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Biomedical subjects

H Busse

Publications and source records attributed to H Busse.

At least 37 records · Page 2Linked to original sources

Fluence and mutagenic side effects of excimer laser radiation applied in ophthalmology in human lymphocytes in vitro.

PURPOSE: To investigate the influence of different fluences in 193 and 248 nm excimer laser radiation on the yields of chromatid and chromosome aberrations induced in human lymphocytes in vitro. METHOD: Heparinized human blood was exposed to 193 or 248 nm excimer laser radiation. The fluence was gradually increased from 21 to 400 mJ/cm2 in 193 nm (constant total energy of 250 J) and from 150 to 377 mJ/cm2 in 248 nm radiation (constant total energy of 500 J). Chromatid and chromosome aberrations were then analysed microscopically. RESULTS: The yields of chromatid breaks and achromatic lesions depend on the fluence per pulse. This dependence contains a linear component, indicating a threshold of about 70 mJ/cm2 fluence in 193 nm and of about 250 mJ/cm2 fluence in 248 nm laser radiation. An increase of the yield of dicentric chromosomes could only be observed at the highest fluence tested (377 mJ/cm2) in the 248 nm series. Over 126 mJ/cm2 in 193 nm radiation no lymphocytes could be cultured and therefore no aberrations could be found. CONCLUSIONS: Our findings show that the fluence of 193 nm and of 248 nm excimer laser radiation has an effect on the yields of chromatid breaks and achromatic lesions in human lymphocytes under in vitro conditions.

Adult↗

Corneal haze after mechanical debridement for overcorrection after myopic photorefractive keratectomy.

A 47-year-old man had photorefractive keratectomy (PRK) to correct myopia. Three months after surgery he was slightly overcorrected with +1.25-0.5/170 degrees. He then suffered a gout attack and showed a refraction of +2.5-0.5/4 degrees which decreased to +1.75-0.5 degrees. To reduce this permanent overcorrection we performed mechanical debridement of the corneal epithelium. the patient had haze grade 2-3 after 2 weeks and haze grade 0-1 some 4 months later. The refraction was +1-0.5/25 degrees. This case report indicates that mechanical debridement is able to reduce overcorrection after PRK and bears a risk of haze formation comparable to that associated with PRK.

Corneal Diseases↗

p53 oncoprotein overexpression in choroidal melanoma.

This study immunohistochemically demonstrates p53 oncoprotein overexpression on routinely processed choroidal melanomas by means of four different anti-p53 antibodies after high-temperature antigen retrieval. The results were correlated both with morphologic and clinical parameters. Routinely formalin-fixed and paraffin-embedded tumor tissues from 43 choroidal melanomas were immunohistochemically investigated with four different anti-p53 antibodies directed against four different epitopes (CM-1, DO-7, PAb1801, PAb240) after wet autoclave antigen retrieval. The application of this technique is of outstanding importance for the demonstration of p53 protein on routinely processed tissues. Five patients (11.6%) of 43 showed more than 10% p53-positive tumor cell nuclei, which was regarded as p53 overexpression; these five patients underwent preoperative telecobalt or ruthenium irradiation. An additional 18 patients (41.9%) showed a few positively stained nuclei with at least one of the antibodies applied. p53 expression was more often found in epithelioid cell tumors; there was no statistical correlation between p53 overexpression and the clinical outcome. Our results suggest that p53 oncoprotein overexpression in choroidal melanomas indicates a late event in the progression rather than a crucial step in the development of these tumors. This conclusion is supported by the finding that all tumors with immunohistochemical p53 overexpression underwent preoperative irradiation, which might have caused p53 alteration(s) and thus enabled its immunohistochemical demonstration.

Adult↗

Endophthalmitis induced by atypical mycobacterial infection.

Granulomatous uveitis induced by Mycobacterium tuberculosis infection has been less frequently encountered over the last 20 years. Differential diagnosis of M. tuberculosis and other atypical mycobacteria is nevertheless of particular interest in patients with acquired immune deficiency syndromes. We present the case of a 60-year-old man who was referred to our clinic because of therapy-refractive endophthalmitis. Diagnostic vitrectomy including microbiological examination as well as further extensive serological examinations did not reveal any further information on the etiology. Despite intensive anti-inflammatory treatment, the eye became blind and developed secondary glaucoma. Evisceration of the globe had to be performed. Histopathological examination showed a granulomatous inflammation without the tuberculosis-typical development of central caseous necrosis. Further molecular pathological investigations had to be performed with regard to differential diagnostic aspects. By means of the polymerase chain reaction we could detect mycobacterial gene sequences that corresponded to atypical mycobacteria. The diagnosis of atypical mycobacterial infection was confirmed Molecular-genetics examination techniques, especially those involving the polymerase chain reaction, will become more important in routine histopathological examination. These techniques can be performed on paraffin-fixed or formalin-embedded material for further differential diagnostic considerations.

Antigens, Bacterial↗

[Detection of atypical mycobacterial endophthalmitis by PCR].

We report a case of a 60 year old male who presented with a therapy resistant endophthalmitis which led to an evisceratio bulbi. Histologically, a granulomatous inflammation was present, in which acid-fast bacilli could not be detected. Molecular genetic examination by means of polymerase-chain-reaction technique (PCR) of the routinely processed tissue material revealed the diagnosis of an atypical mycobacterial infection, because DNA specific for atypical mycobacteria was detected. This example shows that PCR technique provides a useful tool in the diagnosis of mycobacterial infections as an adjunct to surgical pathology.

Aged↗

Correcting myopic astigmatism with an areal 193 nm excimer laser ablation.

A new system to correct symmetric bow-tie myopic astigmatism with the excimer laser using oval apertures for toric ablations is described. Initial results in two patients who had -5.0 and -5.5 diopters of astigmatism after surgery with six-months follow-up showed a reduction of up to 85% with a minimal axial error of two degrees.

Aged↗

[Unilateral tucking and advancement of the inferior oblique muscle for treatment of A-pattern strabismus].

PATIENTS: The clinical results of the unilateral tucking and advancement of the inferior oblique base on the retrospective data of 81 patients. METHOD: Tucking and advancement of the inferior oblique was used in A-pattern strabismus, which showed a marked hypofunction of the inferior oblique in relation to hyperfunction of the superior oblique. RESULTS: The unilateral tucking and advancement of the inferior oblique improves the incomitance as well as the elevating deficiency in adduction. The effect of the operation relative to incomitance depends on its preoperative state. With increasing A-pattern strabismus has an increased effect of the advancement and tucking is revealed. CONCLUSION: Unilateral tucking and advancement of the inferior oblique is not a routine procedure in the treatment of A-pattern strabismus, but it is possible to improve the incomitance and the elevating deficiency in adduction.

Adolescent↗

[Endonasal implantation of a silicon mold improves the long-term outcome of revision surgery in lacrimal duct stenoses].

BACKGROUND: Uncomplicated dacryocystorhinostomy after dacryocystitis with lacrimal sac obstruction has a success rate of 85%. However therapy of restenosis poses a problem. Vast destruction of lacrimal and nasal mucosa renders the drainage system susceptible for further stenosis. This article presents a new surgical procedure for the treatment of restenosis of the nasolacrimal apparatus. The major difference from other techniques is the endonasal implantation of a silicon foil. This counters the development of synechiae and promotes the epitheliasation of wound surfaces. As a result the nasal mucosa can easier gain access to lacrimal mucosa. A complete mucosal coating of the reconstructed lacrimal drainage system is an important condition for the sufficient drainage of the tear-film. PATIENTS AND METHODS: In 30 patients with restenosis after one or multiple dacryocystorhinostomies a silicon foil was implanted endonasally as part of their surgical revision. After skin incision and removal of scar tissue the bony ostium was enlarged. The canaliculi were intubated with silastic tubing. Afterwards the endonasal synechiae were split and a 0.2-0.4 mm silicon foil was implanted endonasally und fixed. The silastic tubing was brought through a hole in the silicon foil and knotted inside the nose. Then the wound was closed. Postoperative evaluation of the surgical success ranged from 3 to 36 months (mean 16 months). RESULTS: The postoperative result was good in 24 patients. Sixteen patients were without symptoms. 8 had epiphora only on stress. The latter felt their situation to be greatly improved. The long-term results were directly proportional to the amount of reconstructable mucosa and inversely proportional to the severity of canaliculus damage. Adverse reaction to the silicon foil were not noted. CONCLUSION: Endonasal implantation of a silicon foil is a new, easy and successful technique for the treatment of endonasal synechiae and restenosis of the nasolacrimal apparatus.

Adolescent↗

[Treatment guidelines in various stages of senile retinoschisis].

BACKGROUND: Concerning the indications, progression in course and the possible complications, the different methods of treatment in cases of retinoschisis in its different expressions were examined. A staging of senile retinoschisis is presented. PATIENTS: Patients' natural course, prophylactic treatment against expansion and treatment of retinal detachment were examined. RESULTS: The lateral and central barrier of laser or cryo around the schisis is contradictory since a progression in direction to the macula is the result. Three of such cases could be found. In 6 of 52 cases with prophylactic treatment of an outer layer defect with cryo the result was a schisis detachment. In all these cases a retinal reattachment was performed with the Custodis procedure. The final anatomic result of 95 treated schisis retinal detachments was a 98% success. The symptomatic or progressive cases had a little less favourable outcome. CONCLUSIONS: The only indication for treatment of a schisis at present is the symptomatic or progressive schisis detachment with threatening of the macula. Lateral or central barring of a schisis or treatment of the borders of an outer layer retinal break should be avoided. The rate of reattachment and the functional results are better than in the group of rhegmatogenous retinal detachments including the 50.5% schisis retinal detachments without symptoms.

Adult↗

[Special indications for photorefractive (PRK) and phototherapeutic (PTK) excimer laser keratotomies. A presentation of 5 cases].

Five patients with specific indications for photorefractive and phototherapeutic keratectomy (PRK and PTK) by excimer laser at 193 nm were treated successfully: they had presented with epithelial dystrophy of the cornea, amyloid, von Szilly's scleroperikartitis, myopia after cataract extraction and before secondary implantation of an intraocular lens in the other eye, and myopia. In all cases it was possible to avoid extensive surgical procedures such as lamellar keratoplasty or intraocular lens exchange. There were no recurrences in the patients with superficial corneal diseases, and the patients who had undergone PRK were within 0.25 Dpt of the target acuity. The follow-up was between 8 months and 1 year.

Adult↗

[Excimer laser phototherapeutic keratectomy (PTK) and modified bare sclera technique for treatment of pterygium].

Forty-six pterygia were surgically removed using a modified "bare sclera" technique. Additionally, an excimer laser PTK was performed using the immersion method to smooth the irregular surface of the cornea. Follow-up was 6 to 10 months. We found 24 recurrences. In patients with pterygia of more than 4 mm who were from southern Europe, the Middle East, or Africa, the recurrence rate was 100%. In pterygia from 2 to 4 mm the recurrence rate was 50%; in pterygia up to the limbus no recurrences were noted. The excimer laser has no positive influence on pterygia recurrences that have been removed using the modified "bare sclera" technique.

Adult↗

[Occupational therapy and possibilities for interpersonal contact in a psychiatric department of a social psychiatry center].

Patients of the Department of Psychiatry of the Municipal Hospital Centre in Duisburg-Rheinhausen, Germany, are offered work therapy mainly by the nearby Sociopsychiatric Centre "Cuckoo's Nest". The possibilities of working and establishing contacts are described in detail after a brief review of the development and the advantage of shifting work therapy to an external, non-clinical site. Finally, the question is discussed whether the areas "work" and "leisure time" complement or substitute each other.

Combined Modality Therapy↗

[15 months photorefractive keratectomy at the Munster University Eye Clinic].

We performed a photorefractive keratectomy (PRK) in 51 myopic eyes of 34 patients. Cortisone-responders were excluded. All patients were unable to tolerate contact lenses. The intended correction was between -1.75 and -7.0 D. None of the patients demonstrated a decrease in visual acuity at its highest level of correction. The maximum haze was +1. No eye had to be reoperated upon. Nine months after PRK, the maximum deviation from the intended correction was 2 D in a -6.5 D correction. After 12 months, however, we found a regression of 2 D without signs of keratoconus or increase of haze in 2 patients.

Cornea↗