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Biomedical subjects

S Behrendt

Publications and source records attributed to S Behrendt.

At least 19 recordsLinked to original sources
PubMed2004

[Psychotherapeutic care of dysphonic patients].

The diagnosis of vocal dysfunction is a prerequisite for referring a patient for specialized medical therapy. This mostly requires a holistic approach, and should also consider related symptoms and the social environment of the patient. Regulations on psychotherapy, promulgated in 1999, have provided clarity in relation to the indications for treatment in an inpatient and outpatient basis. Within the German health care system, every individual can now directly contact an officially certified psychotherapist (so called psychological psychotherapist) for probationary sessions, aimed at determining a basis and indication for further psychotherapy. In case of psychotherapy provided from others than physicians, an additional medical report from a physician is obligatory. Patients with functional and psychogenic voice problems often believe that organic disorders are the reason for their dysphonia. Thus, when caring for voice disordered patients and sending them to a psychotherapist, it is of great importance that physicians facilitate their referral by reacting in an empathic, fear reducing, and professional way.

Combined Modality Therapy↗
PubMed2000

Interaction of Bartonella henselae with endothelial cells results in rapid bacterial rRNA synthesis and replication.

Bartonella henselae is a slow-growing microorganism and the causative pathogen of bacillary angiomatosis in man. Here, we analysed how interaction of B. henselae with endothelial cells might affect bacterial growth. For this purpose, bacterial rRNA production and ribosome content was determined by fluorescence in situ hybridization (FISH) using rRNA-targeted fluorescence-labelled oligonucleotide probes. B. henselae grown on agar plates showed no detectable rRNA content by means of FISH, whereas B. henselae co-cultured with endothelial cells showed a rapid increase of rRNA production within the first 18 h after inoculation. The increased rRNA synthesis was paralleled by a approximately 1000-fold intracellular bacterial replication, whereas bacteria grown on agar base showed only a approximately 10-fold replication within the first 48 h of culture. Pretreatment of host cells with paraformaldehyde prevented adhesion, invasion, intracellular replication and bacterial rRNA synthesis of B. henselae. In contrast, inhibition of host cell protein synthesis by cycloheximide did not affect bacterial adhesion and invasion, but prevented intracellular replication although bacterial rRNA content was increased. Inhibition of actin polymerization by cytochalasin D did not affect adhesion, invasion, increased rRNA content or intracellular replication of B. henselae. These results demonstrate that rRNA synthesis and replication of B. henselae is promoted by viable host cells with intact de novo protein synthesis.

Anti-Bacterial Agents↗
PubMed2000

[Differential diagnosis of sinugenic enophthalmos].

BACKGROUND: Spontaneous enophthalmos without recent trauma is a rare condition. Its origin is difficult to evaluate. METHOD: Specific properties of this symptom complex are presented based on a literature review and on case reports. Possible connections between enophthalmos and paranasal sinus diseases as well as differential diagnoses are analysed. PATIENTS: 1. 31 year old female patient with right spontaneous enophthalmos and no history of trauma. CT-imaging disclosed tissue formation in the maxillary sinus, partially destroyed medial orbital wall and floor, descended orbital contents following Caldwell-Luc procedure several years previously. After endonasal surgery of ethmoidal and maxillary sinus with removal of a large cyst good functional and cosmetical result. 2. 25 year old male patient complaining of pain in the periorbital region, presenting with left enophthalmos and superonasal deviation of the eyeball. MRI and CT revealed a tumor in the orbital floor region with total destruction of the roof of the maxillary sinus. Removal of the tumor by a combined lateral rhinotomy and subciliary approach. DIAGNOSIS: Leiomyoma. Orbital reconstruction with PDS-sheet. Postoperatively, improved globe position and motility. No recurrence during three year follow-up. CONCLUSION: When evaluating the causes of enophthalmos, chronic diseases of the paranasal sinuses or their walls must be considered. Surgical therapy is promising.

Adult↗
PubMed1999

[Severe intra- and postoperative supra-choroid hemorrhage. Risk factors, therapy, results].

BACKGROUND: The aim of this study was to analyze risk factors, therapeutic strategies, and functional and anatomic results of eyes with severe suprachoroidal hemorrhage. PATIENTS: Eight of 11 bleeding episodes occurred intraoperatively and 3/11 postoperatively. Bleeding was associated with the following surgical procedures: perforating keratoplasty (5x), extracapsular cataract extraction (3x), pars plana vitrectomy (2x), intracapsular cataract extraction (1x). RESULTS: Nine operations were performed with general anesthesia, two after retrobulbar injection. Ocular risk factors (e.g., prior operations, ocular diseases) and general risk factors (e.g., cardiovascular diseases, diabetes) were analyzed. At the end of the follow-up time visual acuity had improved in three eyes, and it was unchanged in one eye and worse in seven eyes. Four eyes were amaurotic; two of them had to be enucleated. CONCLUSIONS: In spite of using state-of-the-art surgical techniques the prognosis of suprachoroidal bleeding remains serious. Patients who have a combination of several ocular and general risk factors almost exclusively are the ones who afflicted by this complication.

Adult↗
PubMed1999

Effect of folding on the multifocal silicone intraocular lens: scanning electron microscopic study.

PURPOSE: To evaluate whether the surface of the refractive zonal multifocal silicone intraocular lens (IOL) is altered by different folding and implantation instruments and is more sensitive to manipulation during folding than the surface of a monofocal IOL. SETTING: Department of Ophthalmology, University Hospital, Kiel, Germany. METHODS: Evaluated were the refractive multifocal silicone IOL (SA-40N, Array) and an otherwise identical monofocal IOL (SI-40NB) from the same manufacturer (Allergan Inc.). Different folding devices (folding blocks, folding and implantation forceps, and an injector system) were used. The IOLs were kept folded for 60 seconds; 24 hours later, scanning electron microscopy (SEM) was performed. In addition, the cartridges of the injector system were examined by SEM. RESULTS: Overall, regardless of the folding and implantation instruments used, both the multifocal and monofocal IOLs had discrete surface alterations. The cartridges of the injector system had a rough surface at the tip, while the proximal portion appeared smooth. CONCLUSION: There were no signs of lesions particularly affecting the surface of multifocal IOLs.

Elasticity↗
PubMed1998

[Bilateral simultaneous acute amaurosis in neuritis nervi optici. Initial manifestation of encephalomyelitis disseminata].

BACKGROUND: Bilateral simultaneous acute amaurosis as a primary manifestation of demyelinating disease is extremely rare. PATIENT: The clinical course of a 24-year-old patient who initially presented with a bilateral complete loss of vision is demonstrated. Morphologically both optic discs appeared slightly blurred and prominent. Otherwise there were no anterior and posterior segment abnormalities. Examination of the cerebrospinal fluid revealed an increased number of cells and protein without oligoclonal bands. On MRI multiple white matter lesions were visible. Laboratory tests showed no specific abnormalities, especially with respect to infectious or vasculitic diseases. Under intensive steroid therapy (initially 1000 mg prednisolone/day), visual acuity recovered almost completely. Nine months after onset of the disease visual acuity was 1.0 in both eyes. CONCLUSIONS: Even in patients with a fulminant onset of the disease almost complete visual recovery is possible. Differential diagnosis should rule out vasculitic autoimmune optic neuritis, infections, tumors, processes of the paranasal sinuses, toxic, and hereditary causes.

Adult↗
PubMed1998

MRI features of craniofacial fibrous dysplasia.

A 13-year-old female with a 4-year history of monostotic fibrous dysplasia had noticed a progressive proptosis of the right eye and diplopia on upward gaze for 4 weeks. A few years previously an incisional biopsy of the skull had verified the presumed diagnosis of fibrous dysplasia with recurrent bleeding into pathologic cystic bony structures of the skull. The patient was known to have craniofacial fibrous dysplasia with involvement of the frontal and intermediate cranial base, the posterior ethmoidal labyrinth, and the sphenoidal and maxillary sinuses. Eye examination showed a reduced visual acuity in the right eye without defects of the visual field. MR imaging showed a fluid-filled cystic cavity in the orbital frontal bone pushing the globe downwards. Four months later she developed similar symptoms on the other side while proptosis of the right eye was regressive. T2-weighted MRI revealed a large fluid-filled cystic cavity with a fluid-fluid level in the upper part of the left orbit. It is concluded that follow-up studies can be easily performed by MRI without additional exposure to radiation. The total extent of osseous involvement can be determined. Thus, MRI may be helpful in deciding between operative or conservative therapy.

Journal Article↗
PubMed1997

[Intraoperative skiascopy for determining the refractive value of an implantable intraocular lens].

BACKGROUND: Preoperative biometry for calculation of the refractive power of intraocular lenses is not sufficiently reliable in certain cases. Most frequently inaccuracies tend to occur in highly myopic eyes. Preceding refractive procedures can also impair IOL-calculation or even make it impossible. PATIENTS: In a highly myopic patient IOL-power calculation was not possible with conventional calculation formulas due to a preexisting refractive silicone lens located between the cataractuous natural lens and the iris. In another myopic patient ultrasound measurement of axial eye length produced variable and unreliable results. Therefore retinoscopy was performed intraoperatively in the aphakic eye. Refractive power of the IOL was calculated using a new formula. For validation of the method retinoscopy was performed intraoperatively in a second group of 11 patients with unproblematic ultrasound biometry. RESULTS: In 3 eyes IOL power was chosen according to intraoperative retinoscopy. A maximal deviation of 1.25 D from the aimed refraction resulted. In the second group, the retinoscopic method produced partially considerably inaccurate results as compared to the ultrasound biometry. Inaccuracies increased with the extent of hyperopia. CONCLUSIONS: In cases of difficult or inaccurate preoperative ultrasound biometry IOL power can be estimated after intraoperative retinoscopy in the aphacic highly myopic eye. IOL power can be calculated instantly using computer programs or tables. This method additionally enables the surgeon to control the refractive result of intraocular lens implantation prior to wound closure. However this method lacks reliability in higher hyperopic eyes, as in these cases small changes in corneal vertex distance of the lens used for retinoscopy highly alter the result.

Adult↗
PubMed1997

[ORBIT-NET. Discussion forum on orbitology on the internet].

INTRODUCTION: A basic service in the public network "Internet" is electronic mail (e-mail). E-mail makes the participation in discussion groups possible by mailing contributions to the discussion to all members electronically. To complement the existing list of ophthalmologic discussion groups ORBIT-NET was introduced. It offers experts in research, clinic, diagnostic and therapy of orbital diseases the opportunity to make queries or present interesting casuistries and to ask for comments, differential diagnosis or advice on therapy. Other participants can be made aware of new scientific results, actual publications or meetings. MATERIAL AND METHODS: For participation a computer, a modem, an Internet-Provider and special software are required. Registration is made either by e-mail or regular mail. A verification is necessary to limit the list of participants to experts. RESULTS: Since the introduction of ORBIT-NET on November 9th, 1996, there have been no technical problems. ORBIT-NET has been effective as a platform. CONCLUSIONS: The international, interdisciplinary platform ORBIT-NET is an addition to the existing ophthalmologic discussion groups. ORBIT-NET offers orbitologists an international discussion of results and diagnosis, supports further training and can give encouragement to further research.

Computer Communication Networks↗
PubMed1996

[Visual evoked potentials in low blood alcohol concentrations].

BACKGROUND: Both the acute toxic effects of ethanol on the central nervous system and the effects of chronic alcohol consumption on the optic nerve (tobacco-alcohol amblyopia) are well known. We investigated the acute effect of low blood alcohol concentrations on visual evoked potentials. MATERIALS AND METHODS: A pattern VEP (stimulation by TV monitor, alternating chequerboard patterns, 45', 2 Hz, contrast 90%) was performed in ten healthy volunteers in sober condition and 0, 30, 60, 90 and 120 min following ingestion of 1 g/kg body weight ethanol (resulting in a blood alcohol concentration of 0.8-1.1%). Blood samples were drawn from the cubital vein simultaneously with each recording to determine blood alcohol concentration. RESULTS: Neither peak latencies nor amplitudes showed significant changes related to blood alcohol concentration. CONCLUSION: No acute impairment of the optic nerve caused by ingestion of low doses of alcohol could be found using pattern VEP.

Adult↗
PubMed1996

[Butterfly-shaped dystrophy of the macula].

BACKGROUND: The butterfly-shaped dystrophy of the macula is an extremely rare autosomal dominant retinal disorder first described by Deutman in 1970. Two cases are presented. CASE REPORTS: The first patient presented to the clinic with slight deterioration of vision OD. Corrected visual acuity was OD 0.63 and OS 0.8. Examination of anterior segments was normal bilaterally. Funduscopically there was a mild disturbance of the foveolar retinal pigment epithelium. Fluorescein angiography, however, disclosed a large pattern-like hypofluorescence with hyperfluorescent areas in the macular region. Visual fields and electroretinography were normal. The second patient complained of decreased visual acuity OU. Funduscopic and angiographic findings were similar to the first patient. CONCLUSION: Different forms of pattern dystrophies of the macula have been described in the literature with moderate visual impairment. Differentiation is sometimes difficult as some forms have been reported to occur in one family. They may represent different clinical entities of the same disease. Diagnosis is usually made by fluorescein angiography.

Chromosome Aberrations↗
PubMed1995

Complications of silicone disc intraocular lenses.

Through a 4.5 mm corneoscleral incision, we implanted one of two types of foldable, silicone disc, posterior chamber intraocular lenses (IOLs) in the bag in 35 eyes of 32 patients after phacoemulsification and capsulorhexis. Five lenses were explanted in the early postoperative period because of complications. We followed 24 eyes for an average of 38 months. At the end of follow-up, 5 of the lenses had decentered by 1 mm; 8 (33%) had developed clinically significant posterior capsule opacification (PCO). We believe the IOLs' disc shape may not allow firm fixation, resulting in opacification. On average, there were no significant differences in long-term results between the two silicone disc lens types.

Aged↗
PubMed1995

[Sandwich intraocular lens implant: a concept for aphakia correction in children].

BACKGROUND: In the management of congenital cataracts the correction of aphakia is still an unsatisfactorily solved problem. As far as surgical techniques and materials are concerned, the implantation of an IOL seems to be justified even in younger children; but choosing the refractive power of the lens is somewhat difficult regarding the expected growth of the eye. MATERIALS AND METHODS: A new type of IOL is presented as a solution for this problem. Being composed of a PMMA-fashioned optic and haptic it bears a silicone lens which is fastened on top of it. The supporting lens is made of PMMA (polymethylmethacrylate) with a biconvex surface with modified J-loops. The diameter of the optic is 6 mm, the overall diameter is 11 mm. The supplementary lens is made of the same silicone material as used for foldable intraocular lenses. Its diameter is 4.5 mm. This additional component can be removed from the implanted lens so that the needed reduction of refractive power after completed growth of the eye can be performed. The PMMA-fashioned basic component remains in situ just like a conventional posterior chamber lens. The lens was examined using scanning-electron microscopy. Im- and explantation was performed in isolated porcine eyes. RESULTS: The high quality of the lens could be demonstrated using scanning-electron microscopy. The technical feasibility of this concept could be demonstrated on isolated porcine eyes. DISCUSSION: Currently the sandwich lens is being tested in animal experiments. Our special interest is focussed on biocompatibility, formation of secondary cataract, biological reactions in the interface and the possibility of atraumatic explantation of the silicone lens.

Aphakia, Postcataract↗
PubMed1995

[Progress in laser sclerotomy ab externo] Enlarging the sclerostomy channel and local mitomycin administration].

In a previous study we presented our first results after sclerostomy using a pulsed erbium/holmium: YAG laser. At a fiber diameter of 300 microns a success rate of 20-30% was found after a 1-year follow-up. This study concentrates on the improvement of the parameters for filter survival. METHODS. The fiber diameter and thus the size of the fistula increased to 400 microns. Patients who had undergone fibrosis for a previous fistula were treated intraoperatively with topical mitomycin administration. RESULTS. After a follow-up of 6 months, filter function in the 300 microns group was maintained in 26% of the treated eyes (n = 23), while 400 microns fistulas were successful in 48% (n = 26). In the mitomycin-treated group (n = 6), sclerostomy achieved an IOP regulation in four patients. Postoperative hypotony was more frequent, but did not exceed 2 weeks. CONCLUSION. An increase in fistula diameter improves the long-term results of laser sclerostomy. Mitomycin is useful in maintaining filter function in patients with an unfavorable prognosis.

Antibiotics, Antineoplastic↗
PubMed1994

[Perspectives in diagnosis and therapy of orbital diseases].

New or prospectively promising developments in diagnostics and therapy of orbital diseases are presented. Essential improvement concerns computerized tomography (finer stratification) and magnetic resonance tomography (specific imaging methods like suppression of the orbital fat signal). Three dimensional reconstruction is particularly useful. Diagnostic of vascular processes is facilitated by color doppler imaging. The Doppler signal is superimposed in color over a conventional gray-scale ultrasound image, thus giving additional information about blood flow in vessels. Application of endonasal surgery, which in ENT has been developed to great perfection, enables different surgical interventions, e.g. extraction of favourably positioned foreign bodies and decompressive procedures in Graves' disease. More precise and less side-effect-producing radiotherapy is permitted by a new procedure in which special plastic tubes are implanted, which tips are positioned as closely as possible to the area to be irradiated. Irradiation commences by insertion of radioactive iridium into these tubes by a computer-controlled injection-device. As a prospect for near future the possibility of endoscopical orbital interventions, e.g. biopsies is to be mentioned.

Brachytherapy↗
PubMed1994

[Complete occlusion of the capsulorhexis incision by anterior capsule shrinkage].

UNLABELLED: The capsulorhexis technique has become established as procedure of choice for anterior capsular opening in cataract surgery. With the spread of the method even relatively rare complications are gaining in importance. CASE: In a patient with cataract and multifocal chorioretinitis, phacoemulsification with implantation of a one-piece PMMA posterior chamber IOL through a capsulorhexis opening was performed without complications. Within a period of 3 months, shrinking of the anterior capsule led to complete occlusion of the anterior aperture. To our knowledge, no comparably severe finding has been reported. The anterior capsule was successfully opened by by means of Nd:YAG laser capsulotomy. However, improvement in visual acuity was limited by cystoid macular edema due to the basic condition. CONCLUSION: No relations with other systemic or eye diseases have yet been demonstrated. As another case report describes a similar--though less severe--combination of progressive constriction of the anterior capsule and inflammatory eye disease, the opening of the anterior capsule in such cases should be sufficiently large. If anterior capsular shrinkage has developed, Nd:YAG-laser capsulotomy is a low-risk method of therapy.

Aged↗