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Biomedical subjects

W Bauer

Publications and source records attributed to W Bauer.

At least 19 recordsLinked to original sources
PubMed1996

Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study.

The mandible of a deceased 19-year-old young woman who had been treated with an edgewise appliance was removed during autopsy. The overall tooth movements during the 19 months of treatment were reconstructed (treatment documents) and compared with the macroscopic, radiologic, and micromorphologic findings of the incisor/alveolar bone/symphysis complex of the dry mandible. The initial lateral cephalogram revealed an extremely narrow and high symphysis, with an incisor position straight above the thin bone. During treatment, the incisors had been moved to lingual (lingual root torque) and derotated. Morphologic evaluation of the dry mandible revealed lingual (oral) aspects of the roots reaching some millimeters out of the lingual alveolar bone and largely without cortical plate covering. Lateral dental contact radiographs of any bone/incisor segment showed the sagittal alveolar bone width to be smaller than the labiolingual (orobuccal) diameter of the incisor roots. A comparison of the approximate pretherapeutic alveolar bone height, which was assessed by measuring the distance from the cementoenamel junction to the most coronal margin of any root resorption in scanning electron microscopy, with that of the specimen showed a calculated bone loss on the lingual aspect extending from 2.3 to 6.9 mm. On the labial (buccal) aspect, bone loss was far less pronounced. These results suggest that in the case of a narrow and high symphysis, pronounced sagittal incisor movements and derotation during routine orthodontic treatment with a fixed appliance may be critical and lead to progressive bone loss of lingual and labial cortical plates.

Adult↗
PubMed1996

[Disk displacement of the temporomandibular joint: correlation of magnetic resonance tomography and clinical findings].

PURPOSE: To evaluate the value of magnetic resonance imaging (MRI) in symptomatic patients with different degrees of internal derangement. MATERIAL AND METHODS: We prospectively investigated 117 temporomandibular joints (TMJ) of 59 symptomatic patients and 31 asymptomatic volunteers and correlated this with clinical parameters. RESULTS: There was a positive correlation between the degree of internal derangement and deformity of the disc, maximal mouth opening, signal intensity of the posterior band, thickness of the bilaminar zone, proliferative bony changes, size of the condyle and reduced translation movement of the condyle, which in addition moved upward and backward. Patients most often complained of pain which was dependent on the degree of disc displacement and condylar changes. Clinical parameters were found to be inaccurate in predicting disc displacement. CONCLUSION: Patients with internal derangement of the temporomandibular joint may be asymptomatic. Patients history may give the only pointer to the disorder.

Adult↗
PubMed1996

[Conservative versus surgical therapy of unilateral fractures of the collum mandibulae--anatomic and functional results with special reference to computer-assisted 3-dimensional axiographic registration of condylar paths].

A clinical, radiographic and computer-assisted axiographic follow-up was carried out on 60 patients who had been treated for unilateral subcondylar fractures. These were patients of the Department of oral, maxillofacial and facial plastic surgery of the Medical Faculty of the University of Technology in Aachen, Germany. After surgical reduction of the condyle with fixation by osteosynthesis where results were positive, 27 patients exhibited a shortening of the condyle paths on the side operated on by up to 16.4%. Although conservative therapy produced slighter straightening of the condyle with more or less strongly marked condylar deformations in two-thirds of the cases, functionally more positive results were obtained by markedly slighter limitation of the condyle paths on the traumatized side. These results would appear to indicate operative therapy of unilateral subcondylar fractures in the case of luxation fractures, condylar dislocation in excess of 50 degrees, and in those cases where intermaxillary immobilization is not feasible. In the remaining cases, conservative treatment is preferred, due to it showing functionally more positive results.

Adult↗
PubMed1995

[Findings in the panoramic tomogram in orthodontic patients with functional disorders].

In our study of 107 patients, for whom data derived from clinical functional analysis, axiography and, in part magnet resonance imaging, were present, we were able to show that in routine orthodontic diagnosis the use of panoramic X-ray in the normal course of a general examination of the mandibular joint can also provide important indications of the presence of cranio-mandibular disorders. The panoramic X-ray revealed that in patients with Angle class II and front deep and open bite there were significantly mor changes in the form of the condyles. A definite morphologic finding of a retracted fovea pterygoidea was found frequently in patients with anterior disk replacement with or without reduction. Lastly, the panoramic X-ray showed that a change in form of the condyles, with in some cases a serious arthrosis, occurs significantly most frequent in patients with anterior displacement without reduction.

Adolescent↗
PubMed1995

Computer simulation of occlusal discrepancies resulting from different mounting techniques.

The effect of arbitrary mounting of maxillary casts on occlusal relationships was investigated in this study. Maxillary casts of 31 volunteers were mounted on an articulator by use of two split cast bases. This mounting was done first with the arbitrary face bow and second with a hinge bow. Three reference points were defined and measured on each maxillary cast with a three-dimensional digitizer. The measurements were taken from the arbitrarily mounted cast and from the cast mounted according to the hinge axis. Opening and closing movements that were transferred according to the hinge axis. Opening and closing movements that were transferred from the articulator to the mouth of the patient were simulated by a computer based on measurements of the reference points. The results revealed that the use of an arbitrary face bow causes a deviation of the hinge-axis points from the precise axis of more than 5 mm in 77% of the cases. Resulting occlusal errors depended on the angles between the arbitrary and precise axes and the direction of the axis shifts. The occlusal error is roughly proportional to the shift or tilting of the hinge axis in millimeters or degrees. For a given deviation of the arbitrary and precise axes, the occlusal error is proportional to the record height. For a record height of 2 mm or more, an occlusal error of more than 0.1 mm will occur. An average occlusal error of more than 0.1 mm would most likely lead to the necessity of extensive selective grinding of occlusal discrepancies in the patient's mouth.

Adult↗
PubMed1995

Gingival invagination area after space closure: a histologic study.

The aim of this study was to show the micromorphologic findings (epithelium, connective tissue, bone) in a region of pronounced gingival invagination after space closure by analyzing a maxilla taken in autopsy from a 19-year-old woman who was orthodontically treated. The dental records were also at our disposal. The second left premolar was congenitally absent. This area displayed before therapeutic horizontal bone atrophy. For space closure, the first upper left molar was moved mesially with a fixed appliance. After space closure, pronounced gingival invagination was diagnosed. The lateral segments of the specimen were prepared histologically in the horizontal plane. The microscopic observations revealed deep epithelial proliferation, hyperkeratinization, and one isolated keratin pearl in the connective tissue. Irrespective of location, the broad connective tissue layer showed disparate characteristics. Cell-rich, loose connective tissue with low fiber density were dominant in the subepithelial layer. The epiperiosteal layer displayed multiple tough fibers, some running parallel, some with reticular meshing, permeated with many blood vessels. Very few inflammatory cells were detected in the soft tissue. The bone had been resorbed in the mesiopalatal area of the molar (tooth movement direction) apart from one small isolated bony islet. These observations suggest that inflammatory influences were unlikely for marginal bone loss mesiopalatal to the tooth.

Adult↗
PubMed1994

[The diagnosis and orthodontic relevance of anterior disk displacement without reduction. Clinical, axiographic and magnetic resonance tomographic studies].

Magnet resonance imaging was used to diagnose 24 temporomandibular joints of 18 patients as having anterior disk displacement without reduction. By comparing clinical functional analysis, axiography, and magnet resonance imaging it was demonstrated that a valid diagnosis could be made on the basis of magnet resonance imaging alone. Former joint clicking and limitation and a dental Angle Class II were diagnostic indications of a disk displacement without reduction. Because of often only slight clinical symptoms or their absence, there is always a danger that disk displacement without reduction will go undiagnosed. In relation to orthodontic therapy, such patients are at risk, because pain can arise during treatment.

Adolescent↗
PubMed1994

Activated T cells and cytokines in bronchoalveolar lavages from patients with various lung diseases associated with eosinophilia.

Increasing evidence suggests an important role for cytokines in the regulation of eosinophilic inflammation. In the present study we investigated the distribution of leukocytes, lymphocyte subsets, their activation state, and the cytokine profile present in BAL fluid from patients with various lung diseases associated with eosinophilia. For this purpose, we analyzed the levels of IL-1 beta, IL-2, IL-4, IL-5, IL-6, IL-8, GM-CSF, TNF-alpha, and IFN-gamma, as well as soluble IL-2 and TNF receptors, in concentrated bronchoalveolar lavage (BAL) fluid obtained from clearly defined patients with allergic and nonallergic asthma, eosinophilic pneumonia, allergic bronchopulmonary aspergillosis (ABPA), hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. BAL fluid from normal individuals and sarcoidosis patients was analyzed as noneosinophilic controls. BAL cytokine levels were compared with the cellular infiltrate and the activation state of CD4+ and CD8+ T cells as measured by the expression of IL-2 receptors (CD25), HLA-DR, and the very late activation antigen VLA-1. Beside the characteristic leukocyte infiltrate in the various lung diseases, all patients demonstrated significantly increased numbers of activated CD4 and CD8 T cells compared with normal individuals. The analysis of the cytokine profile present in BAL fluid revealed a T helper type 2 (Th2) cell cytokine pattern, with elevated IL-4 and IL-5 but normal levels of IL-2 or IFN-gamma in allergic asthma. ABPA patients demonstrated significantly increased levels of IL-4 and IL-5, with low but significantly elevated concentrations of IL-2 and IFN-gamma. In contrast, the analysis of the cytokine profile in sarcoidosis patients revealed a Th1 cell cytokine pattern characterized by increased concentrations of IL-2 and IFN-gamma but normal levels of IL-4 or IL-5. All other patient groups showed a cytokine pattern incompatible with a pure Th1 or Th2 cell response, because IL-5, IL-2, and IFN-gamma were found to be significantly increased. The BAL fluid analysis of the other, mainly non-T cell-derived cytokines and soluble receptors showed increased levels in all patients compared with normal individuals and may represent the ongoing inflammatory responses. In conclusion, whereas increased IL-4 levels were found only in diseases characterized by increased IgE production, IL-5 was elevated in all patients with increased numbers of eosinophils. The close correlation between IL-5 levels, number of eosinophils, and activated T cells further supports a role for IL-5 in causing tissue eosinophilia.

Adult↗
PubMed1994

Emergency nurses' perceived knowledge and comfort levels regarding pediatric patients.

OBJECTIVE: To assess emergency nurses' levels of preparation and education regarding pediatric patients, their levels of knowledge and comfort with specific medical conditions of these patients, and the need they perceive for special policies for pediatric patients. METHODS: Surveys were mailed to nurse managers and emergency nurses in six diverse counties, including Los Angeles and vicinity. Fifty-one nurse managers and 362 emergency nurses from 51 hospitals responded to the questionnaires. RESULTS: More than half of the emergency nurses had 6 or more years of experience; many had certificates, professional designations, and pediatric nursing education. Those with more pediatric education and those designated Pediatric Advanced Life Support, Certified Emergency Nurse, and Mobile Intensive Care Nurse reported the greatest comfort and knowledge with pediatric patients. The greatest discomfort and least knowledge were associated with neonatal emergencies, major trauma, child abuse or sexual abuse, sudden infant death syndrome, envenomation, psychiatric emergencies, meningococcemia, near-drowning, respiratory arrest, and cardiac arrest. Opinions regarding the need for special pediatric policies differed in some cases from current practice. CONCLUSION: Pediatric medical conditions associated with high nurse discomfort and low knowledge point to areas of need for specific education.

Child↗
PubMed1993

Central nervous system involvement in Leber's optic neuropathy.

Six months after the onset of visual loss a 23-year-old male patient with Leber's optic neuropathy associated with a mitochondrial DNA mutation developed brain stem involvement with Parinaud's syndrome and oculopalatal myoclonus. Magnetic resonance imaging (MRI) revealed a high signal area in the brain stem, corresponding to a hypodense area in the CT scan that did not show contrast enhancement. Distinct diminution but not complete remission of the MRI findings was found in the 5-year follow-up, which was not accompanied by clinical improvement. Although the MRI findings were compatible with a demyelinating lesion, neither extensive evoked potential studies nor spinal fluid examination supported this.

Adult↗
PubMed1993

[Occlusal splint therapy in reciprocal TMJ clicking. A critical observation within a follow-up study].

During post-treatment examination the effect of splint therapy on 14 temporomandibular joints (TMJ) with anterior disk displacement were examined using clinical and instrumental findings and magnet resonance imaging (MRI) to judge the therapeutical success of the treatment from an orthodontic perspective. A stable reposition of the TMJ disk was achieved in four joints, which showed no relapse over a two-year period of observation. The success of the therapy was dependent on the extent of the tissue damage to the TMJ and also on patient compliance. The MRI yielded therapeutically valuable information, which is not revealed in the clinical-instrumental analysis, on the tissue structure of the disk and the ligaments. In certain cases the use of MRI is necessary to confirm the clinical diagnosis.

Adolescent↗
PubMed1993

SDZ CO 611: a highly potent glycated analog of somatostatin with improved oral activity.

To obtain orally active octreotide (Sandostatin, SMS 201-995) analogs a new class of glycated somatostatin derivatives were synthesized by the Amadori reaction (Maillard reaction). The synthesis, chemical and biological characterization of a series of new compounds is described. These oligopeptides bind with high affinity to somatostatin receptors and retain full biological activity. Whereas generally polypeptide hormones are almost completely inactive after oral administration, we report here for the first time that these analogs show remarkably high activity by the oral route. Thus for example SDZ CO 611, the D(+)-maltose Amadori derivative of octreotide, has about 10 times higher oral effect bioavailability than octreotide while maintaining the selectivity, metabolic stability and long duration of action of the parent compound.

Administration, Oral↗
PubMed1992

[Space closure with T loops (Burstone)--a clinical study].

The theoretically favourable aspects of orthodontic space closure with segmented arch technique and the T-loop type A are clinically reproducible. In our study of eleven patients we found for the isolated canine retraction, as well as for the en masse retraction, controlled types of movement for the active units and maximum anchorage situations for the passive units produced by the torquing force. Because of these good anchorage conditions space closure could be done without headgear. The level of the anchorage segments was negligibly influenced but in the anterior segments a marked tilting was found in several cases. Besides other factors the intrusive force of the T-loops type A must be considered. As a rule the positioning of the T-loop between central and lateral incisor is to be recommended.

Activator Appliances↗
PubMed1991

Identification and determination of the two principal metabolites of minocycline in humans.

A chromatographic method has been developed for the quantification of minocycline in human serum and urine. The chromatographically determined concentration of minocycline correlated well with the microbiologically active concentration in serum. Two metabolites, 9-hydroxyminocycline and N-demethylated minocycline, could be isolated and identified as the principal metabolites of this tetracycline antibiotic. The structure of the 9-hydroxy compound was proved by nuclear magnetic resonance analysis for the first time. About 15% of the drug was actively converted in the body into a substance less microbiologically active than the parent compound and excreted in the urine within 96 h after the application.

Adult↗
PubMed1991

[Tooth germ transplantation or gap closure--a comparative study in the loss of the first molar].

In our study 37 transplanted and 33 mesialized molars by orthodontics were clinically and radiologically compared. The teeth moved by orthodontics showed a better long-term prognosis. As vital teeth with functioning periodontal structures and only slightly shortened roots they were equivalent to healthy teeth. However, the disadvantage of orthodontic space closure is the requirement of a good compliance due to long treatment time. The prognosis of maintaining a transplanted tooth germ is uncertain. One third of the teeth showed an altered periodontium with resorption areas. The danger of a continuing resorption, as well as a late external resorption is still a risk after a long period of time and can eventually lead to tooth loss. As a treatment alternative, germ transplantation may serve as a replacement of a single missing 6-year-molar in adolescence. Orthodontic space closure is indicated at any age with an existing dysgnathia, the loss of several first molars, the loss of space and mesial tipping of the second molars.

Adolescent↗
PubMed1991

Expression of class II molecules on intestinal epithelial cells in humans. Differences between normal and inflammatory bowel disease.

Expression of class II antigens on human intestinal epithelial cells was assessed using a sensitive avidinbiotin-peroxidase technique. HLA-DR was present predominantly in the normal small bowel with diminished but evident expression in the colon. HLA-DP staining was less prominent, and HLA-DQ was absent. In inflammatory bowel disease the expression of both HLA-DR and HLA-DP was increased, but that for HLA-DQ remained absent, suggesting an inherent defect in the ability of intestinal epithelial cells to express HLA-DQ. In related experiments, an interferon gamma-treated malignant epithelial cell line T84 also failed to stain for HLA-DQ and HLA-DP despite the presence of HLA-DR. Isolated RNAs for all three subclasses of HLA-D were detectable by slot-blot analysis, suggesting that the lack of HLA-DQ expression relates to posttranscriptional defects in intestinal epithelium. These and other differences with conventional class II antigen-positive accessory cells (macrophages/B cells) may help to explain the unique properties of intestinal epithelial cells as antigen-presenting cells.

Adenocarcinoma↗