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Biomedical subjects

B Seitz

Publications and source records attributed to B Seitz.

At least 145 records · Page 8Linked to original sources
PubMed1993

[Herpes simplex keratitis. On the long-term prognosis of first transplants after penetrating keratoplasty].

Eighty-six consecutive first grafts performed between 1980 and 1990 (86 patients) for herpes simplex keratitis (HSK) were studied retrospectively (mean follow-up 4.1 years). Indications for penetrating keratoplasty (PKP) included: persistent inflammation, descemetocele or perforation (21/86); stromal opacities with vascularization (43/86), and avascular stromal opacities (22/86). The overall survival rate of clear transplants was 80% after 2 and 68% after 11 years. Corneal inflammation at the time of surgery was found to be a prognostic factor, but not corneal vascularization: The 2-year survival rates for clear grafts were 95% for avascular and 83% for vascularized stromal opacities in clinically inactive eyes, as against 58% for clinically active corneas at the time of surgery. HSV-specific structural proteins were immunohistochemically detectable most often in keratectomy specimens from patients with corneal inflammation before the operation (91%). In the group of clinically inactive stromal opacities, HSV antigens were detectable significantly (P < 0.001, chi-square test) more often in keratectomy specimens from patients with avascular opacities than in those with vascularized opacities. This may explain why corneal vascularization is not a significant risk factor for HSV recurrences. The different frequency of HSV-specific proteins in avascular and vascularized corneas merits attention in the intra- and postoperative management of patients with HSK undergoing corneal transplantation.

Adolescent↗
PubMed1993

[Pilomatrixoma of the eyelids--clinical differential diagnosis and follow-up. Report of 17 patients].

Pilomatrixomas (benign epithelioma of Malherbe) are often located in the eyelid or eyebrow. Clinically the diagnosis is rarely made. Histologically, especially in partial biopsies, they can be confused with a basal cell carcinoma. We evaluated 17 tumors in 17 patients (19 months to 80 years old). The interval between the diagnosis and total excision of the mass ranged from 4 weeks to 2 years. The clinical misdiagnosis appeared to be related to the patient's age: A cystic dermoid (4x) was considered most frequently in children and sebaceous cyst or atheroma (5x) in patients of middle age. Further diagnoses were as follows: Chalazion, basal cell carcinoma or keratoacanthoma, epidermoid cyst, abscess, papilloma. Nine tumors showed calcifications that might be visible by X-ray examination. After a mean follow-up of 7.6 years no recurrence was observed. Pilomatrixoma should be included in the clinical differential diagnosis of subepidermal solid or cystic tumors, especially in the upper eyelid and eyebrow.

Adolescent↗
PubMed1993

Limbus-parallel keratotomies and compression sutures in excessive astigmatism after penetrating keratoplasty.

From 1986 to 1991, among 980 penetrating keratoplasties, all 22 patients were studied retrospectively who had undergone 28 refractive procedures because of high corneal astigmatism after penetrating keratoplasty. In 8 procedures, only relaxing incisions were made, and in 20 procedures, additional compression sutures were placed at 90 degrees to the former. In 7 cases the relaxing incisions were located on the patient's peripheral cornea and in 21 cases, inside the graft margin. The absolute preoperative corneal astigmatism was 7.25-20.0 D (mean, 11.5 +/- 3.1 D). Immediately after surgery it was 0-14.0 D (mean, 7.0 +/- 3.6 D). The vector-corrected astigmatism immediately after surgery was 1.0-28.9 D (mean, 13.2 +/- 7.8 D). After a mean follow-up of 20.6 months, the mean residual astigmatism was 1.0 +/- 11.25 D (mean, 5.4-2.5 D). The mean postoperative vector-corrected astigmatism was 0-19.3 D (mean, 9.1 +/- 4.6 D). The best-corrected preoperative visual acuity was 0.12-0.9 (mean, 0.4), the best postoperative visual acuity was 0.3-1.2 (mean, 0.6). The approach described may reduce disturbing postkeratoplasty astigmatism--although the predictability remains unsatisfactory.

Adolescent↗
PubMed1992

Lamellar excimer laser keratoplasty: reproducible photoablation of corneal tissue. A laboratory study.

We examined the depth of ablation of the recipient bed with different counts of oscillations of excimer laser beam, to determine the correlation between planned and real depth. The ablation rate per oscillation was tested preoperatively by blackened photographic paper of defined thickness and thus was calculated to be 5 microns. Forty pig eyes were used for the first study. Each eight eyes were ablated in the planned depth 100 microns, 200 microns, 300 microns, 400 microns and 500 microns. The corneal thickness was measured with an ultrasonic pachymeter before and after the procedure. The depth measured after the photoablation was 99.4 +/- 36.4 microns for 100 microns planned depth, 186.7 +/- 55.3 microns for 200 microns, 298.4 +/- 68.5 microns for 300 microns, 373.9 +/- 65.7 microns for 400 microns and 480.1 +/- 59.3 microns for 500 microns. Comparing the depth measured after the photoablation to planned depth, there was a significant correlation (correlation coefficient: R = 0.93; p < 0.0001). Five other corneas trephinated from pig cadaver eyes were ablated from the endothelial side to the desired thickness (100 to 500 microns) of lamellar graft. In a second step a donor mask was placed onto the cornea and a laser light spot was led until perforating on all sides. The lamellar keratoplasty was completed by suturing the corneal graft into the bed. Macroscopic and microscopic examination of sutured eyes after fixation showed a good fit of wound margins and stromal interface. These results indicate that excimer laser is useful for reproducible corneal photoablation in lamellar keratoplasty.

Animals↗
PubMed1991

[Lipid pneumopathy and bronchopulmonary adenocarcinoma. Apropos of a case].

The authors report a case of a patient aged 83 who presented with a lipid pneumonia and a primary broncho-pulmonary adenocarcinoma of the left lower lobe. The diagnosis of the lipid pneumonia was confirmed following broncho-alveolar lavage and the autopsy confirms the neoplastic origin of the mass lesion at the left base. The authors report 16 similar cases in the literature between 1943 and 1989.

Adenocarcinoma↗
PubMed1990

[Diagnosis of pleurisy].

Nowadays, the diagnosis of pleural effusion is greatly facilitated by thoracoscopy. Since most pleural effusions are due to neoplasias (notably in patients older than 40 years) and since the prognostic value of an early diagnosis is obvious in case of pleural carcinoma (notably mesothelioma), there is no justification in allowing the effusion to become chronic. If the diagnosis is confirmed by needle biopsy, thoracoscopy can rapidly be performed by skilled operators: in 95 p. 100 of the cases it provides the diagnosis. Five per cent of pleural effusions remain of unknown origin. In such cases the patients must be closely followed up for 12 to 18 months to make sure that no cancer has been missed and another thoracoscopy must be performed at the slightest clinical change. Test treatments (antibuberculous drugs, corticosteroids) are now obsolete.

Biopsy, Needle↗
PubMed1990

[Diagnosis and prognosis of malignant mesothelioma].

The early diagnosis of mesothelioma rests on very common clinical evidence, including pleuritis of recent onset, history of contact with asbestos, chest pain, often moderate loss of weight and slight changes in old pleural fluid cytology, 24% for Adams' needle biopsy and 93% for thoracoscopy, where the only negative results are obtained in patients with adhesive pleuritis. Prognosis depends on several factors, the most favourable ones being the histological type of the lesion (epithelial or mixed), the fact that it is limited to the parietal or diaphragmatic pleural and, on the patient's side and accessorily: female sex, lack of exposure to asbestos, age under 50, good general condition and absence of chest pain.

Adult↗
PubMed1990

The role of thoracoscopy in the evaluation and management of pleural effusions.

Diagnostic thoracoscopy is indicated in every patient where the usual investigations (including biochemistry, cytology, bacteriology, occasionally needle biopsy of the pleura) do not achieve a precise diagnosis. The percentage of so-called "idiopathic" effusions, amounting to approximately 20% in many published series, can be reduced to 4% after thoracoscopy. The sensibility of thoracoscopic biopsy reaches 93-97% of malignant or tuberculous pleural effusions. The procedure requires a short hospitalization of about 36 hr, and complications are rare. Therapeutic thoracoscopy is frequently performed in chronic, malignant, recurrent effusions in order to achieve a pleurodesis by means of a talc poudrage under visual control. The efficacy of the poudrage in the published randomized studies is better than tetracycline. About 90% of patients are cured, the effusion being totally suppressed. Side effects are rare if the quantity of talc does not exceed 10 ml.

Diagnosis, Differential↗
PubMed1990

[Endobronchial tuberculosis simulating cancer].

Endobronchial tuberculosis may simulate a bronchial neoplasm. It is the data from a bronchial biopsy carried out along with the X-ray and endoscopy examination followed by the bacteriology of the expectorating sputum which enables a diagnosis to be made. This form of diagnosis is known but is rare. The clinical outcome is very good after specific treatment, although the radiological signs and above all the endoscopic findings improve more slowly.

Adult↗
PubMed1990

[The value of initial thoracoscopy in the treatment of pneumothorax].

Various methods have so far been used to treat pneumothorax, including rest, needle exsufflation and blind drainage. The results obtained are varied but the recurrence rate is high, averaging 50%. With thoracoscopy, not only can the pleura be explored and the cause of pneumothorax investigated, but specific treatment of the lesions can be carried out in some cases and symphysis can be obtained by pleural poudrage, thereby avoiding recurrences. One-hundred and eleven cases of pneumothorax collected over a 5-year period are reviewed in this study; the results of exploration and those of endoscopic treatments are given and commented upon.

Adolescent↗
PubMed1989

[Experimental study of the pleural effects of the pulverization, under thoracoscopic control, of a fibrin glue (Tissucol)].

The instillation of a fibrin sealant (Tissucol) has been proposed in the treatment of recurrent spontaneous pneumothorax. The present work is devoted to an experimental study in the dog of the effects of this substance on the pleural cavity one and two weeks after instillation under thoracoscopic control. Its action is compared to that of placebo (methylene blue). The instillation of a placebo (n = 5) did not alter the ventilatory mechanics or the structure of the pleura. On the other hand Tissucol (n = 6) led to a fall in the thoraco-pulmonary compliance (-14%), corresponding to that of the vital capacity (-10%). In these animals, no pleural symphysis was noted, but the histological analysis gave evidence of changes in the layers of the parietal and visceral pleura: an inflammatory mononuclear reaction (71% of cases) and/or polymorphonuclear (54%), recent fibrosis (67%) and more rarely a mesothelial hyperplasia (21%). The maintenance of the integrity of the mesothelial cellular layer would explain the absence of pleural symphysis after instillation of Tissucol. These results as well as those recently obtained in the human situation prompt us to advise other methods of pleural symphysis which have been tried and tested, such as talcage or surgery.

Animals↗
PubMed1989

[Complicated hydatid cyst of the lung. Endoscopic diagnosis. Spontaneous favourable outcome].

We report the case of a 16-year old male patient admitted for bronchial suppuration, haemoptysis and opacity with abscess located in the inferior lobe. General deterioration, notably a loss of 10 kg in 2 months, and the radiological findings were strongly suggestive of tuberculosis, pyogenic abscess or malignant process. Bronchial fibroscopy provided a diagnosis of hydatid cyst by showing shreds of the cyst membrane protruding through the opening of the posterior basal segmental bronchus. The diagnosis was confirmed by pathological examination and serological tests. The spontaneous course of the disease was favourable, with complete emptying of the cyst contents following vomica. The need for surgery is discussed.

Adolescent↗
PubMed1988

Mechanical properties of isolated fetal miniature pig lungs after substitution with fluorocarbons.

In our present study we tried to inflate and stabilize isolated immature lungs of fetal minipigs in gestation age of 95 days (= 85% of total normal gestation period) with different fluorocarbons. Based on our previous experiences, the immature lungs at day 95 are almost non inflatable with air. For our experiments we used fluorocarbon 43 (FC-43) with a surface tension of 16 mN/m and fluorocarbon 72 (FC-72) with a surface tension of 12 mN/m. Eighteen fetal immature lungs were used. In group 1 the lungs were rinsed with FC-43; in group 2 the rinse solution was FC-72, and in group 3 the lungs were untreated. After removing the fluorocarbon, in the case of groups 1 and 2, the lungs were artificially ventilated. Pressure-volume (p-v) curves were registered in the beginning (immediately after FC lavage), after 10 and 20 min of artificial ventilation. Airway opening pressure (pi) and weight-specific end-inspiratory lung compliance (ci) were investigated. Statistically significant differences in weight-specific end-inspiratory compliance were found between FC groups and untreated group 3, but no stabilization could be seen during the investigation period of 20 min. No statistically significant improvement in weight-specific end-inspiratory compliance was observed between group 1 and 2, although the compliances of group 2 with FC-72 were better than those of group 1 with FC-43 in three p-v diagrams registered in the beginning and after 10 and 20 min of artificial ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

[Early and late results following 244 reconstructions of the internal carotid artery with contralateral internal carotid occlusion].

Between December 1974 and March 1985 244 reconstructions of the internal carotid artery with contralateral occlusion were performed. 7.3% of the patients were asymptomatic, 48.4% had typical transient ischemic attacks and 44.3% had a completed stroke. The postoperative mortality was 2.0% and a permanent neurologic deficit occurred in 3.3%. An intraluminal shunt was used in only 5.4%. The long-term survival rate after 5 years was 65.2 +/- 4.8%. In the follow-up period of 103 months 9.2% of the patients had a new stroke.

Arteriosclerosis↗
PubMed1985

[Sonographic positioning of the Shaw central Silastic floating catheter].

By means of abdominal ultrasound and two-dimensional echocardiography the exact position of 0.6 mm silastic catheters within the heart and/or great vessels (VCI, PA) can be detected and corrected under continuous control. This eliminates the need for radiological examination by contrast media, since the system might deconnect, become contaminated and/or obstructed during this manoeuvre. While radiology sometimes fails to show the exact position of the catheter, ultrasound reveals the exact position and the interaction of catheter and cardiac structures.

Catheters, Indwelling↗