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Biomedical subjects

H J König

Publications and source records attributed to H J König.

At least 19 recordsLinked to original sources
PubMed1999

Photoablation of meningiomas and neurinomas by Holmium Yag laser radiation.

Cranial rat bone was irradiated by 2.1 microns Holmium Yag laser radiation. Quantitative edge rates were calculated. Histologic sections were investigated by light and electron microscopy. Eighteen cases of hard fibrous or calcified spinal and cranial meningiomas and neurinomas were operated upon using pulsed laser beam. In rat cranial bone ablation rate ranged between 0.3-0.5 mm per pulse. Perifocal thermal damage was observed in a zone of 20-90 microns around the lesion. In all human cases tumors could be removed totally without additional neurological deficit. In vivo heat development was measured by an i.r.-camera.

Animals↗
PubMed1998

Obstructive sleep apnoea and diabetes mellitus: the role of cardiovascular autonomic neuropathy.

Knowledge of conditions associated with an increased prevalence of obstructive sleep apnoea (OSA) may help to identify patients with OSA and might give some insight into the pathogenesis of OSA and its sequelae. A number of earlier, smaller studies hinted at an association between diabetic cardiovascular autonomic neuropathy (AN) and OSA. The present study was, therefore, conducted with the aim of establishing the prevalence of OSA in diabetics with AN and of determining whether OSA is more prevalent in diabetics with AN, than in those without. We studied two groups of diabetic patients: 23 with and 25 without AN. All patients were evaluated for possible OSA (apnoea/hypopnoea index > or = 10) using initial ambulatory screening followed by polysomnography. Six patients with AN (26%) were found to have OSA, but none of the patients without AN met the diagnostic criteria (p<0.01). When the patients with OSA were compared to those without, no differences were found in terms of age, sex, body mass index or diabetes type or duration. In conclusion, about one in four diabetic patients with autonomic neuropathy suffers from OSA. Thus, obstructive sleep apnoea is more prevalent in diabetic patients with autonomic neuropathy, than in those without.

Autonomic Nervous System Diseases↗
PubMed1995

[Restriction enzyme mismatch polymerase chain reaction in the demonstration of Ki-ras-oncogene mutation in carcinoma of the pancreas].

A pilot study was undertaken to test whether combining the polymerase chain reaction with restriction fragment length polymorphism is suitable for the routine diagnosis of carcinoma of the pancreas. The method makes it possible to recognize point mutations in codon 12 of the Ki-ras oncogene. 60 cytological specimens from the pancreatobiliary tract, the bronchopulmonary system (by bronchoalveolar lavage or from pleural effusion) and ascites were tested. Results from nine pancreas carcinoma cell lines served as control. A PCR product was successfully amplified in all cell lines and 47 of the clinical specimens. In all eight samples in which a mutated Ki-ras oncogene was demonstrated, there was at least a suspicion of malignancy by cytological examination. A mutation was also found in four of five pancreas carcinomas. But no mutation was found in one, clinically certain, case of pancreas carcinoma. The described method is an elegant and, most of all, rapid means to complement and optimize any cytological diagnosis.

Ascitic Fluid↗
PubMed1993

[Photoablation using Excimer laser irradiation--a suitable concept for microneurosurgery?].

The suitability of Excimer laser beam for microneurosurgery was investigated in an animal experimental study. Cranial bones, cortex and the nervus ischiadicus of the rat were irradiated with 193 nm argon fluoride, 248 nm krypton fluoride, 308 nm xenon chloride and 351 nm xenon fluoride. After survival times of up to 30 days microscopic and electron optic findings of laser lesions at the tissues mentioned above, were studied. By means of the Excimer laser beam high precision tissue effects without or with only low thermal damage to the surrounding tissue were produced with any desired depth of penetration or extension. In analogy with the experiences gathered from animal experiments, a possible use is discussed for the removal of bone tissue around cranial nerves or vascular structures, of epileptogenic foci, or for cutting off pathways in pain surgery (e.g. the zone of entry of the dorsal root of spinal nerves).

Animals↗
PubMed1992

[Legal evaluation of intervertebral disk surgery including post-discotomy syndrome].

Although lumbar disc surgery (discectomy) definitely improves the overall situation of the patient in most cases, it does create problems of a hitherto absent kund in about 6% of the patients. Expertising of uncomplicated cases should not be too difficult. However, modulated by individual disposition, a syndrome may develop known as "failed back surgery syndrome" caused by intersegmental loosening, crumbling or fusing and scarification. The pain it causes is decisive for its assessment, not so much any motor or other neurological deficits. In mild cases the loss in capacity for gainful employment may be assessed at between 20% to at the most 30%, but the severely handicapped are unable to cope with their daily life without assistance, their incapacitation amounting to as much as 100%. If the patient concerned is on a job that places stress on this spine, he may be unfit for work even if the affliction is relatively mild.

Disability Evaluation↗
PubMed1991

[Cerebrovascular disorders and administration of oral contraceptives containing gestodene--causal relation or coincidence?].

During the last two years oral contraceptives containing gestodene were suspected to cause cerebrovascular disorders. 52 cases with adverse neurological side effects were registered up to October 31, 1990. Anonymous protocols received from the Companies Schering AG and Wyeth Pharma were analyzed from a clinical point of view. There are different arterial and venous, thrombotic and embolic disorders caused by different pathogenetic principles. Only one third of the cases was documented by neuro-imaging to render possible actual diagnostic reliability. Suspected cases represent a great number of different cerebrovascular disorders usually observed in neurological and neurosurgical series, concerning both men and women, OC-users and non users.

Adolescent↗
PubMed1991

Ifosfamide, vindesine and recombinant alpha-interferon combination chemotherapy for metastatic renal cell carcinoma.

Among 29 evaluable patients with progressive metastatic renal cell cancer treated by interferon alpha 2b in combination with vindesine and ifosfamide, we have observed an objective (complete and partial) response rate of 24.1% and an overall (complete and partial response and stable disease) response rate of 58.6%. The median duration of remission has not yet been reached, but the survival of responding patients is considerably longer than that of non-responders. Because we could not find any differences (sex, age, WHO performance status, prior therapy, site of metastatic disease) between responding and non-responding patients, we believe that the treatment might modify intrinsic characteristics of the tumour growth and/or host-tumour relationship in the long term. Although the toxicity recorded is high, the results are sufficiently positive to justify further investigation of this approach.

Adult↗
PubMed1991

[Perioperative preventive use of antibiotics in neurosurgery. Experience with a fixed antibiotic combination of mezlocillin and oxacillin (optocillin)].

We report a retrospective account of 200 patients who have been surveyed after having undergone neurosurgical intervention. They received as perioperative antibiotic prophylaxis a combination of Mezlocillin and Oxacillin in a ratio of 2:1 (Optocillin) in their management. The clinical and bacteriological efficacy including the side effects was examined with standardisation of sterility measures in the operating theatre, careful standardised operative procedures and ward after care. No problems in wound healing were found. There was no certain evidence of side effects.

Central Nervous System Diseases↗
PubMed1990

[Phase II study with pirarubicin in pretreated progressive head-neck neoplasms].

Sixteen heavily pretreated patients (pts) (4 surgery + chemotherapie + radiotherapy; 4 chemotherapy + radiotherapy: 6 surgery + radiotherapy; 2 chemotherapy) and one previously untreated patient, who refused surgery and or radiotherapy, all with progressive disease, with advanced squamous cell carcinoma of the head and neck were included in a phase II study with pirarubicin 60 mg/m2 i.v. day 1 every 3-4 weeks (CT). All pts received at least one course of CT. 15 pts were evaluable for response, all 17 pts were evaluable for toxicity. Female (male ratio 1/16; mean age 56 (42-68) yrs, mean performance status 70% (50-70). Seventeen pts received a mean of 3 (1-8) courses, 2 pts had received only one course of CT. Response and toxicity were assessed according to WHO classification. Results after 1-8 courses of CT: 1 (7%) complete remission; 1 (7%) partial remission; 9 (60%) no change; 4 (26%) progressive disease. No toxicity of grade IV was observed. Mean duration of remission 16 weeks. Median survival time 7 (1-10) months. 9 pts died and 8 pts are alive; six of them had progressive disease.

Adult↗
PubMed1990

Prophylaxis of fungal infections with itraconazole in immunocompromised cancer patients.

During a period of 32 months (August 1986 until April 1989) 108 patients (74 women, 34 men; mean age 53 years) with neoplastic diseases (59 patients with solid tumors, 45 patients with lymphomas, two patients with acute leukaemias, one patient with chronic myelogenous leukaemia, one patient with aplastic anaemia) were studied in the Department of Internal Medicine of the University Erlangen-Nuremberg. Most were treated with a cytostatic chemotherapy. In order to prevent a mycotic infection in these immunocompromised patients, itraconazole, a new broad-spectrum antimycotic drug of the azole group, was given in an oral dosage of 100 mg day-1 (mean duration of prophylactic treatment 24 months). Localized Candida infections involving the oropharynx and the female genital organs were diagnosed in 16 patients (14.8%). Candida endophthalmitis occurred in one patient (0.9%). The serum concentration of Candida antibodies was significantly elevated in one patient (0.9%) without evidence of fungemia. Itraconazole had to be discontinued in four cases (3.7%) due to minor side effects of the drug (nausea, stomach complaints). Itraconazole appears to be a safe and effective antimycotic drug in long-term use in neutropenic patients.

Adult↗
PubMed1990

[Comparative clinical studies of oral premedication in childhood with reference to various pharmaceuticals].

In a randomized prospective study of 206 children aged between one and 14, the influence of oral praemedication on the psychic condition and with regard to anaesthesiologic measures was investigated. Heart rate, inhibition of salivation and the kind and frequency of side-effects were also examined. The praemedication was carried out using diazepam (0.3 mg/kg), promazin (1.0 mg/kg), promethazin (1.0 mg/kg) and chlorphenaethazin (1.0 mg/kg). It was not possible to determine statistically relevant differences between the various drugs concerning the fixed criteria. In general, however, diazepam seems to achieve the best results. In the younger children (1 to 6 years) a frequent and insufficient effect of praemedication was noted immediately. Oral praemedication proved to be a valuable and practicable method which was well tolerated by the great majority of the children.

Administration, Oral↗
PubMed1989

[Patients with craniocerebral injuries and their reintegration into vocational life. The effect of parameters independent of the accident on expert assessment].

A prospective study of 60 patients with head injuries who received both primary care and an assessment at our Department, the influence of various parameters on the assessment was investigated. Catamnestically, the insurance-relevant results actually achieved are shown. It can be seen that at a 40 per cent incapacitation, reintegration into the work-a-day world is hardly possible.

Adolescent↗
PubMed1989

Degenerative and regenerative processes in the peripheral nerve after disconnection and reanastomosis using the Neodym Yag laser.

The development of neuroma after peripheral nerve surgery is still an unsolved problem. Such lesions are not yet controllable by conventional methods. Reports of results achieved using various types of laser surgery appear contradictory. In this experimental study on rats, the Neodym Yag laser was found to be superior the conventional methods. After severance and reanastomosis of the sciatic nerve using this type of laser, no development of neuroma was observed in any of the animals during the first three months of observation.

Animals↗
PubMed1988

[A new model for producing occlusive hydrocephalus in animal experiments].

Production of hydrocephalus in animal experiment has been difficult and not uniformly successful so far. The preparation Ethibloc (supplied by Ethicon, Hamburg-Norderstedt), which is a protein solution in alcohol, and which has been in use in abdominal surgery for occluding the pancreatic duct system, enables production of an obstructive hydrocephalus easily and with reproducible results. The authors report on 24 cases of development of an obstructive hydrocephalus in rabbits after Ethibloc had been introduced into the ventricular system.

Animals↗
PubMed1988

[Clinical aspects of hypophyseal metastases].

Metastatic tumors within the pituitary gland are rare. The incidence--reported by series of autopsies--differs from 1.8-12% of metastatic tumors. Most of the primary tumors are breast cancers, followed by cancers of the gastro-intestinal system. Only 20% of these metastases are clinically diagnosed. Diabetes insipidus is the main symptom, correlating with the greater incidence of metastatic lesions in the posterior lobe. The unusual features of a reported case are discussed. In this case the dysfunction of cranial nerves passing the sella turcica led to the diagnosis. Therapy with Flutamid initiated a remission. Survival of 18 months is remarkably long.

Aged↗
PubMed1988

Synovial fluid involvement in null cell acute lymphoblastic leukemia diagnosed with monoclonal antibodies.

Rheumatic symptoms in patients with leukemia are not uncommon. Often they delay correct diagnosis and therapy. We describe a patient presenting with oligoarticular joint disease in whom immunological analysis of synovial fluid (SF) led to the detection of leukemic cells in the joint. Moreover, analysis with a variety of monoclonal antibodies established the diagnosis of acute lymphoblastic leukemia of null cell type with phenotypically identical malignant cells present in the bone marrow, peripheral blood and SF. Our investigations demonstrate that analysis with monoclonal antibodies is helpful in characterizing joint involvement in patients with leukemia.

Acute Disease↗