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Biomedical subjects

J Teuscher

Publications and source records attributed to J Teuscher.

At least 19 recordsLinked to original sources
PubMed1992

Infectious diseases following major disasters.

A recent surge in the general awareness of the extent of disasters has increased concern over the adequacy of our state of preparedness for these events. Outbreaks of infectious disease after a disaster may have significant societal impacts. In preparation, rescuers must anticipate and identify infectious risks, isolate and treat the individuals with infections, and institute measures that will prevent the further spread of infectious diseases. Epidemiological factors may contribute to the spread of infectious disease after a given disaster. A simple microbiological laboratory in the field may be helpful in attempting to direct therapy at specific infectious etiologies. Prior post-disaster experience suggests that mass immunization may not always be valuable in protecting against disease spread acutely, although immunizations may be considered in a limited number of situations. Disaster medical personnel should prepare themselves with appropriate vaccinations and remain in good health; new pathogens must not be brought in by well-meaning relief personnel. Disasters often occur in a Third-World setting where resources are limited and often compromised. Complete recovery from infectious disease outbreaks and restoration of infection control practices may take years when a Third-World population has suffered a major disaster.

Communicable Disease Control↗
PubMed1990

[Acute appendicitis: avoiding unnecessary laparotomy in young women].

Eighty-eight consecutive patients undergoing surgery for clinical diagnosis of appendicitis are reviewed. The diagnosis was correct in 71 (85%), incorrect in 17 (15%). Of these 17 patients 5 suffered from other diseases demanding surgical treatment (diverticulitis, cholecystitis, torsion of ovarian cyst, pyosalpinx). Pain migration, local tenderness and WBC greater than 10,000/mm3 were significantly associated with appendicitis, whereas duration of pain, défense musculaire and body temperature did not allow any discrimination. In men, the diagnosis was correct in 42 out of 43, whereas in women only in 34 out of 45. All 11 women with incorrect diagnosis were less than 35 years old. We conclude that the diagnosis of appendicitis is particularly difficult in women younger than 35 years.

Acute Disease↗
PubMed1990

[Acute mesenteric ischemia].

83 patients with acute intestinal ischemia are presented. The aim of the study is to characterize anamnestic and clinical signs of this severe disease. Mainly old people with various cardiac illnesses suffer from acute intestinal ischemia. Precise anamnesis sometimes leads to the etiology of the obstruction. Clinical examination may show the extent of the disease. Angiography is mandatory for correct diagnosis. Early recognition and aggressive therapy significantly improve prognosis.

Acute Disease↗
PubMed1988

Pathogenesis of nodular goiter and its implications for surgical management.

Despite sufficient iodine supply, goiter continues to be of considerable surgical significance in formerly endemic countries. It now appears that iodine deficiency and increased thyrotropin stimulation are not the only causes of goiter. Xenotransplantation of human thyroid tissue onto nude mice allowed study of the regulation of growth and function in human goiter tissue. Grafts of human thyroid tissue growing in nude mice could be shown to react to endogenous mouse thyrotropic stimulation and suppression. 131I autoradiographs of xenotransplanted goiter tissue showed as marked a heterogeneity as did the original goitrous tissue prior to transplantation. There was no firm correlation between the morphologic appearance of a follicle and its iodine metabolism. Scintigraphically "cold" and "hot" goiter tissue differed from each other quantitatively but not qualitatively; i.e., both "hot" and "cold" tissue were composed of metabolically active and nonactive follicles. Iodine organification was not completely suppressible by thyroxine treatment; this indicates autonomous functional activity. The distribution of proliferating tissue labeled by 3-H-thymidine did not parallel the distribution of functionally active tissue labelled by 131I. Thyroxine treatment did not completely inhibit 3-H-thymidine incorporation, indicating autonomous growth. Thus, our pathogenetic concept of goiter formation is based on three mainstays: (1) goiter heterogeneity, (2) autonomy of growth and function, and (3) dissociation of growth and function in human goiter tissue. Thus, the surgeon dealing with goiter ought to remove all pathologically altered tissue, i.e., nodular tissue, irrespective of its appearance on scintiscans.

Animals↗
PubMed1987

[Acute massive gastrointestinal hemorrhage in jejunal diverticulosis].

Two cases which presented with acute massive lower gastrointestinal hemorrhage from jejunal diverticulosis are reported. The various clinical presentations of this rare disease are discussed. The life-threatening complication of massive bleeding is specially outlined. The cases reported in the literature resemble the Dieulafoy ulcer lesion of the stomach.

Aged↗
PubMed1986

[Giant abdominal abscesses--a hitherto unrecognized disease].

Two cases of giant intraabdominal supra-colic abscess are described. Since the clinical symptoms are often unimpressive and nonspecific, there was a delay in diagnosis. The causes were unrecognized perforated peptic ulcers in both patients. Pathophysiology, incidence and possible localizations of intraabdominal abscesses are discussed. A review of intraabdominal anatomy is important for an understanding of the peritoneal spaces in which abscesses can occur.

Abscess↗
PubMed1986

[Preoperative prediction of the character of strumas].

We analyzed prospectively collected preoperative data of 278 goiter patients in order to determine predictors of goiter dignity. Aspiration-biopsy-cytology (ABC) revealed to be a good predictor as a result of a regression analysis. Its predictive value could not be improved significantly by combining ABC-data with other preoperative data. Patients with malignant goiters significantly differed from those with benign goiters with respect to age distribution, growth duration of the goiter and its function and texture, whereas sex distribution, nodularity and scintigraphic appearance did not differ significantly in the two groups.

Adenocarcinoma↗
PubMed1985

[Cystic liver].

Diagnostic workup of progressive upper abdominal pain in patients with polycystic kidney disease may lead to the diagnosis of simultaneous polycystic liver disease. Whereas untreated advanced polycystic kidney disease leads to terminal organ failure, symptoms of polycystic liver are mainly due to local mechanical effects. Impairment of liver function is rare. Polycystic liver and kidneys are an autosomal dominant hereditary disease with variable penetrance. The etiology, clinical aspects, and diagnostic and therapeutic procedures are discussed and illustrated on the basis of three clinical cases and a review of the literature.

Chromosome Aberrations↗
PubMed1985

[Surgical treatment of hyperthyroid struma: surgery results, postoperative long-term course and study of a factor connected with recurrences].

None of the 335 patients thyroidectomized for hyperthyroidism in our department of surgery between 1972 and 1982 died as a consequence of the operation. Reassessment of 226 of these patients by questionnaire 68 +/- 25 (SD) months after thyroidectomy revealed the following complications: postoperative paresis of the recurrent nerve (9%), persistent change of voice (2%), and persistent hypoparathyroidism (3.5%). 91 patients underwent a follow-up investigation 74 +/- 33 months after thyroidectomy. Only one had recurrent hyperthyroidism but 6 had a recurrence of the goiter. Patients with recurrent goiters had a significantly higher frequency of increased serum thyroglobulin levels than patients without goiters. These results emphasize the effectiveness of surgical therapy in hyperthyroidism, and suggest that serum thyroglobulin might be a useful predictor for goiter recurrence.

Adult↗
PubMed1985

[Operative strategy in thyroid autonomy and Basedow hyperthyroidism].

The different extra- and intrathyroid origin of hyperthyroidism, the advantages of the surgical procedure and the criteria for the extent of thyroid resection determine the operative tactics. For both forms of hyperthyroidism we recommend a rather extended resection of the diseased thyroid gland in order to prevent recurrent hyperthyroidism and recurrent thyroid growth as well. These recurrences require subtotal thyroidectomy for Graves' disease, monolateral partial lobectomy for a so-called toxic adenoma and bilateral partial lobectomy for toxic multi-nodular goiters. With these procedures lesions of the recurrent nerves and parathyroid glands can be prevented.

Adenoma↗
PubMed1985

Efficient hepatic uptake of chylomicron remnant cholesterol in rats with a portacaval anastomosis.

Portacaval-shunted and sham-operated male rats, fed ad libitum and of similar weight, were studied 2-3 weeks after surgery. At this time serum cholesterol levels did not differ significantly between the two groups, whereas serum triacylglycerols and phospholipids were lower in the shunted group. These animals also showed an increased serum bile acid level and an increased serum estradiol to testosterone ratio. The metabolism of native chyle labeled with [3H]cholesterol and [14C]linoleic acid or of preformed chylomicron remnants with the same labeling was studied in the groups of rats. Ten minutes after intravenous injection of chylomicron remnants 10.6 +/- 0.5% (means +/- SEM, n = 8) of the injected [3H]cholesterol and 7.6 +/- 0.4% of the [14C]linoleic acid were found per 1 g liver in the portacaval-shunted rats; the corresponding figures in the sham-operated group (n = 8) were 6.4 +/- 0.4 and 4.9 +/- 0.3, respectively (p less than 0.001 for both 3H and 14C). Thus, despite a greater than 40% reduction of liver weight induced by the shunting procedure, the total liver uptake of chylomicron remnants was not significantly decreased. The uptake of chylomicron lipids per unit liver weight was normal in the atrophic livers of portacaval-shunted rats also when very large loads of chyle were administered.

Animals↗
PubMed1984

[Experiences with endoscopic placed endoprosthesis in stenosing malignancies of the esophagus and cardia].

Seventy-five patients with obstructing esophagogastric malignancies were palliatively treated by fiberendoscopic insertion of prosthetic tubes. The indications for endoscopic intubation are discussed, the procedure is described. The mortality rate was 6.6%. Complications were obstructions due to food impaction (10), tumor overgrowth (5) or mucosa folds (3), reflux and aspiration (7), dislocation of the prosthesis (5), perforation (1) and desintegration of the tube (1). Normal swallowing was restored in 98% and in general, there was a marked improvement in the quality of life. In summary, we conclude palliative fiberendoscopic intubation as the best existing procedure in patients with an incurable obstructing esophagogastric neoplasm.

Aged↗
PubMed1984

[Hyperthyroidism in thyroid cancer. Retrospective study of 53 cases].

Hyperthyroidism was diagnosed in 53 of 273 thyroid carcinoma patients at the time of their first examination (between 1971 and 1983). This corresponds to 19.5% of these mainly well-differentiated thyroid cancers. In 24 (45%) patients the hyperthyroidism and the thyroid carcinoma were two separate distinct illnesses: of 4 patients with Graves' disease (1.5% of 273), 2 had been operated because of an additional solitary cold nodule, and in the other 2 an occult carcinoma was found intraoperatively. Twenty patients of this group had Plummer's disease: there was a malignant cold nodule within a multinodular goiter with multifocal functional autonomy (MFA)(n = 14) or a carcinoma located near the solitary hot nodule of the toxic adenoma (TA)(n = 6). In these patients the distribution of the different histologies was about the same as in other thyroid cancer patients from this region. The remaining 29 patients (55%) had Plummer's disease, 28 with the classical finding of a solitary toxic adenoma, in which the hot nodule and the malignant tumor were identical. It was possible to confirm this identity histologically in 10 out of 24 cases, retrospectively. Eight of these patients had metastases with radioiodine uptake at the time of the first examination. Of the tumors in this group, 24 were follicular and 5 papillary carcinomas. As a rough estimate, one malignant, scintigraphically hot tumor is found for every 50 benign toxic adenomas. Criteria for the differentiation are: recent growth of the nodule, tumor size of greater than 5 cm diameter or greater than 35 g and an elevated T3-level of less than 0.06 nmol/l/g tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1983

A simplified method for total arterialization of the liver in rats.

Total arterialization of the liver appears to be a promising clinical method in preventing or reducing encephalopathy after shunting. A new technique for achieving total arterialization of the liver in rats in described and illustrated. This method is fast, simple, and associated with a high patency rate, even in the hands of relatively inexperienced microsurgeons. It can be recommended as an experimental model for additional studies in rats.

Animals↗