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Biomedical subjects

J Gärtner

Publications and source records attributed to J Gärtner.

At least 91 records · Page 5Linked to original sources
PubMed1979

[The circulatory system in patients under electrostimulation anaesthesia during ophthalmological operations (author's transl)].

Anaesthesia by electrostimulation and its effects on the circulatory system were investigated in 65 elderly patients, in whom operations on the retina and vitreous body were performed. Stimulation of the dermatomes of the first and second trigeminal nerve as well as of C3 and C4 was performed using stimulating needles in 25 patients and adhesive electrodes in 40 patients. All patients were intubated after injection of thiopentone and a muscle relaxant. Anaesthesia was maintained by continuous electrostimulation, intermittent relaxation and normoventilation with N2O/O2 in a ratio of 1/1. During this anaesthesia technique, marked stability of the circulatory system was observed. This was noted in 32 normotensive and 33 hypertensive patients, the latter being partly under antihypertensive medication. Electrostimulation anaesthesia therefore may be recommended for elderly and high risk patients.

Adult↗
PubMed1979

[Plasma-catecholamines under electrostimulation and neurolept anaesthesia for retina and vitreous body operations (author's transl)].

We determined in two groups of patients with normal circulation and metabolism during operations on the retina and vitreous body the concentration of plasma catecholamines. The intensity of stress was compared between electrostimulation anaesthesia and neuroleptanaesthesia. Venous blood was sampled 1) before premedication, 2) 30' after premedication, 3) at the start of surgery, 4) 45' after the start of surgery, 5) 30' after extubation. Plasma catecholamines (adrenaline and noradrenaline) were determined using a modified trihydroxyindol-spectrofluoremetric method (combined "Batch-technique"). There was no relevant difference between the two techniques of anaesthesia when using the concentrations of plasmacatecholamines as an indicator of stress resulting from operation and anaesthesia.

Acid-Base Equilibrium↗
PubMed1979

[Behaviour of plasma-cortisol during ophthalmological operations in patients under electrostimulation anaesthesia (author's transl)].

Plasma cortisol was determined before, during and after ophthalmological operations. These were performed under electrostimulation anaesthesia using adhesive electrodes attached to the dermatome of the site of operation. Plasma cortisol decreased after premedication and induction of anaesthesia; it increased continuously during surgery beyond the end of operation. Thirty minutes after extubation plasma cortisol decreased again.

Acupuncture Therapy↗
PubMed1978

[Pigmented paravenous retino-choroidal atrophy (author's transl)].

A 22-year-old man presented a typical appearance of pigmented paravenous retino-choroidal atrophy. Fluorescein angiography demonstrated a profound loss of the choriocapillaris in the affected areas. The amplitude of the scotopic and photopic electroretinogramme response was reduced. The electro-oculographic light rise was normal.

Adult↗
PubMed1978

[Fluorescein angiographic study on the retinal vessels of young cigarette smokers (author's transl)].

Caliber irregularities of the small retinal vessels may usually be observed as an early sign of vascular disturbance in young cigarette smokers. A randomized blind study on 28 smokers and 30 non-smokers aged between 17 and 39 years, which were entirely healthy according to the results of physical and ophthalmoscopical examination, was undertaken with the aid of fluorescence angiography. Only smokers with a consumption of at least 15 cigarettes daily and a history of smoking of at least 5 years were taken into account for the study. The angiograms were read as fluorescein angiographic negatives under a stereomicroscope. To the person interpreting the angiograms, name or date of the angiograms were not know. Caliber irregularities of the retinal arteries, veins, arterioles and venoles were found in 18 of the smokers and 2 of the non-smokers. The incidence of vascular irregularity in smokers is highly significant at the 1% level.

Adolescent↗
PubMed1978

[The transcutaneous electrostimulating anaesthesia--the results of patients with retinal and vitreous surgery (author's transl)].

The clinical results of 50 patients with retinal and vitreous surgery performed in combined electrostimulating anaesthesia are reported. Premedication consisted of a barbiturate such as medomin and of atosil, ordered the evening before surgery. 1/2 hour preoperatively 1.5--2 ml thalamonal and 0.5 mg atropine were administered intramusculary. All patients were intubated and controlled respirated; stimulation starting about 5 minutes following intubation procedure. During continuous intermittent relaxation anaesthesia was maintained by a mixture of nitrous oxide/oxygen 1:1 and electrical stimulation at the dermatoms of N. trigeminus I, II and Plexus cervicalis 3 and 4. For the first time stimulation of the dermatoms during anaesthesia was done by self adhesive electrodes. So we were able to eliminate the circumstantial and not even harmless invasivity of the needle technique. The main advantages of the new method we see in a good circulatory stability and in good postoperative cooperation of the patients. Especially in old and poor risk patients the results of transcutaneous electrostimulating anaesthesia are excellent.

Adult↗
PubMed1977

[Can the lifting of heavy weights provoke a spasm of ciliary muscles conducive in turn to retinal detachment?].

It was reported by Harms (discussion remark 62, DOG Heidelberg 1959, p. 234) that, during the lifting of a heavy weight, excessive accommodation occurs. If this is the case, the causing ciliary spasm could possibly be regarded as a predisposing factor in the pathogenesis of a retinal detachment. To obtain objective data whether there is an accommodative spasm under the above mentioned condition, the thickness of the lens of emmetropic young persons was measured by ultrasound. Three series of measurement were performed: (1) during accommodation; (2) during the lifting of a 25-kg-heavy weight without excluding the possibility of focusing nearer objects at the same time, and (3) during lifting of the same weight with the exclusion of any possibility of focusing nearer objects at the same time. According to the results of these experiments, there is only very little likelihood that the lifting of heavy weights could provoke a considerable ciliary spasm.

Accommodation, Ocular↗
PubMed1976

[Episcleral sealing with a safety-circlage in juxtabasal horse-shoe tear (author's transl)].

Primary cerclage with an additional radial episcleral implant is proposed for horseshoe tears with vitreous traction, but without retinal detachment. At the beginning of the operation, the two sutures of the cerclage on both sides of the retinal pathology are tied with a little stretch of the 2 mm silicone rod. Then the radial plombage is placed beneath the encircling element. Afterwards the rest of the cerclage is drawn up without stretch, and the site of crossing is fixed with two sutures. At the end of the operation the radial implant may be secured against lateral movements by one or two sutures. The whole procedure is aided by parabulbar injection of penicilline and a depot of dexamethasone. The main advantages are the abolition of any difficulties in the localization and fixation of the plombage, and the permanent buckling effect. In 37 cases operated in this way, no complications were observed (follow-up time 1/2-2 years). Contraindication to the proposed technique is a narrow chamber angle.

Dexamethasone↗
PubMed1976

[Microsurgical release of subretinal fluid in retinal detachment. Report on 200 cases (author's transl)].

When the incision of the sclera, suprachoroidea and choroidea is performed under the microscope step by step, the release of subretinal fluid becomes an absolutely controlled microsurgical procedure. When employing this technique, one can avoid complications related to the injury of choroidal vessels, especially if one uses transillumination with fibre-optics during the perforation of the choroid. A further useful tool for drainage is a sclerotomy retractor which allows the spreading out the edges of the sclerotomy--wound by grasping the loops and pulling them aside of a pre-placed Mendoza suture. As the retractor does not engage the sclera directly but only with the aid of the pre-placed suture, it is possible to observe the operation field without any hindrance from the instrument and to perform microsurgical incision of the chroid at any desired point.

Choroid↗
PubMed1975

Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.

A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.

Adult↗
PubMed1975

Release of subretinal fluid with the aid of the microscope. Report on 100 cases.

When the incision of the choroid is performed with the aid of the microscope, release of subretinal fluid becomes an absolutely controlled microsurgical procedure. In a consecutive series of 100 eyes, operated with perforation and buckling, an anatomic reattachment rate of 83% was obtained. There have been 4 complications directly related to the release of subretinal fluid, 2 of which healed with good anatomical and functional result after additional treatment.

Adolescent↗
PubMed1975

Fine structural changes of peripheral cystoid degenerations during life.

Peripheral cystoid degeneration is the result of malnutrition of the retinal tissue, already observed in postnatal development. The morphological substrate for a disturbance in the function of the blood-retinal barrier at the ora is the presence of a perivascular space around the capillaries.

Adolescent↗
PubMed1975

[Retinal detachment, caused by hyperaemia of the choroid? Remarks on the supposed relationship between retinal detachment and "indirect trauma" (author's transl)].

It was recently stressed by Scheerer that retinal detachment in a highly myopic eye may be caused by hyperaemia of the choroid, presumably occuring during heavy physical labour which is performed by a non-trained person. Clinical studies have shown, however, that choroidal detachment, resulting from either hemorrhagic, or serous accumulation of fluid during operative procedures or during postoperative periods, is not followed by retinal detachment. Also experimental occlusion of large choroidal vessels, associated with hyperaemia in the choroidal vasculature, does not lead to retinal changes inducing the separation of the neuroretina from the pigment epithelium layer. Thus, it is concluded that choroidal hyperaemia, possibly occuring during heavy physical labour, has no relationship to the development of a retinal detachment in a "disposed" eye.

Aged↗