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Biomedical subjects

S Block

Publications and source records attributed to S Block.

At least 55 records · Page 3Linked to original sources
PubMed1986

Diagnosis and treatment of myofacial pain-dysfunction (MPD) syndrome.

The successful management of patients with MPD syndrome is dependent on establishing an accurate diagnosis and using proper therapy based on an understanding of the etiology of the disorder. Establishing an accurate diagnosis is accomplished by taking a careful history, doing a thorough examination, and having a knowledge of the various other conditions that can produce signs and symptoms similar to those of MPD syndrome. Using proper therapy is related to recognition that MPD syndrome is a stress-induced psychophysiologic disease originating in the muscles of mastication and not an organic disease arising in the temporomandibular joint. Thus, therapy should be directed at reducing stress, relaxing tense jaw muscles, and creating an awareness by the patient of the causes of the problem, rather than at analyzing occlusion, measuring joint spaces, and producing irreversible structural changes in the dentition and the articulation. Because good results can be achieved with these uncomplicated, reversible forms of therapy, it is important that the clinician does not succumb to an unproven fad or use of an irreversible procedure that will not achieve better results.

Adult↗
PubMed1986

Comparison of myointimal hyperplasia in laser-assisted and suture anastomosed arteries. A preliminary report.

Use of the milliwatt CO2 laser to perform microvascular anastomoses is associated with characteristic histologic changes, including intimal hyperplasia and medial necrosis. The extent of myointimal proliferation after both suture and laser-assisted vascular anastomosis was assessed in the rat femoral artery model. At 2 weeks the average intimal height of the laser-anastomosed vessels was 11.7 +/- 2.2 microns (mean +/- standard error of the mean) vs. 21.3 +/- 3.2 microns for sutured arteries (p less than 0.05). By 6 weeks the groups were equivalent (laser, 25.6 +/- 4.6 microns; suture, 17.3 +/- 1.2 microns; p, not significant). The medial changes associated with the laser-assisted method appear to inhibit the proliferative response at 2 weeks but are reversed by 6 weeks.

Animals↗
PubMed1986

Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging.

One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor necroses of the pancreas had been demonstrated with contrast enhanced computed tomography. Ultrasound failed to be diagnostic in 24% of the patients due to meteorism; the sensitivity of the diagnostic studies for pancreatic necrosis was 73% regardless of the extent of the process. Using the early objective signs, seven patients with acute interstitial pancreatitis were classified as having a severe attack, whereas 30 patients with necrotising pancreatitis were categorised as mild attacks. We conclude that the contrast enhanced computed tomography is an aid in deciding on conservative or surgical treatment in a case of acute pancreatitis. Ultrasound does not appear to be an adequate method for determining pancreatic necrosis. The early objective signs fail to sufficiently identify the necrotising form of acute pancreatitis.

Acute Disease↗
PubMed1985

[Diagnosis of necrotizing pancreatitis. Comparison between contrast medium-computed tomography and ultrasonics in a clinical study].

Contrast-enhanced computed tomography and (or) sonography was carried out preoperatively in 93 patients undergoing operation for the treatment of severe acute pancreatitis. 77 patients presented with necrotising pancreatitis and 16 with interstitial oedematous pancreatitis predominantly due to biliary causes. The surgical principle involved necrotomy, continuous post-operative bursal lavage or biliary sanitation and (or) pancreas drainage in the case of interstitial oedematous pancreatitis. Sensitivity of contrast-enhanced CT in necrotising pancreatitis was 85%, in localised necrosis 79%, and in extensive necrosis 89.5%. Sonography was negative in 24% of patients and in 37% of those with severe necrotising processes due to extensive masking by intestinal gas. If successful, its sensitivity was 73% only. Thus, sonography is unsuitable for the diagnosis of severe, especially necrotising, pancreatitis; it should be used for confirming the diagnosis and for monitoring the course of mild pancreatitis. Contrast-enhanced CT is indicated for suspected cases involving the necrotising form of the disease, where extensive pancreatic necrosis is registered with high reliability. Controls are advisable for cases with localised pancreatitis.

Acute Disease↗
PubMed1985

[Necrotizing pancreatitis: peritoneal lavage or bursa lavage? Results of a prospective consecutive controlled study].

In 111 patients with necrotizing pancreatitis two different therapeutical procedures were applied since 1974 in addition to the surgical removal of necrotic tissue. In group I with 64 patients a continuous peritoneal lavage and in group II with 47 patients a local lavage of the lesser sac were performed. In case of extrapancreatic necroses and diffuse peritonitis peritoneal lavage was done additionally in 32 patients. Local lavage of the lesser sac, in some cases combined with peritoneal lavage, is the procedure significantly superior to peritoneal lavage alone.

Acute Disease↗
PubMed1985

[Morphologic and functional changes in the pancreas following acute necrotizing pancreatitis].

Acute necrotizing pancreatitis according to the presented results leads to definite endo- and/or exocrine functional loss in 57% of the patients (n = 21, pancreatic necrosis ascertained by laparotomy) evaluated by orale glucose tolerance test, secretin-ceruletide-test and fluorescein-dilaurate-test. Morphological alterations developed in 76% of patients, predominantly cicatricial ductal lesions shown by ERCP. The finding of a normal pancreatic function after extended necrosis in 43% of the patients can be explained by the enormous functional reserve of the pancreatic gland.

Acute Disease↗
PubMed1984

[Duodenum-sparing pancreas head resection in chronic pancreatitis--results after 10 years' use].

During a ten years period duodenum preserving pancreatic head resection was performed in 56 patients with chronic pancreatitis and related pancreatic head tumor. Immediate lethality was 1.8%, rate of reoperation 3.6%, late lethality after an average follow-up of 24 months (minimum 1, maximum 124 months) 3.6%. At the time of follow-up 87.3% of the patients were back at work, 58% were free of abdominal symptoms, 7.4% complained about occasional to frequent abdominal pains. 72.9% gained weight postoperatively. Duodenum preserving pancreatic head resection constitutes the subtotal resection of the pancreatic head and jejunal interpostition for the parenchymal defect. The procedure is advantageous as compared to Whipple's operation in so far as stomach, duodenum and bile duct remain intact.

Adult↗
PubMed1982

[Necrotizing pancreatitis. Surgical indications and results in 118 patients].

In a ten years period 118 patients were operated with necrotizing pancreatitis. 42% of the patients had a 50% necrosis and 25% a subtotal/total necrosis of the pancreas. Surgical therapy principally includes: necrotectomy with drainage of the pancreas layer and postoperatively local lavage of the pancreatitic cavum (61/24 h). In 28 patients a continuous peritoneal lavage were performed additionally (24.4 +/- 14.71/day, duration 9.6 +/- 8.2 days). The total lethality was 33.9%. The course of the patients with necrotizing pancreatitis is destinated by the extention of the necrosis in the pancrease itself, the development of extrapancreatic necrosis and the bacterial contamination of the necrosis (bacterial retroperitonitis, abscess).

Acute Disease↗
PubMed1979

Sterilization of laparoscopes. Is soaking sufficient?

Controversy exists over the proper methods of sterilizing laparoscopic telescopes. An edict requiring gas sterilization rather than solution soaking of these instruments is in force in all federal hospitals. This rule has necessitated capital investments for new instruments and has led to a severe reduction in the number of cases of laparoscopy that may be scheduled in one day. Fear of contamination is based on theoretical considerations and rusn counter to the actual, observed safety record seen with laparoscopes soaked in activated glutaraldehyde between cases. In an effort to dispassionately approach this problem, cultures of the umbilical area, the laparoscope and the pelvic serosal surfaces were taken to document the type of organisms commonly encountered under clinical conditions. Cultures for aerobic and anaerobic bacteria as well as for fungi were taken after soaking the telescope in activated glutaraldehyde. The results demonstrated growth of common skin organisms even after skin preparation with povidone-iodine and ethyl alcohol. Similar organisms were recovered in some cases from the laparoscope and the pelvic surfaces. The actual degree of contamination suggested by a colony count falls well within the range of the healthy peritoneum to cope with these organisms. Recommendations for laparoscopic sterilization or disinfection are based on the results obtained.

Ascitic Fluid↗
PubMed1976

Bedside hemodynamic monitoring. Its value in the diagnosis of tamponade complicating cardiac surgery.

Cardiac tamponade may be a difficult clinical diagnosis in the early postoperative period in patients undergoing open-hear surgery, particularly when the anterior or lateral pericardium is left open. Bedside monitoring of intracardiac pressures and determination of a "pressure plateau" between right atrial, right ventricular diastolic, pulmonary arterial diastolic, and pulmonary capillary wedge pressures are useful in the early diagnosis of cardiac tamponade. The value of such hemodynamic monitoring in the diagnosis and treatment of cardiac tamponade in three patients with aorta-coronary artery bypass surgery in the early postoperative period is reported. Appropriate therapy, carried out on the basis of these studies, minimized the occurrence of further morbidity or possible death.

Adult↗
PubMed1968

Host-controlled restriction of T-even bacteriophages: relation of four bacterial deoxyribonucleases to restriction.

Escherichia coli strains B and K-12, which restrict growth of nonglucosylated T- even phage (T(*) phage), and nonrestricting strains (Shigella sonnei and mutants of E. coli B) were tested for levels of endonuclease I and exonucleases I, II, and III, by means of in vitro assyas. Cell-free extracts freed from deoxyribonucleic acid (DNA) were examined with three substrates: E. coli DNA, T(*)2 DNA, and T2 DNA. Both restricting and nonrestricting strains had comparable levels of the four nuclease activities and had similar patterns of preference for the three substrates. In addition, mutants of E. coli B and K-12 that lack endonuclease I were as effective as their respective wild types in restricting T(*) phage.

Coliphages↗