈 0.001) than at the moment of loss of consciousness (58.3 ± 17.5), with no overlap (PK 1.0), whereas PK values for cEEG, MAP and HR were all 〈0.85.Conclusions : The pharmacodynamic relationship between eTDes and NI is age dependent with a significantly higher EC50 in children than in adolescents and adults. The NI appears to be superior to cEEG, MAP and HR in differentiating consciousness from unconsciousness.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1460-9592.2005.01465.x

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7

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S-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children (2004)

WEBER, FRANK ; WULF, HINNERK ; GRUBER, MICHAEL ; [et al.]

Oxford, UK : Blackwell Science Ltd

Pediatric anesthesia 14 (2004), S. 0

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ISSN: 1460-9592

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background : It has been suggested that nasal administration of s-ketamine may be used to improve sedation or premedication in combination with nasal midazolam in pediatric patients. In this study we measured and compared plasma concentrations of s-ketamine and its main metabolite s-norketamine after nasal and i.v. administration in preschool children.Methods : During sevoflurane anaesthesia, 20 children, aged 1–7 years, weight 11–25 kg, received s-ketamine 2 mg·kg−1 either intranasally (Group IN, n = 10), or i.v. (Group IV, n = 10). Six venous blood samples were obtained up to 60 min after drug administration for measurement of s-ketamine and s-norketamine plasma concentrations.Results : Plasma concentrations [mean ± sd] of s-ketamine in group IN peaked at 355 ± 172 ng·ml−1 within 18 ± 13 min. vs. 1860 ± 883 ng·ml−1 within 3 ± 1 min. in group IV (P 〈 0.01). Plasma concentrations of s-norketamine in group IN peaked at 90 ± 128 ng·ml−1 within 50 ± 11 min. vs. 429 ± 277 ng·ml−1 within 40 ± 16 min. in group IV (P 〈 0.01). One child in group IN experienced rapid and high level s-ketamine absorption with a peak plasma concentration of 732 ng·ml−1 after 2 min., which decreased to 274 ng·ml−1 after 60 min. Systolic blood pressure and heart rate remained unaltered in both study groups after s-ketamine administration.Conclusions : Nasal administration of s-ketamine 2 mg·kg−1 results in a wide spread of plasma concentrations and absorption times. Rapid and high level drug absorption after nasal drug administration is possible. The use of a pulse oximeter and continuous observation after nasal administration of s-ketamine for pediatric premedication is recommended.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1460-9592.2004.01358.x

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