PubMed Health⌕ Search

Biomedical subjects

M Gunst

Publications and source records attributed to M Gunst.

5 recordsLinked to original sources
PubMed2000

The point of view of the clinician: a prospective study of the mechanism of accidents and the morphology of tibial and fibular shaft fractures.

In a prospective study of 210 tibial shaft fractures, the accident mechanisms and the resultant fracture morphologies were analyzed. 86 fractures occurred due to indirect impact. The fracture morphology in this group consisted of short and long spiral fractures resulting from rotational injuries complicated by anterior torsion butterfly fragments if the person fell forward, posterior torsion butterfly fragments if they fell backwards and complicated by multiple torsion butterfly fragments if it was a high velocity injury. 124 fractures occurred due to direct impact. The fracture morphology in this group consisted of transverse, oblique segmental or crush fractures, complicated by one or more butterfly fragments due to bending, the injury depending on whether it was pure, one-point, three-point, or four-point-bending and on additional axial loading and velocity. In the indirect impact group, there were a few soft tissue injuries and fibular fractures at a different level to the tibial fracture. In the direct group, a large number of soft tissue injuries and fibular fractures at the level of impact were found.

Accidents↗
PubMed1989

[Fornix rupture. A contribution to differential acute abdomen diagnosis].

The diffuse retroperitoneal extravasation of urine most often secondary to an ureteric calculus may present as a surgical emergency with localized or general abdominal symptoms. As the clinical signs are intriguing, history and a blurred psoas shadow on the plain film of the abdomen are the best guides to the right diagnosis definitely confirmed by an intravenous urography. Management usually is conservative and the recovery most often uneventful.

Abdomen, Acute↗
PubMed1983

Effects of ortho-iodo sodium benzoate on acute myocardial ischemia, hemodynamic function, and infarct size after coronary artery occlusion in dogs.

Ortho-iodo sodium benzoate (OISB) decreases the affinity of blood for oxygen, thus enhancing potential tissue oxygen delivery. To test the hypothesis that a change in oxygen affinity would ameliorate regional myocardial ischemic injury resulting from occlusion of the left anterior descending (LAD) coronary artery, experiments were carried out in 55 anesthetized dogs which received an intravenous infusion of OISB. In Protocol I studies (n = 9), preocclusion intravenous infusion of OISB (500 mg/kg) reduced epicardial S-T segment elevation 15 minutes after coronary occlusion, while a similar volume of normal saline solution did not affect this index of ischemic damage. In Protocol II experiments, 34 dogs were randomized to either an OISB or saline group, after which the LAD was ligated, the chest closed, and the animal allowed to recover from anesthesia. Myocardial infarction (MI) size was assessed after the animal died or was killed 8 to 24 hours later, and was found to be 29% smaller in dogs receiving OISB. In 6 dogs, blood P50 (the partial oxygen pressure at which hemoglobin is 50% saturated with oxygen) was increased by OISB infusion, confirming that its administration effected a rightward shift in the oxyhemoglobin dissociation curve. Protocol III studies assessed the effects of OISB on cardiac hemodynamic function and acute myocardial ischemic damage when infusion was begun 15 minutes after LAD occlusion: average epicardial S-T segment elevation was not altered by saline solution, but decreased when OISB was infused during the last 15 minutes of myocardial ischemia. Reductions in heart rate, left ventricular dP/dt, and cardiac output were observed in 7 dogs during OISB infusion, but there were no changes in these measurements during coronary occlusion in 5 dogs receiving a constant infusion of saline solution. There were no changes in regional myocardial blood flow (microsphere technique) to either ischemic or nonischemic zones in either the saline control or OISB treatment groups. Thus, both acute myocardial ischemic injury (assessed by epicardial electrocardiographic mapping) and ultimate MI size are reduced when OISB is infused before experimental coronary artery occlusion. OISB also reduces myocardial ischemic injury when its administration is begun 15 minutes after coronary occlusion, while effecting decreases in heart rate, left ventricular contractility, and cardiac output.

Animals↗
PubMed1981

[Pheochromocytoma].

We present a series of 11 patients with pheochromozytomas. We recommend screening for a catecholamine-producing tumor for every patient with hypertension. Screening and diagnosis are based on demonstration of an increased catecholamine production or -excretion. In our laboratory determination of urinary vanillin-mandelic-acid proved to be quite accurate. As 6 of our 11 pheochromozytomas were found extra-adrenally preoperative evaluation with regard to localization of these tumors appears as sound practice. According to our experience no single examination can be favoured. Therefore localization of these tumors is best accomplished by multiple diagnostic procedures. Morbidity and mortality depend directly upon preoperative recognition of a catecholamine-producing tumor and thus according management. We were able to gather data on 8 of 10 surviving patients 4--13 years postoperatively. Six of these are normotensive without any treatment.

Adolescent↗