"Atypical" Ramsay Hunt syndrome.
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Cranial Nerves↗
Biomedical subjects
R Steffen
Publications and source records attributed to R Steffen.
[Risk groups in travel to tropical countries within the frame of mass tourism].
More than 10,000 tourists returning from tropical countries have been asked about health problems during their stay abroad. Preliminary results from the first 5,550 questionnaires indicate that 74,8% had complaints of any kind concerning their health and 13,6% can be considered as having been ill. The frequency of complaints and illness in relation to different variables is shown and the possibility of definition of high risk groups is being discussed.
Adolescent↗
Formation of spicules by sclerocytes from the freshwater sponge Ephydatia muelleri in short-term cultures in vitro.
Cells from the freshwater sponge Ephydatia muelleri were isolated by dissociating hatching gemmules. During the first 24 h the cells reaggregated, but the aggregates progressively disintegrated again to single cells, among which the spicule-forming sclerocytes were recognized. Such cultures were used to study spicule (megascleres) formation in vitro. The isolated sclerocytes formed the organic central axial filament onto which they deposited inorganic silicon. The size of the spicules (200 to 350 microns in length) as well as the rate of spicule formation (1 to 10 microns/h) under in vitro conditions were similar to the values measured in vivo. Immediately after completion of spicule formation, or even before, the sclerocyte could start formation of a new spicule; 5% of the cells were in the process of forming two spicules simultaneously. Cultivation of sclerocytes in the absence of silicon resulted in the formation of the axial filament only. We succeeded in maintaining the sclerocytes in a proliferating and spicule-forming state for up to 3 mo. These results demonstrate that the establishment of short-term cell cultures from E. muelleri is possible; however, future studies must be undertaken to identify the growth factors required for a permanent culture of sponge cells.
Animals↗
Malaria and mosquitoes: how often for how long?
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Animals↗
Travel medicine--prevention based on epidemiological data.
In travel medicine efforts should be concentrated on preventive measures that are necessary, and travellers should be spared the side effects, costs and stress of superfluous measures. Excess mortality abroad is mainly due to traffic and swimming accidents, indicating the need for appropriate control strategies. The morbidity in travellers to developing countries is high, and is primarily due to traveller's diarrhoea. As prophylaxis is ineffective or unrealistic, and as travellers often need fast relief, it is recommended to include loperamide and an antimicrobial agent in the travel kit. Recent studies have shown that the incidence rate per month of Plasmodium falciparum malaria in Africa may reach 24/1000. The most frequently occurring immunizable diseases are hepatitis A (3/1000) and hepatitis B (0.8/1000). For many tourists and some expatriates pre-travel advice (hygiene, measures against mosquito bites, etc.) as well as chemoprophylaxis and immunization can be limited to these infections, but those travelling or staying outside large centres need additional measures.
Developing Countries↗
Age-dependent increase of DNA topoisomerase II activity in quail oviduct; modulation of the nuclear matrix-associated enzyme activity by protein phosphorylation and poly(ADP-ribosyl)ation.
Nuclear DNA topoisomerase II activity in quail oviduct tissue was found to increase by about 70% with age. This age-dependent increase was observed with both the enzyme in whole nuclear extract and nuclear matrix-associated topoisomerase II. Both purified topoisomerase II and the nuclear matrix-bound enzyme were found to be modifiable by phosphorylation and poly(ADP-ribosyl)ation. Phosphorylation of the purified enzyme by isolated nuclear protein kinase NII or protein kinase C resulted in a 2- to 3-fold increase in specific activity, while poly(ADP-ribosyl)ation by soluble poly(ADP-ribose) synthetase caused a 50% inhibition of the enzyme. Using immunoprecipitation and immunoblotting procedures, phosphorylation and poly(ADP-ribosyl)ation could also be demonstrated to occur with the nuclear matrix-associated enzyme. The nuclear matrix-associated NII-like protein kinase activity, assumed to be involved in post-translational modification of topoisomerase II, displayed a 1.4- to 1.6-fold increase in old animals compared to mature ones, while the matrix-bound poly(ADP-ribose) synthetase activity decreased by about 50%. It is suggested that age-correlated enhancement of DNA topoisomerase II activity, possibly due to age-dependent changes in activities of nuclear protein kinases and poly(ADP-ribose) synthetase, may result in alterations in the topological state of DNA, possibly affecting DNA replication, transcription and repair with age.
Aging↗
MalaQuick versus ParaSight F as a diagnostic aid in travellers' malaria.
In this study we assessed whether travellers can perform malaria rapid tests, following the provided information leaflet, and correctly interpret performed and pre-prepared test strips. Two Plasmodium falciparum testing systems, namely MalaQuick (ICT) and ParaSight F were used. Test performance and test interpretation of pre-prepared tests were compared. There was no significant difference in test performance between the 2 tests. Interpretation of prepared test strips in both test systems was very reliable in blood parasite densities between 0.1% and 2%, but major problems were encountered at low parasitaemia (< 0.1% blood parasites) and also in ParaSight F test strips showing high parasitaemia (> 2% blood parasites). Low parasitaemia ParaSight F test strips were correctly interpreted by 52.1% compared with 10.8% correct interpretations with MalaQuick (P < 0.0001). Correct interpretation of highly positive (> 2% blood parasites) pre-prepared test strips was higher with MalaQuick (96.8%) than with ParaSight F (33.8%), P < 0.0001. Both tests were associated with high levels of false-negative interpretations which render them unsuitable as self-diagnostic kits. Efforts must be made to assist lay individuals in test performance by technical test improvement, by equiping the test strips with an additional reading aid for interpretation, and by providing instruction by a skilled person.
Adult↗
[Biomechanical study on lumbar spondylodeses using an internal fixateur consisting of a titanium alloy].
OBJECTIVE: Biomechanical properties of an internal fixateur manufactured of a titanium alloy (Ti-6Al-4V-alloy) to be evaluated in an in vitro setting. METHOD: Internal fixateurs were inserted into six (four female and two male specimens) human lumar spine segments L2 to L4. Only dorsal instrumentations were performed. Physiological loads were applied (2.0 to 10.0 Nm for torque, 2.0 to 7.5 Nm for extension/flexion and lateral bending). Biomechanical investigations were performed in four settings: Intact specimen without instrumentation, instrumented specimen, instrumented specimen after corpectomy of the middle vertebral body, instrumented specimen after corpectomy of the middle vertebral body with an additional transverse connector. RESULTS: Stability after instrumentation was increased by 84.7 % for flexion/extension, by 78.2 % for lateral bending and by 43 % for axial torsion. Axial torsion was already less distinct in the physiological specimen. The stability of instrumented specimen after corpectomy was superior to that of intact vertebral segments without internal fixation. Additional application of transverse connectors did not significantly enhance the stiffness of the implant. CONCLUSION: For the clinical use there is no difference in the biomechanical properties of the titanium fixateur compared to similar constructions made of stainless steel. The possibility of performing MRI- or CT-scans after implantation of titanium implants is a main clinical advantage. The stabilisation after corpectomy is remarkable, so that a sufficient fracture-stabilisation is possible. Based on the data, the application of transverse connectors cannot be recommended.
Adult↗
[Cup placement in hip replacement surgery -- A comparison of free-hand and computer assisted cup placement in total hip arthroplasty -- a multi-center study].
AIM: The purpose of the current study was to determine the accuracy of free hand and computer-assisted (CAS) cup placement. MATERIAL AND METHODS: Between June 1985 and August 2001, 105 free-hand and from March to November 1999 80 total hip arthroplasties under computer assistance were implanted in the above mentioned centers. To determine the accuracy of the cups, the inclination and anteversion angles were measured. In all cases the cup position was measured with a CT-investigation of the pelvis. Statistical analysis was performed with the F-test. RESULTS: With regard to the inclination and anteversion angles the variability of the cup position was significantly higher in the group of free hand implanted cups. In the CAS group we could not find any "extreme" positions. CONCLUSION: Using computer-assisted surgery a significantly higher reproducible cup position can be obtained. Long time survey may present a lowering of the rate of early and late complications caused by better prostheses alignment in the follow up.
Adult↗
[Triple pelvic osteotomy (according to Tönnis and Kalchschmidt) in the treatment of acetabular dysplasia--medium-term results].
AIM: The triple pelvic osteotomy according to Tönnis and Kalchschmidt has gained major significance in the surgical treatment of acetabular dysplasia in adolescents and adults. The curative and prophylactic potentials of this operative procedure are reviewed in this study by means of a clinical and radiological follow-up trial. METHODS: 34 patients/38 hip joints treated by the triple pelvic osteotomy between 1996 and 2005 were reviewed clinically and radiologically with an average follow-up of 3.5 years. The radiological classification into grades of deviation was done according to Tschauner et al., clinically the preoperative Harris hip score was determined, as well as common epidemiologic parameters. At follow-up, the preoperatively determined radiological and clinical parameters were controlled and subjected to statistical analysis using Student's t-test for the comparison of means between two paired groups. Finally, the subjective assessment of the operation's result by the patients was registered. RESULTS: A statistically highly significant amelioration of the Harris hip score, relevant radiological angles and grades of deviation could be demonstrated at follow-up. This fact coincided with a high or very high patient satisfaction in 81.7% of the cases. The conversion rate to alloarthroplasty was 2.6%. The complication profile was within the scope of similar elective hip surgeries. CONCLUSION: The triple pelvic osteotomy according to Tönnis and Kalchschmidt has shown in the present study a high and constant potential with regard to reduction/absence of disorders as well as a statistically highly significant amelioration of clinical scores and relevant radiological angles. In our experience, this surgical method can be regarded as the joint-preserving method of choice in the cardinal indication of adolescent and adult acetabular dysplasia.
Acetabulum↗
[Biomechanical considerations concerning the use of internal fixator systems in spinal interventions].
Three different internal fixateurs ("Dick", "Kluger", "SOCON") were investigated in an in-vitro setting. The systems showed nearly identical deformation under physiological loads. A new definition for the stabilizing capacity indicated a distinct weakness under compressive and torsional loading. In order to avoid early failure of the implant and/or the vertebra-implant interface bracing and a restricted mobilisation is recommended until healing of the fracture/fusion has taken place.
Adult↗
[Is epidural injection treatment with hypertonic saline solution in intervertebral disk displacement useful? (The effect of NaCl solution on intervertebral disk tissue)].
The effect of sodium chloride solution on disc tissue was investigated in vitro. Tissue material was obtained from 19 discectomies. The specimens were incubated in aqua ad injectionem and in different sodium chloride solutions and weighted regularly during a maximum of 24 hours. Following the incubation periods the specimens were examined histologically. After one hour the surgical specimens showed a weight increase of 290% for aqua bidest., 170% for 0.9% NaCl and 100% for 5.85% NaCl and 10% NaCl. Disc tissue obtained from six autopsies was also examined under the same conditions. The weight increase in nucleus pulposus and anulus fibrosus tissue was less than in the disc tissue obtained from surgery. The weight increase in anulus fibrosus tissue was less than in nucleus pulposus tissue. In vitro incubation of disc tissue in a hypermolar sodium chloride solution always resulted in a weight increase. Successful therapy could not be explained by shrinkage of disc tissue treated with hypermolar sodium chloride.
Adult↗
[Chemonucleolysis using chymopapain and collagenase. 3-year results of a prospective randomized study].
100 patients were prospectively and randomized treated by chemonucleolysis either by collagenase (n = 50/400 ABC-U/disc) or by chymopapain (n = 50/4000 I.U.). The success rate after 1 year was 70% for collagenase and 78% after chymopapain, and 72%/80% after 3 years, respectively. Successful results increased significantly during the first year after treatment and remained stable after that point. After chymopapain, one case of successfully treated anaphylaxis (2%) occurred. After collagenase, 3 cases of secondary sequestrations were observed in cases with primarily closed discograms with intact dorsal longitudinal ligament.
Adolescent↗
[Ultrasound control of the repositioning of hip dislocation in a child in the unstable phase of splint retention (Hanausek position)].
In CDH ultrasound control of reduction in the unstable period of the first 3 months has to be performed by an inguinal access, as the splint can not be removed for the reason of high risks of redislocation. Controls are possible whenever required, according to anglo-american techniques. Thus treatment within the first year of life may be controlled by ultrasound imaging alone. Criteria for detection of posterior and cranial redislocation as well as for the anterior positioning of the femoral head are given.
Follow-Up Studies↗
[Experimental studies of change in the center of rotation of the moveable segment after intervertebral disk removal].
The in vitro effect of nucleus pulposus removal from human lumbar FSU's was investigated in a special test apparatus. Instability was determined by ROM, loss of disc height and displacement of the center of rotation. Disc height showed a decrease of 3.2 mm under axial load (700N). ROM increased up to 70%. The center of rotation demonstrated a distinct displacement in extension and lateral bending.
Biomechanical Phenomena↗
[Comparative biomechanical studies following automated percutaneous nucleotomy and diskotomy].
APLD is considered as the last step of conservative treatment for lumbar disc herniation assuming that a negative biomechanical effect of APLD is not expected. Biomechanical effects of APLD were investigated in comparison to open discectomy. APLD decreased disc height less than open discectomy and increased instability and flexibility less. The position of the center of rotation was not significantly altered.
Adult↗
Worldwide efficacy of bismuth subsalicylate in the treatment of travelers' diarrhea.
So far four randomized studies, three of them double-blind and placebo-controlled, have investigated the role of bismuth subsalicylate (BSS) in the treatment of travelers' diarrhea. When compared with placebo BSS significantly reduced the number of unformed stools and increased the proportion of patients free of symptoms at the end of the trial. In the two studies that compared BSS with loperamide, the latter agent brought significantly faster relief. Diarrhea accompanied by dysenteric symptoms was influenced most favorably by administration of systemic antimicrobial agents. In all four studies only minor adverse effects were noted with BSS or the other active agents. One may include loperamide and a systemic antimicrobial agent in one's travel kit; however, loperamide should not be used for dysentery, and the antimicrobial agent should not be used in uncomplicated cases. As an alternative, although it is less effective, BSS has the unique advantage of being safe enough to use for all patients with travelers' diarrhea.
Adolescent↗
Epidemiologic studies of travelers' diarrhea, severe gastrointestinal infections, and cholera.
A retrospective survey, which is based on interviews conducted between 1975 and 1984 with 20,000 European tourists returning from 15 destinations in various climatic zones, demonstrates that travelers' diarrhea is the most frequent health problem encountered by travelers in the tropics. The incidence varied from 4% to 51%, depending on the destination. High-risk groups were persons younger than 30 years, adventurous travelers, and travelers with preexisting gastrointestinal illnesses. Illness acquired at various geographic regions showed only minor differences in chronology and symptomatology. The clinical course of travelers' diarrhea was usually short and mild. Additionally, by longitudinal and retrospective analyses, the incidence and prognosis of gastrointestinal infections of greater severity that were acquired after a short stay in a developing country, such as giardiasis, amebiasis, typhoid fever, and cholera, were evaluated; typhoid fever and cholera, in particular, were found to be quite rare.
Adult↗