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Biomedical subjects

R Heilbronner

Publications and source records attributed to R Heilbronner.

12 recordsLinked to original sources

Extracranial vertebral artery dissection causing cervical root lesion.

The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. Color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals.

Adult↗

Identification of malingered head injury on the Halstead-Reitan battery.

Heaton et al. (1978) demonstrated that the performance of malingerers and actual head trauma patients could be distinguished on the HRB by discriminant analysis. The present study replicated Heaton et al.'s methodology on a larger sample to provide a more stable function for discriminating simulated and real head trauma. Malingerers (n = 80) were instructed to fake severe deficits without being obvious. Patients (n = 80) had documented trauma and were not litigating for compensation. Groups were matched on age, gender, and overall Impairment Index to permit comparisons between patterns of performance. A crossvalidated step-wise discriminant function correctly identified 88.75% of the groups, with 83.8% true positives and 93.8% true negatives. This function was applied to several published data sets. Both malingerer and patient groups were accurately identified in Heaton et al. (1978) and Trueblood and Schmidt (1993). Faust et al.'s (1988) adolescent malingerer and the malingered performance of three litigating patients published by Cullum et al. (1991), were also correctly classified.

Journal Article↗

Preoperative and postoperative auditory and facial nerve function in cerebellopontine angle meningiomas.

Preoperative and postoperative facial nerve and auditory function were reviewed retrospectively in 13 cases of cerebellopontine angle meningiomas. According to their location within the posterior fossa and with special reference to the internal auditory canal, they were classified into a premeatal and a retromeatal group. All the tumors were removed by an otoneurosurgical team by use of a retrosigmoid approach. Postoperative results (1 year after operation) were compared within the two groups with respect to preservation of hearing (normal hearing in 31% and preservation of preoperative hearing in 69% of the cases) and facial nerve function (no or mild postoperative impairment in 69% of the cases). Both preoperative and postoperative impairment of facial nerve and auditory function prevailed in the premeatal group. For preservation of vital vascular and central nervous structures, subtotal resection with consecutive fractionated radiation therapy had to be performed in 30% of the cases. Our results provide substantial evidence that in cerebellopontine angle meningiomas a precise preoperative study of tumor location will assist in improving individual operative strategy and thus postoperative functional results.

Adult↗

Computed tomography of the postoperative intervertebral disc and lumbar spinal canal: serial long-term investigation in 19 patients after successful operation for lumbar disc herniation.

The first part of this work, published in 1988, included 25 patients who had computed tomographic (CT) scans without contrast enhancement and plain x-rays of the lumbar spine before, 1 week after, and 6 to 7 weeks after a successful operation for lumbar disc herniation. The present study extends the follow-up period to 3 years in 19 of the 25 original patients. Clinical examinations, lateral plain x-rays, and CT scans without contrast enhancement of the operated disc were repeated. The results indicate a decrease or even a disappearance of the hyperdense extradural material thought to represent fibrosis. An image suggestive of persistent disc herniation was still present in 5 of 8 patients with this finding on early postoperative CT scans. Persistent intradiscal gas was seen in nearly half of the patients. Total normalization of the posterior extraspinal structures was the rule. There was no correlation between CT appearance and residual complaints of the patients. CT scans without contrast enhancement may be sufficient to guide the surgeon in postoperative patients with massive signs and symptoms of recurrent root compression in whom a second operation is indicated on clinical grounds. In all other cases, myelography followed by CT scans is considered appropriate to investigate failed back surgery syndrome.

Adipose Tissue↗

Unilateral testicular disease: effect on the contralateral testis (morphometric study).

Unilateral testicular disease has been reported to damage the contralateral testis. In order to find out whether this detrimental influence is permanent in nature or can be avoided by therapeutic measures, and furthermore to quantify the damage, the following experiments were performed. Seventy-five rats were classified into the following five groups: I) testicular torsion persisting for eight hours; II) ipsilateral semicastration after torsion persisting for eight hours; III) semicastration; IV) sham operation as control; V) immunosuppression with azathioprine after torsion persisting for eight hours. The contralateral testes were removed two months later and perfused with fixative via the testicular artery. Stereologic techniques were employed to obtain quantitative morphologic data. Serum hormone levels were determined. The volume density of the contralateral germinal epithelium was not decreased two months after torsion for eight hours, torsion following by semicastration or torsion followed by immunosuppression. The same was true of the total volume of germinal epithelium per rat testis. The hormone levels remained essentially unchanged.

Animals↗

Stereologic and fine-structural studies of prostatic acinar basal cells in the dog.

There are two distinct types of epithelial cells in the lining of the glandular acini of the prostate in adult male Beagle dogs, i.e., the columnar secretory epithelial cells and the basal cells. In contrast to the secretory epithelial cells, basal cells exhibit an abundance of micropinocytotic vesicles on their basal surface. Blood capillaries are often found in the stromal tissue in close proximity to these cells and their walls frequently display chains of fenestrations bridged by diaphragms. Stereological analysis shows that the volume density of the basal cells in the reference volume of acinar parenchyma is 0.056, and there are approximately 132.14 million cells per cm3 of prostatic tissue. An average basal cell has a volume of 373.5 micron3, and the volume densities of its nucleus, rough endoplasmic reticulum, Golgi apparatus, mitochondria and micropinocytotic vesicles, are 0.49, 0.04, 0.04, 0.094 and 0.013, respectively. These data are distinctly different from those that have been reported for the prostatic secretory epithelial cells of the same animals.

Animals↗

Human skin grafts on nude athymic mice: a light microscopic stereological study.

A morphometric procedure is presented, which allows quantitative information to be obtained from the epidermis at the light microscope level. The application of this procedure to human skin grafted to the nude mouse revealed acanthosis of the grafted epidermis compared to the original donor skin. All epidermal layers were thicker, but the increase in the granular layer was especially marked. The ratio of the basement membrane surface to the epithelial surface showed no significant change. A possible explanation for the acanthosis of the graft might be the higher mechanical stress on the nude mouse compared to the original site on the abdomen. This adaptation of the grafted epidermis does not limit the usefulness of this animal model for dermatological research, when it is assessed by objective methods, allowing statistical comparison as described here.

Animals↗

Do's and don'ts in stereological pathology or possibilities of stereological-biochemical correlation in uropathology.

The problems and the interpretation of combined stereological-biochemical investigations in benign prostatic hyperplasia (BPH) research are discussed. As BPH is characterized by a primary stromal enlargement the role of the smooth muscle cell (SMC) is focussed. For determination of the single cell volume of the SMC several methods are applicable leading to different results. Thus interpretation of these results has to be done with caution. Finally as an example there is a discussion of a correlation of stereological-biochemical dates of human prostatic tissue samples.

Adult↗