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Biomedical subjects

B Schick

Publications and source records attributed to B Schick.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Long-term results of endonasal frontal sinus surgery].

Most conditions of the frontal sinus requiring surgery can now be managed successfully by endonasal procedures. To date there has been no clear position regarding indications and results of different types of endonasal frontal sinus drainage. In a retrospective study we evaluated long-term results of Draf's type II and III endonasal frontal sinus drainages using endoscopy and computed tomography. Twelve to 98 months following type II drainage, 58% of 83 frontal sinuses were ventilated and normal. A ventilated frontal sinus but with hyperplastic mucosa was seen in 12%. Scarred occlusion with total opacification on CT occurred in 14%. Furthermore, total opacification in 16% was due to recurrent polyposis. Patients were free of symptoms or had only minor problems in 79%. Twelve to 89 months following type III drainage, 59% of 81 frontal sinuses were ventilated and normal. A ventilated frontal sinus with hyperplastic mucosa was seen in 17%. Scarred occlusion with total opacification on CT was present in 7%. Furthermore, total opacification in 16% was due to recurrent polyposis. In all, 95% of the patients were free of symptoms or had only minor problems. Combining our results with those of other authors and utilizing the physiology of wound healing after sinus surgery, we developed a protocol of differential indications for endonasal frontal sinus drainage.

Adolescent↗
PubMed1996

The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study.

OBJECTIVE: Our purpose was to examine the potential teratogenicity of calcium channel blockers. STUDY DESIGN: Six teratogen information services prospectively collected and followed up 78 women with first-trimester exposure to calcium channel blockers. Pregnancy outcome was compared (by paired t text of chi2 analysis) with that of a control group matched for maternal age and smoking. RESULTS: There was no increase in major malformation (2/66=3.0% [calcium channel blockers] vs 0% [nonteratogenic controls], p=0.27); a fivefold increase was ruled out (baseline 2%, alpha = 0.05, beta = 0.20). The defects reported were attributable to maternal diabetes or coingestion of teratogens. The increase in preterm delivery 28% [calcium channel blockers] vs 9% [nonteratogenic controls], p=0.003), attributed to maternal disease by stepwise regression, was the most important factor responsible for the observed decrease in birth weight (mean -334 gm vs nonteratogenic controls, p=0.08). CONCLUSION: This study suggests that calcium channel blockers do not represent a major teratogenic risk.

Abnormalities, Drug-Induced↗
PubMed1996

Computer-assisted documentation and analysis of wound healing of the nasal and oesophageal mucosa.

Our aim was to analyse the dynamics of healing processes in the nose and oesophagus by videoendoscopic examination and reconstruction of the natural dynamics and continuity of a process using modern computer technology and so-called morphing software. Thirteen patients were followed-up for six months after sinus surgery and three weeks after oesophagitis. Four overlapping and meshing phases of wound healing following sinus surgery with significant interindividual differences. Topical budesonide shortened the duration of wound healing phases. Healing of oesophagitis occurred approximately symmetrically from the wound edges to the centre with constant velocity. Computer-assisted morphing enables dynamic analysing of mucosal processes under the following preconditions: Availability of a valid imaging method for documentation and measurement with the generation of congruent images. The process under analysis must run without sudden leaps and there must be adequate choice of timing of single measurement procedures.

Endoscopy↗
PubMed1996

[Effects of postoperative care on wound healing after endonasal paranasal sinus surgery].

BACKGROUND: There is no standard for postoperative care after paranasal sinus surgery. METHODS: In a prospective study we evaluated the influence of modifications of postoperative care on wound healing after paranasal sinus surgery. We used a new method of documenting the natural dynamics of wound healing after endonasal paranasal sinus surgery that combines morphing and time-lapse video. Computer-assisted morphing means transformation of one shape into another by means of two-dimensional interpolation. The computer reconstructs the changes between the single frames taken by videoendoscopy at each examination by morphing. Editing all single frames from videoendoscopy and from morphing together resulted in a 60-second video showing wound healing over a period of six months. We documented wound healing 23 operations. Twelve patients with chronic polypoid sinusitis of similar extent were documented in a similar manner. Minimal postoperative care consisted of packing the operative cavity with rubber fingers for three days and irrigation with Ems brine. The effect of long-term packing and topical application of budesonide were studied. Analysis consisted of evaluating the time-lapse videos and final flexible endoscopy of the sinuses. RESULTS: Wound healing after complete endonasal sinus surgery varies greatly. In the first 7-12 days blood crusts covered the whole wound. Granulation was visible for 2-4 weeks. The increasingly edematous swelling reached its maximum in the 3rd-5th week and decreased in 7th-12th week. A macroscopically normal mucosa was observed from the 12th-18th weeks. Subepithelial changes occurred for longer than 6 months. CONCLUSIONS: The following measures are recommended for decreasing postoperative granulations, edema and swelling: minimizing the surgical trauma, long-term packing with a occlusive, nonadherent material (rubber finger packing), topical steroids (Budesonide). Stenosis of paranasal sinuses due to excessive scarring could not be prevented (especially in the frontal sinus).

Administration, Topical↗
PubMed1996

[Dura-plasty in the area lf the sphenoid sinus].

BACKGROUND: Surgical treatment of CSF leakage in the sphenoid sinus is difficult for several reasons: 1. the close neighbourhood between the sphenoid sinus and the internal carotid artery, the cavernous sinus and cranial nerves (II, III, IV, VI), 2. a strong liquorrhoea caused by basal cisterns surrounding the sphenoid sinus, 3. it can be difficult to visualise completely the sphenoid sinus depending on the extent of pneumatisation. MATERIALS AND METHODS: In this retrospective study 20 cases of duraplasty around the sphenoid sinus were evaluated. The approach, materials, operative techniques and results are described. RESULTS: 90% of the dura lesions were closed successfully by one operation (average follow-up time 5 years). Including our two revisions all defects have been sealed effectively. CONCLUSIONS: Currently, the endonasal approach using microscope and endoscope is the technique of choice for dura repair in the sphenoid sinus. The different techniques and materials vary in order of size, location and etiology of the dura lesion.

Aged↗
PubMed1996

[Orbital hematomas].

BACKGROUND: Orbital hematomas may occur spontaneously, as a result of vascular anomalities, or they may be induced by trauma or occur following paranasal sinus surgery. The retrobulbar hematoma requires special attention because of its potential compression of the optic nerve may compromise vision or cause blindness. PATIENTS AND METHODS: We report on four cases: two subperiostal orbital hematomas, a spontaneous retrobulbar hematoma, and one orbital hematoma due to trauma. RESULTS: In one case a vascular anomality was detected by angiography. Though temporary blindness occurred in this case, it was possible to preserve 30% vision by surgery. An infected subperiostal hematoma was successfully treated using an endonasal approach. Two cases (a traumatic and a subperiostal orbital hematoma) required no operative treatment. CONCLUSIONS: The diagnosis of an orbital hematoma should be made as quickly as possible to permit adequate early therapy. Decrease of vision or blindness caused by orbital hematoma may be improved through a lateral canthotomy as emergency measure and subsequently by draining the hematoma to relieve compression of the optic nerve.

Adult↗
PubMed1996

[Chemotherapy of juvenile angiofibroma--an alternative?].

Since February 1979, 22 juvenile angiofibromas have been treated among 312 tumors of the skull base managed in the ENT Department, Fulda. According to a general staff consensus the treatment of choice was complete surgical removal. This was achieved in 20 cases with one operation and in one case with two operations. In addition to removal of tumor, functional and aesthetic aspects had to be considered as aims of operative treatment, including among others preservation of the facial skeleton, infraorbital nerve, nasolacrimal drainage system and vision. In rare cases complete excision of the tumor is not possible. The value of cytostatic therapy is demonstrated in one patient with uncommonly advanced disease. Considering the extensive regression of tumor achieved in this case after chemotherapy with Adriamycin and decarbazine, one has to raise the question if the chemotherapeutic approach was more than just palliative. From our experience chemotherapy should be considered a possible alternative to radiation in the management of unresectable juvenile angiofibromas.

Adolescent↗
PubMed1996

[Interdisciplinary cooperation in primary care of elderly patients--results of results with consequences for general practice].

In the networking of health care provision for the elderly the inclusion of the general practitioner is considered to be lacking, although the "Gesundheitsreformgesetz" (GRG) demands that the GP should act as a coordinator (Section 73 of German social welfare legislation). The views of GPs on already existing cooperation and on barriers to such cooperation in a selected district of Hamburg were examined by means of guided interviews. With the help of the agents in the region the building blocks for promoting cooperation were then developed in the district. A significant precondition for this was to make sure that the available local services on offer in respect of health promotion and health care provision are utilised by means of a data bank and a directory. On this basis the potential cooperation partners were identified and a local work circle comprising representatives of the most important health and social services was set up. From this a quality circle which was interdisciplinary and also consisted of members from all relevant fields was established, together with a working group on the development of a community based advice centre for the elderly.

Aged↗
PubMed1996

[Papillary tumor of the endolymphatic sac].

A papillary neoplasm that was presumed to originate from the endolymphatic sac was described by Heffner in 1989. This tumor was considered to be a "low-grade adenocarcinoma" because of its behavior: slow growth, local destruction and failure to metastasize. The clinical manifestations are hearing loss, vertigo, facial nerve paralysis and/or cerebellar disorders. Endolymphatic sac tumors have previously been mistaken for such neoplasms as paraganglioma, choroid plexus papilloma and carcinoma, adenomatous tumor of the middle ear and secondary metastases. The diagnosis of this neoplasm is facilitated by CT and MRI. The treatment of choice is total removal of tumor as soon as possible and requires clinical awareness of this rare but important pathologic entity.

Adenoma↗
PubMed1996

[Augmentation of the temporal fossa with Ionos bone cement].

To compensate for the loss of tissue after transferring the temporalis muscle, it is advisable to fill the temporalis fossa for aesthetic reasons. In so doing, we have used IONOS bone cement to augment the fossa after muscle transfers. Twelve procedures have been performed within the past 3 years. The average follow-up time has been 23 months. Surgery was required in 6 cases following delayed reconstruction to rehabilitate the paralyzed face after loss of facial nerve function, four times to stabilize a duraplasty at the skull base and twice for aesthetic facial augmentation. A prefabricated IONOS implant (IONOROC implant) was attached to the squama temporalis with fresh bone cement. In all cases a good aesthetic result was achieved. A temporary seroma occurred in 6 patients (50% of the cases) but resolved in 1-2 weeks without requiring further care. However, we now recommend that suction drainage be inserted for approximately 1 week after surgery. In two cases the IONOS implant had to be removed because of an infection.

Adult↗
PubMed1994

Extension of the diffraction resolution of crystals.

The diffraction resolution of crystals of the guanine nucleotide-exchange factor complex, EF-Tu-Ts, has been extended from 5.0 to 2.5 A by lowering the solvent content in the crystals as well as the temperature of data collection. The common form of EF-Tu-Ts crystal belongs to space group P2(1)2(1)2(1) with a = 81.1, b = 109.9, c = 207.5 A and has a solvent content of 61%. The crystals diffract to a resolution of 5.0 A at 293 K and 4.0 A at 273 K. When cryoprotective agents are slowly diffused into the crystals, the cell constants shrink to a = 74.4, b = 109.9, c = 198.7 A and the solvent content falls to 55%. After the cryoprotective agent has been added, the crystals diffract to 2.7 A resolution at 293 or 273 K and 2.5 A at 250 K. X-ray diffraction data, collected before and after the transformation of individual EF-Tu-Ts crystals, demonstrate that a large percentage of the improvement in diffraction resolution is due solely to the addition of cryoprotective agents. The transfer procedures for the successful introduction of cryoprotective agents into EF-Tu-Ts crystals as well as the general applicability to other crystal systems will be discussed.

Journal Article↗
PubMed1994

Outcome after maternal varicella infection in the first 20 weeks of pregnancy.

BACKGROUND: Infection with the varicella-zoster virus during pregnancy can produce an embryopathy characterized by limb hypoplasia, eye and brain damage, and skin lesions. The risk is greatest when infection occurs during the first 20 weeks of pregnancy, but the magnitude of the risk is uncertain. METHODS: We studied 106 women with clinically diagnosed varicella infection in the first 20 weeks of pregnancy and compared the outcomes with those in 106 age-matched, nonexposed controls. RESULTS: Among the women with varicella, there was a trend toward more elective terminations of pregnancy (14 percent, vs. 7.5 percent among the controls; P = 0.1), corresponding to a significantly higher perception of teratogenic risk (P = 0.03). The proportions of miscarriages and live births and the mean birth weights were similar in the two study groups; there were more premature births (< or = 37 weeks) among the women with varicella infection (14.3 percent vs. 5.6 percent, P = 0.05). Congenital defects occurred in four infants born to the women with varicella (varicella embryopathy, hydrocephalus, meningocele and clubfeet, and hammer toe) and two infants born to the controls (ventricular septal defect and hip dislocation). The risk of varicella embryopathy after infection in the first 20 weeks was 1.2 percent (95 percent confidence interval, 0 to 2.4 percent). When we pooled our results with those from other prospective studies, the mean risk of embryopathy after infection with varicella-zoster virus in the first trimester was 2.2 percent (95 percent confidence interval, 0 to 4.6 percent). CONCLUSIONS: The absolute risk of embryopathy after maternal varicella infection in the first 20 weeks of pregnancy is about 2 percent.

Chickenpox↗
PubMed1994

Developmental patterns of expected consequences for simulated bicycle injury events.

Bicycle injuries follow a developmental pattern that differs from that of most injuries, where toddlers and individuals in young adulthood are most at risk. Children in late childhood and early adolescence appear most at risk for bicycle injuries. The present study of 2nd-grade, 4th-grade, 6th-grade, and undergraduate college students documented that after videotaped simulations of bicycle injury events, younger children anticipated greater injury severity and more fear than older children and adolescents. The potential influence of reduced expectations for injury with increasing age is described, and challenges are advanced for establishing the link between lowered injury expectancies and increased risky behavior.

Adolescent↗
PubMed1993

Empirically derived injury prevention rules.

This study describes a set of empirically derived safety rules that if followed, would have prevented the occurrence of minor injuries. Epidemiologists have criticized behavioral interventions as increasing "safe" behavior but failing to demonstrate a decrease in injury. The present study documents retrospectively the link between safe behavior and injury. It demonstrates that these empirically derived rules are very similar to rules for the prevention of serious injury. The study also shows that these rules are not widely accepted and implemented by parents. Suggestions for future research in this area are advanced.

Accident Prevention↗
PubMed1993

Both isoforms of skeletal muscle subfragment 1 (S1A1 and S1A2) can induce actin polymerization with equal speed in the absence of ATP.

The ability of myosin subfragment 1 to induce actin polymerization was reinvestigated using the DNase I inhibition assay, by electron microscopy after negative staining, cosedimentation, measurement of viscosity and the fluorescence increase of pyrenyl-labeled actin. Using these techniques we demonstrate that rabbit skeletal muscle myosin subfragment 1 containing either the alkali light chain 1 (S1A1) or the alkali light chain 2 (S1A2) is able to promote actin polymerization even in the absence of divalent cations or salt. In the presence of ATP the rate of induction of actin polymerization by S1A2 is slower than by A1A1. In contrast, in the absence of free ATP, both subfragment 1 variants exhibit equal ability to induce actin polymerization. Evidence is given that the slower rate of induction of actin polymerization by S1A2 in the presence of free ATP is due to a slower rate of ATP-hydrolysis by S1A2 and thus to a slower rate of ATP depletion. We therefore assume that the formation of rigor type complexes involving the subfragment 1 heavy chain is necessary for the induction of actin polymerization. The ability of subfragment 1 to induce actin polymerization is retarded by a synthetic heavy chain mimetic peptide which inhibits its actin binding or after proteolytic cleavage of the subfragment 1 heavy chain by trypsin.

Actins↗