Biomedical subjects
Publications and source records attributed to W Dick.
A new anaesthesia system for infants and small children has been designed. The system--consisting of clinically proven - is easy to handle and to be exchanged; the components problem of anaesthesia gas exhausting (filters or central suction system) has been simplified, compared to the previous fresh gas system (Kuhn or Rees).
In 70 healthy women under labor, the clinical properties of the combination DHB (0,1 mg/kg) and Pethidin (0.4 mg/kg) was studied for analgesia purposes in obstetrics; on request, Pethidin was given repeatedly. The fallowing conclusions can be drawn from this study: 1. The recommended "analgesic mixture" of DHB and Pethidin i.v. in the above mentioned doses is usually without harm to mothers and fetuses or new born respectively. 2. The Pethidin dosage, used in this study, agrees with the doses, recommended in the literature (0,4 mg/kg/h). 3. There was no difference between I-para, II, III-para etc., as far as the Pethidin requirement are concerned. 4. The analgesic properties of the mixture, judged by using clinical criteria only, were not quite convincing. This may be due to an increase of the intensity of uterine contractions by the mixture itself.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Results from cases of appendicitis occurring during the first three years of life are compared with those found in the literature. In the Departments of Surgery and Paediatrics in the University of Köln-Lindenthal 26 cases of appendicitis occurred in this age group between 1960 and 1975. The majority of cases were of the advanced forms of the disease in which the appendix was already perforated. Successful operations were performed in 25 children, but in a 12-day old infant the disease was diagnosed only at autopsy. An early diagnosis is imperative, and can only be deduced from a thorough diagnosis and compilation of symptoms.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This is to discuss regulatory mechanisms which enable the organism to respond optimally to special nutritive conditions. Those regulatory mechanisms are often in disorder with patients who need nutritive therapy. However, normal functions of the body are required for nutrition. Disarrangements in microcirculation, oxygen supply, water and electrolyte metabolism and acid-base metabolism are described and the way they will influence nutrition therapy. Furthermore, we try to describe special conditions of metabolism in stress and its influence to efficiency of nutritive therapy.
26 healthy pregnant women at term were divided into 2 groups and anaesthetized with either 1 mg/kh or 2 mg/kg ketamine - N20/02 - for primary caesarean section. Maternal venous ketamine plasma levels, neonatal ketamine plasma levels (umbilical artery and umbilical vein) and blood gases were measured. Maternal venous ketamine plasma levels in group I exceeded those in group II by 2.8 (30-60 sec after injection) and 2.0 (at the time of delivery) respectively. Independent of the dose used, the plasma levels of ketamine in the umbilical artery or the umbilical vein were found to be identical in the two groups of newborn infants. Neonatal blood gases and acid base parameters did not significantly differ between the two groups, except for the oxygen tension in group II which slightly exceeded the PO2 values in group I 15, 60 and 120 min after delivery. pH and standard bicarbonate values were found to be higher (1 and 5 min) in both groups, compared to pH and standard bicarbonate levels in a group of newborns delivered spontaneously.--The results of this study show: 1. Independent of a low or high ketamine dosage, neonatal blood concentration of the drug remain low, probably due to a placental barrier effect.--2. The post partum recovery of the newborns was neither influenced by the ketamine anesthesia itself nor by different drug doses.
Severe Hallux valgus deformity in adolescents and young adults has been treated by the McBride operation in 53 cases during the period from 1965 to 1974. With 85% good results in our material this type of operation is very satisfactory. Other authors have made the same experience. The principles and technique of this soft tissue correction are described and the results of reexamination presented.
The technical equipment necessary for modern anaesthesia and intensive care medicine needs special and organized outfit control of the apparatus used and of their operation and proper function. Setting up of a centre for maintenance work on anaesthetic equipment is a possibility. Studies have shown that the necessary technical and hygienic maintenance work may be subdivided into 12 working phases each need special working sites and technical equipment corresonding to the requirements. The above systematic study is recommended to decrease risks assoicated which technique and hygiene.
The localisations of bone cysts known under the title of "intraosseous ganglion, synovial cyst of bone and solitary unicameral cyst" are summarised from the literature. Two of the authors' patients are added to the few cases of talar cysts recorded up to the present. In addition, a patient with a calcaneal cyst is described. The cysts can be traumatic or non-traumatic in origin. The various theories concerning their etiology are discussed. The clinical findings, differential diagnosis and therapy of subchondral bone cysts particularly in the region of the foot are considered.
Explore the source record for details and available documents.
An operative technique for total hip arthroplasty is described which does not require a guiding instrument to obtain the necessary angles for the acetabular part. Instead, the acetabular rim serves as a guide. The result was examined in 159 cases on the basis of a standard X-ray of the entire pelvis from which the angular relations of the acetabulum could be read or calculated. The values found corresponded to the normal anatomical distribution. The technique is simple and safe. The influence of the angular relationships on the danger of a prosthetic luxation on the one hand and on mobility on the other hand is discussed.
Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of non-glucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of frucose : glucose : xylitol in a ratio of 2 : 1 :1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.
Biochemical function and biological significance of Cu, Zn and Cr are reviewed briefly. During a longterm perenteral nutrition a depletion of the organism of copper and zinc is to be expected. Therefore, in parenteral nutrition, an early substitution of zinc seems to be usefull. Up to now a similar recommendation for copper cannot be given. As many infusion solutions are contaminated with chromium, there is no need to substitute this element in parenteral nutrition.
At least 16 cases of posttraumatic chondromalacia of the patella out of a total of 79 patients operated between 1968 and 1971 were diagnosed on the basis of a questionnaire and follow-up examination. The clinical findings and delineation of this complaint from femoro-patellar osteoarthritis are discussed. The diagnosis was confirmed by arthroscopy in 2 patients. The significance of cartilagenous damage due to direct contusion is pointed out. The mechanisms which result in a degradation of the cartilagenous layer in the weeks following the accident are mentioned. The therapeutic consequences for the treatment of fractures of the patella are as follows: One must aim at exact bony reduction. Macroscopically damaged parts of the cartilage should be removed. Indication to partial patellectomy should be on a broad basis. A long term treatment with salicylic acid or Chloroquin-both of which are said to prevent enzymatic degradation of cartilage-should be considered.