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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 433 records · Page 24Linked to original sources
PubMed1989

[Reconstructive foot surgery following complex trauma of the foot].

Compound post-traumatic foot deformity may follow indirect, direct, or combined trauma. This is demonstrated by a number of case reports. Particularly during adolescence, primary injuries to the soft tissue, with neurovascular injury or compartment syndrome, and post-traumatic skin contractures can cause severe growth deformity at the site of the injury and distal to it. Compression screw arthrodesis, using the 6.5-mm cancellous screw with the triple arthrodesis and the 3.5-mm cortical screw with the Lisfranc arthrodesis, has particular significance. It is stable, it allows functional treatment later, and bone union takes place rapidly. The most important surgical principles in post-traumatic foot surgery are: precise reconstruction of the foot axes, the medial and lateral foot length, and the longitudinal and transverse arches, i.e., restitution of the normal foot anatomy.

Adolescent↗
PubMed1989

[Is the search for Meckel's diverticulum in appendectomy still a current problem in common surgical practice?].

During a ten year period from 1978 to 1988, 46 Meckel's diverticula (MD) were removed from patients with clinical symptoms of appendicitis. These were detected incidentally among 3230 appendectomies which were routinely followed by small bowel exploration. Only 45.6% had histopathologically inconspicuous diverticular mucosa. 17.4% of MD displayed pathological mucosal changes in the face of a normal appendix. In 10 patients both conditions co-existed. There were no postoperative deaths. Postoperative complications requiring operative revision occurred in one patient. The search for a MD should be routine, and not only consequence of finding a normal appendix. The rationale for the routine removal of a MD is not only its role as a potential risk factor and the lesser operative risk, but the fact that a macroscopically bland diverticulum reveals histopathological abnormalities considerably more often than commonly assumed.

Adult↗
PubMed1989

[Combination of cancellous bone grafts and free microvascular bone transplantation in large osseous defects].

Fourteen autogenous vascularized fibular bone grafts have been performed. The indications for surgery were segmental bone defects 17 cm in length on average, seven times because of radical tumor resection (three malignant, two locally aggressive tumors) and seven times because of primary or secondary bone loss in trauma patients. Two free vascularized fibular grafts were done in the upper extremity, four in the femur and eight in the tibia. The results with a follow-up from one half to seven years show that all extremities could be saved with no recurrence of tumor or infection. All vascularized fibular grafts healed with a good functional result. With stable osteosynthesis (AO-plates and external fixateur) partial weightbearing was possible after three weeks, full weightbearing after 8 to 12 months. For the femur a plate or interlocking nail should be used and for the tibia an external fixateur. Additional cancellous bone grafting should be done in two stages.

Adolescent↗
PubMed1988

Diagnostic and therapeutic possibilities for fibreoptic bronchoscopy in inhalation injury.

Inhalation injury is a relatively common complication of burn injury requiring early attention with respect to diagnosis and therapy, and frequent assessments of the tracheobronchial status. Clinical, radiological and laboratory findings often cannot fulfil these needs. Therefore the advantages of flexible fibreoptic bronchoscopy (FFB) in diagnosis and therapy of respiratory tract injury are shown by these case reports.

Adolescent↗
PubMed1988

Angiologic observations following autologous vein grafting and free radial artery flap elevation.

Fifteen cases with radial forearm flap harvesting and autologous vein-graft reconstruction of the missing radial artery portion, are reported. Post-repair follow-up examinations, using segment plethysmography, photoplethysmography, and Doppler ultrasound, demonstrated an angiologic donor site morbidity, even when radial artery reconstruction was performed. Typically diminished blood pressure occurred, in comparison with the contralateral healthy extremity. Index shifting of pulse wave peaks, as well as widening of pulse wave bases occurred, especially in the thumb and index finger. These latter findings appear to be discrete indicators of arterial insufficiency.

Adult↗
PubMed1988

A homogeneity test for follow-up studies.

A statistical method is presented for detecting random variation in the transition probabilities of certain simple, discrete-time Markov chains that have been found useful for modelling follow-up studies.

Animals↗
PubMed1988

The central hypotensive effect induced by methionin-enkephalin involves a serotonergic pathway.

Both endogenous opiate peptides and serotonin are known to be involved in blood pressure control. In this work we present results obtained in anaesthetized normotensive rats in which we studied the possible interaction between the central blood pressure effects induced by methionin (met)-enkephalin and serotonergic pathways. Met-enkephalin administered intracerebroventricularly produced a dose-dependent hypotensive action that was prevented by pretreating the animals with naloxone (opioid antagonist), or with methiothepin (serotonergic S1 and S2 receptor antagonist) or 5,7-dihydroxytryptamine (a serotonergic neurotoxin). In contrast, ritanserin, a serotonergic S2 receptor antagonist, failed to alter the hypotensive action of met-enkephalin. These data suggest that the central activation of opiate receptors induces a hypotensive action in which a serotonergic pathway is required. In this case the serotonergic receptor involved seems to belong to the S1 subtype.

5,7-Dihydroxytryptamine↗
PubMed1988

Hypotensive spinal serotonergic effect. Are S1 or S2 receptors involved?

Since previous data obtained in anesthetized rats supported the idea that the activation of spinal serotonergic receptors induced a hypotensive effect, it was decided to characterize more closely the serotonergic spinal involvement and to elucidate the serotonergic receptor type involved in this effect. After female Wistar rats were anesthetized, the femoral artery (for blood pressure measurement) and vein (for parenteral injection of drugs) were cannulated. An intrathecal catheter was positioned with the tip at the T6-L3 intervertebral space. The results showed that the dose-dependent decrease in mean blood pressure induced by serotonin administered at the T6-L3 level was prevented by giving the serotonergic S2 antagonist ritanserin intravenously. The intravenous administration of 5-methoxy-N,N-dimethyltryptamine, a direct serotonergic agonist, induced a dose-dependent hypotension previously shown to originate at spinal cord level. This effect was prevented by intrathecal administration of ketanserin, an S2-receptor antagonist. The selective agonist of the S1-type receptors, 8-hydroxy-dipropylaminotetralin, given at the same level of the spinal cord, failed to induce any effect on mean blood pressure. The results suggest that the hypotensive effect obtained after the spinal serotonergic activation involves serotonin receptors of the S2 type.

Animals↗
PubMed1988

The one-stage surgical treatment of multilocated pressure sores using various myocutaneous island flaps.

Report on 32 patients suffering from chronical pressure sores (n = 18 solitary, n = 14 multilocated), Campbell stages IV-VI, overlaying sacral bone, ischial tuberosity and tuber femoris, which were treated by using various combinations of myocutaneous island flaps (uni- or bilaterally glutaeus maximus and/or biceps femoris flaps). Indications, operative procedures, perioperative management and follow-up results are presented. Superficial skin lesions (n = 2) and wound dehiscence (n = 1) appeared as temporary wound complications in the 14 patients with multilocated pressure sores. In all cases stable and durable coverage was achieved without any recurrence. The value of adequate rehabilitation in avoiding relapses is pointed out.

Adult↗
PubMed1988

[Initial treatment of amputation injuries].

Emergency treatment of an amputation injury is based on the correct assessment of the extent and functional loss of the amputated part. In addition to choosing the best treatment for the patient and amputated part, timely organization of transport and early contact with the replantation center are of utmost importance. We present the results of our experience based on replantations in 323 patients.

Amputation, Traumatic↗
PubMed1988

[Skin transplantation or artificial skin replacement].

Temporary cover of skin defects, using artificial material, cannot be a substitution for autologous material. Heterologous skin grafts may turn out to be sources of infection. A combination of artificial skin of collagen preparations with epithelial cell cultures is a new alternative to exclusive autologous transplantation. Only limited surfaces so far can be covered by means of epithelial cultures.

Bandages↗
PubMed1988

Effects of caffeine consumption on pregnancy outcome. A review.

Caffeine's metabolism, mechanisms of action and effects on pregnancy outcome in laboratory animals and humans have been studied extensively. A review of those studies suggests that until more information is available, it might be prudent to limit caffeine intake to approximately 300 mg/d during pregnancy in view of decreases in birth weight that might occur at or above that level of consumption. That level might also be appropriate for nursing mothers since caffeine is known to enter breast milk.

Animals↗