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Biomedical subjects

A Huber

Publications and source records attributed to A Huber.

At least 199 records · Page 11Linked to original sources
PubMed1989

[Follow-up after surgery of the bile ducts].

The main emphasis of aftercare after surgery of the biliary tract is on monitoring the bile flow as a means of assessing the underlying disease and the patient's postoperative condition. If there is evidence of a bile flow disturbance, the cause must be discovered and eliminated in order to prevent secondary lesions from occurring in the liver.

Bile Duct Diseases↗
PubMed1989

[After-care following surgery of the pancreas].

Postoperative treatment after pancreas surgery is concentrated on the function of the exocrine and endocrine part of the gland. While functional disturbances of the endocrine pancreas may give rise to serious problems associated with diabetes, functional disturbances of the exocrine pancreas are less important. On the other hand, flow disorders of the exocrine pancreas may lead to pancreatitis, fistulas, cysts, and abdominal sepsis. Pancreatic tumours are not infrequently apudomas whose biology has an important bearing on the after-treatment. Thrombophlebitic splenomegaly may lead to portal and possibly to segmental portal hypertension. In this event, a careful follow-up examination will be needed to decide whether further surgery is necessary.

Humans↗
PubMed1989

[Diagnosis and therapy of liver injuries in the polytraumatized patient].

We examined 120 patients with liver trauma, 100 retrospectively (1973-1986 group I) and 20 prospectively (1986-1987 group II). The severity of the liver injury was categorized in 5 grades (modified after Moore) and the degree of multiple trauma was assessed by the injury severity score (ISS). Patients in the liver injury groups were equally distributed among grades I to IV; there was one patient with a grade V injury in both the retrospective and prospective group. The overall mortality was 14%, 15% for the retrospective and 10% for the prospective group. Mortality was mainly due to concomitant injuries (head injuries, ARDS, multiple organ failure, pneumonia) and only 3 patients in the whole group died as a result of continuous bleeding or because of prolonged hemorrhagic shock due to the liver injury. The defined protocol for the prospective group included early efficient resuscitation and blood/fresh frozen plasma transfusion, systematic and rapid assessment of injuries and determination of priorities of treatment. Immediate ultrasonography or peritoneal lavage was used for assessment and diagnosis of a liver injury and early selection of treatment according to the grade of the liver injury: Conservative management for stable cases consisted of close supervision and repeated investigations (CT, angiography). Immediate operation was undertaken for continuing hemorrhage. Postoperative care in an intensive care unit with a low threshold for reoperation in cases of suspected sepsis, ongoing hemorrhage or necrosis of liver tissue was an important part of the treatment. Our results suggest that death in multiple trauma patients should almost never be due to liver injury alone. Conservative treatment may be justified in some patients, but early resuscitation and operation directed at definitive or provisional control of hemorrhage with removal of all devitalized tissue and liberal use of early reoperation are essential in the management of severe liver injury.

Adolescent↗
PubMed1989

[Mediastinal neuroblastoma in Wiedemann-Beckwith syndrome].

A mediastinal neuroblastoma developed in a female infant with Wiedemann-Beckwith syndrome. Careful and close examinations in children with Wiedemann-Beckwith syndrome should therefore not only include screening for Wilms tumour but also for neuroblastoma.

Abnormalities, Multiple↗
PubMed1989

[After-care in liver transplantation].

Liver transplantation is assuming an increasingly important role in present-day hepatology; it is the preferred treatment in many cases of acute or chronic liver disease. The results have shown constant improvement thanks to the introduction of standardized techniques for removal and implantation of the liver, improved immunosuppression and postoperative care. Good long-term results--a five-year survival rate in up to 70% of the cases--can only be achieved by strict self-discipline on the part of the patient and careful postoperative follow-up, with close collaboration between the general practitioner, the hepatologist and the transplant surgeon.

Combined Modality Therapy↗
PubMed1988

Inflammation of the hind limb as a model of unilateral, localized pain: influence on multiple opioid systems in the spinal cord of the rat.

Inoculation of the right hind paw with Mycobacterium butyricum rapidly led to swelling and inflammation. The afflicted limb showed an enhanced sensitivity to noxious pressure (hyperalgesia) and a reduced sensitivity to noxious heat 24 h following treatment. Both naloxone and MR 2266 (which has greater activity at kappa-opioid receptors) further increased the sensitivity to pressure (that is, potentiated the hyperalgesia) but did not affect the response to heat. They did not affect the response of the uninflamed paw. At 1 week, only MR 2266 was effective. At both 24 h and 1 week, the inflamed paw showed pronounced supersensitivity to the antinociceptive action of morphine against noxious pressure. At both 24 h and (to a greater extent) 1 week, a rise in levels of immunoreactive (ir)-dynorphin (DYN) was seen in the ipsilateral dorsal horn of the lumbar spinal cord. There was no alteration in the contralateral dorsal horn or in either ventral horn. Furthermore, levels of ir-met-enkephalin (ME) and ir-leu-enkephalin (LE) were unaffected. There was no difference in the density of mu-, delta- or kappa-binding sites in any part of the lumbar cord, at either 24 h or 1 week, between ipsilateral and contralateral tissue. By 3 and 5 weeks postinoculation, the symptoms had spread to the contralateral hind limb and ir-DYN was elevated in the contralateral dorsal horn and the ipsilateral ventral horn. At 5 weeks, levels of ir-ME and ir-LE also were increased in the ipsilateral and contralateral dorsal horns, but not in the contralateral ventral horn. Furthermore, levels of ir-DYN were increased in the cervico-thoracic spinal cord, and rats displayed adrenal hypertrophy and a rise in plasma levels of ir-beta-endorphin (beta-EP). These data indicate: (1) Peripheral inflammation localized to a single limb selectively modifies levels of ir-DYN in ipsilateral dorsal horn. The effect is specific to DYN as compared to ME and LE. The density of mu-, delta-, or kappa-receptors in the lumbar spinal cord is unmodified. (2) The altered response to opioid agonists and antagonists shown by rats with an inflamed limb may be selective to the injured tissue. (3) Alterations in opioid systems associated with unilateral hind limb inflammation may not be exclusively chronic in nature: they appear very rapidly (within 24 h) of the induction of pain. With time, the contralateral limb becomes affected and, eventually, the effects resemble those seen with generalized polyarthritis.

Animals↗
PubMed1988

Motivational effects of opioids in an animal model of prolonged inflammatory pain: alteration in the effects of kappa- but not of mu-receptor agonists.

An unbiased preference conditioning procedure was used to characterize and compare the motivational effects of opioids in naive rats and those suffering from the prolonged pain associated with Freund's adjuvant (FA)-induced inflammation of one hind limb. The mu-opioid agonist morphine functioned as a reinforcer in naive animals, producing marked preferences for the drug-paired place. Similarly, rats injected with FA 7 days prior to conditioning exhibited a preference for the morphine place, and the magnitude of this effect did not differ between groups. Administration of the kappa-opioid receptor agonist U-69593 to naive rats produced dose-related place aversions. The aversive effect of this kappa-agonist was, however, abolished in FA-treated rats. Thus, regardless of the dose administered, U-69593 produced conditioning similar to that observed in response to saline. These data suggest that kappa-agonists may lack aversive effects in subjects experiencing prolonged noxious stimulation, and as such may be effective therapeutic agents in the management of chronic pain states.

Animals↗
PubMed1988

[Homonymous hemianopsia in brain tumors].

Homonymous hemianopsia may be caused by tumors in the region of the optic tract, the lateral geniculate body, the optic radiation, and the visual cortex. Tumors are responsible for about two-thirds of the temporal lesions and about one-half to one-third of the parietal and occipital lesions. With brain tumors a chronological sequence of two groups of signs and symptoms is the rule: first the focal symptoms corresponding to the tumor lesion in a defined cerebral area, later the distant effects of the increasing volume of the tumor, which lead to the general signs of increased intracranial pressure. The different types of homonymous hemianopia in tumor lesions along the suprachiasmatic pathway (optic tract, lateral geniculate body, temporal lobe, parietal lobe, occipital lobe) are described and discussed. The general neurological signs and symptoms are briefly reviewed. Demonstration of important cerebral diagnostic examination methods (plain X-ray, electroencephalogram, computer tomogram, nuclear magnetic resonance, angiography). Differential diagnosis of brain tumors (hematomas, abscesses, granulomas, parasites etc.).

Brain Mapping↗
PubMed1988

Macrophage size determinations in the diagnosis of tuberculous effusions.

This study investigated the usefulness of macrophage size determinations in lymphocyte-rich pleural effusions to improve the cytologic diagnosis of tuberculous pleurisy. The size of pleural macrophages was analyzed by quantitative morphometric planimetry in 18 effusions due to tuberculosis, 21 effusions following radiotherapy for malignant disease and 10 effusions due to congestive heart failure. Macrophages were identified and clearly separated from mesothelial cells by latex phagocytosis and immunostaining with the monoclonal antibody My4 (CD14). The mean macrophage area (+/- standard deviation) in tuberculous effusions (92 +/- 14 sq micron) was significantly smaller than in postradiation (141 +/- 28 sq micron) and heart-failure effusions (154 +/- 22 sq micron) (P less than .0001). There was also a smaller ratio of mesothelial cells in tuberculous effusions (0.5 +/- 0.9%) in comparison with effusions following radiotherapy (4 +/- 5%) or congestive heart failure (10 +/- 12%). In summary, this study demonstrated some cytomorphologic parameters that may be helpful in the differential diagnosis of tuberculous effusions.

Adolescent↗
PubMed1987

Anatomy of the pelvic floor for translevatoric-transsphincteric operations.

The parasacral transsphincteric-translevatoric approach has proved of great interest in surgery of the lower rectum and urogenital organs. Due to this experience, anatomic specimens of the pelvic floor and pelvic organs were prepared in order to perfect the operative technique. The anatomic specimens show the pelvic floor and sphincter muscles and the blood supply by the pudendal vessels and nerve, as well as the topography of pelvic organs and fascias from the view of a surgeon performing parasacral surgery. The clinical experience with 118 cases of parasacral translevatoric-transsphincteric interventions at the Departments of Surgery of the University Hospital, Basel, and the Canton Hospital, Luzern, Switzerland, is presented. The results were mainly good. The operation technique is illustrated with selected cases of rectum resection, procedures for treatment of urethrorectal fistulas, reconstruction of pelvic floor for malformations, and reconstruction of injured urethra.

Abnormalities, Multiple↗
PubMed1986

Behavioral effects of intraventricular dibutyryl cyclic AMP in domestic fowl.

Intraventricular administration of dibutyryl cyclic AMP (dbcAMP) to domestic fowl induced behaviors within 60 seconds which persisted for 7-120 minutes. Stereotyped head movements and increases in preening were observed at the lowest dose (50 nmol), while at higher doses (150 and 225 nmol) head movements were interspersed with escape behavior, increases in locomotor activity, salivation and a loss of coordination. Administration also elicited vocalizations, mainly laying and type 1 warning calls. These calls contained many abnormal elements, possibly caused by relaxation of the syringeal musculature. The rate of calling was influenced by testosterone, being greater in hens and capons than in roosters or capons implanted with testosterone propionate. Caponization also intensified escape behavior. No behaviors were induced by administration of the hydrolysis product of dbcAMP, butyric acid. These behavioral effects of dbcAMP are similar to those reported to occur during electrical stimulation of loci in the avian brain.

Animals↗
PubMed1986

[Use of botulinum toxin in ophthalmology].

Botulin toxin A was introduced as a treatment in ophthalmology by Dr. Scott of San Francisco. One important application is in cases of blepharospasm, where the toxin is injected into the lateral parts of the lower and upper lid and, if necessary, over the eyebrows in a single dose of 1-2 nanograms, preferably using a needle under electromyographic control. The effect on the blepharospasm is visible after a few days and lasts for several months. The procedure can be repeated several times. The second application is in cases of strabismus. In paralytic strabismus, contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulin toxin with a coaxial electrode under electromyographic control. Good results were observed in cases of eye muscle disorders in endocrine ophthalmopathy. In concomitant strabismus (exotropia or esotropia) administration of botulin toxin is also possible although a certain paresis of the injected muscle has to be taken into account. The doses for strabismus vary between 1/2 and 2 nanograms of the toxin. The administration of botulin toxin either in blepharospasm or strabismus has no systemic side effects and is a safe procedure if performed under careful electromyographic control. First personal experiences in the treatment both of blepharospasmus as well paralytic strabismus and concomitant strabismus are reported.

Blepharospasm↗