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Biomedical subjects

W Pirsig

Publications and source records attributed to W Pirsig.

At least 91 records · Page 5Linked to original sources
PubMed1988

Wedge resection in rhinosurgery: a review of the literature and long-term results in a hundred cases.

First a historical review is given of the development of the concept of wedge resection of the bony nasal pyramid since Joseph, 1907. In a second part the technical details about wedge resection are described for different types of nasal deformities. In a third part long-term results in 100 patients, 18 months after septorhinoplasty are presented. In 61 patients unilateral and in 39 patients bilateral wedge resections were performed as one step of rhinoplasty. The long-term results were good in 93 patients, there was undercorrection in six cases, whereas one patient had an overcorrected nose. These results are better than the long-term results following classic osteotomies alone. Thus the wedge resection, for the indications as defined in this study, is a very useful step in the concept of corrective and aesthetic septorhinoplasty.

Adolescent↗
PubMed1988

[Preventive antibiotic administration in complicated rhinosurgical interventions--a double-blind study].

Revision rhinoplasty was performed in 100 patients. In most cases a complete rhinoplasty with septal reconstruction, osteotomies, wedge resection and free transplants had to be done. Intranasal swabs for bacterial culture were taken pre- and postoperatively. 48 patients received three mega units of propicillin transorally for 12 days, 52 patients received a placebo. White blood count, erythrocyte sedimentation rate, and temperature were taken to indicate inflammation of the nasal region. Turbid nasal secretion, reddening and swelling of the nasal linings, and bleeding of the noninjured nasal mucosa were taken as clinical signs of infection. Preoperatively staphylococcus epidermidis was cultured in 69% from the nasal cavities, staphylococcus aureus in 42%, streptococci in 24%, diphtheroids in 22% etc. (see Table 1). Serious infections developed in six patients (five of them without antibiotics), more localized infections in twelve patients (nine of them without antibiotics). Some of the infections developed after removal of the nasal packing. In five patients with serious infections either streptococcus viridans or streptococcus pneumoniae could be cultured preoperatively. In three of five cases the streptococci were propicillin-sensitive. Clinical signs and laboratory parameters were not helpful in identifying patients with infections. We conclude that patients undergoing revision rhinosurgery should be followed carefully for at least two weeks. Postoperative administration of propicillin appears to be able to prevent serious nasal infections especially if free transplants are used.

Adult↗
PubMed1987

The head-pad in art and medicine: a forgotten nasal protector.

From the beginning of the 16th century the use of the padded cap to prevent injuries of the middle-face and skull in infants during their period of learning to walk is documented in art and medicine. Especially the painters of the Dutch and Flemish schools left beautiful paintings and drawings showing children with head-pads. Till the end of the 18th century the use of the head-pad was widely spread over Europe. In the 19th century the educational concepts of Rousseau and Kant probably induced a rejection and an abolition of this useful protective cap, which has been rediscovered during the past 20 years.

Craniocerebral Trauma↗
PubMed1987

[A skull with deformed nasal structure from the 17th century].

A skull from the baroque period is presented which attracted our attention because of its round piriform aperture and enlarged nasomaxillary bones. The deformity is very probably due to large nasal polyps. Some medical documents in literature and an oil-painting with the portrait of an old woman with a bloated nose from the 17th century show that this type of nasal disease was well known three hundred years ago.

Adult↗
PubMed1987

[Therapy of ankylosis of the cricoarytenoid joint following intubation].

The immobility of the vocal cord following endotracheal intubation is often misinterpreted as a paralysis. Possibilities are pointed out to differentiate between vocal cord paralysis and ankylosis of the cricoarytenoid joint. Furthermore it is shown another simple therapeutic procedure to mobilize the fixed joint.

Adolescent↗
PubMed1986

Surgery of choanal atresia in infants and children: historical notes and updated review.

This review of the surgical treatment of congenital choanal atresia starts with the first descriptions of the disease and its successful operations in the 19th century. Then, data concerning the facial development of the untreated and surgically corrected disease are presented. After that, advantages and drawbacks of the transnasal, transpalatal and transseptal approaches are discussed.

Adolescent↗
PubMed1986

[Phases of postnatal nasal growth. A critical review].

This review evaluates anatomical, anthropological, and radiographic cephalometric data of the growing nasomaxillary complex, with special regard to their reliability and value for therapy planning. Within the two post-natal years and during puberty parts of the nose grow faster than during other periods of life. After the second decade there is still some growth measurable in some nasal parts up to an advanced age.

Adolescent↗
PubMed1985

Human nasal septal cartilage: local distribution of different enzyme activities in healthy adults and acromegalic patients.

Septal cartilage was obtained during septoplasty from healthy adults or during transnasal hypophysectomy from acromegalic patients. Small strips of cartilage were excised from five different areas of the septum: the anterior free end, the suprapremaxillary area, the central area, the posterior area, and the caudal prolongation of the septum. Five different enzymatic pathways were analyzed in these areas. Cathepsin D, an acid proteinase, did not show a specific local activity pattern and was not influenced by the augmented growth hormone level in acromegaly, whereas cathepsin B, a neutral proteinase, showed its highest activity in the caudal prolongation and the posterior area and was significantly increased in all areas in acromegaly. Beta-hexosaminidase activity was highest in the central and posterior area and caudal prolongation of the septum. In acromegaly, a significant increase of its activity was found in the suprapremaxillary and posterior area. Acid phosphatase activity was highest in the caudal prolongation of the septum, but its activity was significantly increased in all tested areas in acromegaly. Alkaline phosphatase activity could only be found in the posterior area and the caudal prolongation in healthy adults. However, in acromegaly this enzyme could be detected in the central area and the posterior end of the suprapremaxillary area suggesting an altered process of mineralization. A distinct local pattern of enzymes related to intercellular substance metabolism and mineralization can be demonstrated in the septal cartilage of healthy adults and acromegalic patients.

Acid Phosphatase↗
PubMed1985

Clonal proliferation and cell density of chondrocytes isolated from human fetal epiphyseal, human adult articular and nasal septal cartilage. Influence of hormones and growth factors.

The present study characterizes the cell density and cellular growth characteristics of functionally and morphogenetically different human cartilages. In fetal epiphyseal, in postnatal nasal septal and in articular cartilage the influence of aging on cell density and in vitro growth characteristics were investigated. Cell density was highest in fetal epiphyseal cartilage and lowest in articular cartilage. In vitro growth of isolated chondrocytes as measured by clonal growth in a semisolid assay was almost identically high in fetal epiphyseal and septal cartilage and significantly lower in articular cartilage. Cell density increased with age in the nasal septal cartilage whereas no age dependency was found in the other cartilages. The stimulatory effects of human biosynthetic insulin, human growth hormone and partially purified IGF I on clonal growth of chrondrocytes were assessed. Only IGF I stimulated clonal growth of chondrocytes and its stimulatory effect was significantly higher in postnatal than in fetal chondrocytes.

Adolescent↗
PubMed1984

Historical notes and actual observations on the nasal septal abscess especially in children.

The recognition of the nasal septal abscess is traced back to 1810 when Cloquet healed an abscess by drainage. This therapy does not prevent the saddle nose deformity and its functional problems in many cases. Since 1963 the immediate reconstruction of the destroyed septum in the acute phase of the septal abscess by means of homologous cartilage has proved to prevent long-term effects of the abscess especially in the growing nose. This is underlined by some of our own long-term results and histological findings. Finally, some new pathogenetic aspects are discussed based on histological and enzymatic findings of the human septal cartilage.

Abscess↗
PubMed1984

Patterns of growth in human septal cartilage: a review of new approaches.

Recent results of the growth activities of the septal cartilage in children, adolescents, and adults are reviewed. Cartilaginous biopsies were obtained during septoplasty . Matrix synthesis was measured by in vitro incorporation of labeled sulphate; DNA synthesis was measured by in vitro incorporation of labeled thymidine. The cell density of the septal cartilage was determined by cell counting, and chondrocytes were grown in culture in an assay to determine the number of chondrocytes capable of proliferation. With data from these 4 types of experiments 5 different areas could be distinguished in human septal cartilage: (1) anterior free end, (2) suprapremaxillary area, (3) central area, (4) posterior area, and (5) caudal prolongation. Metabolic activities, degree of cell replication, and proliferative capacity are highest in childhood in all areas; they decline with age, but remain surprisingly high in the central area and in the anterior free end, even in adults. These results help to explain some clinical observations and may help the rhinosurgeon in his decision to resect the septal cartilage, especially in children.

Adolescent↗
PubMed1984

Growth of the human septal cartilage: cell density and colony formation of septal chondrocytes.

Human chondrocytes from 24 patients (5 to 52 years) with septal deviation were isolated in different areas of the septal cartilage. Cell density was counted, and the chondrocytes were grown in an assay system for determining the number of chondrocytes capable of proliferating. High cell density and excellent proliferative capacity were found in the anterior free end of the septal cartilage in all age groups. The central area showed the highest growth index in childhood, and increasing cell density from childhood to puberty. Generally the growth index decreased with age in all septal areas. The results help to explain some clinical observations: increasing septal cartilage even in adults, growth of nasal tip in adults, regenerative potential of septal cartilage after injuries or surgery, importance of the central area for septal growth and surgery.

Adolescent↗
PubMed1984

[Synovial sarcoma of the larynx. Case report and brief review of the literature].

Synovial sarcomas are connective tissue tumours. In most instances they are located at the extremities; a rare variant is known as orofacial synovial sarcoma. In the case under report, a synovial sarcoma of the larynx in a 19-year old man is described. 11 months after surgical removal of the tumour neither recurrence nor lymph node metastasis had occurred. The literature on this rare tumour is briefly reviewed.

Adult↗
PubMed1984

[Otorhinolaryngology in the work of the Ulm town physician Johannes Scultetus (1595-1645)].

Extracts concerning ear-nose-throat-diseases are given in this small historical study of "Armamentarium Chirurgicum " written by Johannes Scultetus d.A. This book is the first textbook of surgery in the form of an encyclopedia : it combines excellent illustrations of surgical procedures and instruments with a collection of 100 case-reports from the time of the 30 years war. The book was printed 18 times in 5 languages. There are facsimile -prints (1974) from the Latin (1655) and German (1666) edition.

History, 16th Century↗