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Biomedical subjects

A Beigel

Publications and source records attributed to A Beigel.

At least 19 recordsLinked to original sources

[The magnetic resonance tomographic signs of Wegener's granulomatosis in the head area].

MRI of the head was performed in 25 patients suffering from Wegener's granuloma. 23 patients showed evidence of mucosal thickening in the paranasal sinuses, the middle and inner ears and in the mastoid cells; these were characterised by low signal intensity of T1-weighted and high signal intensity of T2-weighted images. In 10 patients there were granulomas in the paranasal sinuses and in the orbits which showed low signal intensity of both T1-weighted and T2-weighted images. In 4 patients, additional images were obtained after the intravenous injection of Gd-DTPA. In 2 patients this resulted in non-homogeneous contrast accumulation in the granuloma. In 7 patients there were signal changes in the brain which were typical of infarcts. The complete extent of bone destruction in the facial skeleton was visible only by CT.

Adult

[Rhabdomyoma of the mouth floor--a case report].

We report a rare case of an adult rhabdomyoma of the floor of the mouth in a 52-year-old woman. To date only 25 cases of such tumors have been described in the oral cavity. In spite of its large size (approximately 10 x 8 x 6 cm), the tumor could be completely removed. Up to now, 20 months after the removal of tumor, no recurrences, have occurred.

Biomarkers, Tumor

[Immunological reactions against preserved tracheal transplants? Studies on inbred rat strains].

To determine whether chemical (cialit, merthiolate, alcohol, formaldehyde solution) preserved tracheal segments maintain immunogenicity we performed systematic transplantation-immunological investigations using in vivo-, in vitro- and immunohistological tests. In contrast to other authors no indication of residual antigenicity was found. The survival rates after orthotopic grafting of preserved tracheal segments were shortened. This seems due to the loss of the mucociliary clearance, caused by chemical induced damages in the tracheal mucosa.

Animals

[Cefmenoxime penetration in human lacrimal sac mucosa after systemic administration].

Access to microbiological, pharmacokinetic and toxicological information is necessary for useful, controlled application of antibiotics in intraocular and periocular infections. It is important to know whether the antibiotic is effective against ophthalmologically relevant bacteria and if suprathreshold concentrations of the antibiotic can be achieved in the contaminated tissue. In the study presented we investigated the usefulness of cefmenoxime in cases of dacryocystitis. Lacrimal sac tissue--and serum specimens were obtained from 15 patients who underwent dacryocystorhinostomy 0.5 to 13 h after intravenous injection of 25 mg cefmenoxime kg. The usual Toti procedure was performed in 7 patients, whereas the other 8 underwent endonasal surgery. Out of the 15 patients 12 suffered from recurrent dacryocystitis. Before application of the antibiotic a serum control sample was obtained in all patients. The highest cefmenoxime levels in the lacrimal sac (72 mg/kg) were measured 30 min after injection. Thirteen hours after the injection, the cefmenoxime levels were too low to be measured. The levels of cefmenoxime in the lacrimal sac tissue were compared with the minimal inhibitory concentrations for the frequent occurrence of bacteria in lacrimal sac infections.

Adolescent

The seriously mentally ill: another perspective on treatment resistance.

There is a subpopulation of the seriously mentally ill who remain acute care recidivists, rarely becoming engaged in follow-up treatment. It has been argued that these individuals are system, rather than treatment resisters. The perceptions they have of their problems are often in conflict with staff evaluations, or with what the system has to offer. In the present study, patients who dropped out of residential care against staff's advice were compared to patients who remained in treatment. The results suggest that the greater the difference between the perceptions a patient and therapist have concerning the patient's problem, the greater the likelihood of the patient dropping out of treatment.

Adult

[Pathogenesis of alcohol-induced hyperlipidemia: case report of hypertriglyceridemia over 10,000 mg%].

A 53-year old woman developed excessive hypertriglyceridemia (greater than 10,000 mg/dl) with features of toxic liver damage after prolonged ethanol ingestion. Lipoprotein-lipase-activity was not decreased, apolipoprotein-C-II analysis, as shown by gel-electrophoresis, revealed a regular pattern. Treatment with parenteral nutrition and abstinence of ethanol resulted in a complete normalization of plasma triglycerides after transient remnant-hyperlipidemia. Decrease of triglycerides was accompanied by declining liver enzyme activities. As suggested by unimpaired activity of lipolysis, the extent of hypertriglyceridemia may be explained by a reversible receptor mediated defect of hepatic catabolism, aggravated by hepatic overproduction of triglyceride-rich-particles. Although receptor dysfunction is not yet understood, the transient appearance of remnant particles may be a helpful criteria in diagnosis of ethanol induced hypertriglyceridemia.

Alcoholism

[Ultrasound, computerized and nuclear magnetic resonance tomography of soft tissue processes of the head and neck].

14 patients with a space-occupying growth in the head and neck region were examined via sonography, CT and MR to explore and demonstrate by means of a prospective comparative study the possibilities offered by these three imaging methods. Stages are best diagnosed by means of sonography; the leading role of this method is undisputed. To clarify sonographically unclear findings and especially in pre-surgery planning, MR offers advantages over CT on account of the high soft-part contrast and multiplanar visualisation. However, it is impossible or very difficult to differentiate abscesses and lymphadenitides from malignant growths with these three methods solely on the basis of image-morphological criteria.

Abscess

[Squamous epithelial carcinoma and undifferentiated carcinoma of the inner nose and paranasal sinuses].

272 patients with tumours of the nasal cavity and paranasal sinuses were followed up from 1949 until 1982 at the ENT Department of the University Hospital in Kiel. 53% of the tumours were classified as squamous cell or undifferentiated carcinomata. At an early stage such tumours cause nonspecific symptoms which may mimic those of chronic sinusitis. Early diagnosis is usually hindered by the occult growth within the facial skeleton and especially by the minor symptoms caused by tumours of the paranasal sinuses. In contrast, tumours of the nasal cavity cause symptoms at an early stage and consequently are diagnosed early. The majority of cases with tumours of the paranasal sinuses present at an advanced stage (T3 to T4) in 70% of cases. The most common site of squamous cell carcinoma is the maxillary sinus (50%). Distant metastases and regional lymph node metastases are rarely seen at presentation regardless of the size of the primary tumour. Metastases usually indicate a tumour dependent death in the near future. The main prognostic indicators are the size of the tumour (significantly worse prognosis for T4 in comparison to T2 or T3 tumours) and the localisation (significantly better prognosis for tumours of the floor of the nasal cavity or the nasal septum compared to tumours of the paranasal sinuses). The age of the patient or the degree of differentiation of the tumour did not influence on the survival rate. Tumour-dependent deaths rarely occur after more than five years. Patients were assigned to two treatment groups and matched according to the tumour stage. One group received surgery only, whereas the second group received a combined treatment of surgery with subsequent radiotherapy. There was a significant difference between the two groups in favour of the surgical treatment. According to these data we recommend surgical excision without postoperative irradiation in cases where complete removal of the tumor has been histologically proven.

Age Factors

How to survive in the private practice of psychiatry.

The private practice of psychiatry is being transformed by the new economics of medical care. Patients are paying more out-of-pocket for necessary care (demand-side cost sharing), and health care providers are being asked to assume part of the risk of treatment through prospective payment (supply-side cost sharing). Specific survival strategies for psychiatrists in private practice include development of a balanced practice, expansion of referral networks, participation in alternative delivery systems such as health maintenance organizations and preferred provider organizations, active involvement in utilization and claims review, participation in outcome studies, and expansion of patient care advocacy and community involvement.

Health Maintenance Organizations

[Morphologic changes in the epithelium of myocutaneous pectoralis major islands flaps. A light and electron optic study].

On a long-term basis, the epithelium of pectoralis major flaps incorporated in the mouth and the oropharynx is macroscopically and microscopically very similar to the sourrounding mucosa. Light microscope and electro microscopic investigations show that the type of keratinization of the epithelium of this flap has changed from orthokeratosis to parakeratosis which is typical for the mucosa of the mouth. The possible reasons for these changes, which, to our knowledge, have not been described before, are discussed.

Biopsy

[ACPA: the first serologic marker for Wegener's granulomatosis].

The anticytoplasmatic autoantibody against intracytoplasmatic antigens of granulocytes (ACPA) was demonstratable in 23 patients in the active generalised or incomplete remission phase of Wegener's granulomatosis, but absent in 17 patients in the initial or complete remission phase. The test was negative in 900 serum samples from a control group. This autoantibody seems to be a marker of unusual specificity for Wegener's granuloma, and contributes to better assessment of activity in this disease.

Autoantibodies

Changing a state mental health system through litigation: the Arizona experiment.

Litigation may be a viable means to change mental health systems for the chronically mentally ill. Court orders achieved in the 1970s have been ignored or proven inefficient over the years. However, in Arizona, a strategy was designed by a team of lawyers and psychiatrists to deal with failures seen elsewhere in court actions seeking adequate services for chronically mentally ill patients. This novel approach produced a favorable court outcome and triggered a chain reaction at the executive and legislative levels to reform radically the system of care for the chronically mentally ill in Arizona.

Arizona