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Biomedical subjects

P Munk

Publications and source records attributed to P Munk.

At least 19 recordsLinked to original sources
PubMed2003

Alagille syndrome: case report with bilateral radio-ulnar synostosis and a literature review.

We report a case of Alagille syndrome (arteriohepatic dysplasia) with the unusual radiological abnormality of synostosis of the proximal portions of the radius and ulna bilaterally, a manifestation which, to our knowledge, has not previously been described in a specific patient in the English language literature. We also describe additional features of the syndrome in the same patient and review the published literature on radiological manifestations of this condition.

Adult↗
PubMed2003

Avulsion fracture of the anterior superior iliac spine following apophysitis.

The case of an avulsion fracture occurring in an 18 year old athlete after repeated running is presented. The fracture involved the tensor fascia lata muscle and the external oblique abdominal muscle. It was treated by open reduction and internal fixation with two screws. The patient returned to full training, including long distance running, only four weeks after the operation.

Adolescent↗
PubMed2002

Electroencephalography in primary diagnosis of mild head trauma.

OBJECTIVE: the aim of this study was to compare the clinical examination and EEG examination regarding their relevance in diagnosing cerebral function changes in early head trauma. METHODS: ninety four male patients who suffered from mild head trauma (GCS 13-15) were assigned into two groups. The first group fulfilled at least one sign of cerebral concussion (amnesia, anisocoria, changes of vigilance or vegetative symptoms such as vomiting), the second group did not. EEG examination was performed in both groups. RESULTS: in the first group, more pathologic EEG records were found. These findings showed a statistical significance (p = 0.019). The concussion group showed more focal changes (p = 0.283) and specific changes (p = 0.317), but they were statistically not significant. CONCLUSION: EEG can be used for detecting pathologic unspecific alterations with a high accuracy, but is not useful in specifying the findings for an exact diagnosis.

Adolescent↗
PubMed2000

[Lesions of peripheral structures of cadaver fingers caused by Kirschner wires].

Fractures of the hand skeleton are common injuries. These are or are associated with phalangeal fractures. Kirschner wires can be used for osteosynthesis, but can cause lesions of peripheral finger structures. The aim of our study was to record the incidence of lesions in peripheral structures of the fingers caused by retrograde crossed inserted Kirschner wires of 1.0, 1.25, 1.4 and 1.6 mm diameter into the middle and proximal phalanges of the long fingers and the proximal phalanx of the thumb of 120 fresh cadaver hands. We found an increase of insertion attempt frequency and an increasing number of lesions with increasing Kirschner wire diameter. Because of these findings Kirschner wires of 1.0 or 1.25 mm diameter should be preferred to prevent the peripheral functional finger structures.

Bone Wires↗
PubMed2000

A new approach for the estimation of the axial velocity using ultrasound.

The most used estimation method for calculating the blood velocity in commercial scanners is the autocorrelation approach. The calculation of the mean velocity used in this method depends on the center frequency of the interacting ultrasound pulse which downshifts as a function of depth, introducing a bias. A new velocity estimator for the mean axial velocity is presented. The estimation principle is based on the 2D Fourier transform and the Radon transform. The input data are a sequence of RF data forming a 2D data input, one column for each pulse emission. A 2D segment is selected for a specific depth. This data segment is first transformed by a 2D Fourier transform, and the result is then transformed by a Radon transform. The center of gravity for the angles of the lines intersecting the origin of the R-theta coordinate system in the Radon domain gives the mean axial velocity for the data segment. The benefit of this method is an estimate of the mean axial velocity which is independent of the center frequency of the propagating ultrasound pulse. The estimate will only depend on f(s) and f(pr f). Results of the estimation method is presented based on both simple generated RF harmonic data for different signal/noise ratios and simulated acoustic RF responses from a 3D measurement situation with an array transducer and a tube with plug flow. The new method shows improvement with a factor of 1.5-4 on the standard deviation on the estimated mean velocity for the simulated case.

Blood Flow Velocity↗
PubMed1999

[Smoking intervention among hospital staff at the H:S Bispebjerg Hospital. Toward a non-smoking hospital--short-term results].

As part of aiming towards a non-smoking hospital environment, staff at a Copenhagen university hospital were offered participation in a differentiated smoking cessation programme. This consisted of lectures, group therapy, follow-up visits and individually tailored nicotine replacement therapy free-of-charge for six weeks. Three hundred and seventy-four employees started the programme, with 353 continuing for the full six weeks. They were moderately nicotine dependent with a Fagerström score of 5 (0-10). Almost all smoked daily and smoked at work, with 87% having a CO measurement above 5 at the first visit. At six weeks follow-up 209 (59%) were still not smoking and a further seven (2%) had reduced their tobacco consumption substantially. The remainder had started smoking again. Only 10% had a CO measurement > 5 at the end of the study. In conclusion, a combination of theoretical education, individual follow-up visits and nicotine replacement therapy is useful and worthwhile in the effort to support hospital staff in smoking cessation.

Adolescent↗
PubMed1999

[Rupture of the pes anserinus superficialis and partial rupture of the patellar ligament. Rare concomitant injures in complex knee injuries].

We present a rare case of combined knee joint lesions in a 25 year old patient. Besides the commonly reported injuries of the knee joint due to directly applied valgus force, forceful quadriceps muscle contraction, external rotation at flexed knee causing combined lesions such as rupture of the anterior cruciate ligament, rupture of the posterior cruciate ligament and rupture of the medial collateral ligament, a rare combination of the above mentioned lesions and a rupture of the lateral meniscus, an osteochondral fracture of the lateral femur condylus, a rupture of the medial patellofemoral retinacula as well as a complete rupture of the superficial pes anserinus and a partial rupture of the patellar ligament was encountered.

Adult↗
PubMed1998

Self-reported prescribing of antibiotics for children with undifferentiated acute respiratory tract infections with cough.

BACKGROUND: Physicians are often called on to manage children with acute respiratory tract infections with cough when the clinical presentation may not allow a differentiation between viral and bacterial etiology. To develop guidelines for appropriate antibiotic use, it is necessary to understand the present prescribing patterns of physicians who manage children presenting with such an undifferentiated acute respiratory tract infection with cough (UARTIC). OBJECTIVES: To determine the variability of self-reported prescribing habits for antibiotics for children with UARTIC. METHODS: In this cross-sectional survey by a modified Dillman's Total Design Method, a mail-out questionnaire was administered to a random sample of 181 primary care family physicians and pediatricians (Toronto, Ontario, Canada) to assess perceptions of their own antibiotic-prescribing habit. RESULTS: Completed questionnaires were received from 136 (75%) eligible physicians; 32% reported that > 10% of their office visits were for UARTIC. For a 3-day history of UARTIC 24% reported prescribing antibiotics or antibiotics in reserve (i.e. a prescription to be filled if the patient's condition does not improve) always or most times. This increased to 45% when UARTIC had worsened in the 24 h before the office visit (P < 0.001). CONCLUSION: When a pediatric patient presented with UARTIC, antibiotics or antibiotics in reserve were prescribed in the absence of clear indicators of bacterial infection. Research- and evidence-based guidelines are needed to support rational antibiotic use for UARTIC.

Acute Disease↗
PubMed1996

The use of radiologically placed gastrostomy tubes in head and neck cancer patients receiving radiotherapy.

PURPOSE: Patients undergoing radiotherapy to the head and neck area frequently experience radiation reactions that can markedly restrict oral intake, require hospitalization, and occasionally cause treatment interruptions. The Vancouver Cancer Center (VCC) has recently employed radiologically placed gastrostomy tubes (G-tubes) in the management of this problem. A review of the patients on whom this procedure had been performed is the subject of this review. METHODS AND MATERIALS: Thirty-four patients had gastrostomy tubes inserted under radiologic guidance. This group is compared to a control group matched for age, sex, irradiated volume, and radiation dose, who did not have gastrostomy tubes. Patients with gastrostomy tubes were divided into two categories: (a) patients who had tubes inserted in anticipation of severe reactions, and (b) patients who developed severe radiation reactions necessitating nutritional support. RESULTS: The gastrostomy group consisted of 65% males with an average age of 59 years and stage range of II (12%), III (24%), and IV (65%). In both the elective group and the nonelective group, patients maintained their weight at 95 to 97% of the pretreatment weight, at follow-up of 6 weeks and 3 months. This compared with an average weight loss in the control group of 9% at 6 weeks and 12% at 3 months. The length of hospitalization was a mean of 4.9 days in the elective group and 19 days in the nonelective group. Complication were low compared to those documented in the literature, but included two tube migrations, two aspirations, and one gastrointestinal bleed. CONCLUSIONS: We believe that gastrostomy tubes contribute significantly to the management of patients with head and neck cancer, particularly in maintanence of nutrition, and they may decrease the need for hospitalization.

Enteral Nutrition↗
PubMed1993

The role of colour flow Doppler ultrasonography in the investigation of disease in the eye and orbit.

Colour flow Doppler ultrasonography is a relatively new technique in which colour-encoded representations of flowing blood are imposed over a conventional grey-scale ultrasound image. This allows interrogation of a relatively large volume of tissue to determine the presence and direction of blood flow. The waveform tracings are then evaluated by means of conventional Doppler imaging. We demonstrate examples of normal vascular structures in the orbit and describe the application of this technique in the investigation of vascular disease, such as carotid-cavernous fistula and ischemic disease. The technique can also be used to evaluate ocular membranes and masses. Colour flow Doppler imaging promises to be an important advance in ophthalmic ultrasonography.

Blood Flow Velocity↗
PubMed1983

An unusual procedure in performing brachial plexus block.

A new surgical treatment of pseudarthrosis humeri needed specific anesthesiological management. The relevant problems for the anesthesiologist were the following: one year prior to the present admission the patient suffered from a polytrauma with contusio cerebri and had, as a result of prolonged intubation during the following period of intensive therapy, an excessive tracheal stenosis in the subglottic area, however without any clinical signs. For these reasons, general anesthesia did not seem to be practicable and the conventional way of blocking the brachial plexus appeared to be somewhat problematic owing to the postoperative scar tissue in the previously surgically treated region. For these reasons an unusual anesthetic management was chosen: the brachial plexus was anesthetized in the subaxillar region by surgical exposure of the neurovascular bundle. We feel, that the surgical exposure of the brachial plexus as described here is a practicable alternative to the common techniques of blocking the brachial plexus in very special situations.

Adult↗
PubMed1979

Subunit structure of dihydrolipoyl transacetylase component of pyruvate dehydrogenase complex from Escherichia coli.

Limited tryptic digestion of the pyruvate dehydrogenase complex of Escherichia coli or its dihydrolipoyl transacetylase core cleaves the trypsin-sensitive transacetylase subunits into two large fragments, A (lipoyl domain) and D (subunit binding domain). Release of fragments A from the complex does not significantly affect its sedimentation coefficient or its appearance in the electron microscope. Fragment A contains the lipoyl moieties ((3)H-labeled), is acidic with an apparent isoelectric point of about 4.0, has a M(r) of 31,600 as determined by sedimentation equilibrium analysis, and has a swollen or extended structure (f/f(o) = 1.78). Fragment A exhibits anomalous properties, probably due to its acidic nature. It is resistant to staining with Coomassie blue and it migrates on sodium dodecyl sulfate/polyacrylamide gels as if it had a M(r) of 46,000-48,000. Further tryptic digestion converts fragment A into a lipoyl-containing fragment of M(r) 20,000 (fragment B) and eventually into an apparently stable product of estimated M(r) about 10,000 (fragment C). Fragment D has a compact structure of M(r) about 29,600 as determined by sedimentation equilibrium analysis in 6 M guanidinium chloride, and it possesses the intersubunit binding sites of the transacetylase, the binding sites for pyruvate dehydrogenase and dihydrolipoyl dehydrogenase, and the catalytic site for transacetylation. The assemblage of fragments D is responsible for the cube-like appearance of the transacetylase in the electron microscope. High-resolution electron micrographs of the transacetylase show fiber-like extensions, apparently corresponding to tryptic fragment A, surrounding the cube-like core.

Acetyltransferases↗
PubMed1978

[Blood supply of the scaphoid bone of the hand].

For investigation of the vascular supply of the os scaphoideum we produced post mortem injection specimens of hands with latex milk. The estraosseous vessels were prepared macroscopically and microscopically. The intraosseous vascular distribution was represented by cleared specimens (Spalteholz technique). A branch of the arteria radialis or of the ramus dorsalis arteriae radialis enters the dorsal face in the middle and distal third by several foramina nutricia. This artery effects the blood supply almost completely. Other vessels entering the navicular bone are small calibrated and only sometimes demonstrable. The proximal third of the scaphoideum shows no artery entrance.

Aged↗
PubMed1976

Hemoglobin-oxygen affinity in hypophosphatemic rickets.

In 14 patients with simple X-linked hypophosphatemic rickets, 5 were below the third percentile in height and 9 were between the third and twenty-fifth percentile. Although the mean serum inorganic phosphorus level was only 2.01 +/- 0.65 (normal range for all age groups is 3.8 to 6.0 mg/100 ml), both the mean values for red cell 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) were normal at 4.78 +/- 1.23 and 1.02 +/- 0.17 mumol/ml of red blood cells respectively. Moreover, the mean P50 value was normal at 26.4 +/- 0.9 mmHg. These normal oxygen transport data make unlikely any proposal that short stature seen in these patients is secondary to chronic tissue hypoxia. They also indicate that the intra-erythrocytic organic phosphate levels are maintained at normal levels despite profound chronic hypophosphatemia.

Adenosine Triphosphate↗