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Biomedical subjects

W Millesi

Publications and source records attributed to W Millesi.

At least 55 records · Page 3Linked to original sources
PubMed1996

Optimized growth medium for primary culture of human oral keratinocytes.

The effect of different media additives in defining optimal growth conditions for primary cultures of human oral keratinocytes was studied. A cocultivation technique with irradiated Swiss-3T3-fibroblasts in 96-well plates enables the comparison of additives for primary keratinocyte cultures derived from one patient. 3H-labeled thymidine uptake showed no growth or growth inhibition with adenine, choleratoxin or transferrin compared to basal medium (Dulbecco's modified Eagle's medium (DMEM) and 10% fetal calf serum). Among single additives, 5 micrograms/ml hydrocortisone, 5 micrograms/ml insulin, 10 ng/ml EGF, 2 micrograms/ml bovine pituitary extract, and 10(-9) M triiodothyronine showed the greatest capacity to promote keratinocyte growth. With all possible combinations of additives, maximum stimulation was found with a combination of EGF (10 ng/ml), insulin (5 micrograms/ml), and hydrocortisone (5 micrograms/ml); none of the other combinations were more effective. Our data indicate that in short-term cultures (up to 5 days) various media additives described in the literature are not necessarily required in this system of primary culture of human oral keratinocytes.

3T3 Cells↗
PubMed1996

Horseshoe Le Fort I osteotomy in combination with endosteal implants--a median-term follow-up study.

Fourteen patients with Class VI resorption of the maxilla were treated with horseshoe Le Fort I osteotomy. In 11 cases, the procedure was followed by the placement of endosteal implants. In six patients, simultaneous placement of implants was carried out, while in five patients this was done in a second procedure. Ten patients wore their implant-supported dentures. In one patient, 5/8 implants were lost due to nonintegration. Three patients lost one implant each. The total number of implants placed was 76, and the survival rate of the implants was 88.1%. In the one-step procedure (n = 42), the survival rate was 84.8%; in the two-step procedure (n = 34), 92.3%. In comparison of the one-step to the two-step procedure, there was no statistically significant difference (P > 0.11) between the amount of marginal peri-implant bone loss and the condition of the peri-implant soft tissues as measured 2 years after implantation.

Adult↗
PubMed1996

First-pass uptake of methotrexate after intra-arterial bolus injection in human head and neck cancers.

The aim of this study was to quantify first-pass uptake of methotrexate into tumour and healthy tissue after intra-arterial (i.a.) injection in patients with head and neck cancers. Twenty-one patients were studied; during surgery, a bolus injection of 10 mg of 3H-labelled methotrexate was administered into the tumour-supplying artery. At 15-20 s after injection, and again 2-3 h later, a biopsy of the tumour and of surrounding healthy tissue was taken and radioactivity was measured. In 8 of 17 pretreated patients the biopsy specimens contained no tumour cells. In tumour-bearing patients, radioactivity in tumour was three times higher than in healthy tissue (P = 0.006). In tumour-negative patients there was no difference in activity between the two biopsy sites (P = 0.889). However, after 2-3 h the concentration of methotrexate in all surgical specimens returned to near background level and the initial difference between tumour-positive and tumour-negative samples was lost. Our results show that i.a. injection of methotrexate does not necessarily lead to high tumour cell exposure.

Antimetabolites, Antineoplastic↗
PubMed1996

[Experiences and results in management of mandibular fractures with the modified Krenkel lag screw--a retrospective study].

The stable osteosynthesis of mandibular fractures with the modified lag screw (Krenkel) has proven superior to conventional lag screws in theoretical models and clinical use. Compared to osteosynthesis with plate systems, the lag screw technique is more difficult to learn for the unexperienced, but the reduction of fragments under compression with a lag screw and the stabilisation of lower jaw rotation with an additional short miniplate in our experience has proven successful in clinical use.

Adolescent↗
PubMed1996

Conventional vs accelerated fractionation in head and neck cancer.

From October 1990 to March 1994, 90 patients entered a prospectively randomised trial in head and neck cancer. All patients had verified squamous cell carcinoma and were referred for primary radiation therapy. Tumours originated in the oral cavity in 25, oropharynx in 37, larynx in 15 and hypopharynx in 13 cases. Patients' stages were predominantely T3 and T4 (71/90) and had lymph node metastases (60/90). Seventy-nine male patients and 11 female patients, with a median age of 57 years (range 37-76 years) were treated. Patients were randomised to one of three treatment options: conventional fractionation (CF) consisting of 70 Gy in 35 fractions over 7 weeks or continuous hyperfractionated accelerated radiation therapy (Vienna-CHART) or Vienna-CHART with administration of a single dose of mitomycin C on day 5 of treatment (V-CHART + MMC). By the accelerated regimen a total dose of 55.3 Gy was given in 33 fractions within 17 consecutive days. Acute mucositis was the main toxicity recorded in those patients treated by accelerated fractionation, although the overall duration of mucosal reaction did not differ in the three treatment groups. There was no influence on local toxicity if MMC was added to radiation therapy or not. Those patients treated with additional MMC experienced a grade III/IV haematological toxicity in 4/28 cases. Complete remission (CR) was recorded in 48% following CF, 79% after Vienna-CHART (P < 0.05) and 71% after Vienna-CHART + MMC. The overall local failure rates were 73%, 59% and 42% (P = NS) for patients treated by CF, Vienna-CHART and Vienna-CHART + MMC respectively.

Adult↗
PubMed1995

Posterior ischemic optic neuropathy following bilateral radical neck dissection.

A patient is presented with posterior ischemic optic neuropathy (PION) after bilateral radical neck dissection, probably caused by hemodynamic hypotension, combined with other factors. A postmortem histologic study of the optic nerve was performed to analyze the pathogenic mechanism of blindness. To prevent this complication, one should favor a two-stage procedure, avoiding drug-induced hypotension, overtransfusion, and anemia. During the postoperative period, visual acuity should be monitored regularly, and proper positioning of the patient's head is necessary.

Anemia↗
PubMed1995

[Evaluation of long-term results and donor site defects following transposition of connective tissue flaps].

Nine patients suffering from chronic pain after surgery for thoracic outlet syndrome or after radiation therapy underwent neurolysis of the brachial plexus. To avoid a recurrence of scar formation, a pedicled subpectoral transposition flap of connective tissue, utilizing the pectoral branch of the A. thoraco-acromialis, was wrapped around the neurolyzed structures. Long-term follow-up results are presented.

Adult↗
PubMed1995

[Indications and use of stereolithographic skull reconstructions in oromaxillofacial surgery].

Stereolithography (SLA), a rapid prototyping technique, was introduced in 1991 at the Clinic for Maxillofacial Surgery in Vienna and was adapted, in cooperation with the company Laserform, for our clinical requirements. As a refinement to physical models milled out of polyurethane, which had been used since 1989, this technique offered new applications for preoperative planning in craniomaxillofacial surgery. The proportions of these 3D models correspond 1:1 to the patients dimensions, with a possible accuracy of 0.25 mm. Since 1992 stereolithography has been used in 124 cases, primarily in traumatology, tumor surgery and in craniofacial surgery.

Adult↗
PubMed1994

[Imaging in parotid tumors: US versus MRT].

27 patients, clinically suspected of having parotid tumours, were examined prospectively by sonography (high frequency linear array) and MRI (1.5 T, T1- and T2-weighted SE sequences before, and T1-weighted SE sequences after contrast). In 23 patients, 25 intraglandular tumours were demonstrated (two were multicentric); they consisted of 6 malignant parotid tumours, 11 pleomorphic adenomas, 7 cystadenolymphomas and one oncocytic adenoma. 4 patients had extraglandular tumours. All tumours were demonstrated by either method, but two extraglandular tumours were incorrectly diagnosed by sonography as being intraglandular and 8 tumours (28%) were not completely delineated by sonography. MRI localised the tumours correctly in all cases and demonstrated all lesions accurately, independent of their position or size. In summary, sonography appears suitable as the primary imaging method in the investigation of parotid tumours but in case of large, parapharyngeal or malignant tumours, MRI is clearly superior to sonography.

Adolescent↗
PubMed1994

Subpectoral gliding tissue flap.

By cadaver dissection, the anatomy of the connective tissue between the pectoralis major and the pectoralis minor muscle was studied. The possibility of creating a pedicled flap of gliding tissue based on the pectoral branch of the thoracoacromial artery was confirmed. The clinical relevance of this tissue was defined in nine patients. To avoid recurrent fibrosis after neurolysis of the structures of the brachial plexus in patients with recurrent pain syndromes, the envelopment of the neurolyzed nerves by a subpectoral gliding tissue flap was carried out and was successful in eight cases. After the transposition of the subpectoral gliding tissue flap, the remaining pectoralis major muscle showed only a small partial atrophy in the clavicular segment without any functional impairment; this was confirmed by physical examination and by electromyogram.

Adult↗
PubMed1994

[Technique and applications of stereolithographic cranial models].

3-D-modelling of the skull is useful referring to improve diagnostics, for surgical planning and simulation of surgical procedure. Stereolithography is a constructive process producing a model by building it up layer by layer with plastic using an "ultraviolet" laser to catalyse the polymerization of a liquid plastic solution. This fast prototyping derives from using a new interface between a CT-Scanner and a SLA. By avoiding the tool path problems inherent in conventional computerdriven CNC milling machines we succeeded in producing closed cavities and even intraosseous course of vessels and nerves. The compact and smooth surface makes manual postprocessing unnecessary. By using a new software (interpolation +/- 0.25 mm) we could improve the accuracy. At our studies we found a maximum aberration of at least 0.25 mm.

Adolescent↗
PubMed1992

Ankylosis of the temporomandibular joint. Follow-up of thirteen patients.

We undertook a postoperative clinical study of 13 patients with ankylosis of the temporomandibular joints. The study consisted of an evaluation of the surgical concepts of resection and subsequent surgical reconstruction by osteotomy in previous height of the joint space and lining of the glenoid fossa with lyophilized dura. Early mobilization and aggressive physiotherapy are mandatory postoperative measures. According to the theory of mandibular growth as a result of functional matrix, early surgical intervention to correct ankylosis should be performed, regardless of the age of the patient, to prevent recurrence and later asymmetry or distoclusion.

Adolescent↗
PubMed1992

[Atypical fractionation in advanced squamous-cell carcinomas of the head-neck area].

From May 1990 to May 1991, 23 patients with advanced, inoperable squamous cell cancers, clinically staged as III or IV, were treated by unconventional fractionation radiotherapy. Treatment consisted of a continuous hyperfractionated accelerated radiotherapy, delivering a total dose of 55.3 Gy within 17 consecutive days. In ten patients radiation therapy was combined with chemotherapy; 20 mg mitomycin C/m2, administered by intravenous bolus injection on day 5 of treatment. Apart from a confluent mucositis, treatment tolerance was good. Haematological toxicity from mitomycin C was minor and did not require any specific therapy. The mucosal reaction lasted six weeks (median duration) and was not thought to be increased by additional chemotherapy. In twelve of 23 patients a complete remission of the primary tumour was seen, in patients with lymph node metastases there was a complete response in 14 out of 20 patients. After a median follow-up of 18 months, ten of 23 patients have survived (8/23 without evidence of disease). Eleven patients have died due to local tumour progression and one patient died with distant metastases, being without evidence of local tumour. The advantage of this unconventional fractionation, which takes the described short potential tumour doubling time for head and neck cancers into account, is discussed.

Adult↗