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M Kottow

Publications and source records attributed to M Kottow.

At least 19 recordsLinked to original sources
PubMed1993

[Changes in ethical attitudes during medical studies].

The aim of this work was to explore the attitude changes towards ethico-medical issues in medical students as they went through medical school. A personal standardized questionnaire containing 14 closed and direct questions was applied to 27 freshmen, 38 interns and 14 post graduates. The most outstanding differences in ethical attitudes occurred between first year students and the older groups. The younger students adhered to ethical principles, valued justice towards patients and moral integrity in physicians. The older students and post graduates emphasized the professional role of physicians and preferred institutional ethical regulations over public control. They also considered more valuable therapeutic efficiency and paternal attitudes towards patients as well as social prestige and economical rewards. We conclude that there is a progressive erosion of humanistic principles along the medical studies, that are substituted by a model of professional competence, social recognition and internal ethical control.

Attitude of Health Personnel↗
PubMed1983

[Papilloarterial ischemia].

Papilloarterial ischemia (PI) is the designation for a clinical picture characterized by circulatory insufficiency of the optic disk and the retinal arteries. Optic disk ischemia leads to visual loss, altitudinal field defects, pale papilledema and fluorescein angiographic filling defects of the disk capillaries. Retinal ischemia manifests itself by ophthalmoscopic and angiographic signs of caliber variations, focal constrictions or even occlusions of peripapillary retinal arteries. PI occurs more frequently in young females, in whom an inflammatory origin must be suspected in view of the angiographic staining of arterial walls, elevated sedimentation rates and clinical remission with systemic corticosteroids. Medical check-ups rarely relate PI convincingly with systemic disease, except in the elderly, where arterial hypertension or arteriosclerosis are often seen, and where the condition may improve after medical treatment of the cardiovascular status. PI was first described by the author in 1981; 10 cases are described in this paper and nosologically differentiated from other diseases of the optic disk and the retina.

Aged↗
PubMed1983

Medical ethics: who decides what?

The FME symposium on teaching medical ethics takes up the issue of competence and responsibility in matters concerning bioethics (1). Foreseeably, the medical participants argue that physicians are prepared, or can be easily prepared, to handle all relevant aspects of medical ethics. The contrary position is sustained by the philosophically trained participants, who believe that physicians do not, in fact cannot, sufficiently manage medico-ethical problems. This paper sees a role for both parties. Medical ethicists should properly be involved in medical education and in analytical and systematic study of medical ethics. They should not generally be involved in clinical medico-moral decision-making, which is properly the realm of patient and (ethically competent) doctor.

Bioethics↗
PubMed1980

Peripheral retinal degenerations and breaks.

One-hundred-three patients referred for evaluation of peripheral retinal lesions were reviewed; 56 eyes had peripheral degenerations without breaks, 62 eyes had atrophic holes, and 88 eyes presented retinal tears. Peripheral degenerations of the snail-track and typical lattice-like types occurred with reasonable uniformity throughout the periphery and were seen symmetrically in both eyes. Atrophic retinal holes frequently occurred within these degenerative areas. Peripheral degeneration with or without holes were ofter seen in young myopes and occurred mostly without giving rise to symptoms. Retinal tears occurred in older, predominantly hyperopic or emmetropic subjects, and usually presented with symptoms of acute entopsiae and/or photopsiae. The tears presented mainly in the upper temporal quadrants and were only associated with lattice degenerations of the ipsi or contralateral eye in one-third of cases. It was concluded that the population suffering from retinal tears only partially overlaps with that presenting with lattice degeneration of the retinal periphery, and that it is questionable if a causal link is present between these two conditions. As a result the raison d'être of prophylaxis can be called into question.

Adult↗
PubMed1980

[Acute multifocal placoid pigment epitheliitis of the retina (author's transl)].

Two cases of acute, multifocal, placoid, pigment epitheliitis, are described. In acute multifocal placoid pigment epitheliopathy (AMPPE) visual acuity falls precipitously, accompanied by whitish, confluent, blurry lesions of the posterior pole retina. On fluorescein angiography, these lesions characteristically block the normal choroidal flush. Visual acuity improves over a period of months, in spite of heavy residual chorioretinal scarring. In acute pigment epitheliitis, visual acuity also drops suddenly, but the objective findings are limited to slight depigmentation of the foveal area, especially visible in early stages of fluorescein angiography. Vision improves over a period of weeks. These diseases of the retinal pigment epithelium must be correctly diagnosed, since their visual prognosis is far better than that of central chorioretinitis or other macular diseases.

Acute Disease↗
PubMed1980

[Differential diagnosis of blurred optic disks by fluorescein angiography (author's transl)].

Fluorescein angiography has been underrated as an exploratory tool in the diagnosis of blurred optic disks. The ten cases presented here had blurred disks of diverse etiology; fluorescein angiography helped in the differential diagnosis and therapeutic approach. Irrigation of the disk, type, magnitude and location of dye leakage, as well as objectivation of peripapillary and retinal vascular characteristics all help to explain the pathogenic mechanisms leading to different types of optic disk edema. Although it is known tha papilledema due to increased intracranial pressure can not be differentiated from locally caused blurring of disks, there remain a number of mechanical, ischemic and inflammatory conditions that can be diagnosed by means of fluorescein angiography. Thus, optic neuritis, ischemic optic neuropathy, papillovasculitis and juxtapapillary chorioretinitis are some of the diseases in which chorioretinitis are some of the diseases in which angiography may help in differential diagnosis and lead to adequate therapeutic approaches.

Adolescent↗
PubMed1979

[Vascular anastomoses at the posterior pole of the eye (author's transl)].

Anastomoses between vessels of the fundus may occur as congenital malformations or secondary to vascular diseases affecting the eye. Congenital anastomoses can be of the racemose hemangioma type, with severe malformation of the retinal vessels, ocular complications, and neurologic manifestations, or as simple A-V shunts with visual impairment but limited tendency to show other ocular or neurologic involvement. These anastomoses must be distinguished from other vascular malformations like telangiectasis (Leber, Coats) or the angiomatous lesions of von Hippel's disease. Secondary anastomoses may be confined to the retinal vessels or involve chorioretinal connections. Retinal anastomoses occur in vascular disorders like retinal vein occlusions, diabetes, periphlebitis and hemoglobinopathies. They are often amenable to treatment by light coagulation. Chorioretinal anastomoses occur whenever Bruch's membrane is destroyed by traumatic, inflammatory, degenerative or physical (light coagulation) influences. Light coagulation may be the appropriate treatment, although complications are not rare.

Adolescent↗
PubMed1978

Anterior segment reactions after experimental trauma to rabbit eyes.

The effect of experimentally induced uniocular trauma was investigated in the adult albino rabbit by means of iris fluorescein angiography. Paracentesis, blunt trauma, occlusion of all four vortex veins or of the two long posterior ciliary arteries, or local instillation of nitrogen mustard, were performed in a number of animals, some of which received systemic aspirin preoperatively. Iris angiograms of the injured and the contralateral eye were performed immediately after the traumatic insult. The injured eye always showed an increased permeability to fluorescein. Except for paracentesis, the ipsilateral response often included ischemia of the iris. The contralateral eye always showed an increase in fluorescein permeability into the aqueous. In some cases, sector ischemia of the contralateral iris was seen. Aspirin inhibited some ipsilateral responses but had no effect on the consensual reactions. It is concluded that ipsilateral trauma almost invariably causes a contralateral reaction in the rabbit eye, which is more severe if the injury creates ischemia of the iris. Since these reactions are inefficiently blocked by aspirin, they are not prostaglandin-mediated. The interocular pathway involved may be neural or vascular in nature.

Animals↗
PubMed1977

Fluorescein angiographic behaviour of iris masses.

28 cysts and tumours involving the iris are studied by means of fluorescein angiography of the anterior segment. Iris cysts usually showed abnormally dilated and tortuous feeding vessels, but only exceptionally did they leak fluorescein. Inflammatory masses presented massive dye leakage from both tumour-involved and distant iris vessels. Benign stromal masses showed normal angiograms or dye leakage limited to the tumour site. Benign pigmented lesions were angiographically always silent, whereas malignant melanomata showed moderate to heavy leakage from the tumour. This leakage occasionally extended to apparently uninvolved iris areas, specially to the pupillary margin. Exceptionally, a malignant melanoma of the iris was angiographically silent. It is concluded that iris angiography is a useful but not error-free method for the evaluation of iris masses.

Adolescent↗
PubMed1975

Provoked iris ischaemia in the rabbit. II. Histochemical localization of sodium fluorescein.

The distribution of injected sodium fluorescein in the iris and ciliary body of albino rabbits was studied in normal animals and in animals subjected to different surgical procedures. The study was performed with two techniques: whole-mount preparations and the paraffin-section method on freeze-dried eyes. Fluorescein distribution showed marked changes after surgical procedures as a result of reduced blood perfusion. In normal iris vessels no penetration of fluorescein was observed. The permeability barrier was impaired if there were ischaemic conditions in the anterior segment. The results were compared with clinical and iris angiographic studies.

Animals↗
PubMed1975

Provoked iris ischaemia in the rabbit. I. Clinical and histopathological examinations.

Various surgical procedures were performed on albino rabbits, which impaired anterior segment blood circulation. Our early and late clinical observations showed a consequent development of anterior-segment ischaemia into anterior-segment necrosis. The significance of different surgical procedures for resulting complications is discussed. Histopathological observations showed ischaemic changes in the anterior segment: iris and ciliary body atrophy, cataract formation, rubeosis iridis. Even though changes in the anterior segment were not observed on biomicroscopic examination in the cases with ligation of one LPCA, histological studies revealed different degrees of sectoral iris atrophy with minor rubeosis.

Animals↗
PubMed1975

Iris angiography in cystoid macular edema after cataract extraction.

Iris angiography was performed on eight patients (nine eyes), who had cystoid macular edema postcataract extraction. The fundus fluorescein angiographies showed typical star-shaped, multiloculated staining of the macular area. The iris angiographies demonstrated moderate to massive leakage of dye from the iris, and possibly leakage of ciliary body vessels into the anterior chamber, thus evidencing the until now suspected but undocumented fact that fluorescein leakage is not restricted to the fundus vessels. These data tend to support the idea that this type of macular edema is due to a vascular abnormality, and not to altered vitreous mechanics.

Aged↗