Biomedical subjects
Publications and source records attributed to M Mettler.
The case of a 12-year-old girl with Klippel-Trénaunay syndrome and the signs of median nerve entrapment is reported. A cavernous haemangioma surrounding the median nerve is thought to be responsible for the carpal tunnel syndrome through mechanical compression and ischemic damage to the nerve due to the changed haemodynamic situation in the carpus.
Two cases of diaphragmatic hernias are reported. Both cases were previously undiagnosed and were found during diagnostic colonoscopy. In one case sudden respiratory distress occurred during the endoscopic procedure owing to a barotraumatic perforation in a left-sided hernia with tension pneumothorax. The diagnoses were made by fluoroscopy without delay. Endoscopists should be aware of the possible occurrence of diaphragmatic hernias and their risk as life-threatening complications. To avoid such dangerous complications access to X-ray facilities with fluoroscopy is recommended in endoscopic units where colonoscopies are performed.
Hepatitis B is not perceived as a serious health hazard in the general population, even less so in adolescents. Specific information in a clear and understandable language is crucial to obtain good acceptance of vaccination against hepatitis B. Adolescents are the best mediators to communicate this message to persons of their age as they take into account the group's specific sensitivity, culture and language. A close collaboration between youngsters and experts is needed to produce attractive, precise and correct information concerning the prevention of hepatitis B infections.
Laparoscopic cholecystectomy has become the preferred treatment for patients with symptomatic gallstones. During this procedure, perforation of the gallbladder with spillage of stones into the peritoneal cavity is not uncommon. Finding and removing all of the spilled gallstones can be laborious and is often avoided. Left in the peritoneal cavity, however, the stones may lead to intraperitoneal abscess formation, which may require a second procedure. We report here on a patient with an intraperitoneal abscess located between the right liver lobe and the anterior abdominal wall, which contained a large gallstone (4 cm3), found 3 months after an undetected stone spillage during laparoscopic cholecystectomy. Healing was achieved after conventional laparotomy, removal of the gallstone, and surgical drainage of the abscess cavity. The review of the literature emphasizes the clinical manifestations of this rare laparoscopic complication.
Mostly mallet finger can be treated conservatively. In cases of fracture of the distal phalanx open reduction and fixation is recommended. We favour the well-established cerclage, yet perform it in a more comfortable way with the use of cannulated drilling. This technique was applied on 13 patients even with lesions several weeks old. The evaluation 5-16 months postoperatively based on radiological, clinical and subjective criteria. We present the technique and the results followed by the discussion of the advantages over conservative and other operative managements.
The complete acromioclavicular dislocation impairs the motility of the shoulder girdle. The surgical transfixation of the AC-joint with a screw, with K-wires or with special plates has a quite high complication rate and requires a second operation. We suggest the dynamic augmentation of the sutured ligaments with a coracoclavicular and an acromioclavicular PDS-cord cerclage. The paper presents the results of a follow-up examination of 10 patients.
Medical self-care has always been a primary means of caring for health problems. Educational materials and interventions have been used for centuries to improve the quality of medical self-care. However, relatively few studies have been undertaken to examine the effects of these interventions on the health of the individual or on the use of professional services. This review was undertaken to provide (1) a summary of studies describing the practice of medical self-care and (2) a summary of studies evaluating the impact of medical self-care interventions to improve self-initiated responses to symptoms. In addition, we summarize the effectiveness of those self-care interventions.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Intermittent mandatory ventilation (IMV) is a combination of CPAP and IPPV. In the newborn period it offers the following advantages compared to IPPV alone: weaning is faster, independent control of respiration is maintained and the effect on cardiac venous return is minimized. 36 patients with idiopathic respiratory distress syndrome treated by IMV were compared with 18 patients ventilated with IPPV: IMV reduced the total time on the respirator by more than 50%. Exposure to increased FIO2 and hospital stay were markedly shortened, and the incidence of complications was decreased. Intermittent mandatory ventilation represents an optimal method for stress-free and safe ventilation of newborn infants.
Deuterated tyrosine, 4-hydroxyphenyllactic acid, 4-hydroxyphenylpropionic acid, 4-hydroxyphenylacetic acid and 4-hydroxybenzoic acid were incubated under anaerobic conditions with human faecal specimens for the in vitro study of their respective metabolisms. After 1 week, aromatic acids and phenols were extracted and analyzed by gas chromatography-mass spectrometry. [3',5'-2H2]Tyrosine produced 4-hydroxyphenyllactic acid, 4-hydroxyphenylpropionic acid and 4-hydroxyphenylacetic acid; [3',5'-2H2]-4'-hydroxyphenyllactic acid produced 4-hydroxyphenylpropionic acid, 3-hydroxyphenylpropionic acid, 4-hydroxyphenylacetic acid and phenylproionic acid; [3',5'-2H2]-4'-hydroxyphenyl-propionic acid produced 3-hydroxyphenylpropionic acid and phenylpropionic acid; [3',5',2,2-2H4]-4'-Hydroxyphenylacetic acid produced p-cresol; and [3',5'-2H2]-4'-hydroxybenzoic acid produced phenol. Thus the intestinal flora showed activities for decarboxylation leading to phenol and p-cresol, dehydroxylation leading to phenylpropionic acid and rearrangement leading to 3-hydroxyphenylpropionic acid. Rentention of both deuterium labels was observed in the rearrangement reaction.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
53 patients underwent 68 Swanson's Silastic prosthesis implantations in great toes from 1979-1984. 51 patients (96%) with 66 implantats were followed up from 1 to 7 years. The results of self-judgement and clinical examination at control were favourable, in contrast to the large number of unfavourable radiologic findings at control. Statistical analysis revealed a significant association between the number of weared prostheses with narrowing or fragmentation and increasing follow-up time (p = 0.04), but no significant association between the results of self-judgement and clinical examination and follow-up time.
A new autosomal recessive coat color mutant in the Mongolian gerbil (Meriones unguiculatus) is described: chinchilla medium (symbol c(chm)). The mutant has typical acromelanistic features similar to those of several acromelanistic c locus mutants of other species of mammals. Previously a more severe form of acromelanism (c(h)c(h)) has been described in the Mongolian gerbil. The new allele shows to be allelic with this form. On a nonagouti background compound heterozygotes (aac(chm)c(h)) show an intermediate phenotype that is very similar to that of the Siamese mouse (Mus musculus) and rat (Rattus norvegicus). Homozygotes (aac(chm)c(chm)) display a very dark acromelanistic phenotype reminiscent of that of the sable rabbit (Oryctolagus cuniculus). The gray phenotype (gg) in the Mongolian gerbil resembles the albino locus phenotype chinchilla (c(ch)c(ch)) in mice. We show that the new mutant is not allelic with gray. Fertility and viability of the new mutant are within normal range.