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H Neubauer

Publications and source records attributed to H Neubauer.

At least 109 records · Page 6Linked to original sources

The Montgomery Lecture, 1979. Ocular metallosis.

'Redox processes' and complex biochemical formations offer a simple key to understanding metallotic damage to the eye. Various factors determine the timing and severity of this damage. Siderosis is a process with a chronic course. In a large group of patients with copper-containing foreign bodies the majority showed a more acute course. In the past, the relatively rare cases of chronic chalcosis without fibrotic reactions in the vitreous determined the text book descriptions familiar to our fathers. In our series of 282 cases of copper-containing foreign bodies in the vitreous, the chalcosis took a subacute, acute, or fulminating course in 68 per cent, and only half of the other 32 per cent represented time chronic chalcosis. In 18 per cent the injury was recent and the cellular reaction was only just beginning. Cellular reactions, especially fibrosis, are the chief characteristics of acute chalcosis. Vitrectomy permits the surgical treatment of eyes with severe vitreous fibrosis and retinal detachment, but because these eyes are in the pre-phthisic stage, a fair number of successes is counterbalanced by an increasing number of enucleations.

Acute Disease↗

[Assessing functional health and sociability of aged persons: the development and validation of two guttman-scales (author's transl)].

Studies to develop and validate two Guttman-scales are reported, which aim at measuring level of functional health and inclination to engage in social contacts in aged persons. A first scale analysis, based on the answers of 150 old persons, resulted in two, 12-item scales, which according to Guttman's criterion were fully satisfying. In two consecutive studies Guttman-selfratings of two other samples of old people were validated against ratings of experts, who disposed of profound knowledge of the sampled persons (a physician of a nursing home, managers of homes for the aged). A second scale analysis was performed, too. The results, especially the very significant correlations between expert ratings and selfassessments, suggest a broader application of at least the functional health scale. It is proposed to use the scales, if one aims at increasing the fit between individual needs and amount of services provided, and as instruments to control for sample characteristics, if different care programs are evaluated.

Aged↗

Pars plana vitrectomy after intraocular foreign bodies.

Pars plana vitrectomy after intraocular foreign body injuries led to a good or at least useful vision in 60% of the cases. Without exception, these were eyes which were practically blind or eyes which according to our experience would have been blinded without vitrectomy. Retinal detachments which have arisen preoperatively have a decisive negative effect on the prognosis: there is a low rate of healing in consequence of traumatic, contusional and metallotic retinal lesions and high MPP rate. Increasing surgical experience, so-called secondary vitrectomy 'in time' as well as improved and more refined vitrectomy instruments lead to better results.

Eye Foreign Bodies↗

Cardiovascular effects of tricyclic and tetracyclic antidepressants.

Cardiovascular effects of therapeutic doses of tricyclic or tetracyclic antidepressants (TCA) were examined in 66 patients. After three weeks of therapy, heart rate and PR interval were increased (P less than .02, P less than .05), while prolongation of the QTc time and the QRS interval did not reach significant levels. We observed significant flattening of T waves (P less than .05), which was not associated with changes in the serum potassium level. These changes were reversible after treatment was discontinued. When therapy was maintained for 13 months, only the heart rate continued to be increased, whereas all other ECG values had returned to normal. The TCA therapy led to a significant prolongation of the preejection period (P less than .01) and slight shortening of the left ventricular ejection time, indicating a decrease in myocardial contractility. There was no difference of effects on the values studied between tricyclic and tetracyclic antidepressants.

Adult↗

Management of trauma of the anterior segment.

Since the introduction of the operating microscope the technique of wound repair has improved from purely reconstructive to preventive principles. In dealing with severe injuries of the anterior segment, the performance of vitrectomy seems to be the main problem. Secondary damage of the vitreous base has to be avoided, especially in children and juveniles. Prophylactic measurements against retinal detachment has proved to be useful. Using a light interference technique, the mode of action of different cutting instruments in the vitreous can be demonstrated. The guillotine technique seems to have the least distant effect. The scheme of surgical treatment has to be adapted to the individual situation and to the capability of the surgeon.

Animals↗

A depressive syndrome responsive to lithium. An analysis of 20 cases.

The authors analyze a series of 20 patients seen over the past 4 years who have shown a dramatic improvement following the introduction of lithium carbonate to their therapy. The results indicate that these patients showed a consistent syndrome with the following features: a) anergic endogenous depression; b) positive family history in first degree probands; c) obsessional personality traits and symptoms; d) hypochondriasis and somatic symptoms; e) failure to respond to previous antidepressant therapy with tricyclic and MAOI compounds as well as ECT. A previous study by Gittleson showed that one third of a series of psychotic depressives admitted to the Maudsley Hospital, London, also displayed obsessional symptoms and hypochondriasis. These patients, however, seemed to do as well with standard antidepressant treatment as a control group of psychotic depressives without obsessional features. However, in this series, there was a 7 per cent residue whose obsessional symptoms worsened, even after recovery from their depression. The authors' group of patients represented approximately 3 per cent of all psychotic depressives seen over the 4-year period and could, therefore, coincide with Gittleson's residue. The mean age of onset of illness in the authors' depressive group was 45.5 years, and this finding, coupled with the high incidence of psychotic depression in first degree relatives, indicates that these patients were suffering from a psychotic depression modified by personality traits, rather than an atypical obsessional neurosis. The consistency of clinical features and specificity of response to lithium therapy appear to indicate that this is a clearly definable clinical syndrome worthy of further investigation.

Adult↗

Clinical ultrasonography of intraocular foreign bodies.

92 eyes have been examined with A-scan ultrasonography (8 MHz, Kretz-Technik apparatus 7100 MA and 7200 MA). Ultrasonic location of nonmagnetic and magnetic foreign bodies is compared to Comberg's radiographs and to intraoperative methods usch as stereoradioscopy or transillumination with the glass fiber diaphanoscope. Definitely corresponding results have been obtained in 60 cases. Ultrasonic location was difficult with small foreign bodies (reflecting surface less than 2 mm-2) within the orbit, the sclera, or within less than 2 mm from the sclera, as well as in severe vitreous clouding. Such cases should be evaluated with all location procedures available before considering further management.

Eye Foreign Bodies↗

[Atypical oculoplastic surgery in children (author's transl)].

The problems of restorative surgery for inborn eyelid-alterations are indicated here with examples. The following experiences result. 1. Inborn eyelid colobomas without disfigurement of the inner canthus are in general readily correctable. 2. Inborn eyelid colobomas with a disfigured inner canthus and atresia of the canaliculi hardly ever permit the production of a cosmetically satisfactory inner canthus, and never permit a functionally satisfactory one. The use of lacoductorhinostomy, according to L. Jones, is problematic here. 3. The correction of inborn eyelid colobomas in the case of Goldenhar's syndrome is difficult because, due to additional dermoids and fibromas, irregular excisions become necessary. Thus, the lid margin becomes significantly deformed. A considerable temporal displacement of the skin cannot be avoided. 4. Any plastic correction of an inborn, genuine eyelid tumor is difficult, if the important structures of the eyelid--especially the tarsus and levator muscles--are only fragmentarily developed. In the case of the large, soft fibroma of the upper eyelid in neurofibromatosis, only a static eyelid in middle position can be accomplished. 5. Very often, motility problems arise in this connection. Both in Goldenhar's disease and in Recklinghausen's disease, primary dysplasis of the rectus externus muscle occurs.

Adolescent↗