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Biomedical subjects

R Kiel

Publications and source records attributed to R Kiel.

7 recordsLinked to original sources
PubMed2005

[Wooden spike orbital injury].

A 71-year-old female patient fell in her garden, inducing a skin wound on the temporal left eyebrow. Skin disinfection and wound closure were performed elsewhere, an X-ray image did not reveal a foreign body. She was referred to our service three days later with a progressive left periorbital swelling. Clinical inspection demonstrated a painfully, fluctuant swelling around the wound with an inflammatory pseudoptosis of the left eye. Vision was reduced on the left eye; anterior and posterior segments of both eyes were unharmed. After opening the wound sutures a purulent liquid was drained and a wooden fragment was found, measuring 22 x 0.5 mm. Because of restriction of abduction of the left eye, magnetic resonance imaging (MRI) was performed, detecting another organic intraorbital foreign body and a fracture of the left medial orbital wall. Anterior orbitotomy was performed and a wooden fragment was removed, measuring 47 x 0.6 mm. Under administration of intravenous antibiotics vision and ocular motility recovered uneventfully. This case emphasizes the value of MRI in the diagnostics of retained wooden foreign bodies as well as the importance of a soigneuse inspection of skin wounds with a high risk for remaining foreign bodies.

Aged↗
PubMed2002

[Diagnosis of retinal diseases. Comparison between multifocal ERG and fundus perimetry - a case study].

BACKGROUND: There are new methods available for function testing of the macula, i.e. multifocal Electroretinography (mfERG) as well as fundus perimetry with the scanning laser ophthalmoscope (SLO). The value and clinical impact of these methods have still to be evaluated. We wanted to compare the results from patients having undergone both examinations. PATIENTS AND METHODS: A total of 33 eyes from 25 patients (visual acuity 0.03-0.8) aged 14-79 years were examined using fundus perimetry with the SLO. In addition, multifocal ERG was performed in all eyes, where 61 local ERGs inside the 30 degrees visual field were recorded. We compared the depth of the scotoma with the reduction of the amplitudes during mfERG taking the fixation status into consideration. RESULTS: Examination time was comparable for both examination techniques. There was good concordance for eyes with retinitis pigmentosa with only central response. In contrast, patients with juvenile macular dystrophy demonstrated different results with comparable size of the defect while sometimes an enlarged pathology during mfERG was observed. Correlation between pathology findings observed in mfERG and fundus changes was difficult due to the change of the point of fixation caused by central scotoma. In age-related macular degeneration correlation of the findings was less obvious. DISCUSSION: The different setting with supra-threshold stimuli during ERG in contrast to near-threshold stimulus presentation during perimetry, might be the reason for differences even in the beginning of retinal diseases. In addition, reduced stability of fixation leads to artifacts during mfERG while it may be compensated for in fundus perimetry. Both methods are of additional value and demonstrate different results depending on the disease.

Adolescent↗
PubMed2002

[Satisfaction with low vision aids].

PURPOSE: To study satisfaction with the prescription of low vision aids (LVA) and to correlate LVA with eye disease and visual function one year after prescription. METHODS: A questionnaire was sent out to 576 patients who had received LVAs in 1998. We evaluated their subjective satisfaction with the LVA as well as with the whole examination in our low vision department and compared the kind of LVA with disease and visual acuity. In addition, we observed whether additional functional deterioration led to problems with the LVA. RESULTS: 301 questionnaires were returned (52 %). They reported on high satisfaction with the management and the LVA (> 90 %). 57 % used their optical LVAs more than 5 times daily mostly for reading and writing (74 % and 78 %, respectively). However, 20 patients were no longer able to read with their LVA due to decrease of function. When comparing the LVAs, most patients with age-related macular degeneration were supplied with magnifiers (30 %). Thirty percent of the patients supplied with CCTVs (43 %; visual acuity 0.02 to 0.3) used the CCTV daily. CONCLUSIONS: The majority of low vision patients is very satisfied with the prescription of LVAs and frequently uses these aids. The adequate LVA is a major factor improving the quality of life. However, due to the possibility of greater deterioration after the disease, follow-up examinations on a regular basis appears to be necessary. The early prescription of CCTVs often helps to preserve the reading ability and should therefore be kept in mind by the physician dealing with low vision patients.

Adolescent↗
PubMed2000

Extracorporeal perfusion of the human uterus as an experimental model in gynaecology and reproductive medicine.

Experimental perfusion of various organs has primarily been used in transplantation medicine to study the physiology, pathophysiology and metabolism of tissues and cells. The purpose of this study was to establish an experimental model for the extracorporeal perfusion of the human uterus with recirculation of a modified, oxygenated Krebs-Henselait solution, in comparison with a non-recirculating perfusion system. With consent of the patients we obtained 25 uteri after standard hysterectomy. We performed an isovolumetric exchange of the perfusion medium at different intervals from 1 to 6 h and examined pH, pO(2), pCO(2), lactate, lactate dehydrogenase and creatine kinase by taking arterial and venous samples every hour for 24 h. We found the perfusions to be adequate when maintaining flow rates at 15-35 ml/min and at pressures ranging from 70 to 130 mmHg. Isovolumetric exchange of the perfusate every 3-4 h was the maximum interval to keep pH, the arterio-venous gradients of pO(2) and pCO(2), and the other biochemical parameters in physiological ranges. Examination by light and electron microscopy showed well-preserved features of myometrial and endometrial tissue. However, a 6 h exchanging interval led to increasing hypoxic and cytolytic parameters during the whole perfusion period. X-ray studies using digital subtraction angiography and perfusion studies with methylene blue demonstrated the homogeneous distribution of the perfusion fluid throughout the entire organ.

Adult↗
PubMed1986

Successful treatment of disseminated Trichosporon beigelii (cutaneum) infection with associated splenic involvement.

Fungemia caused by Trichosporon beigelii (cutaneum) has been recently recognized as a fatal infection afflicting immunocompromised patients. The authors report the case of a leukemic patient who developed splenic infection from disseminated T. beigelii. Treatment with amphotericin B, 5-fluorocytosine, and splenectomy proved successful. The etiology of disseminated T. beigelii infection, visceral seeding, and combination antifungal therapy also are discussed.

Adult↗