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Biomedical subjects

G Neff

Publications and source records attributed to G Neff.

At least 19 recordsLinked to original sources
PubMed2006

Liver transplantation for primary or metastatic sarcoma to the liver.

Sarcoma is generally a rare disease in the US, with poor survival in patients with both primary angiosarcoma and metastatic disease from sarcoma and GIST. In order to determine if liver transplantation for sarcoma is a realistic option, we examined records of all patients in the US component of the Israel Penn International Transplant Tumor Registry were reviewed. Those patients with liver failure from primary or metastatic liver sarcoma were evaluated. Patient outcome analysis was then performed. Patient and tumor demographics were reviewed as well as patient survival after transplantation. 19 patients are identified having received liver transplantation after treatment for sarcoma of the liver, 6 patients with primary hepatic sarcoma and 13 patients with metastatic sarcoma of the liver. Recurrence was almost universal in 18 of 19 patients (95%) after a median interval of 6 months. Survival for the group as a whole was 47% for 1-year, 15% for 3-years and 5% for 5-years. Given the early recurrence of tumor and meager 1-year survival outcome, liver transplantation is a poor therapeutic choice for patients with either primary or metastatic liver sarcoma, including high-grade leiomyosarcoma (GIST) regardless of primary site or primary therapy.

Adult↗
PubMed2003

[The artificial hand. An overview of hand prostheses].

In spite of constant demands made by patients for optimal reconstruction of the hand in cases of injury or amputation, prosthetic devices allow only basic functions of the hand. The most important function, i.e., to connect sensitive-tactile abilities of the hand with the eye and central nervous system, has not yet been achieved and will not be feasible in the near future. There have been numerous attempts to reconstruct single hand functions such as subtle finger control in all known directions etc. Until now none of these attempts have led to any serial production of a functional "tool" because the interface between prosthesis and CNS has not been sufficiently resolved. Minute finger control requires considerable mechanical engineering that includes an efficient motor drive and an adequate power supply,which renders possible prototypes for hand prostheses heavy and complicated in everyday performance. This survey offers a short and comprehensive introduction to high-performance but simple "down-to-earth" orthotic and prosthetic devices for the replacement of lost forearm,hand, and finger function.

Amputation, Traumatic↗
PubMed2000

[2- and 3-dimensional correction of scoliosis by corset treatment. Optimized conservative therapy of idiopathic scoliosis with the improved Cheneau corset].

It is generally accepted that the progression of an idiopathic scoliotic deformity with a Cobb angle of between 25 degrees and 40 degrees can be stopped by brace treatment alone provided that the generally acknowledged criteria for the treatment concerning skeletal growth of the individual are respected. In Europe, the Cheneau brace, which was originally designed as an active derotation orthosis, is widely in use and is constantly being improved. The biomechanical principle of this orthosis consists of a pressure vector that is applied laterally (with regard to the 3-point principle) to exert pressure on the peak of the curvature in the frontal and transversal planes. Thus, the thoracic, lumbar and pelvic body mass that was rotated out of normal body symmetry is transferred back to its original position via pressure and derotation. Therefore, an active back like the Cheneau orthosis must provide pressure surfaces and sufficient expansion spaces. Subtle insights into the actual effect of braces have furthered ongoing development to take into consideration the changes to the trunk in the sagittal plain and have respected the different states of expansion of the two halves of the trunk in the craniocaudal direction. The thoracic flat back and cyphosis of the lumbal spine, which were formerly ignored, actually provide a real challenge for the technical realization of the brace. The new generation of Cheneau braces potentially provides an effective means for the active correction of scoliotic spinal deformity in all three dimensions and thus fulfills the requirements of modern conservative scoliosis treatment.

Adolescent↗
PubMed1999

Braces do not reduce loads on internal spinal fixation devices.

OBJECTIVE: To determine the effect of a brace or harness on loads on internal spinal fixation devices. DESIGN: The implant loads were measured in vivo using telemeterized internal spinal fixators. BACKGROUND: Only limited information exists regarding the load reduction due to a brace or harness. METHODS: A Boston overlap brace, a reclination brace, and a lumbotrain harness were examined to determine how they affect the loads on internal spinal fixation devices. The implant loads were measured using telemeterized fixators in six patients for several positions and activities, including sitting, standing, walking, bending forward, and lifting an extended leg in a supine position. RESULTS: None of the braces studied were able to markedly reduce the loads on the fixators. Frequently even higher fixator loads were measured when wearing a brace or harness. CONCLUSIONS: It does not seem helpful to brace patients after mono- or bisegmental stabilization of the lumbar spine.

Adult↗
PubMed1998

Suspected biliary complications after laparoscopic and open cholecystectomy leading to endoscopic cholangiography: a retrospective comparison.

To study how suspected postoperative biliary complications are influenced by surgical technique, we compared clinical profiles of 63 patients referred for ERCP after open (OC) and laparoscopic cholecystectomy (LC) over a four-year period. ERCP was not performed for postoperative pain alone and only six (9.5%) studies were normal. Referrals after LC were younger (mean 39.1 vs 53.6 years, P < 0.001) and ERCP was requested earlier (mean 71.6 vs 2360 days, P < 0.001) in the postoperative course. Choledocholithiasis (CDL) alone, the most common finding, was successfully managed with a single ERCP in 97.2% of cases. CDL after LC occurred in younger patients (35.5 vs 58.9 years, P < 0.01) who presented earlier (mean 98.6 days vs 5.1 years, P < 0.01), without biliary ductal dilatation (P < 0.01). Although CDL after LC was associated with higher ALT and bilirubin levels than after OC, the difference was not statistically significant. Cystic duct leaks (LC: six patients, OC: four patients) were typically associated with CDL after OC and 90% resolved with endoscopic therapy. Biliary ligation (four cases) was managed successfully with choledochojejunostomy. We conclude that findings at ERCP for suspected biliary obstruction or injury after OC or LC are similar and usually can be endoscopically managed. After LC, referrals currently are younger, present much earlier, and retained stones are less likely to be associated with ductal dilatation than after OC.

Adult↗
PubMed1996

Helicobacter pylori: current concepts.

Although first described almost a century ago, only in the last 15 years has Helicobacter pylori been characterized and associations with disease states recognized. H pylori has been linked to both gastritis and peptic ulcer disease. There is also evidence for a relationship with non-Hodgkin's lymphoma, mucosa-associated lymphoid tissue lymphoma, and perhaps even adenocarcinoma of the stomach. There is currently insufficient evidence to link H pylori to nonulcer dyspepsia. Current recommendations are to treat all patients with gastric or duodenal ulcers who test positive for H pylori, as therapy will significantly reduce the recurrence rate of these conditions.

Anti-Bacterial Agents↗
PubMed1992

Results of surgical procedures for the correction of foot-drop and of lagophthalmus due to leprosy.

Leprosy mutilations of the muscles and skeleton can be relieved by reconstructive surgery, but evaluation of the results of these operations is seldom undertaken. Between 1975 and 1984, 59 leprosy patients were operated on at the Marie Adelaide Leprosy Centre, Karachi, Pakistan, for lagophthalmus with the transposition of the posterior tibial muscle. We were able to re-examine 39 patients: tibialis posterior transposition was performed 25 times, and temporalis transposition was carried out 33 times; 18 of the 25 patients with the tibialis posterior transposition were pleased with the result, 7 were not: 21 patients could extend their feet above the neutral position; 24 of the patients with the temporalis transposition were satisfied, 9 were not: complete closure was demonstrated in 21 eyes; Persistent corneal damage was noted in 15 eyes; 12 of the 23 male patients cared for themselves, 16 lived with their families; 7 of the 8 female patients lived with their families. The results of the rehabilitation, in relation to the degree of mutilation, are considered satisfactory for a developing country. These surgical procedures give a good result, provided they are followed by intensive physiotherapy.

Adult↗
PubMed1989

[Prosthetic management of amputees].

The prosthesis of a lower limb amputee usually consists of a socket custom made out of wood, glass fiber, reinforced resin or other plastic material. This is also true for modern flexible sockets. Individually selected components depending on the amputee's level of activities, such as hip, knee and ankle joints, torsion adapter and different prosthetic feet, are produced by the orthopaedic industries. Function, however, depends significantly on the quality of the stump-created by the surgeon. Even a skilled prosthetist cannot improve the stump.

Amputation, Surgical↗
PubMed1986

[Amputations of the child's foot].

Various partial foot amputations are described in detail, ranging from incomplete or total loss of one or several toes, transverse or longitudinal metatarsal amputation, proper performance of the Lisfranc's amputation (tarsometatarsal disarticulation) to Chopart's tenomyoplastic procedure, a modification of Pirogoff's procedure and an improved form of Syme's amputation (preserving most of the cartilage for better weight-bearing). Appropriate orthopedic footwear and prostheses compensating for the amputated parts of the foot and optimizing the remaining function are also presented. In most incidences, satisfying results can be achieved, especially in children. These consist of total weight-bearing of the stump, combined with minor disability from the functional point of view and an almost invisible handicap with regard to daily activities.

Amputation, Surgical↗
PubMed1985

Determination of the central effects of the asthma prophylactic ketotifen, the bronchodilator theophylline, and both in combination: an application of quantitative electroencephalography to the study of drug interactions.

Ketotifen (Zaditen) is a new, orally active benzocycloheptathiophene derivative for use in the prophylaxis of asthma. Besides possessing anti-allergic properties, it also has H1-receptor mediated antihistaminic activity. Drugs which block H1-receptors are known to have some sedative properties. On the other hand the bronchodilator theophylline is a CNS stimulant. We investigated whether these side-effects could be reduced by concomitant administration. In a balanced-sequence crossover study, 12 healthy males received placebo, 1 mg ketotifen + 300 mg theophylline, 1 mg ketotifen + 600 mg theophylline, and each drug separately at 1-week intervals. Quantified electroencephalograms, cardiovascular and behavioral measurements, symptom reports, and blood drug assays were used to assess the drug interaction. Results showed EEG and behavioral effects with both ketotifen and theophylline alone which were less evident with the drugs in combination. Blood drug levels were not altered by combined drug administration. These findings suggest a mutual attenuation of the CNS effects of ketotifen and theophylline at therapeutic doses and encourage their combined use in asthma therapy. The combined effect may be optimized by modifying formulations or timing. The applicability of quantitative EEG to such problems is well demonstrated.

Adult↗
PubMed1984

Pharmaco-EEG studies with fluperlapine.

In the first of 2 studies, the effects of 3-fluoro-6-(4-methyl-piperazinyl)- 11H -dibenz[b,e]azepine ( fluperlapine , NB 106-689) 5 and 10 mg, clozapine 5 and 10 mg, and placebo on the EEG and on subjective mental and emotional state were investigated in 8 healthy male volunteers. The study was carried out as a double-blind within-subject comparison, with randomized sequence of treatments. Quantitative spectral analysis of the EEG revealed that changes after fluperlapine were strikingly similar to those after clozapine, i.e. an increase in delta and theta and a decrease in alpha activity. These changes were associated with a reduction in self-rated "wakefulness" and are evidence of a sedative effect. The drugs' effects differed only in the magnitude of the increase in beta activity in the 20-40 cps frequency band (beta 2), which was greater after fluperlapine than after clozapine. Since increased beta 2 activity has been reported with tricyclic antidepressants, it is suggested that fluperlapine , besides possessing neuroleptic properties, might also have some properties of a (sedative) antidepressants. It is estimated from the EEG findings that, at equal doses, fluperlapine (capsules) has approximately one half of the sedative potency of clozapine (tablets). A second study in schizophrenic patients revealed strong correlations between EEG effects and blood levels of unchanged fluperlapine during long-term treatment.

Adult↗
PubMed1983

Pharmaco-EEG and Psychometric study of the effect of single doses of temazepam and nitrazepam.

A double-blind, daytime, placebo-controlled study was carried out in 12 healthy volunteers to investigate the effects of single doses of 5, 15 and 30 mg temazepam and of 5 and 10 mg nitrazepam on the EEG, psychomotor performance, subjective mental and emotional status, blood pressure and heart rate. Each subject received all 6 treatments in a random sequence at intervals of 1 week. The EEG tracings were evaluated quantitatively by spectral analysis. Psychomotor performance was assessed by means of the tapping test. Subjective mental and emotional status were assessed using the Bond and Lader analogue self-rating scale. Procedures were carried out before and at 1/2, 1, 2, 4, 6, 7, 8 and 9 h after drug administration, with the exception of the tapping test, which was carried out before and, again, after 2 and 7 h. EEG estimates of equipotency, based on magnitude of peak effect, were as follows: 15 mg temazepam approximately 5 mg nitrazepam; and 30 mg temazepam greater than or equal to 10 mg nitrazepam. At these approximately equipotent doses, temazepam had a somewhat earlier onset of action on the EEG, a clearly shorter duration of EEG action, and lesser impairment of psychomotor performance than nitrazepam. Qualitatively, both drugs had similar effects on the subjective mental and emotional states of the subjects. There were no clinically relevant changes in mean or individual sitting and standing blood pressure values. After temazepam, but not after nitrazepam, heart rate increased (maximal mean change 10 bpm) as part of a normal startle response to arousal. The results suggest that temazepam has less hangover potential than nitrazepam.

Adult↗
PubMed1983

Confirmatory and exploratory analysis applied to pharmaco-EEG and related study data: contradiction or useful enrichment?

Besides hypothesis testing, which should be done as sparingly as possible, the measured or observed data should be described as extensively as possible. The traditional reliance on profiles of the mean responses may neglect useful information, and such profiles may also be misleading. With the aid of exploratory data analysis, different aspects of the structure of a data set can be considered. 'Data snooping' may discover coherences, non-trivial structures and peculiarities, which lead to a new hypothesis or to new mathematical-statistical models. It is, in our opinion, a necessity to consider exploratory and confirmatory data analyses in conjunction. This will be illustrated by examples taken from pharmaco-EEG studies.

Aged↗
PubMed1981

[Extension according to Matev in malformations of the hands (author's transl)].

Step-by-step distraction of the metacarpal I according to Matev in traumatic loss of the thumb is demonstrated in a modified form with interposition of a corticospongious bone chip. Subsequently, the article reports on the use of this method in congenital malformations of the hand on the basis of three different examples.--Firstly, monodactyly with extension of a second metacarpal as passive counter-support,--Secondly, symbrachydactyly with rudimentary metacarpal rests I to V with extension of I and then of III and IV, followed by subtotal resection of the second metacarpal stump and phalangisation, and--Thirdly, bilateral severe malformation of the hand through amniotic segmentations and exogenous syndactylies with extension of metacarpal I, ligamental transposition and commissural deepening. The results show that--provided indication is strict on account of the almost always satisfactory substitute grasping actions in congenital malformations of the hand--an effective improvement of the grasping function can be achieved in selected individual cases by means of Matev's method.

Adolescent↗
PubMed1979

[Apophyseolysis, evulsion fractures and osteochondropathy of the anterior inferior iliac spine (author's transl)].

Evulsion fractures of the anterior inferior iliac spine in adults usually are the result of sudden contraction of the rectus femoris muscle during sporting activities, particularly football. In children, before fusion of the apophysis, there may be an apophyseolysis. This may result in a chondropathy because of abnormal development of the frequently multiple ossification centres. In contrast to the relatively frequent evulsion fractures of the anterior superior iliac spine, such an event is very rare in the anterior inferior iliac spine. Three illustrative cases are described showing the typical combination of history, localisation, pain recurrence during exercise and x-ray changes, which usually consist of a curved osseous structure separate from the iliac bone. These findings permit a correct diagnosis.

Adolescent↗