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J Lang

Publications and source records attributed to J Lang.

At least 199 records · Page 11Linked to original sources
PubMed1996

[Studies of the course of the marginal branch of the facial mandibular nerve].

BACKGROUND: In many operations involving the submandibular and lower cheek region, the mandibular branch of the facial nerve is in danger. METHODS: On the basis of 55 facial dissections, we classified the course of the nerve into one of three types. RESULTS: In about 66% of cases, the nerve runs below the angle and below the inferior border of the mandible. Typically, the mandibular branch consists of up to four major branches. The maximum distance between the lowest point of the mandibular branch and the inferior border of the mandible was 1.4 cm. We also studied the location of the nerve in relation to the facial vessels and the posterior facial vein. CONCLUSIONS: Incisions in the submandibular region should be performed at least 2 cm below the inferior border of the mandible. The nerve can be spared by ligature and by retracting the anterior facial vein.

Aged↗
PubMed1996

Magnetic resonance imaging of the upper airway. Effects of propofol anesthesia and nasal continuous positive airway pressure in humans.

BACKGROUND: Anesthetic agents inhibit the respiratory activity of upper airway muscles more than the diaphragm, creating a potential for narrowing or complete closure of the pharyngeal airway during anesthesia. Because the underlying mechanisms leading to airway obstruction in sleep apnea and during anesthesia are similar, it was hypothesized that anesthesia-induced pharyngeal narrowing could be counteracted by applying nasal continuous positive airway pressure (CPAP). METHODS: Anesthesia was induced in ten healthy volunteers (aged 25-34 yr) by intravenous administration of propofol in 50-mg increments every 30-s to a maximum of 300 mg. Magnetic resonance images of the upper airway (slice thickness of 5 mm or less) were obtained in the awake state, during propofol anesthesia, and during administration of propofol plus 10 cm nasal CPAP. RESULTS: Minimum anteroposterior diameter of the pharynx at the level of the soft palate decreased from 6.6 +/- 2.2 mm (SD) in the awake state to 2.7 +/- 1.5 mm (P < 0.05) during propofol anesthesia and increased to 8.43 +/- 2.5 mm (P < 0.05) after nasal CPAP application. Anteroposterior diameter of the pharynx at the level of the dorsum of the tongue increased from 7.9 +/- 3.5 mm during propofol anesthesia to 12.9 +/- 3.6 mm (P < 0.05) after nasal CPAP. Pharyngeal volume (from the tip of the epiglottis to the tip of the soft palate, assuming this space to be a truncated cone) significantly increased from 2,437 +/- 1,008 mm3 during propofol anesthesia to 5,847 +/- 2,827 mm3 (P < 0.05) after nasal CPAP application. CONCLUSIONS: In contrast to the traditional view that relaxation of the tongue causes airway obstruction, this study suggests that airway closure occurs at the level of the soft palate. Application of nasal CPAP can counteract an anesthesia-induced pharyngeal narrowing by functioning as a pneumatic splint. This is supported by the observed reduction in anteroposterior diameter at the level of the soft palate during propofol anesthesia and the subsequent increase in this measurement during nasal CPAP application.

Adult↗
PubMed1996

Avulsion of the popliteus muscle in a malinois dog.

A four-month-old malinois was presented for lameness which was attributed to an avulsion of the origin of the popliteus muscle. Surgical repair by internal fixation with a lag screw and washer resulted in resolution of the lameness.

Animals↗
PubMed1996

Expression, localization and functional role of small GTPases of the Rab3 family in insulin-secreting cells.

We examined the presence of small molecular mass GTP-binding proteins of the Rab3 family in different insulin-secreting cells. Rab3B and Rab3C were identified by western blotting in rat and in human pancreatic islets, in two rat insulin-secreting cell lines, RINm5F and INS-1, as well as in the hamster cell line HIT-T15. In contrast, Rab3A was detected in rat pancreatic islets as well as in the two insulin-secreting rat cell lines but not in human pancreatic islets and was only barely discernible in HIT-T15 cells. These findings were confirmed by two-dimensional gel electrophoresis followed by GTP-overlay of homogenates of pancreatic islets and of the purified protein. Northern blotting analysis revealed that Rab3D is expressed in the same insulin-secreting cells as Rab3A. Separation of the cells of the rat islets by fluorescence-activated cell sorting demonstrated that Rab3A was exclusively expressed in beta-cells. Rab3A was found to be associated with insulin-containing secretory granules both by immunofluorescence, immunoelectron microscopy and after sucrose density gradient. Overexpression in HIT-T15 cells of a Rab3A mutant deficient in GTP hydrolysis inhibited insulin secretion stimulated by a mixture of nutrients and bombesin. Insulin release triggered by these secretagogues was also slightly decreased by the overexpression of wild-type Rab3A but not by the overexpression of wild-type Rab5A and of a Rab5A mutant deficient in GTP hydrolysis. Finally, we studied the expression in insulin-secreting cells of rabphilin-3A, a putative effector protein that associates with the GTP-bound form of Rab3A. This Rab3A effector was not detectable in any of the cells investigated in the present study. Taken together these results indicate an involvement of Rab3A in the control of insulin release in rat and hamster. In human beta-cells, a different Rab3 isoform but with homologous function may replace Rab3A.

Animals↗
PubMed1996

Establishment and functional characterization of human peritoneal fibroblasts in culture: regulation of interleukin-6 production by proinflammatory cytokines.

The functional and morphologic integrity of the peritoneal membrane is of major importance for the successful treatment of patients with chronic peritoneal dialysis. This study aimed at the establishment and functional characterization of human peritoneal fibroblasts (HPFB) in cell culture. HPFB were isolated from human omentum by enzymatic digestion and cultured. Confluent HPFB could be identified as spindle-shaped cells, growing in parallel arrays and whorls which stained positive for vimentin and negative for factor VIII, cytokeratin 18, and desmin. Maximum cell growth was observed after 24 h in medium supplemented with 10% fetal calf serum. HPFB could be growth arrested and maintained in fetal calf serum-depleted medium (0.1%) for > 48 h without loss of cell viability as evaluated by intracellular ATP determination. Stimulation of resting HPFB for 0.5 to 48 h with increasing doses of interleukin (IL)-1 beta and/or tumor necrosis factor-alpha (1 to 10,000 pg/mL) resulted in a dose- and time-dependent induction of IL-6 messenger RNA and an increase in immunoreactive IL-6 protein secreted into HPFB supernatants, which was significant with IL-1 beta or tumor necrosis factor-alpha doses as low as 1 pg/mL. HPFB IL-6 production could be inhibited by both actinomycin D or cycloheximide, which suggests that the induction of IL-6 occurs both on a transcriptional and a post-transcriptional level. In summary, this cell culture model is expected to facilitate further investigation of the potential role of the HPFB in the peritoneal cytokine network of patients treated with chronic peritoneal dialysis.

Cell Cycle↗
PubMed1996

[Diagnosis and treatment of amblyopia].

The word amblyopia means weak vision on a functional basis. The most important form is strabismic amblyopia. Its diagnosis is easy in cases of obvious unilateral strabismus; in cases with slight squint angles this may be difficult. The most important treatment is carefully controlled occlusion of the dominant eye.

Amblyopia↗
PubMed1996

Assessment of health status in peritoneal dialysis patients: a potential outcome measure.

OBJECTIVES: To determine the feasibility and practicality of measuring general health status (GHS) in an outpatient peritoneal dialysis population. To determine whether GSH correlated intuitively with biochemical, socio-demographic and co-morbidity measurements. DESIGN: The Medical Outcomes Study 20-item short form was administered on a voluntary basis in the outpatient setting. Demographic and current biochemical data were extracted from the medical record. The effects of the socio-demographic, biochemical and physiologic variables on the six subscales of GHS generated by the questionnaire were estimated using multivariate linear regression analysis resulting in the development of six separate models. SETTING: Peritoneal dialysis program of a University Hospital. PATIENTS: Sixty stable patients on home peritoneal dialysis completed the GHS questionnaire during regularly scheduled outpatient visits. Ages ranged from 13 to 81 years. The study group included 14 diabetics (23%). RESULTS: Administering the questionnaire caused no logistical difficulties in the outpatient setting. Regression models for predicting GHS were both significant and intuitively correct. The presence of co-morbidities such as diabetes mellitus (p = 0.002; Social Subscale) and peripheral vascular disease (p = 0.016: General Health Subscale) had the most significant negative impact on GHS. An increased length of time on dialysis was associated with a higher GHS (p = 0.002; Physical Subscale). CONCLUSION: General Health Status questionnaires can be readily administered to peritoneal dialysis patients in the outpatient setting. They have face validity as a measurement of wellness and functioning. The longitudinal use of such instruments in conjunction with clinical and laboratory findings may identify both medical and non-medical factors impacting on our peritoneal dialysis population.

Adolescent↗
PubMed1996

[Nephrectomy for chronic, unilateral suppurative pyleonephritis in cattle].

This report presents the case history of a five-year-old Eringer cow suffering from chronic hematuria. Results of clinical examination, ultrasonography of the kidneys, endoscopy of the bladder, and cytologic and bacteriologic analysis of the urine revealed unilateral pyelonephritis of the right kidney caused by Corynebacterium renale. Antimicrobial treatment with procaine penicillin was not successful. Therefore, nephrectomy of the affected kidney was performed through a right flanc approach in the standing animal. Follow-up examination ten months after surgery revealed normal general condition. Etiopathogenesis and diagnostic and therapeutic procedures of pyelonephritis in cattle are discussed.

Animals↗
PubMed1996

[Expression of epidermal growth factor receptor (EGFR) in endometrioid carcinoma of the ovary].

OBJECTIVE: To determine the expression of EGFR expression in endometrioid carcinoma of the ovary and its relationship to clinicopathologic features and prognosis. METHODS: Expression of EGFR oncoprotein was studied by immunohistochemistry in paraffin-embedded tumor tissues from 28 patients with endometrioid carcinoma of the ovary. RESULTS: Tissues from 13 patients (46.4%) were stained positively with EGFR polyclonal antibody (1005). The staining was membranous and/or cytoplasmic. There was no relationship between EGFR expression and age at diagnosis, preoperative CA125 titer, clinical stage, histologic grade, and lymph node metastases. A higher expression rate was observed in patients with residual tumors (56.3% versus 33.3%). The mortality rate was higher in patients with EGFR expression than in those without EGFR expression (46.2% versus 14.3%), but the difference was not statistically significant. CONCLUSION: EGFR expression was not related to the clinicopathologic features in endometrioid carcinoma of the ovary, but was related to the poor prognosis of this disease.

Carcinoma, Endometrioid↗
PubMed1996

[Uterine papillary serous carcinoma--one kind of special type of uterine endometrial carcinoma].

OBJECTIVE: To study the clinico-pathologic features of uterine papillary serous carcinoma and point out the complete difference between the two kinds of endometrial carcinoma. METHODS: One hundred and ten cases of endometrial carcinoma who received treatment in the our hospital from May 1, 1982 to April 30, 1994 were analyzed retrospectively. RESULTS: Of them, 10 cases (9.1%) of uterine papillary serous carcinoma (UPSC) were found. The age in average was 67.2 years old, which is nearly 10 years older than those with ordinary endometrial cancer (P < 0.01). The occurrence of UPSC was revealed no relationship with the relative factors of occurrence of endometrial carcinoma. The study shows that tumor has very marked tendency of lymph node metastasis, much worse grade, much deeper myometrial invasion and much earlier extrauterine disease. CONCLUSIONS: UPSC is a special pathologic type of endometrial carcinoma with completely different clinico-pathologic behavior. The surgical staging is necessary for the patients with UPSC to get comprehensive stage because the clinical stage is usually not correct enough.

Aged↗
PubMed1996

Management of ovarian endodermal sinus tumor.

OBJECTIVE: To evaluate the role of combination chemotherapy and the optimal cycles of treatment in improving the prognosis of ovarian endodermal sinus tumor, and to study the relationship between the type of surgical management and the outcome of the disease. PATIENTS AND METHOD: Sixty-three patients with ovarian endodermal sinus tumor were divided into 3 groups according to the postoperative chemotherapy they had received. Group 1 (37 patients) patients were treated with at least 6 cycles of VAC (vincristine, actinomycin-D and cytoxan) or 4 cycles of PVB (cysplatin, vincristine and bleomycin). Group 2 (17 patients) patients were treated with VAC in less than 6 cycles or PVB in less than 4 cycles. Group 3 (9 patients) patients received no VAC or PVB but some other drugs like TSPA, 5FU, MTX and cytoxan in various combinations. The sustained remission rates and survivals were compared among these 3 groups. For patients with full courses of treatment with VAC or PVB (Group 1), different types of surgical management were studied about their relationship with the outcome of the disease. RESULTS: The persistent remission rates are 81.8%, 23.5% and 11.8% for group 1, group 2 and group 3 patients respectively (P < 0.001). The survival curve of group 1 is very much different from that of group 2 and group 3 patients. With full courses of chemotherapy with VAC or PVB, it appears that the different types of surgical managements (unilateral vs bilateral adenectomy; with vs without systemic lymphadenectomy; residual tumor < 2 cm vs > 2 cm) did not show definite relationship with the outcome of the disease. CONCLUSION: Combination chemotherapy with VAC or PVB dramatically improved the prognosis of ovarian endodermal sinus tumor but it should be emphasized that the favorable results could be obtained only when the treatment is given on time and in optimal cycles. Although ovarian endodermal sinus tumor is chemosensitive, appropriate surgical treatment is still important, however, the surgical techniques need some further studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

[Comprehensive staging laparotomy in stage I epithelial ovarian cancer].

OBJECTIVE: To evaluate the significance of comprehensive staging laparotomy in stage I epithelial ovarian cancer. METHODS: Forty-three patients with stage I epithelial ovarian cancer were divided into 3 groups and retrospectively analysed. Thirty two of these patients allotted to stage I ovarian cancer according to FIGO criteria were ascertained by comprehensive staging laparotomy (group A), 5 patients were upstaged following comprehensive staging laparotomy (group B) and 6 patients were staged without comprehensive laparotomy (group C). RESULTS: The mean operation time was 2 hours and 40 minutes, the mean volume of blood loss was 460 ml and no severe complications occurred during the comprehensive staging laparotomies. 13.5% (5/31) of patients were found to have retroperitoneal metastasis and then therefore were upstaged as stage III. Group A and B had better prognosis. During the 39.7 months followup period, tumor-free survival rates in group A and B were 97% (31/37) and 5/5 respectively. In group C, 2 patients recurrent and one died of the diseases, a tumor-free survival rates of 4/6. There was a significant difference in tumor-free survival rates between group A and C (P = 0.038). CONCLUSION: Comprehensive staging laparotomy should be considered as an important criterion in FIGO staging of epithelial ovarian cancer and a standard procedure in the treatment of stage I epithelial ovarian cancer.

Carcinoma, Endometrioid↗
PubMed1996

[Single-dose intramuscular methotrexate for treatment of ectopic pregnancy].

OBJECTIVE: The efficacy and indication of single-dose intramuscular methotrexate to treat early ectopic pregnancy were explored. METHODS: 27 cases of ectopic pregnancy were treated by single-dose intramuscular methotrexate (50 mg/m2) without citrovorum rescue. The beta-hCG was monitored regularly till it became normal. Twelve of them recieved this regimen in outpatient service. RESULTS: 24 cases (88.9%) were successfully treated. Three failed and switched to operation. There were no significant differences (P > 0.05) in gestational age and size of adnexa ectopic mass between successful cases and failed cases, but highly significant differences (P < 0.01) in occurrence rate of abdominal pain and beta-hCG titers before treatment. CONCLUSION: The early diagnosis and adherence to strict criteria are the keys to successful management. No abdominal pain, ectopic mass < or = 5 cm in greatest dimension and titer of serum beta-hCG < 6000 IU/L were mainly indications of drug treatment.

Adult↗