[Meralgia paresthetica].
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Biomedical subjects
Publications and source records attributed to M Andersen.
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Nineteen patients operated on suspicion of bilateral orbital floor fractures are described. All of the patients had severe comminute midfacial fractures. Orbital floor deficiency requiring transplantation was found in 68% of the cases, demonstrating homolateral maxillary and zygomatic fractures. On the basis of their findings, the authors recommend acute reposition of the fractures and routine exploration of the orbital floor in the case of deficiencies requiring transplantation and in cases of homolateral combined maxillary and zygomatic fractures.
Ninety patients operated on, on suspicion of unilateral orbital floor fractures are described. Age, sex, and etiology are given. Operative indication is examined and related to the operative findings. Fifty-six of the patients had fractures requiring transplantation, 24 had fractures which did not. Ten patients had no fractures. Only autogenous bone graft was used. The patients were examined three months and one to 11 years postoperatively (questionnaire). Of 82 operated patients who answered the questionnaire diplopia was found in eight, enophthalmos in two, hypesthesia in 18, reduced mobility in four and sinuitis in four. Preoperative X-ray: Three patients showed false positive X-ray findings. In 19 patients with false negative X-ray findings 12 required transplantation. Twenty-five tomographed patients showed fractures, two of which proved to be false positives. In eight patients with negative tomographical findings, fractures were found, seven of which required transplantation. The frequency of complications assessed in relation to the time of operation shows no significant difference, if surgery takes place within seven days of injury. Surgery performed later than this seems to produce more cases of chronic sinuitis.
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Five children earlier treated for capillary hemangiomas of the eyelid and orbit have been examined for cosmetic and functional results of treatment as well as their ocular status. In all cases the optic axis has been obstructed for a varying period in the first year of life. Two patients got exceedingly amblyopic and 3 patients moderately amblyopic. The cosmetic result is satisfactory in three cases. Different treatments have been used in these cases, i.e. surgical, X-ray and corticosteroid. The most essential aspect of the treatment is to open the eyeslit so much that the optic axis is free and in this way try to prevent amblyopia.
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Alkyl 2-cyanoacrylate adhesives were tested for mutagenicity in Salmonella typhimurium strains TA98, TA100, TA1535 and TA1538. Both a normal spot test and a spot test specially designed to test volatile compounds were used. The adhesives were also tested in the plate incorporation assay. These investigations showed that methyl 2-cyanoacrylate adhesives are mutagenic in strain TA100. The spot test for volatile compounds showed that it is the vapors from the methyl 2-cyanoacrylate monomer that are responsible for the mutagenic effect. One can conclude that working with methyl 2-cyanoacrylate adhesives entails exposure to vapors with a mutagenic effect and may therefore pose a carcinogenic hazard. Because the adhesives are used in industry, their mutagenic effect has a special importance in work environment.
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In order to construct a catheter, capable of monitoring cardiac output, a specially designed double-conical hot-film anemometer probe was fastened at the tip of a Swan-Ganz thermodilution catheter. Common sources of error for most catheter velocity probes include difficult calibration, unknown velocity profile at the point of measurement and unknown position of the probe in this profile. By using mongrel dogs and in order to exclude these sources of error, the intermittent thermodilution method was used to in vitro calibrate the hot-film anemometer, which registered velocity continuously. A mean correlation coefficient between these two methods was found to be 0.886. A mean line of regression between thermodilution (abscissa) and anemometer (ordinate) had a slope of 0.796 +/- 0.223 (+/- SD) and a y-intercept of 24 +/- 14 ml/min/kg. The slope was significantly lower than one (t test, p less than 0.05) and the y-intercept significantly larger than zero (t test, p less than 0.02). As a control of the thermodilution method, electromagnetic flow in the ascending aorta was registered and a mean correlation coefficient of 0.967 found. The hot-film sensor itself can be used as thermodilution method with the hot-film anemometer's continuous registration of velocity.
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Three elderly subjects with Down's syndrome and biochemical evidence of hypothyroidism were investigated before and after four months of thyroid replacement treatment. The patients' appearance was demonstrated by photographs and the biochemical thyroid values and the intellectual performance were assessed. The appearance before treatment varied from a florid myxoedematous appearance to a state without features indicating myxoedema. Thyroid replacement therapy was given in usual dose and the biochemical response was similar to that seen in normal subjects. The intellectual performance improved little or not at all. The characteristic discomfort usually associated with hypothyroidism was very pronounced in one case and disappeared totally during treatment. It is concluded that the diagnosis of hypothyroidism in elderly subjects with Down's syndrome can be very difficult when based on appearance and history alone and biochemical thyroid tests are often necessary. The patients should be treated with replacement therapy just as other patients suffering from hypothyroidism.
During the immediate postoperative course after upper abdominal surgery, pulmonary complications often occur, caused, inter alia, by reduced regional ventilation and by atelectases as a result of: (1) narrowing of the small peripheral bronchi, and (2) impaired respiratory function. Based on these pathophysiological mechanisms, an instrument (Bartlett-Edwards Incentive Spirometer) has been devised, which aims at giving the patient an opportunity of sustained maximal inspiration under standardized and controlled conditions. The use of this instrument has been followed by reports of a considerable reduction in postoperative pulmonary complications. In a controlled clinical investigation of the pre- and postoperative condition of the lungs, we were unable to show any beneficial effect of the instrument. In general, we have a low frequency of severe postoperative pulmonary complications, as compared with the results reported in the literature. We ascribe this to our very effective pre- and postoperative respiratory therapy.
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