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Biomedical subjects

R Hagen

Publications and source records attributed to R Hagen.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Voice rehabilitation following total laryngectomy: microvascular laryngeal replacement-plasty (laryngoplasty) instead of voice prosthesis].

Since the introduction of the so-called voice prostheses tracheoesophageal puncture is currently the most widely used surgical procedure for vocal rehabilitation after total laryngectomy. The voice prosthesis renders possible a reliably reproducible voice, which is superior (period of uninterrupted sound production, basal frequency, voice intensity) to the other techniques (esophageal speech, external vibrators, other surgical reconstructive measures), but has the following disadvantages: high initial phonation pressure, formation of granulation tissue around the voice shunt, blockage or leakage of the prosthesis or the voice shunt, displacement of the prosthesis, spontaneous occlusion when the prosthesis is accidentally removed, overtaxing the patients who have difficulties in replacing and cleaning the prosthesis. As an alternative new surgical technique a substitute larynx tube (laryngoplasty) was formed by a microvascular anastomotic forearm flap and connected to the trachea and pharynx in ten patients with extensive (T3-T4) laryngohypopharyngeal carcinoma. All ten patients developed a voice comparable with those of patients who have a voice prosthesis (frequency, voice intensity, period of uninterrupted sound production). An advantage of this graft over the voice prosthesis is that the phonation pressure required is low. While they were still in hospital eight patients learned to speak without using their hands by means of a tracheostomal valve. So far (six months postoperative) this surgical procedure has proved to be a practicable surgical alternative to a voice prosthesis.

Animals↗
PubMed1990

[Voice rehabilitation after total laryngectomy in West Germany. Current state of the art].

In 1987 Lopez published the results of a survey of voice rehabilitation after total laryngectomy as carried out by 400 North American ENT surgeons. In order to obtain the same information on the current state of voice rehabilitation in the German Federal Republic we did a similar survey of 103 ENT clinics. Ninety-five (92%) questionnaires were evaluated. Each year, 2200 laryngectomies are carried out in Germany. Oesophageal speech is the most frequently used form of voice rehabilitation in both countries. In the USA voice prostheses are fitted by 88% of the surgeons questioned to a total of 30% of patients; in Germany only 22% of the clinics in which laryngectomy is carried out fit these devices to a total of 5.6% of patients. External vibrators are used with equal frequency (28%). In contrast to the United States, where intraoral aids are currently used in 15% of patients, we do not employ these at the present time at all. Voice shunt operations (Staffieri, Asai, Amatsu etc.) are still carried out in 7 clinics (6.7%) on 0.7% of all patients (USA: 16% of surgeons on 15% of patients). In the United States 9% of patients are not rehabilitated compared with 6.7% in the Federal Republic.

Germany, West↗
PubMed1990

[Diagnosis of oropharyngeal function with FLASH-MR tomography].

Magnetic resonance imaging (MRI) has several advantages over conventional X-ray methods: the patient is not exposed to radiation; images of any chosen level can be taken without changing the position of the patient; soft tissues are well differentiated; and artefacts due to dental materials are avoided. Thus, in certain fields of ENT diagnosis MRI is superior to computed tomography, for example, in the imaging of acoustic neuromas, glomus tumours and tumours of the parotids, oropharynx and orbit. The measuring time per slice image, which was previously measured in minutes, has been reduced by a factor up to 1000 by the FLASH (fast low angle shot) technique. Thus, it is now possible to follow human physiological processes on an MRI film with a frame speed of 5 pictures using a whole-body magnet. Films of speech, tongue movements and the act of swallowing reveal the value of this technique for the functional diagnosis of disease of the oropharynx. Precise imaging of the anatomical and functional situation, especially of soft tissues, is superior to that of previous methods such as ultrasound, X-ray, and endoscopy.

Deglutition↗
PubMed1988

Anaesthetic management in patients with epidermolysis bullosa dystrophica.

Successful anaesthetic management of two patients with severe epidermolysis bullosa dystrophica was accomplished with the use of ketamine-diazepam dissociative anaesthesia in one and brachial plexus block in the other. The classification and pathology of epidermolysis bullosa is considered, and the problems associated with anaesthesia in patients with this disease are discussed.

Adult↗
PubMed1988

Spondylolysis and spondylolisthesis. Treatment by internal fixation and bone-grafting of the defect.

Eighteen patients who had symptomatic spondylolysis or Grade-I spondylolisthesis, and whose symptoms had not been relieved by non-operative treatment, were operated on using the Buck method for bone-grafting and internal fixation of the defect of the pars interarticularis with screws. There were six male and twelve female patients and the average age was twenty years (range, fourteen to thirty-eight years). The amount of slipping ranged from zero to ten millimeters. After an average period of follow-up of forty-one months (range, twenty-four to seventy-two months), the result was excellent in ten, good in five, and poor in three patients. Thus, a satisfactory result was obtained in 83 per cent of the patients.

Adolescent↗
PubMed1984

[Value of early diagnosis of urinary tract infections in pregnancy].

Clinical report of severe nephrological and urological complications in pregnancy leading to the importance of early diagnosis of urinary tract infections in pregnant women. In this respect the central point is looking for asymptomatic significant bacteriuria. Microscopical methods and chemical practices are to be abandoned. The method of choice is quantitative urine culture. Early diagnosis and treatment of clinically symptomless infections in pregnancy is one of the fundamental criteria of quality in prenatal care.

Adult↗
PubMed1983

Surgical treatment of dislocations of the sternoclavicular joint.

Six patients with dislocation of the sternoclavicular joint are presented. Their main complaints were chronic recurrent spontaneous dislocation and local tenderness and discomfort during normal use of the shoulder. Two patients were treated according to Brown's modified procedure while four patients were operated with Burrow's technique. Ten weeks immobilization postoperatively is recommended to obtain a satisfactory result.

Female↗
PubMed1982

Release of endogenous histamine in the hypothalamus of anaesthetized cats and conscious, freely moving rabbits.

The hypothalamus of anaesthetized cats and conscious, freely moving rabbits was superfused with CSF through double-walled, push-pull cannulae and the release of endogenous histamine was determined in the superfusates by a radioenzymatic assay. In the posterior hypothalamic area of the anaesthetized cat, the rate of release of endogenous histamine varied rhythmically; phases of high rate of release appeared at 60 min cycles. The release of histamine was increased by electrical stimulation of the superfused area, as well as by hypothalamic superfusion with potassium-rich CSF. In the conscious rabbit, the anterior hypothalamic area and the posterior hypothalamic nucleus were superfused simultaneously. In both regions, the resting release of histamine varied rhythmically at approximately 70 min cycles. Phases of high or low-rate of release in the anterior hypothalamic area coincided with the corresponding phases in the posterior hypothalamic nucleus. The rhythmic release of endogenous histamine in the hypothalamus, as well as the ability of depolarizing stimuli to enhance the release of the amine support the idea that histamine acts as a neurotransmitter in the central nervous system.

Anesthesia↗
PubMed1982

Juxta-articular bone cyst.

Juxta-articular bone cyst was first described as a distinct clinical entity by Hicks in 1956 and called "intraosseous ganglion". Hitherto, some 150 similar cases have been described. The cyst, which is usually solitary, occurs in the epiphysis near a weight-bearing joint in middle-aged persons. It may cause persistent pain but is easily overlooked on ordinary X-rays. The histogenesis is uncertain. Six patients treated by thorough curettage and autologous bone transplantation are presented. All achieved immediate relief from pain. Some theoretical aspects concerning the histogenesis are discussed.

Adult↗