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Biomedical subjects

J Esser

Publications and source records attributed to J Esser.

At least 55 records · Page 3Linked to original sources

[Acute psychosis caused by poisoning with cyclopentolate].

The authors report on a 17-year-old female patient who suffered an acute psychotic attack after local application of cyclopentolate 1.0% in both eyes. The literature is reviewed with regard to systemic side effects of local application of cyclopentolate. Toxicity of cyclopentolate may be found in every age group even if tolerated without side effects before and it has no specificity for patients with certain (especially brain) diseases. The rapid short-term cycloplegic effect and the rare cases of systemic toxicity support the authors opinion that cyclopentolate is a very useful and well-tolerated diagnostic substance.

Adolescent↗

Post-traumatic parotid fistulae and sialoceles. A prospective study of conservative management in 51 cases.

The management of parotid sialoceles and fistulae have been unsatisfactory in the past, and numerous methods of treatment with varying success and morbidity have been described. The present prospective study reports results of conservative therapy in 51 patients over a 3-year period. In 50 patients, the injury healed upon conservative management. During the early phase of the study, a limited conservative regimen through which the patients received nothing orally for 5 days only was used. During the latter part of the study, patients were administered nothing orally until complete healing of the injury. In terms of the time it took for healing of the injury, the differences of the two regimens (24 +/- 4 vs. 9.4 +/- 0.9 days) was highly significant (p less than 0.001). The response to conservative management depended on the severity of injury as demonstrated by sialography. Injury to minor intraparotid ducts (G1) healed in significantly less time compared with that to a major intraparotid duct (G2) or ductal injuries (p less than 0.001). There was no difference between the healing of G2 injury (10.3 +/- 1.8 days) and partial ductal transections (10.5 +/- 2.2 days) (p greater than 0.05). There was a significantly greater delay in healing with complete duct transections (21.5 +/- 3.7 days) compared with partial duct transections and G2 injuries (10.2 +/- 2.1 days) (p less than 0.01). There was no difference in the mean period for healing between salivary fistulae and sialoceles (p greater than 0.05). It is concluded that a new classification of parotid fistulae based on sialographic findings has prognostic and therapeutic value. Furthermore, the excellent results achieved with conservative therapy in this study suggest that it may be the initial treatment of choice for parotid fistulae.

Acute Disease↗

Technetium-pertechnetate uptake by ectopic antral mucosa. An experimental study.

The ability of ectopically placed fundic mucosa and retained antral mucosa to concentrate technetium has previously been demonstrated. The ability of ectopically placed antral mucosa to concentrate technetium was investigated. The denervated antrum implanted into the colon concentrated technetium in 5 dogs. However, this response was significantly less than that of parietal cell-containing mucosa (P less than 0.005) of the stomach. Technetium scanning may be useful in detecting ectopic and retained antral mucosa.

Animals↗

Management of gastric emptying disorders following the Roux-en-Y procedure.

In 46 patients with gastric resection and Roux-en-Y gastrojejunostomy, gastric emptying was studied with the gamma camera. Seventeen patients were free of symptoms, 11 vomited occasionally (less than 5 times weekly), and 18 were severely incapacitated with daily vomiting, weight loss, and bezoar formation. Patients with occasional vomiting had early rapid emptying similar to that seen in the patients who were without symptoms and responded satisfactorily to nonsurgical therapy. The 18 patients with severe vomiting showed a marked delay in the emptying of the solid meal (p less than 0.01) but normal emptying of the liquid. There was no difference between those with and those without stomal ulceration or stomal stenosis. The stasis occurred in the stomach and not in the Roux limb. All 18 patients had a further extensive gastric resection, leaving a 50 to 75 ml upper gastric remnant drained by Roux-en-Y gastroenterostomy. Fifteen of these patients showed improvement and gained weight, and the gastric emptying of both the solid and liquid test meals is now faster than in any of the other groups (p less than 0.03). We conclude that extensive gastric resection is an effective means to reduce symptoms and improve gastric emptying in selected patients with severe gastric stasis of solid food after the Roux-en-Y procedure.

Anastomosis, Roux-en-Y↗

Silicone oil and its influence on electrophysiologic findings.

Twenty patients with complicated retinal detachments who were treated with scleral buckling procedures, vitrectomy, and temporary silicone oil filling underwent electrophysiologic tests before and after silicone oil removal. Electroretinographic responses were markedly low or even absent as long as the silicone oil was in the eye but a few days after silicone oil removal the electroretinographic amplitudes had increased in all 20 patients and did not change significantly thereafter. In 12 patients the basic level of the electrooculogram was low as long as the oil was in the eye but was at least twice the previous value in seven patients after oil removal. A light peak of more than 150% occurred in two patients before oil removal and in six after oil removal.

Adult↗

The clinical value of scintigraphic brain scanning. Experience at the Hillbrow Hospital, Johannesburg, South Africa.

Patients were referred to the Department of Nuclear Medicine for brain scintigraphy to be screened for possible intracranial pathology. These referrals were made in order to reduce the heavy load on the transmission computerized tomography (TCT) facilities. Great clinical importance, therefore, has been attached to scintigraphic findings; this emphasizes the need for an accurate assessment of the predictive value of this procedure.

Adolescent↗

[Pharmacologically-caused eye movement disorders--differential diagnosis and mechanisms of action].

The variety of drug induced patterns of pathological eye movements is reviewed with emphasis on hydantoins, barbiturates, carbamazepine, benzodiazepines, amitriptyline and alcohol. These different substances may be analogous or distinct in their site of action within the labyrinths, brain stem and cerebellum. Ocular oscillations are described in correlation to drug uptake or serum levels such as positional, downbeat, gaze evoked, periodic alternating nystagmus as well as saccadic pursuit, slowing down of saccades, alteration of VOR gain or suppression by fixation, internuclear and complete ophthalmoplegia. Most of the ocular motor disturbances are possibly due to a pharmacologically induced transient dysfunction of the vestibulo-cerebellar flocculus loop.

Alcoholism↗

[Prognosis of functional healing of infantile strabismus].

One hundred and forth-three patients suffering from infantile strabismus, who had undergone surgery on the horizontal eye muscles between the ages of 0 and 6 years were re-examined with the aim of establishing a correlation between the date of operation and functional healing (binocular single vision in space). In 89 patients (62%) a cosmetically satisfactory result (alignment) was achieved. The number of operations and functional healing (binocular single vision in space). In 89 patients (62%) a cosmetically satisfactory result (alignment) was achieved. The number of operations needed decreased with increasing age. Of the 89 patients with alignment, 61 (69%) were found to have binocular single vision in space, while 13 (15%) patients presented with stereopsis. Impairment of functional results was found to correlate with higher age at the first operation or on the date when alignment was reached for the first time, respectively. In cases with amblyopia or vertical divergences which had received insufficient postoperative treatment, attainment of binocular single vision or, respectively, the stability thereof was impaired. Therefore, with respect to functional healing, early surgical correction of strabismus is only recommended if adequate postoperative conservative and/or surgical after-treatment is assured. The postulate that successful functional healing can only be achieved by operations up to the second year (early surgery) is not supported by our data.

Child↗

Radiocolloid imaging in primary liver cancer and amoebic liver abscess. Accuracy of differential diagnosis and extent of inter-observer variability.

Radiocolloid liver scans from 58 patients with primary liver cancer and 56 patients with amoebic liver abscess were examined 'blind' and independently by three nuclear physicians and one registrar in training in order to evaluate the accuracy of the differential diagnosis between the two conditions and to assess the extent of inter-observer variability in the interpretation of these scans. Each of the observers incorrectly interpreted about 12% of scintiphotographs and at least one observer was wrong in 25% of the scans. The difference in diagnostic accuracy between individual observers was not statistically significant. Observers disagreed in 21,6% of the scans. The main reasons for misdiagnosis were failure to realize that excessive extrahepatic uptake of radiocolloid can occur with liver abscesses, and the indistinguishable appearance of the defect or defects in some cases of primary liver cancer and amoebic liver abscess. This margin of error and of inter-observer variability must be borne in mind when interpreting liver scans of patients thought to have either primary liver cancer of amoebic liver abscess.

Colloids↗