PubMed Health⌕ Search

Biomedical subjects

W Buschmann

Publications and source records attributed to W Buschmann.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Fibrin adhesion and postoperative anti-fibrinolytic care of conjunctival wounds].

The closure of conjunctival wounds by means of the fibrin adhesive technique has been reported by several authors; however, the clinical results were only partially satisfactory. Premature clot lysis resulted in disturbances of wound healing. These observations were corroborated by our the present authors' findings. Investigations of the proteolytic and fibrinolytic activity of aqueous humor and the lacrimal fluid revealed no activity in the aqueous humor, but significant activity in the lacrimal fluid. These findings indicated that proteolytic activity is responsible for the rapid dissolution of the fibrin clot after contact with tears. Stimulated by these findings, the present authors developed a topically applicable antifibrinolytic postoperative treatment based on eye drops containing Aprotinin (Trasylol). This technique has been applied in 3 patients so far and has resulted in stabilization of the fibrin clot until the wound has healed sufficiently. This cure is recommended for closure of conjunctival fistulas following glaucoma surgery, as well as for conjunctival wounds and partially dehiscent corneoscleral sections. It is noted that suturing of the latter is often complicated by scars or atrophy of the tissue.

Aprotinin↗
PubMed1984

[Ophthalmo-rhinosurgical decompression operation in malignant endocrine exophthalmus].

The thyroid metabolism has to be treated first. If this is not followed by regression of the exophthalmos, treatment with prednisone over a period of several weeks is indicated. If this does not result in permanent improvement, surgical decompression of the orbit is indicated, especially if the exposition of the cornea or compression of the optic nerve represent an imminent danger. In such cases surgical decompression is preferable to multiple series of prednisone or radiation treatment (Wright 1981, Trokel 1982). Both the Krönlein-Berke operation for resection of the lateral orbital wall as well as neurosurgical resection of the orbital roof have proved to be excellent for removal of correspondingly located orbital tumors; effective decompression of the orbit in malignant endocrine exophthalmos, however, cannot be achieved this way, as the temporal muscle and the brain, respectively, prevent protrusion of the swollen orbital tissues through these apertures. Resection of the orbital floor is somewhat more effective. The mucosa of the maxillary sinus can easily be moved by the protruding orbital tissues, resulting in a reduction in the size of the maxillary sinus. This decompression, however, is effective only in the anterior two-thirds of the orbit, while the optic nerve must be relieved from the pressure of the swollen muscles in particular in the posterior one-third of the orbit. The only effective way is to remove the medical orbital wall up to the tip of the orbit. Surgical techniques for this purpose have already been recommended, but appeared unsatisfactory from a rhinological point of view.(ABSTRACT TRUNCATED AT 250 WORDS)

Graves Disease↗
PubMed1984

[Ethmoidectomy and orbital decompression in endocrine ophthalmopathy].

23 orbita decompression operations were performed in patients suffering from endocrine exophthalmos (Grave's disease) after normalization of thyroid metabolism and systemic corticoid therapy remained unsuccessful. We developed a modification of an external ethmoidectomy. The lamina of the middle nasal concha is carefully preserved, any opening to the nasal cavity is closed. Flap door incisions of the periorbita complete this procedure. Results are good and were followed up for a period of 30 months. The operation resulted in prompt restitution of normal eye position with fast normalization of visual acuity and field. Squint surgery was done in addition.

Ethmoid Bone↗
PubMed1983

[Operation technic and after care in lens injuries].

Extensive experimental research proved that the healing of lens capsule wounds can be supported effectively by application of a fibrin tissue adhesive. The result is a circumscribed scar in an otherwise clear lens. The clinical application of the method was successful as well. Preliminary results have been published and a review covering all patients treated is in preparation. This paper is devoted to the indications, techniques and postoperative treatment. The application of the fibrinogen tissue adhesive is indicated if spontaneous healing cannot be expected or has failed and the major parts of the lens are still clear. Even very large traumatic posterior subcapsular rosettes may disappear after closure of the lens capsule wound. Therefore, they are by no means a contraindication for this lens-saving fibrinogen application. The tissue adhesive should be applied as soon as possible after injury. Especially in larger lens capsule lesions we apply it regularly as part of primary surgical care. Successful application of the tissue adhesive is still possible in the days following a perforating injury if the lens capsule wound is small and the progress of lens opacification is slow. Up to now we have used only the easiest application technique in clinical work. Thrombin solution and fibrinogen concentrate were applied successively to the lesion area and its surroundings, using thin, blunt needles. Swollen, denaturated lens fibers should be removed before application. In case of perforation of the anterior and posterior lens capsule, fibrin closure of the anterior lesion usually suffices. A corneoscleral incision and full exposition of the lens wound to be sealed will be preferred in future in larger lens capsule wounds, particularly equatorial ones.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Differential echographic diagnosis in small tissue areas--exemplified by the orbits].

Measurement-based ultrasonography proved mandatory in ophthalmic diagnostic work. It provides comparable examination conditions and therefore, comparable results, in contrast to simple, empirical ultrasonic examination. Measurement methods which can be easily applied under clinical conditions have been developed for determination of those technical characteristics of the apparatus and transducer probes which proved decisive for the diagnostic results. Some echographic criteria can be additionally or better evaluated using this basis. All echo-amplitude measurements should be related to a well-defined test-reflector echo. In addition to sensitivity and resolution, frequency and frequency spectrum are especially important. Manufacturer's data have proved insufficient up to now, insufficient; even within one manufacturer's series of one equipment or transducer probe type considerable deviations from the declared data have been found. Such deviations may mimick pathologic alterations in the echograms. The size of a lesion area can be better evaluated when using well-defined technical conditions. The echographic presentation of tissue structures in the depth is especially dependent on frequency and on the frequency spectrum. Pathologic alterations of tissues may cause changes in the ultrasound attenuation which results in emphasized or reduced presentation of echoes from normal structures behind the lesion area. Tissue differentiation should be based on additional A-scan echograms. Computerized echogram averaging provides a more reliable evaluation of echo amplitudes and ultrasound attenuation. Use of measurement-based ultrasonography permits to compare measured echo-amplitudes and ultrasound attenuation with the results of other working groups, even if these are based on other equipment and transducers.

Equipment Design↗
PubMed1982

[Restoration of a reasonably clear lens after perforating injury].

Experimental research demonstrated that a concentrate of human fibrinogen could successfully be used to close wounds of the lens capsule with sufficient mechanical strength and barrier function. Progression of lens opacification was stopped, and healing took place with a circumscribed scar and an otherwise clear lens. This method has now been employed successfully for the first time in clinical practice: A construction worker presented with a steel foreign body in his eye which had caused a double perforation of the lens. Thirty hours after the accident the gaping lens capsule wound showed no tendency for spontaneous closure. Following closure of this capsule wound with fibrinogen glue the extensive subcapsular posterior rosette opacities regressed markedly and visual acuity improved from 0.1 to 0.7. The same technique was applied more recently in a 13-year-old boy suffering from a double perforation of the lens. Up to the time of writing (eighth postoperative day) the course was as favorable as in the case described above.

Adult↗
PubMed1981

[Experimental and clinical examinations of the effect of cryosurgery of intraocular pressure].

Diathermy and cryosurgery have different effects on living tissue. Cell membranes are ruptured by cryosurgery, but the proteins are less affected than by diathermy. A short review of experimental cyclocryosurgery and the clinical results are presented. Data from the literature as well as evaluation of patients confirm that, as yet, the results are not satisfactory. The sequelae of freezing are very different in slow-and fast-freezing procedures. Therefore, the results in rabbits treated with a cryosurgical unit used for retinal detachment surgery (Amoils, -80 degrees C) were compared with the results using a cryoprobe cooled with liquid nitrogen (-180 degrees C). A permanent reduction in intraocular pressure was not achieved using cyclocryotherapy applied with the equipment used for detachment surgery (-80 degrees C). Repeated cryosurgery of this type did not result in a permanent pressure reduction. Histopathology demonstrated that the ciliary epithelium had regenerated and prolongation of the cyclocryotherapy applications did not result in a permanent intraocular pressure reduction. Lens opacities occurred in all rabbits of this series. Application of cryotherapy with a nitrogen-cooled cryoprobe (2.5 mm2 contact area) caused severe damage, resulting in phthisis bulbi. Another nitrogen-cooled probe (contact area of about 1 mm2 diameter) resulted in a permanent reduction in intraocular pressure, but the anterior parts of the lens became opaque. Histopathology revealed total necrosis of the ciliary epithelium and the basal membrane. Three months after cyclocryotherapy of this type the ciliary processes were atrophic and covered with connective tissue and regeneration of epithelial cells was not found in areas of such cryotherapy scars. Further experiments have been commenced including a reduction of application time, in order to find the optimum application technique resulting in permanent intraocular pressure reduction and the fewest possible side effects.

Animals↗
PubMed1981

[Corneal damage due to contact lenses (author's transl)].

Severe subepithelial opacification and ingrowth of vessels with a marked reduction of visual acuity were observed in a patient who bought soft corneal contact lenses (HEMA) from an optician. He was given no information on possible side-effects nor was he advised to see an ophthalmologist at regular intervals to have the condition of the cornea checked. The patient had been aware for some time of a continuous deterioration of visual acuity when he used his spectacles, although it at first appeared almost unchanged when he wore the contact lenses. This encouraged him to use the contact lenses more often, until inflammation and pain made it impossible. Stopping the use of contact lenses and topical application of vitamins (drops and ointment) and ethylmorphine ointment resulted in slow but nearly complete recovery.

Adult↗
PubMed1978

[Diagnosis in diseases of the eye and orbit. Indications and value of ultrasonic diagnosis and radio computer tomography].

The principles of diagnostic ultrasound and computed X-ray tomography are briefly described. The informations to be expected can be derived. First, the clinical use in determination of size and localization of the bulbus is discussed. This proved helpful in follow-up studies of buphthalmos, localization of intraocular foreign bodies and differentiation of pseudo-protrusion and protrusion (ultrasound exophthalmometry). The differentiation and localization of intraocular disorders (e.g. retinal detachment, intraocular tumors, vitreous hemorrhages, aqueous cysts) is facilitated. In space-occupying orbital disorders both methods complement but cannot replace each other. Therefore it appears that further development of ultrasonic diagnostic techniques should be promoted to reach at least the standards which are nowadays already achieved in computed X-ray tomography.

Cysts↗
PubMed1978

[The tensile strength of human zonule and its alteration with age (author's transl)].

A series of 91 cryoextractions was performed on autopsy material. The scleral section was placed near to the chamber angle and was nearly circumferential (about 330 degrees). Cornea and adjacent sclera could be flapped over this way, and did not interfere with a straightforward lens extraction. The pupil was medically dilated. A cryoprobe was fixed to a specially constructed scale, and frozen to the anterior pole of the lens. Its weight was counterbalanced by a plastic water container at the other end of the scale. The extraction was performed by filling additional water into the counterbalancing container. The statistical evaluation of the results showed a very significant dependence of the average tensile strength on age. However, a considerable standard deviation was found throughout all ages. The nutritional state of the autopsy bodies and the time interval between death and start of the measurement had no significant influence. The differences between right and left eyes were also not significant, as could be expected. The methodological error remained small. Age proved to be an unreliable indicator for the tensile strength of the zonule. All results apply to clear lenses. We known from clinical experience that the tenacity of the zonule may also be different in the various types of cataract.

Adult↗
PubMed1978

[Changes in the indications and techniques in the surgery of retrobulbar orbital tumours (author's transl)].

In the past 3 decades, surgery of retrobulbar tumours was mainly done by neurosurgeions (transfrontal orbital approach) or ENT surgeons (transethmoidal approach), especially in Europe. More recently, especially in USA this has changed and the majority of these cases, in an increasing number of hospitals, are now treated by a modified Krönlein operation, usually performed by ophthalmic surgeons. In this paper we tried to elucidate the background of this development. Ultrasound exophthalmometry (Fig. 3), ultrasound A- and B-scans of the orbital tissues (Fig. 4 and 5) and computerized axial X-ray-tomography of the orbits (Fig. 6) improved the preoperative diagnoses markedly. In the most cases it is now possible to decide preoperatively on the existence, size and location (and sometimes even on the nature) of a spaceoccupying lesion in the orbit. The technic and the instruments for Krönlein's operation have been improved (Krönlein-Berke, Fig. 8-11). The oscillating saw (Stryker) facilitates the resection of the bone, and microsurgical technics are now preferred for removal of the tumour from the orbit. The modified Krönlein operation is also recommended for orbital decompression in severe endocrine exophthalmos, provided the lateral orbital wall is removed to the described extent.

Exophthalmos↗
PubMed1978

[On the proof of late sequelae of bulbal and orbital contusion (author's transl)].

Contusion cataracts may develop long time after injury, without visible lens changes in the interval. The lens opacities appear like those known in senile cataracts if the eye was injured after the 45th year of age. Demonstration of other traumatic changes becomes then very important for the evaluation of the role of the accident as a cataract cause. As late sequelae of eye (and orbit) contusion, enophthalmos and supersensitivity of the pupil to adrenergic drugs can be found. Ultrasound exophthalmometry proved to be more accurate for checking the former than Hertel's optical exophthalmometry alone. The pupil was studied by the reaction following local instillation of one drop of 1% adrenaline solution (comparison with other eye). The results found in 2 patients are described.

Adult↗