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Biomedical subjects

W Meuser

Publications and source records attributed to W Meuser.

At least 19 recordsLinked to original sources
PubMed1998

[Single shot MRI cholangiopancreatography (MRCP) with a "fast acquisition spin echo" sequence (FASE). Replacement of ERCP?].

PURPOSE: 118 Patients with suspected obstruction of the biliary tract of pancreatic duct were examined to evaluate the accuracy of MR cholangiopancreatography (MRCP) in comparison with diagnostic findings in endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Using a 0.5-Tesla MR imaging system (FLEXART, Toshiba) and a QD body-coil, a recently developed heavily T2-weighted fast acquisition spin echo sequence (FASE) was applied. In this FASE sequence two significant features are implemented. A fast spin-echo (SE) sequence allows a large number of echos and conjugate K-space filling speeds up data acquisition. Thus, the acquisition time of single-shot breath-hold images takes only 3 seconds, which makes MRCP a feasible technique even in elderly or suffering patients. There is no need for time-consuming postprocessing procedures. RESULTS: In all MRCP examinations images of satisfactory quality were obtained. In cases of obstruction of the biliary or pancreatic duct, locations and lengths of stenoses were correctly demonstrated. Gallstones within the gallbladder or in the extrahepatic bile ducts were also properly visualised in MRCP. Stenoses caused by non-depicted pancreatic carcinoma, gallbladder carcinoma, or segmental pancreatitis were reliably shown. CONCLUSION: Even if MRCP will not replace ERCP, a number of clinical applications for non-invasive MRCP examination arise: primary diagnosis in patients with obstructive jaundice, obstruction of the biliary or pancreatic duct, if ERCP is not possible due to anatomic reason and in patients scheduled for laparoscopic cholecystectomy.

Adult↗
PubMed1985

The exenterated mastoid: a problem of ear surgery.

The exenterated mastoid behind an intact posterior ear canal wall is one of the preconditions for the development of hidden cholesteatoma recurrences. Retraction pockets can develop into the cavity owing to persisting malfunction of the eustachian tube. Matrix inadvertently left in the tympanic space or in the mastoid process can grow into or in the cavity unnoticed. The way to avoid this nesting site is permanent obliteration of the mastoid process immediately after the eradication of the disease. Furthermore, the disadvantages of old radical operation cavities can be eliminated by secondary obliteration, connected with a revision and repair of the sound pressure transfer mechanism if necessary. It is important to use a nonresorbable obliteration material. We use methacrylate (Sulfix-6) for this purpose, so far without any negative consequences in the ears.

Bone Cements↗
PubMed1984

Permanent obliteration of old radical mastoid cavities combined with tympanoplasty.

An open radical mastoid cavity presents a handicap to the patient. If elimination of the cavity appears desirable, one should use an operative technique which does not incur the risk of a cholesteatoma redeveloping. In our experience obliteration of the cavity with non-resorbable methacrylate Sulfix-6 is the best way to achieve this. The arguments in favour of this view are presented and the operative technique is described.

Bone Cements↗
PubMed1982

[Complete obliteration of the mastoid apophysis with an artificial material. A concept for the prevention of the recurrence of cholesteatoma].

Recurrences of cholesteatoma may occur, following closed operation techniques, if retraction pockets or matrix inadvertently left in the tympanic space invade the exenterated mastoid cavity. The precondition for such recurrence is the existence of the exenterated cavities, which serve as "nesting sites" for the matrix or the retraction pockets. These recurrences can be avoided by obliterating the mastoid cavity behind a reconstructed posterior ear canal wall with a non-resorbable material (plastic bone cement) and by uniting the lateral part of the attic with the outer ear canal. This will definitely prevent the exenterated spaces from the being invaded by any recurrence. The operation technique is described.

Cholesteatoma↗
PubMed1981

Plugging the mastoid cavity with Palacos R-a new technique to avoid recurrent cholesteatoma.

The requisite for the development of recurrent cholesteatoma caused by a retraction pocket is that the retraction takes place through a bottleneck into an otherwise closed cavity. In order to avoid this kind of recurrence either the bottleneck must be removed or the exenterated mastoid cavity must be plugged. This paper refers to an operation technique which was developed 14 years ago and which removes the bottleneck. Since, however, this technique leads in about half of the cases to an open cavity with the well-known disadvantages, we have tried to obliterate the cavity permanently following a posterior tympanotomy. Obliteration is achieved by means of Palacos R, which makes fixed contact with the bone. The technique and details of its application are described.

Cholesteatoma↗
PubMed1980

[Obliteration of the Mastoid Cavity by Means of Palacos R in Order to Prevent Recurrent Cholesteatoma (author's transl)].

When treating cholesteatoma the postoperative tendency, following closed techniques, to develop retraction pockets cannot be influenced by means of a causal therapy. What can be done, however, is to prevent the retraction pocket from becoming a recurrent cholesteatoma. This can be achieved by permanently obliterating the exenterated mastoid cavity with a non resorbable plastic. The bone-cement, Palacos R, we use makes fixed contact with the walls of the operation cavity. Negative effects of such an obliteration have so far not been observed.

Bone Cements↗
PubMed1979

[Direct laryngoscopy under difficult conditions (author's transl)].

The direct view into the glottis can be difficult due to long teeth in the upper jaw or abnormities of the neck vertebrae. It is recommended in these cases to use either a mediastinoscope with a lateral slot or the McIntosh laryngoscope, which is commonly used for intubation. The latter can be attached to the chest stay of the normal laryngoscope by using a special joint. The tip of the McIntosh laryngoscope is inserted into the valleculae instead of loading up the epiglottis as is done with the normal laryngoscope. Recommended aids for ciopsy or polypectomy are the 30 degrees-optical system of bronchoscopy or the gastroscope, each with its forceps.

Fiber Optic Technology↗
PubMed1978

Can recurrent cholesteatoma be avoided?

After closed operation techniques recurrences of cholesteatoma are often caused by retraction of squamous epithelium under the bony annulus, under which it spreads into the attic or the mastoid cavity. Consequently, retractions under the bony annulus can be avoided, if the annulus is removed. An endaural operation technique is described in which the superior and posterior bony ear canal wall is completely removed and the posterior wall is reconstructed by means of a meatal skin flap. As the oval window is often partly hidden by the frame of the tympanic membrane it is more favourable for the restoration of the sound conducting mechanism if the frame and surface of the tympanic membrane are extended backwards. This can be done by repositioning the posterior cutaneous ear canal wall and grafting the tympanic membrane with fascia. By doing this, the attic is incorporated into the ear canal. Should the factors which originally induced the development of the cholesteatoma remain effective and cause a new retraction, the full breadth of the posterior ear canal skin will retract into the exenterated mastoid cavity. An easily accesible open cavity and not a recurrence will be the result. In a follow-up study of 112 patients it was found that 67 of them had developed such an open cavity, which caused no serious problems.

Cholesteatoma↗
PubMed1978

[Reflections on the technique of inserting the esophagoscope (author's transl)].

Due to the muscular attachments of the hyoid bone to the posterior part of the base of the skull, and the larynx to the sternum, the larynx will be pressed posteriorly against the vertebral column if the head is kept in a reclined position. This causes a greater resistance when trying to open the hypopharynx with the esophagoscope. If, however, the head is held forward, this resistance will be considerably reduced.

Esophagoscopy↗
PubMed1978

[How great is the risk of injury to vessels during mediastinoscopy? (author's transl)].

In performing mediastinoscopy the scope will pass the innominate artery, the innominate vein, the aortic arch, and the right pulmonary artery. The pretracheal fascia will protect these vessels if the tube is inserted exactly between the trachea and the fascia. However, bleeding could be caused by injuring a lymph node vessel or a bronchial artery. If this happens the bleeding can be stopped by packing the wound canal with a gauze wick soaked in adrenaline, by electrocoagulation, or by using an Ethislipknot. When mediastinoscopy is performed as micromediastinoscopy by means of using the Zeiss operation microscope and special instruments in most cases bleeding will be avoided.

Blood Vessels↗
PubMed1977

[Sex hormones and depth of voice in the male (author's transl)].

Correlations between sex hormone levels and the male depth of voice were investigated in 102 singers. As compared to tenor singers higher testosterone and lower oestradiol plasma concentrations were measured in bass and baritone singers. This resulted in higher testosterone/oestradiol ratios due to increased androgens in those with deeper voices. Deeper voices were associated with taller and heavier body build. In the young age group sexual activity was highest among the bass voices, in the middle and old age group tenors were most active. There were no depth of voice-related differences as regards the sequence and occurrence of different pubertal characteristics. Only future bass singers had an increased of acne. The results indicate that the different depths of the male voice are influenced by different concentrations of circulating sex hormones and also by the androgen sensitivity of the target organs.

Acne Vulgaris↗
PubMed1976

[Puncture of the maxillary sinus (author's transl)].

In some texts on operative technique it is recommended, when puncturing the maxillary sinus via the inferior meatus, to aim towards the outer canthus of the eye. It is demonstrated on a skull that aiming at the inner canthus avoids the danger of piercing the premaxillary tissue and in addition the diameter of the sinus is greater at this angle.

Humans↗
PubMed1975

[Considerations on stellate ganglion blockage (author's transl].

It has been considered why it is possible to inject the local anaesthetic into a vessel even though the previous aspiration-test for blood had a negative result. To avoid an intravasal injection it is to be recommended to interrupt the injection with 15-20 further aspiration tests.

Autonomic Nerve Block↗