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Biomedical subjects

J Rustemeyer

Publications and source records attributed to J Rustemeyer.

17 recordsLinked to original sources
PubMed2006

Outcomes after surgical treatment of facial skin basal cell carcinomas.

BACKGROUND: Missing recurrences and the aesthetic outcomes after reconstructions of the face are preoccupations in the surgical treatment of basal cell carcinomas. Hence, the different reconstructive techniques in particular and the rate of recurrence are evaluated in this study. PATIENTS: 205 patients receiving resections of basal cell carcinomas and facial skin reconstructions were included and data were analyzed. RESULTS: The rate of recurrence was 7.3% after follow-up at an average of 2.5 years (0.5-5 years). Local flaps, full-thickness skin grafts and skin extension closures were carried out most often; indications for split-thickness skin grafts were rare. Sensitivity disturbances occurred in only 3.6% of skin extension closures and in 11.7% of local flaps, but in 22.7% of full-thickness skin grafts and in 38.7% of split-thickness skin grafts. The aesthetic outcomes were evaluated through clinical inspection and by using patients' scale. They were classified as "unobtrusive" and "excellent or good" in 88.4% of local flaps and in 92.6% of skin extension closures, but in only 66.4% of full-thickness skin grafts and in 54% of split-thickness skin grafts. CONCLUSION: Local flaps and skin extension closures provide better aesthetic and neurological outcomes after facial skin reconstructions. However, skin grafts are alternative procedures for critical indications of local flaps.

Adult↗
PubMed2005

[Experiences with surgical management of facial basal cell carcinoma and procedures for plastic reconstruction].

BACKGROUND: No recurrences and optimal aesthetic outcomes after R0 resection and plastic reconstruction of the face are the goals in the surgical treatment of basal cell carcinoma. The aim of this study was to evaluate recurrence rates and to evaluate different reconstructive techniques. PATIENTS AND METHODS: This study included 205 follow-up patients undergoing R0 resection of primary basal cell carcinoma and facial skin reconstruction between 1998 and 2002; data were analyzed retrospectively. RESULTS: The most frequent locations of basal cell carcinoma were the nasal (40.5%) and orbital (22.9%) regions. The rate of recurrence after 2.5 years (6 months-5 years) was 7.3%. Local flaps, full-thickness skin grafts, and sliding flaps were usually performed; indications for split-thickness skin grafts were rare. Disturbances of sensation were found in only 3.6% of the sliding flaps and in 11.7% of the local flaps, but 22.7% in full-thickness and 38.7% in split-thickness skin grafts. The aesthetic outcome, evaluated by clinical inspection and a patient satisfaction score, was classified as "unobtrusive" and "good or excellent" for 88.4% of local flaps, 92.6% of sliding flaps, but only for 66.4% of full-thickness and 54% of split-thickness skin grafts. CONCLUSION: Local flaps and sliding flaps result in better aesthetic and neurological outcomes after reconstruction of facial skin regions. Skin grafts have their indications as an alternative procedure in cases of critical indications for flaps.

Adult↗
PubMed2005

[Pierre Robin sequence: postoperative complications following cleft palate surgery. A retrospective study covering 25 years].

BACKGROUND: In a 25-year retrospective review of 1976-2000, the postoperative course after cleft palate surgery and pharyngeal flap surgery in 87 children with Pierre Robin sequence was studied. PATIENTS AND METHODS: The study comprised 114 interventions with 87 primary palatoplasties; 17 patients required palatal fistulae repair and 10 children were treated with secondary pharyngoplasty procedures. All children were divided into three postnatal risk groups according to the severity of their symptoms at birth and in the course of the early months of life. RESULTS: A direct correlation was seen between the incidence of early postnatal difficulties and the postoperative obstructive complications after cleft palate surgery and pharyngeal flap surgery. Thus, children experiencing obstructive problems at birth (high postnatal risk group) displayed more severe complications at the time after cleft palate repair. In children undergoing pharyngeal flap surgery not only early postoperative obstruction but also late obstructive sleep apnea can occur.

Abnormalities, Multiple↗
PubMed2002

[Foreign body in paranasal sinuses].

AIMS: All cases of the last 5 years requiring foreign bodies to be removed from the paranasal sinuses were investigated as to causes, special aspects in diagnostics and therapy, occurrence of pathologic germs and possible sequels. PATIENTS: 68 cases were evaluated: 43 patients were male, 25 female. Average age was 29 years in males and 37 years in females. RESULTS: In our patients foreign bodies in the paranasal sinuses were in more than 60% the result of medical or dental procedures followed by industrial accidents (25%). The maxillary sinus was affected in 75%, the frontal sinus in about 18%. Involvement of the ethmoid or sphenoid sinus was rare. The spectrum of pathologic microbes was dominated by mixed infections, the share of actinomyces and aspergillus was unexpected high. Most important acute complications were bleeding, compression of the optic nerve and liquorrhoe. Late complications consisted mainly of pain--often associated with disturbances of sensibility- and infections. CONCLUSIONS: A smear should be taken whenever the foreign body remained in the sinus for more than 4 days. Foreign bodies jammed in the posterior wall of the sinus require a sufficiently open view since the risk of heavy bleeding is especially high.

Adult↗
PubMed2001

[Frey syndrome].

AIMS: The incidence of Frey's syndrome after parotidectomy as cited in the literature varies distinctively. Strategies for successful treatment are also assessed differently. PATIENTS: Between 1980 and 1994 a total of 372 parotidectomies were performed in 364 patients at the Bochum University Hospital. RESULTS: After an average of 18 months following parotidectomy, 86 patients (23.5%) developed Frey's syndrome. Thirty-five patients were treated with scopolamine ointment. The symptoms improved in nine cases after an average of 25 months of therapy. Of the patients receiving no treatment (n = 20), seven improved after an average follow-up of 20 months. Therapy with scopolamine ointment did not elicit significantly better results compared to no treatment at all. CONCLUSION: Gustatory sweating after parotidectomy still has to be regarded as an unpleasant complication which is difficult to cure.

Adolescent↗
PubMed2001

Reasons for patients' discontent and litigation.

Introduction: Discontent and litigation among patients is a problem which increasingly preoccupies the medical profession. Aim: We aim to analyse the origin of discontent and litigation and to help avoiding these claims. Material: One hundred and seventy-eight medical expert opinions were evaluated, all made following examination of the complainant. Methods: Depending on the results of the clinical examination and the study of the files it was determined whether there was either a case of malpractice or insufficient informed consent, or no fault at all in a legal sense. In addition the patient and the surgeon were questioned as to their point of view regarding the procedure and their communication and relationship before and after treatment. Results: Frequent complaints were pain (either during treatment or afterwards), major swelling or bleeding, disturbances of trigeminal or facial nerve function, poor scar formation, loss of teeth or fixtures, faulty occlusion and discrepancies between the expected and the actual result of treatment. In 26 cases actual faults made during medical treatment were discovered. In 49 further cases, poor explanation of the proposed procedure was the reason for complaint. In the majority of remaining cases, neither faulty treatment nor insufficient information given to the patient lead to the complaint but the patient's expectations were unrealistically high. Conclusion: A considerable proportion of lawsuits originate from misunderstandings, and not treatment errors: The surgeons often concentrate on the legal requirements of informed consent and neglect to explain the practical consequences of the operation; the patients in turn tend not to ask about possible complications. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed2000

[Associated anomalies in lip-maxillopalatal clefts].

BACKGROUND: Retrospective studies of cleft lip and palate patients suggest a multifactorial aetiology for this condition. Many patients exhibit multiple defects, often removed from the orofacial region. The frequency and location of such coexistent abnormalities vary between studies. PATIENTS: A retrospective case-note study of 1,737 individuals with orofacial cleft, treated between 1974 and 1998 at our centre, was undertaken to assess the frequency of associated malformations and syndromes. RESULTS: Associated malformations were found to be present in 33% of all cases investigated. In nearly one half of these individuals (48%), defects could be attributed to recognisable syndromes. Patients with isolated palatal clefts (45.6%) and those with bilateral clefts of the lip and palate (35.3%) were particularly well-represented. The following problems were observed relatively frequently: Cerebral anomalies (16%), facial anomalies (14%), heart malformations (15%), anomalies of the extremities (9%) and urogenital tract abnormalities (8%). In contrast, endocrine aberrations were identified sporadically (0.5%). A partial situs inversus was found only in one case. CONCLUSION: As clefts of the lip and palate are frequently associated with additional malformations, the importance of thorough interdisciplinary neonatal screening cannot be over emphasised.

Abnormalities, Multiple↗
PubMed1999

Amplification of the mdr1-gene is uncommon in recurrent ovarian carcinomas.

Ovarian carcinomas are known to rapidly develop drug resistance against chemotherapeutic agents. This phenomenon is often associated with the expression of pl70-glycoprotein. A high rate of transcription of the corresponding mdr1-gene in resistant tumors is reported. Amplification of the mdr1-gene has been observed in tumor cell lines exposed to cytotoxic drugs; however, significant information is lacking as to whether this holds true in clinical carcinomas. To fill this gap, we investigated the rate of gene amplification of the mdr1-gene in 63 recurrent ovarian carcinomas and we determined the resistance pattern of these cells using an ex vivo assay. The tumors showed varying ex vivo resistance patterns which did not correlate to clinical parameters. Amplification of the mdr1-gene was not observed in any of the cancer specimens. Therefore, we conclude that mdr1-gene amplification is not a common pathway for the development of chemoresistance in clinical ovarian carcinomas.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1980

[Treatment of sleep disorders in the elderly].

The physiological and pathophysiological peculiarities of the aging organism require to be observed in the treatment of sleep disorders. After eliminating extracerebral causes one has to consider changes of cerebral blood flow as a reason for impaired sleep, for instance resulting from cardial insufficiency or pathological changes of blood pressure. In using sleeping drugs one should keep in mind type and severeness of the sleep disorders and prescribe with care, since the elimination potential in the aged is mostly reduced and the quote of side effects is increased.

Aged↗
PubMed1975

[Quantitative investigation of the amino acid levels in putrefying liver (author's transl)].

To elucidate the post-mortem proteolysis we investigated the behaviour of the free amino acids in rotting liver homogenates by means of two-dimensional thin-layer chromatography and reflection densitometry. The post-mortem alterations of the amino acid levels are characterized mostly by a two-phase increase with maxima at the end of the first and after the third week. A few amino acids showed only little changes hardly above the physiological intra-cellular levels. Anaerobic rat experiments and experiences with antibiotic treatment give rise to the supposition that increasing amino acid concentrations indicate a predominance of proteolytic activities over aminoacid catabolism. In the beginning autoenzymes are prevalent, while afterwards bacterial proteases probably predominate. The transient regression about the second and thrid week is interpreted as the effect of a temporarily intensified amino acid degradation by foreign enzymes (maximal bacterial growth).

Amino Acids↗
PubMedDate not supplied

[Melanotic neuroectodermal tumor of infancy].

BACKGROUND: The melanotic neuroectodermal tumor of infancy is a rare and so far as being classified neoplasm with a high rate of recurrence for one year after diagnosis. Since Krompecher described 1918 the tumor at first, only about 200 cases are reported until today, mostly with manifestation in the maxillary region. CASE-REPORTS: The authors present two infants at the age of six and eight weeks with first clinical manifestation of the tumor in the maxillary region. Although there were no other common signs, the tumor destroyed wide areas of the mid-face. In spite of a treatment with radical surgery, recurrences occur rapidly in the first living year. CONCLUSIONS: Our clinical and histological findings show characteristics of local malignant growth. For these facts the radical resections of the primary tumor and its recurrences are individually the therapeutical consequences. A follow up of seven years of one infant shows a hypoplasm of the mid-face as a result of the inhibition of further growth by the loss of germs after maxillary hemisection.

Humans↗
PubMedDate not supplied

[20 years geriatric rehabilitation at the Hannover at the Henrietta Foundation].

This report includes the historical formation of the institution in regard to the background of the development of the German Society of Gerontology. A description of the newly formed clinic and its special institute for geriatric rehabilitation is supposed to provide a survey about the conditions of clinical work as well as the special courses and training possibilities. This is followed by the presentation of treatment methods and results.

Aged↗
PubMedDate not supplied

[Organization and implementation of clinical rehabilitation at a special hospital].

This contribution offers guidance in the planning, organization, and operation of a clinical gerontological rehabilitation unit. The first part outlines the important requirements of a geriatric rehabilitation clinic and considerations for medical and non-medical staffs (with recommendations showing keynumbers), as well as the structure and equipment for the clinical buildings and recommendations for room area and amount of beds. The general requirement for clinical geriatric rehabilitation beds in Germany is mentioned and training for geriatric rehabilitation is considered. The second part deals with the organization and operation of clinical rehabilitation, in particular, regarding directions and responses of rehabilitation teams, and especially their priority to use collected data as a management function. The contribution concludes with an example of an inpatient rehabilitation at the Klinik für medizinische Rehabilitation und Geriatrie, Henriettenstiftung Hannover, FRG.

Activities of Daily Living↗
PubMedDate not supplied

[Intervention possibilities in the geriatric rehabilitation clinic].

Aged people often are incapable to get on with their homes, for instance with the use of the bathroom, WC, and the kitchen, especially after illness. The author listet the most important localities of problems and difficulties, and proved the therapeutical ways suitable for geriatrical and reha-hospitals to make aged people fit for living at home. The outcome of these researches and the results of working on this base during one year are reported.

Aged↗