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1.
J Finsterer E-W Kues S Brunner 《The European journal of contraception & reproductive health care》2006,11(3):237-240
OBJECTIVES: Pseudotumour cerebri has been previously recognized as a neurological side effect of combined oral contraceptives but has not been diagnosed with a delay of 3 years after initiation of combined oral contraceptives. CASE REPORT: A 19-year-old obese woman developed visual impairment and headache, 4 months after starting combined oral contraceptives. Three years later symptoms deteriorated and she presented with prominent tendon-jerks and congested optical-discs. Normal CSF drained with high pressure from the spinal tap. Pseudotumour cerebri was diagnosed. Headache and visual impairment resolved within 3 weeks after discontinuation of combined oral contraceptives. CONCLUSIONS: Combined oral contraceptives-induced pseudotumour cerebri may remain undetected for years. Young, obese women with visual impairment and headache under combined oral contraceptives should undergo immediate neurological and ophthalmological investigation. 相似文献
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For large shaft defects of tibia and femur, distraction-compression osteosynthesis (Ilizarov) provides an ideal autologous bone graft. Combination of this with an intramedullary interlocking nail instead of an external fixator could improve patient comfort, because transport with a small external device takes only one-third of the total fixation period. Using 21 adult female sheep we created standardized tibia shaft defects 20 mm (medium size) and 45 mm (large size) in length. The tibiae were stabilized with non-reamed intramedullary interlocking nails. Following corticotomy by chisel, segments were transported using subcutaneous traction wires with a screw as a fulcrum to maintain stationary skin exit points without soft tissue problems. The external traction devices were removed after 12 or 16 weeks. Animals were sacrificed after 12 or 24 weeks with medium-size defects, and after 16 or 32 weeks with large defects. We evaluated the results clinically, by standardized weekly X-rays and, after sacrifice, by quantitative computed tomography (QCT). No animals had to be excluded from the study. Despite primary destruction of the intramedullary circulation all distraction gaps were spanned with bone. X-Rays showed typical signs of good quality of distraction bone regeneration (narrow radiolucent zone in the middle of the regenerate, longitudinal structure), continuous calcification, and cortex formation. QCT cross sections showed completely circular bone regeneration with small and large defects. Bone regeneration was faster on the dorsal side, where more bone was formed than ventrally. Small defects can remain ventrally in the regenerate; these close secondarily.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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G Tufveson W Geelings M Broyer F P Brunner H Brynger S R Dykes J H Ehrich W Fassbinder G Rizzoni N H Selwood 《Nephrology, dialysis, transplantation》1989,4(3):161-171
This paper summarises the information given on the 1986 EDTA Registry centre questionnaire which was returned by 82% of the 2,065 known dialysis and transplant centres in 33 European countries. Information is given on the number of patients alive on haemodialysis according to the type of dialysis facilities available where the patient was receiving dialysis and the number of patients receiving special types of dialysis. The centre questionnaire also included questions on testing for HIV infection, serological evidence or symptoms of AIDS and the diagnosis of hepatitis B in patients and staff. The data given in response to these questions are presented together with data on the involvement of dietitians and social workers in the treatment of patients with end stage renal failure. Finally, information on transplant activity in Europe and the treatment policies of transplanting centres is provided. 相似文献
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Binet I; Bock A; Vogelbach P; Gasser T; Kiss A; Brunner F; Thiel G 《Nephrology, dialysis, transplantation》1997,12(9):1940-1948
Background. The growing shortage of cadaver kidneys,
the limited possibilities to expand the living related donor pool and the
good results obtained in our centre with poorly matched cadaver kidneys,
led us in 1991 to begin accepting highly motivated, unrelated, living
kidney donors who had a strong emotional bond with the recipients.
Methods. Between 1 January 1991 and 1 January 1996, 46
potential living kidney donors and their emotionally related recipients
were evaluated. Twenty-three cases were accepted for renal transplantation
after thorough somatic and psychological evaluation. The mean
post-transplant follow-up until 1 April 1996 was of 28±3 months.
Compatible blood groups and a negative cross-match were mandatory, but no
minimal HLA matching was required. Results. There was
a 50% drop-out rate following the initial screening. The main reasons for
not performing transplantation were immunological contraindications in 39%
of the cases, somatic in 30.5%, psychological in 26% and socioeconomic in
4.5%. In the accepted group of recipients, 48% (11/23) received transplants
without chronic dialysis. Donor survival was 91%; two deaths unrelated to
nephrectomy occurred 1 year after donation. The 2-year actuarial recipient
and graft survivals were 100% and 91% respectively, compared to 99%
(recipients) and 93% (grafts) in the non-HLA-identical living related
kidney transplant group, and to 93% (recipients) and 83% (grafts) in the
cadaver kidney transplant group. Recipient rehabilitation was completed
after 4±1 months. Emotionally related donors returned to work
5±2 weeks after nephrectomy, and no donor regretted his
decision, even in the case of failure. Conclusions.
Kidney transplantation from emotionally related living donors represents a
valuable option, allowing more patients with end-stage renal disease to
avoid chronic dialysis. Recipient and graft outcome were superior to
cadaver kidney transplantation. Motivated and emotionally related donors
should be allowed to donate one of their kidneys provided that they are
carefully selected and thoroughly informed. 相似文献
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J B van de Biezenbos J G Nijhuis H G Brunner 《Nederlands tijdschrift voor geneeskunde》1992,136(50):2480-2482
We describe the maternal and neonatal complications of pregnancy in two patients with myotonic dystrophy. The disease leads to an increased spontaneous abortion rate, hydramnios, prolonged first and second stages of labour, retained placenta, postpartum haemorrhages and anaesthetic sensitivity in the mother. The neonatal problems are caused by the congenital form of the disease. The major clinical features of congenital myotonic dystrophy are bilateral facial weakness, hypotonia, neonatal distress, feeding difficulties, talipes, tent-shaped mouth, mental retardation and delayed motor development. Relatives of a known myotonic dystrophy patient should be advised to let themselves be examined for this disease. If the disease is diagnosed, information should be given regarding possibilities for prenatal diagnosis. Pregnancy in myotonic dystrophy patients should be monitored by a gynaecologist. Labour has to take place in a hospital with intensive care facilities for mother and child. 相似文献
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