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Biomedical subjects

G Pfeifer

Publications and source records attributed to G Pfeifer.

At least 73 records · Page 4Linked to original sources
PubMed1980

[The arteries of the forehead as the basis of nasal reconstruction with forehead flaps].

For the reconstruction of nasal defects, paramedian forehead flaps with a small pedicel are used. The nutrition of these flaps depends on the presence of an arterial blood vessel in the pedicel. In constructing the flap it is absolutely necessary to know the position and the course of the vessles in the forehead. The branches of the ophthalmic artery - dorsal nasal artery, supratrochlear artery, and supraorbital artery - are responsible for the nutrition of the forehead. These arteries are connected with those lying next to them. Additionally, they all anastomose with the frontal branch of the superficial temporal artery. The branches of the ophthalmic artery, lying in a more lateral position, follow a diagonal course compared with those lying more medially. Considering all forehead vessels, the forehead branch of the dorsal nasal artery is widely unknown, although it is very important for the supply of the central part of the forehead. Together with the supratrochlear artery, which lies on a paramedian line passing through the medial angle of the eye, it represents the nutrition vessels of the forehead flap. In case of injury of the ophthalmic artery, the anastomosis of the angular artery with the dorsal nasal artery can be of great importance for the supply of the flap.

Adult↗
PubMed1979

The arrangement of muscle fibres in cleft lips.

A total of 63 laterally situated partial clefts of the lip were studied. The biopsies obtained during the first operation were evaluated histologically. With a special stain, the fibre of the orbicularis oris muscle were demonstrated and their arrangement in relation to the cleft lip was recorded. The results indicate a close relationship between type and degree of the cleft and the arrangement of the muscle bundles: In microforms like lip indentations and minor clefts of the lip the natural anatomy is almost unaltered. The muscle "flows" around the "obstacle". But the larger the cleft the more often the muscle fibres end right at the border of the cleft and insertions are often found here. In the remaining skin bridge the number of muscle fibres decreases and their arrangement deteriorates. In the extreme forms, i.e. the band of Simonart and the completely cleft lip, we must assume that most of the fibres stop at the border of the cleft as muscle no longer crosses the defect.

Cleft Lip↗
PubMed1979

[The influence of some inhalation anaesthetics on the intracranial pressure with special reference to nitrous oxide (author's transl)].

The influence of inhalation anaesthetics on intracranial pressure (ICP), arterial blood pressure and cerebral perfusion pressure (CPP) was investigated on 12 unconscious patients with head injury having an initial ICP of about 20 mm Hg. Halothane, enflurane and nitrous oxide induced a considerable rise of ICP during a 15 to 25 minute period of observation. The moderate fall in blood pressure caused by halothane and enflurane enhanced the reduction of the calculated CPP. Besides, a regular fall in blood pressure of about 16% was observed under the influence of nitrous oxide, subsequently reducing the CPP in some cases under 40 mm Hg. Inhalation anaesthetics, including nitrous oxide, should therefore not be used in patients with decreased intracranial compliance before the increased ICP is treated.

Anesthesia, Inhalation↗
PubMed1978

The influence of intravenous anaesthetic agents on primarily increased intracranial pressure.

In the choice of anaesthetics and techniques the danger of a possible progressive increase of intracranial pressure (ICP) should be considered. Therefore the influence of intravenous anaesthetic agents on mean arterial pressure, ICP, and cerebral perfusion pressure (CPP) in patients with primarily increased ICP was observed under standard conditions for 20-40 minutes. Etomidate, thiopentone, propanidid, and ketamine showed remarkable effects on ICP, even in patients with disturbed cerebro-vascular reactivity. Etomidate and thiopentone cause a fall of ICP by 26%. Because of its stabilizing effects on circulation etomidate does not induce a reduction of CPP, whereas thiopentone will do so because of its depressing effect on blood pressure. Propanidid appears to be a less suitable agent when there is raised ICP, because it induces fluctuations of ICP and blood pressure up to the third minute after injection. According to our results, monoanaesthesia with ketamine cannot be recommended when there is increased ICP because it causes a prolonged increase in ICP, and reduction of blood pressure and CPP.

Adolescent↗
PubMed1978

[Effects of etomidate and thiopentone on the primarily elevated intracranial pressure (ICP) (author's transl)].

In 8 patients having primarily an increased ICP, the effects of etomidate on ICP, arterial pressure and cerebral perfusion pressure (CPP) were studied by comparison with thiopentone. The patients received no premedication or basic anaesthesia and relaxation was obtained using pancuronium bromide. Blood gas analysis was performed at regular intervals to maintain a constant level of the arterial pCO2. Under the conditions of a reduced intracranial compliance and an elevated ICP, thiopentone lowered the arterial pressure considerably in contrast to etomidate. The primarily elevated ICP was reduced by both, etomidate and thiopentone to an extent of 27 per cent for more than 10 min. The considerable decrease of arterial pressure by thiopentone caused marked lowering of CPP during more than 10 min. In the same period etomidate did not influence either arterial pressure or CPP. These results show that for the induction of anaesthesia in neurosurgical patients having a primarily increased ICP etomidate has good properties.

Adolescent↗
PubMed1978

[An experimental study of the effect of etomidate on central sympathetic activity, respiration and circulation (author's transl)].

The effect of Etomidate on central sympathetic activity, respiration and circulation were studied in animals at rest and under asphyctic conditions. The doses used were 0.15, 0.3 and 0.6 milligrams/kilogram bodyweight. Injection of the drug into animals at rest caused excitation lasting for about 10 seconds and then lowering of sympathetic activity by about 15-30 per cent. With doses of 0.6 mg the depression lasted for about 15 minutes. Central stimulation by asphyxia often a more pronounced dose-dependent depression of sympathetic activity by about 15-40% of the original level was observed. Activity of the phrenic nerve was affected only with doses of 0.6 mg; the reduction by about 30% lasted for up to 15 min. Injection of 0.6 mg was followed within one minute by a short-lasting fall in blood pressure by about 10%. The heart rate remained unchanged at rest but during asphyctic conditions the heart rate was less slowed down than would normally occur with vagal stimulation. Etomidate apparently also depressed the vagal centres. Similarities and differences in action between Etomidate and propanidid are discussed.

Animals↗
PubMed1977

[Immunological aspects of syngenesioplastic bone transplantation in treatment of infantile bone tumors (author's transl)].

Bone transplantations are made often in the treatment of benign bone tumours or tumour like affections. Especially at the appropriate infantile illness the use of an autologous transplant may prove impossible. Homologous and heterologous osseous transplants are largely unsuitable, because of the induction of immunological reactions. So called syngenesioplastic transplants let expect a tolerance of the recipient organism. This is a report of the results of clinical, radiological and especially immunological follow-up-examinations of 11 patients treated from August 1974 to October 1976 with syngenesioplastic spongiosa transplantation.

Bone Cysts↗
PubMed1977

[The value of artificial respiration for patients with myasthenia gravis (author's transl)].

The value of artificial respiration for the bridging of crises in patients with myasthenia gravis is emphasized on some typical cases. Further use, beyond a life-saving indication, for limited periods is described. Such relative indications may exist, when there is not yet complete respiratory failure but when a worsening of myasthenic weakness or cholinergic intoxication may threaten a respiratory crisis. In order to prevent serious complications, early artificial respiration may be indicated in the following situations: deterioration of cardio-pulmonary complications, important changes in therapy, particularly at the start of immuno-suppressive treatment, following tracheobronchial aspiration, in chronic cholinergic intoxication, following operations under general anesthesia, particularly after thymectomy. The importance of careful psychotherapy of myasthenics threatened by respiratory crises and the well-timed information on the chances, intentions and goals of intensive care including artificial respiration is emphasized.

Anesthesia, General↗
PubMed1977

[Branchiogenic preauricular fistulae].

Seventeen patients with dimples, fistulae and cysts in the region of the cheek and the preauricular field are reported. All are located in the neighborhood of the dorsal end of the first visceral arch. Both the fistulae of the ascending helix and the upper preauricular fistulae must be regarded as relics of the dorsal end of the first branchial cleft. This interpretation supports the theory of Wood-Jones and I-Chuan according to which the tragus is formed from the material of the mandibular arch, and the remaining part of the auricle from the mesoderm of the second visceral arch. Similar anomalies in the neighborhood of the angle of the mouth, the extraoral opening of an accessory duct of Stensen and the inferior preauricular fistula are sufficiently explained by the incomplete closure or tearing of the embryonal oral aperture.

Adolescent↗
PubMed1977

[Disturbances of the clotting mechanism in severe cerebro-cranial injuries (author's transl)].

Factors II, V, X, VIII, thrombin time, platelet count and the thrombelastogram were estimated in 58 persons who had suffered cerebrocranial injuries of varying degree of severity. The aim of the investigation was to elucidate whether and to what extent the injury affected these parameters and whether the destruction of brain tissue could be regarded as the sole cause of the impairment of the clotting mechanism. First estimations in cases of cerebrocranial trauma uncomplicated by other injuries and in cases of cerebrocranial trauma complicated by moderately severe other injuries showed changes in factors II, V, X, VII as well as a pathological thrombelastogram, viz.: hypercoagulability. More pronounced changes were observed in cases where the cerebrocranial injuries were associated with severe complicating lesions: factors II, V, VII, X and the platelet count were reduced by 50-70 per cent of their normal values. Subsequent estimations carried out over a period of 15 days showed that the clotting mechanism had returned to nearly normal within 6-10 days. The use of heparin for normalizing disturbances of the clotting mechanism in cerebrocranial injuries is discussed.

Blood Coagulation Disorders↗