Biomedical subjects

T Frank

Publications and source records attributed to T Frank.

At least 19 recordsLinked to original sources

PubMed2006

Mechanical properties of the human abdominal wall measured in vivo during insufflation for laparoscopic surgery.

BACKGROUND: Carbon dioxide insufflation of the peritoneal cavity for laparoscopic surgery offers a unique opportunity to measure some mechanical properties of the human abdominal wall that hitherto have been difficult to obtain. METHODS: The movement and change of the abdominal wall during insufflation to a pressure of 12 mmHg was studied in 18 patients undergoing laparoscopic surgery using a remote motion analysis system that does not compromise the sterility of the operative filed. These data together with the known abdominal wall thickness of each patient (measured by preoperative ultrasound scanning) enabled estimates of mechanical stiffness. RESULTS: The findings showed that the abdominal wall changes from a cylinder to a dome during inflation, and that its area is increased by 15%. A volume, averaging 1.27 x 10(-3)m(3), results from expansion, reshaping of the abdominal wall, and displacement of the diaphragm. The abdominal wall is stiffer in the transverse plane than in the sagittal plane (Young's modulus, 42.5 +/- 9.0 kPa vs 22.5 +/- 2.6 kPa; p = 0.03; paired t-test). CONCLUSIONS: Measurements of mechanical properties of the abdominal wall in patients undergoing laparoscopic surgery were obtained using a remote motion analysis system.

Abdominal Wall↗

PubMed2006

Histological aspects of the syrinx of the male mallard (Anas platyrhynchos).

The syrinx of the duck is characterized by a conspicious sexual dimorphism. In the male mallard, a large osseous bulla is present on the left syringeal side. The present work describes the structures of the male syrinx, which were studied by means of histochemistry, immunohistochemistry and electron microscope. In the right distal tympanum a caudally oriented, protruding structure was observed, which was identified as the valvula syringealis. The syringeal structures like valvula, tympanum, bulla, pessulus and the bronchi were in general covered by a respiratory epithelium, however, local modifications in cellular height and numbers of ciliated and goblet cells were observed. The presence of intrinsic musculature was confirmed by means of immunohistochemistry. Smooth muscle cells reaching from the lateral parts of the inter-bronchial ligament to the medial line and cranially to the inner tympaniform membranes were demonstrated. We suppose that these muscle cells play a role in syringeal sound generation by influencing the tension of the medial tympaniform membranes.

Animals↗

PubMed2006

Clonal dissemination of a CTX-M-15 beta-lactamase-producing Escherichia coli strain in the Paris area, Tunis, and Bangui.

One hundred twenty CTX-M-15-producing Escherichia coli strains isolated in 10 different hospitals from Paris (France), in the Hospital Charles Nicolle in Tunis (Tunisia), and in the Pasteur Institute in Bangui, Central African Republic (CAR), between 2000 and 2004 were studied. Eighty isolates, recovered from the three countries, were clonally related by repetitive extragenic palindromic PCR and pulsed-field gel electrophoresis. Various resistance profiles were identified among these clonal strains. After conjugation or electroporation of plasmids from E. coli strains representative of each profile and each geographic region, we observed seven resistance profiles in the recipient strains. Incompatibility typing showed that all the plasmids transferred from the clonal strains studied, except one, belonged to the incompatibility group FII. They all shared a multidrug resistance region (MDR) resembling the MDR region located in pC15-1a, a plasmid associated with an outbreak of a CTX-M-15-producing E. coli strain in Canada. They also shared the common backbone of an apparent mosaic plasmid, including several features present in pC15-1a and in pRSB107, a plasmid isolated from a sewage treatment plant. This study suggests that although the plasmid-borne blaCTX-M-15 gene could be transferred horizontally, its dissemination between France, Tunisia, and CAR was due primarily to its residence in an E. coli clone with a strong propensity for dissemination.

Central African Republic↗

PubMed2005

Urinary pharmacokinetics of cyanidin glycosides in healthy young men following consumption of elderberry juice.

We investigated the urinary pharmacokinetics of monomeric anthocyanins in seven healthy volunteers. The volunteers were administered a single oral dose of 3.57 g total anthocyanins contained in 150 ml of a concentrated elderberry juice under fasting conditions. Within 24 h the urinary excretion of unchanged cyanidin-3,5-diglucoside (cyanidin-3-sambubioside-5-glucoside and cyanidin-3,5-diglucoside were calculated as cyanidin-3,5-diglucoside equivalents), cyanidin-3-glucoside, cyanidin-3-sambubioside and total anthocyanins (i.e., the sum of all quantifiable anthocyanidin glycosides) was 0.16, 0.06, 0.05 and 0.06% of the administered doses, respectively. Maximum excretion rates were determined within 1.0 h after intake. The estimates (arithmetic mean +/- SD) of t1/2 were 1.25 +/- 0.25, 1.53 +/- 0.36, 1.38 +/- 0.20 and 1.35 +/- 0.18 h for cyanidin-3,5-diglucoside, cyanidin-3-glucoside, cyanidin-3-sambubioside and total anthocyanins, respectively. The urinary excretion of intact anthocyanins was fast and the decline of excretion rates appeared to be monophasic, suggesting a one-compartment pharmacokinetic model. The low urinary excretion of dietary anthocyanidin glycosides with values below 1% indicates that a large proportion of these plant pigments consumed are metabolized before entry into the circulation.

Adult↗

PubMed2004

Staphylinidae and Carabidae overwintering in wheat and sown wildflower areas of different age.

Species richness and abundance of staphylinid and carabid beetles overwintering in winter wheat fields and 1- to 3-year-old wildflower areas were investigated during 2000/2001 on 16 study sites in Switzerland. Abundance and species richness of overwintering staphylinids significantly increased with successional age of the wildflower areas and were always higher in older wildflower areas than in winter wheat. A similar but less distinct pattern was observed for the abundance and species richness of carabid beetles. The influence of habitat parameters (vegetation cover, fine sand content, organic matter, pH, soil pore volume, surrounding landscape structure, habitat area) on the staphylinid and carabid assemblages based on the number of individuals per species and site was analysed using canonical correspondence analysis. Vegetation cover was the most significant parameter significantly characterizing both staphylinid and carabid assemblages. The amount of vegetation cover explained 15.7% of the variance, fine sand content accounted for 13.3% and surrounding landscape structure for 10.9% of the variance in the staphylinid assemblage. In the carabid assemblage, vegetation cover was the only significant factor, explaining 24.7% of the variance. This study showed for the first time that the significance of wildflower areas as a reservoir for hibernation for generalist predatory beetles increases with progressing successional age.

Animals↗

PubMed2004

Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice.

Pharmacokinetic parameters and the bioavailability of several dietary anthocyanins following consumption of blackcurrant juice and elderberry extract were compared exploratorily in 6 healthy volunteers. They were given a single oral dose of either 137 ml of blackcurrant juice (144.8 mg total anthocyanins) or 30 ml of elderberry extract (147.3 mg total anthocyanins). Within 7 hours, the urinary excretion of total anthocyanins (i.e. the sum of all assayed anthocyanidin glycosides) was 0.04% and 0.37% of the administered dose following blackcurrant juice and elderberry extract ingestion, respectively. Pharmacokinetic parameters based on non-compartmental methods for plasma and urine concentrations exhibited higher variability in urinary excretion after ingestion of elderberry extract. Anthocyanin absorption was significantly greater following the intake of elderberry extract than after the intake of blackcurrant juice as shown by the 5.3- and 6.2-fold higher estimates of dose-normalized Cmax and AUC(0-tZ) of total anthocyanins, respectively. The geometric means of t(1/2) were not significantly different following elderberry extract (1.74 h) and blackcurrant juice ingestion (1.73 h, p > 0.05). The urinary excretion rate of intact anthocyanins was fast, appeared to be monoexponential for both blackcurrant juice and elderberry extract. However, in order to evaluate the contribution of anthocyanins to the health-protecting effects of blackcurrant juice and elderberry extract it will be necessary to perform further studies on the unchanged glycosides and their in vivo metabolites in human plasma and urine.

Adult↗

PubMed2002

[Clonidine vs. Midazolam for premedication - comparison of the anxiolytic effect by using the STAI-test].

OBJECTIVE: Many investigations described a positive effect of clonidine for premedication (reduction of perioperative stress response, analgetic effect, anaesthetic-saving effect, prophylaxis of postoperative shivering). The most important objective in premedication is undisputed anxiolysis. The anxiolytic effect of clonidine is differently discussed. Therefore we investigated the anxiolytic effect of clonidine in comparison to midazolam. METHODS: 50 patients (ASA 1 - 3) were included in the present doubleblinded, prospective study. These patients got an oral premedication with 1 mg flunitrazepam in the evening before surgery and 5 microg/kg(-1) clonidine or 100 microg/kg(-1) midazolam 60 - 90 minutes before surgery. By using Spielbergers State-Trait Anxiety Inventory (STAI-G X1) we registered the degree of state-anxiety before and after premedication. RESULTS: Both clonidine as well as midazolam showed a significant reduction of the state-anxiety over time (p < 0,001). Between the groups there were no differences in the STAI-scores at any time (p > 0,05). The degree of reduction in the state-anxiety were comparable between the groups. CONCLUSION: In addition to the higher up listed effects clonidine showed a anxiolytic effect, which is comparable to midazolam. Therefore clonidine is an interesting alternative to benzodiazepines, which are commonly used drugs for premedication.

Adrenergic alpha-Agonists↗

PubMed2001

High-frequency (8 to 16 kHz) reference thresholds and intrasubject threshold variability relative to ototoxicity criteria using a Sennheiser HDA 200 earphone.

OBJECTIVE: The first purpose of this study was to determine high-frequency (8 to 16 kHz) thresholds for standardizing reference equivalent threshold sound pressure levels (RETSPLs) for a Sennheiser HDA 200 earphone. The second and perhaps more important purpose of this study was to determine whether repeated high-frequency thresholds using a Sennheiser HDA 200 earphone had a lower intrasubject threshold variability than the ASHA 1994 significant threshold shift criteria for ototoxicity. DESIGN: High-frequency thresholds (8 to 16 kHz) were obtained for 100 (50 male, 50 female) normally hearing (0.25 to 8 kHz) young adults (mean age of 21.2 yr) in four separate test sessions using a Sennheiser HDA 200 earphone. RESULTS: The mean and median high-frequency thresholds were similar for each test session and increased as frequency increased. At each frequency, the high-frequency thresholds were not significantly (p > 0.05) different for gender, test ear, or test session. The median thresholds at each frequency were similar to the 1998 interim ISO RETSPLs; however, large standard deviations and wide threshold distributions indicated very high intersubject threshold variability, especially at 14 and 16 kHz. Threshold repeatability was determined by finding the threshold differences between each possible test session comparison (N = 6). About 98% of all of the threshold differences were within a clinically acceptable range of +/-10 dB from 8 to 14 kHz. The threshold differences between each subject's second, third, and fourth minus their first test session were also found to determine whether intrasubject threshold variability was less than the ASHA 1994 criteria for determining a significant threshold shift due to ototoxicity. The results indicated a false-positive rate of 0% for a threshold shift > or = 20 dB at any frequency and a false-positive rate of 2% for a threshold shift >10 dB at two consecutive frequencies. CONCLUSIONS: This study verified that the output of high-frequency audiometers at 0 dB HL using Sennheiser HDA 200 earphones should equal the 1998 interim ISO RETSPLs from 8 to 16 kHz. Further, because the differences between repeated thresholds were well within +/-10 dB and had an extremely low false-positive rate in reference to the ASHA 1994 criteria for a significant threshold shift due to ototoxicity, a Sennheiser HDA 200 earphone can be used for serial monitoring to determine whether significant high-frequency threshold shifts have occurred for patients receiving potentially ototoxic drug therapy.

Adult↗

PubMed2000

In vitro colonisation of acrylic resin denture base materials by Streptococcus oralis and Actinomyces viscosus.

AIM: The aim of the study was to compare the attachment of two typical strains of oral bacteria to four denture base materials. DESIGN: In vitro study. METHOD: Discs of acrylic resin denture base materials (Paladon 65, polished and unpolished; Palapress; Microbase, polished and unpolished, and Triad VLC) were placed into Petri dishes with Schaedler's medium, inoculated with Streptococcus oralis 34 or Actinomyces viscosus T14V. MAIN OUTCOME MEASURES: After 24 h or 48 h the numbers of adhering bacteria were measured. RESULTS: The bacteria adhered to all discs in similar numbers: 3-9 x 10(6)/ml (viable cell count) and 9-22 x 10(8)/ml (total cell count) for T14V, and 2-6 x 10(6)/ml (viable cell count) and 1.5-3 x 10(8)/ml (total cell count) for 34. CONCLUSIONS: Polishing had little effect on adherence. Denture base materials are not resistant against adherence and possible surface damage by oral bacteria. Therefore, thorough oral hygiene is important for denture wearers.

Acrylic Resins↗

PubMed2000

High thiamine diphosphate concentrations in erythrocytes can be achieved in dialysis patients by oral administration of benfontiamine.

OBJECTIVE: The influence of either orally administered S-benzoylthiamine-O-monophosphate (benfotiamine) or thiamine nitrate on the thiamine status was tested in a randomised, two-group comparison study in 20 end-stage renal disease (ESRD) patients. Main outcome measures were the pharmacokinetics of thiamine diphosphate (TDP) in blood, the in vitro erythrocyte transketolase activity, its activation coefficient (alpha-ETK) and the TDP concentration in erythrocytes. METHODS: After ingestion of a single dose of either 100 mg thiamine nitrate (corresponding to 305 micromol thiamine) or 100 mg benfotiamine (corresponding to 214 micromol thiamine), the blood levels of thiamine phosphate esters were analysed by means of high-performance liquid chromatography for a 24-h period. The TDP concentration in erythrocytes was calculated using the haematocrit and TDP concentration in blood. Erythrocyte transketolase activity and alpha-ETK were measured before and 10 h after administration. The pharmacokinetics of TDP in blood were compared with healthy subjects of other studies retrieved from database query. RESULTS: Regarding the blood concentrations of TDP, the patients with ESRD had a 4.3 times higher area under the concentration time curve after benfotiamine administration than after thiamine nitrate. After benfotiamine administration, the peak plasma concentration of TDP exceeded that in healthy subjects by 51%. In the ESRD patients, after 24 h, the mean TDP concentration in erythrocytes increased from 158.7+/-30.9 ng/ml initially to 325.8+/-50.9 ng/ml after administration of benfotiamine and from 166.2+/-51.9 ng/ml to 200.5+/-50.0 ng/ml after thiamine nitrate administration. The ratio between the maximum erythrocyte TDP concentration and basal concentration was 2.66+/-0.6 in the benfotiamine group and 1.44+/-0.2 in the group receiving thiamine nitrate (P < 0.001). After 24 h, it was 2.11+/-0.4 and 1.23+/-0.2, respectively. The transketolase activity increased from 3.54+/-0.7 microkat/l initially to 3.84+/-0.6 microkat/l after benfotiamine intake (P = 0.02) and from 3.71+/-0.8 microkat/l to 4.02+/-0.7 microkat/l after thiamine nitrate intake (P = 0.08). Likewise, alpha-ETK decreased from initially 1.10+/-0.07 to 1.04+/-0.04 (P = 0.04) and from 1.12+/-0.05 to 1.08+/-0.06 (P = 0.09). After 24 h, the phosphorylation ratio in whole blood decreased from 12.9+/-6.9 initially to 5.6+/-3.2 after benfotiamine administration (P = 0.02) and from 13.5+/-7.3 to 9.0+/-4.8 (P = 0.03) after administration of thiamine nitrate. No correlation between erythrocyte TDP concentration and transketolase activity and/or alpha-ETK was observed in ESRD patients, either before or 10 h after administration. CONCLUSION: Compared with thiamine nitrate, the oral administration of benfotiamine leads to higher TDP concentrations in erythrocytes accompanied with a significant improvement of the erythrocyte transketolase activity in ESRD patients.

Administration, Oral↗

PubMed2000

Assessment of thiamin status in chronic renal failure patients, transplant recipients and hemodialysis patients receiving a multivitamin supplementation.

The thiamin status of patients with chronic renal failure (CRF, n = 14), dialysis patients (DP, n = 24) and patients after renal transplantation (RT, n = 19) was assessed. Thiamin intake was calculated at mean levels of 1.26 mg/d (CRF), 0.83 mg/d (DP) and 1.42 mg/d (RT). Corresponding mean plasma concentrations were 64.2 nmol/l (CRF), 78.3 nmol/l (DP) and 55.1 nmol/l (RT). Thiamin supplements of 1.5 mg or 8.0 mg orally given to patients of the DP-group after each dialysis session showed slightly higher thiamin concentrations in plasma. Transketolase activity coefficients (ETK-AC) were in the same range (1.11...1.19) except for RT-patients who had a slightly but not significantly higher ETK-AC of 1.22. During dialysis treatment (DT), thiamin plasma concentrations dropped to 75 and/or 82% in patients supplemented with 1.5 and/or 8.0 mg. They both reached initial levels again 44 hours later. Despite large inter-individual differences, thiamin concentrations increased in the non-supplemented DP-group. ETK-AC did not change after a 14-day interruption of supplementation and did not deteriorate after a single dialysis session, both in supplemented and non-supplemented patients. A daily thiamin supplementation which complies with the RDA for healthy subjects is indicated in DP and is sufficient to keep thiamin status within the normal range.

Adult↗

PubMed2000

Does a 100-km walking affect indicators of vitamin status?

The status of thiamin (B1), riboflavin (B2), ascorbic acid (AA), and tocopherol was determined in 60 leisure athletes (age 46 +/- 10 y, BMI 23.7 +/- 2.0 kg.m-2, VO2max 39.4 +/- 6.5 ml.min-1.kg-1), who completed a 100-km walking race. Vitamin plasma levels and activities of erythrocyte transketolase (ETK) and glutathione reductase (EGR) were measured before start, immediately after finishing and 6 hours later. The participators finished the entire distance in 14.25 h (average speed 7 km.h-1). Before start, all participators showed an excellent vitamin status (prevalences of low vitamin status ranged between 1.7 and 1.8%). Plasma tocopherol concentrations correlated significantly with increased age (r = 0.35, p = 0.008). Compared to the values before start, plasma concentrations of B1 and B2 as well as ETK and/or EGR were increased significantly after finishing. The raised levels persisted 6 hours after finishing, whereas AA remained unaltered. The univariate analysis of variance revealed that the change in vitamin status after finish and 6 hours later was in part highly dependent on age, BMI and the level of physical fitness. Despite the long distance, the extensive character of the 100-km walking with its low intensity did not deteriorate the measured indicators of vitamin status.

Adult↗

PubMed2000

Bioavailability of water- and lipid-soluble thiamin compounds in broiler chickens.

The bioavailability of thiamin mononitrate, thiamin chloride-hydrochloride and benfotiamin was compared in broiler chickens. A thiamin-deficient diet was supplemented with either 1.8 and 1.5 mg/kg thiamin equivalent as water-soluble salts, or with 1.5 and 1.2 mg/kg thiamin equivalent as benfotiamin, respectively, and fed to 3 replicate groups/treatment for 21 days. Weight gain, feed consumption and feed conversion rate were not significantly affected by solubility or dietary level of thiamin. Likewise, using biochemical indices of thiamin status (erythrocyte transketolase activation coefficient, and thiamin concentrations in blood and liver), no differences were found between the water-soluble thiamin salts, indicating that they have identical potency. In contrast, biochemical indices of thiamin status showed a significantly higher bioavailability for benfotiamin than for the water-soluble sources.

Animals↗

PubMed2000

ANSI update: maximum permissible ambient noise levels for audiometric test rooms.

The American National Standards Institute (ANSI) specifies maximum permissible ambient noise levels (MPANLs) allowed in an audiometric test room to ensure that hearing thresholds obtained down to 0-dB HL will not be elevated due to masking by ambient noise. MPANLs were originally specified in 1960 and have been revised in 1977, 1991, and most recently in 1999. The purpose of this report is to offer an overview by providing a historical perspective of the MPANLs recently specified by ANSI (ANSI S3.1--1999), the rationale for revising the MPANLs, the new computational method used for determining the 1999 MPANLs, the ANSI S3.1--1999 octave and one-third octave band MPANLs, and information concerning compliance with the new MPANLs.

Audiometry↗

PubMed2000

Clinical rubella reinfection during pregnancy in a previously vaccinated woman.

We report a documented case of clinically apparent rubella reinfection during pregnancy with rubelliform rash and fever followed by lymphodenopathy at the 18th week of gestation, in a previously vaccinated woman with haemagglutination inhibition (HI) antibody titre of 1:32. The serological tests results (including neutralizing antibodies) demonstrated a significant rise in her rubella specific IgG level with strongly positive IgM reactivity. In addition, rubella-specific IgG antibody avidity testing displayed high avidity index (53-88%) typical of rubella reinfection. Umbilical cord blood, drawn by sonographic-guided cordocentesis at 24 weeks' gestation, was found to be negative for rubella-specific IgM antibody. The pregnancy was continued to term, and a healthy infant was born.

Adult↗

PubMed2000

[Premedication in maxillofacial surgery under total intravenous anesthesia . Effects of clonidine compared to midazolam on the perioperative course].

OBJECTIVE: The effects of the currently favoured preanaesthetic drugs (benzodiazepines, alpha 2-adrenoceptor agonists) on the perioperative course are inadequately investigated for new ways of performing anaesthesia with recently introduced drugs (e.g. remifentanil). Therefore clonidine and midazolam were used for premedication in maxillo-facial surgery under total intravenous anesthesia, and the perioperative courses were analyzed. METHODS: Thirty patients (ASA 1-2) were included in the present doubleblinded, prospective study. 60-90 minutes preoperatively these patients got an oral premedication with 5 micrograms kg-1 clonidine or 100 micrograms kg-1 midazolam. For anaesthesia a standardized procedure with propofol, remifentanil and rocuronium was performed. After induction of anaesthesia the infusion of remifentanil was regulated by using spectral edge frequency (target-SEF90, 10-13 Hz). The efficiency of the premedication as well as the emergence and recovery were assessed by using established standardized tests. The perioperative stress response was assessed by recording the effects on haemodynamic parameters (NIBP. heart rate. Holter-ECG). RESULTS: Referring to the effects of premedication (sedation, anxiety) there were no differences between the groups. The clonidine group required a lower remifentanil rate in keeping a steady-target-SEF90 (-24%). The time until emergence and recovery was not significantly different. Even the occurrence of PONV, VAS or the postoperative analgetic requirement did not differ between the two groups. However, the incidence of postoperative shivering was significantly higher in the midazolam group. Intraoperatively the values of MAP were quite equal between the groups. However, heart rate was significantly lower in the clonidine group. Postoperatively both MAP as well as heart rate were lower in the clonidine group. Furthermore, in the midazolam group there was a significantly higher cumulative duration of tachycardia (heart rate > 100 min-1; following descripted as medium with 25% and 75%-percentage; clonidine: 29/0/563 sec.: midazolam: 1058/232/3171 sec.). CONCLUSION: After remifentanil supplemented anesthesia there is, especially in the postoperative period, a benefit in using clonidine compared to the premedication with midazolam.

Adjuvants, Anesthesia↗

PubMed2000

[Clonidine within the scope of balanced inhalation anesthesia with sevoflurane--effects on pEEG parameters].

The anaesthetic-saving property of clonidine has often been reported. In our own prospective, randomized study, in which the depth of anaesthesia was controlled by using spectral edge frequency (target-SEF90 = 10 Hz) and clinical parameters, we confirmed the anaesthetic-saving property only for fentanyl (-20%). On the other hand, there was no difference in MAC-sevoflurane values between the groups in keeping a steady target-SEF. For this reason, we analysed the stored pEEG data with regard to clonidine-specific effects. Twenty-eight patients were included in our study. The patients were randomly treated preoperatively with an infusion of 4 micrograms/kg KG Clonidine (clonidine group) or a placebo (placebo group). For anaesthesia, a standardized procedure with fentanyl, propofol, rocuronium, N2O/O2/sevoflurane was performed. The depth of anaesthesia was controlled by using SEF90 and clinical parameters. SEF90, SEF50 and the EEG power-spectrum were analysed over a five-minute period in the steady state of anaesthesia without surgical manipulation. Both placebo and the clonidine showed comparable values for SEF90 (9.9 +/- 1 vs. 10.7 +/- 0.9 Hz). On the other hand, there were differences in the SEF50 values between the groups (3.3 +/- 0.7 vs. 6.4 +/- 2.2 Hz). In the clonidine group, relative alpha-power was higher than in the placebo group (36.3 +/- 15.8 vs. 16.8 +/- 8.8%). Parallel to this effect, there was a reduction in relative delta-power in the clonidine group (47.6 +/- 15.2 vs. 65.4 +/- 9.1%). The described EEG effects on the power-spectrum inevitably influence SEF50 and SEF90. In our opinion, SEF50 is not a powerful predictor of depth of anaesthesia, when anaesthesia is performed in the way described. By performing this variation of balanced anaesthesia and co-medication with clonidine, higher values of SEF90 (11-14 Hz) seem to be adequate for surgical manipulation.

Adrenergic alpha-Agonists↗

PubMed2000

What the Internet means for the medical device industry.

The Internet is dramatically changing the structure of the industry. For the first time, direct communication between all suppliers and all hospitals is available. The Internet-based electronic market place not only provides the ability to choose products from a standardized catalogue, but also to send orders direct to suppliers' enterprise resource planning systems. One-to-one marketing is also becoming a reality. Medical device manufacturers are advised to test the different electronic sales and marketing initiatives that are now available.

Equipment and Supplies↗