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Biomedical subjects

K Schumann

Publications and source records attributed to K Schumann.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Complications after surgery of ENT-tumors. A comparison between preoperatively irradiated and nonirradiated patients].

Complications after preoperative high-dosage radiation of head and neck cancer are reported: 1. Preoperative radiation leads to complications in 42% compared to surgery alone in 20%. The results are statistically significant (alpha = 2%). 2. The complications after preoperative radiation are more severe (three ruptures of the carotid artery, three defects, which could only be managed by flap rotation). These results indicate the preoperative high-dosage radiation implies the risk of major surgical complications.

Adult↗
PubMed1980

Pitfalls after laryngectomy and neoglottis formation.

Intrraluminal manometric investigations in the hypopharynx and sphincter area post laryngectomy revealed pressure recordings of 54 mm Hg and 33 mm Hg, respectively, during the act of swallowing. Aspiration of saliva or food after a laryngectomy with a hypopharyngeal-tracheal shunt can be explained on these grounds.

Deglutition↗
PubMed1980

[The critical point in laryngeal and tracheal obstruction (author's transl)].

Laryngeal and tracheal obstruction can be more fully assessed using plethysmography. Experiences with 46 patients show that airway resistances exceeding 150 mm H2O/l/s always indicate a critical situation and these patients require urgent tracheostomy or intubation. - Three patients with glottic tumours and one patient with glottic oedema were tracheotomized because of the danger of asphyxiation. In these, resistances of between 107.4 and 150 mm H2O/l/s were found. Airway resistance exceeding 100 mm H2O/l/s are therefore critical indicators in patients with glottic oedema and laryngeal tumours.

Airway Resistance↗
PubMed1980

[Histological evaluation of pre-operative radiation in squamous cell carcinomas of the tonsil, the base of the tongue and the hypopharynx (author's transl)].

The histological diagnostics of 13 patients with epithelisma of tonsils, tongue base and hypopharynx were examined before and after radiation with 2000 cGy telecobalt 60 with a planimetric method. The quantitative results related on mean percentage of surface of five different tissues showed the following variations: 1. an increasing of dead tumor tissue from 0.5-27.5% 2. an decreasing of still vital tumor tissue from 50.7-9.7%. 3. an increasing of fibrous tissue from 3.6-17%. 4. an increasing of granulation tissue from 0.3-3.8%. 5. a decreasing of vascular tissue from 2-0.6%. - As shown by these results, this kind of radiation may satisfy the most important requirements of a pre-operative radiotherapy. Affirmations about long time results of this kind of therapy may not yet be published with the present material.

Carcinoma, Squamous Cell↗
PubMed1980

[Experiences with surgery of the trachea. An analysis of 135 cases (author's transl)].

The different surgical approaches for the correction of tracheal stenosis are analysed in 135 patients who were treated by us during the past 15 years. Poor results were associated with dilatation alone. Tracheomalacia was successfully managed in 51% of the patients by using Schobel's technique of acrylic plastic frames, while sleeve resections succeeded in nearly 90% of the cases (particularly when absorbable suture material was used and the patient was given cortisone for six weeks postoperatively). The staged open "channel" technique described by Rethi (1959, 1967) was also used, and was modified by an island flap method. We have used this one-stage method during the past three years, and have been able to reduce the time needed for treatment from nearly one year to 110 days. In so doing, the average number of operations for one patient could be decreased from 4.25 to 1.27, while the success rate for surgery increased from 73 to 92%.

Age Factors↗
PubMed1979

[Prenatal diagnosis of congenital defects through the determination of alpha fetoprotein].

The prenatal diagnosis of neural tube defects is based on elevated alpha-fetoprotein (AFP) concentrations in the amniotic fluid as well as in the maternal serum. Amniocentesis has to be performed in those women who already gave birth to an affected child and have the high risk to bear another. On the other hand more than 90% of the newborns with anencephaly and spina bifida are born by mothers without any increased risk in anamnesis. Therefore maternal serum screening is indicated in all pregnant women to rule out a neutral tube defect. The pittfalls of a general serum screening are discussed an a survey of the datas from different international centers is presented.

Amniotic Fluid↗
PubMed1979

Indirect measurement of laryngeal and tracheal resistance.

We used a body plethysmograph to determine airway resistances in 485 cases of laryngeal and tracheal stenoses. 143 cases who had resistances exceeding 60 mm H2O/l.a.sec underwent surgery. A vocal cord was laterally fixed in 49 patients suffering from bilateral recurrent paralysis. Optimal results were obtained at a postoperative resistance level of 30 mm H2O/l.a.sec (standard value: 14.77 +/- 6.53 - n - 387). The patients could carry out work of medium intensity and had a steady voice. We performed tracheal interventions in 94 cases of tracheal stenoses. A mean postoperative resistance of 29.9 mm HWO/l.a.sec, with a tracheal diameter of 7-8 mm was attained. In practice, only a few patients found the remaining obstruction a hindrance, during work of maximal intensity. No recurrences were observed after treatment. Airway resistance exceeding 150 mm H2O/l.a.sec were found in 13 new admissions and 73 times in those undergoing therapy. In these cases asphyxiation threatens. These patients must be tracheotomized or intubated immediatly.

Airway Resistance↗
PubMed1979

Ostium resistance in acute maxillary and frontal sinusitis.

Ostium function tests were performed in 18 normal maxillary and 6 normal frontal sinuses. Further 57 patients with acute maxillary and 16 patients with acute frontal sinusitis were followed using sinumanometry until resolution of infection occured. After initial obstruction of the ostium, resistance decreased exponentially until complete decongestion. Respiratory pressure changes in the sinus during forced nasal breathing are a positive sign for healing of sinusitis. The amplitude of these fluctuations should be documented during each lavage and facilitates indication for drainage procedures.

Adult↗
PubMed1979

The indirect measurement of laryngeal and tracheal resistance.

We used a body-plethysmograph to determine air-way resistances in 485 cases of laryngeal and tracheal stenoses. We decided in 143 cases to intervene after observing resistance exceeding 60 mm H2O/l and sec. A vocal chord was lateral fixated in 49 patients suffering bilateral recurrent paralysis. Optimal results were obtained at a postoperative resistance level of 30 mm H2O/l and sec (standard value: 14.77+/-6.53--n = 387). The patients could carry out work of medium intensity and had a steady voice. We performed tracheal interventions in 94 cases of tracheal stenoses. A mean, post-operative resistance of 29.9 mm H2O/l and sec, with a tracheal diameter of 7--8 mm was attained. In practice, only a few patients found the remaining obstruction a hindrance during work of maximal intensity. No recurrences were observed after treatment. Airway resistances exceeding 150 mm H2O/l and sec were found in 13 new admissions and 73 times in those undergoing therapy. In these cases asphyxiation threatens. These patients have to be tracheotomized or intubated immediately.

Airway Resistance↗
PubMed1979

[Basalioma of the face: problems of treatment and rehabilitation (author's transl)].

The authors communicate the results of their experiences with 96 basaliomes. 62.5% of patients were men. The mean age was 62 +/- 1.38 years. Basaliomes were most frequent on certain sections of the face: 49 were situated in the ear region, 19 in the eye region and 24 on the nose. We observed only one basliome on the upper lip, and five others in the temporal and occipital region. 26 out of 96 patients were already treated outside, some of them even several times, before coming for our treatment. Our best results were obtained by surgical operation and this for of the following reasons: 1. Results are as good as with other methods. 2. Better cosmetic results were obtained by methods of plastic surgery. 3. Costs are reduced because of short treatment. Therefore most basaliomes were operated (77 = 80.2%). In 17 cases combination with radiotherapy was necessary because of the importance of the tumor. Two patients were only radiated because they refused surgical treatment. We observed relapse in 11 cases, 4 of them were reoperated, 6 were reoperated and radiated and one of them was only radiated. So we obtained on overall cure-rate of 98.9%. Because of high frequency of basaliomes on nose, ears and eyes certain surgical procedures related by us showed good results and didn't need hospitalisation of the patients. We recommend to hospitalise patients with angular basaliomes of the eye always, because they often have a deep extension, and the defects created by operations are difficult to be treated by plastic surgery. We think that our methods of therapy could be taken as an example.

Adult↗
PubMed1978

Relationship between tubal function, craniofacial morphology and disorder of deglutition.

26 children without hearing impairment have been examined by otolaryngologists and orthodontists. According to the tubal function test in a pressure chamber they were classifed into a group with good and poor tubal function. The E.N.T. examination was unconclusive for a possible relationship between rhinological findings, mode of breathing, sinusitis, size of tonsils, nasal airway resistance and tubal function. Adenoids proved to be a mechanical impairment for active tubal function as stated by many authors. The cephalometric analysis of lateral head films combined with a static and dynamic-functional evaluation of tongue posture revealed significant differences between children with good and poor tubal function. Subjects with a vertical craniofacial growth pattern seem to be predisposed for poor tubal function. Analysing static tongue posture in children with poor tubal function the tongue lies more retracted in a backward position. The back of the tongue is flattened in relation to the palatal arch. In children with good tubal function there is a much closer contact between the back of tongue and the hard palate. Subjects with poor tubal function have an increased incidence of abnormal deglutition combined with tongue-thrust, teeth-apart swallowing, lack of sealing off the anterior oral cavity and contraction of the circumoral musculature. In children with good tubal function one can find the somatic type of swallowing that means no contractions of the circumoral muscles, no tongue-thrust during deglutition but contact of the molars and contraction of the masseter muscle.

Airway Resistance↗
PubMed1978

[Investigations carried out to ascertain the dose-effect relationship of a BCG vaccine, strain 1331 Copenhagen, in neonates and young infants (author's transl)].

1405 neonates and infants were vaccinated with BCG Vaccine (strain 1331 Copenhagen) at five clinics in the Federal Republic of Germany. Doses in logarithmic increments from 22000 to 250000 VU (viable units)/0.1 ml were given by strictly intradermal injection. Carrying out the post-vaccinal tuberculin test by the MENDEL-MANTOUX technique, the dose-effect relationship could be demonstrated (Fig. 3). Conversion rates raised from 43% to 76% (Tab. 1); they are furthermore depending from the tuberculin dose and the assessment of the skin reaction. Tests with up to 50 I.U. of purified tuberculin were resulting in conversion rates over 90% for vaccination doses of 100 000 VU and more, any palpable infiltration regarding as a positive result (Fig. 4). The vaccine showed good safety in all concentrations employed concerning reactions at the site of injection. Lympnode enlargement, palable even 12 weeks postvacc., was common. In the course of the trial there was one case of suppurative lymphadenitis among the 262 children who were given the vaccine in the highest concentration (250000 VU). Subsequent trials revealed a rate of this complication in the 1:1000 range. The approval for the vaccine with 100000-300000 VU/dose has subsequently been given by the Federal Bureau for Sera and Vaccines.

BCG Vaccine↗
PubMed1978

[The activity of L-cystine-aminopeptidase (oxytocinase) in the serum of pregnant women during intravenous application of oxytocin (author's transl)].

The oxytocinase levels have been tested prior to, during and after oxytocin challenge tests in 42 pregnant women. There was no relation between labour and the activity of the enzyme. There was no change in the activity during and after oxytocin infusion. Repeated challenge tests did not change these results. The use of the oxytocinase as a parameter of placental function is not influenced by oxytocin infusions.

Aminopeptidases↗
PubMed1978

[Misinterpretation of alpha-fetoprotein (AFP) values in amniotic fluid due to fetal hemorrhage (author's transl)].

The AFP concentration in the amniotic fluid is elevated after contamination of the sample with fetal blood during a traumatic amniocentesis. Though the calculation of AFP due to fetal hemorrhage is possible by counting the fetal red cells there may be execssive errors resulting from the variability of fetal red cell count, amniotic volume, fetal serum AFP concentration, AFP concentration in the amniotic fluid changing with fetal age. Therefore it is impossible to interpretate elevated AFP values from a sample stained with fetal blood. A repeated amniocentesis is unavoidable. The correct time to do a second punction is still a matter of question.

Amniotic Fluid↗
PubMed1978

[Alpha-fetoprotein, HPL, ostriol and SP1 concentrations in prostaglandin-induced mid-trimester abortions (author's transl)].

Maternal serum concentrations of AFP, HPL, SP1 and Estriol were measured in the course of prostaglandin-induced abortions. Termination of pregnancy between the 13th and 25th week of pregnancy was done for medical reasons. Patients were treated with PGE2, PGF2alpha and with 16-phenoxy-PGE2-methansulfonamid, respectively. Prostaglandins were administered systemically, i. e. intravenously. Current measurement of HPL and AFP-concentrations showed a contrary sense. These changes of concentrations were related to fetal death and membrane rupture in some cases as is demonstrated in four diagrams. Typical and sharply decreasing values of Estriol followed fetal death in patients with intact pregnancies before. As for an anencephalic fetus, AFP-concentrations increased slightly too, HPL values decreased like in other abortions. Only minimal changes of SP1 concentrations were found generally in all patients and during abortion time.

Abortion, Induced↗