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Biomedical subjects

J Ilgner

Publications and source records attributed to J Ilgner.

7 recordsLinked to original sources
PubMed2005

[Infectious mononucleosis].

The primary infection with Epstein-Barr virus in an immunocompetent individual leads to infectious mononucleosis with symptoms of diphtheroid angina, lymph node swelling in the neck and hepatosplenomegaly. The most common age of infection lies between 15 and 25 years. The illness can affect a number of organs simultaneously and thus requires interdisciplinary diagnostics. For differential diagnosis, a differential blood analysis and a EBV quick test are required. The presence of IgM antibodies demonstrates the presence of the infection. Ultrasound of the abdomen can be made to determine the involvement of additional organs. In most cases, recovery occurs without complications. Acute cases can usually be handled successfully with medication. If symptomatic treatment fails, pharyngeal airway obstruction is possible and a tonsillectomy may be necessary. Otherwise, surgical treatment is obsolete. Generally, the prognosis is good. Severe courses and complications are rare.

Humans↗
PubMed2005

[Time-dependent vestibular function loss of semicircular canals and otolith organs in Menière's disease].

INTRODUCTION: Since Dohlmann's investigations the extremely variable interindividual natural course of Menière's disease has been documented. The description of sub-entities of Menière's disease shows, the localisation of dysfunction within the labyrinth is of considerable importance. The selective investigation of crista and macula sensor organs and its time-dependent progression even provides information for the disease's staging. METHODS: In the retrospective trial presented here, 126 patients suffering from vertigo were tested by the methods described above. 10 of these patients who showed a triad of symptoms including vertigo attacks, unilateral sudden hearing loss and tinnitus were selected for this study. All 10 patients were tested within 48 hours after the last acute vertigo attack by means of caloric irrigation and VEMPs. RESULTS: The function loss verified in saccular testing could be found in Menière's disease progression at an earlier stage than the utricular function loss. Most patients with a long history of vertigo attacks also suffered from a dysfunction of the semicircular canals. DISCUSSION: The differential testing of the otolith function is a valid tool for the recognition of early labyrinth dysfunction in Menière's disease and could lead to an earlier onset of specific therapy. It also provides the base for a differentiated staging prior to therapy planning.

Adolescent↗
PubMed2005

[Otolith function tests--a differentiated, quality-assured screening system].

INTRODUCTION: More than 30% of all otogenic vestibular disorders are related to isolated macular dysfunction. Videooculographic examination techniques for the otolith-ocular reflex, e. g. by means of eccentric rotation tests, are not widely used in clinical routine as these put a considerable strain on technical and staff resources. Thus, there is a considerable risk of "false negative" classification of vertigo disorders being labelled as "non-otogenic". By means of vestibular-evoked myogenic potentials (VEMPs) and caloric irrigation in prone and supine position, several examination techniques for a side-related investigation of macula-induced vestibulo-ocular reflexes are available. The objective of this study is to compare and evaluate these techniques as screening tests. METHODS: In 32 patients with vestibular disorders we performed investigations for VEMPs, eccentric rotation tests, as well as caloric irrigation for macular reaction in prone and supine position. In addition, we performed other audiologic and vestibular function tests which were complemented by the clinical course in order to differentiate each case between otogenic and non-otogenic vertigo with or without macular affection. RESULTS: The technical feasibility as well as patients' acceptance for VEMP testing is better than for eccentric rotation tests. The sensitivity index for VEMPs (89%) as well as for caloric irrigation in prone and supine position for macular examination (71%) is satisfactory. However, the specificity of VEMPs is inferior (53%) to eccentric rotation (100%). DISCUSSION: Both the examination for VEMPs as well as caloric macular testing in prone and supine position carry features which make them feasible for screening, even though these two procedures test for two different parts of the otolith system. However, to confirm a diagnosis and to set up a therapeutic concept for macular function disorders, eccentric rotation should be added.

Caloric Tests↗
PubMed2003

[Electro-mechanic steering device for head-lamp mounted miniature video cameras].

BACKGROUND: Endoscopic or microscopic video recordings set a widely established standard for medico-legal documentation of operative procedures. In addition, they are an essential part of undergraduate as well as postgraduate medical education. Macroscopic operations in the head and neck can be recorded by miniaturised video cameras attached to the surgeon's head lamp. METHODS: The authors present an electro-mechanic steering device which has been designed to overcome the parallax error created with a head-mounted video camera, especially as the distance of the camera to the operative field varies. RESULTS: The device can be operated by the theatre staff, while the sterility of the operative field is maintained and the surgeon's physical working range remains unrestricted. As the video image is reliably centred to the operative field throughout the procedure, a better orientation and understanding for spectators who are unfamiliar with the surgical steps is obtained. CONCLUSIONS: While other adverse factors to macroscopic head-mounted video recordings, such as involuntary head movements of the surgeon, remain unchanged, the device adds to a higher quality of video documentation as it relieves the surgeon from adjusting the image field to the regions of interest. Additional benefit could be derived from an auto-focus feature or from image stabilising devices.

Endoscopy↗
PubMed2002

[Clinical experience with power-regulated contact laser surgery for the paranasal sinuses and the anterior skull base].

BACKGROUND: While laser surgical methods in Otorhinolaryngology have become widely established, their use in revision surgery for chronic-polypous sinusitis has been regarded as hazardous due to the vicinity of the anterior skull base and the orbit. However, new experience with laser-tissue interaction in contact irradiation together with effective power feedback control mechanisms require a re-evaluation of laser revision surgery in this field. PATIENTS AND METHODS: After 742 primary, endonasal-microscopic sinus surgery procedures, 86 patients had 128 Nd:YAG-laser sessions performed within an interval of 1 - 24 months after primary surgery for recurrent polyposis, which had been irresponsive to medication. The maximum power delivered was 10 to 20 W. RESULTS: Recurrent polyposis appeared mostly in the maxillo-ethmoid angle, followed by the maxillary sinus roof and the maxillary sinus bottom. In 63 of 86 patients, no further polyposis was seen after laser surgery. If more than one laser session had to be performed, recurrent polyposis appeared in a different region in most cases. Those areas lasered first showed a reduced tendency to recurrence. There was moderate bleeding during laser surgery in 6 cases with reduced visibility, but no other serious complications were recorded. CONCLUSIONS: Laser surgery for chronic-polypous sinusitis is an alternative to conventional revision surgery, if medical treatment fails and recurrent polyposis is confined to certain regions. Feedback-controlled contact laser power delivery adds further therapeutic safety when applied next to the anterior skull base and the orbit.

Adolescent↗
PubMed2001

[Low-grade malignant peripheral nerve sheath tumor of the neck soft tissues].

BACKGROUND: Malignant Peripheral Nerve Sheath Tumours (MPNST) either grow sporadically, after radiation or chemotherapy respectively. In many cases they are associated with Neurofibromatosis I. Because of the multiform histologic picture they are often difficult to differentiate from other soft tissue tumours. PATIENT: We present the case of a sporadic MPNST which developed from the vagus nerve of a 39-year-old patient following radiation of the neck 7 years before. After complete excision there has been no recurrence up to now. RESULTS AND CONCLUSIONS: Sporadic MPNST of the head and neck are comparatively rare. With regard to the strong association with Neurofibromatosis I and the difficult differential diagnosis to other soft tissue tumours the emphasis should be put on excluding further manifestations of Neurofibromatosis I and of secondary tumours.

Adult↗