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Biomedical subjects

C Ulrich

Publications and source records attributed to C Ulrich.

At least 91 records · Page 5Linked to original sources
PubMed1991

[The surgeon in emergency medicine--early management in the areas of the extremities].

The general principles at the scene of the accident are the following: Soft tissue wounds are covered with local sterile compresses to stop bleeding and abandon contamination. In fracture or luxation of small joints immediate reposition by careful traction and splint-fixation in neutral position ist most important. The correct primary management of open fractures combines the measures for wound and fracture treatment. Even in cases of spine trauma primary careful traction is essential, with emphasis on physiologic lordoses. Gentle transport and observation for neurologic changes ensue. The primary destination should be the nearest trauma center, not a specialist clinic.

Emergencies↗
PubMed1991

[Hemodynamic aspects of retinitis pigmentosa].

While retinal vascular attenuation is a typical finding in retinitis pigmentosa (RP), studies on changes in choroidal vasculature have yielded contradictory results. In 44 patients with RP the relative pulse blood volumes were measured, and perfusion pressure videoangiography (PVA) was performed in 7 of them. Follow-up examinations were performed in 14 of the patients between 1.5 and 6 years later. The results show that the choroidal circulation is considerably reduced in RP patients; it was found to be further reduced at the follow-up examinations. PVA shows atrophy of the choroid capillary network. Characteristic changes occur not only in the retinal but also in the choroidal circulation, depending on the form, duration (stage) and prognosis of the disease.

Adolescent↗
PubMed1991

Fasciitis necroticans of the head: a rare localization.

A 61-year-old diabetic woman was admitted with high fever, dehydration and acidosis caused by fasciitis necroticans of the forehead. The electrolytes and blood sugar level were corrected, broad spectrum antibiotics started and extensive débridement performed, followed by a second-look operation the next day. After the bacterial culture was known, the antibiotics were adapted. A split-skin graft gave an acceptable result.

Debridement↗
PubMed1990

[Blunt abdominal trauma--sonographic findings].

Results of sonographic investigations from 435 patients with blunt abdominal trauma or polytrauma admitted to a traumatology service are given. Complete evaluation of the abdominal organs was impeded in 94 cases by meteorism or other factors like immobility or hyperactivity of inebriated patients. Evaluation of the pancreas was inhibited in most of these cases. In 33 cases lesions of an organ could be verified during surgery. In one case the false positive diagnosis of "spleen rupture" led to operation. Suspicion of free fluid in the abdominal cavity (5 cases) could not be verified in any of the cases during a second investigation and was deemed to be negligible. Rupture of the spleen was diagnosed in 12 out of 14 cases, renal contusion in 7 out of 7 cases. Liver-, bowel- and mesenteric lesions were occasionally diagnosed indirectly (evidence for free fluid). Quality assessment did not reveal a difference between day time or nocturnal work shifts provided the investigators were experienced in sonography.

Abdominal Injuries↗
PubMed1990

[Birdshot retinochoroidopathy. Case report].

The clinical findings and results of perfusion-pressure videoangiography (PVA) are described in a 50-year old patient suffering from birdshot retinochoroidopathy. PVA according to Ulrich and Ulrich makes it possible to observe the gradual filling of the retinal and choroidal vessels relative to ocular perfusion pressure. The patient's PVA reveals that the fluorescein penetrates the vessel wall in the interstitial tissue in the region of the large choroidal arterioles close to the entry of the short posterior ciliary arteries in the eye. This occurs long before the blood flow has reached the choriocapillaries, i.e., at distinctly lower perfusion pressures than are necessary for filling the leaking choroidal capillaries. The leakage of fluoresceine from the large choroidal arterioles explains the typical birdshot pattern of the fundus.

Blood Pressure↗
PubMed1990

[Functional diagnosis in follow-up of temporal arteritis treatment].

Fourteen patients (28 eyes) suffering from histologically confirmed temporal arteritis were examined with oculo-oscillodynamography (OODG) according to Ulrich and Ulrich as well as with orbital dynamography (ODG) according to Hager. These examinations were performed before and during prednisolone treatment. When ocular and orbital vessels are involved, temporal arteritis will result in a strong reduction of the ocular and orbital pulse blood volumes. Ocular perfusion pressures may also be reduced. In all 28 eyes of the 14 patients, OODG showed the ocular pulse blood volumes to be significantly reduced, while with ODG the ocular pulse blood volumes appeared to be within the normal range in 50% of the cases. Therefore, OODG is more reliable than ODG in the diagnosis of temporal arteritis. When performed during prednisolone treatment, OODG is a very sensitive indicator of successful or unsuccessful therapy. OODG permits an early detection of relapses and helps to avoid their sequelae. Since OODG can be repeated as often as desired and can be performed within a short time, it is very suitable for controlling the management of temporal arteritis.

Aged↗
PubMed1989

Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study.

The efficacy of a relatively cheap regimen of selective decontamination (SDD) was evaluated in a diverse population of ICU patients. Patients requiring prolonged ICU stay (greater than 5 days) were randomly allocated to a treatment group or control group. Control patients (n = 52) received perioperative antimicrobial prophylaxis and antibiotic treatment was instituted only on sound clinical and bacteriological criteria. Treated patients (n = 48) received gastro-intestinal and oro-pharyngeal decontamination with polymyxin E, norfloxacin, amphotericin B and systemic antibiotic prophylaxis with trimethoprim until decontamination was achieved. The rate of gram-positive infections was not altered by SDD. The incidence of gram-negative respiratory tract, urinary tract and line infections was significantly reduced from 44%, 27% and 15% respectively in the control group to 6%, 4% and 0% in the treatment group. Mortality from nosocomial sepsis and overall mortality were also significantly reduced from 15% and 54% to 0% and 31% respectively. The ICU stay was not reduced by SDD, nor was time on the ventilator or use of therapeutic antibiotics. The reduction in morbidity and mortality was achieved at a relatively low cost.

Bacterial Infections↗
PubMed1988

[Clinical aspects and functional diagnostic findings of Takayasu disease].

Aetiopathogenesis, clinical picture, laboratorical and functional diagnostic methods of ten patients suffering from Takayasu's arteritis out of 1164 patients suspicious of cerebrovascular insufficiency are described. The combined use of Dopplersonography, ophthalmodynamometry and ophthalmodynamography permit in all cases the assessment of vascular pathology in supraaortic arteries. The specific diagnosis was made in connection which clinical, anamnestical and paraclinical findings. There are some characteristic functional diagnostic results in Takayasu's arteritis. The noninvasive diagnostic methods are useful tools to estimate the progredience of this disease in his chronical course.

Adolescent↗
PubMed1988

[Temporal arteritis--diagnosis and therapeutic control].

33 patients suffering from temporal arteriitis (Morbus Horton) were investigated noninvasively by Oculo-Oscillo-Dynamography (OODG), Orbita-Dynamography (ODG) and Temporalis-Dynamography (TDG). The ocular, orbital and temporal oscillograms and oscillodynamograms revealed characteristic and unmistakable alterations; i.e., striking reduction of the pulse volumes and a decrease of the blood pressures in the respective circulatory regions as a result of a stenosing and occluding vascular process. The 3 methods yielded typical patterns of the occluding process, which led to the conclusion that in untreated persons the stenosing process of the arteritis cranialis tends to start in the vascular branches of the external carotid artery and subsequently includes branches of the internal carotid system, such as the ophthalmic artery. High doses of prednisolone resulted in reopening of the vessels that had been stenosed and occluded by arteritis, and in most cases restored normal circulation in the regions examined within several weeks or months. From the investigations made on 66 eyes of the 33 patients, the authors conclude that combined use of OODG, ODG, and TDG makes it possible to diagnose temporal arteritis with a high degree of certainty. In all 33 cases the disease was diagnosed with OODG, ODG and TDG and confirmed histologically. Since the OODG, ODG, TDG examinations are well tolerated by the patient and can be repeated at any time, it is suggested to employ them for the supervision of therapy as well to detect any possible relapse of the inflammatory occluding vascular process.

Dose-Response Relationship, Drug↗
PubMed1988

Crohn disease of the ileocecal region: US visualization of the appendix.

In three of 52 consecutive patients with a painful mass in the right lower quadrant, ultrasound (US) disclosed severe mural thickening of the terminal ileum and cecum and moderate mural thickening of the appendix. In all three, the tentative diagnosis of Crohn disease was subsequently confirmed. If these US features are found in a patient with a suspected appendiceal mass, the diagnosis of Crohn disease must be seriously considered, and further evaluation is imperative.

Adolescent↗
PubMed1987

Comparative study of the stability of anterior and posterior cervical spine fixation procedures.

Both posterior and anterior procedures of stabilization are used for operative immobilization of unstable functional units of the cervical spine. The primary stabilizing effect of each procedure was examined and the two were compared in an experimental study. To this end the functional units C-5 and C-6 were removed from ten fresh cervical spines, the discoligamentous structures being preserved, and C-6 was embedded in methacrylate. As a result of a tensile force in a vertical direction applied to the base of the spinous process of C-5, a flexion bending load was introduced into the unit, the main component of which was measured with the aid of one vertical- and two horizontal-displacement transducers. The respective tilting angle alpha and the translation were calculated on the basis of these values. Each individual functional unit was measured with and without the discoligamentous lesion. This posterior instability was then stabilized with an H-plate, a hook plate, sublaminar wiring, and various combinations of these. Our results lead to the following clinically relevant conclusions: With isolated posterior instability, posterior fixation with the hook plate appears to bring about exercise stability. With complete discoligamentous instability, the combined procedures certainly produce exercise stability, from a biomechanical point of view, the posterior hook, plate alone being capable of guaranteeing secure fixation. Exclusive posterior wiring with complete discoligamentous instability may, without external immobilization, result in permanent subluxation in the functional unit. Exclusive anterior H-plate fixation with complete discoligamentous instability requires additional external immobilization in the postoperative stage in order to prevent flexion.

Biomechanical Phenomena↗
PubMed1987

[Oculopression tonometry (OPT): a new tonographic procedure in the diagnosis of glaucoma].

OPT is a new tonographic procedure permitting easy and reproducible examination of the regulative IOP behavior and the detection of impaired hydrodynamics as an early sign of glaucoma. OPT avoids errors associated with conventional tonographic procedures, takes measurements in IOP ranges where better separation between healthy and glaucoma eyes may be expected, performs simultaneous examination of both eyes, and permits IOP measurement by applanation tonometry in all phases of the examination process. OPT is easier to perform, is better tolerated by the patient and only takes half as long as conventional tonography. The effectiveness of the new procedure is demonstrated by the results of examinations of 253 eyes.

Glaucoma↗
PubMed1987

[Stable soft tissue reconstruction using an autochthonous muscle flap transposition and simultaneous bone reconstruction in post-traumatic and osteitis defects of the lower extremity].

Posttraumatic soft tissue and bone defects can pose problems for the surgeon. Autogenous bone from the iliac crest may be used to fill bone defects. To achieve bone healing, a well vascularized recipient site for the graft is important. Local muscle flaps or distant microvascular flaps improve vascularity by introducing a fresh blood supply. Cellular and humoral antibodies are more effective and allow quicker revascularisation of the transplanted graft. 49 soft tissue defects were treated by local muscle flaps. In 14 cases the soleus, in 28 the gastrocnemius, in three the tibialis anterior, in two the abductor hallucis, and in two the gracilis muscle was transposed. 38 cases had posttraumatic osteitis, in eight the defect was merely a soft tissue defect and in three due to tumour excision. In 24 patients a combination of soft tissue repair and cancellous bone grafting was performed. Four flaps failed because of total or partial necrosis. In all cases full weight bearing on the leg with good soft tissue cover was achieved.

Bone Transplantation↗
PubMed1986

Intraoperative transesophageal two-dimensional echocardiography in total hip replacement.

A number of studies in medical literature suggest that during implantation of hip prostheses pulmonary embolism of medullary contents and of air may occur. Proof of this suggestion was based on histological examination of lung tissue in animal experiments as well as on post mortem examinations of human tissue. In vivo evidence of this suspected embolism has been lacking so far, since an appropriate technique has not been available. Using transesophageal two-dimensional echocardiography, continuous imaging of the right atrium and the right ventricle can be performed in order to prove this suspected embolization in vivo. Thus, in a prospective randomized study of 26 patients undergoing hip surgery, the right atrium and right ventricle were continuously imaged. Simultaneously, the end-expiratory CO2 partial pressure was recorded. The medical literature suggests that a venting hole in the shaft of the femur prevents the rise in pressure in the medullary space and thus also averts embolism. Therefore, prior to the implantation of the shaft prosthesis, and in order to vent the medullary space, in 13 patients a 4.5-mm lateral borehole was drilled into the femoral shaft, located two finger breadths distal to the point were the end of the prosthesis would be positioned. In 12 of 13 patients in the control group without boreholes, transesophageal two-dimensional echocardiography revealed that air bubbles formed during the implantation of the shaft. In the group with boreholes, however, presence of air could be demonstrated in only four patients (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Marrow↗