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Biomedical subjects

R Brunner

Publications and source records attributed to R Brunner.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Endothelial precipitates and cytomegalovirus infection].

In patients with the typical features of intraocular cytomegalovirus infection endothelial precipitates were identified that had a characteristic morphology, which included subtle, non-pigmented linear deposits with reticular arrangement that can spread diffusely over the corneal endothelium without preference for the inferior quadrants. The appearance of these precipitates was comparable to heterocromic cyclitis. Specular microscopy identified lymphocytes and macrophages on the endothelial layer. The present observations are based on five case reports of necrotizing retinitis, typical for intraocular cytomegalovirus infection, in connection with the atypical endothelial precipitates. In four of the five patients reported, HIV-infection was confirmed. In one patient with serologically confirmed cytomegalovirus infection (however without HIV-infection), a diagnostic work-up of the aqueous humor was carried out. Local production of specific antibodies against cytomegalovirus was identified in the aqueous humor. Topical treatment with antiviral and/or steroidal drugs was unsuccessful. The antiviral drug gancyclovir was applied systemically in two patients, but there was no impact on the corneal precipitates described. No intravitreal therapy was given. If these endothelial changes can be regarded as pathognomonic for cytomegalovirus infection, thorough slit lamp examination may be important for diagnosis of the presence of or the reactivation of cytomegalovirus infection in the eye. So far, no correlation has been found between the time course of corneal/endothelial precipitation and necrotizing retinitis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Therapeutic concepts in infected hip prosthesis].

In the period from January 1980 to December 1987, 62 patients with infected hip joint arthroplasties were treated. The duration of observation was on average 37 months (minimum 12 months, maximum 91 months). The choice of treatment modality depended on the type of infection, the state of anchorage of the endoprosthesis, the general condition of the patient, the type of bacterium and the state of the tissue surrounding the implant. 42 arthroplasties (67%) healed primarily. The remaining 20 were subject to 46 further operations (2.3 relapse operations/patient). 14 subsequently healed (23%) and six cases remained definitively infected.

Debridement↗
PubMed1987

Para-articular ossification in total hip replacement: an indication for irradiation therapy.

The results of postoperative irradiation therapy after total hip replacement or resection of para-articular ossification in 25 patients are reported. The patients were kept under radiological observation for an average period of 26 months and clinical observation for an average period of 31 months after surgery. There were only two clinically relevant recurrences of para-articular ossification. The earlier radiotherapy with a total dose of 2000 rads (2000 cGy) was begun, the better was the effect. In this small population sample statistical significance could not be calculated. No side effects were detected.

Adult↗
PubMed1987

[Treatment of naevi flammei with the argon laser].

We report on 901 patients with port wine stains treated by means of an argon laser. The treatment results have been definitively evaluated in 371 patients. They were significantly influenced by the patients' age and by the colour of the lesions. The worst response to the therapy was seen in pink port wine stains in children and juvenile patients (20% good results), in contrast to red and purple lesions in adult patients (80% excellent and good results). The size of the port wine stains did not significantly influence the treatment results, but in extensive lesions homogeneous lightening could not usually be attained and treatment often extended over some years. Port wine stains in the head and neck area responded best to therapy, and lesions on the legs, worst. Altogether, in 60%-70% of adult patients excellent or good results were obtained, the lesions being completely removed or significantly lightened and reduced in size. The side-effects of laser therapy were scar formation (7.3%) and changes in pigmentation (8.6%).

Adolescent↗
PubMed1986

Effects of argon, dye, and Nd:YAG lasers on epidermis, dermis, and venous vessels.

The aim of the present study, which was performed at the dorsal aspects of the ears of guinea pigs, was to compare effects of different lasers on epidermis, dermis, and small venous vessels. Irradiations were performed with argon, dye, and Nd:YAG lasers. In the first series tissue repair processes were studied after argon laser application. Laser defects were excised after 1, 4, 8, and 14 days and were prepared for routine histological examination. The breadth of epidermal defect and extent of dermal coagulation and occlusion of vessels by thrombus formation were examined histologically. In a second series parameters of irradiation (ie, exposure time, laser power) of the three different lasers were changed systematically. Laser-induced morphological tissue changes could be best observed 24 hours after irradiation. Each of the lasers led to occlusion of vessels by thrombus formation and also coagulated epidermis and dermis. The extent of dermal and epidermal coagulation was less pronounced after dye laser application. Using short exposure times it was possible to reduce the extent of epidermal damage caused by argon and Nd:YAG lasers. Only 50-msec dye laser pulses led to intravascular thrombus formation without epidermal and dermal damage.

Animals↗
PubMed1986

Neodymium-YAG laser therapy for vascular lesions.

Three patients with port-wine stains with a nodular surface, one patient with macrocheilia resulting from a port-wine stain, and one patient with a capillary hemangioma were treated with a Nd-YAG laser (mediLas, MBB-AT, Munich). Irradiance was between 800 and 1,600 watts/cm2, with energy fluence between 400 and 1,600 joules/cm2. Treatments were performed with local anesthesia on an outpatient basis. In all patients, marked improvements could be obtained after only a few treatments. Histologically there was necrosis of epidermis and dermis immediately after laser application, and ectatic vessels contained coagulated erythrocytes. Depth of coagulation was up to 3.5 mm. Quick restoration of epidermis was observed. After some days, macrophages, fibroblasts, and capillary blood vessels grew into the agglutination thrombi and ectatic vessels were replaced by granulation tissue and, later, by fibrous tissue. In comparison with the argon laser, the Nd-YAG laser coagulates at a much deeper level, but processes of tissue repair take longer and fibrosis is more pronounced after Nd-YAG laser application. Clinically, therefore, scar formation is more likely. Chilling the skin surface during irradiation and shorter exposure times may be effective in reducing the risk of scar formation in the future.

Adult↗
PubMed1986

Laser therapy of bowenoid papulosis and Bowen's disease.

Six patients with bowenoid papulosis and two patients with Bowen's disease of the genital area were treated by means of an argon, Nd:YAG, and CO2 laser. In all of the patients, complete resolution of the lesions was achieved. Due to a superficial coagulating effect, application of the argon laser should be restricted to macular and papular pigmented lesions. In contrast, Nd:YAG and CO2 lasers could be used even for treatment of extensive leukoplakia-like and verrucous lesions. Advantages and disadvantages of these two lasers are discussed.

Adult↗
PubMed1986

LAV/HTLV-III infection and atopy: serum IgE and specific IgE antibodies to environmental allergens.

The incidence of atopic diseases and IgE production was investigated in 69 patients of the AIDS outpatient clinic. In LAV/HTLV-III infected homosexuals there was a trend to lower serum IgE levels and decreased frequency of atopic diseases. The incidence of patients with positive RAST against common environmental allergens was significantly lower in LAV/HTLV-III-infected versus non-infected homosexuals.

Acquired Immunodeficiency Syndrome↗