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Biomedical subjects

W Steiner

Publications and source records attributed to W Steiner.

At least 19 recordsLinked to original sources
PubMed1991

[Postoperative urinary retention].

In 359 patients 371 operations were performed under general or regional anesthesia, and these were followed up with regard to anesthesiological technique, postoperative course and voiding of the bladder. Patients under 15 years of age, with severe incontinence or with a bladder catheter were excluded from the study. The surgical specialties were general surgery, orthopaedics, gynecology, ENT and ophthalmology. If any patient had not urinated by 6-10 h postoperatively and was found to have a full bladder on palpation, urinary retention was diagnosed. There were 75 patients (20%) who had urinary retention, significantly fewer women than men (p less than 0.025), and men under 35 years old had significantly less retention than older men (p less than 0.0025). The anesthesiological technique is an important factor in postoperative urinary retention: spinal anesthesia with tetracaine and adrenaline caused significantly more retention than spinal anesthesia with lidocaine 5% (p less than 0.005), and more than epidural or general anesthesia (p less than 0.005). No significant difference concerning urinary retention was found regarding surgical specialty, emergency operations, morphine or adrenaline added to tetracaine for spinal anesthesia, amount of local anesthetics used for epidural anesthesia or between spinal anesthesia with lidocaine 5% and epidural anesthesia with mepivacaine. Once urinary retention is diagnosed, conservative (privacy, relaxation exercises, getting up) or medical treatment (propyphenazone + hexahydroadiphenine (Spasmocibalgin), carbamoyl choline chloride) should be given. Catheterization should be performed only as a last resort.

Adolescent↗
PubMed1991

[Fractures of the lateral process of the talus].

In approximately 1% of all ankle sprains a fracture of the lateral process of the talus can be found. This fracture is probably even more common than this suggests, as it is often missed. We recommend that CT examination be performed in the investigation of ankle sprains when swelling, hematoma, and pain are present, when there is no instability of the ankle ligaments, and when no conclusive findings are yielded by conventional X-ray. Various theories on the best therapy have been propounded in the literature. Our retrospective study involved six patients. In two cases the fracture was treated by surgical operation. The remaining four patients received conservative therapy. Both patients who were operated upon had dislocated fractures sustained shortly before. On follow-up they were found to be completely symptom free. One further patient, who underwent conservative treatment for a fresh undislocated fracture, was also found to be free of all symptoms at follow-up. The late radiological findings in these three patients were incontestable. The three remaining patients, whether they had undergone conservative our functional treatment, reported considerable problems at follow-up, i.e. starting pain and a decreased range of motion in the talo-calcanear joint.

Adult↗
PubMed1990

Neuroleptic-induced supersensitivity psychosis in patients with bipolar affective disorder.

Clinical syndromes thought to arise from neuroleptic-induced dopamine receptor supersensitivity are well described in psychiatry. Tardive dyskinesia may arise from neostriatal supersensitivity and supersensitivity psychosis may arise from mesolimbic supersensitivity in schizophrenics chronically treated with neuroleptics. The authors present 5 cases of supersensitivity psychosis that developed in patients with bipolar affective disorder. The clinical syndrome is described and the implications for the long-term course of bipolar affective disorder are discussed.

Adult↗
PubMed1989

Experimental method for the in vitro testing of the initial stability of cementless hip prostheses.

Micromotions at the interface between bone and prosthesis are believed to induce bone resorption and ultimately lead to loosening of the implant. Thus the initial stability achieved by a hip prosthesis is an important factor for the long-term function of the implant. Knowing the biological consequences of the mechanical conditions, it appears to be mandatory to measure the extent of these three-dimensional movements. An in vitro dynamic method for measurement of the micromotion of the femoral component of hip prostheses has been developed. Tests in cemented prostheses have confirmed that the use of cement reduces sinkage and rotation manyfold and have yielded reference values for stability. Comparison with two types of cementless prostheses has shown that certain cementless implants may achieve stability comparable to cemented ones in some load directions.

Bone Cements↗
PubMed1989

[Total hip prosthesis with or without preventive use of antibiotics].

514 patients with total hip replacement were operated in 3 years in our county hospital. The patients were divided in two groups: 1. high risk patients: these patients had an antibiotica prophylaxis with 3 doses of 2 g of cefamandole beginning at the time of the induction of the anaesthesia; 2. patients without risks: they had no antibiotica. The two groups of patients were controlled at 3 and 12 months after the operation. 159 patients had a risk for an infection and had antibiotica, 355 patients had no antibiotica. The infection rate after 1 year was 0.6% in the group of patients with antibiotica, and 1.4% in the group of patients without antibiotica. This gave no statistical significance. The only statistical difference between the 2 groups was a significantly higher rate of urinary infection in the group with antibiotica. Thus it has been shown that urinary infections after total hip replacement correctly treated with antibiotica are not a high risk for an infection in the prosthesis. We conclude that antibiotica prophylaxis for total hip replacement in patients with high risk factors (like diabetes, corticotherapy, intraarticular injection, obesity and operation on the same hip) may help to have a postoperatively low infection rate, in our case 0.6%.

Anti-Bacterial Agents↗
PubMed1988

[Percutaneous biopsy technic. Aspiration fine needle and cutting biopsy cannula in an experimental comparison].

Guided percutaneous biopsy for cytological or histological diagnosis is well tried. Various types of needles and calibres are available. Only few studies have been performed comparing different needle configurations. Fine needles and cutting needles were evaluated quantitatively and qualitatively in an experimental study obtaining specimens of resected tumours. Weight measurement and preservation of the material were analysed. Material for cytological diagnosis was obtained with all types of needles. Increasing needle size resulted in higher yield of diagnostic tissue. Small-bore cutting needles having an acute bevel angle provide better results in soft or semiliquid tissue. It is not necessary to increase the needle size over 18 gauge.

Biopsy, Needle↗
PubMed1988

[Transthoracic excisional biopsy of focal pulmonary lesions].

The results of percutaneous, fluoroscopically-guided cutting biopsies of focal pulmonary lesions in 126 patients were evaluated retrospectively. In 90% of malignant lesions an exact diagnosis could be made from the material obtained. In 40% of the malignant lesions, histological examination was possible, in addition to cytology. In 87% of these, there was agreement between histology and cytology. Of the cases coming to surgery, 84% of the biopsies proved correct. Specificity was 100%. Multiple punctures were necessary in only 13%. Significant complications occurred in 5%. The cutting biopsy technique has the advantage of producing more biopsy material suitable for histology.

Biopsy, Needle↗
PubMed1988

Capgras' syndrome: a synthesis of various viewpoints.

The authors review the literature on Capgras' Syndrome and note that there has been little attempt to integrate the various etiological theories into a cohesive synthesis which accounts for both the organic and the psychodynamic theories. It is proposed that Capgras' Syndrome represents a nonspecific symptom of regression to an early developmental stage characterized by archaic modes of thought, resulting from a relative activation of primitive brain centres. Thus, either psychological regression alone or organic disorders that compromise higher cerebral functioning may result in Capgras' Syndrome. Two cases are presented for discussion and elaboration of these concepts.

Adult↗
PubMed1988

[Fine-needle and incisional biopsy technics in the percutaneous puncture of abdominal space-occupying lesions].

Cutting needles for guided percutaneous biopsy of abdominal tumors have been introduced in recent years and provide better results than fine-needle aspiration. A total of 292 biopsies in 273 patients were evaluated retrospectively. The diagnostic accuracy was 83.4% with cutting needles and 54.4% for fine-needle aspiration. The sensitivity in detection of malignancy was 86.8% and 88.6%, respectively. The location of the lesion to be biopsied determined whether CT or US was used for guidance. US control was used in biopsies of the upper abdomen; CT was preferred for guidance in the retroperitoneal space and in the pelvis. The caliber of the cutting needles in transperitoneal or transintestinal biopsy was limited to 19 gauge. The complication risk using cutting needles up to 18 gauge is no higher than for fine-needle aspiration biopsy if suitable access routes are selected.

Abdominal Neoplasms↗
PubMed1987

[Combined treatment of hypopharyngeal carcinoma].

From 1978 through 1984, 120 patients with hypopharyngeal carcinomas were treated cooperatively by the University Hospitals of Erlangen. 120 out of these patients were men and 6 women. 96 patients (80%) suffered from cervical lymph node metastases, 91 (76%) were already in UICC stage IV. There were two cases with stage I, eight cases (7%) with stage II, and 19 cases (16%) with stage III. Among the 116 patients treated by causal therapy, 70 (60%) reached complete remission (CR), 34 (29.5%) partial remission (PR), and 12 (10.5%) were non-responders (NC,P). The cumulative survival at five years was 14% in 120 patients and 24% in 70 patients after CR. None of the patients with PR or NC survived more than two years. 111 patients were irradiated. Group 1: radiotherapy alone (41 patients), group 2: surgery and radiotherapy (47 patients), group 3: chemotherapy and radiotherapy (19 patients). The medium treatment period was 76, 107, and 141 days, respectively. The cumulative survival at five years was 3% in group 1, 28% in group 2, the survival at three years in group 3 was 14%. The results of postoperative radiotherapy, amounting to 36%, were better than the rate of 20% achieved by preoperative radiotherapy and surgery. A survival at five years of 46% was obtained after transoral microlaryngoscopic laser resection and postoperative irradiation, which was therefore superior to conventional operation techniques combined with radiotherapy (16%). Moreover, better functional and cosmetic results were achieved with this method. The prognosis is unfavorably influenced by a high stage, lymph node manifestations, and dedifferentiated tumor histology.

Adult↗