Search PubMed⌕ Search

Biomedical subjects

A Ganz

Publications and source records attributed to A Ganz.

8 recordsLinked to original sources

[A new method for the evaluation of stone fragmentation after ESWL].

INTRODUCTION: Efficacy of ESWL treatment can be evaluated by determining the number and size of urinary stone fragments. However, the available methods for classification of stone fragments are inaccurate. Therefore, a method for semi-automatic determination of fragment size and number after ESWL was developed. METHODS: Artificial struvite stones (BON[N]-STONES) were disintegrated with a lithotriptor (Siemens, Lithostar plus) by application of 50 and 200 shock waves at 19 kV. The stone fragments were collected and pre-sorted on cascade sieves. Pictures taken of the fractions were digitalized and the images optimized in edge sharpness, contrast, and colour depth using an image processing software. Finally, the pixel number of each fragment was determined and the real area was calculated. Fragment size and volume were then depicted by frequency of occurrence in a histogram. RESULTS: Fragments with a diameter ranging from 0.3 - 5 mm could be determined by the system described. About 2,000 - 3,600 fragments were generated in this size range from the artificial struvite stones. With low shock-wave application, a considerable number of fragments larger than 2 mm could be observed. By increasing the impact to 200, more than 90 % of the stone volume was found in fragments smaller than 2 mm (previously 50 %). CONCLUSION: The system described enables a qualitative and quantitative description of stone fragmentation after ESWL not achieved thus far.

Humans↗

The epidemiology, economics and quality of life burden of age-related macular degeneration in France, Germany, Italy and the United Kingdom.

Age-related macular degeneration (AMD) is a major public health issue, but little is known about the economics of the disease. This contribution describes the epidemiology and the economics of AMD in four European countries: France, Germany, Italy and the United Kingdom (UK). We reviewed published information on AMD, including guidelines, official statistics, and local literature and interviewed AMD experts. All available health-related quality of life studies (HRQoL) on AMD were also reviewed. Data collection focused on epidemiology, medical management and resource use (both medical and non-medical items). Prevalence of AMD among persons older than 65 years is 8% and increases with age. There are two forms of the disease: atrophic (80-85% of AMD cases) and exudative, which is characterised by choroidal neovascularisation (CNV; 15-20% of AMD cases). No treatment for the atrophic form is available. Laser photocoagulation is the mainstay of treatment for CNV, although less than 30% of persons with CNV can benefit from it. Photodynamic therapy (PDT), a new treatment for CNV, reduces the risk of vision loss in forms with predominantly visible lesions. Several other new procedures are also under development. Rehabilitation and low-vision aids are useful palliative interventions when there is a residual visual acuity. The yearly budget impact of AMD was found to be between 51.3 and 101.1 million euros in the four countries studied. Information on social services and resource use was scant and little is reported on the impact of AMD on HRQoL. Economic studies of AMD should be conducted in order to assist public health decision making.

Journal Article↗

Transient radiculopathy after 5% lidocaine or 0.75% bupivacaine spinal anesthesia in 3 surgical positions.

The present study was conducted to compare the incidence of transient radicular irritation (TRI) after spinal anesthesia with 5% lidocaine or 0.75% bupivacaine in the supine, prone, and lithotomy surgical positions. A non-rAndomized survey approach was used. The convenience sample consisted of 243 adults receiving spinal anesthesia for elective surgery at 1 of 3 hospitals. Patients were questioned by telephone postoperatively to determine whether they had experienced TRI. Statistical analysis using the Fisher exact test revealed no significant difference in TRI incidence between local anesthetics in the supine or prone position groups. In the lithotomy position group, the incidence of TRI was significantly higher in patients receiving 5% lidocaine. Further, chi 2 testing revealed no significant difference in TRI incidence between surgical position groups when position alone was considered. The findings suggest that TRI after spinal anesthesia occurs more frequently with 5% lidocaine than with 0.75% bupivacaine only when patients undergo surgery in the lithotomy position. Providers need to consider the risks and benefits of 5% lidocaine when selecting an agent for spinal anesthesia, especially with patients undergoing surgery in the lithotomy position. When lidocaine is used, providers should discuss TRI as a risk of spinal anesthesia with patients during preanesthetic counseling.

Adult↗

Salvage surgery of chemorefractory germ cell tumors with elevated tumor markers.

PURPOSE: We evaluated the prognostic criteria for salvage surgery in patients with persistent marker elevation after chemotherapy for metastatic germ cell tumors. MATERIALS AND METHODS: Of 125 men who underwent post-chemotherapeutic resection of residual tumors 30 had persistent marker elevation at surgery. This group was subdivided into 17 patients with no evidence of disease, 7 dead of disease and 6 others. Outcome analysis was performed in the subgroups with regard to preoperative and postoperative parameters. Mean followup was 120.3 months (range 1 to 228) after surgery. RESULTS: Of the 30 patients 17 (57%) with persistently elevated tumor markers after chemotherapy were long-term survivors after salvage surgery. Overall persistent viable cancer and teratomatous elements were identified in 64% and 11% of cases, respectively. Significantly more patients died of disease who had a poor prognosis according to International Germ Cell Cancer Collaborative Group guidelines. Embryonal carcinoma was the predominant initial histology in this group and residual disease was more often located at various sites, for example the viscera, with a lower chance of complete surgical resection. Marker status before surgery, and chemotherapeutic pretreatment and postoperative histological findings did not differ significantly in patients with no evidence of disease and those dead of disease. CONCLUSIONS: Salvage surgery results in long-term success in greater than 50% of patients. Complete resection is the most important single parameter for a favorable outcome. Even patients with visceral metastasis benefit from surgery. Our data do not justify omitting surgery in certain subgroups.

Biomarkers, Tumor↗

Hemangioma of the nasal bones: radiographic appearance.

Four additional cases of hemangioma involving the nasal bones are presented, bringing the reported cases to 15. The radiographic findings of nasal bone hemangioma are distinctive, permitting easy diagnosis. Hemangioma involving the nasal bones may result in a reticular or "soap bubble" osteoporosis, spiculation, bone thickening, or a channelled appearance of the nasal bone. Treatment is by local excision.

Adult↗

[Concordance of prune belly syndrome and VACTERL association].

We report on a male premature infant with hypoplastic abdominal wall musculature, urinary tract anomalies and kryptorchism--the main features of Prune-Belly-syndrome. Furthermore the patient showed cardiac anomalies, urinary tract anomalies, limb defects, vertebral anomalies and anal atresia, which belong to the main features of VACTERL-association. As far as we know, the combination of the Prune-Belly-syndrome and the VACTERL-association has not been reported in literature until now.

Anus, Imperforate↗