Biomedical subjects
Publications and source records attributed to H Feldmann.
ICP monitoring appears not to be essential for the prognosis of head injury patients, but it may be of some clinical value in association with the neurological status and other clinical data. The results of ICP measurement show that a high level in brain pressure and the poor outcome have a better correlation with one another than a lower level of brain pressure and a good recovery.
The authors stress the advantage of the operative treatment of fresh lesions of the cervical spine versus conservative treatment. The anterior approach after Cloward with additional osteosynthesis of the adjacing vertebrae proved to be superior.
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We have devised a reciprocating saw for microsurgery, which performs 100 oscillations per second. The amplitude of the oscillations is adjustable within the range of 3-3 mm, by pressing a pedal. The width of the saw cuts is 0.2-0.3 mm. In the osteoplastic approach the superior and posterior segment of the ear canal wall is temporarily removed. Starting from a mastoidectomy 4 cuts are performed: cut 1 from the superior anterior angle of the mastoidectomy in a horizontal direction parallel to the dural plate through the whole thickness of the lateral epitympanic wall. Cut 2 from the ear canal above the short process of the malleus in a superior direction so as to meet cut 1. Cuts 3 and 4 start from the facial recess, one from the inside of the ear canal, the other from the mastoid cavity, both meeting in a groove along the facial ridge. This exposes all middle ear spaces as in a radical mastoidectomy. After elimination of disease and reconstruction of ossicles the canal firmly into its bed, needing no further fixation. Healing of the re-implanted canal segment presents no problem.
An osteoplastic modification of the Caldwell-Luc operation is described. Starting from two small drill holes a quadrangular lid is cut out of the anterior wall of the maxillary sinus using the reciprocating micro-saw after Feldmann. This allows adequate access to the cavity as in the classic procedure. If required the window can be extended in the superior medial angle with rongeurs. After completing the operation within the cavity the osseous lid is reimplanted and fixed with 3 sutures of chromic catgut, which are threaded through small drill holes. By this prodecure prolapse of fat into the sinus is prevented, postoperative closure of the antral nasal window is less likely to occur, the bony structure of the maxilla is restored. Keeping of the reimplant presents no problem. Sequestration or other complications have not been encountered either in suppurative or in polypous sinusitis.
Hypochondriacal perception and evaluation of symptoms are discussed as an abnormal cognitive process. From a phenomenological viewpoint, a self-centered focussing on the perception of bodily sensations and a restriction of risk-taking behaviour is emphasized. In behavioral terms, several cognitive mechanisms and concepts including perceptual awareness, selection, 'set' as well as signal-detection, decision processes and 'anchoring' factors are considered to be important aspects of hypochondriacal perception.
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A reciprocating saw for osteoplastic microsurgery of the ear is presented. An electromagnetic oscillator of a common electric razor, used as motor, drives the saw with 100 oscillations per second. The amplitude of the vibrations can be adjusted by a special device within the range of 0.5 to 3 mm. The saw blades are 0.2 mm thick and not set. They perform very smooth straight cuts of 0.2 to 0.3 mm width and can easily be applied in the narrow operative field of the middle ear.
A new technique of osteoplastic operation in chronic otitis with cholesteatoma is described. It combines an optimal exposure of all middle ear spaces with the advantage of preserving the posterior canal wall. Starting from an attico-antrotomy the lateral epitympanic wall and the posterior canal wall are temporarily removed by 4 slanting cuts with the micro-saw. Thus an exposure of the middle ear as in a radical operation is achieved. After removing all pathology and reconstructing the ossicular chain and tympanic membrane the wedge-shaped canal segment is reimplanted firmly without any cleft due to the special arrangement of the saw cuts.
In rabbits, cryogenic injuries of the walls of abdominal aorta and iliac arteries were histologically examined after application of a cryoprobe ob -160 degrees C for 1 minute. Seven days thereafter the animals were killed. Extended partial and circular necroses and calcifications of the vascular walls were found. The alterations were less expressed when the blood stream was maintaimed during the freezing. Maximal changes occured at additional centripetal pinching the vessels.
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tRNA3Met, one of the non-initiating methionine-specific tRNAs in brewer's yeast was purified from bulk tRNA labelled with [32P]phosphate by two column chromatographic steps. The primary structure of this tRNA was determined by the usual fingerprinting technique. Analyses of the isolated nucleotides and oligonucleotides from digests with pancreatic and T1 ribonucleases were in good agreement and stated that tRNA3Met consists of 76 nucleotide residues including 13 minor nucleotides. Overlaps from which the complete sequence could be deduced were derived from the analyses of 15 fragments obtained by partial digestion with T1 ribonuclease.
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Investigations by light and electron microscopy showed more details of potential patterns of injuring after application of low temperatures to rabbit brain. The authors were actually concerned to transforming the intensity of cooling into exact and reproducible degrees of necrosis. According to these experimental results, the application of cryotechnique to human central nervous tissue is just permitted on special premises (size of probe, low-level of temperature, and period of application).
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