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Biomedical subjects

G Hesse

Publications and source records attributed to G Hesse.

At least 19 recordsLinked to original sources
PubMed2003

[Ultrasound diagnostic techniques in dermatologic angiology and phlebology].

The diagnostic uses of high-resolution ultrasonography (7.5-20 MHZ) have dramatically advanced in the past 20 years. We present representative examples of ultrasound diagnosis, based on our experience with over 15,000 examinations. For example, peripheral arterial disease was identified in 30% of older patients with venous diseases, while peripheral emboli and vasculitis can lead to widespread skin disease. Ultrasonographic diagnosis is required for appropriate interdisciplinary treatment. In addition, regular evaluation of the supra-aortic vessels and coronary arteries as well as arteries and veins of the limbs is needed in some forms of vasculitis. The causes of peripheral venous disease can be subdivided into four groups based on sonographic findings: Primary or secondary epi- and/or subfascial venous insufficiency, thrombotic venous occlusion, venous compression syndrome and arteriovenous-lymphatic malformations. The diagnosis and therapeutic approach to lymphedema and soft tissue diseases, with or without lymphadenopathy, requires careful sonographic evaluation. Ultrasonography is an essential part of dermatologic oncology, both for planning primary therapy and for follow-up. A sound command of ultrasonography is today an essential aspect of dermatologic diagnosis and therapy.

Algorithms↗
PubMed2003

[Multifactorial dizziness].

We report about a patient with recurrent dizziness, looked upon for about 8 years as Menière's disease.He suffered from benign positional vertigo, which led to an additional psychogenic dizziness, connected to early live events. The different parts of complex dizziness, diagnosis and treatment will be described.

Aged↗
PubMed2002

[Oncocytic adenocarcinoma of the submandibular gland].

BACKGROUND: Malignant oncocytic tumors rarely occur in major salivary glands and generally account for < 1% of all salivary tumors. There is no difference of both sexes and appearing mainly between 50 and 60 years of age. They comprise oncocytes, which are epithelial cells with abnormally formed cytoplasm and acidophilic granular cytoplasma. In the process of the malignant transformation the coexistence from oncocytic rests and untypical oncocytic carcinoma portions can be seen. The tumors show no capsule and an infiltrative local growth with perineural and vascular expansions. PATIENT AND METHOD: A rare case of a 59-year-old man with malignant oncocytoma is presented. The tumor was found in the left submandibular gland with one enlarged lymph node near by. RESULT AND CONCLUSIONS: A general overview of the available literature and the histological classification of oncocytomas is given. Therapy consists of surgical resection and radiotherapy. Close clinical controls are necessary.

Adenocarcinoma↗
PubMed2002

[Myositis proliferans. Differential cervical space-occupying lesion diagnosis].

Myositis proliferans is a rare and benign pseudosarcomatous tumour of soft tissue. In most cases it is found in the region of the shoulder and arm and its occurrence in the region of the neck is described in literature in 16 cases in all. For the ear, nose and throat specialist it is an important differential diagnosis in contrast to malignant tumours. In this report we present the cases of two patients, who were suffering from painful cervical swelling that had been increasing for some days. The problems inherent in the diagnosis of this illness are discussed. Due to its rapid growth the tumour is generally falsely diagnosed and radically removed. Therefore, in appropriate case history, this possibility should be considered and excluded in order to prevent the patient from unnecessary radical operation. In addition to clinical symptoms, imaging and trial excision are suitable.

Diagnosis, Differential↗
PubMed2002

[Acoustic neurinoma with preserved inner ear function. Interesting audiologic constellation of findings].

Neurofibromatosis (NF) is a syndrome with multiple neuromas. With the central form or NF2 very often bilateral acoustic neuromas are found. Tumours derive from Schwann cells of the eighth cranial nerve; symptoms are tinnitus, hearing loss and vertigo. Therapy is surgical, if possible with the protection of remaining hearing function. We report the case of a 28 year old female patient with neurofibromatosis type 2. After complete resection of the left AN and partial resection of the right AN the patient suffered from bilateral complete deafness, although almost normal DPOAE can be recorded on one side. Therefore we find the classical neural deafness with intact function of outer haircells (OHC).

Adult↗
PubMed2002

[The assessment of subjective distress related to hyperacusis with a self-rating questionnaire on hypersensitivity to sound].

BACKGROUND: So far there has been no adequate measure to assess or illustrate, in terms of different levels, subjective distress related to hypersensitivity to sound. METHOD AND PATIENTS: The here presented work describes and discusses the construction of a questionnaire to assess subjective distress related to hypersensitivity to sound (GUF). Between May and September 2000 226 patients that experienced suffering from hypersensitivity to sound as well as from chronic tinnitus, completed a first version of the questionnaire on admittance to the hospital. Of these patients 27.9 % were out-patients and 72.1 % were in-patients. In addition, the in-patients completed the questionnaire again during their last week of treatment. The 27 items of the GUF were interpreted by factor analysis to explore and determine the structure of the questionnaire; the number of items was reduced under the aspects of consistency and reliability. Finally, the revised version of the GUF underwent a first validation. RESULTS: The factor analysis shows three factors explaining 50.65 % variance (factor 1 [KRH], cognitive reactions to hyperacusis; factor 2 [ASV], actional/somatic behaviour; factor 3 [ERG], emotional reaction to external noises). First attempts to validate the questionnaire are promising; it appears that the GUF is also sensitive to therapy effects. CONCLUSIONS: The here presented questionnaire is suitable for identifying distinct levels of subjective distress related to hypersensitivity to sound. Thus, for the first time, there is an adequate measure for assessment available. Furthermore, results of part of the sample show that the GUF is also suitable for therapy evaluation.

Adaptation, Psychological↗
PubMed2001

[Increasing pigmentation in Schmidt syndrome (polyglandular autoimmune syndrome type II].

An 18-year old man presented with increasing pigmentation in multiple nevi as well as so-called "eruptive nevi" over a 24 month period. The first excisional biopsy was from a plantar nevus which showed melanocytic hyperplasia. Following excisions of both hyperpigmented and newly appearing nevi showed only increased pigmentation. Two years after the first examination Addison-like hyperpigmentation was noticed in typical locations. Both Addison disease and Hashimoto thyroiditis were then confirmed by elevated serum levels of ACTH, TSH, and decreased levels of cortisol and L-thyroxine. This confirmed the diagnosis of Schmidt syndrome as part of polyglandular autoimmune disease (PGAS) type II. After another 18 months of treatment with hormone substitution of L-thyroxine and hydrocortisone, the hyperpigmentation resolved and the hyperpigmented nevi decreased in number.

Addison Disease↗
PubMed2001

[Intensive inpatient therapy of auditory processing and perceptual disorders in childhood].

UNLABELLED: PRELIMINARY REMARKS: The prevalence of central auditory processing disorders (CAPD) is supposed to be 2-3% of all children. Given the number of affected children and restricted resources in the public health there is a need for an effective and evaluated therapeutic approaches. On the other hand the number of outcome studies is remarkably small. PATIENTS AND METHODS: The presented study reports strategies and pitfalls in outcome measurements of 34 children with CAPD, based upon a 3-weeks indoor therapeutic intervention. Diagnostic criteria of auditory processing and perception were recorded before and after therapy. RESULTS: The data shows a highly significant improvement of certain perceptive abilities, including audiological parameters (dichotic testing, discrimination, loudness scaling) and awareness, psycholinguistic development and orthographic tests. CONCLUSION: The study demonstrates that an effective therapy of CAPD in children is possible and scientifically proven. Long term surveillance however seems to be necessary. It also has to be studied whether intensive indoor treatment is superior or equal to out clinic therapy.

Auditory Perceptual Disorders↗
PubMed2001

[Is recurrent loss of low frequency tone perception--without vertigo--a precursor of Meniere disease?].

PURPOSE: Recurrent low-frequency sensory hearing loss is one characteristic sign of Meniere's disease. It is therefore often assumed to be a prodromal sign of Meniere's disease. METHODS: We report on 81 patients with recurrent low-frequency sensory hearing loss who did not previously suffer from vertigo. All patients underwent a follow-up examination after at least 1 year up to more than 10 years after the onset of the disease [average: 64.65 months (SD 56.33)]. CONCLUSIONS: Only 3.7% of these patients developed the typical signs of Meniere's disease with labyrinthine vertigo, whereas 25.9% suffered from recurrent hearing loss and an unspecific vertigo, which could be diagnosed and treated as psychogenic vertigo; 3.7% showed a typical benign positional vertigo. We can thus conclude that although almost every patient with Meniere's disease suffers from recurrent hearing loss, only a few patients with recurrent hearing loss will develop Meniere's disease. However, many patients with low-frequency sensory hearing loss develop anxiety and psychogenic dizziness in expectation of "imminent" Meniere's disease. Therefore, it is important to counsel the patients carefully that the probability of this occurring is not very high.

Adult↗
PubMed2001

Tungiasis: a neglected health problem of poor communities.

Tungiasis is caused by the flea Tunga penetrans. Growing urbanization, improved housing and use of appropriate footwear presumably have led to an overall reduction of the occurrence of this ectoparasitosis within the last decades. However, it is still highly prevalent where people live in extreme poverty, occurring in many Latin American and African countries. Although the infection has long been known, data on the ectoparasite's biology and the epidemiology of the disease are scant. Methods for treatment, prevention and control have never been evaluated in a scientific manner. Tungiasis remains an important public health problem for the very poor, a problem neglected by those who are affected, by the medical profession and by the scientific community.

Animals↗
PubMed2001

[Chronic complex tinnitus: therapeutic results of inpatient treatment in a tinnitus clinic].

BACKGROUND: In-patient treatment of patients with chronic tinnitus is necessary only when these patients have a severe psychosomatic co-morbidity and suffer severely. However this therapeutic approach has to be supervised and evaluated properly. METHODS: We present data and results of 1841 patients suffering from chronic tinnitus. Due to the severity of the symptom and psycho-neurotic side effects in-patient treatment was necessary. Therapy lasted 5 - 6 weeks, the main aspect was an intensive psychotherapeutic evaluation and stabilisation next to retraining and habituation programmes. Relaxation techniques were taught. Patients suffered from their tinnitus more than six month; 95 % further suffered from hearing-loss, mainly in high frequencies. The study evaluates results of patients from October 1994 until June 2000. Basis of the study was the evaluation of a specific tinnitus-questionnaire (TQ), published by Hallam in the UK and translated by Goebel and Hiller in Germany. Data was recorded at registration in our clinic, 4 - 6 months later during admission and at the end of the therapy. Final data was gained during a special meeting or questioning 6 months after dismissal from the clinic. RESULTS: Patients that suffered most showed the greatest improvement; directly after therapy there was a highly significant improvement in the TQ for an average of 13.01 points. Highly significant improvements were found in all the TQ-subscales respectively. Only 10 % of the patients did not show any improvement at all. CONCLUSION: Therapy of most severe cases of chronic tinnitus is possible, using an integrated concept of otologic and psychosomatic treatments. With large numbers of patients and sufficient data a thorough and necessary evaluation of this therapy can be achieved.

Adolescent↗
PubMed2000

[Ear dysfunction due to air bag detonation?].

Air bags are among the latest developments in extensive automobile safety systems. They successfully have saved the lives of car occupants in road accidents. Many additional injuries caused by air bags from minor to severe have been reported. With the help of two acceleration sensors, the electronic tuner amplifier records the vehicle's deceleration. This is the adequate trigger for air bag deployment, which creates an intense noise of up to 170 dB sound pressure level. This noise level can cause cochlear damage. We present two patients with otologic symptoms after spontaneous air bag deployment.

Adult↗
PubMed1999

A computer-based method for continuous single pulse analysis of intracranial pressure waves.

INTRODUCTION: The single pulse analysis of intracranial pressure waves provides valuable information about the autoregulative processes after head injury. This method has not been used for routine clinical assessment as yet. Current methods for evaluation of intracranial pressure waves are based on spectral analysis or related techniques. This imposes restrictions on the wave sequences available for the investigation of ICP attributes. Therefore, we have developed a computer-based method, which enables continuous analysis of each pulse of the ICP wave, in any clinical setting. METHOD: Firstly, the raw data of the ICP wave is continuously recorded by the Multifunctional Anaesthetic Record System (MARS, Hewlett Packard). The recorded data is then subjected to single pulse wave analysis by our software. Each single pulse is identified by the algorithm. The maximum, minimum and mean value, as well as amplitude and gradient are calculated in each pulse pressure. All conceivable correlations of the listed parameters can be examined. RESULTS: We applied our software in 9 cases with head injury and evaluated the measurements over 59 days (1400 h). More than 7 million single pulse pressures have been analyzed off-line. The software proved to be accurate and easy to apply. It was possible to calculate correlations between the different wave attributes on a broad basis of data. Parameters of special clinical interest were the amplitude of the single pulse pressure and the gradient. CONCLUSION: This method is an improvement on ICP single pulse pressure analysis and facilitates its clinical application. It creates the possibility for continuous long-term analysis of the ICP wave attributes under any clinical condition without loss of data. There are indications that the amplitude and the gradient of the ICP pulse pressure could provide valuable additional information for clinical assessment. However, further evaluation is required.

Craniocerebral Trauma↗