Biomedical subjects

K Schunk

Publications and source records attributed to K Schunk.

52 records · Page 3Linked to original sources

PubMed1993

[The safety belt: effects on injury patterns of automobile passengers].

Since 1984 the law concerning safety belts has been implemented; this paper deals with the findings in 386 victims of motor accidents who were x-rayed between 1981 and 1989. Minor injuries have been ignored. The number of passengers wearing belts increased by 30% after 1984. The number of passenger injuries did not decrease. Injuries directly caused by the belts included a small number of fractures of clavicles, the sternum and ribs and one pelvic fracture, one serious abdominal injury with tearing of the mesenteric artery and one ruptured spleen. An indirect result of wearing seat belts was a marked increase in cervical whiplash injuries and some increase in thoracic vertebral fractures. None of the belt induced injuries proved fatal. Amongst those using seat belts there was a significantly lower fatality rate and injuries causing prolonged disability. In particular, using seat belts, serious injuries to the skull and brain were reduced by 80%. Similarly injuries to the abdomen, the odontoid, pelvis and hip joint were greatly reduced. The advantages of wearing a seat belt greatly outweigh the disadvantages.

Accidents, Traffic↗

PubMed1993

[Injuries of the thoracic skeleton].

Injuries of the thoracic skeleton are an important indicator of other, relevant traumatic changes after a polytrauma. Most fractures occur in the ribs, followed by fractures of the clavicle, the scapula and the sternum. Because of their high kinetic energy, car accidents are the main reason for thoracic fractures. The basic radiologic tool is the a.p. projection of the thorax in supine position; in addition, other conventional x-ray examinations or computed tomography are performed. Most thoracic fractures are treated conservatively, only in few cases (instability of the thorax, risk of pseudoarthrosis, incongruence of joint surfaces) surgical procedures are used.

Clavicle↗

PubMed1992

[Intestinal contrasting in abdominal computed tomography].

In 56 patients undergoing abdominal CT the gastrointestinal tract was defined by negative contrast instead of the conventional positive contrast from an iodine containing contrast medium. The contrast material was a 2 1/2% mannitol solution and was used for filling the rectum. Filling of the gastrointestinal tract was of similar quality to that obtained with positive contrast media. The number of artifacts due to high contrast boundaries was slightly greater with the negative contrast than it would have been with positive contrast. Differentiation of the gastrointestinal tract from other abdominal organs was equally good for both methods. The negative contrast method was poor in diagnosing cystic tumours but proved much better than positive contrast for evaluating the wall of the gastrointestinal tract.

Adolescent↗

PubMed1992

[The clinical relevance of sonography in intensive care units].

336 sonographic examinations were performed with a portable ultrasound scanner on 217 patients in intensive-care units. In 302/336 (90%) cases, the region of clinical interest could be demonstrated completely or mostly by ultrasound. The clinical question could be answered by ultrasound in 270/310 (87%) cases partially. In 17/210 (5%) cases the clinical question could not be answered by ultrasound, in 26/336 (8%) cases there was no clinical question at all. 211/336 (63%) sonographic examinations were retrospectively classified as clinically relevant. A large part of clinically relevant examinations was found at the sonographic evaluation of the liver (100%), of the pericardium (96%), of the kidneys (89%), of the blood vessels (80%), of the gallbladder (78%), of the pleural space (76%) and on sonographic evaluation of patients with blunt abdominal trauma (91%). A relatively small part of clinically relevant examinations was found at sonographic evaluation of circumscribed or free intraabdominal fluid (59% resp. 57%), of cholestasis (53%) and of suspected neoplasm (11%). Sonographic examinations of the pancreas (40%) or the spleen (33%) and examinations without any clinical question (50%) also showed little clinical relevance.

Critical Care↗

PubMed1991

[Intestinal contrast imaging in abdominal computed tomography: water or contrast medium?].

The suitability of water as an oral or rectal contrast medium for abdominal CT was studied in 56 patients and compared with an iodine-containing water-soluble contrast medium (ioxital amino acid). In some cases it was impossible to differentiate gastrointestinal structures from extraluminal fluid collections (cystic tumours, ascites, abscesses) and there was poor filling of distal small bowel and colon. The routine use of water can, therefore, not be recommended. In some cases, however, water can result in improved image quality by reducing artifacts and improving the demonstration of the mucosa.

Adolescent↗

PubMed1990

[Local fibrinolysis in renal artery occlusion].

The indications and technique of local fibrinolysis therapy of acute renal artery occlusions are discussed in relation to four patients. Because of the short period for which ischaemia is tolerated by the kidney, the result of treatment depends largely on the time interval between occlusion and the beginning of treatment. Partial perfusion of the renal artery was obtained in three patients. Since the "ischaemia time" of the kidneys had been exceeded, it was not possible to obtain complete restitution of renal function in any of these patients.

Adult↗

PubMed1990

[Clinical experience with the Kensey catheter system--complications and results].

Fifteen procedures have been carried out in 14 patients using the Kensey rotation angioplasty system. Sixteen occlusions of the superficial femoral artery, with an average length of 10.2 cm (3 to 24 cm) and one artery with multiple stenoses were treated. The following results were obtained: creation of a lumen, with subsequent balloon dilatation in eight out of fifteen procedures; in two patients the vessels were occluded shortly after the procedure, due to complications (one obstructive plaque and one haematoma); five perforations, three dissections and one peripheral embolus. The total complication rate was 11 out of 15 cases, clinical improvement was obtained in six out of 15 cases.

Aged↗

PubMed1990

[Computerized tomography findings in hormonally inactive adrenal gland tumors].

CT examinations of 6 years served as basis for the incidence of hormonally inactive space-occupying masses at the adrenal. Of a total of 25,000 patients, 313 (1.3%) suffered from disease of the adrenals, and of these 261 patients had a hormonally inactive adrenal tumour. Adenomas were the most frequent space-occupying growths (101 patients), followed by metastases of the adrenals (77 patients), whereas adrenal carcinomas (4 patients), myelolipomas (3 patients), ganglioneuromas (3 patients) adrenal cysts (3 patients) and adrenal haemorrhages (2 patients) were rare findings.

Adenoma↗

PubMed1989

[The supinator fat pad in fractures of the elbow joint].

The position of the supinator fat pad is regarded as a valuable sign in fractures of the elbow. In our patients the pad was visible in 277 out of 337 cases (82%). The sign was positive in only 27 out of 55 proximal fractures of the radius (sensitivity 0.49). There was no correlation between the severity of the fracture and the sign. There was marked variation in the distance between the pad and the radius, depending on age, build and projection. Our results indicate that the sign is not suitable for the diagnosis of fracture of the elbow.

Adipose Tissue↗

PubMed1989

[Pseudarthrosis of the scaphoid: frequency, pathogenesis and course].

Eight-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixty-seven were present at the first examination and 16 pseudoarthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion.

Adult↗

PubMed1989

[Traumatology and diagnosis of scaphoid fracture].

In 9 years, 1,104 patients had one or more roentgenological studies of the scaphoid; 252 fractures of the scaphoid were found. The most reported traumatic mechanism was a fall on the extended wrist. The form of fracture most seen was transverse fracture of the scaphoid; most of the fractures were found in the middle third of the scaphoid. The primary radiodiagnostic procedure should contain pictures of the wrist in two planes and four special pictures of the scaphoid. The "fat-pad sign" seems to be an unreliable indicator of fracture, but nearly two-thirds of fractures of the scaphoid showed a swelling of the soft tissues in the X-ray picture.

Accidental Falls↗

PubMed1988

[Fractures of the clavicle: classification, diagnosis, therapy].

Clavicular fracture is one of the most frequent skeletal lesions. In most cases the median third of the clavicula is affected (this is due to the peculiar biomechanical structure). Accompanying lesions and complications of clavicular fractures are rare. A total of 13 x-ray diagnostic techniques are described for clavicular fractures. X-ray film should, as a matter of principle, always be taken in two planes. Definitely the major part of clavicular fractures are treated conservatively (rucksack dressing), whereas surgery is reserved for few and strictly defined indications.

Clavicle↗

PubMed1988

[Kidney metastases in computerized tomography].

The CT image of renal metastases is described for 29 patients. The most frequent primary tumour was the bronchial carcinoma, followed by melanoma and cervical carcinoma. In 12 of 29 patients (41%) the metastases occurred bilaterally, in 17 (59%) unilaterally. 9/29 (31%) had solitary, 20/29 (69%) multiple renal metastases. In 19 (66%) these had a size of up to 3 cm and were situated intraparenchymally. Space-occupying growths up to a size of 10 cm which grew exophytically were seen in melanoma and carcinoma of the larynx and chorion. In the plain CT the metastases presented isodense or slightly hypodense in 25 of 27 examinations (93%). After application of contrast medium all presented hypodense with the exception of metastases of a chorionic carcinoma.

Humans↗

PubMed1987

[Sonographic study of Béclard's nucleus as a method of determining the maturity of the newborn infant].

The size of the distal femoral epiphysis is an important criterion for determining the maturity of a neonate. The distal femoral epiphysis has been demonstrated and measured sonographically in two planes during the first month of life in 174 neonates. The sum of the epiphyseal diameters has been related to gestational age. The average sum of the sagittal and transverse diameter of both distal femoral epiphysis was 10.9 mm in the 35th week (standard deviation 7.6 mm) and increases to 38.4 mm at 43 weeks (standard deviation 6.3 mm). Linear regression of the mean values of the sum of the epiphyseal diameters y against gestational age x shows a correlation coefficient of 0.95 (regression gradient y = -117.7 + 3.7 x). Sonographic demonstration and measurements of the distal femoral epiphyses is a valid alternative to radiological examination.

Epiphyses↗

PubMed1987

[Cavernous hemangioma of the mediastinum].

After presenting an own case of a cavernous hemangioma of the mediastinum, the clinical pattern, differential diagnosis, diagnostic procedure (computed tomography), and therapy of this rare tumor form are described.

Diagnosis, Differential↗

PubMed1984

Familial reflex myoclonus in Labrador Retrievers.

Three 6-week-old male purebred yellow Labrador Retrievers were presented with intermittent stimulus-sensitive contractions of the appendicular and axial muscles. Five littermates were normal, although the grandsire of the affected litter had sired 2 previous litters containing similarly affected pup. Although alert and responsive, the affected dogs appeared decerebrate with extensor rigidity and opisthotonus during handling. During severe episodes, respiratory distress was observed. Generalized contractions were initiated by voluntary movements, but at rest the muscles relaxed. Neurologic deficits were not detected, although efforts to elicit segmental reflexes, assess muscle tone, or assist walking resulted in generalized stiffness. Electromyograms from the semitendinous muscles (musculi semitendinosus) had increased motor unit amplitude (up to 5,000 microV) with polyphasic action potentials. There were no myotonic discharges. A reduced interference pattern was seen. A single tactile stimuli of the distal limb resulted in 3 responses, each lasting less than or equal to 10 ms at latencies of 0 to 12 ms, 20 to 30 ms, and 35 to 40 ms, characteristic for reflex myoclonus. The motor nerve conduction velocities were normal for age (32 to 35 ms). Age-matched control dogs had motor unit action potentials of 100 to 200 microV and single compound motor unit discharges to single tactile stimuli. Therapeutic trials with diazepam and clonazepam produced minimal effects on the muscle contractions. Values of urinalyses, complete blood cell counts, and serum chemistries were within normal limits. Frozen muscle section biopsy findings, including enzyme histochemical assessment of muscle fiber types, were normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗