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Biomedical subjects

A Kessler

Publications and source records attributed to A Kessler.

At least 37 records · Page 2Linked to original sources
PubMed2000

Nasal obstruction in the adult: is CT scan of the sinuses necessary?

OBJECTIVE: To determine whether CT (computerized tomography) scan of the paranasal sinuses is essential in the diagnosis and medical/surgical management of nasal obstruction. DESIGN: One hundred thirteen adult patients with nasal obstruction but without signs of sinusitis who underwent CT examination prior to surgery, were included in the study. RESULTS: Fifty seven percent of the CT scans revealed a variety of abnormal findings. Of the patients with an abnormal CT scan, surgical planning had to be altered in 16 patients due to significant abnormalities found on the CT scans. CONCLUSIONS: We conclude that CT scan of the nose and paranasal sinuses is an effective presurgical planning tool in patients with nasal obstruction.

Adolescent↗
PubMed1999

The role of ultrasound in the diagnosis of stitch granulomas following paediatric herniotomy.

OBJECTIVE: To study the role of US in the diagnosis of stitch granulomas following paediatric herniotomy. MATERIALS AND METHODS: A retrospective 10-year study of herniotomies performed by a paediatric surgical service. RESULTS: Twenty children developed stitch granulomas following herniotomy. In all cases, silk sutures had been used in the repair. Masses appeared 1-10 years following surgery and were demonstrated by preoperative US in 17 patients, by CT alone in 1 patient and by both CT and US in 2 patients. CONCLUSIONS: US is an accurate and cost-effective method for evaluating stitch granulomas following herniotomy in children. The procedure is also valuable in marking the position of these foreign bodies prior to removal.

Child, Preschool↗
PubMed1999

Goitre presenting as an oropharyngeal mass: an unusual finding in the elderly.

Thyroid goitre presentation in the neck with extension inferiorly to the mediastinum is well-known. Extension superiorly into the retropharyngeal space is very rare and may be accompanied by change in voice and/or airway compromise. A case is described of a patient with change in voice and mild airway compromise secondary to a goitre presenting in the oropharynx. Computed tomography (CT) and physical findings are discussed with the need to recognize this rare entity.

Aged↗
PubMed1999

Vasomotor rhinitis following trauma to the nose.

Complaints of nasal obstruction following nasal trauma without any deformation have been noticed by rhinologists for many years. However, neither an epidemiologic nor a pathophysiologic connection has ever been established. The complaints and physical examination findings of these patients resemble those of vasomotor rhinitis. Only very few articles suggesting nasal trauma as a possible cause for vasomotor rhinitis have ever been published. We present a retrospective study that found 87 of 802 patients to suffer from vasomotor rhinitis following nasal trauma. No other factors known to cause vasomotor rhinitis were present in these patients. None had any previous nasal problems. We therefore suggest that nasal trauma was the causative factor in their vasomotor rhinitis.

Humans↗
PubMed1999

Platysma myocutaneous flap for intraoral reconstruction: an option in the compromised patient.

The platysma myocutaneous flap is an infrequently used flap in head and neck reconstruction. This flap should be considered for reconstruction of small and medium-sized defects of the oral cavity. We present two cases demonstrating the utility of this local flap in reconstruction. Advantages, contraindications and limitations of the platysma myocutaneous flap are discussed.

Aged↗
PubMed1999

Measurement of urea in human serum by isotope dilution mass spectrometry: a reference procedure.

BACKGROUND: A reference measurement procedure is needed to demonstrate the traceability of results of urea measurements in human serum. We developed a measurement procedure using the principle of isotope dilution gas chromatography/mass spectrometry. METHODS: [(13)C,(15)N(2)]Urea as internal standard was added to a serum sample and equilibrated with endogenous nonlabeled urea. For the preparation of calibrators, the same amount of labeled urea was mixed with known amounts of nonlabeled urea. The serum samples were treated with ethanol to remove proteins by precipitation. The labeled and nonlabeled urea of the samples was converted into a trimethylsilyl derivative of 2-hydroxypyrimidine. The gas chromatography/mass spectrometry system was adjusted to monitor m/z 153 and 168 for the nonlabeled urea derivative and m/z 156 and 171 for the isotopically labeled analogs. The results of the determination were calculated from peak ratios by a hyperbolic calculation function based on the theory of isotope dilution analysis. RESULTS: The procedure was applied to control samples and patient samples and evaluated with respect to its trueness and precision. The standard uncertainty of the results was 0.47-1.72%. CONCLUSIONS: This reference measurement procedure allows values to be assigned to controls and calibrators that are traceable to the primary urea reference material of NIST and, therefore, to the Système International unit "mole" with a low degree of uncertainty. This procedure provides a tool for the highly accurate determination of urea in control materials as well as in patient sera.

Gas Chromatography-Mass Spectrometry↗
PubMed1998

Expression of the ATM gene is significantly reduced in sporadic breast carcinomas.

The gene mutated in ataxia telangiectasia (A-T) patients (ATM) is located on chromosome 11q22-23, a region frequently altered in mammary tumors. Patients homozygous for ATM mutations are prone to develop a variety of different neoplasms. Female heterozygotes have been reported to carry a 5- to 8-fold increased risk of breast cancer. However, germline mutations in the ATM gene are rare in women with sporadic breast carcinomas. Most of the alterations described in A-T patients result in a functionally inactive ATM protein. Moreover, it has been suggested that mutations of the ATM gene in A-T patients influence the amount of ATM mRNA and that this may affect the severity of the disease. In the present study, we have analyzed ATM transcripts in a series of 39 breast carcinomas, 14 benign breast lesions and 12 normal breast tissue samples. ATM mRNA levels were determined by semiquantitative competitive RT-PCR. Competitor RNA molecules for the ATM gene and the housekeeping gene beta-2-microglobulin (B2M) were generated by PCR mutagenesis. Low concentrations of ATM transcripts were detected in breast carcinomas, intermediate levels in benign lesions and highest levels in normal breast tissue specimens (F-test, p = 0.0013). Our results indicate that reduced expression of the ATM gene may contribute to the development and/or malignant progression of breast carcinomas.

Ataxia Telangiectasia Mutated Proteins↗
PubMed1998

Signalling pathways of an insulin-mimetic phosphoinositolglycan-peptide in muscle and adipose tissue.

A novel phosphoinositolglycan-peptide (PIG-P) from the yeast Saccharomyces cerevisiae potently mimicks insulin action on glucose transport and metabolism in rat muscle and adipose tissue. The aim of the present study was to elucidate the cellular signalling pathways of this insulin-mimetic compound. Rapid onset and reversibility of PIG-P action on glucose transport were observed in isolated adipocytes with a half-time of transport stimulation of 6-8 min (insulin less than 5 min). Combined treatment with PIG-P and insulin indicated additive stimulation of glucose transport at submaximal concentrations and non-additive action of both agents at maximal doses. The tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) was markedly increased in response to PIG-P in rat cardiomyocytes without any effect on the tyrosine phosphorylation of the insulin receptor beta-subunit. PIG-P action in these cells was accompanied by phosphorylation/dephosphorylation of several proteins with molecular masses of 15-30 kDa, a response not detected with insulin. Downstream signalling of IRS-1 was then analysed by monitoring IRS-1-associated phosphatidylinositol 3-kinase (PI 3-kinase) activity in cardiomyocytes. A stable (2 and 15 min incubation with PIG-P) 7-fold stimulation corresponding to about 50% of insulin action could be detected. Increased tyrosine phosphorylation of IRS-1 and enhanced PI 3-kinase activity in response to PIG-P independent of the insulin receptor was also observed in isolated adipocytes. Involvement of PI 3-kinase in PIG-P action was subsequently confirmed by the dose-dependent inhibition of PIG-P-activated glucose transport in rat diaphragm and adipocytes by the PI 3-kinase inhibitors wortmannin and LY294002. These data suggest divergent upstream signalling by insulin and PIG-P involving phosphoproteins not affected by insulin. However, PIG-P and insulin action converge at the level of IRS-1 inducing insulin-independent PI 3-kinase-mediated signalling to glucose transport.

Adipose Tissue↗
PubMed1998

Abdominoscrotal hydrocele in infancy: a study of 15 cases.

Only 25 cases of unilateral abdominoscrotal hydrocele (ASH) and 3 of bilateral ASH have been reported since 1834. Fifteen infants with ASH were treated on a single pediatric surgery service during a period of 4 years, accounting for 1.7 per 1,000 outpatient visits. In 4 cases the defect was bilateral. Although this unusual concentration of cases in unexplained, recognition and careful documentation of ASH in infancy is recommended.

Humans↗
PubMed1998

Transnasal endoscopic drainage of a medial subperiosteal orbital abscess.

The exact incidence of orbital complications due to sinusitis in children is unknown. However, a medial subperiosteal orbital abscess is the most common serious complication to occur. Surgical intervention is mandatory whenever antibiotic treatment fails. Most authors prefer open surgical procedures such as external ethmoidectomy, while others recommend transnasal endoscopic drainage as the first attempt at sinus decompression. Five out of 12 children with proven subperiosteal orbital abscess and sinusitis on computed tomographic scans failed antibiotic treatment and required surgical drainage. Transnasal endoscopic drainage of the abscess was performed on four patients, while one child underwent external ethmoidectomy. Our experience with endoscopic surgery in these four cases is discussed, along with a brief review of the advantage of this procedure over external surgery.

Abscess↗
PubMed1998

Use of intranasal endoscopic surgery to relieve ostiomeatal complex obstruction in fibrous dysplasia of the paranasal sinuses.

The use of endoscopic nasal surgery for debulking ethmoidal fibrous dysplasia, blocking the right ostiomeatal complex is presented. Removal of the obstructing bony mass was done by ear curette and drills. The procedure was limited to the ostiomeatal complex in order not to violate the orbital contents. The advantages of this method over the external approach are outlined in this paper.

Adolescent↗
PubMed1997

Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients.

Light is known to be an important modulator of circadian rhythms. We tested the hypothesis than an enduring increase in the daytime environmental illumination level improves rest-activity rhythm disturbances in demented patients. Actigraphy was performed before, during, and after 4 weeks of increased illumination in the living rooms of 22 patients with dementia clinically diagnosed as probable Alzheimer's disease, multi-infarct dementia, dementia associated with alcoholism, or normal pressure hydrocephalus. The results indicated that during increased illumination, the stability of the rest-activity rhythm increased in patients with intact vision, but not in visually impaired patients.

Aged↗