Biomedical subjects
Publications and source records attributed to E Grandjean.
Secondary localisations of malignant tumors to the ENT areas are rare. One case of renal adenocarcinoma metastasis to the thyroid has been followed in our department. After a quick recall of the clinical story, we will try to point out the epidemiological and physiopathological specificities of this localisation and to emphasize its therapeutic difficulties.
Neuroendocrine tumors are rare neoplasms of the larynx and hypopharynx. This tumors are divided in paragangliomas (usually benign, although malignant case have been reported), large cell neuroendocrine carcinoma, described in this case as a primary pharyngo-laryngeal locate, and small cell neuroendocrine carcinoma (characterized by early and diffuse metastatic disease, and best treated by radiotherapy and chemotherapy). Through the international literature, the authors reviewed the characteristics of the large cell neuroendocrine tumors and their management.
The authors report an unusual case of laryngeal sarcoidosis. After having explained it, they describe the elements of diagnosis about this rarely isolated pathology, its complications and treatment as well.
A retrospective study have been conducted in 117 cases of sudden sensori-neural hearing loss, between 1988 and 1991, int he department of Head and Neck Surgery (Strasbourg). After a brief review of actually treatments, they show, in a statistic and comparative analysis, that efficacy of therapeutics are never significant. This results are compared with international bibliography, and show that treatments of sudden loss remains doubtful.
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In the surroundings of five industrial plants, noise immissions (industrial noise and non-industrial noise) were measured and residents asked by a questionnaire about the effects (annoyance and reactions) caused by industrial noise. The questionnaires of a total of 1498 (58%) residents could be analyzed. The Leq for the industrial noise ranges from 37 to 68 dB(A) in the daytime and from 37 to 59 dB(A) in the nighttime. Ten to 20% of the residents are already strongly annoyed at industrial noise Leq levels of 50 dB(A). The sensitivity to noise is higher in the evening and at night. Residents are disturbed mainly during their rest and recreation and often react by closing the windows. Limits for noise immissions caused by industrial plants in residential areas are proposed (Switzerland).
We have described a 22-year-old man with an HBsAg-positive chronic active hepatitis who developed an attack of pancreatitis during the course of treatment with prednisone and azathioprine. Clinical and biochemical abnormalities subsided when azathioprine was stopped and reappeared after rechallenge with the drug. Azathioprine-associated acute pancreatitis is well recognized mostly during treatment of Crohn's disease and after renal transplantation. This adverse effect should, therefore, also be kept in mind during the treatment of chronic active hepatitis.
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Railway controllers and points men of the Swiss Railways retire more often prematurely because of medical reasons than civil servants. A pilot study on 120 controllers and 60 points men revealed adverse effects of the irregular working hours as well as of mental loads. Furthermore, the controllers disclose symptoms and signs caused by physical and environmental loads.
An adjustable VDT workstation was studied under practical working conditions. The preferred settings of keyboard and screen were assessed in a vertical and horizontal plane. The great majority of operators preferred a backward leaning trunk posture which was associated with a lower incidence of physical complaints.
Split keyboards have been developed based on laboratory and field studies. They are characterized by a large forearm/hand support, an angle between the two half keyboards of 25 degrees, a frontal-, lateral inclination of 10 degrees and a hand-conforme key arrangement. These split keyboards reduce constrained postures in arms and hands. The keyboard can be operated with supported forearms. Work on a split keyboard is more comfortable and it was preferred by a large majority of the users.
A medical examination and questionnaire in various office workplaces (N = 295) shows that in intensive work at visual display terminals rheumatic and asthenopic disorders are very frequent. Muscle pain and eye complaints are correlated. The incidence of eye disorders and visual acuity are related to lighting conditions (local and temporal oscillation of characters on the visual display) at the individual workplaces.
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An apparatus for measuring the sharpness, the oscillation degree and the stability of characters of 8 different VDTs were developed. Furthermore the contrast of luminances between the essential surfaces was measured. The following results were observed: 2 VDTs had good ergonomic qualities, one was only sufficient and 5 VDTs had insufficient ergonomic light conditions.
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