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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 487 records · Page 27Linked to original sources
PubMed1985

The differential diagnosis of juvenile digital fibromatosis.

Juvenile digital fibromatosis is a rare condition in which distinctive benign soft tumours occur in the hands and feet of children and adolescents. If bony involvement is found at presentation a malignant soft tissue tumour must be excluded and extensive investigation is required using plain x-rays, scintigraphy and angiography. Histological examination, however, is the only definitive diagnostic measure. In this paper a case of juvenile digital fibromatosis is presented with a discussion of the differential diagnosis.

Adolescent↗
PubMed1985

Endoscopic evaluation of slow-release potassium chloride preparations.

In a double-blind, randomized, placebo-controlled clinical trial, 30 healthy subjects took one of two potassium chloride preparations or placebo three times a day for 1 week with concomitant oral glycopyrrolate dosing. The upper digestive tract was endoscopically examined immediately before and after the treatment period. One subject in both of the KCl treatment groups and six subjects in the placebo group developed submucosal lesions. All lesions were minor and of limited clinical significance. There may be reason to believe that glycopyrrolate plays a role in the production of such lesions. If so, the concomitant use of glycopyrrolate in clinical trials of KCl preparations may cloud the results of such studies.

Adult↗
PubMed1985

Continuous plexus blockade for improved circulation in microvascular surgery.

Five patients are presented who were fitted with an axillary plexus catheter for postoperative sympathetic blockade: 1 finger replantation, 3 toe-finger transfers, and 1 finger-finger transfer. This catheter caused spasmolysis and an increase in the circulation and in the acral systolic blood pressure. Simultaneously an adequate analgesic effect was achieved through the administration of local anesthetic. The muscle relaxation helped immobilize the extremity. The improved circulation, the analgesic effect, and the suppression of muscular activity through continuous plexus anesthesia help healing in replanted or transferred digits.

Adolescent↗
PubMed1985

Treatment of total sternal necrosis using the latissimus dorsi muscle flap.

Complications after a median sternotomy incision, which is used currently in most cardiac and mediastinal surgical procedures, although infrequent, are serious. If sternal dehiscence follows median sternotomy, infection extends to vital underlying structures, exposing the anterior part of the heart and ascending aorta. Permanent hemorrhage, septic thrombosis, or septic perforation of prosthetic material demand soft-tissue coverage. In 5 patients with total sternum necrosis the retrosternal space was covered with a latissimus dorsi muscle flap in order to achieve stable protection of the exposed mediastinal organs.

Arm↗
PubMed1985

The subcutaneous absorption of human and bovine ultralente insulin formulations.

The subcutaneous absorption of 125I-labelled semisynthetic human ultralente insulin was compared with that of 125I-labelled beef ultralente in eight insulin-dependent diabetic patients using a balanced cross-over design. In randomized order, 6 U of human ultralente was given in the thigh and in the abdominal wall while 24 U was given in the contralateral thigh and 6 U of bovine ultralente in the abdominal wall. On a second occasion the injection sites of human and bovine ultralente were reversed. Human ultralente was absorbed significantly faster than bovine ultralente. Thus, the 50% disappearance time of the radioactivity in the thigh was 15 +/- 3 h versus 44 +/- 9 h for the high dose, and 13 +/- 2 h versus 21 +/- 5 h for the small dose for human and bovine ultralente, respectively. Correspondingly, values for the abdomen (6U) were 9 +/- 1 h and 16 +/- 2 h. The difference between the absorption rates for 6 U and 24 U was statistically significant for bovine ultralente only. Human ultralente, but not bovine ultralente showed faster absorption from the abdomen than from the thigh. The absorption rate of human ultralente insulin, though faster than bovine ultralente insulin, makes it suitable as the basal insulin preparation for multiple insulin injection regimens.

Adult↗
PubMed1985

[Neurocryptococosis and immunosuppression: experimental model in mice].

In order to accomplish a model for immunosuppression in experimental conditions two lots of 50 young mice were divided into groups of 10, and submitted to dexamethasone ingestion. Two experiments were considered in the study. In the first experiment conditions for immunosuppression were established in 50 mice, by per os supply of several concentrations of dexamethasone in the water given for normal daily intake ad libitum. Criteria of immunosuppression considered include: hair standing on end; leukopenia by decrease of lymphocyte population; spleen atrophy in relation to controls, with severe hypoplasy of all lymphoid structures. In the second experiment another lot of 50 mice in similar conditions established for the first experiment and concerning the immunosuppression were submitted to intraperitoneal inoculation of near 10(6) Cryptococcus neoformans. Culture suspensions of cryptococci isolated from cerebrospinal fluid samples of human neurocryptococcosis cases were used for this purpose. Although fungi could be recognized in lungs, liver and spleen from every mice inoculated, only those with central nervous system involvement (near by an half of all) died. The discussion included considerations about the role of the blood-brain barrier function in the findings registered.

Animals↗
PubMed1985

[Reconstruction of the neck outline after burns using microsurgical technics].

Cervical burn contractures require early correction because of aesthetic, mechanical and functional reasons. Respiration may be impaired and intubation prove difficult due to contractures. If correction of the contracture is not possible with conventional techniques, then free flaps may be used for neck reconstruction. In this series seven patients had two radial arm flaps, two had latissimus dorsi myocutaneous flaps, one had a latissimus dorsi muscle flap, one a dorsalis pedis flap, and one had a groin flap. Six out of seven free flaps healed without any complications. In one case, using a free groin flap a superficial necrosis was excised and skin grafted. In all cases unrestricted movement of the neck was achieved after physiotherapy. By contouring the flaps a good cosmetic result was achieved.

Adolescent↗
PubMed1985

[New aspects of the reconstruction of large defects of the oral mucosa with microvascularly anastomosed small intestinal grafts].

Our experience in reconstruction of extensive defects in the oral mucosa with free jejunal grafts in 15 patients is reported. The jejunum provides a well vascularised mucosal lining, which is resistant to mechanical stress and being a thin flap contours well in the mouth. Methods of avoiding technical failure are described. The technique permits radical resection of oral tumours.

Carcinoma, Squamous Cell↗
PubMed1985

[Dupuytren contracture in childhood].

A two-year old boy suffered a contracture of the second and third digit beginning at the age of seven months. The clinical examination suggested a diagnosis of early Dupuytren's disease. A partial fasciectomy was performed. Histological examination showed a fibrosis palmaris similar to Dupuytren's disease. The biochemical examination (Glycans, hyaluronic acid, chrondroitinsulfat, dermatansulfat and heparansulfat) showed also changes in the extracellular proteoglycanmatrix similar to those found in adult Dupuytren's disease.

Child, Preschool↗
PubMed1985

[Modified patient positioning in long-term hand surgery intervention by regional anesthesia].

The authors report a modified positioning of patients for long-term handsurgical operations under regional anaesthesia. After equalizing the level of hand- and operating table, the operating table is tilted 10-15 degrees towards the hand-table. The upper limb is abducted only 30-40 degrees and then rotated outwards. This guarantees a comfortable positioning of the patients for a longer period of time.

Anesthesia, Conduction↗
PubMed1985

[Anatomical variations in blood vessels and their effect on the technic in toe transfer].

In the absence of grasp, either traumatic or congenital, free transfer of the second toe to the hand is one of the reconstructive possibilities. An essential prerequisite for the acceptance of the transferred toe is a guaranteed blood supply through the vascular pedicle. The blood supply of the second toe can be either by dorsal or plantar arteries, a fact which is due to anatomic variations. Through preoperative angiographic examination the arterial blood supply of the second toe can be defined. The location and length of the vascular pedicle have to be considered in the design of the anastomosis with the recipient vessels of the hand.

Adolescent↗
PubMed1985

[Circulation in myocutaneous flaps in the area of the tibia].

After a free myocutaneous flap transfer to the lower leg the necessary circulation may be prevented by spasm of the donor vessel, despite of a tension-free anastomosis. Application of bupivacaine-hydrochloride through a peridural catheter results in a sympathetic blockade. The ability thus to influence vascular spasms pharmacologically has been evaluated. Three clinical cases are presented discussing the surgical consequences of such pharmacological intervention.

Adult↗
PubMed1985

[Reconstruction of large defects of the oral mucosa with free, revascularized jejunum transplants].

The resection of oropharyngeal cancer often creates large mucosal defects which may impair chewing, swallowing or speech function severely. Therefore, proper reconstruction is crucial for the patient. In five cases with cancer of the floor of the mouth, the tongue, the cheek and the soft palate respectively, a successful reconstruction was achieved by means of a free revascularized jejunal graft. Tumour resection and preparation of the jejunal graft are performed synchronously by two surgical teams. After suturing the graft into the oropharyngeal defect its mesenteric vessels are usually anastomosed to the facial artery and the external jugular vein. Results showed that the jejunal graft is a most adequate substitute for oropharyngeal defects and superior to skin flaps. In a sixth patient the graft was lost because of an arterial thrombosis. This failure was not life threatening, but led to a poor functional result. Postoperative radiation therapy was tolerated by the transplanted jejunal mucosa in spite of a marked inflammatory reaction.

Adult↗