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Biomedical subjects

H Sailer

Publications and source records attributed to H Sailer.

At least 19 recordsLinked to original sources
PubMed2000

Effect of preoperative prophylaxis with filgrastim in cancer neck dissection.

BACKGROUND: Cancer surgery is known to lead to a deterioration in host defence mechanisms and an increase in susceptibility to infection after operation. Filgrastim enhances important antimicrobial functions of neutrophils including chemotaxis, phagocytosis and oxidative killing mechanisms. METHODS: The effects of additional (all patients received perioperative 3 ' 25 mg kg-1 cefotiam and 1 ' 20 mg kg-1 metronidazole) preoperative prophylaxis with filgrastim (5 microg kg-1 12 h prior to surgery plus 5 microg kg-1 0 h prior to surgery) on neutrophil phagocytosis and reactive oxygen radical production and postoperative infections in 24 patients undergoing cancer neck dissection were studied. Phagocytic capacity was assessed by measuring the uptake of fluorescein isothiocyanate-labelled Escherichia coli and Staphylococcus aureus by flow cytometry. Reactive oxygen generation after phagocytosis was estimated by determining the amount of dihydrorhodamine 123 converted to rhodamine 123, intracellularly. RESULTS: In the filgrastim-treated patients a higher neutrophil phagocytic capacity was seen intraoperatively, and 1-5 days postoperative, but not prior to surgery. Reactive oxygen radical production was significantly higher in filgrastim-treated patients prior to surgery, intraoperative and postoperative (1-5 days). 2/12 (17%) patients had postoperative infections in the filgrastim group and 9/12 (75%) patients had infections in the placebo group (P < 0.001). In particular, wound infections were recorded more often in the placebo group (1/12 vs. 6/12; P = 0.004). CONCLUSION: We conclude that filgrastim enhances perioperative neutrophil function and could be useful in the prophylaxis of postoperative wound infections in patients undergoing cancer neck dissection.

Adult↗
PubMed1999

Patulous eustachian tube in a case of adolescent anorexia nervosa.

Autophonia, the hyperperception of one's own voice and breathing, is one of the consequences of rapid weight loss and is explained within the syndrome of the patulous eustachian tube. We report on a female adolescent, who presented to an otologist for autophonia and was finally diagnosed with anorexia nervosa. The occurrence and relevance of this symptom in eating-disorder patients is discussed.

Adolescent↗
PubMed1998

Biodegradable polylactide plates and screws in orthognathic surgery: technical note.

In orthognathic surgery, the bone fragments are usually fixed with metallic plates and screws. Metallic devices other than titanium plates are usually removed after the osteotomy has consolidated, which often requires general anaesthesia. Titanium plates, supposed to be biotolerable, have been introduced in order to overcome this need for secondary intervention. However, due to corrosion, titanium particles have been found in scar tissue covering these plates and in locoregional lymph nodes. Therefore, their removal is also advocated. Self-reinforced poly (L-lactide) homopolymer (PLLA) and poly (L/D-lactide) stereocopolymers with a L/D molar ratio up to 85/15 have sufficient strength to overcome the need for additional support for the fixation of fractures. The plates can be bent at room temperature. The surgical technique and early results of a case of bimaxillary surgery and genioplasty fixed with bioresorbable material without postoperative rigid maxillomandibular fixation are reported.

Absorption↗
PubMed1996

Cerebellomedullary compression in recessive craniometaphyseal dysplasia.

Craniometaphyseal dysplasia (CMD) is a very rare disorder of bone remodelling characterised by sclerosis of the skull base, vault and facial bones and metaphyseal splaying of tubular bones. The recessive form appears to be more severe than the dominant. Cranial nerve deficits have been reported in infancy and early childhood in a few patients, but the long-term history of recessive CMD is not well documented. We report cerebellomedullary compression in a girl with recessive CMD recognised at 14 years because of progressive truncal ataxia. MRI revealed backward angulation of the thickened clivus, narrowing of the foramen magnum and upward deviation of the cerebellum by a markedly thickened occipital squama, tonsillar herniation and obliteration of the infratentorial cerebrospinal fluid spaces. Posterior cranial fossa decompression resulted in marked improvement of the ataxia. Compression of posterior cranial fossa structures has to be considered in the natural history and management of CMD.

Brain Diseases↗
PubMed1996

[Malignant transformation of a peripheral nerve sheath tumor in the area of the paranasal sinuses].

BACKGROUND: Distinguishing schwannoma from neurofibroma of the paranasal sinuses can be difficult. PATIENTS: We present the rare case of malignant peripheral nerve sheath tumor of the frontoethmoid complex that occurred in a patient who had suffered from schwannoma at the same site 7 years before. The tumor was examined clinically, histologically, and immunohistochemically. RESULTS: Although complete surgical excision of the primary tumor should have been an apparently adequate management for benign schwannoma, the tumor recurred and even metastasized into the brain. The tumor was resistant to aggressive surgical therapy combined with adjuvant irradiation and gamma knife therapy. The results of histological examinations identified schwannian features of the primary tumor and clearly outlined differentiation to solitary neurofibroma. CONCLUSIONS: Considering that schwannomas can be predominantly benign with foci of malignant areas and that there are reported cases of malignant transformation of benign schwannomas, the present consensus in management of small and low-grade malignant schwannomas is complete surgical excision with negative margins. The therapy of choice for high-grade malignant schwannomas is aggressive surgical resection, with wide tumor free margins, combined with adjuvant irradiation and chemotherapy.

Aged↗
PubMed1991

[Gorlin-Goltz syndrome].

We present here a case of a patient with Gorlin-Goltz Syndrome treated and followed up for more than 22 years. During the evolution of the disease, we have noted a severe development of symptoms that necessitated the resection of multiple face and trunk basalioms, as well as numerous maxillary keratocysts. One of the cysts has presented the histologic characteristics of an ameloblastic fibroma. Later on, the growth of a squamous cell carcinoma required a partial mandibular resection, primary reconstruction (with AO-plate) and postoperative radiotherapy. Afterwards, a relapse in the symphysar region necessitated, in spite of the presence of lung metastases, another resection of the same region including part of the lower lip with secondary reconstruction by the means of a myocutaneous flap (PMM). A review of the main features of this syndrome has been carried out. With the help of a literature review, all the similar cases already published are here presented and discussed. Furthermore, our therapeutic concept concerning this syndrome is briefly discussed.

Adolescent↗
PubMed1990

On the relation between photo- and gravitropically induced spatial memory in maize coleoptiles.

The interaction of photo- and gravitropic stimulation was studied by analysing the curvature of maize (Zea mays L.) coleoptiles subjected to rotation on horizontal clinostats. Gravitropic curvature in different directions with respect to the stimulation plane was found to be transient. This instability was caused by an increasing deviation of response direction from the stimulation plane towards the caryopsis. The bending angle as such, however, increased steadily. This reorientation of the gravitropic response towards the caryopsis is thought to be caused by the clinostat-elicited nastic curvature found in maize coleoptiles. In contrast, the response to phototropic stimulation was stable, in both, orientation and curving. Although stimulation by gravity was not capable of inducing a stable tropistic response, it could inhibit the response to opposing phototropic stimulation, if the counterstimulation was given more than 90 min after the onset of gravistimulation. For shorter time intervals the influence of the phototropic stimulus obscured the response to the first, gravitropic stimulation. For time intervals exceeding 90 min, however, the phototropic effects disappeared and the response was identical to that for gravity stimulation alone. This gravity-induced inhibition of the phototropic response was confined to the plane of gravity stimulation, because a phototropic stimulation in the perpendicular direction remained unaffected, irrespective of the time interval between the stimulations. This concerned not only the stable phototropic curving, but also the capacity of the phototropic induction to elicit a stable directional memory as described earlier (P. Nick and F. Schafer, 1988b, Planta 175, 380-388). This was tested by a second blue-light pulse opposing the first. It is suggested that gravity, too, can induce a directional memory differing from the blue-light elicited memory. The mechanisms mediating gravi- and phototropic directional memories are thought to branch off the respective tropistic signal chain at a stage where photo- and gravitropic transduction are still separate.

Cotyledon↗
PubMed1990

Inversion of gravitropism by symmetric blue light on the clinostat.

Gravitropic stimulation of maize (Zea mays L.) seedlings resulted in a continuous curvature of the coleoptiles in a direction opposing the vector of gravity when the seedlings were rotated on a horizontal clinostat. The orientation of this response, however, was reversed when the gravitropic stimulation was preceded by symmetric preirradiation with blue light (12.7 micromoles photons m-2). The fluence-response curve of this blue light exhibited a lower threshold at 0.5 micromole m-2, and could be separated into two parts: fluences exceeding 5 micromoles m-2 reversed the direction of the gravitropic response, whereas for a range between the threshold and 4 micromoles m-2 a split population was obtained. In all cases a very strong curvature resulted either in the direction of gravity or in the opposite orientation. A minor fraction of seedlings, however, curved towards the caryopsis. Furthermore, the capacity of blue light to reverse the direction of the gravitropic response disappeared with the duration of gravitropic stimulation and it depended on the delay time between both stimulations. This tonic blue-light influence appears to be transient, which is in contrast to the stability observed for tropistic blue-light effects.

Cotyledon↗
PubMed1990

[Biodegradable osteosynthesis applied to craniofacial surgery].

Since skin problems as decubitus and infections are well known risks in osteoplastic trepanations in congenital malformations in children, we searched for a reduction in size of the implants and the possibility to use biodegradable materials. After design of special constructions regarding dimension and stability purposes for children below one year, we performed osteoplastic trepanations in 27 minipigs. In 78% the healing was uneventful and the osteoplasty remained in place whereas in 22% (= 6 animals) we observed a local infection which lead to loss of implants as well as cranioplasty in 3 animals. Based on this research, we used our biodegradable implants in osteoplastic trepanations of congenital craniostenosis in children. The postoperative follow-up is now from 3 to 6 months in 4 children and the results are perfect in all. We did not observe any local infection, neither cutaneous problems, even not in bilateral frontal advancement and floating forehead procedures. The implants are presented as well as the results in animal research and the first follow-up in 4 children.

Acrocephalosyndactylia↗
PubMed1989

[Long-term course in congenital analgesia].

We describe the longterm history of eight patients with congenital insensitivity to pain, a rare autosomal recessive condition. Pain perception did not significantly improve with increasing age, but all affected individuals learned to live with their handicap. A marked tendency to dissimulate was obvious. The longterm outcome was dominated by orthopedic complications: there were impressive arthropathic changes in knee and ankle joints but - to our surprise - no hip joint involvement. These changes are the result of skeletal injuries in childhood (fractures, aseptic bone necrosis, osteomyelitis) and of apparently progressive neuropathic lesions due to pain insensitivity. The latter resulted in marked lumbar spine changes with progressive neurological deterioration, so far requiring spondylodesis in three patients. In three pregnant women total absence of labour pain was observed. All affected individuals had anosmia but no deficits of autonomic nervous system functions.

Adult↗
PubMed1989

Intracranial abnormalities associated with facial plexiform neurofibromas in neurofibromatosis type 1.

From 1975 to 1988 seventeen patients with neurofibromatosis type 1 and a disfiguring facial plexiform neurofibroma (FPN) were investigated. The FPN was left-sided in 13 patients. It was orbital/periorbital in 4, lower facial in 7 and involved the whole face in 6 subjects. Neuroimaging (n = 13) revealed a tumor (of optic pathways or basal ganglia) in 8, an ipsilateral middle cranial fossa arachnoid cyst in 2, multiple areas of high signal intensity (in T2-weighted magnetic resonance imaging) in 1, and normal findings in 2 patients. In NF-1 patients with FPN there seems to be a high incidence of intracranial tumors and possibly of arachnoid cysts. Our observation has to be confirmed in a larger patient series.

Adolescent↗
PubMed1989

[Preliminary results of biodegradable osteosynthesis in craniofacial surgery in the child].

After an experimental study on biodegradable implants for fixation purpose in skull plasties of the minipig we began a clinical trial. Six children aged 1-18 years and suffering from trigonocephaly, Morbus Apert and Morbus Crouzon as well as plagiocephaly underwent a reconstructive procedure of the skull and midface, mostly frontal advancement. The different part of skull have been fixed by biodegradable implants made of polylactate acid. Another two infants, one with a skull defect after removal of an encephalocele and the other for reconstruction of the skull after open cerebral injury and consecutive osteoclastic trepanation, have been treated with skull splitting. The two halves of the skull have been fixed by biodegradable material too. The follow-up of these 8 children now is from 2-20 months (medium 10 1/2 months). From the aesthetic point of view as well as from radiological and clinical signs we judge the result as good as with conventional materials, for example wire loops. No material had to be removed and CT scans show a fully resorption of the implants. The present paper shows the preoperative, intraoperative and postoperative evolution.

Acrocephalosyndactylia↗
PubMed1986

Mechanism of the plasma cholesterol lowering effect of tazasubrate in rats: accelerated plasma cholesterol transport with increased liver lipoprotein receptor activity.

Tazasubrate (30 mg/kg/day) a new lipid lowering agent, chemically unrelated to fibrates, reduces plasma cholesterol in rats within 2-3 days to 50% of controls. During the early rapid decrease of plasma cholesterol, increased liver cholesterol concentrations are observed. These return to normal, once the new steady state of plasma cholesterol (at 50% of controls) has been reached. Radiotracer studies with 3H-cholesterol labelled plasma very low density lipoproteins are consistent with an accelerated plasma cholesterol turnover. Analysis of the binding to liver membranes of 125I labelled cholesterol rich very low density lipoproteins (beta-VLDL) shows a marked increase in the total binding (Bmax rising from 106 ng/mg of protein 378 ng/mg), without significant alterations in the receptor affinity.

Animals↗
PubMed1986

Pharmacokinetics and metabolism of bisoprolol-14C in three animal species and in humans.

The pharmacokinetic properties of bisoprolol-14C were studied in Wistar rats, beagle dogs, and Cynomolgus monkeys. Bisoprolol is well absorbed in these species; independent of the route of administration (i.v. or p.o.), 70-90% of the 14C-dose was recovered in urine. Faecal excretion was approximately 20% in rats and less than 10% in dogs and monkeys. Rats excreted approximately 10% of the dose in bile after i.v. as well as after oral administration. The plasma half-life of the unchanged drug was approximately 1 h in rats, 3 h in monkeys, and 5 h in dogs. The bioavailability was 40-50% in monkeys, approximately 80% in dogs, and 10% in rats. Studies in rats have shown that the drug is rapidly taken up by the tissues. After i.v. administration, high levels of radioactivity were found in lung, kidneys, liver, adrenals, spleen, pancreas, and salivary glands. After oral administration, the highest concentration occurred in the liver and kidneys. With the exception of plasma and liver, unchanged bisoprolol was the major radioactive constituent in all tissues studied. Both the blood-brain and placental barriers were penetrated, but only to a small degree. No accumulation of radioactivity in tissues was observed after repeated dosing (1 mg/kg/day). The metabolism of bisoprolol was studied in the same three animal species and in humans. The major metabolites are the products of O-dealkylation and subsequent oxidation to the corresponding carboxylic acids. The amount of bisoprolol excreted unchanged in the urine is 50-60% of the dose in humans, 30-40% in dogs, and approximately 10% in rats and monkeys.

Absorption↗
PubMed1981

A pilot study on the effect of alteration of the suprahyoid muscles on the growth of the marmoset monkey.

A pilot study was undertaken to determine the effect, if any, of alteration of the suprahyoid muscles on mandibular growth in the marmoset. It was postulated that releasing the attachment of the digastric and geniohyoid muscles at their junction with the mandible might produce a growth change in the rotation pattern of mandibular growth. Similarly, shortening these muscles might produce a different but significant growth change. Ten animals were used, five of which were controls. Two animals had their suprahyoid muscles sectioned, and three others had their suprahyoid muscles shortened by plication. The animals were examined with cephalometric radiographs at the commencement of the experiment and at specific intervals thereafter until they reached maturity (approximately 1 1/2 years of age). The results indicate that releasing the digastrics and the suprahyoids at the mandible causes no significant change in the length of the mandible. Shortening of the suprahyoids through plication, however, appears to result in a notable change in the mandible and possibly the face. This study suggests that further research in this area may be fruitful in producing a primate model with a' retruded genial area or a tongue protrusion by plication or otherwise shortening the suprahyoid muscles.

Animals↗