Biomedical subjects
Publications and source records attributed to P Huber.
We report an unusual case of anorectal syphilis. The literature reviewed supports the difficulty in identifying the varied presentations of this disease. Diagnostic and therapeutic maneuvers are based on an understanding of the pathophysiology of luetic infections. Penicillin remains the drug of choice in treating all stages of syphilis.
The use of an ultrasonic transcranial Doppler technique for noninvasive evaluation of cerebral vasospasm is described. Middle cerebral arteries (MCA's), classified as spastic on angiography, demonstrated blood-flow velocity between 120 and 230 cm/sec. The flow velocities in these arteries had a clear inverse relationship to the diameter as measured from angiograms in 38 patients with recent subarachnoid hemorrhage. This relationship in the proximal anterior cerebral artery (ACA) was found to be more complicated to assess, due to the collateral channels in the anterior part of the circle of Willis. The authors conclude, however, that the new method of measuring vasospasm will also detect spasm in the ACA if it has a hemodynamically significant effect upon flow resistance.
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458 patients with systemic allergic reactions following hymenoptera stings were investigated with regard to the incidence of atopic disease. Personal atopy (13.7%) and a family history of atopy (26.4%) were not found more frequently than in a normal population. The age of the first manifestation of hymenoptera sting allergy was however significantly lower in atopic than in non-atopic patients, sensitization occurred following a smaller number of stings and there was a preponderance of respiratory symptoms.
From 1971-1982 121 patients with arterial occlusions of the lower limbs underwent systemic thrombolysis treatment at the Kantonsspital Basel. During 4 time-periods, 3 different treatment schedules were evaluated consecutively: a) individually titrated high dose streptokinase (SK), b) individually titrated low dose SK and c) p-plasmin, followed by low dose SK-infusion. Thrombolytic success rates did not differ significantly with the 3 treatment schedules. Nevertheless, the p-plasmin-SK scheme tended to the thrombolytically more effective (68%) than high-dose (58%) or low-dose (50%) SK. The most frequent side effects were bleeding complications. In 6 out of the 121 patients, intracranial bleeding occurred and was lethal in 1 of the patients. The incidence of this most serious complication of 4/47 during the sequential p-plasmin-SK schedule led the authors to abandon this scheme for the treatment of arterial occlusions. The intracranial bleeding complications are much less frequent in patients with deep venous thrombosis undergoing systemic thrombolysis, and hence seem to be due in part to the generalized arteriopathy often present in patients with arterial occlusions. The p-plasmin-SK schedule induced the strongest systemic proteolysis in the light of thromboplastin time and factor V values. Comparison of these data with those of other authors is very difficult because of differences in patient selection, treatment schedules and observance of contraindications. The serious prognosis for patients with acute arterial occlusions, with an overall hospital mortality of 26% (experience at the Kantonsspital Basel, 1978-1982) relativizes the importance of the side effects due to systemic thrombolysis.(ABSTRACT TRUNCATED AT 250 WORDS)
The photoactivatable phospholipid 1-palmitoyl-2-[10-[4-[(trifluoromethyl)diazirinyl]phenyl]-[9-3H] -8-oxadecanoyl]-sn-glycero-3-phosphocholine [( 3H]PTPC) was synthesized with high specific radioactivity. When a sonicated dispersion of [3H]PTPC was incubated with human erythrocyte membranes (ghosts), the radiolabel was inserted spontaneously into the erythrocyte membrane. Photo-cross-linking of [3H]PTPC to membrane components and subsequent analysis of the distribution of radiolabel among polypeptide fragments of glycophorin allowed conclusions concerning the transbilayer distribution of [3H]PTPC in the erythrocyte membrane. Thus, [3H]PTPC was inserted exclusively into the outer leaflet of resealed ghosts, whereas with unsealed (leaky) ghosts, the photosensitive lipid was incorporated into both halves of the membrane simultaneously. These results are incompatible with fusion of [3H]PTPC liposomes with the erythrocyte membrane being responsible for the lipid transfer observed and suggest instead that PTPC exchanges spontaneously between membranes. This property of PTPC could be related to the critical micelle concentration of this lipid [(6 +/- 2) X 10(-9) M at 23 degrees C].
Rectal abscess may result in necrotizing soft-tissue infection including fasciitis, myositis, and extraperitoneal dissection of pus without muscle necrosis. The presentation and therapy of ten patients treated over the past six years are reviewed. Early recognition of rapidly spreading infection was imperative. The mortality rate of 40 per cent correlated with the degree of sepsis present at admission. The high mortality attendant with the complications of rectal abscess emphasizes the need for aggressive therapy, including frequent examinations under anesthesia, wide debridement, systemic triple antibiotic therapy, diverting colostomy, aggressive wound care, and hyperalimentation.
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The clinical, neurophysiological and neuroradiological data of 10 babies who, at the age of three months showed a severe leucomalacia usually combined with cortical atrophy, are presented. All had shown signs of intrauterine asphyxia and were severely hypotonic and suffered from seizures in the neonatal period. At the age of 3 months, all patients were hypo- or hypertonic and had infantile spasms. Computed tomography (CT) in the neonatal period showed unspecific hypodensities and at the age of 3 months the complete CT picture of leucomalacia. Thereafter, CT remained unchanged. An angiographic examination in two cases showed a very marked rarefication of the leptomeningeal vessels and circulatory delay in the medial cerebral artery. The risk factors leading to this clinical and neuroradiological picture are discussed.
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It is known that nonsteroidal antiinflammatory drugs such as indomethacin can attenuate the pharmacologic effect of loop diuretics such as furosemide and ethacrynic acid and that indomethacin may also reduce the pharmacologic response to chlorothiazide. To examine further this potential drug-drug interaction, we administered 50- an 100-mg single oral doses of hydrochlorothiazide with and without indomethacin to 10 healthy, normal subjects. We observed no significant influence of indomethacin to 10 healthy, normal subjects. We observed no significant influence of indomethacin either on the pharmacokinetics of hydrochlorothiazide or the pharmacologic response to this diuretic. The adsorption and disposition of hydrochlorothiazide demonstrate that this drug is rapidly absorbed and produces a diuretic and natriuretic response that peaks at approximately 2 hours after dosing and is essentially terminated 12 hours after dosing. There appeared to be no greater pharmacologic response to the 100-mg than to the 50-mg hydrochlorothiazide dose in the ten subjects in this study.
Marvelon was tolerated without side effects by 338 women during 2,104 cycles. Although some errors of administration were made by patients there were no pregnancies. In contradistinction to other low dosage combination oral contraceptives this new oral contraceptive has a good control of the menstrual cycle. The incidence of clinical side effects was low. An over-suppression syndrome after the discontinuation of the treatment was not observed. Hormonal assays were done in order to investigate the difficult problems of oligomenorrhoea in adolescents with oral contraception. A marked inhibition of ovulation evident by low values of pituitary ovarian hormones was found. When the treatment was discontinued the majority of the patients showed ovulation in the first post-treatment cycle.
1 We investigated the relationships among dose, plasma concentration and beta-adrenoceptor blockade after single and repeated doses (0.5-20 mg) of timolol and placebo in six normal men. 2 Maximal suppression of exercise-induced tachycardia (bicycle ergometry) was dose-dependent and greater at 2 than at 6 h after dosing; activity up to 12 h was evident on the last dosing day. 3 Attenuation of exercise-induced tachycardia was strongly correlated with the timolol dosage over the 0.5 to 5-10 mg range. 4 A plasma timolol concentration of 27 ng/ml was associated with maximal suppression of exercise-induced tachycardia. 5 Suppression of exercise-induced tachycardia and areas under the plasma concentration-time curves did not differ significantly on the first and last dosing days.
In a series of 819 patients with recent closed head injuries, 20 cases were found to exhibit traumatic central brain haemorrhage analogous to spontaneous central brain haemorrhage in computed tomography. Computed tomographical findings, clinical evolution and the predictable course of these 20 patients have been reviewed. 7 patients died (35% mortality rate).
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