[Coordinated army medical service and the reorganization of the army medical service].
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Biomedical subjects
Publications and source records attributed to A Huber.
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990 cases of women using standard copper IUDs (Cu 7; Cu T; Multiload) up to a maximum period of 8 years have been analyzed statistically. The long-term use effectiveness was evaluated mainly by using statistical methods (life table). Pregnancy rates decreased during the whole period of observation but more evidently after 2 years of use. It is recommended that medicated IUDs, free of side effects, be exchanged only after 5 years of use, corrosive changes being not too far advanced after this period. New IUD models are less likely to be subject to corrosion and will therefore need to be replaced less frequently.
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In a 16-year-old boy with congenital bilateral paralysis of the sixth cranial nerve and unilateral paralysis of the seventh nerve (on the right) heterochromia of the right eye was observed, characterized by a lighter color of the iris, precipitates on Descemet's membrane and absence of synechiae. The development of Fuch's heterochromic cyclitis in combination with Moebius' syndrome is discussed in connection with possible pathogenic factors, in particular immunopathologic processes which may contribute to an understanding of the origin and progression of the disease.
The surgical treatment of an eye muscle palsy is indicated at the end stage of all possible conservative therapeutic measures. If after an interval of 8 to 12 months an eye muscle palsy manifests no change of pattern, the indication for surgical treatment is given, provided the pathologic process causing the palsy is no longer active. Of great importance for the evaluation of surgery are the forced duction test, measurement of saccadic velocity and electromyography. The aim of the surgical intervention is to eliminate diplopia and restore parallelism of the visual axes if possible with every line of vision, but above all with the largest possible visual field in the primary position and in downwards gaze. Any eye muscle palsy produces an overaction of the homolateral antagonist, an overfunction of the contralateral synergist and a secondary inhibition of the contralateral antagonist. Theoretically four surgical possibilities would result from these conditions. However, in practice the choice is reduced to weakening (recession, faden-operation) of the homolateral antagonist or the contralateral synergist or possibly both and to strengthening (resection, tucking) of the primary paretic muscle. Not infrequently, the surgical intervention has to be performed in different steps on different muscles of both eyes. In cases of total palsies muscles transposition or transplantation procedures (Hummelsheim-O'Connor, Jensen etc.) must be considered. A promising new method of restoring innervation to a paralyzed muscle is muscular neurotization (implantation of the inferior oblique muscle into the paralyzed denervated external rectus muscle in cases of abducens nerve paralysis).
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Ultrasonographic examination was carried out on 38 patients suffering from obstructive jaundice. Diagnoses after these examinations were compared with the intraoperative findings: 37 of the 38 obstructions of the bile ducts had been diagnosed and located correctly. No such success was obtained in the identification of the aetiology. Of 15 cases of gall stones 9 were identified and of 20 tumors 15 were determined. A skilled examiner performs the examination in less than half an hour. The method is not invasive and may be applied also on patients with severe malfunction of the liver. Even high risk patients can undergo this examination without undue sufferings.
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12 homologous umbilical cord veins prepared according to the method of MINDICH from February to November 1978 were used as either femoro-femoral or femoro-popliteal bypass. 6 of the 12 implanted umbilical veins after an average of 4 months were still open and showed good results, whereas 4 were blocked by thrombosis due to bad outflow conditions or dissection. On two implants that had had to be removed, histological examinations were used, and these showed a destruction of the graft's wall. In contrast to the advantages of their problem-free availability and good technical suitability stands the destruction of these grafts observed by us and hence the questionable nature of tenacity in the receiver. Further experiences of longer duration dealing with this interesting subject of vascular substitute are needed.
The diverticular disease of the colon is one of the most frequent causes of massive bleeding of the large bowel. The results of emergency operations without localisation of the bleeding are disappointing. The bleeding point can be localised by selective angiography, and this renders possible the most favourable surgical procedure as shown by the case report of a high risk patient.
102 pacemakers have been implanted under local anesthesia. The electrodes have been introduced through the left vena cephalica and the pacemakers placed in the infraclavicular groove. Exchanged pacemakers have been put in the already existing cavity. The wounds have been closed by sutures consisting solely of polyglycolic acid. One hematoma and one infection have been observed. In 12% of the cases the electrode was introduced through the vena jugularis externa, owing to obstruction or unsuitable size of the vena cephalica. Reoperation was necessary in 3 cases due to dislocation of the electrode, and in one case due to the perforation of the ventricle caused by the electrode.
Craniofacial traumata may be accompanied by retroorbital fractures with severe ophthalmologic complications. Each of the clinical syndromes is characterized by a combination of ophthalmoplegia, paralyzed pupillary function and visual disorder. These deficiencies are caused by injury of muscles, nerves and vessels and compressive retroorbital hematoma. In the case of such damage, the poor prognosis can be improved by surgical intervention consisting in the evacuation of the retroorbital hematoma.
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