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Biomedical subjects

J de Lange

Publications and source records attributed to J de Lange.

At least 19 recordsLinked to original sources
PubMed2006

Calcitonin therapy in central giant cell granuloma of the jaw: a randomized double-blind placebo-controlled study.

The successful therapeutic use of calcitonin in patients with a central giant cell granuloma has been shown in several case reports. In a prospective, randomized, double-blinded, placebo-controlled clinical trial, 14 patients with a histologically confirmed central giant cell granuloma and normal calcium and parathyroid hormone serum levels were studied over 2 years. Patients were treated with intranasally administered salmon calcitonin (200 IU/day) or a placebo once a day. The placebo-controlled period was 3 months, after which all patients were treated with calcitonin for 1 year. Treatment response was assessed at the end of the placebo-controlled study phase (3 months), at the end of therapy (15 months' timepoint with patients being on calcitonin treatment for either 12 or 15 months) and at 6 months' follow-up. The chi(2)-test was used to compare the proportion of patients with a tumour reduction >/=10% of the pretreatment measurement between the 2 populations at the 3 timepoints: no differences were observed between the placebo group and the calcitonin group. At the 6-month follow-up timepoint, tumour volume had decreased by >/=10% in a total of 7 patients with a 37.9% (95% CI 31.3-44.5%) mean volume reduction in this subgroup. Complete remission was not observed.

Adolescent↗
PubMed2006

Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy: a report of 2 cases.

Central giant cell granuloma (CGCG) is a benign lesion of the jaws with a sometimes locally aggressive behaviour. The most common therapy is surgical curettage which has a high recurrence rate, especially in lesions with aggressive signs and symptoms (i.e. pain, paresthesia, root-resorption and rapid growth). Alternative therapies such as interferon alpha (INFalpha) or calcitonin are described in the literature. In this study 2 patients with an aggressive CGCG are presented who were treated with INF mono-therapy. INF mono-therapy was capable of terminating the rapid growth of the lesion in both patients and induced a partial reduction. Total resolution, however, was not obtained and alternative treatment is still necessary.

Adolescent↗
PubMed2006

[Maxillofacial growth and dental implants in the maxillary anterior region].

Single tooth replacement with a dental implant is an increasingly popular solution in patients with loss of an upper anterior tooth. There is a risk, however, of placing the implant prematurely in youths. In a case series the effects of residual maxillary growth on the results of implant treatment in the anterior maxillary region were measured. The results confirm findings from other studies on this subject and indicate that cessation and degree of vertical growth are unpredictable. This may result in infraposition of the implant and lead to periodontal bone loss around the implant region and its neighbouring teeth. Clinicians should be aware of this and inform their patients that these changes may eventually compromise the aesthetic result of the treatment.

Adolescent↗
PubMed2006

[Treatment of snoring by a Herbst-activator. Satisfaction of patient and bedfellow].

Snoring is primarily a social problem which for instance brings considerable pressure on someone's conjugal relationship. Often treatment is demanded by the bedfellow. Patient as well as bedfellow needs to be involved in the treatment of the problem. In this study, twenty-three habitual snorers and their bedfellows completed a questionnaire concerning the effect of the treatment of snoring by a Herbst-activator before treatment and 3 and 6 months after treatment. Two-thirds of the patients and bedfellows were satisfied with the therapy results. The bedfellows exhibited an even more positive therapy effect than the patients.

Adult↗
PubMed2005

[A mandibular swelling].

Nevoid basal cell carcinoma syndrome (NBCCS) is characterised by skeletal anomalies, cutaneous basal cell carcinomas and multiple keratocysts. NBCCS is an autosomal dominant disorder, but can have a variable phenotypic penetration. NBCCS can also arise spontaneously. The prevalence is 1:60.000 and 50-65% of patients with NBCCS have affected family members. A recently diagnosed patient is presented and the manifestations of the syndrome are discussed.

Basal Cell Nevus Syndrome↗
PubMed2004

[Treatment of snoring and sleep apnea. Maxillo-mandibular advancement osteotomy].

In this article, a patient is presented who was treated by a maxillo-mandibular advancement osteotomy, in order to increase the volume of the oropharynx as a final treatment of the obstructive sleep apnea syndrome. This syndrome is a common affliction, characterized by excessive daytime sleepiness and unintentionally falling asleep. It can be diagnosed by patient history and polysomnography. Nasal-continuous positive airway pressure is the golden standard of treatment. However, in mild to moderate cases of the syndrome, treatment with a mandibular reposition appliance is also an option. The extraoral device of the first treatment option as well as the intraoral appliance of the second treatment option are demanding patients' compliance. Therefore, research into other treatments is necessary. The initial results of the advancement osteotomy among six patients were very good and in accordance with other literature reports. These results justify further research to clarify the importance of this treatment option of the obstructive sleep apnea syndrome.

Humans↗
PubMed2004

[Distraction osteogenesis of the maxilla in cleft patients. Worth considering].

Three cleft patients were treated with RED-distraction for maxillary hypoplasia. In all patients, the desired advancement could be achieved easily. The occlusion, the lip relation and the facial profile improved remarkably post treatment. Although the treatment was well tolerated by the patients, some limitations of the treatment were also noted, such as a nasal speech and discomfort by the head frame. Distraction osteogenesis in the maxilla has several advantages when compared to the conventional Le Fort 1-osteotomy: atraumatic advancement of the maxilla, absence of need for an autogeneous bone transplant, and applicability at relatively young age. The advantages and disadvantages of distraction osteogenesis must be considered for each individual patient.

Adolescent↗
PubMed2003

[A mistake in the picture processing procedure?].

A 12-year old boy was referred to an orthodontist. During examination of his dental status a swelling was seen at the right side of his palate. Further examination demonstrated a central giant cell granuloma. This is a rare benign tumor that often causes local destruction of the bone and displacement of teeth. Surgical curettage of these large central giant cell granulomas gives mulilations of the jaws and loss of teeth and tooth germs. Furthermore, it has a high recurrence rate. Therefore, calcitonin was chosen as an alternative therapy.

Calcitonin↗
PubMed2001

The quality of nursing home care: do the opinions of family members change after implementation of emotion-oriented care?

OBJECTIVE: The present study focuses on opinions on the quality of nursing home care of family members of nursing home residents with dementia. Furthermore, we examined whether family members' appreciation of the care increased as a result of the implementation of emotion-oriented care. DESIGN: Randomized clinical trial. INSTRUMENT: An 18-item questionnaire was developed. The following subjects were addressed: communication activities between staff and family members; satisfaction regarding contacts with staff; the extent to which family members can participate in care; the contact that family members experience with the person with dementia, and opinions about the way in which nursing staff treat residents. RESULTS: Most family members already had a positive opinion on the nursing home care prior to the implementation of emotion-oriented care. The most positive assessment concerned the way in which nursing staff treated residents. The lowest scores concerned communication activities between ward staff and family members. Comparison of the first and end measurements showed that in general opinions on the quality of care did not change. STUDY LIMITATIONS: A large number of incomplete questionnaires made it impossible to conduct factor analysis on the classification of the questions in various sections and therefore allowed us only to make statements at the item level. CONCLUSIONS: For the most part family members had a positive opinion on the nursing home care. In general, implementation of emotion-oriented care did not lead to a more positive assessment. Despite the generally accepted notion that involving family members in care is important, family members were regularly treated as outsiders. This demonstrates that there is room for improvement in the communication by nursing home staff with family members (e.g. more frequent contacts and information about the illness).

Activities of Daily Living↗
PubMed1999

Clarithromycin as a single-modality treatment in mycobacterial avium-intracellular infections.

Atypical mycobacterial infections are frequently associated with chronic cervical lymphadenopathy, particularly in children between 1 and 5 years of age. The treatment of choice is regarded to be "optimal" surgical treatment, which often requires wide excision of affected lymph nodes. Although surgical excision is a reliable treatment, it has obvious drawbacks. Because branches of the peripheral facial nerve may be intimately involved in the inflammatory reaction, damage is a potential complication. In addition, keloid scars and wound breakdown are possible complications. Successful drug treatment is hampered by poor susceptibility of the Mycobacterium avium-intracellulare and Mycobacterium scrofulaceum strains to antimicrobial drugs. Reports of results with clarithromycin in the treatment of patients with AIDS who are infected with the M avium complex, however, are promising. The cases of 2 children with infections caused by the M avium complex, resulting in preauricular and cervical lymphadenitis, are described. Treatment with clarithromycin as a monotherapy led to complete healing without recurrence.

Anti-Bacterial Agents↗
PubMed1999

Treatment of central giant cell granuloma of the jaw with calcitonin.

Giant cell granuloma of the jaw is a benign lesion that may cause local destruction of bone and displacement of teeth. The common therapy is curettage or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. An alternative treatment has recently been introduced, in which patients receive a daily dose of calcitonin. Four patients who have been treated with calcitonin in various concentrations for at least 1 year are reported. In all patients, complete remission of the giant cell granuloma was observed, without signs of recurrence. The working mechanism of calcitonin is discussed, as are length of treatment and optimal dose.

Adolescent↗
PubMed1999

[New residents of residential care homes for the elderly. The problems of elders with mental disorders].

The article reports on a study involving participants in six projects set up jointly by mental health care facilities and homes for the elderly. The projects were designed to offer protection and guidance in residential homes to older people whose psychiatric problems have rendered them permanently dependent on professional care. The primary focus of the study was on their problems and care needs. Structured interviews were conducted with 136 residents and with their supporting and treating staff. The older people presented an atypical pattern of symptoms. The supporting staff and the treating staff both cited the unsociable, apathetic behaviour of the residents as the most serious problem, followed by emotional problems. Only 37% of the residents were free of cognitive problems, and only 18% had no physical impairments. Although the projects were specifically designed for older people suffering long-term mental instability, more than a quarter of the residents turned out to have had little or no contact with mental health care services. Many had even been admitted to the projects with no prior psychiatric assessment. The study recommends that the projects mobilise more mental health expertise in carrying out needs assessment. To help alleviate the residents' apathy, in-service training programmers for the care staff should focus not on psychopathology alone, but also on ways to create a more stimulating residential and social atmosphere.

Aged↗
PubMed1996

[Nurses' experiences with euthanasia in AIDS patients].

This article describes the experiences of nurses concerning the activities related to euthanasia of patients with aids. The nurses were employed in departments where relatively young, mature people wanted to arrange their own death. Our findings are based on six in-depth interviews with experienced nurses, that are part of a qualitative study into the experiences of nurses in taking leave of terminal patients with aids. The research strategy was based on the Grounded Theory. In order to analyse the experiences of the nurses, four phases were distinguished: set date and time unto application of lethal agent; application unto becoming unconscious; unconsciousness to death; death until transferring the body from the unit. Feelings that occur when taking leave of the patient, if not already taken care of at an earlier instant, play a major role in the phase from application to becoming unconscious. The fact that a deadly agent is being administered can generate feelings of guilt and anxiety. The period from unconsciousness to death is one of waiting. During this period nurses feel alienated and alone. The nurses indicated explicitly that an adequate preparation, evaluation and support are extremely important.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The rate of percutaneous permeation of xylene, measured using the "perfused pig ear" model, is dependent on the effective protein concentration in the perfusing medium.

In order to study the dermal permeation of compounds through the skin, an in vitro model was developed which utilized pig ears perfused with autologous pig blood (de Lange, J., van Eck, P., Elliott, G. R., de Kort, W. L. A. M., and Wolthuis, O. L. (1992). J. Pharmacol. Toxicol. Methods 27, 71-77). In the present article we investigated to what extent the rate of permeation of xylene through pig ear skin is dependent on the perfusion medium used. Pig ears were exposed to xylene (10 cm2 area) for a 4-hr period (30 degrees C, relative humidity of 40-60%) and the perfusate was analyzed for xylene using gas chromatography. The rates of permeation of xylene for whole blood, blood depleted of white blood cells, and a buffer containing 4.5% albumin were similar (+/- 300 ng/min/cm2). The rate of penetration was fivefold higher when pig plasma was used and ninefold lower when albumin was excluded from the buffer. Using the buffer, we found that the rate of permeation of xylene was proportional to flow (constant protein concentration) and protein concentration (constant flow). Our data demonstrate that the measured permeation rate for xylene is, to a large degree, dependent on the effective protein concentration (mg/min) passing through the ear. Differences in this parameter could explain the variations in rates of permeation found using the different perfusion media. To avoid problems associated with the choice of receptor fluid for permeation experiments, we suggest that full blood remains the vehicle of choice, although the practical perfusion period is limited to about 6 hr. If longer perfusion periods are required, then it should be possible to reproduce results obtained with whole blood by choosing an appropriate buffer.

Animals↗