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Biomedical subjects

R Brunner

Publications and source records attributed to R Brunner.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Malunited supracondylar and condylar humeral fractures].

We present three important types of posttraumatic deformity of the distal humerus: varus deformity, valgus deformity and complex deformity. Their primary causes are discussed. Slight varus deformities are the result of purely lateral slip of supracondylar fractures or radial overgrowth after a lateral condylar fracture. Severe varus deformities occur after ulnar slip of the distal fragment following supracondylar fracture caused by a rotational deformity. The results after correlation of varus deformities with a rotational deformity are poor. The only way of obviating this problem is to recognize a rotational deformity as soon as possible before adaptation of the elbow occurs, and also to correct it early, if necessary. Valgus deformities occur mostly after radial malunion. Depending on the size of the fragment and the disability of the patient, the fragment should be stabilized-but the potential involvement of the malunion in the elbow function must be borne in mind. Complex deformities and their unknown origins are also discussed. The correction of such deformities depends exclusively on the elbow function. More aggressive primary regimens are urgently needed to prevent the necessity for such secondary corrections, which are very demanding and, depending on the type, have a high failure rate.

Adolescent↗
PubMed1991

Erythrocyte apheresis in combination with elimination of fibrinogen and plasma proteins of higher molecular weight in macular disease and in uveal effusion syndrome.

Reduction of hematocrit as well as elimination of fibrinogen and plasma proteins of higher molecular weight are effective approaches in hemorheology. A combination of these therapeutical concepts was applied in one patient with uveal effusion syndrome and in 16 patients with maculopathy. The hematocrit was reduced by erythrocyte apheresis. Fibrinogen and plasma proteins were eliminated by plasma exchange. In the case of uveal effusion syndrome the filling of the scleral veins as well as the uveal effusion were reduced. Furthermore visual function was improved significantly. In 9 of the 16 patients with maculopathy a significant increase in visual acuity occurred. The therapy described lowers significantly the following parameters: hematocrit, fibrinogen, serum proteins, plasma viscosity, erythrocyte aggregation and apparent whole blood viscosity (native and standardized). In a multiple linear regression analysis we found correlations as follows: plasma viscosity correlates with fibrinogen and proteins of higher molecular weight (r = 0.82), erythrocyte aggregation with fibrinogen and proteins of higher molecular weight (r = 0.88), standardized apparent whole blood viscosity with fibrinogen and proteins of higher molecular weight (r = 0.88) and native apparent whole blood viscosity with hematocrit, fibrinogen and proteins of higher molecular weight (r = 0.91).

Blood Component Removal↗
PubMed1990

[Vascular risk factors in patients with ophthalmoplegia].

The occurrence of high-risk factors for vascular disorders was analysed in a group of 43 patients suffering from diplopia of unknown aetiology. The subjects (25 men and 18 women) were aged between 17 and 78 years. Previously excluded were patients with intracranial or orbital tumors, ocular myositis or myasthenia, multiple sclerosis, endocrine orbitopathy, head trauma, cerebral hemorrhage or aneurysms, leucaemic infiltrates or metastasising tumors. Compared to the control groups of extensive epidemiological studies, the patients showed a higher prevalence of arterial hypertension and diabetes mellitus. Adipositas, lipometabolic disturbance and cigarette smoking were also more frequent. The findings support the hypothesis of a vascular origin of eye-muscle paresis.

Adolescent↗
PubMed1990

[Early diagnostic criteria of ankylosing spondylitis in patients with acute anterior uveitis].

A group of 59 patients with acute anterior uveitis (AAU) were examined for ankylosing spondylitis (AS) according to the New York criteria und criteria for early diagnosis of AS: 17/59 (29%) presented AS according to the New York criteria: a further 13/59 (22%) were classified as having incipient AS according to the early diagnosis criteria. These findings indicate that in a group of AAU patients there are, in addition to patients with definite AS, patients with initial AS though X-rays of the sacroiliac joints are still negative or equivocal. Early diagnosis criteria seem to be useful for identification of these patients at an early stage and can be used as a major selection criterion for monitoring programs.

Acute Disease↗
PubMed1989

[Recording and analysis of the electrooculography using a personal computer. Initial experiences with normal probands and patients with diseases of the posterior eye segment and intraocular foreign bodies].

The electro-oculogram (EOG) is recorded by a personal computer and analyzed during the examination. If the results obtained with this method in normal subjects are compared with the conventional method (with which data recorded in analog form have to be measured manually), there is no significant difference. In patients with diseases of the posterior segment (e.g., posterior uveitis) or intraocular foreign bodies the results of computer and manual analysis are also practically identical. There are two computer analysis techniques: for subjects with almost normal EOGs the trigger-independent method is sufficiently accurate. In patients with pathologic EOGs, however, and in particular those with small potential differences, the trigger-related method is more likely to lead to correct results. The analysis path can be displayed on the computer monitor at any time, so that the examiner can always check whether it is correct. In contrast to manual analysis, the computer analysis cannot be influenced subjectively by the examiner. This considerably improves the comparability of examination results. A further advantage of computer analysis is its speed: the result is available immediately following the examination. It is a low-cost system which is easy to install and use, and thus suitable for routine clinical work.

Chorioretinitis↗
PubMed1989

Nd:YAG laser therapy of an oral verrucous leukoplakia.

A 75-year-old female patient afflicted with an extensive verrucous oral leukoplakia is reported. With treatment by the Nd:YAG laser under local anesthesia on an outpatient basis, the disease could be kept under control for 4 years.

Aged↗
PubMed1989

Peripheral hemodynamics, blood viscosity, and the renin-angiotensin system in hemodialysis patients under therapy with recombinant human erythropoietin.

Treatment of renal anemia with rhEPO (120 U/kg body weight/hemodialysis) in transfusion-dependent patients on maintenance hemodialysis led to an increase in blood pressure, regional peripheral resistance and whole blood viscosity. Our results are in agreement with earlier findings that partial correction of renal anemia results in hemodynamic changes characterized by a fall in cardiac output together with an increase in blood pressure due to increased vascular resistance. The increase in whole blood viscosity correlated with the increase in regional peripheral resistance but not with the increase in mean arterial blood pressure. Thus, other regulating factors of vascular resistance must be involved. Correction of renal anemia does not influence the reninangiotensin system. However, peripheral responsiveness of vascular smooth muscles may have changed due to improved tissue oxygenation and thus leading to an increase in vasoconstriction.

Adult↗
PubMed1989

[Endothelial precipitates and cytomegalovirus infection].

In patients with the typical features of intraocular cytomegalovirus infection endothelial precipitates were identified that had a characteristic morphology, which included subtle, non-pigmented linear deposits with reticular arrangement that can spread diffusely over the corneal endothelium without preference for the inferior quadrants. The appearance of these precipitates was comparable to heterocromic cyclitis. Specular microscopy identified lymphocytes and macrophages on the endothelial layer. The present observations are based on five case reports of necrotizing retinitis, typical for intraocular cytomegalovirus infection, in connection with the atypical endothelial precipitates. In four of the five patients reported, HIV-infection was confirmed. In one patient with serologically confirmed cytomegalovirus infection (however without HIV-infection), a diagnostic work-up of the aqueous humor was carried out. Local production of specific antibodies against cytomegalovirus was identified in the aqueous humor. Topical treatment with antiviral and/or steroidal drugs was unsuccessful. The antiviral drug gancyclovir was applied systemically in two patients, but there was no impact on the corneal precipitates described. No intravitreal therapy was given. If these endothelial changes can be regarded as pathognomonic for cytomegalovirus infection, thorough slit lamp examination may be important for diagnosis of the presence of or the reactivation of cytomegalovirus infection in the eye. So far, no correlation has been found between the time course of corneal/endothelial precipitation and necrotizing retinitis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Therapeutic concepts in infected hip prosthesis].

In the period from January 1980 to December 1987, 62 patients with infected hip joint arthroplasties were treated. The duration of observation was on average 37 months (minimum 12 months, maximum 91 months). The choice of treatment modality depended on the type of infection, the state of anchorage of the endoprosthesis, the general condition of the patient, the type of bacterium and the state of the tissue surrounding the implant. 42 arthroplasties (67%) healed primarily. The remaining 20 were subject to 46 further operations (2.3 relapse operations/patient). 14 subsequently healed (23%) and six cases remained definitively infected.

Debridement↗
PubMed1987

Para-articular ossification in total hip replacement: an indication for irradiation therapy.

The results of postoperative irradiation therapy after total hip replacement or resection of para-articular ossification in 25 patients are reported. The patients were kept under radiological observation for an average period of 26 months and clinical observation for an average period of 31 months after surgery. There were only two clinically relevant recurrences of para-articular ossification. The earlier radiotherapy with a total dose of 2000 rads (2000 cGy) was begun, the better was the effect. In this small population sample statistical significance could not be calculated. No side effects were detected.

Adult↗
PubMed1987

[Treatment of naevi flammei with the argon laser].

We report on 901 patients with port wine stains treated by means of an argon laser. The treatment results have been definitively evaluated in 371 patients. They were significantly influenced by the patients' age and by the colour of the lesions. The worst response to the therapy was seen in pink port wine stains in children and juvenile patients (20% good results), in contrast to red and purple lesions in adult patients (80% excellent and good results). The size of the port wine stains did not significantly influence the treatment results, but in extensive lesions homogeneous lightening could not usually be attained and treatment often extended over some years. Port wine stains in the head and neck area responded best to therapy, and lesions on the legs, worst. Altogether, in 60%-70% of adult patients excellent or good results were obtained, the lesions being completely removed or significantly lightened and reduced in size. The side-effects of laser therapy were scar formation (7.3%) and changes in pigmentation (8.6%).

Adolescent↗