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Biomedical subjects

R Mosimann

Publications and source records attributed to R Mosimann.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Quantitative pulsed Doppler measurement of common femoral artery blood flow variables during postocclusive reactive hyperemia.

Quantitative blood flow measurements were performed on 37 normal lower limbs with a 128-channel digital pulsed Doppler (MDPD) system. The evolution of mean flow (QM), peak systolic flow (QS), diastolic flow (QD), and prograde stroke volume (PSV) was observed at rest, during postocclusive reactive hyperemia (PORH), and at 1-, 2-, and 3-min intervals. The QM at rest was 2.9 +/- 1.1 ml/s; PORH induced a four- to fivefold increase in QM and PSV secondary to a slight increase in QS and the disappearance of the reverse protodiastolic component of resting flow. Reverse flow was restored after 1 min. Both QS and QD returned to resting values after 2 min, whereas QM remained significantly higher after 3 min. To provide a better description of the hyperemic response, we also studied the evolution of the pulsatility index as as applied the flow curve (PIQ). Similarly, the systolic amplitude index (SAI) is presented. Our study demonstrates that pulsed Doppler techniques can be used for noninvasive quantitative assessment of blood flow at rest and during PORH. The values obtained on normal subjects provide base-line data for further investigation of pathological conditions.

Adult↗
PubMedDate not supplied

Portal pressure measurements before and after Hassab's decongestion operation. A preliminary report.

This preliminary study included five patients with a history of haematemesis resulting from rupture of oesophageal varices complicating schistosomal hepatic fibrosis. Simultaneous measurements were taken of the endoscopic variceal pressure (EVP) and the free portal pressure (FPP) obtained by the cannulation of a mesenteric vein radical. These measurements were taken after laparotomy, after removing the spleen and after devascularization of the lower oesophagus and upper two thirds of the stomach. At the beginning the EVP was found to be identical with the FPP. Following splenectomy, the EVP dropped from a mean of 41.9 cm H2O to a mean of 25.8 cm H2O, whereas the FPP dropped from 40.7 cm H2O to 27.8 cm H2O. After decongestion, the EVP had a mean of 21.3 cm H2O and the FPP had a mean of 32 cm H2O. Two weeks after the operation the EVP remained unchanged at the end of the operation in two cases and increased by 5 cm H2O in one case. Accordingly it was concluded that Hassab's operation results in an immediate diminution of the EVP and FPP. However, the long-term results of this operation required further studies.

Adult↗
PubMedDate not supplied

Superinfected actinomycotic abscess of the liver.

Isolated actinomycotic liver abscess is rare. We report a case with fulminant evolution, which was treated successfully with surgery and penicillin. In human actinomycosis, Actinomyces israeli is the main infective agent. An abdominal localisation is uncommon, occurring in less than 25% of cases. Isolated liver lesions are extremely rare; their presence might be interpreted as the result of the hematogenous spread of a no longer present intestinal lesion. The evolution of actinomycosis is usually torpid. In the present case, mixed infection with Fusobacterium nucleatum might explain the acute evolution.

Actinomycosis↗
PubMedDate not supplied

Chronic pancreatic pleural effusions and ascites.

The occurrence of pleural effusion or ascites, secondary to internal pancreatic fistula, is a rare clinical syndrome and diagnosis is, therefore, often missed. The fluid accumulation has been attributed to disruption of the pancreatic duct or to rupture of a pseudocyst. In a 20 year period, 106 patients were hospitalized in the department of surgery, CHUV, with a diagnosis of chronic or chronic relapsing pancreatitis, and 77 with that of pancreatic pseudocyst. During this time, five patients with chronic pancreatic and pleural or peritoneal effusions have been observed. These five cases present a good pattern of the possible causes and evolution of the disease. Wirsungography is of great value for the surgical management of these patients, allowing the right technique to be chosen for each particular case. Surgery caused disappearance of the effusions in our five patients.

Adult↗
PubMedDate not supplied

Aorto-intestinal fistula after reconstructive arterial surgery.

In a group of 184 patients with synthetic, arterial bifurcation grafts, we have performed 16 operations for distal anastomotic pseudo-aneurysms and 11 for proximal anastomotic pseudoaneurysms. Four of the latter were encountered in three patients and took the form of aorto-intestinal fistulae. Excision of the arterial prosthesis, suture of the intestinal orifice and insertion of a new extra-anatomic bypass seems to be the treatment of choice. However, excision of an aortobifemoral prosthesis and replacement in situ with a new prosthesis or even suture of the aortic fistula with a patch represent acceptable treatment in certain particular situations.

Aged↗
PubMedDate not supplied

[Clipping for prophylactic partial occlusion of the inferior vena cava].

The partial occlusion of the inferior vena cava in the prevention of fatal pulmonary embolism has been used for years in different ways. Over a period of one, and a half year, we put 11 clips of Miles, once for prophylaxis and 10 times after pulmonary embolism. Two patients died during the first 15 postoperative days. Seven patients had a phlebologic control by a Doppler ultrasound, venous plethysmography, isotopic cavography, and grey scale ultrasound. It has been proved that the inferior vena cava was permeable in 6 of the 7 controlled patients. The indications as well as the late results of these operations are discussed.

Adolescent↗