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  • Cerebral ischemia  (3)
  • Gastrektomie  (2)
  • 1
    Electronic Resource
    Electronic Resource
    No-reflow after cardiac arrest (1995)
    Springer
    Intensive care medicine 21 (1995), S. 132-141 
    Details
    ISSN: 1432-1238
    Keywords: Brain resuscitation ; Cardiac arrest ; Cerebral ischemia ; Closed chest cardiac massage ; Microcirculation ; No-reflow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Successful resuscitation of the brain requires unimpaired blood recirculation. The study addresses the question of the severity and reversibility of no-reflow after cardiac arrest. Design Adult normothermic cats were submitted to 5, 15 and 30 min cardiac arrest by ventricular fibrillation. The extent of no-reflow was assessed in each cardiac arrest group after 5 min closed chest cardiac massage in combination with 0.2 mg/kg epinephrine or after successful resuscitation followed by 30 min recirculation. Measurements and results Reperfusion of the brain was visualized by labelling the circulating blood with FITC-Albumin. Areas of no-reflow, defined as absence of microvascular filling, were identified by fluorescence microscopy at 8 standard coronal levels of forebrain, and expressed as percent of total sectional area. During cardiac massage, noreflow affected 21±5%, 42±38% and 70±27% of forebrain after 5, 15 and 30 min cardiac arrest, respectively. After 30 min spontaneous recirculation following successful resuscitation of the heart, no-reflow significantly declined to 7±11% after 5 min cardiac arrest (p〈0.05) but persisted in 30±11% and 65±21% of forebrain after 15 and 30 min cardiac arrest, respectively (n.s.). Conclusion Our observations demonstrate that resuscitation of the heart by closed chest massage causes severe (and after prolonged cardiac arrest irreversible) no-reflow of the brain. This suggests that no-reflow is an important cause of postresuscitation brain pathology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01726536
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  • 2
    Electronic Resource
    Electronic Resource
    Thrombolysis using plasminogen activator and heparin reduces cerebral no-reflow after resuscitation from cardiac arrest: an experimental study in the cat (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1214-1223 
    Details
    ISSN: 1432-1238
    Keywords: Key words Brain resuscitation ; Cardiac arrest ; Cerebral ischemia ; Microcirculation ; Thrombolytic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Successful resuscitation of the brain requires complete microcirculatory reperfusion, which, however, may be impaired by activation of blood coagulation after cardiac arrest. The study addresses the question of whether postischemic thrombolysis is effective in reducing cerebral no-reflow phenomenon. Design: 14 adult normothermic cats were submitted to 15-min cardiac arrest, followed by cardiopulmonary resuscitation (CPR) and 30 min of spontaneous recirculation. The CPR protocol included closed-chest cardiac massage, administration of epinephrine 0.2 mg/kg, bicarbonate 2 mEq/kg per 30 min, and electrical defibrillation shocks. Interventions: During CPR, animals in the treatment group (n=6) received intravenous bolus injections of 100 U/kg heparin and 1 mg/kg recombinant tissue type plasminogen activator (rt-PA), followed by an infusion of rt-PA 1 mg/kg per 30 min. Measurements and results: Microcirculatory reperfusion of the brain was visualized by labeling the circulating blood with 300 mg/kg of 15% fluorescein isothiocyanate albumin at the end of the recirculation period. Areas of cerebral no-reflow – defined as the absence of microvascular filling – were identified by fluorescence microscopy at eight standard coronal levels of forebrain, and expressed as the percentage of total sectional area. One animal in the treatment group was excluded from further analysis because of intracerebral hemorrhage due to brain injury during trepanation. Autopsy revealed the absence of intracranial, intrathoracic, or intra-abdominal bleeding in all the other animals. In untreated animals (n=8), no-reflow affected 28±13% of total forebrain sectional areas, and only 1 out of 8 animals showed homogenous reperfusion (i.e., no-reflow 〈15% of total forebrain sectional areas). Thrombolytic therapy (n=5) significantly reduced no-reflow to 7±5% of total forebrain sectional areas and all treated animals showed homogeneous reperfusion at the microcirculatory level. Conclusions: The present data demonstrate that thrombolytic therapy improves microcirculatory reperfusion of the cat brain when administered during reperfusion after cardiac arrest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709339
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  • 3
    Electronic Resource
    Electronic Resource
    Thrombolysis using plasminogen activator and heparin reduces cerebral no-reflow after resuscitation from cardiac arrest: An experimental study in the cat (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1214-1223 
    Details
    ISSN: 1432-1238
    Keywords: Brain resuscitation ; Cardiac arrest ; Cerebral ischemia ; Microcirculation ; Thrombolytic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Successful resuscitation of the brain requires complete microcirculatory reperfusion, which, however, may be impaired by activation of blood coagulation after cardiac arrest. The study addresses the question of whether postischemic thrombolysis is effective in reducing cerebral noreflow phenomenon. Design 14 adult normothermic cats were submitted to 15-min cardiac arrest, followed by cardiopulmonary resuscitation (CPR) and 30 min of spontaneous recirculation. The CPR protocol included closed-chest cardiac massage, administration of epinephrine 0.2 mg/kg, bicarbonate 2mEq/kg per 30 min, and electrical defibrillation shocks. Interventions During CPR, animals in the treatment group (n=6) received intravenous bolus injections of 100 U/kg heparin and 1 mg/kg recombinant tissue type plasminogen activator (rt-PA), followed by an infusion of rt-PA 1mg/kg per 30 min. Measurements and results Microcirculatory reperfusion of the brain was visualized by labeling the circulating blood with 300 mg/kg of 15% fluorescein isothiocyanate albumin at the end of the recirculation period. Areas of cerebral noreflow — defined as the absence of microvascular filling — were identified by fluorescence microscopy at eight standard coronal levels of forebrain, and expressed as the percentage of total sectional area. One animal in the treatment group was excluded from further analysis because of intracerebral hemorrhage due to brain injury during trepanation. Autopsy revealed the absence of intracranial, intrathoracic, or intra-abdominal bleeding in all the other animals. In untreated animals (n=8), no-reflow affected 28±13% of total forebrain sectional areas, and only 1 out of 8 animals showed homogeneous reperfusion (i.e., no-reflow 〈15% of total forebrain sectional areas). Thrombolytic therapy (n=5) significantly reduced no-reflow to 7±5% of total forebrain sectional areas and all treated animals showed homogeneous reperfusion at the microcirculatory level. Conclusions The present data demonstrate that thrombolytic therapy improves microcirculatory reperfusion of the cat brain when administered during reperfusion after cardiac arrest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709339
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  • 4
    Electronic Resource
    Electronic Resource
    172. Kann die Incidenz der Anastomoseninsuffizienz nach Gastrektomie durch das SPTU-Gerät gesenkt werden? (1981)
    Springer
    Langenbeck's archives of surgery 355 (1981), S. 547-547 
    Details
    ISSN: 1435-2451
    Keywords: Anastomotic insufficiency ; SPTU stapler ; Gastrectomy ; Anastomoseninsuffizienz ; Gastrektomie ; SPTU-Klammernahtgerät
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven, konsekutiven Studie wurden 26 Kranke wegen Magencarcinom gastrektomiert und nach Longmire-Gütgemann eine 40 cm lange Jejunumschlinge End-zu-End isoperistaltisch durch SPTU-Klammernaht (12 Kranke) bzw. Cerny-Handnaht (Polyglykoleinzelknopfnähte, 14 Kranke) interponiert. Die Gruppen waren vergleichbar hinsichtlich Alter, Geschlecht, Gewicht, TNM-Stadium und Anzahl der Operateure. Die Insuffizienzrate betrug bei der SPTU-Naht 6/12, bei der Handnaht 2/16. 2mal versagte das Gerät intraoperativ. Eine generelle Empfehlung des SPTU ist daher nicht möglich.
    Notes: Summary Gastrectomy and gastric replacement by an isoperistaltic 40-cm jejunal loop with end-to-end anastomosis between the esophagus and jejunum were performed on 26 patients with adenocarcinoma of the stomach. This anastomosis was performed by the SPTU in 12 and by hand (Cerny interrupted sutures) in 14 cases. Patients were comparable according to age, sex, weight, TNM stage, and number of surgeons. Rate of anastomosic insufficiency was 6/12 in the SPTU and 2/16 in the Cerny group. Technical defects occurred twice intraoperatively with SPTU. Therefore, regular use of the SPTU is not recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01287002
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  • 5
    Electronic Resource
    Electronic Resource
    182. Subtotale Resektion oder Gastrektomie (1982)
    Springer
    Langenbeck's archives of surgery 358 (1982), S. 500-500 
    Details
    ISSN: 1435-2451
    Keywords: Gastric cancer ; Subtotal resection ; Gastrectomy ; Magencarcinom ; subtotale Resektion ; Gastrektomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Vom 1. 1. 1970 bis 31. 12. 1981 wurden am Klinikum rechts der Isar 711 Patienten wegen eines Magencarcinoms behandelt. 62,5 % wurden reseziert subtotal und total in gleicher Häufigkeit: Die FünfJahres-Überlebensrate insgesamt betrug 19 %, bei den kurativ resezierten 35 %, bei den palliativ resezierten nur 3 %. Die Fünf-Jahres-überlebensrate beim Intestinalen Typ nach Lauren war mit 26 % deutlich besser als die des diffusen Typs mit 11 %. Ohne Lymphknotenbefall war die Fünf-Jahres-überlebensrate 44 %, im Stadium N1-3 nur noch 11 %. Von sämtlichen gastrektomierten Patienten lebten nach 5 Jahren noch 27 %, von den subtotal resezierten 33 %.
    Notes: Summary From January 1, 1979 to December 31, 1981, 711 patients were treated at Klinikum rechts der Isar for gastric carcinoma: 62.5 % were resected, of which the number of subtotal and total resections was almost the same. The total 5-year survival rate was 19 %, curative resections ended up at 35 % at 5 years, and palliative resection declined to 3 %. The 5-year survival rate increased significantly (29 %) when the diagnosis was the intestinal type according to Lauren, in contrast to the diffuse types (11 %). When all gastroectomized patients were taken together, 27 % reached the 5-year survival border and 33 % for the subtotal resection procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01271928
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