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Biomedical subjects

S Jelen

Publications and source records attributed to S Jelen.

At least 19 recordsLinked to original sources
PubMed2005

An unusual solution after bilateral lower extremity amputation.

The authors present a case of a 40-year-old male with devastating amputation trauma of both lower extremities. Reconstruction of the right lower extremity was solved by the unusual use of inserted vascularized bone-skin graft from the left crus with a simultaneous replantation of the right foot. The result after 3.5 years is preservation of one extremity with full knee mobility. The other lower extremity was fitted for thigh prosthesis.

Adult↗
PubMed1992

[Primary adenocarcinoma of the appendix].

The authors published experience with the treatment of four patients with primary adenocarcinoma of the appendix and an analysis of 20 patients with primary adenocarcinoma of the appendix treated in the North Moravia region during a ten-year period (1980-1989). The incidence of the disease is rare. Usually it is manifested by symptoms imitating acute appendicitis. In exceptional instances there are other symptoms such as melaena, invagination, infiltration of neighbouring organs etc. Only rarely the disease is diagnosed during appendectomy. Most frequently an adenocarcinoma of the colonic type is involved with a tendency of rapid local spread. In that case right-sided hemicolectomy is the method of choice. In exceptional instances simple appendectomy is sufficient (mucinous type of adenocarcinoma, Dukes A). In advanced stages of the disease a palliative surgical operation may frequently suffice. Radiotherapy and chemotherapy should be always considered with regard to the stage of the disease and the general state of the patient. The prognosis is similar as in adenocarcinoma of the colon.

Adenocarcinoma↗
PubMed1979

[A retrospective study of the impressions and psychic reactions experienced by patients in a traumatological intensive care unit (author's transl)].

30 persons who had been treated for an average of 22 days on a traumatological intensive care unit were asked to comment on their impressions and experiences. 80% of the patients had been in need of artificial respiration; but this had not unduly distressed them and they remembered it only vaguely. The major worry in 30% of the cases was awareness of their condition and the fear of permanent physical and mental disablement. 25% had greatly suffered from thirst. There was no mention that finding themselves in an intensive care ward, being dependent on a respirator or monitoring equipment or being disorientated had caused distress. None of them had seriously contemplated the possibility of his own death. The frequent visits by relatives were regarded as great comfort and help towards achieving mental equilibrium. All these critically ill persons were highly impressed by the constant and dedicated medical and nursing care they had received.

Anxiety↗
PubMed1979

[A case of severe multiple trauma (author's transl)].

A case of severe multiple trauma sustained in a road accident is reported. The aim of the report is to show the determing role played by diagnostic and surgical methods and therapeutic possibilities available in the intensive care unit (shock treatment, controlled respiration, parenteral feeding, haemodialysis) in winning the five-months' battle for the life of the patient. Early haemodyalisis as supporting therapy in respiratory failure and conservation treatment of intestinal fistulae are important. Post-traumatic pancreatitis which is a not infrequent complicating feature of severe multiple trauma may present diagnostic difficulties.

Accidents, Traffic↗
PubMed1978

Transthoracic electrical impendance in anaesthesia and intensive care.

Pulmonary fluid accumulation plays an important role in the development of post-traumatic pulmonary insufficiency. Yet initially diagnosis may be difficult. The measurement of transthoracic electrical impedance was used to detect early pulmonary fluid overload. In healthy test persons infusions of isotonic electrolyte solutions and diuresis were accompanied by changes of impedance dependent on the amount of infused or withdrawn fluid. In patients with pulmonary insufficiency a relatively low mean body impedance was recorded. Enforced diuresis resulted in a rise and in diminution of the alveolar-arterial oxygen difference.

Adult↗
PubMed1978

Changes in essential fatty acids in plasma lipid fractions of polytraumatized patients with different parenteral nutrition.

We investigated changes in the fatty acid pattern of plasma lipids during the phase of total parenteral nutrition in two groups of polytraumatized patients. For parenteral nutrition we gave L-amino acid solutions in a dose of 0.24 g N day-1kg-1 body weight. In addition, we administered in the first group glucose and fructose, and in the second group glucose, fructose and fat emulsions in a total dose of 30 kcal day-1kg-1 body weight. In the latter group, the proportion of the fat emulsions was 30-40% of the calories administered. The most striking findings were the decrease of the essential fatty acids with regard to the phospholipid fraction from about 60% to 30% in the early post-traumatic phase. In the first group of patients we observed a further reduction of the essential fatty acids in the period of observation. This could be avoided by administering fat emulsions of the same type as we gave in the second group of patients. The functions of essential fatty acids in membranes and in the intermediary metabolism are discussed.

Dietary Fats↗
PubMed1978

[Changes of the essential fatty acids in plasmalipid fractions of polytraumatized patients with different parenteral nutrition (author's transl)].

In two groups of polytraumatized patients we investigated changes in the fatty acid pattern of plasma-lipids during the phase of total parenteral nutrition. For parenteral nutrition we gave L-amino acid solutions in a dose of 0.24 g N/kg body weight/day. In addition, we administered in the first group glucose and fructose and in the second group glucose, fructose and fat emulsions in a total dose of 30 kcal/kg body weight/day. In the latter group, the proportion of the fat emulsions was 30-40% of the administered calories. We compared the achieved results with the values of a group of control persons. The most essential findings of these studies were the striking decrease of the essential fatty acids with regard to the phospholipid fraction in the early post-traumatic phase. In the first group we observed a further reduction of essential fatty acids during the period of observation. This could be avoided by administering fat emulsions of the same type as we gave in the case of the second group of patients. The functions of essential fatty acids in membranes and in intermediary metabolism are discussed.

Amino Acids↗
PubMed1977

[Acute respiratory distress syndrome after near-drowning (author's transl)].

After successful rescue from drowning there may develop a situation which is called secondary drowning, resulting in acute respiratory distress characterized by interstitial pulmonary oedema, hypoxaemia, hypercapnia and acidosis during drowning, direct alteration of the alveolar membrane by aspirated water and particulate matters and a volume overloading by adsorption and--not seldom--inept therapy. This situation requires mechanical ventilation and forced diuresis, combined with high doses of steroids, antibiotics and digitalis. We present the case of an eleven year old patient whose clinical course demonstrate the necessity of exact clinical observation after rescue from drowning. After development of acute respiratory distress only the immediate utilization of the therapeutic modalities of an intensive care may result in a satisfactory outcome. Four months later our patient had normal pulmonary function except for a moderate reduction of compliance.

Anti-Bacterial Agents↗
PubMed1976

[Health hazards to the anaesthesist].

During the past years there has been increasing concern regarding potential hazards to the anaesthetist presented by, e.g., anaesthetic agents, exposure to X-rays, virus hepatitis. Chronic exposure to inhalational anaesthetics, in particular, has been held responsible for a variety of complants and disorders. Investigations at the Technical University, Munich, have shown no appreciable difference in the sick rate between the staff of the Department of Anaesthetics and the Department of Medicine. Whereas exposure to X-radiation cannot be regarded as a health hazard provided the prescribed safety measures are adhered to, virus hepatitis still constitutes a major risk. There is also some evidence of an increased incidence of miscarriages amoung the female anaesthetic personnel. The causes are unknown. Halothane hepatitis is very rare and does not present a major risk.

Abortion, Spontaneous↗