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Biomedical subjects

P Huber

Publications and source records attributed to P Huber.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Overview of therapies for prevention of restenosis after coronary interventions.

Coronary artery disease is a leading cause of morbidity and mortality in the United States and across the world. The economic impact of coronary artery disease is staggering and on the rise. Percutaneous transluminal coronary angioplasty is widely used to treat severe, symptomatic coronary stenosis. The Achilles heel of angioplasty is restenosis of those treated arteries. As a result, numerous therapies, including mechanical and pharmacological approaches, to prevent restenosis have been studied. A greater understanding of the pathophysiology of restenosis has enhanced the success of these therapeutic approaches. To date, the most important and successful approach to limit restenosis has been the use of coronary stents. Stents have reduced the rate of restenosis from approximately 50% down to 20-30%. However, in-stent restenosis presents a new and an even more challenging dilemma. The success of adjunctive drug therapy has been promising, but, as of yet, very limited. Antithrombotic agents have reduced acute thrombosis and many of the acute complications of angioplasty. New approaches and therapies are very encouraging, and provide great hope in the treatment of restenosis. Brachytherapy has shown success in the treatment of in-stent restenosis, and recently has been approved by the United States Food and Drug Administration for this indication. Drug-eluting stents using antiproliferative drugs are the most exciting new advance in preventing restenosis, currently in Phase III trials. Gene therapy, targeted drug delivery, and newer antithrombotic agents are also under investigation. We will review the pathophysiology of restenosis, animal models, pharmacological therapies, and mechanical approaches for the treatment of restenosis.

Animals↗
PubMedDate not supplied

Dural ectasia of the optic nerve sheath in neurofibromatosis type 1: CT and MR features.

OBJECTIVE: Optic nerve glioma is a common finding in patients with neurofibromatosis type 1 (NF-1). Although dural ectasia of the optic nerve is encountered rarely, it has to be considered in the differential diagnosis. MATERIALS AND METHODS: Three patients affected by NF-1 were examined sequentially by CT and MRI. RESULTS: Computed tomography demonstrated nonprogressing enlargement of the anterior optic pathways. Magnetic resonance imaging displayed widening of the perioptic dural sheath without any suggestion of tumor. CONCLUSION: These findings are compatible with meningocele or dural ectasia of the optic nerve sheath. This entity represents a differential diagnosis to optic glioma in patients with NF-1.

Adolescent↗
PubMedDate not supplied

Facial intraosseous arteriovenous malformations: CT and MR features.

OBJECTIVE: To present the CT and MR findings of two patients with maxillofacial intraosseous arteriovenous malformations (AVMs) before and after endovascular therapy. MATERIALS AND METHODS: Two young girls suffering from AVMs in the maxilla and mandibula with spontaneous bleeding in the oral cavity were examined by CT and MR on a 1.5 T GE unit before and after selective endovascular embolization. RESULTS: Computed tomography using a high-resolution algorithm and two-dimensional reconstructions demonstrated the morphology of the bony lesions as well as the regrowth of the bone after successful embolization. Magnetic resonance was the best imaging technique to show vessel structures and the accompanying soft tissue changes. Angiography showed the exact angioarchitecture of the AVM and was essential for therapy planning. CONCLUSION: Because selective endovascular embolization of maxillofacial AVMs is gaining in importance, CT and MRI are, therefore, essential for diagnosis and therapy planning as well as for follow-up imaging.

Arteriovenous Malformations↗
PubMedDate not supplied

Evaluation of cerebrovascular disease by combined extracranial and transcranial Doppler sonography. Experience in 1,039 patients.

Results from 1,039 combined cervical and transcranial Doppler examinations are reported. Satisfactory transcranial signals were not found in 2.7% of the cases. Compared with angiography, the accuracy of transcranial criteria in assessing collateral flow over the circle of Willis was 94 and 88% for anterior and posterior circulation, respectively. The method also appeared very promising for detection of lesions of the intracranial arteries although the number of such cases with angiographic verification was limited in the present series. Arterial narrowing due to cerebral vasospasm was diagnosed with a sensitivity of 80%. In patients with ruptured intracranial aneurysms, an incidence of 93% arterial narrowing in basal cerebral arteries was found. Patients with subarachnoid hemorrhage and no aneurysm on angiography also showed arterial narrowing with an incidence of 56%. It was possible to monitor the time course and severity of cerebral vasospasm. Arteriovenous malformations were characterized by Doppler findings of high velocities and low pulsatilities. These lesions were diagnosed with an accuracy of 95%.

Cerebral Angiography↗
PubMedDate not supplied

[A multicenter trial of a device for treating obstructive sleep apnea by continuous positive pressure].

The efficacy and tolerance of a nasal CPAP device marketed in France (Pression +, Sefam) for the treatment of obstructive sleep apnoea syndromes have been evaluated in a co-operative trial including 12 patients. This study confirmed the efficacy of nasal CPAP on sleep parameters: total sleep time was increased; light non-REM sleep was diminished; slow-wave sleep and REM sleep were augmented; sleep apnoeas were eliminated completely or almost completely; oxygen saturation was markedly improved. At one month follow-up, most clinical features were improved; daytime blood gases showed little change but the number of red cells was decreased. On the whole, the tolerance was good in this highly motivated group of patients: eleven patients (92%) were willing to continue their home treatment with the same device. Most difficulties were due to the making of a tailored molded nasal mask and its use during sleep.

Adolescent↗
PubMedDate not supplied

The use of somatosensory evoked responses in carotid surgery for monitoring brain function.

One of the problems in carotid surgery is the intra-operative detection of brain ischemia. None of the methods applied so far have been successful. Experience has shown that the results were unsatisfactory. Experimental studies have detected a strong correlation between regional cerebral blood flow and somatosensory evoked potentials. At the Surgical Clinic of the University of Cologne, 60 patients had continuous intraoperative monitoring of somatosensory evoked responses during carotid endarterectomy. Our previous experiences suggest that monitoring of somatosensory evoked responses during carotid endarterectomy provides a suitable method for the registration of brain function. Furthermore it is possible to pinpoint the causes of ischemia and to immediately begin treatment based on the causes of ischemia.

Aged↗