[Nobel Prize in Medicine 2005. Helicobacter pylori--the versatile surviving artist ].
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Australia↗
Biomedical subjects
J Fricke
Publications and source records attributed to J Fricke.
[Surgical options in retraction syndrome].
BACKGROUND: A causative therapy for Duane's retraction syndrome, which is the most prominent example of connatal ocular misinnervation, does not exist. Eye muscle surgery is indicated in cases with manifest strabismus in primary position and an annoying compensatory head posture to maintain binocular single vision. Different surgical approaches to the different types of Duane's retraction syndrome, mostly on the affected eye but also on the fellow eye, are described in the literature. METHOD: We retrospectively analyzed the pre- and postoperative findings of 55 patients in whom we performed surgery because of Duane's retraction syndrome during the years 1999 to 2004. The type of retraction syndrome, the angle reduction in primary position and the reduction of head posture were evaluated in regard to the surgical procedure chosen. RESULTS: In 37 cases surgery was primary. In 25 cases a single recession of the medial rectus (16 cases) or the lateral rectus (9 cases) muscle of the affected eye was performed. For a dose-response relationship of the one-muscle recessions, the mean angle reduction in the primary position was 2 pdpt (cm/m) per mm recession. The mean reduction of head posture was 1.5 degrees per mm recession. In 10 cases combined surgery on the affected eye was performed. The correlation between the mean angle reduction and the recession was 3 pdpt (cm/m) per 1 mm. CONCLUSION: Depending on the type of retraction syndrome, the angle in primary position, the head posture and the globe retraction, different surgical options exist which aim at rehabilitation of the patient suffering from Duane's retraction syndrome.
Adolescent↗
[A comparison of mother-child joint admission for postnatal mental disorders in different countries].
Postnatal depression is among the most frequent mental disorders in young women (incidence 10-15 %). Besides depressive illness, however anxiety disorder, stress disorder and psychosis play an important role as well. These disorders have not only negative impact on women's mental health, but may also adversely affect the child's development as well as the mother-child relationship. Inpatient mother-child care as established e. g. at the Heidelberg University Hospital offers adequate treatment without the need for the mother to separate from her child. In a retrospective study a profile of the women treated at the Psychiatric Department of the University Hospital Heidelberg was developed which reflects the psychological and social stress in their life situations. In order to gain an overview on the specific treatment options the data were then compared with those of other national and international centres. Analysis of demand shows that this mother-child psychiatric care is well accepted by the population and that there is a considerable need for adequate in- and outpatient care of postnatal mental disorders.
Adult↗
[Acute diplopia in tilted upward gaze].
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Adult↗
[Extra-ocular muscle surgery using combined topical and subconjunctival anesthesia].
A retrospective study of a consecutive series of 284 cases of strabismus surgery under local anesthesia is presented. A total of 284 operations on the extraocular muscles, performed with topical and subconjunctival application of local anesthetics-in some cases combined with anesthesiological sedation and monitoring-were analyzed retrospectively for adverse effects or complications caused by the type of anesthesia chosen. No ophthalmological complications caused by the mode of anesthesia and no vital complications occurred. In three cases, the intended surgery could not be fully completed due to discomfort of the patient caused by pain perception. In this case series, combined topical and subconjunctival anesthesia in strabismus surgery had a low frequency of complications.
Adolescent↗
[Dissociated nystagmus in side gaze. Major symptoms in the diagnosis of an internuclear ophthalmoplegia].
A prerequisite for a qualified analysis of nystagmus is the recognition of uncommon forms of this condition. In internuclear ophthalmoplegia (INO), a dissociated nystagmus in side gaze is typical. This is accompanied by limited medial excursion of the adducted eye together with a dissociated nystagmus, which is stronger in the abducting fellow eye. This motility disturbance stems from a lesion in the medial longitudinal fasciculus running in the brain stem between the sixth and the third nerve nuclei. The lesion is often due to multiple sclerosis, but can also be ischemic, traumatic, neoplastic or inflammatory (e.g. HIV infection).
Adult↗
[Diplopia after contusion of the posterior skull. A case for the ENT physician?].
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Brain Injuries↗
Analgesic efficacy of a single dose of lumiracoxib compared with rofecoxib, celecoxib and placebo in the treatment of post-operative dental pain.
This randomised, double-blind, placebo-controlled, parallel-group study compared the efficacy and tolerability of lumiracoxib (a novel COX-2 selective inhibitor) with rofecoxib, celecoxib and placebo in patients with moderate-to-severe post-operative dental pain. Following third molar extraction, patients received single oral doses of lumiracoxib 400 mg, rofecoxib 50 mg, celecoxib 200 mg or placebo (n = 355). Additional patients from a similar study, assigned to lumiracoxib, rofecoxib or placebo (n = 155), were included for analysis of the primary variable, Summed Pain Intensity Difference over the first 8 h post dose (SPID-8). For SPID-8, lumiracoxib was superior to rofecoxib (p < 0.05), celecoxib (p < 0.001) and placebo (p < 0.001). Lumiracoxib demonstrated the fastest onset of analgesia and the longest time to rescue medication use. Patient global evaluation of lumiracoxib was comparable to rofecoxib and superior to celecoxib and placebo. All treatments were well tolerated. Lumiracoxib 400 mg provides rapid, effective and sustained relief of post-operative dental pain, comparable or superior to rofecoxib.
Adolescent↗
Optimization of the microbial synthesis of dihydroxyacetone from glycerol with Gluconobacter oxydans.
An optimized repeated-fed-batch fermentation process for the synthesis of dihydroxyacetone (DHA) from glycerol utilizing Gluconobacter oxydans is presented. Cleaning, sterilization, and inoculation procedures could be reduced significantly compared to the conventional fed-batch process. A stringent requirement was that the product concentration was kept below a critical threshold level at all times in order to avoid irreversible product inhibition of the cells. On the basis of experimentally validated model calculations, a threshold value of about 60 kg x m(-3) DHA was obtained. The innovative bioreactor system consisted of a stirred tank reactor combined with a packed trickle-bed column. In the packed column, active cells could be retained by in situ immobilization on a hydrophilized Ralu-ring carrier material. Within 17 days, the productivity of the process could be increased by 75% to about 2.8 kg x m(-3) h(-1). However, it was observed that the maximum achievable productivity had not been reached yet.
Bioreactors↗
[Cyclotropia in macula translocation. Possible eye muscle surgery solutions].
BACKGROUND: Macular translocation for treatment of age-related maculopathy often necessitates surgical counter-rotation of the external eye muscles. Excyclorotatory effects can be attained generally by various surgical methods on all extraocular eye muscles. If procedures on different muscles are combined, anterior segment perfusion has to be maintained. PATIENTS AND METHODS: The results of 29 operations were analysed in order to examine the excyclorotatory effects of 4 different combined surgical approaches. RESULTS: In 23 patients a partial transposition of all 4 m. recti together with a high dose combined operation on both oblique muscles yielded a mean effect of 21.6 degrees excyclorotation. In four patients a vertical transposition of the horizontal m. recti in opposite directions together with a high dose combined operation on both oblique muscles led to a mean excyclorotation of 22 degrees. A full tendon transposition of the superior oblique muscle to the nasal part of the orbit in one case combined with a downward transposition of the medial rectus muscle resulted in an excyclorotation of 37 degrees, in another case combined with an anterior margin advancement of the inferior oblique muscle led to an excyclorotation of 35 degrees. CONCLUSIONS: All approaches yielded mean counter-rotatory effects over 20 degrees. The indications are discussed under the aspects of the possibility of a one-step correction of horizontal or vertical angles, dosage, induction of inconcomitancies and operation time.
Humans↗
[Childhood vision disorders. Screening programs in international comparison].
Worldwide in a number of countries, screening programs aimed at detecting visual disorders in children are established. Repeatedly, proposals are brought forward to optimize already existing programs. Countries without such a program are interested in learning about current models as a guide for planning their own program. This study was performed to take stock of the screening programs for visual dysfunction in children in existence in the years 1999-2000 worldwide. The aspects considered were the child's age at examination, examiner's qualification, type of examinations performed, cost-bearing entity, and cost-efficacy analysis. The health ministries of 190 sovereign countries were asked via a questionnaire for information about possibly existing screening programs. The results of the survey were analyzed quantitatively regarding geographic, political, and socioeconomic aspects, yielding data for the exchange of experience in optimizing existing programs and developing new programs.
Child↗
[Macular translocation with 360 degree retinotomy in the treatment if exudative macular degeneration. Functional and angiographic results].
BACKGROUND: During surgical extraction of choroidal neovascular membranes (CNV) in age-related macular degeneration (AMD), the defective foveal retinal pigment epithelium (RPE) is removed. Subsequent translocation of the foveal neural retina to adjacent healthy RPE should result in stabilization and possibly improvement of visual acuity. METHODS: A prospective case series was carried out using controlled surgery and examination protocols with examinations made at fixed intervals. The surgical procedures combine counterrotation of the globe, phacoemulsification and implantation of a posterior chamber lens, complete vitrectomy, induction of a total retinal detachment, 360 degrees anterior retinotomy, removal of the subfoveal neovascular complex, foveal translocation outside the RPE defect, reattachment of the retina using F6H8, peripheral laser retinopexy and temporary silicone oil tamponade. PATIENTS: Macular translocation surgery was performed on 100 patients between December 1997 and December 1999. All patients had experienced recent visual loss due to exudative AMD and of these, 26 patients had major macular subretinal hemorrhage, 39 patients had occult and 25 patients classic subfoveal choroidal neovascularization. The preoperative findings in the remaining patients included tears in the pigment epithelium (n = 4), polypoidal choroidal vasculopathy (n = 1), recurrent subfoveal CNV following laser therapy (n = 2) and deep retinal vascular anomalous complexes (n = 3). RESULTS: A total of 97 patients completed the 12-month examination. Visual acuity increased by 15 or more ETDRS chart letters in 24 patients, remained stable in 42 patients and deteriorated by 15 or more EDTRS chart letters in 34 patients 12 months postoperatively. The silicone oil tamponade was removed in 97 patients, in 10 patients, silicone oil had to be reinjected because of severe complications. A secondary procedure was necessary in 25 patients, primary PVR was observed in 9 eyes, secondary PVR developed in 10 eyes, a macular pucker in 5 eyes and a macular hole in 1 patient. Other postoperative complications included persistent hypotonia, macular edema, IOL dislocation, keratopathy and recurrent CNV (n = 3). CONCLUSIONS: Macular translocation is a technically demanding operation, which requires a considerable learning curve. Although the procedure has a high rate of surgical and postoperative complications, the functional and anatomical results appear to be promising for selected patients with subfoveal CNV secondary to AMD.
Aged↗
[Sensory problems after macular translocation].
Following macular translocation, spontaneous compensation of subjectively felt tilt can occur by central adaptation to the rotation of the retinal meridians. However, in cases of large angle rotations or under binocular conditions, efforts to counter-rotate the globe have to be made in order to achieve comfortable vision. For restoring binocular vision postoperatively, the fusionable residual angle of 7-8 degrees should not be exceeded.
Adaptation, Ocular↗
[Surgical eye muscle counter-rotation after macular translocation].
Surgical counter-rotation after macular translocation is indicated when a non-fusionable cyclodeviation exists by lack of suppression. Different surgical options exist to counter-rotate the globe after macular translocation. Primary angles of retinal rotation up to 40 degrees can be compensated for.
Eye Movements↗
A family of closely related bovine viral diarrhea virus recombinants identified in an animal suffering from mucosal disease: new insights into the development of a lethal disease in cattle.
Induction of lethal mucosal disease (MD) in cattle is linked to the generation of cytopathogenic (cp) bovine viral diarrhea virus (BVDV) in animals persistently infected with a noncytopathogenic BVDV. In most cases the cp variants are generated by recombination with cellular or viral sequences. BVDV was obtained from the serum of an MD animal and propagated in tissue culture without plaque purification. Analysis of cDNA clones established from RNA of these cells showed that apparently a variety of different viral RNAs were present. Seven of the cDNA clones contained a cellular sequence coding for light chain 3 (LC3) of microtubule-associated proteins 1A and 1B. This insertion had already been found in the cp virus JaCP obtained from the same animal and isolated by plaque purification. Analysis of further plaque-purified cp viruses showed that the diseased animal contained a family of closely related cp BVDV recombinants. A set of viruses with different duplications of viral sequences in their genomes and a variety of defective viral RNAs with deletions were found that all contained the LC3* insertion. For all the recombinants the 3' recombination sites and, in all but one case, also the 5' recombination sites between cellular and viral sequence were identical. Variation between the individual deduced genome structures resulted from different duplications or deletions of viral sequences located upstream of the cellular insertion. These results suggest that within the animal a primary recombinant with a genome containing the LC3* insertion was generated. In a trimming process a set of secondary virus recombinants was generated from this hypothetical primary recombined RNA. These secondary recombinants display genome structures that represent variations of the basic scheme already present in the primary recombinant. Apparently this trimming process that finally led to an outbreak of MD lasted a long time since recombined RNA with the basic genome structure of the cp viruses could be demonstrated in samples already taken a long time before outbreak of the disease.
Animals↗
Effect of the homogeneity of the column set on the performance of a simulated moving bed unit. I. Theory.
Although it is impossible to manufacture identical columns for use in a simulated moving bed (SMB) process, theoretical studies assume that all the columns in an SMB unit have identical characteristics. In practice, calculations in modeling and optimization studies are made with the average values of each column parameter set. In this report, the effects on SMB process performance caused by column-to-column fluctuations of the parameters are discussed. As a first step, we show how the differences in porosity of the columns may be taken into account with a revised set of separation conditions. Reductions in the purity of the extract and the raffinate streams are quantitatively related to the column-to-column fluctuations of the retention times of the two components arising from these porosity differences. For the sake of simplicity, the discussion first addresses the case of a four-column SMB operating under linear conditions. Then, the scope is extended to the cases of SMB units incorporating several columns in each section and to SMB units operating under nonlinear conditions.
Chromatography↗
Modified transposition procedure of the vertical recti in sixth nerve palsy.
PURPOSE: To report a modified transposition procedure of the vertical recti for severely limited abduction of the globe caused by sixth nerve palsy and to compare this with the Hummelsheim transposition procedure. METHODS: Retrospective study of 13 eyes of 12 patients that had Hummelsheim transposition procedure and 19 eyes of 17 patients that had modified transposition procedure of the vertical recti for severely limited abduction of the globe caused by sixth nerve palsy. The modified transposition procedure joins lateral strips of the vertical recti and sutures this junction to the lateral rectus muscle. Functional results of the Hummelsheim procedure are compared with functional results of the modified transposition procedure. RESULTS: Abductive capacity improved by 4.19 +/- 1.67 mm in the Hummelsheim group and 4.08 +/- 1.7 mm in the modification. The angle of squint changed from +22.33 +/- 6.74 degrees to -0.20 +/- 2.61 degrees in the Hummelsheim group and from +25.54 +/- 5.66 degrees to +0.95 +/- 5.26 degrees in the modification group. The functional results as to abductive capacity and postoperative angle of squint showed no significant difference between the two methods (P >.05, t test). The modification was less time consuming. CONCLUSIONS: A modification of the transposition techniques of eye muscles in sixth nerve palsy is introduced. Its functional results are comparable to the classic technique of Hummelsheim. Operative risk and trauma are reduced, because the technique avoids scleral stitches and was found to be less time consuming than the Hummelsheim procedure.
Abducens Nerve Diseases↗
Viral kinetics in patients with chronic hepatitis C treated with standard or peginterferon alpha2a.
BACKGROUND & AIMS: Covalent attachment of a 40-kilodalton polyethylene glycol moiety to interferon alpha2a (peginterferon alpha2a) results in sustained delivery and reduced clearance compared with standard interferon alpha2a. The aim of the study was to compare viral kinetics in patients treated with standard or peginterferon alpha2a. METHODS: Patients with chronic hepatitis C were randomly assigned to receive either standard interferon alpha2a thrice weekly (n = 16) or 180 microg peginterferon alpha2a once weekly (n = 17) for 48 weeks. HCV RNA was quantitated before and frequently during treatment. RESULTS: The extent of the second-phase decline of HCV RNA, representing the degradation rate of infected cells during therapy for responding patients, was 0.02 +/- 0.03 day(-1) (HCV-1), 0.88 +/- 0.64 day(-1) (HCV non-1), 0.06 +/- 0.08 day(-1) (HCV-1), and 0.44 +/- 0.33 day(-1) (HCV non-1) in patients treated with standard or peginterferon alpha2a, respectively. The second-phase decline was low (<0.05 day(-1)) in most patients without a virological end-of-treatment response, and the second-phase decline was high (>0.25 day(-1)) in all patients with sustained virological response. CONCLUSIONS: The degradation rate of infected cells is HCV genotype dependent. Treatment with peginterferon alpha2a may reinforce the death rate of infected cells (particularly in HCV-1-infected patients) or stabilize the therapeutic effect on viral production. The second-phase decline of HCV RNA is predictive of virological sustained response.
Adult↗