[Coordination of disaster medicine].
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Biomedical subjects
Publications and source records attributed to K Jessen.
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After a reference to the introduction of the obligitory verification of tonometers in the Federal Republic of Germany in 1970 the legal basis for the verification as well as for the type approval of tonometers are described. A delivery is given of all tonometers which have been approved for verification in the Federal Republic of Germany since 1970.
The histopathology and clinical presentation of 19 cases of primary gastrointestinal lymphoma is described. Our patients are similar to others in the Middle East but have a lower incidence of diarrhoea and malabsorption. All revealed a widespread chronic inflammatory background. Four patients with primary gastric lymphoma had endoscopic biopsies from the duodenum; these biopsies were completely free from tumour but showed a moderate to severe diffuse lymphoplasmacytic infiltrate. Electron microscopy shows that tumour cells penetrate basement membranes and invade the epithelium which becomes thin and attenuated. Substances which inhibit lymphocyte tropism might be useful in preventing intestinal ulceration. The MALT concept has been found useful in classification of the tumours. Two patients with unusual mesenteric node histology are described and it is thought that the appearances may indicate a substantial capacity for differentiation in the group of tumours.
Keratokyphosis is a procedure of lamellar refractive corneal surgery in which corneal tissue does not have to be frozen. Corneal lamellae of 30 pig eyes were separated with either the Berlin microkeratome developed for keratokyphosis or the Barraquer microkeratome. The layer thickness was measured within the optical area at 25 measuring points 0.2-mm apart using the Universal Measuring Microscope. Corneal lamellae separated parallel to the surface by means of the Berlin microkeratome showed layer-thickness differences of 0.008 +/- 0.028 mm in the optical zone between the beginning and end of the incision. When using a convex applanation surface in the microkeratome with an optical zone of 5 mm and a vertex of 0.22, 0.2, and 0.15 mm, the vertex of the central part of the optical zone in the corneal disc attained a value of 0.114 +/- 0.018 mm instead of 0.114 mm (100%), 0.075 +/- 0.015 mm instead of 0.105 mm (72%), and 0.076 +/- 0.014 mm instead of 0.080 mm (84%) (mean +/- standard deviation [SD]). When using a concave applanation surface with the same vertex, it attained 0.076 +/- 0.020 mm (67%), 0.075 +/- 0.019 mm (72%), and 0.067 +/- 0.027 mm (84%). The measured vertex of the corneal lamellae was shifted up to 0.8 +/- 0.5 mm in the feed direction of the microkeratome, probably due to the frictional forces acting on the blade during the cutting process. After separation of the lamellae, the cut surface of the eye was measured planimetrically.(ABSTRACT TRUNCATED AT 250 WORDS)
The Danish helicopter rescue service in its present form was founded in 1966. The use of the Sikorsky (S-61) helicopter has generally been satisfactory. In 1973, the crew was supplemented by an aerospace-medically-educated and helicopter-trained physician. From 1973 to 1989 there were 5,733 missions, of which direct medical intervention occurred in 2075 cases; 94% of the missions supported the civilian public health service in Denmark. Many sorts of diseases and injuries have been seen, but especially trauma, abdominal, and cardiopulmonary diseases. Experience has shown the benefit of having a designated physician, specially trained in aerospace medicine and acute medicine/surgery, as a permanent crewmember.
Twelve patients with primary small intestinal lymphoma were followed prospectively for 3 years. Endoscopic abnormalities were diagnostic of lymphoma in all cases where the duodenum was involved (83%). In three cases (25%) the disease extended to the stomach. One patient (8%) had diffuse small cell cleaved and 11 (92%) diffuse large cell lymphoma stages I (8%), II (25%), III (58%) and IV (8%). Nine of them were unresectable and primarily treated with combination chemotherapy; 67% achieved complete remission, 22% partial response and 11% no response. Only one patient relapsed and achieved a second remission. All complete remission patients are currently alive and free of disease at a median follow-up of 36 months. Overall survival for all patients is 58%, and disease-free survival is 50%. No instance of chemotherapy-related bleeding or perforation was seen. Tetracycline was necessary for the treatment of IPSID-associated diarrhea and malabsorption in spite of cytotoxic chemotherapy.
With respect to their diagnostic utility CA 19-9, CEA, AFP and POA were determined in pancreatic secretions and serum of patients suffering from pancreatic cancer (n = 76/55) or chronic pancreatitis (n = 79/45) and of controls (n = 81/42), respectively. While the determination of AFP and POA both in pancreatic secretions and serum does not permit a differential diagnosis, serum CEA (greater than 10 ng/ml) and CA 19-9 (greater than 50 U/ml) levels were indicative of pancreatic cancer in 30% and 83%, respectively, with a rate of false positive results of 5% and 8.5% confined to the chronic pancreatitis patients. A combination of tumor marker analyses, that is, serum CA 19-9 (greater than 50 U/ml) and pancreatic secretion CEA (greater than 70 ng/ml), proved to be positive in 92.9% of tumor patients with a maximum of 10.5% false positives. Likewise, values of serum CA 19-9 (greater than 50 U/ml) and serum CEA (greater than 10 ng/ml) were found in 85.8% of the pancreatic cancer patients with only 8.8% false positives, which were confined to the chronic pancreatitis patients. These results indicate the superiority of multiparametric tumor marker analyses for the diagnosis of pancreatic cancer, especially when including new monoclonal antibody defined tumor markers.
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Using the applanation tonometry of Goldmann (mechanical-optical applanation principle with constant diameter of the applanation circle) as a reference system, a test plan inclusive of the necessary conditions for the clinical control measurements of new tonometer types and guiding values for judging the usefulness of these new developments are described. For calculation of the statistical values a computer program in BASIC system is specified.
The intraocular pressure, the ophthalmic artery pressure, and the episcleral venous pressure increased after changes from sitting to recumbent body position, whereas the subclavian artery pressure remained unchanged or decreased slightly. Changing from recumbent to sitting position was followed by a decrease in IOP, ophthalmic pressure, and subclavian artery pressure. Comparing the last measurement in the first position to the first value after change, it was found that the IOP alters by about 20%, the ophthalmic artery pressure by 15%, and the episcleral venous pressure by 50%. In all series a decrease in subclavian artery pressure was observed during the first 15 min. The mean pressure in the ophthalmic artery diminished in the series that changed from sitting to recumbent position, whereas it increased in the other series during the first 15 min. The episcleral venous pressure increased more than the corresponding IOP after changing to the recumbent position.
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Comparing measurements with Non-Contact-Tonometer and handapplanation tonometer on 462 eyes with normal and elevated intraocular tension are statistically evaluated. The 2-s-limits for normal i.o. pressure at +/- 6.52 mm Hg (+/- 8.6 mbar), for elevated intraocular pressure +/- 13.2 mm Hg (+/- 17.6 mbar). This means less reliability than conventional applanation tonometers or even Schiötz-tonometers. The unability to read the tension when the corneal surface is rough means remarkable disadvantages to clinical use.