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W Bauer

Publications and source records attributed to W Bauer.

At least 19 recordsLinked to original sources
PubMed2000

Effect of quinapril initiated during progressive remodeling in asymptomatic patients with healed myocardial infarction.

Approximately 20% of patients with healed myocardial infarction develop asymptomatic progressive left ventricular (LV) dilation and remodeling and are at increased risk for progression to symptomatic congestive heart failure and premature death. It was the goal of this study to test whether quinapril may interrupt this process and to analyze potential mechanisms. Of 138 patients with an average infarct age of 56 months, 25 had asymptomatic progressive LV dilation and were randomized in a prospective, double-blind study to placebo or quinapril. At baseline (mean +/- SEM) ejection fraction was reduced (35 +/- 3% and 39 +/- 3%) and end-diastolic volume (gated single-photon emission computed tomography) increased (104 +/- 9 and 117 +/- 12 ml/m(2)) with placebo (n = 13) and quinapril (n = 12), respectively. Progressive dilation continued in patients taking placebo (6 months: 9.4 +/- 5.2 ml/m(2), 12 months 24.6 +/- 5. 4 ml/m(2); change from baseline: p <0.05 vs baseline; p <0.05 vs 6 months), but not with quinapril (6 months: -0.9 +/- 4.0 ml/m(2); 12 months: 4.1 +/- 5.2 ml/m(2) [p <0.05] vs placebo). Wedge pressure during bicycle exercise was similar at baseline, but at 12 months tended to be lower with quinapril (17 +/- 1 mm Hg) than with placebo (24 +/- 4 mm Hg, p = 0.1673). Thus, quinapril prevented further progression of asymptomatic LV dilation and remodeling after remote myocardial infarction, possibly due to attenuation of an exercise-induced increase in LV filling pressure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2000

Randomized trial on the effect of radiotherapy in addition to 6 cycles CMF in node-positive breast-cancer patients. The German Breast-Cancer Study Group.

In 1984 the GBSG started a multicenter randomized trial to compare the effectiveness of 6 cycles of cyclophosphamide, methotrexate and fluorouracil (CMF) with or without radiotherapy (RT) as adjuvant treatment in node-positive breast-cancer patients treated by mastectomy. During 5 years, 199 patients were randomized. After a median follow-up of about 9 years, the treatment groups 6 x CMF and 6 x CMF + RT were compared regarding time to recurrence and death. As the first event of failure, we observed locoregional recurrence in 22 patients, distant metastases in 66 patients, a secondary malignancy in 9 patients and death without previous event in 5 patients. For event-free survival (EFS), no significant difference was observed [relative risk (RR) 6 x CMF + RT vs. 6 x CMF 0.82, 95% confidence interval (CI) 0.55-1.21]. Event-specific analysis showed a significant decreased risk after radiotherapy for locoregional recurrence. The risk for distant metastases was estimated as slightly decreased and the risk for secondary malignancy and for death without previous event was estimated as increased in treatment group 6 x CMF + RT in comparison with treatment group 6 x CMF, but these effects were not significant. For overall survival (OS) and breast-cancer-specific survival (BCS), no significant treatment effect could be demonstrated. There is a beneficial effect of radiotherapy on locoregional recurrence. For EFS and BCS, a tendency in favour of radiotherapy is observed, but this is not significant; for OS, no difference can be demonstrated, but the power of the study is too low to detect small treatment effects.

Adult↗
PubMed2000

Spontaneous Assembly of a Schiff Base Tetramacrocycle We thank Professor D. Sellmann and Priv.-Doz. Dr. T. Clark (Universität Erlangen-Nürnberg) for generous suppport of this work. We also thank Professor R. Robson (University of Melbourne, Parkville, Victoria, Australia) for his interest in the results presented here. Financial support by the Deutsche Forschungsgemeinschaft and the Fonds der Chemischen Industrie is gratefully acknowledged.

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Journal Article↗
PubMed1999

[A rare differential diagnosis of a pregnancy gestosis].

HISTORY AND ADMISSION FINDINGS: After an unremarkable course of her pregnancy a 26-year-old woman was admitted in the 32nd week because of her poor general condition with nausea, vomiting and headache. Her blood pressure was 220/140 mmHg and the pulse irregular with a rate of about 90/min. INVESTIGATIONS: The urine was markedly positive for glucose and protein, the cardiotachogram was unremarkable. DIAGNOSIS, TREATMENT AND COURSE: Antihypertensive treatment was started because pre-eclampsia was suspected. At first the patient's condition improved, but a few hours after admission an emergency section had to be performed for maternal and fetal indications, but the eutrophic male child was dead. Postoperatively the electrocardiogram and increased creatine kinase activity were suspicious of an acute myocardial infarction. Chest radiogram and echocardiography showed signs of marked ventricular dysfunction. Coronary angiography excluded coronary artery disease. The concentrations of catecholamine and its metabolites in 24-hour urine were greatly elevated above normal. Ultrasound and computed tomography demonstrated a tumour in the region of the left adrenal suggesting phaeochromocytoma, a diagnosis that was confirmed when the tumour was resected. CONCLUSIONS: Phaeochromocytoma is a rare cause of toxaemia of pregnancy and presents a high maternal and fetal risk. Its prognosis for both mother and child can be improved only if it is diagnosed and treated prenatally.

Adrenal Gland Neoplasms↗
PubMed1999

Progression of burn wound depth by systemical application of a vasoconstrictor: an experimental study with a new rabbit model.

The final depth of a necrosis resulting from burn trauma is determined within 3 days. The zone of stasis has the potential for complete regeneration or there may be ischemic influences that lead to necrosis. In our model, we examined the dermal influence of vasoconstrictors with reference to the development of burn necrosis. On the backs of New Zealand white rabbits (4.0-4.5 kg) standardized lesions were made with a heated aluminum stamp at 80 degrees C, 14 s in duration. The lesions were intradermal, whereby the border zone of the coagulated tissue was found in the middle two quarters of the dermis in 100% of untreated animals after 72 h. For dermal vasoconstriction epinephrine in a dose of 0.5 microg/kg/min was used. There were two groups of seven animals each. One group received epinephrine and the dosage was dependent on the clinical state of the animal. Several cycles were administered within a 3-day period. The reduction of skin perfusion was documented by Laser-Doppler-flowmetry. After 3 days, the skin with the lesions was excised and using a hematoxylin dye, a histological examination followed. The parameter used to determine the efficacy was the thickness of the uncoagulated part of the excised dermis. Over a period of 48 h, an average of 2.3 epinephrine cycles of average of 88 min per animal in duration resulted in an average reduction of skin diffusion of 41%. The uncoagulated part of the dermis in the epinephrine group was 28.6% average; in the control group, this was 43.5%. The statistical analysis revealed significant differences with a p-value of 0.0312 (significant, when value is less than 0.05). The test results indicate that temporary reduction of skin perfusion through external administration of vasocontrictors may lead to progression of burn necrosis in our animal model. Clinically, this result indicates that for patients with burn injuries and systemic inflammatory response syndrome who have insufficient volume therapy, the administration of vasocontrictors may produce similar results in the injured area.

Administration, Topical↗
PubMed1998

Anterior disk displacement of the temporomandibular joint. Significance of clinical signs and symptoms in the diagnosis.

In order to examine the diagnostic significance of typical clinical symptoms in temporomandibular joint (TMJ) disorders for diagnosis of anterior disk displacement, clinical findings were compared with the degree of disk displacement in 84 TMJs of 59 patients with TMJ disorders, who were examined clinically and by means of magnetic resonance imaging (MRI). The control group consisted of 31 subjects with no TMJ symptoms. No significant correlation between the degree of anterior disk displacement and palpation pain of the masticatory muscles or clicking/crepitus of the TMJ could be found. Joint clicking was observed in 65% of patients with TMJ symptoms in normal disk position (NDP). The percentage of joint clicking was almost the same in patients with anterior disk displacement with reposition (ADWR) (68%). There were significant correlations between active mouth opening and disk position as well as between a history of pain and disk position. Patients with NDP and ADWR had almost identical mouth opening values: 48 (+/- 5) mm and 46 (+/- 5) mm respectively. In contrast to these groups the mean values decreased significantly to 42 (+/- 6) mm in patients with anterior disk displacement without reposition (ADWOR). There were no significant correlations between occlusal findings (centric relation and habitual relation, early occlusal contacts, abrasion facets) and disk position when viewed either collectively or individually.

Adult↗
PubMed1998

Influence of screen and copy holder positions on head posture, muscle activity and user judgement.

A study was conducted on eight subjects, in order to investigate the influence of head posture with regards to the screen and copy holder position, the activity of cervical muscles and the subjective judgement given by the subjects. A total of eleven different positions (exercises) of screen and copy holder were investigated. Four different screen positions were examined in the upright (middle) sitting posture and three different screen positions were investigated in the backward sitting posture. In addition, four different positions of the copy holder were examined in the upright sitting posture. Head posture and muscle activity were continuously measured in each exercise for a duration of 5 min. At the end of each exercise, the subjects were asked how they judged the position of the screen and/or the copy holder in comparison with other positions. The results show that preference is to be given to a screen position in which the vision axis is horizontal or inclined slightly downwards. The copy holder should be arranged at one side of the screen.

Adult↗
PubMed1997

Wear in the upper and lower incisors in relation to incisal and condylar guidance.

The incisors of 85 patients were examined for tooth wear with the aim to evaluate possible association between the degree of wear and anterior guidance. Apart from clinical functional analysis electronic axiography using the system CADIAX was carried out. Anterior guidance in protrusive movement was marked on individually mounted plaster casts and scanned using a pantograph. The cephalometric analysis program CADIAS was used for the metric determination of the anterior guidance angle to the axis-orbital plane, and in order to relate the anterior guidance to the horizontal condylar inclination. The interincisal angle was included in the evaluation as a further functional angle and according to overjet and overbite there were classified typical incisor relations. Where both anterior guidance and incisor inclination and relation were in the normal range, there was an increase in incisal tooth wear in the group investigated. With reduced functional space, frequently found together with anterior deep bite, incisor wear was less extensive. While the occurrence of parafunction was shown not to be related to anterior guidance and incisor inclination and relation parafunctions were the decisive factor in the occurrence of severe incisor wear. Where anterior guidance and incisor inclination and relation are normal, the area of enamel under load is smaller and the space for bruxism larger. Parafunctional forces thus appear to result in a higher degree of wear than is found with the reduced functional space of a steep incisor position. Anterior guidance could not be evaluated as a parafunctonal inducing factor, but only as determining the wear pattern in the individual.

Adult↗
PubMed1997

[Temporomandibular joint morphology and morphometric findings in relation to degree of disk displacement. Comparative magnetic resonance tomography studies].

In order to evaluate magnetic resonance imaging (MRI) changes in correlation with different degrees of internal derangement of the temporomandibular joint, we evaluated 117 joints of 59 symptomatic patients and 31 volunteers. Data analysis included morphologic and morphometric characteristics. Sixteen joints (19%) were considered normal, 40 demonstrated anterior displacement with reduction (47%) and 27 anterior displacement without reduction (32%). In three of the volunteers anterior displacement with reduction was noted. Advancing anterior position of the disk was associated with reduced ability to open the mouth, progressive deformity and shortening of the disk, thinning of the bilaminar zone, regressive and proliferative bony changes of the condyle, reduced translatory movement of the disk and condyle, thinning of joint space, cranial and dorsal displacement of the condyle and flattening of the slope of the tuberculum. In addition to alterations in condylar and disk morphology, MRI can demonstrate various additional measurable changes that correlate well with the degree of anterior disk displacement.

Adult↗
PubMed1997

Primary surgery of skeletal dysgnathias.

Three case studies from the patient population of the University Hospital of Aachen (RWTH) are used to describe indications for primary surgical intervention in skeletal dysgnathia. Such preconditions may apply in the case of mandibulo-alveolar protrusion, anomalies where there is little or no option to fixing orthodontic appliances (enamel hypoplasia or shortened crowns), severe transversal discrepancies and skeletal dysgnathia with pronounced malpositioning in the alveolar process and the teeth. The advantages are improved compliance (through the patient experiencing success at the outset of treatment) and limitation of postoperative orthodontic treatment to occlusive fine adjustments of the occlusion, resulting in an appreciable reduction in both the degree and duration of tooth movement and tissue damage.

Adult↗
PubMed1996

Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study.

The mandible of a deceased 19-year-old young woman who had been treated with an edgewise appliance was removed during autopsy. The overall tooth movements during the 19 months of treatment were reconstructed (treatment documents) and compared with the macroscopic, radiologic, and micromorphologic findings of the incisor/alveolar bone/symphysis complex of the dry mandible. The initial lateral cephalogram revealed an extremely narrow and high symphysis, with an incisor position straight above the thin bone. During treatment, the incisors had been moved to lingual (lingual root torque) and derotated. Morphologic evaluation of the dry mandible revealed lingual (oral) aspects of the roots reaching some millimeters out of the lingual alveolar bone and largely without cortical plate covering. Lateral dental contact radiographs of any bone/incisor segment showed the sagittal alveolar bone width to be smaller than the labiolingual (orobuccal) diameter of the incisor roots. A comparison of the approximate pretherapeutic alveolar bone height, which was assessed by measuring the distance from the cementoenamel junction to the most coronal margin of any root resorption in scanning electron microscopy, with that of the specimen showed a calculated bone loss on the lingual aspect extending from 2.3 to 6.9 mm. On the labial (buccal) aspect, bone loss was far less pronounced. These results suggest that in the case of a narrow and high symphysis, pronounced sagittal incisor movements and derotation during routine orthodontic treatment with a fixed appliance may be critical and lead to progressive bone loss of lingual and labial cortical plates.

Adult↗
PubMed1996

[Disk displacement of the temporomandibular joint: correlation of magnetic resonance tomography and clinical findings].

PURPOSE: To evaluate the value of magnetic resonance imaging (MRI) in symptomatic patients with different degrees of internal derangement. MATERIAL AND METHODS: We prospectively investigated 117 temporomandibular joints (TMJ) of 59 symptomatic patients and 31 asymptomatic volunteers and correlated this with clinical parameters. RESULTS: There was a positive correlation between the degree of internal derangement and deformity of the disc, maximal mouth opening, signal intensity of the posterior band, thickness of the bilaminar zone, proliferative bony changes, size of the condyle and reduced translation movement of the condyle, which in addition moved upward and backward. Patients most often complained of pain which was dependent on the degree of disc displacement and condylar changes. Clinical parameters were found to be inaccurate in predicting disc displacement. CONCLUSION: Patients with internal derangement of the temporomandibular joint may be asymptomatic. Patients history may give the only pointer to the disorder.

Adult↗