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Biomedical subjects

R Seiler

Publications and source records attributed to R Seiler.

At least 19 recordsLinked to original sources
PubMed2007

Lack of microbial DNA in tissue specimens of patients with abdominal aortic aneurysms and positive Chlamydiales serology.

In a case-control study that included a total of 98 patients and 83 controls, the possible link between various pathogens and abdominal aortic aneurysms was investigated. For 68 patients with abdominal aortic aneurysm and age-matched controls, no differences were detected in the levels of immunoglobulin (Ig)A and IgG Chlamydiaceae and Chlamydophila pneumoniae antibodies. Patients with IgA titers positive for Chlamydophila pneumoniae showed progressive disease (defined as an annual increase of the aneurysm diameter of > or = 0.5 cm) more frequently than patients with negative IgA titers (p = 0.046). Polymerase chain reactions performed to detect DNA for Chlamydophila pneumoniae, Chlamydia trachomatis, Chlamydophila psittaci, human cytomegalovirus, Borrelia burgdorferi and Helicobacter pylori in tissue specimens of 30 patients and 15 controls were negative. In summary, Chlamydophila pneumoniae may contribute to aortic aneurysm disease progression, but DNA of this and other pathogens was not found in patients' specimens.

Aged↗
PubMed2006

[Simultaneous defect of visual fields and loss of libido--a coincidence?].

We present the case of a 60 year old male patient with incidentally detected visual abnormalities. Detailed personal history revealed a hypogonadism that had been present for several years. Further investigations established the diagnosis of an infiltrative macroadenoma. Medical treatment with cabergoline led to a rapid regression of ophthalmologic symptoms and, subsequently, of tumor size. In male subjects symptoms of hypogonadism are often reported only late in the course of the disease, thereby leading to a generally larger tumor size at the point of diagnosis. In contrast to other pituitary tumors that are mainly treated by surgery, medical treatment with dopamine agonists is the principal therapeutic option in prolactinomas.

Cabergoline↗
PubMed2006

Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience.

OBJECTIVE: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. MATERIAL AND METHODS: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. RESULTS: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. CONCLUSION: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.

Aged↗
PubMed2005

Treatment outcomes and mortality of 94 patients with acromegaly.

BACKGROUND: Due to new therapeutic modalities and modified therapeutic goals outcome of patients with acromegaly may change over time and differ by centre. We analysed treatment outcomes and mortality of our patients with acromegaly seen between 1971 and 2003. METHOD: The cohort consisted of 94 patients who had been followed for 0.3-31 years (mean 10.6 years). Remission criteria were a normalized IGF-I concentration, a nadir GH level during oral glucose load of <1.0 microg/l and a random GH value of <2.5 microg/l. FINDINGS: Transsphenoidal surgery achieved remission in 80% of patients with micro-adenomas (<1 cm), 65% with meso-adenomas (> or = 1 cm to <2 cm) and 27% with macro-adenomas (> or = 2 cm). Patients with meso-adenomas operated on after 1995 tended to have a better outcome compared to those operated on before 1995 (Remission in 83% vs. 38%). Radiotherapy resulted in disease control in 22 of 47 patients (47%). Intramuscular depot formulation of octreotide (Sandostatin LAR) led to disease control in 17 of 26 patients (65%). After multimodal therapy persistent acromegalic activity remained in 18% of the patients; only one of them had an adenoma of <2 cm. The standardized mortality ratio was 1.30 (95% CI 0.52-2.67) for patients in remission and 1.38 (95% CI 0.51-3.00) for patients with persistent acromegalic activity. CONCLUSIONS. Most patients with adenomas of <2 cm can be expected to achieve remission by transsphenoidal surgery alone. Furthermore, virtually all patients with adenomas of <2 cm and more than 80% of patients with adenomas of > or = 2 cm can be expected to achieve remission by adjuvant treatment. Aggressive multimodal therapy is critical in the management of acromegaly reducing mortality risk close to that of the general population.

Acromegaly↗
PubMed2003

The response of trained athletes to six weeks of endurance training in hypoxia or normoxia.

This study was performed to investigate the effect of training under simulated hypoxic conditions. Hypoxia training was integrated into the normal training schedule of 12 endurance trained cyclists. Athletes were randomly assigned to two groups and performed three additional training bouts per week for six weeks on a bicycle ergometer. One group (HG) trained at the anaerobic threshold under hypoxic conditions (corresponding to an altitude of 3200 m) while the control group (NG) trained at the same relative intensity at 560 m. Preceding and following the six training weeks, performance tests were performed under normoxic and hypoxic conditions. Normoxic and hypoxic .VO2max, maximal power output as well as hypoxic work-capacity were not improved after the training period. Testing under hypoxic conditions revealed a significant increase in oxygen saturation (SpO 2, from 67.1 +/- 2.3 % to 70.0 +/- 1.7 %) and in maximal blood lactate concentration (from 7.0 to 9.1 mM) in HG only. Ferritin levels were decreased from 67.4 +/- 16.3 to 42.2 +/- 9.5 microg/l (p < 0.05) in the HG and from 54.3 +/- 6.9 to 31.4+/- 8.0 microg/l (p = 0.17) in the NG. Reticulocytes were significantly increased in both groups by a factor of two. In conclusion, the integration of six weeks of high intensity endurance training did not lead to improved performance in endurance trained athletes whether this training was carried out in hypoxic or normoxic conditions.

Adult↗
PubMed2001

A worksite intervention module encouraging the use of stairs: results and evaluation issues.

OBJECTIVES: Recent recommendations suggest that health benefits can also be derived from regular daily activities of moderate intensity which accelerate breathing, such as climbing stairs. The purpose of this study was to examine the effect of an intervention programme on behaviour change in stair use in a working environment. METHODS: Intervention field workers were instructed to offer attractive or pull actions. 338 employees of four offices of the Swiss federal government were involved in the evaluation. Two methods were used to assess stair and lift use both before and after the four month intervention period: a non-covered personal observation and an automatic measurement. RESULTS: Taking all four offices together, a significant increase in stair use, from 61.8% to 67.1% (p = 0.028), was found between the baseline and the follow-up observation. The automatic measurement during observation time reveals a change in stair use from 68.8% to 71.4% (p = 0.268). The pattern of stair use examined for 24 hours by automatic means, however, was not so consistent. Due to the proportion of stair use in each office it is assumed that environmental factors influences the behaviour. The highest percentage of stair use at baseline (86.2%) was identified in an office with a bright stairwell and a small number of steps between floors. The lowest proportion (31.4%) was observed in an office with a dark stairwell, a large number of steps between floors and a stairwell accessible only with a key. CONCLUSIONS: However, our findings indicate that intervention with "rewarding" elements encourage individuals to use stairs.

Activities of Daily Living↗
PubMed2001

[Play sports and feel well! Effects of sports on mental health].

The role of mental health is increasingly recognised in the discussion about health. In this article, health is considered to be a dynamic balance between resources and potential risk factors. Sport and physical activity may represent resources that do not only contribute to an increased well-being, but also to an improved self concept as a cognitive representation of one's health-status. Investigations of the short-time effects of sport show that different activities result in different mood changes, but also that the initial mood is important in such a way that people with a bad mood profit more from physical activity programmes. More permanent physical activity results in better well-being, but also in an improved perception of the health status and a higher satisfaction with health. Individually tailored new physical activity behaviour programmes and reinforcing systems have to be developed. These may lead to adequately strengthen the self-efficacy and increase the well-being of a broader population.

Affect↗
PubMed1995

Extended anterior subcranial approach for skull base tumors: long-term results.

The extended anterior subcranial approach differs significantly from more traditional surgical approaches to the skull base in that it allows a broad inferior access to the anterior skull base planes with tumor exposure from below rather than via the transfrontal route. The authors initially used the subcranial approach in 1978 for the treatment of high-velocity skull base trauma and certain craniofacial anomalies. In 1980 they expanded the indications to include the combined neurosurgical-otolaryngological resection of various skull base tumors. Osteotomy of the frontonasoorbital external skeletal frame provides optimum anterior access to the orbital and sphenoethmoidal planes as well as to the nasal and paranasal cavities while avoiding frontal lobe retraction and the external facial incisions characteristic of transcranial and transfacial approaches. The improved visualization of the anterior skull base and clival-sphenoidal region facilitates en bloc tumor removal, optic nerve decompression, exposure of the medial aspect of the cavernous sinus, and watertight realignment of the anterior cranial base dura. In this report the authors present their experience over the past 13 years with 104 patients who underwent operation via the extended subcranial approach. Because extensive frontal lobe manipulation and external facial incisions are avoided with this approach, intensive care unit and overall hospital stay are reduced, related complications are minimized, and postoperative cosmetic appearance is enhanced. The extended anterior subcranial method is therefore an excellent alternative to traditional transfacial-transcranial skull base approaches for the removal of selected skull base tumors.

Adolescent↗
PubMed1993

The subcranial approach for fronto-orbital and anteroposterior skull-base tumors.

We describe 78 patients with fronto-orbital and sphenoethmoidal tumors surgically treated with the subcranial approach. This approach was developed by us in 1978 primarily for the treatment of skull-base trauma and craniofacial anomalies. Since 1980, we have extended the indications to include tumor resections. This extended anterior exposure of the anterior fossa skull base, including the sphenoidal and clival planes, enables an en bloc tumor removal obviating the transfrontal approach or lateral rhinotomy. In contrast with the conventional transcranial approach, the anterior subcranial approach provides an extended exposure of these locations, avoiding frontal lobe retraction. Reduction of complications, such as recurrent cerebrospinal fluid leaks, postoperative brain edema, damage to cranial nerves, and infection plus decreased hospitalization, are the major advantages of this procedure.

Adolescent↗
PubMed1992

[Hypophyseal dysfunction and tumors].

Some pituitary hormones secrete hormones while others do not. Nonsecreting tumors can interfere with normal pituitary hormone secretion and produce tumor symptoms and signs like headaches and visual field defects. The most frequent hormone-secreting tumors are prolactinomas. Growth hormone or ACTH or gonadotropin or gonadotropin-alpha and beta chain-producing tumors are less frequent, TSH producing tumors are extremely rare. The most important elements of the diagnostic work-up are clinical signs and symptoms, assessment of pituitary function (measurement of TSH, free T4, LH, FSH, oestradiol/free testosteron, growth hormone, IGF-1, prolactin, ACTH, Cortisol, serum and urine osmolality), CT and/or MRI and, in patients with large tumors, a visual field exam. The treatment of choice of pituitary tumors is often surgery. Alternative therapies are radiation treatment (in nonoperable patients or when hormone levels are persistently elevated after pituitary surgery) and drug treatment (dopamine agonists in hyperprolactinemia, somatostatin analogues in acromegaly). Pituitary hormone deficiencies are treated depending on the specific deficiency with thyroxine, cortisone, oestrogen/gestagen/testosterone gonadotropines or ADH analogues.

Adenoma↗
PubMed1991

Correlation of regional cerebral blood flow and blood flow velocity in normal volunteers and patients with cerebro-vascular disease.

Transcranial Doppler sonography and measurement of regional cerebral blood flow using the Xenon133-inhalation technique have been used simultaneously in 10 normal volunteers and 13 patients with acute-onset cerebrovascular disorders during normocapnia and during hyperventilatory hypocapnia. Hypocapnia led to a reduction of both blood flow and blood velocity in the territory of the middle cerebral artery. However, correlation was poor in most cases with respect: 1) to hemispheric blood flow and flow velocity over the middle cerebral artery (BFV), 2) cerebral blood flow (CBF) over the middle cerebral artery (MCA) and BFV and 3) percentage changes of CBF over the MCA and BFV during hypocapnia. In normals correlation usually was better than in patients with cerebrovascular disorders. It was concluded that measurement of BFV over the MCA using transcranial Doppler sonography does not reflect either cerebral tissue perfusion or changes of tissue perfusion induced by alteration of CO2-content in the arterial blood.

Adult↗