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Biomedical subjects

D Schumann

Publications and source records attributed to D Schumann.

At least 55 records · Page 3Linked to original sources
PubMed1990

Postoperative hyperglycemia: clinical benefits of insulin therapy.

The hormonal changes associated with surgical stress induce a number of metabolic changes in both nondiabetic and diabetic patients. In nondiabetic patients hyperinsulinemia and hyperglycemia develop, and in diabetic patients hyperglycemia and hypoinsulinemia develop from diminished or lack of islet cell function. The goal for the diabetic patient immediately after surgery is to keep metabolism as nearly normal as possible. Methods to achieve normoglycemia are a matter of physician preference, but failure to maintain physiologic control subjects these patients to a wide range of abnormalities. Insulin deficiency and hyperglycemia modify general metabolism, impair protein synthesis and ion regulation, predispose to neural damage, interfere with blood cell functions, and alter drug detoxification. If exogenous insulin is necessary, intravenous administration has gained wide acceptance, but the subcutaneous route produces satisfactory results. Frequent and accurate blood glucose monitoring is crucial to adjustment of insulin doses for restoration and maintenance of normoglycemia in the postoperative period.

Blood Glucose↗
PubMed1990

[Anatomic studies of the availability of the transverse cervical artery as the stem vessel of pedicled myocutaneous flaps in plastic surgery].

The course and the circulation area of the A. transversa colli were characterized preparatorically as well as with the help of injections of stains and angiographically with contrast media in corpses. Predictions concerning the formation of the angiosomes and thus the size and the shape of musculocutaneous trapezius flaps were derived from the investigations. The presentation of the specific topographic relations of the A. and V. transversa colli revealed indications concerning the formation of the vascular pedicle and thus the possibilities to transpose the musculocutaneous flaps in order to cover skin defects of the head, neck and thorax after extensive surgical intervention.

Aged↗
PubMed1989

Pattern of oral cytokeratins. III. SDS-electrophoretic analysis and immunoblotting of cytokeratins in leukoplakias and squamous cell carcinomas of the oral mucosa.

The frequency of the occurrence of cytokeratins analyzed SDS-electrophoretically in 20 leukoplakic lesions and 14 squamous cell carcinomas of the oral mucosa has shown a picture of "restlessness" with some quantitative, some qualitative deviations from the locally normal pattern of cytokeratins. In most cases the basic pattern typical for the oral mucosa was still recognizable, except for three highly undifferentiated carcinomas. The variations of the cytokeratin pattern existed independently of the clinical form of leukoplakia and of its histological degree of dysplasia. The striking findings in some, but not all cases were: --the presence of cytokeratin no. 18 as a major component which normally appears rarely and faintly, and of cytokeratin no. 19, which is not normally detectable electrophoretically within the whole oral mucosa; --the absence of cytokeratins no. 1-3 despite of the cornification which was reliably proved by histology; --the appearance of the proteins having molecular mass values of 42 kDa and less which very probably may be the products of partial keratinolysis as evidenced by immunoblotting with monoclonal and polyclonal antibodies to cytokeratins. Among these proteins a proteolytically modified cytokeratin no. 19 of only 38 kDa was found.

Antibodies, Monoclonal↗
PubMed1989

[Neovascularization of the myocutaneous rectus abdominis island flap in the rat].

The neovascularisation was investigated in 51 rectus abdominis myocutaneous island flaps (1.5 x 3.0 cm) in rats (Uje: WIST) following ligation of the pedicle vessels (superior epigastric artery and vein) without and with incision of the cranial flap border. The ligation was done on the 3rd, 4th, 5th, and 7th postoperative day. The efficiency of the neovascularisation was estimated quantitatively on the 3rd, 5th, and 7th day after vascular ligation by measurement of the necrotic flap tissue. The findings are expressed in percent of the whole flap area. Vascular pedicle ligation on the 3rd or 4th postoperative day caused an average necrosis rate of 98% and 84% respectively. No flap survived in these experimental group. In case of pedicle vessel occlusion on the 5th postoperative day without incision of the cranial flap border all myocutaneous flaps survived, partly with focal loss of the epidermis. Placing the ligation after incision of the flap border on the 5th day an average necrosis rate of 34% was found, only 5 out of 11 flaps survived. All flaps (n = 9) remained viable following vascular pedicle ligation on the 7th postoperative day. It seems necessary to observe myocutaneous flaps carefully until the 14th postoperative day, because tissue damages due to vascular pedicle occlusion on the 4th day may become visible not before the 10th or 11th postoperative day. Opening of the myocutaneous flap borders between the 5th and 7th postoperative day should be avoided.

Abdominal Muscles↗
PubMed1989

[Temperature determination of the skin surface for the estimation of blood supply disorders in myocutaneous island flaps of rats].

In rectus abdominis myocutaneous island flaps (3.0 x 1.5 cm) of rats (Uje:WIST) skin surface temperature was measured by an infrared pyrometer for monitoring flap viability following experimentally induced blood flow insufficiency. The insufficiency was caused by ligation of the pedicle vessels (epigastric superior artery and vein) on the 3rd, 4th, 5th and 7th d after flap replantation, and by occlusion of these vessels with microclips for 2 h. Only the temperature differences between the intact and the operated skin surface were used to estimate blood flow efficiency not, the absolute values. These differences were statistically insignificant between the intact right and left abdominal skin areas and between the intact skin and the vital flap surfaces. In these cases the maximal temperature differences were 0.52 degree C. Only during the early postoperative period (3-days ligation group) a correlation between blood flow insufficiency and flap viability is expressed by temperature differences (2.14 degrees C). Later on (7-days ligation group) a temperature difference of 1.87 degrees C was no evidence of disturbed wound healing. Thus in advanced stages in myocutaneous flaps differences of blood flow and neovascularization respectively cannot be estimated reliably by measurements of skin surface temperature. However, temperature differences greater than 2 degrees C signal impaired flap viability.

Animals↗
PubMed1989

[Transcutaneous oxygen partial pressure in the evaluation of circulatory disorders in myocutaneous island flaps in the rat].

In rectus abdominis myocutaneous island flaps (3.0 x 1.5 cm) of 86 rats (Uje: WIST) transcutaneous oxygen tension measurements (tcPO2) were made by a Universal-PO2-Meter MO 10.1 (PRACITRONIC, Dresden, GDR) for monitoring flap viability following blood flow insufficiency produced experimentally. This insufficiency was induced by ligation of the pedicle vessels (superior epigastric artery and vein) on the 3rd, 4th, 5th and 7th day after flap reposition and by occlusion of these vessels with microclips for two hours. Only the tcpO2 differences between the intact skin and the contralateral myocutaneous island flap were used to assess effects on blood flow and not the absolute values. These differences were statistically insignificant between the right and left non-operated abdominal skin (0.24 +/- 0.11 kPa), the non-operated skin and the rectus abdominis myocutaneous island flap with intact pedicle vessels (group 2) (0.59 +/- 0.14 kPa) as well as flaps ligated at 5-days (0.71 +/- 0.18 kPa) in which vascular pedicle ligation were induced following incision of the cranial flap border. In the two-hour-ischemia group, the 3-days, 4-days and 7-days ligation groups the average tcpO2 differences were greater (1.17 +/- 0.40; 1.58 +/- 0.31; 1.24 +/- 0.22; 1.22 +/- 0.28 kPa) and statistically significant (p less than 0.05) in comparison to the myocutaneous flaps of group 2. Transcutaneous oxygen tension monitoring was useless in predicting flap survival in later postoperative blood flow insufficiency and in assessing the neovascularization. Only during the intraoperative manipulations or the early postoperative period (24 h) tcpO2 monitoring was valuable in assessing the blood supply of myocutaneous flaps in rats.

Animals↗
PubMed1988

The influence of postoperative vessel occlusion on the viability of free microvascular skin-fat flaps and island flaps in rats.

Using a method of vascular pedicle ligation without skin incision, some minor differences were found between the progress of neovascularization in microvascular free skin-fat flaps and island flaps, both with and without 1-hr ischemia in rats. Viable flap areas were established following vascular pedicle ligation (both vessels or only artery or vein), on the third day after flap replantation in both island and free flaps. Vascular pedicle occlusion on the fifth day after operation resulted in complete survival of free flaps only. Island flaps survived completely following vascular pedicle ligation on the seventh postoperative day. A clear correlation existed between the timing of vascular pedicle ligation and the necrosis and shrinkage rates. In free flaps, clinical signs of viability disturbances were seen earlier in single or total vascular pedicle occlusions, on the third or fourth day compared with island flaps. Insufficiency of the pedicle vein in island or free flaps was tolerated earlier than arterial or total pedicle occlusion. Venous occlusion three days after flap replantation caused significantly higher necrosis and shrinkage rates (p less than 0.05) in free flaps than in island flaps.

Animals↗
PubMed1988

Pattern of oral cytokeratins: I. SDS-electrophoretic analysis of the frequency of cytoskeletal keratins in the normal human mucosa of mouth.

In the SDS-electrophoretic pattern of cytokeratins of the normal human mouth mucosa one has to distinguish between the cytokeratins which occur continually and stamp the organ and site specificity of pattern, from those not always detectable. The cytokeratins no. 5, 6/11, and 14/15 are solidly expressed in the whole oral mucosa, no. 1 only in the regions forming a stratum corneum, no. 3 and 16 in the masticatory mucosa, and no. 8 in gingiva and the lining mucosa. Moreover, no. 16 and 18 in the lining mucosa and no. 2, 4, 17, and 18 in the masticatory mucosa appear as minor components with interindividually varying frequency. The highest variability of the cytokeratin pattern exists in the specialized mucosa.

Cytoskeleton↗
PubMed1988

Pattern of oral cytokeratins. II. SDS-electrophoretic analysis of cytokeratins in reactive hyperkeratoses and Lichen ruber planus of the oral mucosa.

In SDS-electrophoresis the hyperortho- and hyperparakeratoses showed cytokeratin patterns fairly similar to those in the normal masticatory mucosa in cases of reactive hyperkeratosis due to mechanical stimulatory action; however, in Lichen ruber planus they agreed only incompletely. The site-specific, normally stably expressed cytokeratins of the mucosa-type concerned were likewise regularly demonstrable in the pathologically changed tissue specimens under study, except cytokeratin no. 1 which is known to be a reliable indicator of keratinocyte cornification merely in orthological but not in pathological conditions. Deviating from the normal cytokeratin pattern in the oral mucosa, a more frequent and more expressed occurrence of cytokeratins no. 17 and 18 was observed in Lichen ruber planus. In 4 extraordinarily reactive hyperkeratoses, among these 2 papillomas the cytokeratins no. 7/13 were present.

Biopsy↗
PubMed1988

[Results of McKissock reduction mammoplasty].

Reducing mammoplasty is medically justified a surgical intervention to handle certain indications. Results obtained from this approach are discussed in comparison to other methods, primarily the Strömbeck technique, with reference being made to 217 patients of whom the majority had undergone McKissock operations. Ninety per cent of these patients were absolutely satisfied, and only eight per cent had restrictions. However, broadened or hypertrophic scars were recorded from 21 per cent in objective assessments by follow-up examiners. The method according to McKissock can be recommended for cases of mammary ptosis and macromastia. A two-stage approach, according to Joseph, should be taken to cases in which more than 1,400 g of tissue are removed from one side. No increased incidence of mammary tumours was recordable in the wake of reducing mammoplasty.

Adolescent↗