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Biomedical subjects

B Schaumann

Publications and source records attributed to B Schaumann.

16 recordsLinked to original sources

Wound-healing disturbances after vein harvesting for CABG: a randomized trial to compare the minimally invasive direct vision and traditional approaches.

BACKGROUND: Harvesting the great saphenous vein for coronary artery bypass grafting is often associated with complications in wound healing, insufficient cosmetic results, and delay in mobilization of the patients. The aim of this study was to compare the results of our minimally invasive technique with the traditional method. METHODS: We report our experience of minimally invasive direct vision harvesting the great saphenous vein with the Aesculap retractor system (Aesculap AG Co KG, Tutlingen, Germany) by performing 3 (to 5) small cutaneous incisions. We scheduled 255 patients for elective coronary artery bypass grafting prospectively randomized to undergo vein harvesting by either the minimally invasive technique (group A: n = 128; age range, 68.2 +/- 9.1 years; male, 53.1%) or by the traditional technique (group B; n = 127; age range, 66.1 +/- 8.3 years; male, 62.9%). We classified and defined leg-wound healing disorders in terms of mild, moderate, and severe wound-healing disturbances. RESULTS: Between group A and B there were no differences with the risk stratification before operation, length of vein being harvested, or total operation time. The time for minimally invasive harvesting of the great saphenous vein was slightly increased. Severe leg-wound healing disorders occurred in 4 of 128 patients of group A (3.1%) versus 12 of 127 patients of group B (9.4%) with significant difference (p = 0.042). CONCLUSIONS: Minimally invasive direct vision harvesting the great saphenous vein is an attractive alternative to the traditional open-harvesting technique. In our trial this procedure resulted in fewer wound complications and showed a much better cosmetic outcome. The total operation time was not increased by using the minimally invasive technique.

Aged↗

[Metastasizing malignant germ cell tumor of the testis with infiltration of the thoracic aorta--a case for metastasis surgery].

HISTORY AND FINDINGS: A 33-year-old man was admitted 7 years after a testicular teratomatous carcinoma had first been diagnosed, treated by a right orchiectomy and two-stage radical retroperitoneal lymphadenectomy. Five years later the first mediastinal metastases were treated with high-dosage chemotherapy and autologous germ-cell transplantation, and remaining paraaortic--mediastinal tumour tissue was resected. Two years later another tumour at that site was only partially resected. A curing treatment seemed impossible, because the aortic wall had been invaded. TREATMENT AND COURSE: Five months after re-thoracotomy the metastasis and the invaded aortic segment were resected, the latter replaced by a vascular prosthesis. Histology indicated metastasis of a malignant teratoma of intermediate type. There has been no evident recurrence in the last 20 months. CONCLUSION: Combined orchidectomy, lymphadenectomy, high-dosage chemotherapy with cisplatin and autologous germ-cell transplantation at present constitute the standard treatment of malignant testicular germ-cell tumour. In case of metastatic infiltration of vital structures, such as the aortic wall, special operative procedures can prolong the period of remission when the success of a standard treatment seems limited.

Adult↗

Dermatoglyphics in juvenile hypertension.

Dermatoglyphics of 172 children and young adults (116 males, 56 females) with hypertension, 13-27 years old, were compared with those of 130 healthy male and 110 female controls. Several differences were observed between the two groups. Hypertensive patients had a somewhat lower frequency of fingertip ulnar loops, higher frequency whorls and a higher total finger ridge count. They also had a somewhat higher mean atd angle, significantly more frequent distal position of the axial triradius (mostly in t' position) and more missing axial triradii compared to controls. The differences between a-b ridge counts, the interdigital, thenar and hypothenar patterns were generally small and sometimes limited to one sex or one hand only. The observed differences seem to indicate a genetic influence in the etiology of essential hypertension.

Adolescent↗

Embryological development and prevalence of thumb flexion creases.

A study of the embryological development and morphology of the thumb flexion creases is presented. We used 178 human fetuses, at 6-20 weeks of gestational age, and 225 normal adults, aged 19-81 years, to observe the morphology and the timing and location of the appearance of the flexion creases. Most creases, that is, the regular, extra, and oblique creases, were found to develop concurrently with the appearance of the fetal volar pads, apparently independently of the thumb flexion movements. Although the regular creases usually appear to be simple, single creases, they seem to be formed by the radial and ulnar lateral crease segments that develop inwards from each lateral side. Our observations also suggest that the oblique and extra creases on the proximal phalanx of the thumb should be considered as common or "regular" creases, rather than anomalies, because of their high frequency in fetuses and in normal healthy adults.

Adult↗

Sister chromatid exchanges in adult epileptic patients on phenytoin therapy.

Sister chromatid exchanges (SCE) were studied in lymphocyte cultures of 12 adult male epileptic patients on long-term monotherapy with phenytoin (PHT) and of matched controls. Significantly increased frequency of SCE was observed in the epileptic patients as a group and in almost all individuals, indicating a detectable chromosome damaging effect of PHT therapy on its human users.

Adult↗

Dermatoglyphics in seizure disorders.

A dermatoglyphic study of 197 adult Caucasian males with a confirmed diagnosis of epilepsy was carried out in an attempt to ascertain possible associations between aberrant dermatoglyphic and seizures and to estimate their diagnostic usefulness. Qualitative and quantitative fingertip and palmar dermatoglyphic traits were evaluated. The data were analyzed by etiology seizures. Previous studies and our own earlier data (Schaumann 1979) analyzed by univariate statistical methods indicated the presence of some dermatoglyphic deviations in patients with epilepsy, suggesting the existence of a genetic predisposition to seizures of various etiologies. In the present study, a multivariate analysis was employed on an enlarged patient sample. Three variables were found to be significant: an increased main line index on the right palm (p less than .01) and decreased a-b ridge counts on both left and right palms (p less than .001). Tests of the eigenvalues showed only one value to be significant and accounting for 71.8% of the intergroup variation.

Adult↗

A family with amyotrophic lateral sclerosis and Parkinsonism.

Amyotrophic lateral sclerosis (ALS) and Parkinson disease (PD) are known to occur simultaneously among some Chamorro inhabitants of Guam and other Mariana Islands (Stanhope et al., 1972). Outside of the Western Pacific Islands, the concurrence of ALS and PD seems to be rare. However, it has been observed to occur with sufficient frequency to suggest some causal association. The following is a report of a patient suffering from ALS whose family history included PD in several of the immediate relatives.

Amyotrophic Lateral Sclerosis↗

Hereditary Amyotrophic Lateral Sclerosis. A report of two families.

An aggregation of 14 cases of amyotrophic lateral sclerosis (ALS) was encountered in two families in Minnesota. Although the classical clinical features of ALS predominated, some members of one family showed, in addition, extrapyramidal signs, peripheral sensory impairment in the upper and lower limbs and mild mental fallout. Autosomal dominant inheritance with incomplete penetrance was the most likely mode of transmission. Pathological changes were the same as those seen in sporadic ALS although one patient also showed degeneration of the substantia nigra. These two families were compared to others in the literature and an effort was made to refine the classification of familial ALS.

Adult↗

The Saethre-Chotzen syndrome.

The Saethre-Chotzen Syndrome (SCS) is characterized by craniosynostosis, low-set frontal hairline, parrot-beaked nose with deviated septum, ptosis of the eyelids, strabismus, refractive error, tear duct stenosis, dystopia canthorum, brachydactyly and abnormal dermatoglyphic patterns. The syndrome follows an autosomal dominant mode of transmission with complete penetrance and variable expressivity. Many cases of SCS have been previously reported but erroneously diagnosed as Crouzon syndrome, "pseudo-Crouzon" syndrome, simple craniosynostis, microcephaly or other inappropriate diagnostic category. Based on the findings in 6 kindreds with 31 affected individuals and an analysis of well-documented cases from the literature, the syndrome is delineated. Close attention to minor skeletal anomalies and "incidental" findings is emphasized.

Abnormalities, Multiple↗

Effects of carbamazepine on human chromosomes.

The effect of carbamazepine (CBZ) on human chromosomes was studied in an effort to determine its mutagenic potential. Analysis of chromosome breakage, sister chromatid exchanges (SCE), and cell cycle studies were performed in peripheral lymphocyte cultures. The in vivo studies failed to detect any significant increase of chromosome aberrations or SCE or any slowing of the cell cycle. A significant dose-dependent increase in chromosome aberrations but not in SCE was observed in the in vitro analyses. No correlation was observed between chromosome breaks and SCE in either the in vivo or in vitro studies. The negative in vivo results indicate an absence of detectable chromosome-damaging effects of CBZ used in monotherapy in human subjects.

Adult↗