Biomedical subjects
Publications and source records attributed to R Brunner.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fibrosis, contraction and opacification of the posterior lens capsule after extracapsular cataract extraction, is a frequent complication following cataract surgery. In these cases, cellular proliferation occurs along an intact posterior capsule. We report a case of fibrosis adjacent to the anterior lens capsule, where cellular proliferations and collagen production completely sealed the anterior capsulotomy three months after a routine extracapsular cataract extraction with implantation of a posterior chamber lens. The fibrosis led to contraction of the remainder of the anterior capsule, significantly reducing vision. Examination of the excised material by light and electron microscopy, and immunohistochemistry, revealed cells with features compatible with fibrocytes that did not stain positive for cytokeratin. The cells were situated in a dense collagen matrix. An anterior capsulotomy that is too small prevents sufficient removal of lens epithelium, and may be a risk factor for this complication.
An intertrochanteric femoral osteotomy is carried out to correct intoeing gait and to improve hip centration in patients with spastic cerebral palsy. The long-term effect of such osteotomies on the neck-shaft angle (NSA) and anteversion angle (ATA), as well as on hip-joint centration, was evaluated in 63 hips of 45 patients with observation times of 11-18 years (mean, 15.4). The postoperative loss of correction of the NSA and ATA was the more pronounced the younger the patients were at the time of intervention. This was particularly true when the hip joint was subluxated or dislocated and when the operation was done before the age of 4 years. Patients of this age group lost 96% of the correction of the NSA and 42% of the ATA. Hip centration always improved, but corrective femoral osteotomy alone did not result in a sufficient coverage in cases of subluxation and dislocation in the short and long term.
Sixty-four dislocated hip joints in 47 patients with spastic cerebral palsy were reconstructed surgically for pain or physical impairment. The procedure included a femoral and pelvic osteotomy, an anterior iliopsoas transfer, and further soft-tissue surgery. The study was based on a research questionnaire (mean follow-up 6.8 years) and radiographs (3.0 years). Upon review of radiographs, it was discovered that three hips had redislocated and that 23 were insufficiently covered. Four complications (one deep infection, three femoral fractures) occurred. Pain was relieved fully in 28 of 37 patients and eased in 9 of 37. Weight-bearing improved sitting problems in 22 of 26 patients and enabled nine of 36 nonwalkers to take at least a few steps.
Among a series of patients with age-related macular degeneration (ARMD), a few individuals could be identified showing larger amplitudes of pattern reversal visual evoked potentials (prVEP) after stimulation of a central 3 degrees field compared to stimulation of a 13 degrees field although in the majority of ARMD patients and in normals, VEP amplitudes increased with increasing field size. An analysis of prVEPs recorded after stimulation of different macular zones showed that the 3 degrees central area and the perifoveal zone contributed differently to the 13 degrees response or macular response. Perifoveal activity in this subgroup of ARMD patients seemed to mask the foveal contribution to the macular prVEP. The cortical magnification factor in ARMD may be higher than in normal controls. Small-field stimulation techniques are therefore also recommended in patients with central retinal pathology.
Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.
BACKGROUND: Only little information on the expression of P-glycoprotein (P-gp) and MRP1 in metastases of breast carcinomas is currently available. The aim of the present study was to investigate the expression of these two proteins in axillary lymph node metastases of breast cancer patients. MATERIALS AND METHODS: We determined the expression of P-gp and MRP1 in axillary lymph node metastases of 63 breast cancer patients and, in 32 patients, compared this expression to the expression of corresponding primary tumors. P-gp was detected by means of C219 and Ab-2 monoclonal antibodies, and MRP1 by means of the MRPr1 monoclonal antibody. RESULTS: In lymph node metastases, P-gp expression was positive, usually at low levels, in 28 (44%) specimens whilst MRP1 expression was positive in all specimens with low, intermediate and high levels in 3 (5%), 46 (73%) and 14 (22%) specimens, respectively. The percentage of P-gp expression was slightly lower in lymph nodes than in primary tumors while MRP1 expression showed a higher staining intensity in lymph nodes than in their corresponding primary tumors. CONCLUSION: These data indicate that both P-gp and MRP1 are frequently expressed in lymph node metastases of breast cancer patients and that MRP1 expression is more pronounced in lymph node metastases than in corresponding primary tumors.
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The effect of two different types of functional ankle-foot orthosis on the gait of patients with spastic hemiplegia was studied. A gap was cut into the conventional stiff orthosis to allow a limited dorsiflexion of 10-15 degrees, while plantarflexion was blocked (spring type). This gap was bridged by an aluminum bar to stiffen the orthosis for the experiment. Fourteen patients of different ages (6.5-20.1 years) walked barefoot and with the orthosis, once springy and once stiff. Kinetics and kinematics were analyzed. Gait was significantly improved into normal pattern by using any type of ankle-foot orthosis. While walking barefoot with a toe-heel-toe gait, the physiological heel-toe gait was restored with any type of orthosis. The spring type of orthosis was significantly superior to the stiff orthosis. This was most clearly expressed in the general parameters of gait-like cadence, velocity, and step length. Kinetic data gave a significant improvement by using any ankle-foot orthosis. Whereas break force was similar with both types, push-off was further improved with the spring type. Kinematics revealed little statistical difference between the two types, although gait was more dynamic and physiological with the spring type of orthosis. Any functional ankle-foot orthosis ameliorates the gait pattern in patients with spastic hemiplegia, but a spring type of orthosis renders the gait more dynamic and best corrects the pathology of gait.