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Biomedical subjects

W Buschmann

Publications and source records attributed to W Buschmann.

At least 19 recordsLinked to original sources
PubMed2006

[Treatment motivation and results of inpatient psychotherapy for women with depressive disorders: a prospective study].

Whether the treatment results in inpatient psychotherapy are significantly influenced by the patient's motivation is a subject of discussion. The goal of this study was to assess whether the primary motivation for therapy in depressive women influences the results of psychotherapeutic treatment. In a prospective study, the monitored results from 64 female inpatients (32 who were highly motivated to enter therapy, and 32 who were minimally motivated) were compared to each other. The period of observation was six weeks. As instruments of assessment, the Fragebogen zur Therapiemotivation (FMP) (Questonnaire on Motivation for Entering Therapy) and the Beck Depression Inventory (BDI) were aministered upon admission; after the fourth and sixth weeks of therapy, the Veränderungsfragebogen des Erlebens und Verhaltens (VEV) (Questionnaire of Changes in Experience and Behavior) was administered as well. All patients who had applied for a pension were found in the group of less motivated patients and consolidated into a subgroup. The analysis was carried out according to the intent-to-treat principle. The variance analysis for the repeat measurements showed significant differences on all the FMP scales and on the BDI (all P< 0.001). The measurements with VEV likewise resulted in a significant difference (P< 0.01). The subgroup of "pension patients" showed significantly less change in all three of the above measurements. Patients with depressive symptomology who essentially are relatively highly motivated for therapy could profit significantly more from inpatient psychosomatic treatment than those who are less motivated. Establishing and developing motivation prior to inpatient hospitalization could possibly contribute to more efficient and cost-effective clinical treatment. Where legal proceedings pertaining to a pension are pending, relatively less motivated patients fare significantly worse not only in their motivational development for therapy, but also in their final treatment results. It should be noted, however, that the relatively small random sample, the restricted blinding, which was only partially possible, could have led to possible distortions.

Attitude to Health↗
PubMed2006

[Treatment results from inpatient psychosomatic rehabilitation of Turkish migrants: a prospective study].

Psychosomatic rehabilitation and the concluding social-medical assessment constitute a particular challenge. The aim of this study was to examine whether inpatient psychosomatic rehabilitation in the context of an integrated treatment concept, conducted in Turkish and German, is effective in the rehabilitation of Turkish migrant laborers, and what concluding socio-medical assessment results from this treatment. 195 Turkish patients--44 male and 151 female--received inpatient psychosomatic treatment for approximately 40 days. Sociodemographic, psychiatric and social-medical data were recorded, as well as Symptom Checklist (SCL-90-R) testing upon admission and discharge. A predominant number of patients were laborers, with a low level of primary education, who were afflicted with psychosocial problems and dissatisfaction with their workplace and who first came into psychosomatic treatment many years following the onset of their illness. Many of them had a clearly defined desire to retire. At the end of their admission, a significant improvement in almost all the scales of the SCL-R-90 was ascertained on the one hand, but on the other, adequate socio-medical results were hardly observed. The symptoms' improvement would confirm that the combination of service offerings in Turkish and German proved themselves. A portion of the patients (approx. 40 %) were classified subsequent to treatment as capable of working for 6 hours or more. Nevertheless, approximately approx. 75 % still sought to retire. Timely psychosomatic treatment could counteract chronification of the illness and the establishment of a steadfast desire to enter retirement, and consequently represent an improvement in the prognosis. Likewise, consistent psychosomatic training of physicians, as well as systematic prophylactic measures with the migrant laborers, should be considered.

Adult↗
PubMed2002

A reappraisal of cryosurgery for eyelid basal cell carcinomas.

BACKGROUND/AIMS: Liquid nitrogen spray freezing has been successfully applied for basal cell carcinomas in the eyelid region, but is not yet in general use. The reasons for this were analysed and the development of a more reliable, safer cryosurgical technique aimed for. METHODS: New cryosurgical apparatus, contact probes with increased freezing power, and a special application technique were developed and clinically tested in a consecutive series of 221 patients with primary basal cell carcinomas of the lid region. Special efforts yielded follow up reports of 220 out of the 221 patients. RESULTS: Experimental measurements and clinical results demonstrated that this cryosurgical technique was at least as effective as spray freezing, with lower risks. The rate of recurrent tumours in patients followed up for 5 years or longer was 5.1% (surgeons first result) respectively 0.6% (result after optimised second cryosurgery). The figures were 6.8%, respectively max 2.7%, when including all patients, independent of follow up time. CONCLUSION: Traditional surgery and histopathology, still used at numerous places, resulted in higher recurrence rates despite extended loss of healthy eyelid tissues and should be abandoned. Micrographic surgery is considered mandatory to save more of the healthy structures and to obtain lower recurrence rates. Cost and time require worldwide restriction of micrographic surgery to selected cases. Updated cryosurgery provides a low cost option to micrographic surgery and results in preservation of eyelid structures and lacrimal pathways, tarsal plate, lid margin. It provides excellent cosmetic results. Thus, primary basal cell carcinomas in the eyelid region of suitable size and location should receive updated cryosurgery, and tumours beyond its range micrographic surgery.

Adult↗
PubMed1992

Sophisticated instrumentation and ophthalmic ultrasonography.

Formerly, ophthalmic ultrasonography was leading in view of high-performance apparatuses and transducer probes: e.g., the first array-scanner in the world was built for ophthalmic use. Within the past 2 decades, however, high-tech innovations were merely developed for other medical specialties. These were studied in view of their use for ultrasonography of eye and orbit. The combination of B-scan and Doppler techniques facilitates detection of orbital vessels. The resolution of ophthalmic digital B-scan video images proved poorer than crt-B-scans. A digital memory, however, is advantageous. But one high-resolution crt-type B-scan needs more than one disc storage capacity. "Frontline digitalization" could help to reduce the amount of data. Array transducers are now available in small sizes and could better show structure movements, but they were not yet adapted to ophthalmic use. This applies as well to annular arrays and dynamic focusing. Different methods of 3-dimensional scanning and (Pseudo-) 3-dimensional imaging might renew Baum's and Coleman's early work.

Eye↗
PubMed1992

[N2 cryotherapy and excision. Indications and limits in eyelid basalioma].

Some ophthalmic surgeons have preferred N2-cryosurgery for many years. Others feel that only excisional surgery should be used. In this article both possibilities are discussed in an effort to facilitate a well-balanced choice. A total of 262 basalioma patients treated by cryosurgery from 1979 to 1988 were evaluated to assess the indications for cryosurgery. The histological findings were taken into consideration, as were the results of other authors. The comparison with histopathologically controlled excisions was based on discussions with users of the Mohs technique, literature, and personal experience. No other technique permits as much healthy tissue to be saved as N2-cryosurgery; this is especially important in the areas of the lid margin and lacrimal pathways. Complete involvement of the tumor edges can be achieved by generous extension of the treatment area and biopsies taken beyond the expected tumor margins and tumor base (subsequent to tunneling and cryosurgery from the basal side). In excisional surgery, the Mohs technique is required. Its advantage is that biopsies can be taken all around the tumor for histology and its disadvantage is prolonged operation time (in ad hoc frozen sections) or delayed wound closure (second or third surgical procedure several days later). This can be avoided in tumors that are suitable for cryosurgery. The Mohs technique, however, is mandatory in deeply infiltrating tumors in which cryosurgery is not indicated. The two methods complement one another. This is supported by the long-term results.

Basal Cell Carcinoma↗
PubMed1991

[Technique and results of nitrogen cryotherapy of eyelid basaliomas].

A new, low-cost and more handy equipment (Erbocryo SN) is presented. It may be used with cryoprobes (closed tip) or spray application. New thin-walled probes proved more effective. This was also true in treatment of patients. - The long-term results of cryotherapy are reviewed and shown in 4 patients as examples. Since 1979, 262 basalioma patients were treated at Würzburg with liquid nitrogen application. The long-term results of the first consecutive series (1979-1983) were published earlier in this journal. They confirmed the favorable results published by american authors and by Matthüs and coworkers. Surgical treatment is suitable as well in small tumours. If, however, larger parts of the lid or the lacrimal pathways would have to be excised in surgical treatment, liquid nitrogen cryotherapy is the better choice. The limitations of this method must be considered in case of deeply infiltrating basaliomas of the cheek. Thorough knowledge of the method and of the preconditions of its efficacy are mandatory.

Basal Cell Carcinoma↗
PubMed1990

[Preserving injured lenses by microsurgical management of capsule wounds. Indications, technic, results and problems].

Following perforating injuries the lens may, in rare cases, heal up with only local scarring and otherwise normal transparency. An analysis of 83 consecutively treated lens injuries and extensive experimental research have shown that this favorable course is so rare in man because the posttraumatic secretion of fibrinogen into the anterior chamber is usually insufficient. However, this can now be substituted by microsurgical treatment of the capsular lesion, including closure with human fibrinogen tissue adhesive. The method was tested on more than 200 isolated human lenses and has been applied clinically since 1982. The microsurgical procedure, including the fibrinogen application technique, is briefly described. Three cases, treated for anterior capsule injuries and through-and-through perforation of the lens, respectively, and followed up for several years, are presented. This is followed by a compilation of results in the first 31 consecutively treated patients. Among the 12 cases of anterior capsule perforation, 7 healed with acceptable visual acuity (1.0 to 0.3) even in this first series. In a total of 19 through-and-through perforations, there were only 2 good results in the first consecutive series of 15 with the method originally used. It was therefore decided to switch to translental fibrinogen application in such cases; in the following 4 patients anterior and posterior capsule wound healing and fairly good visual acuity were achieved with this technique. While the time interval between the trauma and treatment of the injury is important, the tendency toward spontaneous healing, though insufficient in the subsequent course, helps to overcome the first few hours and sometimes even days following the accident.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular↗
PubMed1989

[The role of radiotherapy in endocrine orbitopathy].

The treatment of Graves' ophthalmopathy is symptomatic because the etiology remains unknown though evidence supports an aberrant immune response. Orbital radiotherapy, combined with corticosteroids, is indicated for rapidly progressive ophthalmopathy and troublesome soft tissue symptoms. In case of sight-threatening manifestations operative decompression is the method of choice. However, radiotherapy seems to be a safe and effective method as a good to excellent response in 60-70% of patients can be expected. The treatment results of 15 patients with a long term follow-up are presented.

Adult↗
PubMed1988

[The development of standards for ophthalmologic ultrasound diagnosis].

The performance data of ultrasonic apparatus and transducer probes are decisive in view of the information content of the echograms. Clinically applicable measurement methods, therefore, were developed already in the early sixties for ophthalmic ultrasonography. The sensitivity of each probe apparatus combination was measured first by means of a variable absorption path, the working frequency by counting the oscillations per microsecond in the rf echo signal of a plane reflector. Depth and lateral resolution were determined using monofil filaments mounted to a micrometer gauge. These measurements resulted in marked improvement of safety of diagnosis. In view of the IEC document 854, we developed a test reflector. It reflects a standard echo which can be measured within the control range of most diagnostic machines without need of additional dB-calibrated attenuators. Now, each echo amplitude can be referred to this standard echo (whose difference to the ideal reflector echo is-17 dB). An electronic device (echo simulator) permits additional checking of distinct equipment parts (especially of the dB control, time scale and amplifier dynamics). The entirely empirical use of ultrasonic diagnostic apparatus without measurement of the diagnostically relevant performance data and without readjustment and documentation of comparable examination conditions is, in our opinion, an outdated approach. Repeated measurements at regular intervals and especially after repairs or change of transducer probes are mandatory.

Equipment Design↗
PubMed1987

Microsurgical treatment of lens capsule perforations--Part II: Clinical applications and results.

A microsurgical technique using human fibrinogen concentrate for the closure of anterior lens capsule wounds and through-and-through perforations was developed, experimentally tested and clinically applied. I consider here the first consecutive 31 patients treated. All these patients had perforating injuries of the lens and still localized lens damage; they showed no spontaneous healing tendencies. Successful treatment of lens capsule wounds, where an otherwise clear lens is locally scarred, has been rare. The technique described here was effective in more than 50% of the patients with anterior lens capsule lesions. Removal of degenerated lens cortex matter before fibrinogen application further improved the healing rate. The healing rate was low, however, in through-and-through perforations of the lens when the posterior lesion was not treated at all (of 11 cases, 1 success, 10 traumatic cataracts). It was not much better when the posterior lesion was approached via a basal iridectomy and around the lens equator (of 4 cases, 1 success). But translental fibrinogen application, following the foreign body pathway, together with removal of degenerated cortex matter from the anterior and posterior capsule lesion area, resulted in the prevention of traumatic cataract in all 4 patients treated so far. There were no undesirable local or systemic side-reactions. (Intraocular complications could be avoided by not exceeding the recommended amount of fibrinogen concentrate, 0.01-0.02 ml). The case histories of 3 patients are shown in three photographs.

Aprotinin↗
PubMed1987

Microsurgical treatment of lens capsule perforations. Part I: Experimental research.

Although perforating injuries of the lens capsule typically lead to traumatic cataract in humans and rats, capsular healing is observed regularly in injured rabbits and dogs. This is most likely because protein exudation in rabbits and dogs is much greater than that in humans and rats. Using isolated white Wistar rat lenses, rat lenses in vivo, and isolated human lenses, we attempted both to replace lens protein as well as develop techniques for microsurgically closing the capsule by applying a fibrinogen-based tissue adhesive. This application was effective in preventing traumatic cataract. Use of a fibrinogen-glued capsule graft yielded similarly good (but not better) results.

Animals↗
PubMed1986

[Glaucoma in endocrine exophthalmus].

Elevated intraocular pressure may be found in patients with Graves' disease if it is measured with gaze in the usual straight-ahead direction. In such cases the patient must be allowed to change his direction of gaze, and in particular to his individual "resting" direction of gaze. In pseudoglaucoma IOP will normalize at once. If Graves' disease develops in addition it may become impossible to control existing primary glaucomas by drug therapy. Outflow from the aqueous veins may be impeded by congestion of the orbital veins and lymphatic pathways. It is thus recommended that effective treatment of Graves' disease be carried out first (surgical decompression of the orbit according to Buschmann and Richter if drug therapy fails to reduce the protrusion significantly). After removal of the protrusion and the orbital congestion, it may once again be possible to regulate IOP by drug therapy and glaucoma surgery may not be necessary. If, by contrast, glaucoma surgery is performed on an eye with persistent endocrine exophthalmos, this may result in a fatal progression of the compression in neuropathy of the optic nerve. This should be avoided. Exemplary case histories are discussed.

Adult↗
PubMed1986

[Current results of nitrogen cryotherapy in eyelid basaliomas].

By means of long-term follow-ups of large numbers of patients it has been established that nitrogen cryotherapy for lid basaliomas produces very good results with regard to the cure rate, as well as having considerable advantages over other treatment methods. In contrast to other authors we did not employ the spray method, but a very high-performance nitrogen cryo unit with a closed probe. Experimental measurements showed that this unit is capable of generating at least the same temperatures as with the spray method. The cryoapplication technique is described. The cure rate and causes of recurrence in the first series in the total of 84 patients treated from 1979 to 1983 were evaluated by long-term follow-up. If cryobiological principles are observed and the recommended application technique is adhered to, the same cure rate can be achieved as with the spray method and other forms of treatment. There are considerable functional and cosmetic advantages, also as regards the patency of the lacrimal ducts.

Basal Cell Carcinoma↗