Biomedical subjects

M Sturzenegger

Publications and source records attributed to M Sturzenegger.

At least 109 records · Page 6Linked to original sources

PubMed1991

[Attemoted suicide in the Bern region].

In a European multicenter study all the suicide attempts in the city and agglomeration of Berne which came under medical treatment during a 12-month period were surveyed. There were 243 females and 153 males, corresponding to a rate of 177.1 and 128.6 per 100,000 respectively. The investigated region can be regarded as representative of Switzerland. Comparison with other centers shows that the incidence of attempted suicide in Switzerland--unlike that of suicide--is approximately in line with the European average. The usual method is overdose of drugs, in particular benzodiazepines. Nearly all the drugs involved in the overdoses were obviously prescribed by physicians. The choice of drugs suggests that many suicidal people deliberately take anxiety-and tension-reducing agents, a fact which points to a relationship between anxiety states and attempted suicide. Both are to be regarded as the expression of acute emotional stress and require an appropriate therapeutic approach.

Adolescent↗

PubMed1991

Ultrasound findings in spontaneous carotid artery dissection. The value of duplex sonography.

Extracranial and transcranial Doppler and duplex sonographic findings in six patients with internal carotid artery dissection proven by angiography is reported. Extracranial Doppler analysis showed occlusion without a recordable signal from the internal carotid artery at any level or stenosis with accelerated flow in the high cervical segment. Transcranial Doppler findings demonstrated the hemodynamic consequences of the internal carotid artery occlusion or stenosis with collateral flow across the circle of Willis and also showed the dampened pulse wave of the middle cerebral artery ipsilateral to the dissection. In duplex sonography, the indirect signs indicating internal carotid artery dissection were a patent carotid bifurcation and proximal internal carotid artery segment but with no or only a short systolic flow signal. Atherosclerotic wall changes were absent, an important finding that suggests nonatherosclerotic stenosis or occlusion. Direct signs making the diagnosis likely were a tapering of the internal carotid artery lumen distal to the bulb, an irregular membrane crossing the vessel lumen, and the demonstration of a true lumen with flow and a false one without flow. While cerebral angiography is still considered the gold standard, ultrasound may become the primary modality for early diagnosis. Doppler and duplex examinations help to indicate angiography and are the methods of choice for follow-up investigations. They clearly demonstrate spontaneous recanalization with normalization of carotid circulation or, in case of persistent occlusion, improvement of collateral blood supply. Sequential examinations may prove helpful to determine the duration of anticoagulant treatment.

Adult↗

PubMed1991

Radio-scapho-lunate partial wrist arthrodesis following comminuted fractures of the distal radius.

Painful radiocarpal arthritis following comminuted fractures of the distal radius may be treated either by total wrist fusion or by procedures which preserve movement. The authors have reviewed 15 patients with such fractures who have undergone radio-scapho-lunate partial arthrodesis. They report the results with an average follow-up of 23.8 months. Pain was abolished in 7 patients and resolved virtually completely in 4 cases. Restored grip strength averaged 49% of the contralateral side. There was considerable limitation of postoperative range of motion which was restricted to an oblique plane extending dorso-radial to palmar-ulnar. Most patients did not report this as a problem. Two cases of non-union were reported as well as a 35.7% incidence of secondary degenerative change in the midcarpal joint. This feature casts doubt on the predictability of outcome of this procedure.

Adult↗

PubMed1991

[Radial nerve paralysis--causes, site and diagnosis. Analysis of 103 cases].

The results of a retrospective analysis of 103 patients presenting with a radial nerve palsy are reported. Among the traumatic injuries of peripheral nerves the radial nerve is the one most frequently affected due to its exposed anatomic site with close neighbourhood to the long bones of the arm. Fractures of the shaft of the humerus (18%) and proximal radius (12%) are the main causes of traumatic lesions (55%). Among the non-traumatic peripheral nerve injuries the radial nerve is less frequently affected than the median and the ulnar nerves. The most frequent site of radial nerve lesions in these cases is the upper arm (22%), the most frequent cause is pressure palsy (21%) during unphysiological deep sleep ("Saturday night paralysis").

Arm↗

PubMed1990

[Bilateral radial nerve paralysis. Diagnostic and differential diagnostic aspects].

Bilateral radial nerve palsies are rare, and hence in this situation an underlying generalized peripheral neuropathy must always be considered. Among 103 patients with radial nerve palsies seen at our department during the last five years, there were three cases presenting with bilateral non-traumatic radial nerve palsies. These patients are presented in detail. One had a bilateral nerve entrapment in the supinator channel associated with a neuropathy of unclear origin, the second had bilateral sleep palsy, and the third had mononeuropathy multiplex associated with HIV infection. Following a summary of the cases reported in the literature, diagnostic considerations and additional investigations are discussed.

Adult↗

PubMed1990

[Acute vascular disorder as a complication of replantation and revascularization of the digital area].

This study on vascular complications in digital replantation and revascularization covers the six-year experience of a universitary replantation center. The material comprises 143 patients with 67 replantations and 137 revascularizations. Inadequate circulation was observed in 21.6% of the cases, or 17.6% of the digits. In digital replants, during or following the initial surgery, significant vascular complications were encountered in 28 (42%) of the replanted thumbs and fingers. Of these, seven digits (10.4%) presented with irreparable vascular damage and were amputated without salvage attempts. Single or repeated microvascular revisions saved 13 (two thirds) of the remaining digits. The survival rate of this group was thus raised to 78%. In digital revascularization, the vascular complication rate was much lower. In 137 digits, eight developed complications (6%). One of these was accepted as a failure; of seven reinterventions, five proved successful. The over-all survival rate was 98% in this group. To the factors known to determine survival following replantation and revascularization, those governing the ability to offset vascular complications must be added. In this respect, the analysis of our data revealed additional statistically significant prognostic elements: the decision for or against surgical reintervention, the location of the thrombosis relative to the arterial or venous side, the type of injury and the timing of revisional surgery. Other parameters, such as the age of the patient, the experience of the surgeon, or the type of initial vascular reconstruction were not statistically relevant. In our experience, repeated attempts at microvascular salvage in face of circulatory complications of digital replantations or revascularizations are worthwhile.

Adolescent↗

PubMed1989

[Acute cerebrovascular disorders--clinical aspects and diagnosis].

Loss of neurologic function with acute onset is a hallmark of cerebrovascular disease, but may have several other etiologies. Knowledge of the functional significance of the different brain areas and of their vascular supply is a prerequisite for localizing a lesion. Clinical presentation alone often does not allow etiological diagnosis, which eventually decides upon treatment modality. For that purpose, we need the help of various investigational techniques with different content of information. Their selection depends on individual anamnestic and clinical findings and has to consider the therapeutical possibilities in the individual case, too.

Adult↗

PubMed1989

[Ptosis--clinical differential diagnosis].

When examining a patient with ptosis the first question to be answered is whether the condition is a simple constitutional variant or a symptom heralding disease. Local diseases of the eyelid may lead to pseudoptosis. The three major disease categories to be considered are: myopathies preferentially affecting the eye muscles; impaired neuromuscular impulse transmission at the motor endplate (myasthenia gravis, botulism); and lesions of the somatomotor (third cranial nerve) and visceromotor (sympathetic) nerve fibers innervating the eyelid muscles. The correct diagnosis may be suspected in the light of a detailed patient history and associated signs on general and neurological examination. Additional investigations may be needed to confirm the diagnosis.

Blepharoptosis↗

PubMed1989

[The differential diagnosis of lumbar disk prolapse].

When examining a patient with a radicular syndrome the first step is to localize the neurologic damage. Clinical examination usually allows differentiation of radicular from plexus and peripheral nerve lesions and also from non-neurogenic symptoms. The second step is to look for etiology, which often needs additional investigations. Plain films of the spine with views in flexion and extension show disease of the bony structures and instability. Soft tissue alterations leading to radicular or dural compression are best shown by computed tomography, which is also the method of choice to prove space occupying lesions of the abdominal and pelvic cavity. Myelography shows best longitudinal extension of intraspinal processes. Magnetic resonance imaging is the method of choice to prove intramedullary lesions. Early diagnosis of spine infection needs scintigraphy. Radicular inflammation or irritation by tumor-cells (meningosis) will be missed with-out CSF-examination.

Arachnoiditis↗

PubMed1989

[The dorsal approach to the wrist joint and the distal radius].

The extensor retinaculum is divided between the 3rd and 4th extensor tendon compartment without opening the proper tendon sheaths. For partial wrist joint denervation the posterior interosseus nerve is resected routinely. The special anatomy of the joint capsule is emphasized. Careful preparation allows full protection of healthy structures, keeps their function intact and minimizes additional surgical damage.

Humans↗

PubMed1988

Transcranial Doppler sonographic findings in middle cerebral artery disease.

The transcranial Doppler sonographic findings of 61 patients with middle cerebral artery (MCA) disease were compared with those of 535 controls. According to computed tomographic, angiographic, and/or autopsy findings, the patients were classified as having MCA occlusive lesions in the central (sphenoidal) part or in peripheral branches or MCA stenosis. With MCA lesions, the MCA flow velocity (FV) was reduced. At the same time the anterior cerebral artery FV increased because of collateral flow over leptomeningeal anastomoses. Central MCA lesions showed less marked changes than did peripheral lesions. In MCA stenosis a steep rise of MCA FV appeared inside the stenotic segment. If there was a high-grade stenosis or occlusion of the internal carotid artery, a collateral circulation over the anterior part of the circle of Willis was seen in addition to the changes caused by the MCA disease. From these hemodynamic changes, transcranial Doppler sonographic diagnostic criteria for MCA occlusive and stenotic lesions were established.

Blood Flow Velocity↗

PubMed1988

[Ring avulsion injuries: improved indications for replantation].

Based on experiences with 12 replantations of ring avulsion injuries, an additional classification of type III avulsions (Urbaniak, 1981) is proposed, according to the level of injury of the neurovascular bundles. If this lies proximally (III P), microsurgical reconstruction is usually straightforward and the prognosis generally good; in distal lesions (III D), however, uncorrectable segmental devascularization can occur, which may be detrimental to survival or ultimate function.

Adolescent↗

PubMed1988

Orthodromic (intra/extracranial) neurography to monitor facial nerve function intraoperatively.

This report introduces the technique of orthodromic neurography for monitoring of facial nerve function during operation in the cerebellopontine angle. By stimulation of the intracisternal segment of the facial nerve, a compound nerve action potential with amplitudes of 15 to 480 microV can be recorded extracranially from the nerve near the stylomastoid foramen after 0.95 to 2.27 ms. Usually there is no need for signal averaging, and the method is independent of the effect of muscle relaxants. With the use of the same electrophysiological equipment as for evoked potential neuromonitoring, immediate and repeated localization of the facial nerve and its discrimination from the trigeminal and the lower cranial nerves during nerve preparation within the tumor capsule is possible.

Action Potentials↗

PubMed1988

[Assessment of treatment results of extensor tendon injuries].

Criteria for evaluation of results after extensor tendon lesions are presented, which are easy to apply and based on angular measurements of active joint mobility. The scheme is analogous to the evaluation method for flexor tendon injuries published by Buck-Gramcko et al. in 1976 which is now widely used. A modification was necessary to treat the extension deficits more severely. A comparison is made to the evaluation method proposed by the Group of Erlangen, and both schemes are tested on 68 patients with extensor tendon injuries of different zones, various fingers and combinations. Lesions of the thumb require different criteria.

Adolescent↗

PubMed1986

Muscular strength after rupture of the long head of the biceps.

To measure muscular strength after rupture of the long head of the biceps brachii, we evaluated ten patients treated conservatively and five surgically with the Cybex II testing machine, and compared the values with the data on 20 healthy individuals. In the conservative group, the strength of elbow flexion was diminished by 16%, of supination of the forearm by 11%, and of shoulder abduction by 16%. The patients who underwent surgery lost, on average, only 8% strength for elbow flexion and 7% for forearm supination. Shoulder abduction was decreased by 20%. A moderate advantage was thus found for elbow flexion and forearm supination. Surgical treatment can be recommended for younger individuals, manual workers, and sportsmen, and rarely for cosmetic reasons, or when a subacromial impingement due to a disturbing proximal tendon stump is present.

Adolescent↗

PubMed1985

[Bilateral shoulder dislocation fractures, femoral neck and vertebral fractures: a remarkable combination of injuries during an epileptic seizure].

Fracture complications of convulsions are reported occasionally, e.g.: mono- or bilateral posterior shoulder luxations and luxation fractures, central dislocations of the hip as well as fractures of the femoral neck or compression fractures of vertebrae. A case is reported where the patient sustained four such lesions simultaneously. The epileptic seizure occurred following the sudden interruption of a neurotropic therapy with Carbamazepin (Tegretal). A general osteodystrophy was not found. The simultaneous presence of four such lesions following one convulsion has never before been reported and appears to be very uncommon. The frequency and problems of post-epileptic fractures are discussed and the operative treatment of the lesions briefly described.

Adult↗

PubMed1982

Results of surgical treatment of multifragmented fractures of the humeral head.

This paper reports the results of 27 multifragmented fractures of the proximal humerus treated between 1972 and 1976. Only 3- and 4-part fractures as well as fracture dislocations were included. Internal fixation was performed in 17 cases with buttress plates and in 10 patients by minimal fixation with a tension band wire or simple lag screw. On an average of 3.5 years postoperatively out of 27 patients eight had excellent, eight a good, six a fair, and five a poor overall result. Radiologically six cases of avascular necrosis of the humeral head (22.2%) were detectable in one 3-part, four 4-part and one fracture dislocation. Five times necrosis was observed after plate fixation (34%) once after wiring of the greater tuberosity. The incidence of unfavorable head necrosis is dependent on the primary fracture type. The results point to the fact that further damage due to surgery and its risk to the remaining blood supply is less prominent in gentle exploration and minimal osteosynthesis than with a generous exposure needed for plate fixation. Minimal fixation thus should be preferred.

Adult↗

PubMed1976

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency in Switzerland. Demonstration of a new variant (G-6-PD Aarau) with chronic nonsphaerocytic haemolytic anaemia.

A new variant of erythrocytic glucose-6-phosphate dehydrogenase has been found in a family of Swiss origin. It is associated with chronic nonsphaerocytic haemolytic anaemia. The enzyme from the erythrocytes of a young boy of this family was partially purified 110-fold and characterized. It revealed reduced catalytic activity, increased thermolability and two maxima of the pH activity curve at pH 7.0 and 8.5. The Km value for glucose-6-phosphate was reduced, that for NADP was normal. The enzyme showed an increased inhibitor constant for NADPH with respect to NADP. Electrophoretic mobility was normal (B+). 2-Desoxyglucose-6-phosphate and galactose-6-phosphate were utilized at normal rates, whereas the analogue deamino-NADP gave an increased utilization rate. The mother of the propositus could be identified as heterozygous for this enzyme deficiency. Chronic haemolysis is possibly due to the increased thermolability of the variant enzyme.

Anemia, Hemolytic, Congenital Nonspherocytic↗