Diffusing Fibre Tip for the Minimally Invasive Treatment of Liver Tumours by Interstitial Laser Coagulation (ILC): An Experimental Ex Vivo Study.

A newly developed diffusing laser applicator was examined for interstitial laser coagulation (ILC) of liver tumours. The applicator consisted of a matted quartz core and a quartz glass dome, also matted on its inner surface and sealed to the fibre. The applicator provided a homogeneous light intensity distribution over an active length of about 20 mm.

[Rediscovered techniques--Janeway laparoscopic gastrostomy in comparison with Witzel fistula].

We present the results of 20 patients with a laparoscopic gastrostomy according to Janeway. The laparoscopic gastrostomy was associated with less operation time, less analgetic consumption, and less discomfort in comparison to 24 patients with a Witzel fistula.

[Thermal laser dosimetry in treatment of liver tumors--correlation of optical tissue parameters with in vivo temperature distribution in VX-2 tumors and healthy liver tissue].

Optical properties and in-vivo temperature distribution during laser-induced thermotherapy in normal and tumorous rabbit liver were correlated. Lower absorption and scattering led to a higher optical and thermal penetration depth in the tumor tissue.

[Optimized laser-induced thermotherapy in treatment of liver metastases of colorectal carcinomas, an interdisciplinary responsibility--a clinical study].

In a clinical study, it was investigated whether local tumor control is attainable with laser-induced thermotherapy (LITT) in the treatment of colorectal liver metastasis tumors. Local control of tumor growth was obtainable in completely hyperthermic tumors. Due to the small and inhomogeneous patient population (n = 32), an assessment of the method regarding prognostic gain for the patient is not possible in such a short follow-up period.

[Endoscopic cholecystectomy as cost assessment--still a learning intervention?].

Economic considerations are putting increasing pressure on surgical departments to avoid intra- and postoperative complications and thus additional costs. Under this aspect, it was investigated whether laparoscopic cholecystectomy is a suitable training intervention for young prospective surgeons. These physicians in advanced training did not have a higher intra- or postoperative complication rate in a preselected patient population than senior physicians or specialists.

Opposite effects of angiotensin II and IV in the lateral nucleus of the amygdala.

In this study the effects of angiotensin II and norleucine1-angiotensin IV have been studied in a horizontal in vitro slice preparation of female rat brains. Extracellular field potentials of the lateral nucleus of the basolateral amygdala were recorded. The results show that angiotensin II significantly increased the amplitude of field potentials induced by the electrical stimulation of the lateral nucleus, whereas norleucine1-angiotensin IV caused a significant decrease in the amplitude of field potentials.

Mapping of angiotensin AT1 receptors in the rat limbic system.

The AT1 receptor is one of the two receptor subtypes able to bind angiotensin II. In the present study, immunohistochemical examination of the distribution of the AT1 receptor in several limbic structures of female rats has been done, revealing new aspects of the distribution of AT1-positive cells. The presence of AT1 receptor expressing cells in the hippocampus and the amygdala is described, but their distribution in these regions has not been examined in a detailed way.

Very slow oscillatory activities in lateral geniculate neurons of freely moving and anesthetized rats.

In urethane anesthetized rats many lateral geniculate neurons display a strong very slow oscillatory behavior in the range of 0.025-0.01 Hz.

Role of NO and endothelin in hemoglobin-induced pulmonary vasoconstriction.

Unlabelled: The underlying mechanisms of hemoglobin (Hb)-induced vasoconstriction are not yet well understood. The aim of this study was to elucidate the influence of nitric oxide (NO) and endothelin (ET) on Hb-induced pulmonary vasoconstriction. Therefore, an autologous Hb preparation was administered into isolated rabbit lungs, in which pulmonary artery pressure (PAP) and weight gain was monitored.

Optical properties of native and coagulated human liver tissue and liver metastases in the near infrared range.

Background And Objective: Knowledge about optical parameters and the resultant light distribution in laser-treated tissue is important for predicting the effects of laser-induced thermotherapy of liver metastases (LITT).

Materials And Methods: The absorption and scattering coefficients as well as the anisotropy factors and the optical penetration depths of human liver tissue and colorectal liver metastases were determined at 850, 980, and 1,064 nm under native and thermocoagulated conditions.

Results: Liver metastases had a lower anisotropy factor, absorption, and scattering coefficient than healthy liver (P < 0.

[Laser-induced thermotherapy. Technical prerequisites for treatment of malignant liver tumors].

Laser-induced thermotherapy is an in situ ablation method for the local treatment of liver tumors. The basic prerequisite for induction of adequate treatment volumes for clinical use was the development of a thermostable application system. In an ex vivo test series, the specially developed application system (diffuser tip) with 5760 J had a higher thermic loading capacity than the Ringmode applicator with 4200 J, thus enabling the induction of significantly larger lesions with a volume of 7.

Laser-induced thermotherapy for the treatment of liver metastasis. Correlation of gadolinium-DTPA-enhanced MRI with histomorphologic findings to determine criteria for follow-up monitoring.

Purpose: To evaluate gadolinium (Gd)-diethylenetriamine-pentaacetic-acid (DTPA)-enhanced magnetic resonance imaging (MRI) for follow-up monitoring of laser-induced thermotherapy (LITT) and to determine a useful examination schedule.

Methods: LITT of the liver was performed in 55 rabbits using a neodymium: yttrium-aluminum-garnet (Nd:YAG) laser (4-W power output, 840-s exposure time). Gd-DTPA MRI and histologic examinations were performed at different times (0-168 days).

Technology for in situ ablation by laparoscopic and image-guided interstitial laser hyperthermia.

The technical requirements have been fulfilled for the reliable clinical application of laser-induced thermotherapy for treating liver tumors. Laparotomy as well as percutaneous and laparoscopic access modes are available for this method. Thus, laser-induced thermotherapy is a true minimally invasive procedure for treating liver metastases.

Angiotensin II inhibits long-term potentiation within the lateral nucleus of the amygdala through AT1 receptors.

Long-term potentiation (LTP) of field potentials in the lateral nucleus of the amygdala (LA) evoked by brief tetanic stimuli of the LA were observed in horizontal rat brain slices. The amplitude of field potentials was significantly enhanced after repetitive stimulation. When angiotensin II was administrated the induction of LTP was suppressed.

Tracing of axonal connectivities in a combined slice preparation of rat brains--a study by rhodamine-dextran-amine-application in the lateral nucleus of the amygdala.

In preparation for electrophysiological studies, the fiber pathways within the amygdala of rats have been examined using a combined Nissl- and silver-staining method (Bielshowsky) in horizontal sections of the amygdala. To determine if fibers in the lateral nucleus of the amygdala are in functional connection with other brain regions, an anterograde and retrograde axonal tracing method (application of rhodamine-dextran-amine) was performed. Horizontal slices containing some nuclei of the amygdala (lateral nucleus, basolateral nucleus, central nucleus, medial nucleus), as well as the entorhinal cortex, the hippocampus and parts of the piriform cortex were used.

Interstitial laser coagulation: evaluation of the effect of normal liver blood perfusion and the application mode on lesion size.

Background And Objective: The effect of temporarily interrupted hepatic blood flow and multiple-fiber application on necrosis volume in interstitial laser coagulation (ILC) was investigated.

Study Design/materials And Methods: Single- and multiple-fiber ILC were performed in porcine livers with normal as well as interrupted perfusion. Temperatures were determined.

White blood cell counts and plasma C3a have synergistic predictive value in patients at risk for acute respiratory distress syndrome.

Objective: To investigate and select nonassociated variables with predictive value for acute respiratory distress syndrome (ARDS) in patients at risk.

Design: Prospective, observational study.

Setting: A university hospital intensive care unit.

Blood compatible polymers in intensive care units: state of the art and current aspects of biomaterials research.

The use of artificial organs in cases of acute renal failure, acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome (MODS) has lead to a significant reduction of mortality. However, the interaction between body and biomaterials results in the activation of the coagulation system and in the induction of systemic inflammatory response syndrome. The necessary anticoagulation may be contraindicated and may even further increase the risk for the patient.

[Chronic right heart failure after implantation of a cava filter].

History And Clinical Findings: A 39-year-old woman complained of dyspnoea and increasing abdominal pressure sensation. A Greenfield filter had been implanted into her inferior vena cava (IVC) 4 years previously because of pulmonary embolism from a deep vein thrombosis after a hysterectomy with abscess formation. Physical examination revealed neck vein congestion, jaundiced sclerae, a tense abdominal wall, ascites and a soft machinery murmur in the paraumbilical region.

Double-blind multicenter study comparing alprostadil alpha-cyclodextrin with moxisylyte chlorhydrate in patients with chronic erectile dysfunction.

Purpose: We compared the efficacy and safety of alprostadil alpha-cyclodextrin and moxisylyte chlorhydrate to induce erections adequate for sexual intercourse in a prospective, randomized, parallel double-blind study in patients with erectile dysfunction.

Materials And Methods: A total of 156 men with erectile dysfunction due to organic, nonorganic and mixed origin was randomized into 2 parallel treatment groups receiving titrations of an individual optimum dose of alprostadil alpha-cyclodextrin or moxisylyte chlorhydrate. Erectile response was measured by the buckling test.

Community health centres in Canada.

In an increasing trend, clients are being moved from tertiary and secondary care to primary care. This "down-loading", accompanied by the increasingly complex needs of clients, has forced providers and policy makers to acknowledge the importance of primary care. In exploring options for the reorganization of primary care, the characteristics of community health centres are often promoted as the model with the best potential.