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Biomedical subjects

V Klauss

Publications and source records attributed to V Klauss.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Treating carotid stenosis without surgical trauma. How safe is stenting?].

Because of the reduced stress on the patient, the obviation of surgical trauma and the need for anesthesia, and only brief hospitalization, stent angioplasty is an attractive alternative to surgical treatment of carotid artery stenosis. The data so far available suggest that the results may be expected to equal those obtained with surgery in terms of success rate and complications. The establishment of the indication for this procedure is oriented to the indication for thromboendarterectomy, with certain patient groups possibly benefitting from endoluminal treatment. However, until data from controlled studies become available, stenting of the carotid artery should be limited to scientific studies and be registered with appropriate professional associations.

Angiography↗
PubMed2001

[Predictors of recurrent basalioma of the eyelids and periorbital region].

BACKGROUND AND OBJECTIVES: Basal cell carcinoma is the most common malignant tumour of the eyelids but surgical excision in the eyelid region is often in conflict with preserving lid function. The purpose of this study was to identify factors predictive of basal cell carcinoma recurrence to improve pre- and postoperative planning. PATIENTS AND METHODS: A total of 153 patients with basal cell carcinomas without recurrence of at least 5 years were compared with 45 primary lesions of recurrent basal cell carcinomas. Using bivariate correlations and multiple regression analysis, clinical factors were analysed for their value to predict recurrence. RESULTS: Incompletely excised tumours were most likely to recur and re-excised tumours had a higher recurrence rate than primary completely excised tumours. Morphea or sclerosing lesions had a significantly higher tendency to recur than nodular lesions. The recurrency rate decreased with the tumours distance from the lid margin. Based on these factors the calculated risk of a patient was between 47% and 63%, with an estimated risk of recurrence of 50%. CONCLUSIONS: Predicting recurrence using these factors, is not possible in a clinically relevant dimension. So all patients with a basal cell carcinoma of the eyelids or periocular region must be re-examined regularly to detect recurrent lesions as early as possible. Of all recurrences, 89% occurred within the first 5 postoperative years, therefore this should be regarded as the minimal sufficient follow-up time.

Basal Cell Carcinoma↗
PubMed2001

[Keratography (corneal tattooing) in corneal leukoma].

BACKGROUND: Since antiquity attempts have been made to minimize disfigurement and stigmatization of patients with leukoma. Keratography is a relatively new method for imprinting color pigments into the corneal stroma with an entomological needle. MATERIALS AND METHODS: Keratography was performed in 20 patients at the University Eye Hospital, Munich, between November 1997 and September 1999. Patients had either a leukoma that did not tolerate prothesis or had another cloudy corneal disease. The operation was carried out in our outpatient clinic under local anesthesia. RESULTS: There was a single operation in three patients, two operations in nine, three operations in six, and four operations in two. Postoperatively 33% of patients complained of pain. No postoperative bacterial keratitis or perforation occurred. CONCLUSION: All patients were highly satisfied. The long-term stability of color pigments must still be evaluated.

Adolescent↗
PubMed2001

[Intravascular ultrasound guided directional atherectomy and stent implantation of an unprotected main stem in a heart transplant patient with comorbidity].

Following orthotopic heart transplantation (HTx), development of transplant vasculopathy (TVP) is the limiting medical entity leading to significant morbidity and mortality beyond the first year after HTx. Selection of a suitable strategy for repeat revascularisation--transcatheter angioplasty, coronary artery bypass grafting or repeat HTx--depends on various parameters including coronary morphology, left ventricular performance, comorbidity, availability of graft material and donor organs. Catheter-based interventions on the main stem of the left coronary artery are feasible, but a relatively lower primary success rate and a higher complication rate and significantly increased mortality have to be expected. We report on a patient who underwent HTx 9 years ago and developed severe transplant vasculopathy revealing significant main stem stenosis, making reintervention necessary. Due to age, coronary artery morphology and comorbidity the patient was not considered for coronary artery bypass grafting or repeat HTx. We performed successful IVUS-guided directional coronary atherectomy and stent implantation on a distal stenosis of the unprotected main stem. Our case demonstrates a predictable procedural risk and favourable primary result of left main stem angioplasty procedures, thus providing a therapeutic option for patients who are poor candidates for operative revascularisation strategies.

Aged↗
PubMed2001

Antibiotic resistance pattern and visual outcome in experimentally-induced Staphylococcus epidermidis endophthalmitis in a rabbit model.

OBJECTIVE: To study whether the clinical outcome of Staphylococcus epidermidis-induced endophthalmitis in rabbits is related to the antibiotic resistance pattern of the infecting strain. DESIGN: Experimental animal study. PARTICIPANTS: The right eyes of 36 New Zealand white albino rabbits were inoculated with strains of S. epidermidis that displayed various patterns of antibiotic resistance. METHODS: There were 12 rabbits in each of three study groups: fully antibiotic susceptible (FS), partially antibiotic resistant (PR), and multiresistant (MR). Five days after inoculation, the eyes were enucleated and prepared for histologic studies. MAIN OUTCOME MEASURES: Comparisons among the three groups were made based on electroretinographic (ERG) findings, histologic evaluation by a masked observer, and clinical examination. RESULTS: Electroretinographic findings on all rabbits were made by an unmasked observer. At 30 hours after inoculation, the ERG was diminished to 65% of normal for group FS, compared with a flat ERG waveform for groups PR (P < 0.05) and MR (P < 0.05). The ERG waveform was flat for all three groups at 72 hours after inoculation. Histologic evaluation by use of a histologic score revealed that the degree of inflammation and destruction of the retina was less for group FS (n = 10) compared with groups PR (n = 8) and MR (n = 8). Clinical examination revealed that there was a trend of less ocular inflammation for group FS compared with groups PR and MR. CONCLUSIONS: In a rabbit model of S. epidermidis-induced endophthalmitis, antibiotic-susceptible strains caused less inflammation and destruction of the infected retina than did antibiotic-resistant strains.

Animals↗
PubMed2001

Stent design related neointimal tissue proliferation in human coronary arteries; an intravascular ultrasound study.

AIMS: Histological restenosis models in animals have indicated that stent design has a significant impact on vessel trauma during stent implantation and on the amount of subsequent neointimal tissue proliferation. The impact of different stent designs on intimal hyperplasia in human atherosclerotic coronary arteries has not been determined. METHODS AND RESULTS: Angiographic and intravascular ultrasound studies were performed at the 6 month follow-up in 131 consecutive native coronary lesions of 131 patients treated with 50 Multi-Link stents, 40 InFlow stents and 41 Palmaz-Schatz stents. Lumen and stent cross-sectional areas (CSA) were measured at 1 mm axial increments. Mean intimal hyperplasia cross-sectional area (stent CSA-lumen CSA) and mean intimal hyperplasia thickness were calculated. Intravascular ultrasound demonstrated different levels of intimal hyperplasia proliferation for the three stents. Mean intimal hyperplasia thickness was 0.16+/-0.08 mm for Multi-Link stents, 0.26+/-0.19 mm for Palmaz-Schatz stents and 0.39+/-0.14 mm for Inflow stents (P<0.001). Multivariate analysis proved that stent type was the only independent predictor of intimal hyperplasia thickness at follow-up (P<0.001). CONCLUSION: Coronary stent design has a significant impact on subsequent intimal hyperplasia after implantation into atherosclerotic human coronary arteries. The corrugated ring design of the Multi-Link stent proved to result in less tissue proliferation at 6-month follow-up than the tubular slotted design of Palmaz-Schatz and InFlow stents.

Coronary Disease↗
PubMed2000

[Transnasal anchor suture for facilitating silicone tube intubation in deep congenital nasolacrimal duct stenosis].

BACKGROUND: In silicone intubation of the nasolacrimal duct for congenital obstruction, retrieval of the guide thread behind the inferior turbinate can be difficult and time consuming. To facilitate this maneuver a modification of the conventional technique has been developed. PATIENTS AND METHOD: In the conventional technique, a hollow probe was inserted into both lacrimal puncti and pushed downward into the nasal cavity. A guide thread was forwarded into the pharynx. Using the same hollow probe, a third guide thread was inserted transnasally and also forwarded into the pharynx. These three threads were pulled out of the pharynx transorally and tied together. Pulling on the nasal aspect of the transnasal guide brought all guides back into the pharynx and out of the nose. The intubation was completed in the conventional way. RESULTS: The new method was evaluated in 13 children. With the conventional technique the mean duration of the operation was 35 min, but the time required varied greatly among individuals due to retrieval of the guides. In contrast, no guide retrieval problem occurred using the new technique, and the average duration was reduced to 25 min. No adverse effect was observed. CONCLUSION: Using a simple modification, difficulties with the retrieval of the guide thread could be avoided, thus facilitating the procedure of nasolacrimal duct intubation and reducing its duration.

Child↗