Abstract:
BACKGROUND:To be able to evaluate properly a vascular problem, basic concepts of vascular physiology need to be considered, as they have been taught in physiology for a long time. This article deals with selected definitions and laws of passive vascular mechanics, subdivided into parameters of vascular filling and parameters of vascular flow. PARAMETERS OF VASCULAR FILLING: During vascular filling the transmural pressure distends the vascular wall until it is balanced by the wall tension. The extent of this distension up to the point of balance depends on the elasticity of the wall. Transmural pressure, wall tension and elasticity are defined, and their respective importance is described by clinical examples, e.g. aneurysm and varix. PARAMETERS OF VASCULAR FLOW: The vascular flow can be divided into stationary and pulsating components. Both components are relevant for the bloodstream. Since the blood flow is directed in the circuit, it can be understood in first approximation as stationary ("direct current").The direct current model uses only the average values of the pulsating variables. The great advantage of the direct current model is that it can be described with simple laws, which are not valid without reservation, but often allow a first theoretical approach to a vascular problem: Ohm's law, driving pressure, flow resistance, Hagen-Poiseuille law, wall shear stress, law of continuity, Bernoulli's equation and Reynold's number are described and associated with clinical examples.The heart is a pressure-suction pump and produces a pulsating flow, the pulse. The pulse runs with pulse wave velocity, which is much larger than the blood flow velocity, through the arterial vascular system. During propagation, the pulse has to overcome the wave resistance (impedance). Wherever the wave resistance changes, e.g., at vascular bifurcations and in the periphery, it comes to reflections. The incident (forward) and reflected (backward) waves are superimposed to yield the resulting pulse wave. This pulse wave allows one to distinguish pressure and flow pulse by measurement. Both are described separately, and their respective clinical meaning is illustrated by appropriate examples, e.g., arterial stiffness and pre-/postocclusive high/low resistance flow, respectively.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Nocke H,Meyer F,Lessmann Vdoi
10.1055/s-0032-1327967subject
Has Abstractpub_date
2014-10-01 00:00:00pages
499-507issue
5eissn
0044-409Xissn
1438-9592journal_volume
139pub_type
杂志文章,评审abstract:OBJECTIVE:Incisional hernia repair with conventional techniques (simple closure, Mayo) is associated with high recurrence rates in the range of 30-50%. Surgical repair using different prosthetic biomaterials gains more and more acceptance. Therefore we wanted to evaluate our own results of hernia repair and analyze the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::The functioning of our anti-infectious regimen now working over a period of 7 years with 4 checks per year has been controlled. The wound infection rate came up to a percentage of 1.55. Blunders concerning chemical disinfection especially could be detected in spite of check-ups made every 3 months. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:AIMS:Laparoscopic splenectomy has been established as standard procedure for elective splenectomy and is performed for a variety of haematological diseases. However, different techniques have been used and a four- to five trocar technique is applied in most instances. We report our experience with a three-trocar techni...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-820359
更新日期:2004-10-01 00:00:00
abstract::Preventive intestinal intubation for ileus prophylaxis in cases of diffuse peritonitis and extended adhesion ileus had often been discredited for the technically demanding and thus time-consuming technique involved. Yet, tube-related complications in the context of tube insertion or removal can be minimised by the exp...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::For the hemodynamically unstable patient with pelvic fracture a target focussed and rapid diagnostic and therapy is mandatory. After hemorrhage control at crash site the direct transport in a trauma center follows. Primary therapy in the emergency room sometimes includes stabilization by a pelvic clamp or an external ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-44882
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Invasive Candida infections following abdominal surgery represent a significant medical problem. This study initiates a benchmarking project to pinpoint the current role and epidemiology of candidemia in this patient group in German hospitals. MATERIAL AND METHODS:During the year 2010 data derived from 47 7...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0033-1350814
更新日期:2015-12-01 00:00:00
abstract::Decisions in surgery will have to consider economic obligations more than ever before. Consequences are evident: the assessment of surgical efficiency will be insufficient when only considering the accuracy and results of a clinical study. We actually will have to document, moreover, the economic impact of therapeutic...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:UNLABELLED:Modified radical mastectomy remains the standard for treatment of breast cancer. Women faced with the diagnosis of breast cancer often find it difficult to cope with the arousing emotions. Fear of death or cancer recurrence and a perceived loss of femininity often coexists with the desire for a return to nor...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Pneumothorax is defined as the accumulation of air in the pleural space. A distinction is made between a primary (idiopathic) spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP) as well as between iatrogenic pneumothorax and traumatic pneumothorax. Primary spontaneous pneumothorax (PSP) occurs mai...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1284013
更新日期:2012-06-01 00:00:00
abstract::Together with the classical conservative treatment or the rarely necessary surgical thrombectomy in patients with acute deep vein thrombosis, catheter-directed thrombolysis is becoming more and more popular. This review provides a critical view on the evidence for catheter-directed thrombolysis providing a "Contra" po...
journal_title:Zentralblatt fur Chirurgie
pub_type: 评论,杂志文章
doi:10.1055/s-0034-1368632
更新日期:2014-10-01 00:00:00
abstract:UNLABELLED:This randomized controlled trial aims to evaluate the influence of preoperative relaxation techniques on postoperative outcomes. From January 1997 to June 1998 208 patients were operated on for primary inguinal hernia or goiter. The patients were randomized into two groups: Group A (n = 103) underwent the su...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2000-01-01 00:00:00
abstract::We describe the case of a 54-year-old man with a tumour of the proximal esophagus (cT3-4,N1,M0), who underwent percutaneous endoscopic gastrostomy (PEG) for enteral feeding. Primary radiochemotherapy was initiated shortly after PEG insertion. Five months after PEG insertion the patient detected a nodule at the site. T...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1098769
更新日期:2009-09-01 00:00:00
abstract::Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Changes of the blood flow in the different layers and regions were determined with radioactively labelled microspheres after proximal vagotomy. Under normal conditions and vagal stimulation a significant reduction of the flow in corpus and antrum up to 74% can be observed at least over the time of 3 weeks. This decrea...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Excellent results were found to be achievable from conservative functional treatment of upper arm fractures. A critical appraisal is made in this paper of the authors' own cases and of literature published over the past 25 years for comparison of the above results with surgical therapy. The conservative functional app...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:As laparoscopic surgery develops, one current goal is the reduction of scarring and operative trauma to a minimum. Single-port access surgery (SPA) uses a single small incision hidden in the umbilicus. This report describes our experiences with 69 SPA cholecystectomies compared to the conventional laparoscopic ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1283886
更新日期:2013-02-01 00:00:00
abstract::Hybrid systems with hepatocyte cultures in bioreactors are in development for therapeutical liver assistance. Here, a culture model with a special bioreactor construction was developed: Capillary membrane systems create a three dimensional artificial framework for hepatocyte adhesion, aggregation and reorganization of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Recurrent duodenal ulceration after highly selective vagotomy is best managed by antral gastric resection and gastroduodenostomy (BI). In cases of gastral localisation of the recurrent ulcer and in cases with high postoperative acidity a 2/3 partial gastrectomy (BI) should be performed. Revagotomy after highly selecti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Currently available replacement therapies for the treatment of acute renal failure are reviewed. Particular interest is focused on their application in intensive care, especially in septic patients. Underlying principles and mechanisms of action are explained. The continuous "High flux-dialysis" is shown to be a parti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::The physiological significance of the residual distal stomach after proximal gastrectomy (PG) was evaluated in dogs from the view-point of serum gastrin. The fasting gastrin levels in both (1/2 and 2/3) PG groups were high, especially in the 1/2 PG group. The serum gastrin levels did not decrease with time after test ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Modified skin grafting can be helpful in restoring the abdominal wall to adequate anatomic condition and full functionality, even in the wake of large and very large postoperative incisional hernias. The rate of recurrence recorded by the author from 66 skin grafts amounted to 7.6 percent and was thus below the averag...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::In the last 7 years were observed 945 patients with head injuries in our emergency care. First aid is aimed to stabilize respiration and cardiovascular system and to avoid secondary posttraumatic lesions. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The results of 18-hours of hypothermic pulsatile perfusion and 18-hours of cold storage of canine pancreas are compared. Both methods of preservation yield the same endocrine pancreas function. However preservation of pancreas by perfusion results in considerable oedema of the gland and high enzyme activity in the per...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::In an effort to demonstrate and explain the peristalsis and intact pylorus-function of an oesophagus substituted by a transformed stomach-tube and despite total vagotomy, acute tests were undertaken on 14 dogs of mixed breed in the form of electromyographic examinations on the normal stomach, the stomach after vagotom...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Aetiopathogenesis, diagnosis as well as typical and atypical courses are described and discussed with regard to 50 patients with gallstone ileus. Overall lethality amounted to 36 per cent, including 15 per cent for patients with enterotomy alone and 53 per cent for patients who had undergone enterotomy with faecal asp...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Widely normal stability of the vertebral column with adequate load-bearing capacity should be achieved, following osseous reconstruction of a defect area from which benign tumours or tumour-like lesions had been removed by radical surgery. In malignant processes, surgical tumour removal may add to the effectiveness of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::From 1966 to 1975 1169 patients underwent a partial gastrectomy (Billroth-II). 944 patients (80%) were followed up by their surgeons in a so call "gastric after-care". On the average these patients were pstoperatively out of work for 58 days. This time depends on postoperative complications, disturbed gastric function...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Disruption of the ulnar styloid process is a frequent injury in concomitance with fractures of the distal end of the radius. Healing occurs in many cases in the form of pseudoarthritis. Evaluation of 222 cases of distal radius fracture showed involvement of the ulnar styloid process to have no impact upon long-term wr...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Out of 279 cases of elective radical colonic surgery 109 complicated cases are dealt with. Most of them (66%) were caused by infection. The postoperative mortality came up to 10%. Three quarters of the postoperative deaths were caused by septicaemia and gastrointestinal bleeding. Some of the complications can be effec...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Two surgical methods are compared: resection of the stricture and replacement by large bowel (out of 64 cases, 63 were elective and one emergency), and the usual anti-reflux procedures (13 cases). In this series the mortality rate and the functional results are reported as more favourable after resection and replaceme...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00