Biomedical subjects
Publications and source records attributed to P Kroll.
The authors report on the transplantation of auricular cartilage grafts in the Kuhnt-Meller ectropion operation to stabilize the tarsus. In three cases with spastic and paralytic ectropion the technique was successful.
Report on a case of juvenile macular degeneration manifesting as dysplasia of the pigment layer of the posterior pole, accompanied by a hair abnormality, congenital total hypotrichosis.
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After a short historical survey the indication and technique of the intravitreal injection of SF6-gas within the limits of the actual retinal surgery are discussed and by means of 10 cases demonstrated. The main indications are the tamponade of 1. oral and preoral gigantic tears, 2. central retinal foramina, 3. equatorial gigantic holes of 1 to 2 quadrants as well as tear groups and 4. SF6-gas as substitute of the vitreous body.
In our 114 patients with vitreous loss during a cataract operation there were 21 cases (18.4%) which resulted in severe after-effects leading to the conclusion that vitreous loss during a cataract operation provokes a more frequent development of postoperative complications. Therefore a careful surgical procedure with exact repositioning of the vitreous-free anterior chamber, as well as regular and careful follow-up examinations are required. At our hospital we regularly carry our a three-mirror-contact lens examination after four weeks to enable us to perform a preventive treatment of the retina if necessary. In the event of incarceration of the vitreous with traction, a vitrectomy must be considered. As far as initial maculopathies are concerned we observed in a few cases a positive effect that parabulbar cortisone prevented further development of the disease. Finally, we would recommend regular IOP controls in order to recognize secondary glaucoma at an early stage.
By means of postmortem dacryocystograms and photomicrographs of histological slides, the topography and morphology of the lacrimal passages in premature and mature newborn infants are demonstrated. Because of the bends in the course of the lower tear duct, a percentage of probings will fail to effect satisfactory perforation of Hasner's membrane. In most cases the soft texture of this membrane requires no more than syringing under pressure using a hollow probe.
The authors report on a case of total keratomalacia due to abusive contact lens wearing. An analysis of the case showed that the condition was caused by a poorly fitted lens, lack of information given to the patient and a lack of ophthalmological check-ups.
The authors report on the fairly inexpensive Kaufman-II vitrector which has proved useful and appropriate in "open-sky" vitrectomy. It has been successfully employed in the following applications: 1) aspiration of vitreous, e.g., in the event of vitreous loss during cataract operations; 2) in cases of perforating injuries with prolapse of vitreous; 3) in cases of vitreous abscesses after cataract operations; 4) in cases of hemorrhage into the anterior segment; 5) removal of lens capsule remnants and dense vitreous membranes behind the pupillary plane which render examination of the fundus impossible.
After a brief survey on the indications of the Lincoff buckling technique, the limits of this method are demonstrated by means of varions cases. Then the application of the intraocular gas tamponade with sulfur hexafluoride (SF6) as an additional measure is recommended and described. The combination with vitrectomies in cases of advanced vitreous complications (MPP, proliferations, haemorrhages) is indicated.
After a short historical survey the indication and technique of the intravitreal injection of SF6-gas within the limits of the actual retinal surgery are discussed and demonstrated by means of 10 cases. The main indications are (1) tamponade of oral and preoral giant tears, (2) tamponade of central retinal foramina, (3) tamponade of equatorial giant holes of 1-2 quadrants as well as tear groups, and (4) SF6-gas as substitute of the vitreous body.
A case of total keratomalacia caused by soft contact lens wearing is demonstrated. The reasons for the tragic course were insufficient adaptation to the lens and inadequate information to the patient regarding the problems of wearing of the lens and its cleaning. A subtotal keratoplasty was performed in this case but only the globe could be preserved.
Sixteen alcoholic men under 50 with no gross evidence of intellectual impairment were evaluated by means of neurologic examination, neuropsychologic testing and computerized tomography. Computerized tomography demonstrated mild to moderate cortical atrophy in 11 of the 16 men when compared to an age-matched medical control group. The cortical atrophy was associated with evidence of memory and visual-motor impairment on neuropsychologic testing. The seriousness of the condition paralleled the length and intensity of alcohol abuse.
Fifty psychiatric inpatients at a VA Hospital felt to be at high risk for the development of somatic complaints were surveyed for Briquet's syndrome. When criteria for the syndrome were strictly applied, no men were found with the disorder. If the criteria were minimally relaxed, two patients did have a sufficient number of symptoms in multiple areas to qualify for the diagnosis. However, they had alternative clinical and research diagnoses and none of the personality characteristics noted in previous populations of women surveyed for Briquet's syndrome.
The authors report on the results of an etiological inquiry in 71 patients from 1970 to 1977 suffering from neuritis nervi optici. The study includes also the therapeutical results. The findings demonstrate that modern examination techniques did not bring a definite progress of the clarification of the etiological relation: Approximately 50% stay without causality. The identificated causes are on all fours with those found by Rönne (1930) except the diseases following the application of modern drugs, e. g. contraceptives. Therapeutically a combination of systemic and parabulbar application of corticosteroids, drugs for stimulating the blood flow (e. g. Trental, Cosaldon retard), Vitamin-B-complex, and antibiotics are recommended.
A preliminary, uncontrolled study utilizing hemodialysis in the treatment of chronic schizophrenia reported a high success rate. Two patients are presented who had both schizophrenia and chronic renal failure and who underwent intensive, long term hemodialysis with no change in their schizophrenic symptomatology. This negative finding is consistent with other case reports. Retrospective or limited controlled studies based on previous research with false neurotransmitters, serum protein factors, or endorphins in schizophrenia are urged before further patients with normal kidney function are exposed to the risks of hemodialysis.
During July and August 1975 a large number of patients at the Ann Arbor Veterans Administration Hospital experienced unexplained respiratory arrests, and there were six deaths. These were later shown to be due to the deliberate injection of pancuronium bromide, a muscle relaxant. A questionnaire survey of the reactions of the hospital patients and staff to the deaths revealed that the patients had more confidence in the hospital and their medical treatment than did the staff, and those patients who were theoretically most vulnerable used denial to cope with the unprecedented and frightening situation.
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Marijuana use among the 45,000 Air Force troops stationed in Thailand during the period September 1971 to September 1972 was extensive. Nevertheless, only five cases of prolonged psychosis associated with marijuana use in this population were referred for psychiatric evaluation. These cases resembled several types of adverse reactions previously described in the literature: one case of a "marijuana psychosis"; one case of an "organic marijuana syndrome"; and three cases of "marijuana-mobilized functional psychosis." With the exception of the patient with the "marijuana psychosis," this small group of men had either borderline or schizoidal premorbid personalities. Other more transient psychotic episodes appear to go unreported by the troops because of the rapid clearing of symptoms and the punitive policy of the Air Force toward drug abuse.