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Biomedical subjects

A Berghaus

Publications and source records attributed to A Berghaus.

At least 19 recordsLinked to original sources
PubMed2006

[Squamous cell carcinoma of the nasal vestibule].

The case of a 31-year-old man (smoker) with a progressively enlarging swelling and reddening in the region of the nasal vestibule is discussed. Before he was seen by us, he had been repeatedly treated with antibiotics, but to no avail. A deep excisional biopsy was obtained, and the histopathological work-up revealed a squamous cell carcinoma. Thereupon, complete surgical ablation in healthy tissue was carried out. This case shows that in chronic inflammation of the nasal vestibule that fails to respond to antibiotic treatment differential diagnostic consideration must be given to the possibility of a malignancy.

Adult↗
PubMed2006

Determination of strength and deformation behavior of human cartilage for the definition of significant parameters.

In reconstructive surgery, an artificial supporting scaffold made from autogenous cartilage from the rib, the ear concha, or the nasal septum is used as a substitute for the destroyed endogenous tissue in the ear concha, the nose, the trachea, and in parts of the facial skeleton. For the successful use of polymer materials in reconstructive surgery, an exact knowledge of the material properties of the natural tissues is required. The applicability of conventional material test methods was examined with regard to the suitability of the test methodology. Materials properties are to be assessed for different specimen sizes and geometries. Human cartilage specimens from the septum, rib, and ear were subsected to the following test methods: (1) tension, (2) bending, (3) compression, and (4) micro-hardness measuring. Specimen geometry was evaluated for each experimental method by taking into account the dimensions of samples used in plastics testing as well as the appropriate model of miniaturization. Elastic properties determined using test methods (1), (2), and (3) are Et-sep=(7.2+/-3.4) MPa, Ef-rib=(8.8+/-2.9) MPa, and Ec-rib=(103+/-30) MPa. The micro-hardness values hpl fluctuate for septum from 1 to 4 N/mm2 and for the rib from 0.5 to 1.3 N/mm2. The experiments have shown that, beside the sex- and age-specific values recorded, the standard values and their variation are particularly influenced by preparation technique and by the conditions of storage. As a result of these first investigations, characteristic values for strength and deformation were determined under quasistatic and dynamic load conditions. The aim of this study was not the determination of statistically firmed properties, but the examination of the applicability of mechanical test methods of the polymer testing for these materials.

Cartilage↗
PubMed2006

[Lethal end of a group C streptococcal necrotizing fasciitis in a healthy female].

The necrotizing fasciitis (NF) is a life threatening, quickly progressive soft-tissue infection characterized by necrosis of the superficial fascia. It is very rare in the head and neck region. Usually this infection attacks weak patients with chronic diseases, such as diabetes or cancer. In adults the most common organisms implicated in craniocervical NF are Streptococcus pyogenes, Staphylococcus aureus, Streptococcus viridans and Peptostreptococci. The typical infectious entrance is a deep wound, after surgery or a peritonsillar abscess. We describe a very unusual case of a craniocervical NF with a deadly outcome in a sixty year old female. The patient had no chronic diseases and went to an ENT doctor with an acute tonsillitis for 3 days. Within the next three hours the general condition became dangerous to life. Therefore she was brought to us for immediate therapy. But despite fast and aggressive surgery of the neck, throat and thorax the patient died of a toxic schock syndrome on the intensive care unit within a few hours. The microbiology showed just group C Streptococcus. The postmortem examination confirmed the NF with starting point in the left tonsil after acute tonsillitis. Such a foudroyant course of a craniocervical NF with group C streptococci in a healthy patient is not published yet.

Acute Disease↗
PubMed2005

[New information on chronic rhinosinusitis and polyposis nasi].

New Information on Chronic Rhinosinusitis and Polyposis Nasi Chronic inflammation of the paranasal sinuses is more common than inflammatory or degenerative diseases of the joints or arterial hypertension. The pathogenesis of chronic rhinosinusitis has still not been completely worked out. It is known that in particular the administration of antibiotics is incapable of healing the condition. Once the diagnosis has been established by an ENT specialist, topical or systemic steroids may be helpful. In most cases, however, it is necessary to combine these substances with surgical treatment. For this purpose, endoscopic sinus surgery is an approach that is capable of providing good long-term results.

Adult↗
PubMed2005

[Rhinoplasty--functional and esthetic surgery on the nose].

With the aid of rhinoplasty, functional or cosmetic defects affecting the nose can be surgically corrected. In cases of disturbed nasal breathing due to septum deviations, hypertrophy of the conchae or a crooked nose which, for example, has led to deformation of the inside of the nose and thus to a functional disturbance, there is no question that the insurance will cover the costs. In the case of mild deformities, however, an expertise is first required. Purely cosmetic corrections are not covered by the health insurance and must be paid for by the patient him/herself. At the end of the operation, the nose is supported with splints and tamponades. Any subsequent surgery should be done at the earliest after one year.

Adult↗
PubMed2005

[Carcinogenic and co-carcinogenic effects of metals and ethanol on human salivary gland tissue].

BACKGROUND: The etiology of malignomas of human salivary glands is examined. MATERIAL AND METHODS: Macroscopic, healthy salivary gland tissue from 46 donors was harvested during surgery. Single cells were isolated by enzymatic digestion. These were then incubated for 60 min with Na(2)Cr(2)O(7), NiSO(4), CdSO(4), ZnCl(2) and ethanol. Additionally, incubation with Na(2)Cr(2)O(7) was combined with NiSO(4), CdSO(4), ZnCl(2) and ethanol. The influence of CdSO(4) was analyzed by altered combinations with Na(2)Cr(2)O(7) during incubation and by the DNA-repair period. Evaluation was performed using fluorescent staining and digital analysis. RESULTS: Of all of the substances tested, only Na(2)Cr(2)O(7) showed genotoxic effects. NiSO(4), ZnCl(2) and ethanol had neither genotoxic nor cofactorial impacts. CdSO(4), however, caused additional genotoxic effects in combination with Na(2)Cr(2)O(7), although it lacked direct genotoxic potential. A reduction of DNA-repair of Na(2)Cr(2)O(7)-induced oxidative damage by CdSO(4) could be demonstrated. CONCLUSIONS: In this investigation, sodium dichromate was identified as genotoxic in association with human salivary gland tissue. These effects could be increased by CdSO(4), reinforcing DNA damage based on oxidative stress.

Adolescent↗
PubMed2005

[Effects of magnetic resonance tomography on upper eyelid implants].

BACKGROUND: For the therapy of lagophthalmos in facial palsy, gold (99.99%), platinum (99.95%) and platinum/iridium (97%/3%) alloy weights are implanted into the upper eyelid. Investigations on the MRI compatibility of the different eyelid implants with 1.5 and 3.0 Tesla-MRT-systems, which are often used for the diagnosis of head and neck tumours, are still missing. METHODS: Three different eyelid implants made of pure gold, pure platinum and a platinum/iridium alloy were tested in vitro. As parameters, temperature changes, movements of the implants and picture artefacts of the different implants were determined using a 1.5 and 3.0 Tesla MR system. The deflection forces of the implants were evaluated by thread test, lying in a Petri dish and floating in a water bath. RESULTS: No rise in temperature was recorded in any implant. On the water surface, all three implants changed their positions and floated towards the magnetic field. The velocity of the implants increased in the 3.0 Tesla system. Increasing the frictional resistance by lying the implants in a Petri dish, there was no movement in the 1.5 or 3.0 Tesla systems. In addition, no movement of the implants could be observed in the thread test. All implants made few artefacts, with gold showing the least artefacts. CONCLUSION: MR imaging at 1.5 or 3.0 Tesla may be performed safely for warming up or dislocation of the implant in patients with eyelid implants made of pure gold, pure platinum or a platinum/iridium alloy.

Artifacts↗
PubMed2005

[Contouring of a rigid eyelid implant: indication for the replacement with the platinum chain].

BACKGROUND: The resultant lagophthalmos at peripheral facial palsy can lead to keratopathy of varying degrees. In surgical therapy of lagophthalmos some implants to preserve a sufficient eyelid closure have been described. Besides to the use of magnets, silicone slings or palpebral springs the importance of the gold implantation (lidloading), first described by Illig in 1958, has increased. Unfortunately all of these techniques have often shown unwanted side effects. The platinum chain is a new implant which promises, due to its flexibility, lower postoperative complications. PATIENTS: We present two case reports to show the platinum chain's advantages compared to the older implants. The two patients developed a unsightly contouring (with threatening extrusion) of the rigid gold implant after lidloading. These gold implants were therefore replaced in one step by the platinum chain. RESULTS AND CONCLUSIONS: The further process was complication-free. In our opinion, in spite of the small case number, the new developed platinum chain can lead to a reduction of postoperative complications after lidloading. In complications with the rigid gold implants, such as contouring or extrusion, these implants can mostly be replaced in one step by corresponding platinum chains.

Adult↗
PubMed2004

[Prolactinoma of the sphenoid sinus. Case report and literature review].

In this case study, we report on a patient complaining of headache who, after CT and MRI, was found to have a neoplasia of the left sphenoid sinus. After a transnasal biopsy and histological examination, a prolactinoma was diagnosed. Based on this case, we discuss important aspects of tumor biology, diagnostic procedures, histology as well as differential diagnosis. Prolactinoma has to be considered as a differential diagnose in all sphenoid sinus neoplasias with close contact to the pituitary gland.

Diagnosis, Differential↗
PubMed2004

[The ring-pin anastomosis technique. Long-term clinical experiences with the mechanical ring-pin system for microvascular anastomoses in reconstructive head and neck surgery ].

BACKGROUND: Microvascular anastomosis remains one of the most critical aspects of free tissue transfer. Since microsurgical suture techniques are complicated and time-consuming, other techniques of anastomosis have been created. One of these is the ring-pin system. METHODS: Between January 1996 and October 2001, 48 patients underwent reconstruction with a free radial forearm flap. In 20 patients the venous anastomosis was carried out using a ring-pin system with end-to-end technique. The clinical results were compared to the other 28 patients in whom the anastomosis was sutured with 9-0 prolene. RESULTS: In the group using ring-pin anastomosis ( n=20), two flaps showed venous congestion within 24 h postoperatively. After revision the flaps were well perfused. In the other group with sutured vessels ( n=28), a transplant became ischemic in one patient due to venous thrombosis and had to be partly removed. The time of anastomosis was considerably shortened by the use of the ring-pin system. CONCLUSIONS: The venous end-to-end-anastomosis using the ring-pin system can be carried out relatively easily and rapidly after a comparatively short period of training. Long-term results have shown good tissue tolerance of the material and sufficient blood circulation of the grafts.

Anastomosis, Surgical↗
PubMed2004

[Functional reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage to rehabilitate swallowing].

BACKGROUND: Patients with supraglottic laryngectomy often complain about persisting dysphagia because the resection includes the most important protective mechanisms of the airway. The additional resection of parts of the tongue base or the lateral hypopharyngeal wall leads to increasing aspiration problems. PATIENTS AND RESULTS: Reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage in extended oro-hypopharyngeal and laryngeal carcinomas was carried out in seven patients from 1997 to 2002. In one patient, the reconstruction was performed in a second stage procedure after extended endoscopic laser resection. In four patients, the temporary tracheostomy was closed, and in five total oral feeding was possible. CONCLUSIONS: Preliminary results show that a functional reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage to reconstruct the epiglottis helps to avoid chronic aspiration and to preserve the larynx.

Aged↗
PubMed2004

[Neural control of the respiratory nasal mucosa].

Respiratory nasal mucosa fulfils the function of pretreating the inspired air. The periodic nasal cycle and pathologic functional disturbances of the endonasal tissue influence the nasal passages. The secretion of the seromucous glands and extravasation from the blood vessels are essential for mucocilliary transport. These physiological mechanisms are partially controlled by neural regulation. Besides classic neurotransmitter neuropeptides such as VIP, CGRP, SP and NPY, nitric oxide also shares this role. A network of sensory, sympathetic and parasympathetic nerve fibres protects the respiratory mucous membranes from external and internal irritation. In addition, blood vessels and glands are influenced by endothelial and humoral factors. For the different types of rhinitis, sensory neuropeptides and inflammatory mediators take part in the pathomechanisms and can lead to a so called neurogenic inflammation of the nasal mucosa.

Feedback↗
PubMed2003

Clinical aspects and strategy for biomaterial engineering of an auricle based on three-dimensional stereolithography.

At the present time, the partial and/or complete reconstruction of an auricle from autologous rib cartilage is one of most widely published techniques. In the field of tissue engineering, different techniques have been described to generate cartilage tissue using isolated chondrocytes. The basis of these tissue-engineering techniques is bioresorbable or non-bioresorbable biomaterials, which serve as a three-dimensional cell carrier. Tissue engineering of an auricle requires preformed bioresorbable biomaterials designed to fit the form of a patient's auricular defect. Three-dimensional imaging acquired from computed tomography scans or laser surface scanning has become an important tool in modern medicine. This study represents the preoperative procedures for the reconstruction of an auricle through tissue engineering in accordance with the clinical aspects. Hyaff 11, a hyaluronic acid derivative, was used as a three-dimensional cell carrier for isolated human nasoseptal chondrocytes. The chondrocytes were amplified in a conventional monolayer culture before the cells were seeded on a hyaluronic non-woven mesh and cultured in vitro for 4 weeks. The chondrogenic potential of human nasal chondrocytes in Hyaff 11 was investigated by confocal laser scanning microscopy, histology (toluidine blue) and immunohistochemistry (collagen type II). Computer-aided design (CAD) and manufacture of an auricle model with stereolithographical methods were used for the prefabrication of a bioresorbable three-dimensional cell carrier designed in the form of a patient's auricular defect. The cell carrier used was Hyaff 11, a fully benzyl-esterified hyaluronic acid derivative. Confocal laser scanning microscopy has shown good cell attachment, a homogenous distribution of amplified chondrocytes and a viability of more than 90%. After 4 weeks in vitro culture the human nasoseptal chondrocytes synthesized new cartilage with the expression of cartilage-specific collagen type II. In order to shape a patient's designed scaffold the auricle model was fitted exactly and symetrically to the contralateral side. Subsequently, the mirror image patient-specific model was used to prepare an identical scaffold model made of a fully benzyl-esterified hyaluronic acid derivative. The bioresorbable scaffold that was produced gave a satisfactory representation of auricle structure. Bioresorbable preformed biomaterials in the form of a patient's auricle defect represent an important prerequisite for the tissue engineering of autologous auricle grafts. Hyaff 11 seems to be a promising material for tissue engineering of cartilage transplants, and the application of this approach will improve conventional reconstructive surgery in the future.

Absorbable Implants↗
PubMed2003

[Malignant schwannoma of the trachea].

Malignant schwannoma of the trachea is a rarity among the infrequent neurogenic tumours of the cervical region. Only individual cases have been described in the literature to date. A 30-year-old patient came to us with acute dyspnoea. A bronchoscopy showed a polypoid-stemmed tumour, which was removed using a loop. Histologically, it was a malignant neurogenic tumour of a low-grade schwannoma nature. A tracheal segment resection was carried out to remove the tumour completely. Six years after the operation, the patient was still recurrence-free. The prognosis depends on whether a high or low grade malignant schwannoma is present. The histological grading of the neurogenic peripheral neurilemmoma is made depending on a number of histological parameters and is often rather difficult. Specialists agree that only the radical surgical removal of the tumour might lead to patient's recovery. Adjuvant measures like chemo- or radiotherapy do not significantly prolong the life expectancy.

Adult↗
PubMed2003

[Operative voice pitch raising in male-to-female transsexuals. A survey of our technique and results].

BACKGROUND: Transsexuality constitutes a complex,permanent transposition due to a paradoxical sense of belonging to the opposite sex. The persons concerned experience such a high degree of suffering that they strive to undergo operative sex reversal. Mainly in the case of male-to-female transsexuals this may often lead to a subsequent discrepancy between the external appearance and the character of the voice,since only a deepening of the voice can be achieved by hormonal treatment and not a raising of its pitch.Also,logopedic treatment on its own cannot,as a rule, guarantee a lasting success. In order to adapt the voice as an essential aspect of human identity to the external female appearance,a variety of phonosurgical operation techniques have been developed since the seventies. PATIENTS AND METHODS: In 1993 a modified cricothyroidal approximation via miniplates, following ISSHIKI's technique, has been performed at the ENT Department of the Martin-Luther-University of Halle-Wittenberg. This procedure is based upon an approximation of the cricoid and thyroid cartilages resulting in an increase in the vocal cord tension. This intervention does not affect the inner structures of the larynx and is on principle reversible. Combined with a chondrolaryngoplasty it allows for a reduction of the Adam's apple. So far 57 patients have undergone this surgical intervention. Laryngoscopy, stroboscopy and a detailed voice diagnostic, as well as ultrasound and computertomographic examinations of the larynx are performed pre and postoperatively in order to record the anatomical-physiological and functional data. RESULTS AND CONCLUSIONS: So far good functional results could be achieved showing an average rise of the medium voice range by approximately one fourth. As a long-term result a permanent raising of the basic voice pitch has been reported. The majority of the patients are satisfied with the functional and cosmetic effect reporting an enhanced self-esteem.

Adult↗