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Biomedical subjects

M Haug

Publications and source records attributed to M Haug.

At least 19 recordsLinked to original sources
PubMed2006

Effective treatment of permanent tattoos with combustible particles due to blast injuries with a V-shaped device.

Permanent tattooing due to blast injuries is a rare condition. Treatment with various different methods often yields unsatisfactory results. An innovative way to remove permanent traumatic tattoos is presented. A normal curettage blade is simply compressed with a pincer in order to create the new device. This V-shaped blade was used for surgical excision of the particles. No suture material or special dressing was used. Four patients with multiple explosive tattoos on the face were treated with the V-shaped knife. Due to the ease and speed of this method up to 300 particles were removed in one session. Histological analysis of the tissue samples showed deep dermal and subcutaneous particle location. At follow-up transient hypopigmentation but only minimal scarring was seen. Patients suffered less from itching, a chief complaint preoperatively, and aesthetic appearance of the facial skin was improved. In conclusion, treatment of traumatic tattoos with the V-shaped knife is effective, results in minimal scaring and restores the natural colour of the skin because the particle is completely removed. It is a promising method for treating multiple deep skin inclusions.

Adult↗
PubMed2005

[Postamputation phantom limb pain -- comes the solution into view?].

About 70 % of amputees will suffer from phantom limb pain sooner or later. Nearly all of the amputees will feel some phantom sensations. Phantom limb pain not only impairs quality of life, but also impedes considerably social rehabilitation. Therefore effective strategies of prevention and treatment are urgently required. So far, none of the more than 40 treatment methods has proven to be really effective. It is to be expected that the latest theories regarding the emergence of phantom limb pain, which were developed on the basis of modern neuroimaging techniques, will lead to considerable progress. Accordingly the key to success is influencing cortical reorganization and preventing or extinguishing a pain memory. The demonstrable influence on central activities implicates several preventive and therapeutic modalities, i. e. absolute analgesia before amputation for a longer period of time and reduction of cortical reorganization by drugs, behaviour interventions and/or suggestion.

Adult↗
PubMed2004

Computer aided designed neo-clavicle out of osteotomized free fibula: case report.

Total clavicle reconstruction is a challenging task. We performed a reconstruction of the ventral shoulder girdle by calculating a 3D DICOM representation of the left clavicle to create a right neo-clavicle. Two cuts in correct position and angle leads to a natural 3D shape of the new clavicle. The data were used with a thermo-jet procedure to form model slices of thermoplastic wax. Subsequently, the double titanium osteotomy template with correct cut-angulation was constructed. A 40-year old patient presented with symptoms of progressive pain and instability in the shoulder girdle resulting from complete right clavicle resection due to desmoid tumour 23 years earlier. During the operative procedure, dissection, guided double osteotomy, microvascular anastomoses and acromioclavicular-sternoclavicular fixation were performed. The computer-assisted planning resulted in the exact calculation of the two osteotomy cuts, hence, the 3D appearance of the neo-clavicle. Two years postoperatively, patient showed slightly improved elevation and complete recovery from pain. Our operative procedure demonstrates that the computer-assisted planning with construction of a wax model and an osteotomy template is a useful approach to plan the two precise cuts leading to a predictable shape of the clavicle.

Adult↗
PubMed2002

Clinical characteristics of 13 solid organ transplant recipients with ganciclovir-resistant cytomegalovirus infection.

BACKGROUND: Ganciclovir-resistant (GCV-R) cytomegalovirus (CMV) is now being reported with increasing frequency in solid organ transplant recipients. OBJECTIVE: To describe the clinical characteristics and outcomes of all solid organ transplant patients with GCV-R CMV seen between 1990 and 2000 at a single center. METHODS: Patients with clinically suspected GCV resistance had viral isolates subjected to phenotypic analysis by plaque reduction assay, and also genotypic analysis. Medical records of the 13 patients with GCV-R CMV were reviewed for demographic, microbiologic, clinical, and pathologic data. RESULTS: Thirteen patients were identified, including 5 kidney, 1 heart, and 7 lung transplant recipients. All but one patient (92%) were CMV donor seropositive, recipient negative (D+/R-), and 11/13 (85%) had tissue-invasive CMV. CMV viremia was recurrent in 9/13 (69%); in 2 others, the first CMV episode was fatal. Overall, 9/13 (69%) of patients have died, all of CMV or its complications. Of the 10 who received foscarnet, only one survived. All patients had received GCV-based prophylactic regimens; 8/13 patients (62%) had received CMV hyperimmune globulin (CMVIG) as part of prophylaxis, 6/13 (46%) had received oral ganciclovir, and 5/13 (38%) had received intermittent (3 x/week) IV ganciclovir for prophylaxis. CONCLUSIONS: GCV-R CMV is associated with CMV D+/R- status, tissue-invasive disease, and high mortality even with foscarnet therapy. Exposure to less than fully therapeutic levels of GCV, in the form of oral or intermittent IV GCV, is common. The use of CMVIG in prophylaxis does not appear to prevent resistance. Further work remains to be done to elucidate the risk factors and optimal mode of prophylaxis and treatment for GCV-R CMV.

Cytomegalovirus↗
PubMed2001

Single-stage defect repair with latissimus dorsi free flap after extensive resection of terebrant ulcer of the head: three case reports.

Three cases of advanced ulcerating basal cell carcinoma (terebrant ulcer or ulcus terebrans) of the head are reported. Neglected basaliomas had deeply destroyed larger parts of the skull in three women ages 78, 69, and 65 years when the patients were first admitted for treatment. Death due to meningitis, hemorrhage, or brain damage was imminent. Wide resection and coverage by free latissimus dorsi flaps was carried out in single-stage procedures. The latissimus dorsi, a versatile and very reliable free flap with its constant vascular anatomy and long pedicle, is the ideal flap for the coverage of large defects on the head. The donor site can usually be closed primarily, and the functional deficit is acceptable. All three patients recovered completely. Although only palliative resection could be achieved, the procedures could be justified by the increased survival time and gain in quality of life.

Aged↗
PubMed2001

[External ear injuries--classification and therapeutic concept].

The treatment of traumatic defects of the auricle concerning the exact reconstruction of details and aesthetic aspects is exacting for the surgeon. To face the expectations towards best trauma care, the different locations and extent of auricular injuries should be included in the different therapeutic strategies. The insufficient treatment results in mostly difficult secondary conditions. We present a classification for ear traumas, which considers size and location of defects. Depending on this, different techniques and methods of reconstruction are recommended. Advantages and disadvantages are pointed out and discussed with several examples and with the present literature.

Adolescent↗
PubMed2001

A new contralateral split-breast flap for breast reconstruction and its salvage after complication: an alternative for select patients.

Different approaches to breast reconstruction have been described and nowadays nearly optimized. One major aim in further developments is to reduce donor site morbidity as low as possible. Theoretically, the lowest donor site morbidity could be achieved by using tissue that would be normally discarded during an operation necessary for a different reason. The authors present a new method of breast reconstruction in a mastectomy patient who needed a reduction mammaplasty on the remaining side in addition to the reconstruction. A single-stage split-breast flap from the reduced contralateral side pedicled on its internal mammary perforators was used, thus lowering donor site morbidity by using otherwise discarded tissue. The technical details, patient selection, advantages, possible pitfalls, management of complications, and the risk factors for contralateral malignancy are discussed.

Breast↗
PubMed2000

Anterior cruciate ligament reconstruction as a day case with extended recovery.

The aim of this study was to describe the procedures and the postoperative outcome of arthroscopic anterior cruciate ligament (ACL) reconstruction when carried out a day case with extended recovery. Between December 1995 and September 1998, 91 patients underwent surgery using bone-patellatendon-bone autografts and interference screw fixation. Additional surgical procedures were performed on 35 of the patients. The patient records were evaluated for a mean of 17 months (1-33 months) postoperatively. The course of treatment was. (1) Evaluation and KLT-arthrometer test 14 days preoperatively. (2) Surgery, cryocuff, bupivacain, paracetamol, NSAID and ketobemidon for postoperative pain control. (3) Discharge from hospital within 24 h. (4) Physiotherapy after 14 days. (5) Follow-up after 6 weeks with bandage removal and after 6 months. Eight patients required one further day of hospitalisation due to pain (four), nausea (one), haematoma (two) and prolonged anaesthesia (one). Five patients were readmitted to hospital for a mean of 8 (3-16) days postoperatively. Three patients underwent re-surgery due to haematoma/rupture of the scar. No deep infections were found. We concluded that this effective method of ACL-reconstruction can be carried out safely as a day case procedure with extended recovery to the benefit of the patients.

Journal Article↗
PubMed2000

Review of select transplant subpopulations at high risk of failure from standard immunosuppressive therapy.

Despite improvements in short-term graft and patient survival rates for solid organ transplants, certain subgroups of transplant recipients experience poorer clinical outcome compared to the general population. Groups including pediatrics, African-Americans, diabetics, cystic fibrosis patients, and pregnant women require special considerations when designing immunosuppressive regimens that optimize transplant outcomes. Problems specific to pediatric transplant recipients include altered pharmacokinetics of immunosuppressive drugs, such as cyclosporine (CsA) and tacrolimus (poor absorption, increased metabolism, rapid clearance), the need to restore growth post-transplantation, and a high incidence of drug-related adverse effects. African-Americans have decreased drug absorption and bioavailability, high immunologic responsiveness, and a high incidence of post-transplant diabetes mellitus. Diabetics and cystic fibrosis patients exhibit poor absorption of immunosuppressive agents, which may lead to underimmunosuppression and subsequent graft rejection. Pregnant women undergo physiologic changes that can alter the pharmacokinetics of immunosuppressives, thus requiring careful clinical management to minimize the risks of either under- or overimmunosuppression to mother and child. To achieve an optimal post-transplant outcome in these high-risk patients, the problems specific to each group must be addressed, and immunosuppressive therapy individualized accordingly. Drug formulation greatly impacts upon pharmacokinetics and the resultant level of immunosuppression. Thus, a formulation with improved absorption (e.g., CsA for microemulsion), higher bioavailability, and less pharmacokinetic variability may facilitate patient management and lead to more favorable outcomes, especially in groups demonstrating low and variable bioavailability. Other strategies aimed at improving transplant outcome include the use of higher immunosuppressive doses, different combinations of immunosuppressive agents, more frequent monitoring, and management of concurrent disease states.

Adult↗
PubMed2000

Breast reconstruction facilitated by vertical banded gastroplasty.

BACKGROUND: Vertical banded gastroplasty (VBG) causes weight loss, which is often associated with redundant abdominal tissue. This redundant tissue can be used successfully for breast reconstruction or breast augmentation in case of mastectomy or ptotic hypotrophic breasts. METHOD: One patient with bilateral mastectomy is described in whom the weight fell from BMI 52 to BMI 26 after VBG, giving the patient an abdominal "apron", which facilitated bilateral breast reconstruction. RESULTS: Bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction after weight reduction following VBG resulted in an esthetic pleasing result with additional correction of the cutis laxa abdominis. CONCLUSION: Autologous breast reconstruction can be performed safely with the methods used today, after successful weight loss following obesity surgery.

Breast Neoplasms↗
PubMed1999

[Psoas abscess in pyogenic sacroiliitis].

A 47-year-old man was admitted with septic fever over a few days. A CT-scan showed a psoas abscess, which was drained by surgery. In the meantime antibiotics were started. In spite of this treatment, he continued to have septic fever. Bone scintigraphy and MR-scan showed activity in the right sacroiliac joint compatible with sacroiliitis. The joint was opened surgically and revised. The patient was treated with antibiotics for nine weeks and was fully restituted. It must be concluded that the psoas abscess was secondary to the sacroiliitis, a rare event.

Anti-Bacterial Agents↗
PubMed1999

[Reconstruction of mediastinal veins in same side dialysis shunt].

Centralvenous obstruction is a rare however typical lesion with patients on chronic hemodialysis. A still functional arteriovenous shunt in its run-in can cause serious disorder, especially painful congestion and an insufficient dialysis. Should the shunt be maintained, a run-off reconstruction is required. 13 patients were treated with a centralvenous obstruction combined with a complication of the shunt. In 8 patients the intervention was either impossible from the beginning or finally proved to be not successful after repeated recanalisations. 6 out of these patients underwent a transsternal reconstruction of their bypass (a total of 7 interventions). 2 patients died perioperatively, 2 patients died 1 year, respectively 1 1/2 years later with a still intact reconstruction, 2 patients are still alive. Their reconstruction has been working for two, respectively three years. The bypass material was large-calibrated e-PTFE with external support. Compared to conventional indications the catheter techniques proved to be less effective in the treatment of central venous obstruction. One year after the first intervention only three out of seven shunts could still be used for the dialysis. The longest symptom-free period was 12 months. The operative reconstruction is indeed very effective but it implies considerable risks and effort. This method cannot be recommended to patients on chronic dialysis who are in a poor condition.

Adult↗
PubMed1998

[Anterior interosseus nerve syndrome].

A prolonged period of illness in a patient showing symptoms of reflexdystrophy is described. After going through several examinations and finally being referred to a pain clinic the patient demanded a second opinion from an orthopaedic surgeon. Her symptoms turned out to have been caused by a compression syndrome of the anterior interosseus nerve.

Adult↗
PubMed1998

Cyclosporine disposition and long-term renal function in a 500-pound kidney transplant recipient.

Patient size has been suggested as a risk factor in kidney transplantation. We have followed a recipient of a cadaver kidney who became massively obese (232 kg, 511 lbs) 5 years posttransplantation. He has maintained stable renal function with no rejection episodes and at 5 years has a measured serum creatinine of 2.2 mg/dL, creatinine clearance 42 mL/min, and urinary protein excretion of 320 mg/24h. Both oral and intravenous cyclosporine (Sandimmune) pharmacokinetic studies were done on a steady-state dose of 150 mg, which represents 0.65 mg/kg per dose. The patient exhibited very high bioavailability, F = 95%, and an oral elimination T1/2 of over 21 hours. These data confirm that stable cyclosporine delivery in very obese recipients can be sustained by dosing normalized to the ideal body weight and trough level monitoring.

Biological Availability↗
PubMed1998

Health problems and health actions among community-dwelling older adults: results of a health diary study.

This study examined the health problems and health actions reported by a sample of older adults (N = 60) who maintained health diaries over a 4-week period. The diary sample was 78% (n = 47) White; 52% (n = 31) were women, with a mean age of 75 years (SD = 5.3). Content analysis was used to examine the types of health problems reported in the diaries, which health problems were likely to be considered an illness, and what health actions were reported. Respondents reported an average of four different types of health problems over the 4-week diary period. There were differences in symptom reports related to gender, age, or race. The most frequently reported health problems were musculoskeletal problems (n = 38), runny nose and respiratory problems (n = 24), gastrointestinal problems (n = 22), and headaches (n = 22). Only 36% of all health problems were considered to be illnesses. Subjects recorded a number of health actions in response to their health complaints, including over-the-counter (OTC) medication use (83%), prescription medication use (53%), self-care activities (72%), and professional consultation (43%). Specific strategies that subjects used to deal with various health problems, implications of the findings, and the usefulness of health diaries as a clinical tool are discussed.

Aged↗
PubMed1997

Potential nitrosamine formation and its prevention during biological denitrification of red beet juice.

High nitrate intake has been shown to result in an increased risk of endogenous formation of N-nitroso compounds. Certain vegetables and vegetable juices contain high concentrations of nitrate. Biological denitrification using strains of Paracoccus denitrificans (P.d.) has been proposed as effective means to reduce nitrate contents in such vegetable juices. During this bacterial denitrification process, substantial nitrite concentrations are transiently formed. This study investigated whether N-nitrosation reactions might occur. The easily nitrosatable amine morpholine was added to red beet juice at high concentration (100 ppm) during denitrification 10 different batches of red beet juice served as raw material. Each batch was submitted to denitrification in the presence and absence of ascorbic acid. In the absence of ascorbic acid, formation of N-nitrosomorpholine (NMOR) was observed in the low ppb range (0.5-8 ppb). Addition of ascorbic acid (500 mg/litre) inhibited the formation of NMOR, except for those instances where the pH was less than 6 and/or nitrate turnover was low (< 200 mg NO3-/litre/hr). Under conditions leading to high rates of nitrate turnover (> 200 mg NO3-/litre/hr), nitrosamine formation can reliably be prevented by ascorbic acid. The results show that bacterial denitrification of red beet juice high in nitrate can be accomplished without the risk of nitrosamine formation.

Ascorbic Acid↗
PubMed1996

Neurosteroids in the mouse brain: behavioral and pharmacological effects of a 3 beta-hydroxysteroid dehydrogenase inhibitor.

Inhibition of the aggressive behavior of castrated male mice toward lactating female intruders by dehydroepiandrosterone (DHEA) is correlated with a decrease of pregnenolone sulfate (PREG S) concentrations in brain. We attempted to establish a cause to effect relationship by preventing the decrease of PREG S with trilostane (TRIL), a competitive inhibitor of delta 5-3 beta-hydroxysteroid dehydrogenase delta 5 --> 4 isomerase enzyme. Indeed, TRIL elicited a large increase of PREG levels in brain. Those of PREG S were, however, unchanged, and TRIL unexpectedly decreased the aggressive behavior of control castrated males and did not counteract the inhibition elicited by DHEA. The neurosedative progesterone (PROG) metabolite, 3 alpha-hydroxy-5 alpha-pregnan-20-one (TH PROG), undetectable in the brain of control mice, reached nanomolar concentration range in TRIL-treated ones. However, injection of appropriate amounts of PROG, producing an even larger increase of brain TH PROG, had no antiaggressive effect. Finally, the latter was attributed to the large (up to 80 nM) TRIL-induced increase of brain 3 alpha,21-dihydroxy-5 alpha-pregnan-20-one, which like TH PROG potentiates inhibitory gamma-aminobutyric acid (GABA)ergic neurotransmission.

3-Hydroxysteroid Dehydrogenases↗