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Biomedical subjects

Hans Scherer

Publications and source records attributed to Hans Scherer.

10 recordsLinked to original sources
PubMed2007

A pilot clinical trial of the effects of coenzyme Q10 on chronic tinnitus aurium.

OBJECTIVE: To determine the short-term effects of coenzyme Q10 (CoQ10) on the antioxidative status and tinnitus expression in patients with chronic tinnitus aurium. STUDY DESIGN: A 16-week prospective nonrandomized clinical trial (n = 20). Tinnitus and Short Form-36 Questionnaires (TQ/SF-36) were evaluated together with the plasma concentrations of CoQ10, malondialdehyde, and the total antioxidant status. RESULTS: The mean plasma CoQ10 concentration rose under external CoQ10 supply and remained elevated after medication stopped without overall effects on the tinnitus score. However, in a subgroup of 7 patients with low initial plasma CoQ10 concentration and significant increase in the plasma CoQ10 level, a clear decrease in the TQ score was observed. CONCLUSION: In patients with a low plasma CoQ10 concentration, CoQ10 supply may decrease the tinnitus expression. SIGNIFICANCE: This is the first study to examine the effect of CoQ10 in chronic tinnitus aurium.

Adult↗
PubMed2006

Outcomes of long-term outpatient tinnitus-coping therapy: psychometric changes and value of tinnitus-control instruments.

OBJECTIVES: Increasing tinnitus compliance and coping are desirable aims of successful treatment in chronic tinnitus. However, application of established procedures such as tinnitus retraining therapy (TRT) is often relatively short. In addition, the value of tinnitus control instruments (TCI) is questionable, especially for minor severity levels of tinnitus, and the comparability of treatment results is low. To evaluate long-term changes of tinnitus-related distress, defined psychometric data were collected in patients with compensated tinnitus (cT) or decompensated tinnitus (dT) during a standardized 2-yr outpatient tinnitus-coping therapy (TCT). DESIGN: In a prospective clinical investigation, the data of 70 tinnitus patients were recorded at the beginning and at 6-mo intervals, with a final investigation after 24 mo. The first group consisted of 40 patients with cT and dT who were randomly assigned to a treatment group and a waiting-list control group. After a period of 12 mo without treatment, the control group was treated similarly. The tinnitus questionnaire (TQ) of Goebel and Hiller, visual analog scales (VAS), and a severity questionnaire for tinnitus-associated complaints were used as psychodiagnostic instruments. Therapy components consisted of counseling, fitting patients with TCIs (TCI provision), auditory and relaxation training, and psychosomatic care if necessary. A second group of 30 patients with cT receiving TCT without TCI devices was investigated to evaluate the additive efficacy of TCI in cT. RESULTS: The initial TQ score did not differ between the treatment group and the waiting-list control group. After 12 mo, the control group did not show any significant changes, but the treatment group had improved significantly. During TCT, the combined data of both groups showed a statistically significant decrease of the TQ score in dT (59.1 to 34.8) and cT (32.8 to 24.0). These changes were especially reflected by the subscales of cognitive and emotional distress and also by the VAS and the severity questionnaire. dT patients benefitted without dependence on age or duration of pre-existing tinnitus; for cT patients, this was true mainly of the younger and older subjects and for tinnitus lasting for less than 1 yr. TCI provision improved the efficacy of TCT in patients with cT. CONCLUSIONS: The psychometric changes demonstrate a clear decrease of tinnitus-related distress in all severity levels of sufficiently treated chronic tinnitus. Long-term TCT induces improvement even up to the time of 24 mo. With TCIs established particularly in patients with dT, our results suggest that a supporting adjustment of TCI devices is helpful in cT to foster quicker rehabilitation. The outpatient interdisciplinary TCT, consisting of cognitive tinnitus desensitization, TCI provision, and psychosomatic support if required, represents a successful treatment strategy for both dT and cT patients.

Adaptation, Psychological↗
PubMed2005

Postural control in otolith disorders.

It was the aim of the present paper to investigate the influence of otolith disorders on human postural control by different methods. The 33 patients of our study had undergone a minor head injury and suffered subsequently from an utricular or sacculo-utricular disorder as evidenced by vestibular evoked myogenic potential recordings and eccentric rotation recordings of the otolith-ocular responses. Postural control was assessed by performing stance/gait tests (standard balance deficit test, SBDT) and by evaluating trunk sway (using angular velocity sensors). Moreover, classical tests of the posterior column of the spinal tract (Romberg/Unterberger) and the dynamic posturography (sensory organization test, SOT) were included. It could be shown that SBDT tasks with reduced proprioceptive and visual cues (e.g. standing on foam, eyes closed) are most sensitive for an otolith disorder. The patients showed an increased trunk sway in the pitch plane (i.e. linear motion as adequate utricular stimulus) and an increase in sway velocities (i.e. tilting movements as adequate saccular stimulus) compared to controls. The SOT was most sensitive for combined (sacculo-utricular) otolith disorders (78%) while vestibulospinal tests are not enough sensitive. In essence, otolith disorders evidently impair human postural control and have been possibly underestimated as a source of posttraumatic postural imbalance as yet.

Adult↗
PubMed2005

Management of posttraumatic vertigo.

OBJECTIVE: To evaluate patients after blunt trauma of the head, neck, and craniocervical junction (without fractures) with vertigo and to report the results of treatment after extensive diagnostics. STUDY DESIGN: Prospective study of consecutive new cases with vertigo after trauma at different periods of onset. During 2000-2002, 63 patients were examined and treated. SETTING: Regional trauma medical center for the greater Berlin Area, tertiary referral unit. RESULTS: The primary disorders included labyrinthine concussion (18), rupture of the round window membrane (6), and cervicogenic vertigo (12). The secondary disorders included otolith disorders (5), delayed endolymphatic hydrops (12), and canalolithiasis (9). The patients were free of vertigo symptoms (except cervicogenic and otolith disorder) after treatment, which consisted of habituation training, medical and surgical therapy options. The follow-up was 1 year. CONCLUSION: Posttraumatic vertigo can be treated with a high success rate once the underlying disorder has been identified. The extent of the neurotological test battery determines the precision and quality of diagnostics. Surgical measures should be an integral part of treatment modalities if conservative treatment is not effective. SIGNIFICANCE: Minor trauma of the head, neck, and craniocervical junction can have major impact on the vestibular system at different sites. Patients need to be carefully diagnosed, even if the onset of vertigo occurs a few weeks or months after the initial trauma.

Adolescent↗
PubMed2005

Measurement of upper eyelid implants curvature by ultrasound.

INTRODUCTION: The implantation of eyelid weights in the upper eyelid for treatment of the lagophthalmos in cases of facial paralysis was described for the first time in 1958 by Illig (lid loading). Whereas in the past, only rigid implants made of gold were used, flexible chains made of platinum are now being used frequently to optimize adaptation to the tarsal plate of the upper eyelid. The first step toward assessing the flexibility of the upper eyelid was to determine sonographically the various tarsal diameters of the upper eyelid in healthy eye subjects when the line of vision is changed. In a second step, patients who had received eyelid implants were examined sonographically both pre- and postoperatively to evaluate the curvature response of the upper eyelid after implantation. MATERIALS AND METHODS: The diameter of the upper eyelid tarsal plate in 50 healthy eye subjects was sonographically determined using a 7.5 MHz scanner in a noncontact mode with subjects looking straight ahead and in the abduction position. Rigid gold implants were implanted in 23 patients, and flexible platinum chains were implanted in 24 patients to treat lagophthalmos in facial palsy. The implant diameter was also determined by ultrasound using a 7.5 MHz scanner in a noncontact mode with subjects looking straight ahead and in the abduction position. In addition, the respective upper eyelid tarsal diameters of the patients were sonographically determined preoperatively with subjects looking straight ahead and in the abduction position. RESULTS: The diameter of the upper eyelid tarsal plate in healthy eye subjects changes to a degree that is statistically significant (P < .001) when the line of vision is changed. The mean value of the diameter of the upper eyelid tarsal plate when looking straight ahead is 19.3 +/- 3.8 mm and in abduction position 30.1 +/- 6.3 mm. In the case of the rigid gold implants, the implant radius does not change postoperatively relative to the line of vision, in accordance with expectations. In contrast, in the case of the platinum chains, a statistically significant change (P < .001) in the implant diameter was found when the line of vision is changed, for a median postoperative follow-up period of 8 months. CONCLUSION: Changes in the upper eyelid tarsal plate diameter, which are dependent on the line of vision, and changes in the implant diameter after lid loading can be precisely represented using a 7.5 MHz scanner in the noncontact mode. The flexibility of the upper eyelid when the line of vision is changed also remains intact over an 8 month follow-up when using platinum chains as implant material and thus potentially serves to reduce postoperative complications as well.

Adult↗
PubMed2005

Otolith mass asymmetries in the utricle and saccule of flatfish.

The otolith mass of the saccules and utricles of plaice, Pleuronectes platessa (n = 39) and turbot, Psetta maxima (n = 21) was measured using an electronic microbalance. In the right-eyed plaice, the left utricular otoliths were found to be significantly heavier than the right (p < 0.0001), whereas no significant difference was found between left and right saccular otoliths (p < 0.751). In the left-eyed turbot, both the right utricular and saccular otoliths were found to be significantly heavier (in both cases, p < 0.0001). While the gene and regulative protein responsible for the peripheral biomineralisation process have been identified, it remains unclear how the symmetry between the right and left otoliths in fish species is regulated. Here it is likely that an additional central mechanism is involved. It must be assumed that similar processes govern the systematic asymmetry observed in flatfish such as the plaice and turbot. Taken together these findings are strongly suggestive of concomitant CNS modification and metamorphic plasticity, presumably represented in genetic code.

Animals↗
PubMed2003

Experimentally induced motion sickness in fish: possible role of the otolith organs.

OBJECTIVE: Although the occurrence of motion sickness is largely attributed to sensory conflict, the reasons for the highly variable inter-individual susceptibility to motion sickness remain unclear. One cause may be asymmetry between otoconial masses in the right and left inner ear. This hypothesis has been supported by experiments in fish under conditions of prolonged weightlessness and parabolic flight. In swordtail fish (Xiphophorus helleri) we examined the extent to which a Coriolis force environment, which has a strong motion sickness-triggering effect, disturbs swimming behaviour or produces motion sickness. MATERIAL AND METHODS: In a sealed aquarium, fish (n = 22) were subjected to Coriolis stimulation by constant vertical axis rotation, combined with pendular oscillation around a horizontal axis. RESULTS: Initially, at low stimulus intensity, all fish showed active compensatory swimming behaviour. However, while the majority (n = 19) maintained active compensation movements at higher stimulus levels, the others (n = 3) entered a passive uncoordinated state, from which they recovered again after reduction of stimulus intensity. On examination of the otoconial mass, we found asymmetries between the right and left utricles in all three cases and between the saccules in one case. CONCLUSION: We conclude that a lateral preponderance of the otoconial masses in the utricle or saccule promotes motion sickness under experimental conditions. The utricle appears to play a more important role in this than the saccule.

Animals↗
PubMed2002

Altered cupular mechanics: a cause of peripheral vestibular disorders?

It has taken many decades to arrive at today's concept of cupula mechanics in the stimulation of endolymphatic flows on the hair cells in the ampullae of the semicircular canal. While Steinhausen assumed free swing-door movement of the cupula in the 1930s, Hillman was the first to demonstrate firm cupula attachment to the ampulla wall as a physiological necessity in the 1970s. In contrast to the present clinical concepts of acute peripheral vestibular functional disorders (circulatory disturbances, viral or bacterial infection, altered electrolytes in the endolymph), this study examines the extent to which an impaired attachment mechanism can trigger peripheral vestibular disorders. For this purpose, we used a pigeon model (n = 8), in which mechanical detachment of the cupula from the ampulla wall was achieved by means of a targeted pressure increase in the ampulla of the lateral semicircular canal. In two additional animals the labyrinth was completely destroyed on one side in order to directly compare partial and complete vestibular disorders. In this way partial damage to the lateral semicircular canal ampulla presents a clinical picture whose symptoms are very similar to those of an idiopathic vestibular disorder in humans. Their intensity and course of compensation differ markedly from the symptoms of complete vestibular destruction. Subsequent histological examination revealed that the hair cells remained intact during the experimental detachment of the cupula. Our results thus show that only altered cupula mechanics seem to trigger the clinical picture of a peripheral vestibular disorder. This may result in completely new approaches to differential diagnosis and the therapy of vestibular neuronitis.

Animals↗