Biomedical subjects

A Schmiz

Publications and source records attributed to A Schmiz.

3 recordsLinked to original sources

PubMed2000

[Thrombosis of the basilar artery--a rare differential sudden deafness diagnosis and vestibular failure].

BACKGROUND: Occlusion of basilar artery is a rare and life-threatening event. A quick and safe diagnosis and initiation of adequate therapy are decisive. For the ENT-specialist it is important to know that this thrombosis, which runs a lethal course in many cases, can develop with a disturbance of hearing and/or vestibular function as initial symptoms. PATIENTS: Reported are four cases of thrombosis of the basilar or vertebral artery. Two out of four patients contacted the ENT emergency unit because of symptoms of acute vestibular neuritis, one patient was previously diagnosed with sudden deafness by a local ENT-specialist, one patient was treated for hypertension induced epistaxis in one of our wards. Only one patient initially presented additional neurological symptoms, causing suspicion for a brainstem lesion as well. However these symptoms were only noticed on close examination. By immediate anticoagulation therapy (with Heparin) progress of thrombosis could be avoided. The patient showed a complete recovery and was free of any symptoms two years after thrombosis. Two of the other two patients developed a delayed onset of neurological symptoms next to the initial symptoms of vestibular and cochlear affection (within 24 hours), therefore diagnosis of thrombosis was late and despite of immediate anticoagulation therapy (with Heparin) both patients died. The one patient treated for hypertension induced epistaxis developed only discrete symptoms of basilar artery thrombosis, nevertheless he was diagnosed and treated immediately. He made a complete recovery and was dismissed two weeks later. CONCLUSIONS: It is therefore necessary to carefully control and sometimes correct diagnosis in cases of sudden deafness and acute vestibular neuritis. Especially additional neurological symptoms indicate the necessity of a MRI-angiogram or CT-(angiography)scan to exclude thrombosis of the basilar artery.

Adult↗

PubMed1996

[Surgically managed postoperative hemorrhage after tonsillectomy].

BACKGROUND: Bleeding after tonsillectomy is the most frequent and most dangerous complication. We compared the incidence of postoperative bleeding and secondary haemorrhage after tonsillectomy was examined using two methods of hemostasis (suture ligation versus electrocautery). METHODS: The study covered all tonsillectomies performed from 1992 to 1994. Data from about 2096 patients were assessed. RESULTS: The incidence of postoperative bleeding and hemorrhage was 5.4%. When suture ligation of vessels was used to obtain hemostasis during the operation it was evident that postoperative bleeding was rare but more difficult in comparison to the cases in which electrocautery was used alone. While primary bleeding for both methods was similar, secondary bleeding was more frequent after hemostasis achieved with electrocautery. DISCUSSION: Injury of the vessel by suture ligation is thought to be responsible for massive hemorrhage after tonsillectomy. Using electrocautery avoids this pathogenic mechanism. Since electrocautery of the tissue surrounding a vessel produces initial hemostasis, secondary bleeding is more frequent after the wound clot is opened. CONCLUSION: Use of electrocautery for hemostasis is justified since bleeding after primary hemostasis is usually easily managed.

Adolescent↗

PubMed1994

Kavapyrone enriched extract from Piper methysticum as modulator of the GABA binding site in different regions of rat brain.

Regional differences in the modulation of [3H] muscimol binding to GABAA receptor complexes by kavapyrones, compounds of the rhizome of the plant Piper methysticum which possess sedative activity, were demonstrated using membrane fractions obtained from target brain centers of kavapyrone action: hippocampus (HIP), amygdala (AMY) and medulla oblongata (MED), and from brain centers outside the main kavapyrone effects as frontal cortex (FC) and cerebellum (CER). The kava extract enhanced the binding of [3H] muscimol in a concentration-dependent manner with maximal potentiation of 358% over control in HIP followed by AMY and MED (main target brain centers). Minimal stimulation was observed in CER followed by FC. In contrast, apart from CER, the potency of kavapyrones was similar in the brain areas investigated with EC50 values ranging between 200 and 300 microM kavapyrones. Scatchard analysis revealed that the observed effects of kavapyrones were due to an increase in the number of binding sites (Bmax), rather than to a change in affinity. At a kavapyrone concentration of 500 microM the order of enhancement in Bmax was HIP = AMY > MED > FC > CER. When kavapyrones are included together with pentobarbital or HPO the two classes of compounds produced a more than additive, i.e., synergetic effect on [3H] muscimol binding. Our findings suggest that one way kavapyrones might mediate sedative effects in vivo is through effects on GABAA receptor binding.

Animals↗