43 cases of tumor resection followed by ventral stabilisation are reported in 42 patients with metastases in the spine. Indications for surgery were beginning or incomplete transversal lesion of the spinal cord, bedrest for at least 3 weeks, unsusceible pain caused by instability, or unsuccessful conservative and radiotherapeutic treatment. 46.5% of the cases can be rated as good considering the time of survival and life quality, 18.5% can be judged as a partial success. 7 patients hat to be reoperated in the same level, most of them because of local recurrence. Complications occurred in 40% of the cases. These operations should be performed by a "term of specialists". Postoperative treatment with isotope-, hormone- or radiotherapy is decisive to obtain good results.

Adult↗

PubMedDate not supplied

Obliterations of the proximal subclavian artery: to bypass or to anastomose?

A clinical series has been analysed to determine which of two similar, extrathoracic "extraanatomic" methods of treating proximal blocks of the subclavian artery is the superior option. From 1975 until 1988 direct carotid-subclavian anastomosis was used in 32 patients and carotid-subclavian bypass in 19. There were no statistically significant differences for the probability of postoperative survival (p less than 0.877 Breslow; p less than 0.774 Mantel), intraoperative blood loss or the duration of anaesthesia. Those patients who had undergone subclavian artery repair had a significantly longer survival than those following carotid bifurcation endarterectomy (p less than 0.002 Breslow, p less than 0.0002 Mantel). As patients with subclavian lesions have a reasonable life-expectancy, they may possibly experience late complications of their vascular repair. Therefore it seems important to select the most durable operation, and direct carotid subclavian anastomosis has a significantly greater patency rate than bypass (p less than 0.006 Breslow, p less than 0.006 Mantel). Patients with preoperative symptoms of cerebrovascular insufficiency had a lower probability of survival than those with upper extremity claudication, although this did not reach statistical significance (p less than 0.205 Breslow; p less than 0.198 Mantel).

Adult↗

PubMedDate not supplied

Tissue distribution, disposition, and metabolism of cyclosporine in rats.

Tissue distribution, disposition, and metabolism of 3H-cyclosporine were studied in rats after single and repeated oral doses of 10 and 30 mg/kg and after an iv dose of 3 mg/kg. The oral doses of 10 and 30 mg/kg were dissolved in polyethylene glycol 200/ethanol or in olive oil/Labrafil/ethanol. Absorption from both formulations was slow and incomplete, with peak 3H blood levels at 3-4 hr. Approximately 30% of the radioactive dose was absorbed, which is consistent with oral bioavailability data for cyclosporine. More than 70% of the radioactivity was excreted in feces and up to 15% in urine. Elimination via the bile accounted for 10 and 60% of the oral and iv doses, respectively. Since unchanged cyclosporine predominated in both blood and tissues at early time points, the half-lives of the distribution phases (t 1/2 alpha) of parent drug and of total radioactivity were similar. In blood, kidney, liver, and lymph nodes, t 1/2 alpha of cyclosporine ranged from 6-10 hr. Elimination of radioactivity from the systemic circulation was multiphasic, with a terminal half-life of 20-30 hr. 3H-Cyclosporine was extensively distributed throughout the body, with highest concentrations in liver, kidney, endocrine glands, and adipose tissue. The concentrations of both total radioactivity and parent drug were greater in tissues than in blood, which is consistent with the high lipid solubility of cyclosporine and some of its metabolites. Skin and adipose tissue were the main storage sites for unchanged cyclosporine. Elimination half-lives were slower for most tissues than for blood and increased with multiple dosing. The amount of unchanged drug was negligible in urine and bile.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

[Interdisciplinary research strategies in geriatric psychiatry--studies and results in dementia and depressed patients].

Eighty-one patients (mean age: 66 +/- 9 years) who had been in gerontopsychiatric in-patient care were included in the study. As well as physical, psychiatric and neurological examinations, EEG, brain CT scanning and the determination of the Ischemic Scale were performed, in order to confirm the clinical diagnosis of dementia of Alzheimer type (DAT), dementia of vascular type (DVT) or multi-infarct dementia (MID), and depression in old age, as based on the DSM III criteria. A comprehensive psychological test battery was administered, to one section of the subjects. Our results indicate that EEG and Ischemic Score can differentiate patients with DAT and DVT to a satisfactory degree, whereas CT findings and psychometric assessment were apt to confirm the overall diagnosis of dementia (DAT/DVT) and depression. Patients with dementia showed memory impairment to a greater extent than depressive patients, as could be proved by a memory test (Syndrom-Kurztest). However, a dementia screening test (Information-Memory-Concentration Test) could more accurately differentiate dementia and depression. The application of a comprehensive psychometric testing procedure did not prove to be an effective diagnostic tool in the assessment of various stages of dementia. Short dementia tests and rating scales seem to be appropriate to distinguish depression from dementia, especially in cases of mild to moderate dementia. In patients with very mild and insignificant organic brain disturbances these screening methods fall short of diagnostic validity. Beyond this, there is a current need for assessment instruments in the evaluation of alterations in personality and affectivity, such as are seen in depression.

Aged↗

PubMedDate not supplied

[The pressure of arterial oxygen after intravenous lipid and levulose perfusions in serious cranial trauma].

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Arteries↗

PubMedDate not supplied

[Gerontopsychiatry in Heidelberg: documentation].

This paper is going to investigate 108 gero-psychiatric patients with average-age of 69 +/- 10 years with overwhelming of 70- to 79-year-old persons during one annual. Data of biographic, social and disease factors and diagnostic and therapeutic methods are presented. Diagnostic main-groups are dementias and affective syndromes. At the same time existing internal disorders have a particular importance. The therapeutic concept is composed of group-methods by the side of medical and physical measures. Geropsychiatry is not dependent on "pressure of success". Nevertheless late transfer, previous history for a long time, and old age diminish possibility to improve the mental disorders.

Aged↗

PubMedDate not supplied

[Psychopathology of aging and presenility. Historical development of concept formation].

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Aged↗

PubMedDate not supplied

[Gerontopsychiatric management in a university clinic].

The patients of the Heidelberg Section of Gerontopsychiatry in 1990 (99 persons aged between 52 and 97 years) were studied in respect to their social data, medical history, severity of illness, and extent of their need of nursing care. Of special interest was how they coped after release from the hospital. In comparison to a study performed in 1982/83, there were many more old and (especially physically) severely impaired patients. We also found an increased percentage of transferrals to nursing homes. The results are discussed with regard to gerontopsychiatric care in the Heidelberg area.

Activities of Daily Living↗