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Biomedical subjects

H D Herrmann

Publications and source records attributed to H D Herrmann.

At least 73 records · Page 4Linked to original sources
PubMed1986

Skull base chordoma with cavernous sinus involvement. Partial or radical tumour-removal?

A report of eight cases of skull base chordoma is given and the related literature reviewed. From disappointing experience with incomplete tumour removal and radiation the conclusion is drawn, that radical tumour removal at the first attempt should be strived for, even if the operative risk seems to be high. Cavernous sinus invasion should not be a reason to omit operation. Loss of function of one eye appears to be justified if radical tumour removal can be achieved. Possibly, the operative strategy can be improved by combining a frontal transbasal with a frontotemporal subtemporal approach, thus creating a chance for preservation of oculomotor function even in patients whose tumour has invaded the cavernous sinus region.

Adult↗
PubMed1986

Bilateral microsurgical lysis of the spinal accessory nerve roots for treatment of spasmodic torticollis. Follow up of 33 cases.

In 1981 we reported about a new surgical procedure for the treatment of spasmodic torticollis (ST). 33 patients, who failed to respond to the available conservative treatment, underwent a bilateral microsurgical lysis (BML) of the spinal accessory nerve roots (SRAN). Anastomoses between SRAN and the dorsal roots of the first and second cervical nerve (DRC 1/DRC 2) were cut. DRC 1 and sometimes DRC 2 were divided bilaterally. Moreover, SRAN was freed of all adhesions and vascular contacts. Up to 60 months after surgery we have excellent results in 5(5), good results in 10(7) and improved symptoms in 12(8) patients. In 3(7) patients symptoms were unchanged, 2(1) patients deteriorated (patients self assessment is given in brackets). One patient died during hospitalisation. Comparing torticollis symptoms and the post-operative outcome it can be shown that patients with horizontal ST have the best results (21 out of 22). Bad results were obtained in patients with combined torticollis symptoms such as retrocollis, antecollis and the rotatory/horizontal type (5 out of 9). These results support the hypothesis of a peripheral factor in the aetiology of horizontal ST. It is assumed that a unilateral disturbance of proprioceptive afferents for head control, which reach the CNS via anastomosis between DRC 1/DRC 2 and SRAN (in 94% of the cases) could be involved. This hypothesis is discussed with special regard to different anatomical findings in patients with ST and those revealed in a study on human cadavers without this disease.

Accessory Nerve↗
PubMed1986

Carpal tunnel syndrome and acromegaly.

50 patients with acromegaly and carpal tunnel syndrome have been examined electrophysiologically before and after transnasal operation of the pituitary adenoma. 32 of the 50 patients (64%) had symptoms of carpal tunnel syndrome. 13 of them had neurological deficits. 28 of the examined patients had pathological neurographical findings only. About 1 week post-operatively DL was decreased in 43%; in 10 out of 13 patients with neurological deficits DL decreased. GH was normalized in 80% and reduced to 5-10 micrograms/l in a further 10%. The investigation did not show whether the carpal tunnel syndrome only depended on a GH increase or on other factors also such as e.g., on the duration of symptoms or tissue changes. None of the patients had the transversal carpal ligament operated on. The coincidence between acromegaly and carpal tunnel syndrome was 64%. In 3 cases the carpal tunnel syndrome was the leading sign to the diagnosis of acromegaly.

Acromegaly↗
PubMed1986

Prostaglandins: antiproliferative effect of PGD 2 on cultured human glioma cells.

Five cultured human glioma cell lines were investigated for their reaction to prostaglandin (PG) D2 and E2. In all cases a suppressive effect on DNA synthesis as assessed by 3H-thymidine incorporation was seen with all test substances as early as six hours after the addition of the compounds in doses of usually 10(-5) M. A dose response curve was generated in four cases and showed an estimated ED 50 of about 5 X 10(-6)M. The effect was most pronounced at 12 hours after which the cultures began to recover except those which had been incubated with PGD2. In those cultures which had been exposed to PGD2 virtually no thymidine incorporation was seen after 24 hours and as long as 72 hours. In another set of experiments, the effect of PGD 2, PGE 2, two synthetic PGD 2 analogues, with a chlorine substitution in position 9 (DACl) or with a fluoride substitution in position 9 (DAF) and a synthetic prostacyclin-analogue (Iloprost) was investigated after single and repeated addition of the compounds. A second administration after 12 hours of incubation did not result in a further decrease in 3H-thymidine incorporation like that observed during that first incubation period. In general the cells recovered after 24 hours total incubation time except those which had received PGD 2 or repeated doses of PGE 2. Only in those cells which had been treated with PGD 2, an almost complete blockade of 3H-thymidine incorporation was seen even after the single administration. Parallel evaluation of the cells by flow cytometry showed effects on cell cycle distribution at different times of the incubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Division↗
PubMed1986

Epidermal growth factor--receptors on cultured human meningioma cells.

Equilibrium binding assays of EGF were performed on confluent cultures of 12 human meningiomas at early passage. In all meningiomas complete binding curves were obtained and the resulting ED 50 values ranged between 0.5 and 6.3 nM. In four cases (ED 50 values ranging from 1.5 nM to 3.0 nM) where saturation analysis was performed, the sites were saturable at similar levels (7 nM). In five cases additional experiments were undertaken to evaluate the biological response of cultured cells to EGF as assessed by 3H-thymidine incorporation. In all cases EGF was a potent stimulus and increased 3H-thymidine incorporation by 2.5 to 6-fold. Functionally intact EGF receptors appear to be a regular feature of meningiomas in cell culture and appear not to be related to histological classification.

Cells, Cultured↗
PubMed1985

[Spontaneous healing of a cavernous carotid sinus fistula caused by a gun shot injury].

We report about a 22-year-old male with a carotid cavernous fistula after gunshot injury. A few weeks later the fistula turned into an intracavernous aneurysm of the internal carotid artery. After four years the aneurysm was no longer demonstrable; the ipsilateral internal carotid artery was spontaneously obliterated. According to the literature a carotid cavernous fistula is found in 0.4% to 1.7% of all cases with head trauma. Its spontaneous cure is a rare occurrence.

Adult↗
PubMed1985

Reflex activity and axonal conduction in the L-7 spinal cord segment following experimental compression trauma.

In cats in which the spinal cord was transected at C-1, the exposed L-7 spinal cord segment was compressed with an electromagnetically driven rod applied to the dorsal surface of the segment. With the magnitude of compression constant at 3 mm, the cord was compressed for durations of 50 msec, 0.5 sec, or 1.0 sec. Polysynaptic reflex discharges integrated in the injured segment and action potentials conducted in dorsal column axons traversing the same region were electrophysiologically measured before, during, and for 41/2 hours after trauma. Structural changes were evaluated on frozen serial sections obtained both from compressed segments and from tissue adjacent to the injury. At a compression duration of 50 msec, the amplitude of evoked reflex activity decreased abruptly, and dorsal column axonal conduction was blocked for 1 minute following compression. This early-phase response was followed by partial recovery of both functions which persisted until the end of the experiment. Prolonging compression to 0.5 sec brought about a further decrease of polysynaptic reflex activity. Axonal conduction was also decreased, but not significantly. With compression lasting 1.0 sec, no significant changes in reflex discharges and axonal conduction occurred compared with those measured at 0.5 sec. Neither function was abolished, even after the longest compression time. Prolongation of compression significantly increased both the intensity and the spread of edema, whereas changes in hemorrhage were not significant. Thus, a plateau rather than a progressive increase in severity of functional and structural posttraumatic changes was reached by increasing the duration of compression. This injury model reduces the sources of variability found in other experimental compression trauma models and permits the quantitative assessment of basic spinal cord mechanisms and correlated histopathological changes in the same preparation following trauma.

Animals↗
PubMed1984

[Hemangioblastomas of the central nervous system. A clinical study].

In a survey of 46 patients with haemagioblastoma of the CNS (Neurology Dept. University Hamburg, 1950-1980) most (n = 40) were found to have angioblastomas of the cerebellum (Lindau tumors). Of these patients 21 were re-examined in 1983. Headache was the most frequent initial symptom (43%), and within this group one-third (10%-15%) had dizziness, sensorymotor deficits and cerebellar gait disturbances. Signs of elevated intracranial pressure much more often led to the correct diagnosis than dizziness or dystaxia. After the introduction of CCT to the diagnostic procedure the combined evaluation of angiography of the vertebral arteries and CCT always permitted the correct diagnosis. The low neurosurgical mortality rate (13.5%) has decreased to 0% within the last decade. No relapses were found in 21 re-examinations including CCT and EOG compared to a frequency of 9.7% in all 46 cases. Significantly less often than expected from other data we found: signs of possible hereditary influence (0%), multiple tumor localization combined with angiomatosis retinae (0%), polyglobulia (10.8%). Psychopathologically relevant signs (45.6%) were, in all cases, combined with signs of increased intracranial pressure. The results of our re-examination demonstrate that late postoperative deficits as well as possible relapses are earlier and more precisely evaluated by the combined use of clinical examination, CCT and EOG.

Adult↗
PubMed1982

[Risk of infection in instrumental and surgical urologic interventions with special reference to catheter drainage].

The risk of infection in instrumental and operative urological surgery is particularly high in the use of catheter drainage. Dependent on the duration of use of a fistula catheter or a transurethral catheter, infection of the urinary tract occurs in almost 100% of cases. The pathogens of hospital infection show a clearly increasing drug resistance. The occurrence of multiple resistances is remarkable. Furthermore, fluctuations in the range of pathogens can be detected. An increase of infection by Proteus and Klebsiella and a decrease of infections of the urinary tract with Escherichia coli and staphylococci have been observed. Prophylactic administration of chemotherapeutic agents cannot prevent the recurrence of iatrogenic infections of the urinary tract.

Adult↗
PubMed1981

Treatment of neurogenic torticollis by microvascular lysis of the accessory nerve roots - indication, technique, and first results.

For treatment of spasmodic torticollis (s.T.) microsurgical decompression of the intraspinal-intracranial portion of the accessory nerve (a.N.) has been performed in 11 patients with proved neurogenic lesions of the accessory nerve-dependent muscles. Neurogenic lesions were discovered by meticulous electromyographic (EMG) examination in 26 out of 32 patients with s.T. Based on the EMG findings and a.N. roots were exposed, mostly bilaterally. During operation we found in each case tight adhesions to adjacent structures, in particular the vertebral artery (v.A.), the posterior inferior cerebellar artery (PICA), and spinal arteries. Moreover, various nerve anastomoses were found between the upper dorsal cervical roots and the spinal a.N. roots. After neurovascular lysis and dissection of anastomoses, to C 1 in particular, the a.N. was protected with teflon-foam (Prosthex). Immediately after surgery torticollis had improved in all but one case. Further improvement was achieved by exercises. These first favourable results, and the fact that nerve decompression is less destructive that other surgical procedures in treatment of s.T., make us feel justified in recommending this procedure further to patients suffering from s.T. with proved neurogenic lesions.

Accessory Nerve↗
PubMed1981

Traumatic arteriovenous fistulae of the middle meningeal artery and neighbouring veins or dural sinuses.

Systematic review of the cerebral angiograms of 446 head trauma patients (1971-1978) revealed the presence of an arteriovenous (AV) fistula of the middle meningeal artery (MMA) in 8 cases (1.8%), the total number of angiographically demonstrable injuries of the MMA being 18 (4%). AV fistulae of the MMA may prevent formation of epidural haematoma, but they are frequently associated with so severe damage to skull and brain that prognosis is nevertheless grave. A close relationship between the tighter adherence of the dura to bone in older age and development of an AV fistula of the MMA following trauma to the skull may be presumed.

Adult↗
PubMed1980

Spinal elastance measurement in patients with spondylogenic narrowing of the spinal canal.

Spinal elastance and the time course of pressure decrease after saline injection into the lumbar subarachnoid space was measured in a control group and in a group of patients with spondylogenic narrowing of the cervical spinal canal. The elastance is higher with retroflexion of the head than with anteflexion. This is more pronounced in degenerative diseases of the spine, proving the existence of a pincers mechanism. High elastance values at high volume changes indicate a narrowing of the cervical spinal canal. With a normal spinal canal the pressure decrease shows a slow monoexponential slope (T/2 = 100.8 +/- 13.4 seconds). In patients with partial obstruction of the spinal canal, especially with retroflexion of the head, a secondary pressure increase after termination of the volume injection was observed. This secondary pressure increase decreases in a biexponential manner with a fast slope (T/2 = 37.62 +/- 15.88 seconds) followed by a slow slope. With severe obstructions a plateau remained. This easily performed and well-tolerated measurement can be of aid in the quantification of obstructions of the spinal subarachnoid space.

Cervical Vertebrae↗
PubMed1979

Transarticular (transpedicular) metal plate fixation for stabilization of the lumbar and thoracic spine.

The operation of metal plate fixation of the articular column with the screws traversing the anterior vertebral arch (ventral pedicles) and anchored within the vertebral body is described in detail. The method can be recommended as easy to perform. It gives sufficiently stable fixation in cases where instability of the thoracic or lumbar spine can be expected during an operation from the dorsal approach. Four cases are presented to illustrate the indications and method.

Adult↗
PubMed1978

The sensitizing capacity of Compositae plants. I. Occupational contact dermatitis from Arnica longifolia Eaton.

Three patients with occupational contact dermatitis due to Arnica longifolia Eaton and Arnica montana L. are reported. During cultivation, harvesting of the flower heads, chemical investigation of the sesquiterpene lactone constituents and preparation of therapeutic tinctures, they had frequent contact with the plant materials. Patch tests with the two sesquiterpene lactones carabron and helenalin, isolated during investigation from A. longifolia Eaton, were positive in all three patients, though the second patient had never shown visible allergic reactions of the skin. Sensitization experiments with carabron in five guinea pigs were successful. The investigation results revealed that carabron, helenalin and the acetyl derivative of helenalin must be considered as the sensitizers of A. longifolia, and helenalin acetate and properly arnifolin as sensitizers of A. montana. Studies on cross reactivity in the sensitized animals with six related sesquiterpene lactones showed that only those compounds gave a positive test response which contain an alpha-methylene gamma-lactone group. Cross reactions were obtained with a crude extract of Chrysanthemum indicum L. The case reports supported by the patch test and investigation results demonstrate that persons handling a new drug from the Compositae family run a risk of developing an allergy after intensive contact with the plant and its constituents.

Adult↗
PubMed1976

A simple bubble-flowmeter with quasicontinuous registration.

The construction of a simple bubble-flow-meter is described. The instrument has the following features: 1. automatic bubble injection, 2. precise measurement of the bubble passage time by a digital counter, 3. quasicontinuous registration of the flow rate, 4. alternative run with clear fluid (water) and coloured fluid (blood), 5. low volume, 6. closed measuring system for measurements in low and high pressure systems.

Regional Blood Flow↗