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Biomedical subjects

W Dick

Publications and source records attributed to W Dick.

At least 307 records · Page 17Linked to original sources
PubMed1978

[Complications of arthroscopy. A review of 3714 cases (author's transl)].

This review is drawn from a total of 3,714 knee arthroscopies carried out on patients from six clinics. The diagnostic value of arthroscopy at this site is established for it can improve prognostication, prevention and treatment of derangements of the knee. The complications of the procedure, both theoretical and in practice, have been considered by subdividing them into four groups. Firstly, the infection rate following arthroscopy alone was nil. Secondly, minor articular cartilage damage attributable to the instrument occurred in just over 2% of cases. This complication is more common when the technique is first being learned and is usually avoidable when experience has been gained. Thirdly, complications of a general nature included four cases of subcutaneous emphysema produced by the insufflation of gas, and 22 instances of an allergic skin reaction to the disinfectant preparation. Finally, failures in the technique itself resulted from the instrument bending or breaking when negotiating the condyles. This occurred on 26 occasions. In a further seven instances the fat pad was entered and distended in error, thus preventing examination of the joint. Overall, the complication rate was acceptable low and confirmed that arthroscopy can be safely applied clinically.

Cartilage, Articular↗
PubMed1978

[Subchondral cysts of the iliac acetabulum (author's transl)].

Subchondral solitary bone cysts occur, as well as in numerous other places in the skeletal system, also in the roof of the acetabulum. These cysts differ from typical arthrosis growelcysts in form, position and X-ray appearances. They can be found in hips otherwise normal on X-ray examination (Group I), or in the presence of prearthrosis or arthrosis (Group II). The clinical features and the pathological anatomy of this form of bone cysts are discussed, as well as its aetiology. The pain precipitated by these cysts is very favorably affected by operative filling of the cyst with autologous spongiosa, as shown by follow up of the 19 operations done by the authors. These operations were done on an average 7 years previously. The result was good or satisfactory in 17 out of these 19 cases. The 2 treatment failures were due to wrong indication for operation--the simultaneous arthrosis was already too advanced. The authors prefer for this operation the Watson-Jones approach and recommend, if a large acetabulum-roof-cyst is present, immediate filling of the cyst also if an intertrochanteric osteotomy is done at the same time because of prearthrosis or arthrosis.

Acetabulum↗
PubMed1978

A new positive end-expiratory pressure valve for manually operated artificial ventilation.

The application of positive end-expiratory pressure (PEEP) as part of artificial ventilation is currently considered a basic provision to provide adequate treatment of critically ill patients in intensive care units. Hitherto only the application of intermittent positive pressure ventilation (IPPV) with an end-expiratory pressure of 0 cm water was possible during manually operated artificial ventilation. A new PEEP valve which can be attached to manually operated resuscitators has been developed in co-operation with industry to meet this need. The technical details and experimental testing of the new valve have been presented in this paper. It may be connected via special adaptors to existing Ambu resuscitators, either for use on adults or on neonates, babies and infants. The valve has the characteristics of normal PEEP devices in that the resistances with various PEEP levels remain relatively independent of the flow and thus presents a true positive end-expiratory pressure rather than just an increase of expiratory resistance. The valve can be connected simply to nearly all types of simple and advanced respirators, such as those used for assisting respiration, physiotherapy etc., as well as being used with manually operated resuscitators.

Adult↗
PubMed1978

[Effects of diazepam and flunitrazepam on the undesired postoperative side-effects of ketamine anaesthesia (author's transl)].

150 patients undergoing minor gynaecological procedures (curretages) were anesthetized with ketamine and either diazepam flunitrazepam or placebo in order to establish the best combination for the prevention of postoperative psychotomimetic effects. From observations, up to 24 h after operation, it was found and statistically proven that the combination of ketamine/flunitrazepam as compared to the combinations ketamine/diazepam and ketamine/placebo led to a remarkable reduction of psychotomimetic side reactions.

Adult↗
PubMed1978

[General anaesthesia in microlaryngeal surgery by injection-technique with a modified Carden tube (author's transl)].

A method of general anaesthesia and pulmonary ventilation with automatic intermittent positive pressure for endoscopic laryngeal surgery is described. We have used a technique with a modified Carden tube which gives more freedom to the otolaryngologist. Arterial blood gas studies performed on 10 patients indicated adequacy of ventilation throughout and following the procedure. The special features of this technique are mentioned.

Adult↗
PubMed1978

[Intestinal tuberculosis and differential diagnosis against Crohn's disease in children (author's transl)].

The case of a 9-year-old girl treated elsewhere for anemia due to iron deficit is described. The first diagnosis of Crohn's disease made by us and for which the girl received treatment had to be revised, because an intestinal tuberculosis was later accepted to be the correct diagnosis. The authors emphasize the importance of safe diagnostic distinctions between Crohn's disease and intestinal tuberculosis. Diagnostic and therapeutic procedures are discussed.

Anemia, Hypochromic↗
PubMed1978

[A new method to avoid aspirations (author's transl)].

When treating accident victims and other high-risk patients there is always the danger of aspiration until intubation has been completed. An ancillary unit is described that can be connected to any type of tracheal aspirator, working on the principle of increasing the suction. Thus liquids and solid particles can always be sucked out quickly and effectively. In this way the danger of aspiration is considerably reduced or avoided altogether.

Humans↗
PubMed1978

[The effects of naloxone on oxygen uptake, pulmonary ventilation and cardiac performance in adult non-anaesthetised persons (author's transl)].

10 normal persons were given 0.4 milligrams of Naloxone intravenously, and the following measurements were taken: oxygen uptake, CO2 production, respiratory quotient, respiratory minute volume, tidal air, dead space, effective dead space, specific ventilation, alveolar O2 partial pressure, end-expiratory CO2 partial pressure, heart rate, systolic and diastolic blood pressure and the Burger Index. Analysis of the results established that administration of Naloxone was followed by a statistically significant, but clinically not relevant, reduction in O2 uptake and CO2 production. Higher doses produced the same results. The findings appear to contradict those observed in anaesthetised patients who are given Naloxone during the postoperative stage. However, closer examination of the results suggests that the so-called tachytrophic effect of Naloxone is attributable to its antagonistic action on the analgesic and sedative effects of opiates rather than to a specific pharmacodynamic property of Naloxone.

Adult↗
PubMed1978

[Changes in intraocular pressure with various concentrations of enflurane during constant conditions of ventilation (author's transl)].

A variety of factors influence intraocular pressure. An increase for example, can be found under conditions of hypoventilation, prohibited ventilation and too light anaesthesia. Some pressure decreasing factors are barbiturates, various inhalation anaesthetics, neuroleptics, and also hyperventilation. In 10 gynaecological patients with normal ophthalmological status, IOP was measured under enflurane anaesthesia by means of a Draeger hand-held applanation tonometer. The neuroleptanaesthesia served as a basis. After anaesthetic conditions were stabilized, concentrations of enflurane ranging from 0.5 to 2.0 vol.% were administered. Under constant ventilation (PECO2) the following parameters were measured: pH, PCO2cap,PO2cap,base excess, minute ventilation, respiratory rate, blood pressure and pulse rate. The concentration of enflurane was measured by gas-chromatography. The IOP was decreased by using enflurane in various concentrations. This decrease is caused by enflurane/itself and is independent of blood pressure changes.

Adolescent↗
PubMed1978

[Operations on vertebral bodies by anterior approach (author's transl)].

The origin of most pathological affections of the spine is situated in the vertebral bodies and the intervertebral disks. There have been established standard manners for the anterior approach to all parts of the spine in the last years which allow us to reach every vertebral body from the front. The authors describe the anterior approach to the different parts of the spine and discuss the indications for interventions on the vertebral bodies separately for the cervical, thoracic and lumbar spine. The experience with their 144 own cases is briefly reported.

Cervical Vertebrae↗
PubMed1978

[The anaesthesia outpatient clinic. A new concept of preanaesthetic preparation and treatment after two years experiences (author's transl)].

The anaesthesia outpatient clinic can be a new concept of preanaesthetic preparation and treatment. Related to the figures of 1977, a report is given about our 2-years experience. Patients from the usual outpatient clinics, like gynecology, urology, ENT, who are expected to be operated upon are immediately sent to the anaesthesia outpatient clinic for preanaesthetic check up. After the overall state of the patient has been examined, the original outpatient clinic and/or the family doctor are given information about the patients condition, and probably proposals for a preanaesthetic treatment are made. In 1977, 15% of all anaesthetized patients were checked as outpatients, another 40% were only examined after entering the hospital, whereas as few as 17% were not checked in the anaesthesic outpatient clinic. In patients, checked as outpatients, the period between the first day of hospitalisation and operation was evidently shorter than in patients, having been hospitalized at the time of preanaesthetic examination. This gives the opportunity to save money and beds. Furthermore, the anaesthesia outpatient clinic improves the organisation and efficiency of surgery, urology, gynecology etc., improves the relationship between patients and anaesthetists, decreases the risk of anaesthesia and operation, saves personnel and gives a qualified additional background for the purposes of graduation and student training.

Anesthesia Department, Hospital↗