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Biomedical subjects

R Sailer

Publications and source records attributed to R Sailer.

At least 19 recordsLinked to original sources

Intracellular fluorescence behaviour of meso-tetra(4-sulphonatophenyl)porphyrin during photodynamic treatment at various growth phases of cultured cells.

Meso-tetra(4-sulphonatophenyl)porphyrin (TPPS4) taken up by cells is mainly localized in lysosomes as previously shown by fluorescence microscopical and fluorescence spectroscopical investigations. In the present study the intracellular fluorescence behaviour and the intracellular amount of this dye at various growth periods of cells were examined. For cells irradiated in the growth phase a relocalization of TPPS4 from the lysosomes into the cytoplasm and finally into the nucleus was observed. In contrast, for cells irradiated in the stationary phase no redistribution could be detected and therefore no evidence for severe damage of the lysosomal membranes and subsequently for the release of lytical enzymes is given. In both cases lethal damage of the cells was achieved as examined using the trypan blue exclusion test. This indicates that damage of the lysosomes is less important in the photodynamic inactivation of cells sensitized by TPPS4.

Animals

Time-resolved pH-dependent fluorescence of hydrophilic porphyrins in solution and in cultivated cells.

Fluorescence decay kinetics and time-gated (nanosecond) emission spectra of the hydrophilic photosensitizers meso-tetra(4-sulfonatophenyl)porphyrin (TPPS4) and uroporphyrin III (UP III) are reported. These substances are characterized by low aggregation, preferential accumulation within lysosomes and a pH-dependent composition of unprotonated and protonated species. A comparison of TPPS4 and UP III in buffer solutions and in confluently growing RR 1022 epithelial cells showed that the intracellular pH value of the environment of both photosensitizers was about 4.7. A slight decrease by 0.10-0.15 pH units occurred after light exposure which (in the case of TPPS4) was concomitant with a lethal damage of the cells. A photoproduct at 640 nm with a characteristic fluorescence lifetime of 4.3 +/- 0.8 ns was detected for UP III in buffer solutions at pH values above 5. The absence of this photoproduct in epithelial cells again indicated that UP III was located within lysosomes.

Animals

[Oxygen conserving nasal catheters. Oxymizer pendant].

The Oxymizer pendant consists of a 40 ml pendulating reservoir bag which is connected to the prongs by two tubes. Both reservoir and tubes serve as oxygen reservoirs. We wanted to examine if it was possible to save oxygen by changing from the usual nasal cannula to Oxymizer pendant. 11 patients with hypoxaemia due to chronic obstructive pulmonary disease were examined. We were able to reduce the oxygen requirement by approximately 65% without significant changes in SaO2. All 11 patients evaluated the Oxymizer pendant to be more comfortable than the usual nasal cannula.

Catheterization

Pulmonary artery sling associated with tracheobronchial malformations.

We describe three cases of pulmonary artery slings associated with tracheal stenoses by complete cartilaginous rings and abnormalities in the tracheobronchial branching pattern. This association implicates special problems of management that are different from the simple pulmonary artery sling. Pathologic anatomy, symptoms, diagnostic procedures, and the problems of therapy are described. Considering similar cases in the literature, we conclude that thorough diagnostic evaluation of the tracheobronchial and the cardial system should be carried out in all cases of pulmonary artery sling. Simple correction of the aberrant vessel without correcting the tracheal stenosis is of no value in these cases. In some milder cases, a conservative approach is possible and probably less harmful than an operation.

Abnormalities, Multiple

[Dorsal compression fractures of the distal radius metaphysis. Long-term follow-up with conservative therapy].

Conservatively treated compressed fractures of the distal radius dorsal metaphysis healed despite primarily good reduction and consequent treatment with a decrease in dorsal length. The amount of this decline depends on the primary loss of dorsal length. If the fracture showed a loss of dorsal length at the time of the accident of up to 2 mm, the long-term results were almost anatomical. If there was primarily a larger loss of dorsal length, a decline of the distal fragment into the dorsal cave resulted. Most of the dorsal length regained after reduction was lost when the cast was removed. The long-term follow-up examinations were made after about 9 years.

Adolescent

[Plate osteosynthesis of the radius. Own implant and technique].

In 1989 and 1990, 46 acute distal radius fractures with die-punch compression cavities underwent open reduction and internal fixation using a new compression plate and surgical technique. In 34 of these patients, functional and radiological results after plate removal were studied. Surgical exposure was palmar or dorsal, or combined palmar with a supplementary dorsal incision, depending on the location of the compression cavity and the extent of fracture dislocation. A cortico-cancellous graft from the iliac crest was fitted into the compression cavity, thus supporting the reduced joint surface against the radius shaft. Superior maintenance of the reduction was achieved using cortico-cancellous instead of simple cancellous graft. A new titanius radius reconstruction plate was used for internal fixation. This two-fold support of the fracture allowed for earlier wrist mobilization.

Adolescent

[Snowboarding injuries].

This retrospective study includes 59 people treated at our trauma centre for snowboard accidents that happened in the 1989 winter season. 22 People were severely injured. 2 people died due to a polytrauma. One fracture of the cervical vertebrate column was followed by complete hemiplegia. Reasons for these accidents were a lack of knowledge how to behave outside the marked alpine regions, as well as lack of technical equipment and theoretical education.

Adolescent

[Malignant hyperthermia in a child with acute lymphatic leukemia].

A 5-year-old boy with acute lymphatic leukemia in remission developed signs of malignant hyperthermia (MH) during general anesthesia for removal of a central venous access port. The anesthetic procedure for implantation of the port 17 months before had been uneventful despite use of the same triggering agents, halothane and succinylcholine. Meanwhile, the patient had received chemotherapy (COALL-03-85). The first sign of MH was masseter spasm following succinylcholine; then tachycardia, acidosis, myoglobinuria, and CPK elevation (8953 IU) appeared. There was only moderate temperature elevation to 37.8 degree C. Rapid improvement and complete recovery occurred after dantrolene i.v. The patient's father was found to have undiagnosed muscle pain and an elevated CPK level. An in vitro contracture test with halothane and caffeine revealed susceptibility to MH and supported the patient's diagnosis and genetic predisposition. Referring to several other cases in the literature concerning MH in patients with lymphomas and leukemias, a possible correlation between the two diseases is discussed. As the MH crisis in our patient was most probably genetic in origin, a common acquired cause such as a viral infection seems less probable. We do not believe the chemotherapy our patient received between the two anesthetics was the cause since about one-half of the patients in the literature had not had chemotherapeutic pretreatment at the time of the MH crisis. We believe that a common genetic predisposition is the most likely link between the two diseases. In any case, patients with leukemias and lymphomas should be monitored very carefully for symptoms of MH.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool

[Closed tendon injuries of the hand].

Cases of subcutaneous tendon ruptures of the hand were compiled over a period of 10 years; the lesions were all traumatic rather than due to degenerative illness. The 914 injuries fall into two categories: 867 extensor and 47 flexor tendon ruptures. The localisation of the lesions is most often distal. The extensor tendon lesion is accompanied more often by a ruptured bony fragment; the distal flexor tendon is mostly torn-off bony fragment. The extensor tendon ruptures can be subdivided as follows: distal injuries of the extensor aponeurosis in the DIP joint (751 cases), IP joint (31), tractus intermedius (27), ext. carpi radialis longus (5) and brevis (1), ext. carpi ulnaris (6); proximal ruptures of the ext. pollicis longus (42), ext. digitorum communis II and indicis (1 each) and ext. carpi radialis longus and brevis (1 each). The flexor tendon lesions are as follows: distal injuries to flex. digitorum profundus (32 cases), flex. pollicis longus (9), and the opponens pollicis, which is classified under this heading (2). Proximal lesions to flex. pollicis longus (2) and flex. digitorum profundus and superficialis (1 each).

Hand Injuries

Revascularization of a partially necrotic talus with a vascularized bone graft from the iliac crest.

A 16-year-old patient had a compound dislocation of the right talus. Following primary treatment, which included a subtaler screw arthrodesis, the talus developed clinical, radiological, and isotope scan signs of necrosis. In spite of a walking caliper to prevent weight bearing on the ankle, the talar articular cartilage of the ankle joint also showed signs of degeneration. The talus was revascularized with a vascularized corticocancellous iliac crest bone graft. Six months postoperatively, there were clinical, radiological, and bone scan signs of significant revascularization. The patient is free of pain and able to walk with full weight bearing on the foot.

Adolescent

[Osseous avulsion of the opponens pollicis muscle. Case report of a rare injury in skiing].

Two cases in which the M. opponens pollicis was ruptured with a bony fragment are reported. In each case the injury, which occurred in young people (24-29 years of age), was the outcome of a fall during alpine skiing, whereby the hand hit the icy slope. Operative treatment was necessary due to the intense subjective pain which followed a significant thenar hematoma.

Adult

[Corrective osteotomy following peripheral radius fractures. Method and results].

Malunion of distal radius fractures leads, especially in those patients who are manually employed, to functional disability of the hand. Painful impingement on the ulnar side of the wrist results in decreased range of motion in pronation/supination and loss of strength. By reconstructing as precisely as possible the axial and longitudinal relationship of the forearm bones, the desired congruence of the distal radioulnar joint can be achieved, this improving greatly the strength and function of the hand. Indications, point of time, as well as technique in operating will be presented in short form in 42 of our own cases: complications will also be discussed. The roentgenographic and functional results, as well as the subjective evaluation from 33 patients whose operations took place longer than a year ago, before and after the malunion correction, will be listed according to our postoperative examination protocol for radius fractures. In all three parameters positive results could be shown, especially in the patient's subjective analysis. Notice will be taken on the special difficulties in position corrections in cases in which the ulnar side fragment is dislocated.

Adult

[Distal radius fractures--forms of fracture and injury pattern].

Fractures at the distal end of the radius are the most frequent fractures. There are still many therapeutical problems. The success of conservative or operative treatment depends mainly on the different types of fractures. In order of compare end results and to recommend therapy, it is necessary to define different fracture types, based on practical classification. A classification of fractures at the distal end of the radius is presented, with localization and reference to the extent of injury with consideration of lesions of the radiocarpal joint and indirectly to the distal radio ulnar joint. In the period of growth five types of injuries are differentiated. In adults three main groups, depending on the involvement of the radio-carpal joint are described. These are subdivided according to dislocation. The fractures types were classified by using X-rays of cases over a period of several years. With this classification the pattern of injury of 593 fractures of the distal end to the radius, treated in 1980 in our clinic, was analysed.

Humans

[Hand injuries in Alpine skiing].

In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal-metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial-ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries.

Athletic Injuries

[Wrist para-articular radius fractures in winter sports].

Winter sport is of great importance in the Alpine countries. In 1980 3600 persons (10.24%) of all new admittances hospitalized in our hospital were injured when practicing winter sports. In 1983 they lessened to 2597 (7.73%) and in 1985 2999 (5.74%). Analysis of all injuries caused by winter sport activities shows that the number of injured persons is decreasing, severity of the injuries however, increasing. A comparison of the distal radius fractures in 1980, 1983 and 1985 indicates that extraarticular metaphyseal fracture types have decreased, intraarticular fracture with multiple fragments however, have increased. Mainly younger patient suffer from severe fractures. We regard the high pace-risk of the age group as the main course of this fact.

Adolescent

Functional and morphologic characterization of human insulinomas.

Circulating levels of insulin, proinsulin-like component, glucagon, growth hormone, and pancreatic polypeptide were measured in 12 patients with functioning insulinomas, and the suppressibility of serum insulin by somatostatin and diazoxide was assessed before surgical removal of the tumors. The hormone content of the tumors was evaluated by radioimmunoassay and by immunofluorescence and the structure of the tumor cells by electron microscopy. Based on these findings, we propose a new classification of insulinomas in two groups: group A is characterized morphologically by abundant well-granulated typical B-cells, trabecular arrangement of tumor cells, and uniform insulin immunofluorescence; functionally, these tumors are associated with a moderate elevation of proinsulin-like component and with an almost complete suppressibility of serum insulin by somatostatin and diazoxide. In contrast, tumors of group B are characterized by scarce well-granulated typical B-cells, a medullary-type histologic structure, and irregular insulin immunofluorescence; functionally these tumors show elevated circulating levels of proinsulin-like component and a marked resistance of insulin secretion to somatostatin and diazoxide inhibition. This way of separating human insulinomas in groups A and B represents a simplification of existing classifications and emphasizes the quantitative ultrastructure in relationship to suppressibility of insulin secretion. The proposed classification of human insulinomas in groups A and B, however, does not allow the assessment of the clinical or histopathologic malignancy of the tumors.

Adenoma, Islet Cell