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Biomedical subjects

H Busse

Publications and source records attributed to H Busse.

At least 55 records · Page 3Linked to original sources

[Detailed results of orbital and optic nerve decompression].

Orbital complications of various pathogenesis include impairment or loss of vision inhibition of globe motility and exophthalmos, and are treated best by an interdisciplinary team. Preoperative strategy should include information about underlying diseases, since success of treatment is related to diagnosis. To analyse our postoperative results we examined four groups of cases: injuries, tumors, infections and mucoceles. Diseases were located in the orbit or paranasal sinuses and produced similar symptoms. But prognosis and results of surgical treatment produced significant differences. The best improvement in vision was seen after treatment of inflammatory processes or after post-traumatic optic nerve decompression. An 88% improvement in globe motility and diplopia was seen in patients undergoing treatment for mucoceles, while a 95% improvement was found following transethmoidal surgery for inflammations of the paranasal sinuses. Overall results represent current trends for indications for surgical techniques employed to treat orbital and paranasal sinus disease.

Exophthalmos↗

[Syngeneic transplantation of nasal mucosa and azathioprine medication for therapy of cicatricial ocular mucous membrane pemphigoid. Study of 9 patients with 11 eyes].

Nine patients (11 eyes) with ocular cicatricial pemphigoid were treated with systemic azathioprine and a syngeneic nasal mucosa transplant from the inferior turbinate. Follow-up was 8-26 months (average 15 months). Grafting was successful in all cases. Treatment ameliorated the symptoms of pain in all patients and double vision in one. In 2 eyes in which simultaneous pannus resection had been performed, neither pannus nor corneal vascularization recurred. Late complications were recurrences with symblephara in two cases when azathioprine was stopped; in one patient with a serpiginous ulcer tectonic penetrating keratoplasty à chaud had to be performed; and in another a trophic ulcer was healed with a therapeutic contact lens.

Aged↗

[Distribution of the frequency of various Mendelian modes of inheritance in families with retinopathia pigmentosa. Results of an evaluation of the RP register of the Munster University Ophthalmology Clinic].

International studies on the relative distribution of various genetic types of retinitis pigmentosa (RP) have revealed major regional differences, especially for x-recessive (1-24%) and autosomal dominant inheritance (3-39%). At present there are no data available concerning the population genetics of RP in Germany. We performed a study on the clinical findings and genetic classification of patients with tapetoretinal dystrophies based on a population of 702 German patients examined in our hospital between 1977 and 1990. Data were eligible on 603 of these patients for the standardized final study protocol. 78% (n = 473/603) of the study group patients were classified as typical non-syndrome RP cases. Second was Usher's syndrome (9.5% of all patients) and third choroideremia (2.3% of all patients). In 250 of the enrolled families with RP the reconstruction of pedigrees was sufficiently complete for a definite genetic characterization. The relative incidence of families with the different patterns of inheritance was: (1) single cases: 48.4%; (2) autosomal dominant: 25.2%; (3) autosomal recessive: 16.4%; (4) x-linked recessive: 10.0%.

Adolescent↗

[Retinopathia praematurorum: risks and critical timing].

Two prospective studies were performed to characterize the retinopathy of prematurity (ROP) risk in preterms further. In the first study the gradual relationship between birth weight, gestational age and duration of oxygen therapy and the incidence of ROP was evaluated. A total of 487 preterms were enrolled in this survey. Seventeen percent (67 babies) of 389 surviving children presented clinical signs of acute ROP. Among the analyzed risk factors "gestational" age provided the best correlation with the manifestation of acute ROP. According to the nonlinear regression model the risk of acute ROP can approximately be calculated as: R = 2(39-SSW).0.5 (R = relative risk of ROP in %). The second study focused on the relationship between individual risk factors and the age at stage III onset. The mean age of the first ROP stage III diagnosis was 66 days after birth at an average gestational age (post-menstrual age) of 37.0 weeks. Multifactorial analysis clearly demonstrated that birth weight was most informative among the tested set of parameters concerning the age at onset of ROP stage III. Best fitted linear regression of this relation was: LAT = 100-BW.34 (LAT = age at onset of ROP III expressed as postnatal days; BW birthweight measured in kg). It is suggested to take this approximation into account for the timing of ROP screening.

Birth Weight↗

[Dacryocystorhinostomia externa. Technique, indications and results].

In a retrospective study on the years 1978-1989, the data we obtained on 1014 operative procedures of external dacryocystorhinostomy at the University Eye Hospital in Münster showed an age distribution of 2-93 years with a maximum in the 5th to the 7th decade (average 53.2 years) and a sex relationship of 61% females and 39% males. In the etiology of dacryostenosis, 60% of the patients had recurrent chronic dacryocystitis, 32% history of acute dacryocystitis, 7% facial trauma and less than 1% of the cases (n = 5) tumor diseases. The functional success rate was 85% in a postoperative follow-up period of 1-11 years (average 35.6 months). No serious intra- or postoperative complications were seen.

Adolescent↗

[Visual acuity and automobile driving fitness in the elderly].

BASIC REMARKS: Both physiological age-related degeneration of the organ of sight and its adnexa, and pathological age-related diseases, such as cataract, glaucoma or senile macula degeneration, impair a person's eyesight. MAJOR POINTS DISCUSSED: The consequences include a decrease in visual acuity, impairment of the visual field, diminishment of dark adaptation, twilight vision, contrast perception, and stereoscopic vision, together with a dramatic increase in sensitivity to light. All these phenomena may greatly reduce the elderly person's ability to cope with the demands made by modern traffic. Our investigations do, however, indicate that in parallel with increasing life expectancy, the physiological and pathological age-related changes in the organ of sight may be occurring later than formerly. Moreover, modern surgical techniques, for example senile cataract with implantation of an intraocular lens, may achieve optical rehabilitation. CONCLUSION: Active participation of the elderly in road traffic, for example driving a car, is certainly possible from the point of view of the ophthalmologist. Nevertheless, the introduction of regular testing of vision from the age of 65 onwards is to be recommended.

Accidents, Traffic↗

Ocular findings in Walker-Warburg syndrome.

Ocular symptoms are frequently observed in Walker-Warburg (WWS) and associated syndromes. The majority of patients present with malformations of the anterior segment and severe retinal dysplasia. We report on the findings in a female patient with WWS who died at the age of 9 months. Major ocular findings were: severe iridocorneal malformation, a membrane-like structure of the lens and funnel-shaped retinal dysplasia. The retina presented various grades of differentiation with rosettes and atypical sequences of cells, e.g. ganglion cells intermingled between granular layers. The anterior part of the retina presented as a primitive homogeneous layer with a cell-free space that might be interpreted as the primary optic ventricle. This finding suggests that we are dealing with a primary dysplastic non-attachment rather than a real detachment of the retina in WWS. The malformation of the anterior segment was not typical of the Peters' anomaly, as usually described in WWS, but of Rieger's syndrome.

Abnormalities, Multiple↗

[Clinical use of the excimer laser in treatment of surface corneal opacities--therapeutic strategy and case reports].

BACKGROUND: The authors report on the Phototherapeutic 193nm-Excimer Laser Keratectomy (PTK) for the treatment of superficial corneal opacities. MATERIAL AND METHOD: In two cases with corneal opacities after contact lens wearing and after therapy resistant keratoconjunctivitis epidemica respectively the treatment strategy is presented. The epithelium and the corneal opacities are removed mechanically as far as possible. Then the Excimer laser smoothing with masking fluids of different viscosity is performed. RESULTS: In both patients the visual acuity improved from 1/50 and 0.16 respectively to 0.7. Both eyes had an hyperopic shift. The patients were without pain within a follow-up period of 8 months after treatment. CONCLUSION: The phototherapeutical use of the 193nm Excimer laser to treat superficial corneal opacities can be regarded as a real alternative to conventional surgical techniques.

Adult↗

[Optical rehabilitation by tectonic anterior segment reconstruction].

BACKGROUND: The potential benefits of anterior segment surgery to achieve visual rehabilitation in severely compromised eyes subsequent to infectious complications in the anterior segment remain a subject of controversy. PATIENTS AND METHODS: Anterior segment reconstructive surgery was performed on twelve patients (12 eyes) with infectious adherent leukoma and extensively damaged intraocular structures. Nine patients (nine eyes) were followed up over a period of two years (20-26 months) and three over a period of nine months (8-11 months). RESULTS: Simultaneous and consecutive surgical interventions including corneal grafting, anterior chamber reconstruction and posterior chamber lens implantation combined with antimicrobial and antiviral prophylaxis as well as corticosteroid treatment resulted in visual recovery in nine eyes, and in four in a visual acuity of 0.4 or better (reading VA). CONCLUSIONS: Surgery for optic reasons due to infectious adherent leukoma does not seem to be completely unsuccessful with respect to the low complication rate despite proven retrocorneal membranes in this study.

Adult↗

Coxsackievirus B3-associated panuveitis.

A 29-year-old woman suffered from headaches, diarrhoea, and high grade fever followed by a unilateral retinal vasculitis, papillitis, and chorioretinitis. Abnormal electrocardiographic findings and antibody titre dynamics strongly suggested a coxsackievirus B3 infection. With respect to prior observations on coxsackievirus B group associated uveitis this viral infection may be considered in patients with well defined extraocular manifestations and uveitis.

Adult↗

Neopterin in patients with choroidal melanoma.

Neopterin excretion in urine and the serum concentrations of neopterin were compared in 101 patients with a malignant melanoma of the choroid and in a matched group of healthy volunteers. The majority of cases (n = 99) presented an untreated (n = 20) or treated and either partially (n = 33) or completely regressed (n = 47) melanoma of stage I-III without signs of extraocular manifestation at the time of analyses. The incidence of elevated neopterin concentrations in all melanoma patients beyond the upper limit (mean + 2 S.D. of healthy controls) was 16% for both serum and urine. In patients with critical events, for example orbital infiltration or delayed metastatic disease during the subsequent follow-up period (at least 14 months), the neopterin concentrations were at the higher end of distribution. One patient with verified metastatic disease at the time of analysis presented extremely elevated neopterin concentrations in serum (82.3 nmol/l) and urine (1608 mumol/mol creatinine). It seems that the results of neopterin analyses are informative as a prognostic factor for the follow-up of patients with a malignant melanoma of the choroid.

Aged↗

[Recurrent canaliculitis and dacryocystitis as a sequela of persistent infection with Chlamydia trachomatis].

We report on 4 patients aged 39-62 years with follicular conjunctivitis, canaliculitis, canalicular obstruction, dacryocystitis and nasolacrimal duct obstruction caused by chronic oculogenital infection with Chlamydia trachomatis. Microbiological diagnosis was accomplished by means of the McCoy cell culture technique as a highly specific tool for detection of the chlamydial infection. In addition, serological tests (IgA-IPA and IgG-IPA techniques) were performed. Bacteriological examination of conjunctival smears showed coinfection in 3 patients (Proteus mirabilis in 1, Staphylococcus aureus coagulase-positive in 3). Despite successful operation techniques, the obstructive inflammation caused by oculogenital chlamydial infection could only be cured by systemic treatment with specific antibiotics, such as doxycycline or erythromycin. All cases of chronic follicular conjunctivitis with lacrimal inflammation that are resistant to topical antibiotics should suggest the possibility of infection with Chlamydia trachomatis.

Adult↗

'ValleyScan': a new two-bond drive technique for the calculation of potential energy surfaces with less computational effort.

A novel, CPU-time inexpensive two-bond drive technique, called 'ValleyScan' [1], is described. It makes it possible to omit the chemically nonrelevant points of high energy, which are normally part of a two-dimensional (2D) grid calculation. The new procedure works well for the calculation of the ring inversion of cyclic molecules, but should also be useful for other 'two-bond' problems e.g. side-chain movements in larger molecules (e.g. proteins). The algorithm is based upon pseudocode description and can easily be included in any molecular modelling software with an open user interface. Starting from an energy minimum, the calculation scans the potential surface in all directions up to a user-defined energy limit. With this strategy, attention is paid only to the area close to the stationary points - energetically higher structures do not have to be calculated. We applied the procedure to the test molecules 1,3-cyclohexadiene (4), 2H-pyran (5) and 6H-dibenzo[b,d]pyran (6). The extension of this method to the variation of more than two dihedral angles for more complex problems, e.g. sterically more hindered rotation, is in progress.

Chemistry, Organic↗

[Qualitative analysis of the elasticity of the bovine cornea by holographic interferometry].

Double-exposure holographic interferometry is used for deformation analysis of the surface of bovine corneas subjected to intraocular pressure increase. Reproducible individual fringe patterns are recorded for an intraocular pressure of 1340 Pa and subsequent pressure changes of 20, 40 and 80 Pa, respectively. These interference fringes characterize loci of equal displacement. In spite of interindividual variations of the central fringe pattern some basic types can be differentiated: round, oval, drop-like, double-centers, symmetrical as well as unsymmetrical and irregular forms. The peripheral fringe patterns of the cornea can be described by 3 basic types, even taking into account individual variations: circular, circular with an irregular component and irregular. The precision of the method allows to visualize minute local elasticity differences. Results of these investigations do not support the assumption, that the center of the cornea has a higher elasticity than peripheral regions in general. These elasticity differences between central and peripheral areas vary between individual corneas for small intraocular pressure changes at a basic pressure of ca. 10 mm Hg (1340 Pa).

Animals↗

[Unilateral chronic granulomatous blepharitis as a leading symptom of Oriental cutaneous leishmaniasis in Germany. Giesma stain as rapid diagnosis and initial description of systemic therapy with gamma-interferon].

Nine months after leaving the Lebanon, a four-year-old immigrant boy presented with a 5 months history of blepharitis. The lesion remained therapy-resistant for aminoglycoside antibiotics. Six months later, the patient presented with an indolent granulomatous necrotizing purulent blepharitis and follicular conjunctivitis. Diagnosis was made by Giemsa stain and histopathology, which revealed amastigotes in macrophages consistent with the diagnosis of oriental cutaneous leishmaniasis. Therapy with systemic recombinant gamma Interferon, which is described for the first time in this disease entity, resulted in a successful primary healing of the cutaneous lesion. Self-healing epithelial keratitis was the only side-effect observed. Ophthalmologists in Germany should be aware of the differential diagnosis of oriental cutaneous Leishmaniasis in patients suffering from chronic granulomatous lid lesions of patients from countries endemic/epidemic for Leishmaniasis. Laboratory diagnosis is simple. Insights into the immunology of infection have made possible novel therapeutic avenues using gamma-Interferon being effective without serve side-effects and allowing for a good primary healing of the cutaneous lesions.

Biopsy↗

[Choroid ganglioneuroma in childhood].

The authors report on a case of a 4 1/2-year-old male child, who was referred because of a convergent microstrabisms of the right eye combined with amblyopia and minimal anisometropia and progressive decrease of the visual function from 0.6 to 0.05 although occlussion-therapy was performed. Funduscopy showed a melanoma-like choroidal tumor temporal-inferior of the macula with shallow retinal detachment and severe cellular vitreal infiltration. Because of the progression the tumor was resected by the transscleral technique of Foulds (1983). Histology showed a ganglioneuroma of the choroid, which has not been reported in this localisation up to now. Usually it is found in the retroperitoneal area and in the mediastinum, specially in case of neurofibromatosis (Recklinghausen). This disease could not be objectified in this meanwhile 7-year-old boy. At the last control visual acuity was 1/20, ophthalmoscopy showed gross streaky depigmentation in the macular region, the retina was attached.

Child, Preschool↗