Biomedical subjects
Publications and source records attributed to G Simon.
Crohn's ileocolitis manifested in 2 Black patients with the exceptionally rare complications of pyoderma gangrenosum and sclerosing cholangitis. It is emphasized that Crohn's disease is very rare in the Black population of sub-Saharan Africa, and, as far as we are aware, no patient with large-bowel involvement has hitherto been reported.
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Anaerobic and aerobic-anaerobic threshold (4 mmol/l lactate), as well as maximal capacity, were determined in seven cross country skiers of national level. All of them ran in a treadmill exercise for at least 30 min at constant heart rates as well as at constant running speed, both as previously determined for the aerobic-anaerobic threshold. During the exercise performed with a constant speed, lactate concentration initially rose to values of nearly 4 mmol/l and then remained essentially constant during the rest of the exercise. Heart rate displayed a slight but permanent increase and was on the average above 170 beats/min. A new arrangement of concepts for the anaerobic and aerobic-anaerobic threshold (as derived from energy metabolism) is suggested, that will make possible the determination of optimal work load intensities during endurance training by regulating heart rate.
The absorption and biliary excretion of drotaverin/a papaverine analogue/were studied in rats. In vivo loop technique was used. The absorption of the compounds from the jejunum was found to be rapid and the activity injected into the duodenal sac to disappear only when the common bile duct was ligated. An appreciable activity was detected in the bile collected by cannulation following both i.v. (67%) or per os (31%) administration. Considerable activity was excreted with the bile even 24 hours after drug administration. A partial entero-hepatic cycle for the drotaverin metabolites is suggested.
Venous distensibility in essential hypertension has been reported to be unchanged or decreased; its pathophysiologic role is uncertain. In 27 male hypertensive patients and 21 normotensive control subjects, forearm venous distensibility and capillary filtration rate at 30 cm of H2O distending pressure were measured by strain gauge plethysmography. Plasma renin activity (PRA), plasma volume (PV) by the Evans blue dye dilution technique, mean arterial pressure (MAP) by cuff, and cardiac output (CO) by the CO2 rebreathing method were also measured. Compared to values in normotensive control subjects, forearm venous distensibility in hypertensive subjects was decreased (P less than 0.05); the forearm venous pressure-volume curves (deflation phase) were shifted in the direction of the pressure axis (P less than 0.02); and the capillary filtration rate was increased (P less than 0.05). Venous distensibility changes in hypertensive subjects were unrelated to PRA, MAP, PV, CO, stroke volume, and total peripheral resistance. These findings confirm previous reports of decreased venous distensibility in hypertension and provide direct evidence for increased capillary filtration rate. In view of the lack of significant correlation between venous distensibility and the measured hemodynamic parameters, a patho-physiologic role for venous distensibility in hypertension could not be established.
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An expanding skull fracture with exceptional extension into the frontal sinus, the orbit and the ethmoidal cells is discussed. A 12 year old boy fell down the stairs at the age of 8 years and fractured his left frontal bone with extension to the base of the skull. He was seen because of a swelling of the scalp, an intermittent orbital oedema and convulsions. At neurosurgery a large gaping fracture of the frontal bone was found and this was interposed with fibrous tissue and relatively denatured cerebral tissue. The management both neurosurgical and rhinological is discussed.
The results of echocardiographic studies on 90 athletes representing various sport-types and 18 non-athletic persons are presented. The intracardiac diameter measured by echocardiography was proportional to the heart volume determined radiologically. The thickness of the septum and posterior heart wall compared to the internal heart diameter was greater in athletes with static exercise than in endurance athletes. This must be interpreted as a tendency to concentric hypertrophy. In endurance athletes this relationship tended to be less than in non-athletic persons. In addition stroke volume and cardiac output at rest was higher in endurance athletes than in athletes with static exercise and non-athletic persons. At rest no variations in parameters of heart muscle contractility related to heart size or sport-type could be detected.
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Intrarenal blood flow distribution was studied with the simultaneous use of the 99Tc labelled frog erythrocyte (microsphere) and the radioactive 86Rb fractionation method in the rat. The amount of blood entering the outer cortex (99Tc labelled erythrocytes method) proved to be higher than one perfusing the outer cortex (86Rb method), whereas the amount of blood entering the inner cortex (99Tc method) was less than the amount perfusing the inner cortex and medulla (86Rb method). Hence a group of the preglomerular arterioles in the outer cortex contributes to the blood supply of the inner cortex, on the other hand a group of preglomerular arteries in the inner cortex participates in the postglomerular blood supply of the medulla. Changes in the renal circulation are, however, associated with altered distribution of postglomerular vascular segments supplied by some groups of preglomerular arterioles. From this it is concluded that the postglomerular vessels of the deeper cortical layers constitute a system which is not parallelly coupled but comprises both series- and parallel-coupled sections. The contribution of these sections appears to vary depending on the actual haemodynamic conditions.
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Pseudarthrosis of the clavicula in childhood is rare. Beside the congenital forms, especially dysplasia of the skeleton, the cause of acquired pseudarthrosis is often the complete or partial lack of immobilization and poorly performed or not indicated osteosynthesis. Basically firm osteosynthesis with small DC-plates is the therapy indicated, but because of atrophic or short fragments, great defects, or if the relevant parts of the skeleton are too short, a compromise is often necessary, especially for the sake of strength. The autologeous spongiosaplastic, corticospongio bone parts, which strengthen the osteosynthesis procedure, if involved, are basic to undisturbed healing.
Echocardiographic studies and radiological measurements of heart volume were performed in 30 female track athletes, 17 female shot-putters or javelin throwers, 12 nonathletic women and 8 female patients with arterial hypertension. The following observations were made: The hearts of the female athletes undergoing endurance training were in the whole larger than the hearts of the nonathletic women, although the ratio of internal diameter to wall thickness was unchanged. There was a relative increase in the ratio wall thickness to internal left ventricular diameter in the female shot-putters and javelin throwers compared to the nonathletic females. This is interpreted as being a result of the static training imployed. In all female patients with severe arterial hypertension the heart wall thickness was increased, the internal heart diameter was dependant of the stage of the illness. Using echocardiography it is possible to draw conclusions as to the ratio wall thickness to cavity diameter. This is not possible with radiological heart volume studies.
Analysing 149 late deaths occurring between the years 1958 and 1977, the postoperative survival rate independent of age was in 33% less than three months and another 33% less than one year. The causes of death in the different age groups have been analysed following the scheme proposed by Petren: The most common cause of death was infection (65%), 20% of the children died with an indefinite final diagnosis, but this percentage has decreased since the introduction of computer tomography. Since 1968 the number of late deaths has been reduced mainly because of a decrease of local infections, better follow-up of the children and last but by no means least a better cooperation with the parents.
In addition to an innate functional dysmaturity of the neonate's immune system, operation, anaesthesia, and intensive care measures can significantly worsen this physiological immune deficiency. Given the fact that antimicrobial therapy as well as progress in intensive care of infected operated neonates and prematures did not significantly decrease the high mortality rate in this patient age group we began performing fresh-blood exchange transfusions as supportive immunotherapy in the treatment of neonatal septicaemia. Since indication for exchange transfusion has been adopted as early as septicaemia was suspected only 46% of the operated neonates (13 out of 28) died of their infection, compared to 82% of the patients (23 out of 28) who did not undergo exchange transfusion.
To evaluate the role of systemic autonomic tone in the hemodynamic response to beta-inhibitors, the hemodynamic effects of long-term timolol therapy were studied in hypertensive patients under two sets of conditions: at rest and after pharmacologic systemic autonomic inhibition (SAI). Hemodynamic studies were performed in every subject at the end of a 4-week placebo period and again at the end of a 9-week treatment period. The antihypertensive effect of timolol was associated with decreased cardiac output and unchanged peripheral resistance at rest and with unchanged cardiac output and decreased peripheral resistance after SAI. The hemodynamic response to SAI during the two studies was also markedly different. The findings provide evidence of increased alpha-adrenergic component of systemic autonomic tone during long-term therapy with timolol.
The occurrence of foeveola palatina was studied in 264 patients. The distance of the foveola palatina from the papilla incisiva and palatinal raphe was measured. Light and electron microscopic examinations were carried out on specimens obtained from cadavers. It was found that ducts of functioning mucous glands open into the foveolar lumen lined by stratified epithelium.