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Biomedical subjects

H Breuninger

Publications and source records attributed to H Breuninger.

At least 91 records · Page 5Linked to original sources
PubMed1988

Control of excisional margins by conventional histopathological techniques in the treatment of skin tumours. An alternative to Mohs' technique.

For histological control of excisional margins, routinely fixed tumour specimens or, under certain conditions, specimens fixed immediately in warm formalin are processed in the histology laboratory. Strips are then cut from the undersurface, edge, and cross-section of the remainder of the specimen and processed further by routine paraffin techniques until H&E-stained sections of the entire periphery and mid-section are available. We suggest that the method is simple, easy to apply, and suitable for the assessment of excisional margins of a variety of skin tumours. Extremely low recurrence rates over a relatively long follow-up period substantiate the effectiveness of the method.

Bowen's Disease↗
PubMed1988

[Wound dressings].

The wide variety of dermatologic surgical procedures has resulted in a corresponding choice of wound dressings. Considering the chemical and physical properties as well as the function of the dressings, standardized dressing techniques can be performed with relatively few materials. This saves both time and money.

Bandages↗
PubMed1988

[Resorbable suture material in the human skin: tissue reaction and modified suture technic].

Two-stage excision of skin tumors provided an opportunity for histological evaluation of implanted PDS or Vicryl suture material. Our findings showed a weak or absent tissue response to PDS sutures that was detectable for up to 100 days and a moderately pronounced tissue response to Vicryl that, in rare cases, was evident for up to 80 days. The tissue response to both materials depended on the depth of the implanted suture material. A persistent inflammatory reaction was provoked particularly by Vicryl, a polyfilament suture, when it was embedded near the skin surface. Contact between parts of the suture and the skin surface, which is encouraged by the wick effect of the Vicryl suture, frequently led to suture infection. To avoid infections it is important to place the knot of the stich below the dermis, since the suture ends of the knot decrease the surface-suture distance. A more-or-less horizontal, butterfly-shaped interrupted suture that extends upward is recommended to ensure secure placement of the knot at the lower border of the corium.

Foreign-Body Reaction↗
PubMed1988

[Determining the prognosis of spinocellular cancer of the skin and lower lip based on the TNM system and additional parameters].

Using the TNM classification established by the UICC, 427 squamous cell carcinomas of the skin and lower lip were classified as belonging to the T class. Additional histometric, histologic, and clinical tumor parameters were also recorded. Prognostic relevance was checked by comparing the overall data with those for metastatic tumors. The results showed that the overall metastasis rate was low (carcinoma of skin: 3.5%; carcinoma of lower lip: 2.7%; mean follow-up period: 5 years). Moreover, the prognoses based on the tumor diameter classes in the TNM system were not specific. Earlier findings tend to indicate that tumor thickness, depth of infiltration, and grade of malignancy should also be taken into consideration if the prognosis is to be estimated accurately. If the level and tumor thickness are taken into consideration, a large group of tumors (50%) can be separated: these tumors do not metastasize, even though they are at least 2 mm thick, and they do not infiltrate the subcutaneous tissue (no risk group).

Aged↗
PubMed1987

[Various aspects of the surgical therapy of cancer of the lower lip].

A safety distance of 1 cm from the excision margin as well as, frequently, removal of the regional cervical lymph nodes are usually recommended to ensure radical excision of carcinomas of the lower lip. Investigations on 32 such carcinomas revealed that a safety distance of 3-5 mm is sufficient, if the edge of the excised tissue is histologically controlled. 109 carcinomas of the lower lip were re-examined in order to settle the question of prophylactic dissection of the lymph nodes. The low metastasis rate of 1.8% suggests that prophylactic dissection of the lymph nodes is not necessary in these patients. However, 95% of all tumors classified as T1 according to the current T-classification by the IUAC for carcinomas of the lower lip occurred in this group of patients.

Carcinoma, Squamous Cell↗
PubMed1987

[Problems and planning of excision of large basaliomas].

At the excision of 1083 basal cell carcinomas, the clinically detectable diameters and the safe margins along the tumor border were calculated. The excision edges were histologically controlled. 115 of the 1083 tumors showed diameters exceeding 20 mm. The frequency of excisions with negative or positive edges corresponded to the safe margin and depth of the incision. Our results showed that even for large tumors a safe margin of more than 5 mm is seldom appropriate. The excision should always include the subcutaneous tissue as well as the underlying tissue, if the site of the lesion permits it. The excised edges should be histologically controlled with regard to radical excision. Our findings are illustrated by an exemplary case.

Basal Cell Carcinoma↗
PubMed1987

[Method of histological control of the edges of surgical specimens of basal cell epitheliomas].

For histologic control of excisional margins, routinely fixed tumor specimens or under certain conditions, specimens fixed immediately in warm formalin are processed in the histology laboratory. Strips are then cut from the undersurface, edge and cross section of the specimen and processed further by routine paraffin techniques until HE-stained sections of the entire periphery and midsection are available. The average follow-up time was of 4 years with a recurrence rate of 0.4 per cent.

Basal Cell Carcinoma↗
PubMed1985

[Use of absorbable suture material in dermatologic surgery].

Absorbable synthetic suture material (Vicryl, PDS) alone was used for wound closure in 1860 surgical interventions on the skin. The PDS suture is totally inert in intracutaneous tissue, and proved superior to the Vicryl suture. In combination, PDS sutures can also be used intracutaneously as well as conventionally. Additional advantages of absorbable material are the possibility of meandering and everted stitches in continuous intracutaneous sutures, no need for removal in most cases, and avoidance of intracutaneous scar dehiscences because of the good durability of the suture material.

Adult↗
PubMed1985

[Combined use of the dermatome and high-speed fraise in the treatment of a generalized verrucous nevus (Jadassohn)].

Since her birth, a 24-year-old woman had suffered from an extensive epidermal verrucous nevus on her left trunk. Because of its severe disfigurement and resulting negative psychosocial impact, the nevus was first removed in 1980 by means of a high-speed fraise; the cosmetic results, however, were not altogether satisfactory. Excision was attempted again in 1983 using both dermatome and high-speed fraise; this time, the cosmetic outcome was excellent.

Adult↗
PubMed1984

[Surgical treatment of basaliomas with calculated safety margin and control of the histologic borders. Experiences with 355 tumors].

An integrated concept for the surgical treatment of basal cell carcinoma is presented, which is based on individually calculated safety margins and modified microscopically controlled surgery. The individual calculation of the safety margin assumes there is a relationship between the clinically visible tumor diameter and subclinical infiltration; the calculation of the safety margin therefore is based on the size of the clinically visible portion of the basal cell carcinoma. Detection of subclinical infiltration and exclusion of the possibility of subtotal excision are ensured by routine histological control of the margins of the excised specimen. The surgical treatment of basal cell carcinoma presented in this study is considerably less time-consuming than other forms of microscopically controlled surgery. No recurrences have been observed after radical excision of basal cell carcinomas with this method.

Basal Cell Carcinoma↗
PubMed1983

[Sense and nonsense in the use of eardrops].

Current knowledge concerning the use of eardrops is discussed under clinical and pharmacological aspects. The pharmacokinetics of eardrops is also reviewed. Because of the cost explosion the prices of various eardrops are compared.

Administration, Topical↗
PubMed1982

[Rehabilitation after laryngectomy].

Comparing laryngectomized patients with deaf persons whose disablement in terms of German law is approximately of the same degree, the former seem to be better off in respect of communication due to the availability of better substitute aids. The first step in any rehabilitation-programme is comprehensive information and instruction of the patient, his family and also of his employer by the surgeon, the speech therapist and if necessary by a social worker. Speech rehabilitation may be the most important aspect of such a programme, but reintegration into the family and professional rehabilitation but also not be neglected. The patient should be given an official invalid status without delay to protect him against unwarranted dismissal, and, after having discussed other and minor problems, a timetable to teach him the oesophageal speech is set up; in this regard, we prefer the aspiration method. The patient is informed about oesophageal speech and the use of electronic devices in speech rehabilitation and also about a neoglottis voice. The article demonstrates the character of the resulting "substitute" voice by means of sonagraphic pictorial representations; this also comprises an assessment of the quality of the voice by neutral observers. The problems arising with a neoglottis due to the communication of oesophageal and respiratory tract are discussed and compared with those with oesophageal speech where the voice-forming system and the respiratory system are kept completely separate. Taking the great range of the various situations into consideration, the physical and emotional status and the course of acquiring oesophageal speech are described. The results are partly contradictory to earlier publications. The importance of teamwork in the care of these patients is emphasized.

Communication Devices for People with Disabilities↗
PubMed1982

[Audiometric findings in legasthenics (author's transl)].

The audiological findings in 150 legasthenics are discussed and a review of the literature is given. The E.R.A. and Feldmann's dichotic test did not reveal any characteristic changes in our patients. However, a binaural audiovisual test using normal and synthesized stammered words alternatively showed a statistically significant impairment in recognizing the presented material in legasthenics compared to less gifted individuals of the same age. The results in normal children varied according to age. It might therefore be possible to diagnose legasthenics with this test in combination with an intelligence test in pre-school age.

Audiometry↗
PubMed1982

[Biochemical analysis of free amino acids in human parotid secretions (author's transl)].

Parotid secretion was obtained under standardized conditions from 17 male students by stimulation with citric acid. The average flow rate was 0.65 ml/min. The free amino acids in these samples were determined with the aid of two-dimensional thin layer microchromatography of the dansyl derivatives and TV densitometric determination of the blackening of photographic negatives. Apart from glutamic acid, only amino acids with nonpolar residues such as glycine, alanine, leucine, isoleucine, phenylalanine and proline occurred in all 17 samples. The mean values of the concentrations lay between 0.2 mumol/l for isoleucine and 1.2 mumol/l for proline. There were great interindividual variations. (SD between 40% ad 110%). In the present range of 0.3 to 1.1 ml/min, no dependence of the concentrations on the flow rate could be demonstrated. It was attempted to draw up a standard profile by elimination of greatly deviating samples.

Amino Acids↗