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Biomedical subjects

E Reinhart

Publications and source records attributed to E Reinhart.

12 recordsLinked to original sources
PubMed1996

Craniofacial growth characteristics after bilateral fronto-orbital advancement in children with premature craniosynostosis.

The standardized bilateral fronto-orbital advanced method of osteotomy established at the University of Wuerzburg is applied in all forms of craniosynostosis except scaphocephalus. The intention behind early operation is to halt progression of the disorder and to institute the physiological direction that growth should take. The preoperative severity of the disorder, the particular symptoms of the various malformations concerned, and the postoperative course of growth were analyzed and assessed both clinically and cephalometrically using the retrospective evaluations of the file data of 131 children with various forms of craniosynostosis. In contrast to linear craniectomy and so-called lateral canthal advancement, which have sometimes been thought to lead to undesirable postoperative growth development, only 11 relapses requiring renewed operation were found postoperatively in our own study of 131 children. It became evident that the greater the severity of the malformation, the more probable it was that a relapse would occur. Fronto-orbital advancement can only affect the pathological growth pattern to a limited degree, especially when craniosynostosis is related to a syndrome. Cephalometric evaluation confirmed the limited potential for growth in the area of the anterior skull base and in the mid-face in the presence of syndrome-related brachycephaly and severe facio-craniosynostoses. In such clinical cases, compensatory growth of maxillary hypoplasia cannot be expected after fronto-orbital advancement.

Cephalometry↗
PubMed1996

[Treatment outcome and complications of surgical and conservative management of mandibular fractures].

Retrospective analysis of 712 patients with 1166 mandibular fractures and follow up-study of 374 patients with 593 fractures was performed for discrimination of differences in wound- and bone-healing as well as late results between operative and conservative fracture treatment. 46.1% (328) of all patients have been treated conservatively, 53.9% (384) have been treated by operation. The follow up was performed on 255 patients with operative fracture treatment and 119 patients with conservative treatment. In 3.0% of the operatively treated patients bacterial infections occurred, in comparison to 8.7% of conservatively treated patients. From the viewpoint of functional aspects, such as occlusion, articulation and mandibular movement as well as radiological signs in the fractured region patients after operative treatment have shown partly significantly better results during the follow up compared to the group of conservatively treated patients. Neurological testings of inferior alveolar nerve and mental nerve have shown significantly better results in the group of conservatively treated patients. Since the functional results are much better after operative treatment, osteosynthesis with miniplates should be performed if there are no contraindications. The more precise reconstruction and stabilization of the fragments shortens time of hospitalization and leads to sooner functionality of the mandible.

Bone Plates↗
PubMed1996

[Therapeutic concept in comminuted and defect fractures of the mandible].

Immediate live-saving emergency treatment of patients with heavily communited and partially defective mandibles by airway intubation, control of haemorhage and primary treatment of wounds necessarily must be followed by a staged concept of treatment for the functional and aesthetic rehabilitation of hard and soft tissue in order to enable the patient to survive not only biologically but also socially. Out of 384 patients with surgically treated mandibular fractures, 120 had multiple fractures, 24 heavily comminuted fractures and 6 sustained vast defects. All multiple and communited fractures could be treated successfully by an intraoral approach using function-orientated miniplate-osteosynthesis and in 30 cases functionally stable plates. In patients having sustained vast avulsions of soft and hard tissue, immediate emergency-revascularisation was well to the fore. In cases of tissue destruction, primarily the position of the jaw stumps was secured by plates and reconstruction was done in the early secondary stage using composed microvascularly transferred scapular flaps.

Adult↗
PubMed1995

[Comparative studies with apicoectomy using various surgical techniques and filling materials].

Follow-up examinations were made retrospectively on 799 apicoectomized teeth from a group of patients with a total of 3,524 apicectomies, the mean postoperative interval of observation being 4.2 years. An intraoperatively orthograde root-canal filling was performed in 51.3%, an intraoperatively retrograde in 23.7% and a preoperative filling in 25.0% of the patients. Apart from 126 teeth that had already been extracted, a further 160 teeth had been clinically and/or radiologically conspicuous, so that a total of 286 failures was to be recorded. The dentally related success graphs computed according to Kaplan and Meier (1958) showed a significantly worse success probability for the preoperative filling compared to the two other techniques. With regard to the different materials employed in orthograde application, the silver filling had a higher and the guttapercha filling a less favourable success quota compared to a titanium filling. Moreover, in the retrograde method, amalgam resulted in a significantly higher success probability than glass ionomer cement. With an attendant cyst there was a significantly improved success quota over apical parodontitis or a renewed operation. With regard to the localization of apicectomies, maxillary front teeth attained the highest success rate. The present results point unequivocally to an unfavourable outcome after preoperative endodontics and underscore the good prognosis of an intraoperatively orthograde filling. Due to the fact that biocompatibility is in the forefront today, time-tested materials, such as silver and amalgam, are clearly being used less.

Adult↗
PubMed1994

[Microsurgical scapula transplants for reconstruction of the facial skull--experiences with 44 patients].

Great versatility gives composed scapular flaps a particular significance for the reconstruction of defects in face and skull: According to individual requirements one up to five separate elements may be transferred with one vascular pedicle. Anatomical studies of 120 scapulas measured a mean length of 13.4 cm and a mean diameter of 1.2 cm of the lateral margin offering sufficient bone for most indications in the visceral skull. Up to three cutaneous flaps may cover nearly every defect in the head. 44 patients were treated in the years 1989 to 1993 using scapular flaps, most of them combinations consisting of bone and skin elements. In two patients a so called 4-in-1-flap was transferred including the latissimus-dorsi-flap. All donor sites could be closed primarily. Venous thrombosis caused one loss of a flap. Infections healed without sequelae. Medical gymnastics brought full rehabilitation of the donor site within 6 months.

Bone Transplantation↗
PubMed1992

Combined nitrofurantoin toxicity to liver and lung.

Nitrofurantoin is an antibiotic commonly used for prophylaxis and treatment of urinary tract infections. Pulmonary and hepatic toxicity are rare side effects of this agent. The simultaneous occurrence of pulmonary fibrosis and chronic active hepatitis in a patient undergoing long-term nitrofurantoin therapy is reported. The presence of pulmonary toxicity was evidenced by infiltrates on chest radiographs and impaired diffusion capacity during pulmonary function tests. Prolonged elevation of liver enzyme concentrations together with the presence of increased antibody titers (anti-smooth muscle antibody, antinuclear antibody) was suggestive of chronic hepatitis, a diagnosis corroborated by liver biopsy findings. After discontinuation of nitrofurantoin therapy, the patient had a full recovery. The infiltrates initially found on chest radiographs disappeared, and laboratory parameters normalized without the need for corticosteroid therapy.

Aged↗
PubMed1991

[The diagnostic assessment of enlarged lymph nodes by the qualitative and semiquantitative evaluation of lymph node perfusion with color-coded duplex sonography].

Perfusion of enlarged lymph nodes by colour-coded sonography was studied prospectively in 105 benign and 115 malignant lymph nodes. The diagnosis was confirmed histologically in 158 and clinically in 62. Spectral analysis in the benign lymph nodes provided normal values for pulsatility and resistance indices. A pulsatility index greater than = 1.8, or a resistance greater than = 0.9 indicate lymph node metastases with positive prediction of 93% and specificity of 97%. In addition, subjective, semiquantitative classification of lymph node perfusion in relation to the surrounding fat or connective tissue improves the diagnosis of lymph node metastases and of malignant lymphomas.

Axilla↗
PubMed1991

[Various factors influencing the local anesthetic effect of articaine].

In a field study, the reduction in the anaesthetic effectiveness of Articain was investigated in relation to various influencing parameters. Both in the ZMK-Klinik (Dental Hospital) of Würzburg as well an in various independent practices, the local anaesthetic Articain was given to over 2000 patients in the course of dental treatment. With 12.1% of all test-subjects, inspite of the initial positive effectiveness upon application of the nerve-blocking anaesthetic, touch sensitivity and/or painfulness was established in the area concerned. Statistical evaluations of the recorded data of the test-subjects investigated showed a significantly higher quota of anaesthetic failure in the case of heavy cigarette consumption, chronic exposure to inhaled toxins as well as in the case of the intake of medicines of certain pharmaceutical types. Apart from that, a connection was also established between reduction in the effectiveness of the local anaesthetic and various treatments as well as the way in which the local anaesthetic was applied and the site of injection. Possible causes will be presented and discussed in relation to information from the literature on the subject.

Anesthesia, Dental↗
PubMed1986

Kininase I and II activities in serum of patients with lung diseases.

In serum of 530 patients with various lung diseases and in 70 healthy control subjects, kininase I (E.C. 3.4.17.3) and kininase II (E.C. 3.4.15.1) were measured spectrophotometrically using hippuryl-L-arginine for estimation of kininase Ia (KIa), hippuryl-L-lysine for kininase Ib (KIb) and hippuryl-L-histidyl-L-leucine for kininase II (KII). KIa and KIb were significantly elevated (p less than 0.02) in lung cancer and sarcoidosis, compared to tuberculosis and healthy controls. There was an increase (p less than 0.05) in lung cancer in relation to sarcoidosis, chronic obstructive bronchitis, tuberculosis, pulmonary fibrosis and healthy control subjects. KII was significantly elevated in sarcoidosis (p less than 0.0001). According to the histological types of lung cancer, no differences of KIa, KIb and KII have been found. The ratio KIa/KIb X KII was 2.3 in lung cancer and 6.7 in the group with sarcoidosis. These results show that the determination of kininases can be used for diagnosis of lung diseases.

Carboxypeptidases↗
PubMed1983

A simple spectrophotometric assay of carboxypeptidase N (kininase I) in human serum.

Kininase I (carboxypeptidase N; EC 3.4.17.3) consists of carboxypeptidase N1 (CN1) and carboxypeptidase N2 (CN2); these two enzymes can be differentiated by their activities towards hippuryl-L-arginine and hippuryl-L-lysine, respectively. A spectrophotometric assay for both carboxypeptidases in human serum is described and the biochemical behaviour of these enzymes investigated. The pH optima are found to be 8.4 for CN1 and CN2. The Michaelis-Menten constants are: CN1 4.59 +/- 0.03 mmol/l; CN2 37.26 +/- 3.49 mmol/l. CN2 can be inhibited by EDTA (76%), dimercaprolum (97%) and phenanthroline (98%). Diisopropylfluorophosphate has no influence on both enzymes. Elevated haemoglobin only interferes with CN1 measurements, and high bilirubin concentrations slightly alter the activity of both enzymes. High CN1 activities were found in sera of patients with sarcoidosis, and elevated CN2 activities were found in lung cancer.

Arginine↗