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Biomedical subjects

D Pohl

Publications and source records attributed to D Pohl.

At least 19 recordsLinked to original sources

[Bronchial rupture and lung contusion in multiple trauma].

Tracheobronchial ruptures resulting from blunt chest trauma are rare events. Depending on their anatomical location and extension they may be nearly asymptomatic and escape early diagnosis, on the other hand they may induce an acute life-threatening situation with dramatic symptoms. The awareness of the different clinical and radiological findings may point to this lesion, the definite diagnosis, however, is made by bronchoscopy. A rapid surgical reconstruction intends to avoid severe late complications and to protect all uninjured lung areas for an adequate gas exchange in case of associated lung contusion. In patients with thoracoabdominal injuries, whether to perform thoracotomy or celiotomy first must be decided for each individual case depending on the urgency. The clinical course of a patient, who after a traffic accident suffered from main bronchus rupture, bilateral lung contusion, liver rupture and multiple fractures of the upper extremities illustrates these problems.

Adult

[Spontaneous pneumothorax as the initial symptom of bronchial cancer].

Spontaneous pneumothorax is caused by benign lung diseases in more than 95 percent. Mainly presenting in younger male patients between 20 and 40 years of age its prognosis is generally good.--On the other hand, pneumothorax as initial manifestation of bronchial carcinoma is a rare complication with poor prognosis. We report such a case of a 70 year-old man, review the literature and describe characteristical problems in diagnosis and therapy of very small bronchogenic tumors. Estimating that only 2 percent of all spontaneous pneumothoraces are coexisted with malignant lung diseases--either primary or secondary--this tumor-complication especially must be considered in older patients. Their prognosis may be improved entirely by rapid diagnosis and therapy.

Aged

Pharmacological management of cancer pain. A guide for the health care professional.

Cancer pain continues to remain a significant problem for oncology patients treated in both the university and the community setting. Nursing knowledge regarding pain management has advanced significantly in recent years. This article provides health care professionals with current factual information on cancer pain management. The information focuses on the emotional aspects of cancer pain, specific principles of analgesic management, opioid equianalgesics, multiple approaches to opioid administration, management of unwanted side effects, and a description of inappropriate drug therapies.

Analgesia, Patient-Controlled

Vertebral erosions in patients undergoing maintenance hemodialysis for chronic renal failure.

Unlike articular erosions in the appendicular skeleton, the frequency, appearance, and clinical relevance of vertebral erosions in azotemic osteodystrophy are not known. Lateral vertebral radiographs of 118 patients on maintenance hemodialysis were reviewed to assess the frequency, distribution, and rate of progression of vertebral erosions. Thirty (25%) of 118 patients showed a superficial corner erosion resembling the so-called Romanus lesion of ankylosing spondylitis. Their presence, whether at a single level or at multiple levels, did not correlate with erosive changes in the phalanges or sacroiliac joints that are known to occur in renal osteodystrophy. Vertebral erosions may progress slowly with time, but seem to have limited bearing on clinical symptoms. In two patients, however, the radiographic changes progressed dramatically, simulating an infection. Biopsy and surgical intervention were considered but not carried out because one patient declined and in the other an infected graft was identified as the source of infection. Both patients had negative scintiscans, and their subsequent clinical courses excluded infectious spondylitis. Vertebral erosions in patients on maintenance hemodialysis are frequent, and there appears to be a spectrum of changes from superficial erosions to large resorptive defects. Further diagnostic evaluation of these erosive changes appears to be warranted only rarely.

Adult

The formation of ultrastructural epithelial and subepithelial connective tissue changes in experimentally induced cholesteatomas in guinea pigs.

Histoacryl-induced cholesteatomas were produced in guinea pigs at the posterosuperior part of the external ear canal adjacent to the tympanic membrane. Semithin and ultrathin tissue sections were used to study primary formation of the cholesteatoma as well as the influence of the altered epithelium upon the bordering zone of connective tissue. Quantitative and qualitative tissue changes were analyzed by electron microscopy and showed degradation and new formation of collagen and activation of fibroblasts. Our findings are similar to those previously reported on human cholesteatomas and indicate that the bordering subepithelial tissue seems to be influenced through the basilar membrane.

Animals

[A light and electron microscopic study of the squamous epithelium of the external canal and drum in experimentally induced cholesteatoma in guinea pigs].

The skin of the postero-superior part of the meatus and drum of guinea pigs was treated with enbucrylate and examined via light microscope and electron microscope after three weeks. The squamous epithelium was thickened with extensive rete pegs in the subepithelial space. The epithelial cells were loosely arranged and their nuclei pathologically changed. In the oedematous perimatrix small finger-like epithelial proliferations and activated mesenchymal cells could be seen.

Animals

Skin cancer and water arsenic in Lane County, Oregon.

It was expected that the incidence of skin cancer would be related to the known high arsenic levels in water supplies of Lane County, Oregon. Incidence rates were based on all histopathologically confirmed cases among Lane County residents diagnosed during 1958-1971 and were compared to mean water arsenic levels measured during 1968-1974. Basal cell carcinoma had a mean annual incidence rate of 88 per 100,000, a 5:4::M:F sex ratio, and an increasing risk for both sexes in urban areas. Squamous cell carcinoma incidence was 50 per 100,000 and showed 2:1:M:F sex ratio but no urban predilection. Neither type of skin cancer was directly related to the arsenic levels as expected, although sporadic individuals with sufficient exposure could manifest the relationship. Fewer than expected drinking water sources were found to contain high arsenic content, so that the Lane County data do not necessarily contradict previous reports of positive correlation. The basal cell carcinoma pattern suggested that this disease might be potentiated by urban air pollutants.

Aged