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Biomedical subjects

K Kunze

Publications and source records attributed to K Kunze.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Incidence and prognosis of internal medicine complications in spontaneous intracranial hematomas].

The records of 133 consecutive patients with spontaneous intracranial hemorrhage were reviewed to assess the frequency of systemic complications and their influence on outcome and neurological complications. The mean age of 63 patients with spontaneous intracerebral hemorrhage (ICH) was 11 years higher compared to 70 patients with spontaneous subarachnoid hemorrhage (SAH). Concomitant disease was more frequent in ICH than in SAH, and general atherosclerosis, chronic obstructive pulmonary disease and cardiac failure were associated with an increased mortality. 94% of all ICH and 79% of all SAH patients developed at least one systemic complication. A correlation was found between initial and late hyperglycemia, and high mortality rate and poor survival quality. In both groups an association of cardiac arrhythmias with intracranial pressure and an unfavourable outcome were observed. SAH patients with QT-prolongation had an increase in mortality and developed ischemic deficits more frequently. Pulmonary complications and disturbances of blood pressure regulation were associated with an unfavourable outcome, and in SAH patients with occurrence of neurologic complications.

Adolescent↗
PubMed1987

Cerebral cysticercosis in a European patient: problems of disease activity and therapeutic implications.

The case of a German patient who was treated with two courses of praziquantel for parenchymal cerebral cysticerosis (CC) is reported. Efficacy of the treatment could not reliably be distinguished from the natural course of the disease. After a brief review of the literature concerning problems with assessment of the activity of CC, the criteria recommending praziquantel therapy are discussed.

Adult↗
PubMed1987

[Indications for surgical treatment of spinal injuries].

Now as before, a deteriorating paraplegia as well as a partial transverse lesion are absolute indications for a stabilization of spinal injuries. The operation has to be carried out within a few hours after the accident. A complete transverse lesion as well as an instable situation in the spine are relative indications for surgery. In these cases, the operation should be performed as early as possible considering the easier reposition and the possibility of an earlier beginning of rehabilitation measures. The condition of the posterior vertebral body edge, the root of the vertebral arch and the articular process of a vertebra are decisive for the stability of the spine. Acute surgery in injuries to the spine is dependent on the operability of the patient, the presence of a surgeon skilled in spinal surgery together with an appropriate staff, and the possibility to produce at any time a CT scan of the spine.

Fracture Fixation, Internal↗
PubMed1987

[Osteochondral fracture in the area of the ankle joint].

In diagnostic assessment of a trauma in the ankle joint region, it is important to think of a possible chondral or osteochondral fracture of the upper ankle joint, although the incidence of such fractures is relatively low. Besides the conventional diagnostic procedures, computed tomography becomes more and more important in the assessment of accidental injuries, especially with regard to chondral and osteochondral fractures.

Adult↗
PubMed1987

[Clinical aspects and prognosis following severe craniocerebral trauma].

The practical employment of diagnostic and therapeutic management in the early stage of head-injured patients depends on the precise assessment of the clinical course. In a retrospective study of 39 patients with severe head injury the prognostic value of clinical and methodical (instrument) parameters was analysed and compared with results of 28 international studies. As findings of this study the factors "age", "motoric response", "pupillary light reaction" and "type of intracranial lesion" were combined with the highest precision of outcome prediction. On the other hand, signs originating from the autonomic nervous system were not useful to predict the clinical course. The duration of post-traumatic coma was not appropriate to give an early view of the development of disease. The high value of neurological state in combination with neuroradiological and neurophysiological investigations in the early posttraumatic period of severe head injury is emphasised.

Adult↗
PubMed1987

[Clinical manifestations of rabies in the human. Case report and review].

Clinical symptoms and course in a 28 year old woman who suffered from rabies are reported. Neurophysiological and neuropathological findings in this patient, who died 21 days after developing initial symptoms, are presented in more detail. This disease appears to be rare in Central Europe. It can be treated effectively only by means of early detection and a special vaccination programme. Late recognition of lyssa specific symptoms in non-vaccinated patients is invariably associated with a fatal outcome. A review of current knowledge concerning rabies research is presented.

Adult↗
PubMed1986

[Autologous blood-antibiotic filling as effective therapy of chronic osteomyelitis].

A control of osteomyelitis by parenteral administration of antibiotic drugs is not possible due to sequestration, thrombosis of the peripheral vessels, and encapsulation of the osseous focuses. The autoblood-antibiotic plombage was indicated in 1951 by Winter. The principle used for this method is the concentration of one or more antibiotic drugs in an autogenic carrier releasing the drugs which then exert their effect directly at the site of the disease. In the experimentation on animals, the streptomycin level in the peripheral blood decreases only after 130 hours to the inhibiting threshold value of 0.008 g/ml. The autoblood-antibiotic filling becomes a connective tissue filling and, about seven weeks later, a bone filling. There are three conditions for a therapeutic success of the antibiotic plombage. 1. It must be only a limited, unilocalized, not too extended bone process. 2. large débridement and sequestrotomy, and 3. the bone must be provided with an own absolute stability. 74 out of 112 patients treated with an autoblood-antibiotic plombage were immediately free from symptoms. Two thirds of these patients showed a superficial recovery.

Administration, Topical↗
PubMed1986

Effects of the glycaemic index of dietary carbohydrates on prandial glycaemia and insulin therapy in type I diabetes mellitus.

Four carbohydrate diets with different glycaemic index were fed to 10 type I diabetic patients on continuous subcutaneous insulin infusion (CSII). Every diet consisted of 4 meals with identical carbohydrate content, being consumed during one day each at 8.00, 12.00, 16.00 and 18.00 h. CSII was conducted according to the patients' experiences, aiming at plasma glucose values between 70 and 160 mg/dl. From 8.00 to 20.00 h, plasma glucose was measured every 2 h. Plasma glucose profiles were near-normal with all of the diets; differences between the diets were statistically insignificant. The premeal insulin dosages, as delivered by the patients, varied significantly in relation to the time of the day, and to the premeal plasma glucose concentration. The patients varied their prandial insulin doses also in relation to the 4 diets, indicating that the glycaemic index was helpful for the prediction of their prandial insulin requirements. It is concluded that near-normoglycaemia can be achieved in type I diabetic subjects on CSII irrespective of the glycaemic index of their diet, if the prandial insulin requirements are met adequately.

Adult↗
PubMed1985

[Talus injuries].

Due to function and anatomy the talus plays a special part among the tarsal bones. The extended joint surfaces cause a high rate of arthrosis in fractures, the difficult blood supply leads very often to a disturbance of the supply of the talus in the case of vulneration. Fractures are divided in central and peripheral forms which could be caused either by simple or compound fracture mechanism. The computed tomography offers precious informations in the diagnosis of talus vulnerations. Besides the conservative therapy of peripheral fractures there is the operative treatment of central fracture forms. Infection, arthrosis and necrosis of the talus are to be mentioned especially as postoperative complications.

Follow-Up Studies↗
PubMed1985

[Measurements of blood supply of freely transplanted rib and iliac crest grafts by the tracer microsphere method].

The actual blood perfusion of bone grafts in the lapse of time of their implantation is demonstrable by the tracer microsphere-method. The transplanted rib bone graft turns out to be almost equal to the cortico-spongiose pelvis bone graft concerning the blood perfusion. The long distance bridging rib bone graft shows the blood perfusion of the starting point after six weeks.

Animals↗
PubMed1985

[Continuity resections of long tubular bones and subsequent bone reconstruction].

The osseous restitution of extended deficiency pseudarthroses is possible by means of modern osteosynthesis methods which exactly immobilize the bone. However, numerous operations are required in order to prevent infections and to reconstruct the osseous stability by subsequent bone chip grafts. The treatment may take three to five years, and relapse and even failure will occur frequently. This aspects have to be discussed with the patient before beginning such a treatment, and there must not be any doubt that the patient really desires to be treated in this way.

Adolescent↗
PubMed1984

[Indications and results in shortening osteotomy of the ulna].

A relatively or absolutely too long ulna leads always to pain in the wrist, so that a compensation in length of both forearmbones is achieved by shortening osteotomy. The gradual ulna shortening osteotomy, the stylectomy and the resection of the caput ulnae with or without radius transposition osteotomy are available as shortening operation. In 17 patients of the Giessener Unfallchirurgischen Klinik we performed in 14 cases a shortening osteotomy of the ulna and in 3 cases a resection of the caput ulnae. The shortening osteotomy lead in all cases to a reduction of complaints and to an improvement of the mobility of the wrist. Due to frequent arthropathy the resection of the caput ulnae should be taken more often into consideration in older people.

Fracture Fixation, Internal↗
PubMed1984

[Scapula fractures following electrical accidents].

Injuries to the skeletal system caused by electro-accidents are rare. The authors present two cases of scapula fractures caused by electro-accidents. Cardiac and neurologic symptoms as well as thermal damages are found in most cases of electro-accidents indeed, however, injuries of the skeletal system may not be overlooked and have to be treated according to the principles of traumatology.

Adult↗
PubMed1984

[Principles of first aid to severely injured persons at the scene of the accident].

The therapy-free intervals after an accident have been considerably shortened by the introduction of an emergency system ensuring the treatment of the injured person by a physician on emergency duty already at the place of accident. Injuries threatening life have to be treated first in order to maintain the vital functions. Due to the lack of time and the insufficient equipment available at the place of accident, a precise diagnosis is possible only in exceptional cases. The most dangerous complications are respiratory deficiency, loss of blood, inconsciousness and lack of skeletal stability, and these are to be treated in this order. Intubation and artificial respiration are the most adequate methods to maintain the respiratory function. Exterior bleedings have to be staunched , losses of blood must be compensated by administration of colloidal solutions and electrolyte solutions. Urgent admission to a hospital is necessary in case of interior hemorrhages and in case of inconsciousness , especially if an intracranial hemorrhage is suspected. Fractures and luxations are not primarily threatening life, nevertheless the provisional reposition and immobilization of the injured extremities belong to the task of a physician on emergency duty. The reanimation of patients injured in an accident has a poor prognosis; if a cardiac arrest persists more than ten minutes, further reanimation measures are nearly never successful.

Accidents↗