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1.
Oren N Gottfried Steven Chin H Christian Davidson William T Couldwell 《Skull base》2007,17(5):317-324
The authors present a case of amyloid infiltration involving the trigeminal nerve that mimicked a malignant cavernous sinus tumor with perineural tumor infiltration. A 64-year-old man presented with trigeminal nerve numbness. Imaging revealed a plaque-like enhancing lesion along the right lateral cavernous sinus extending anteriorly into Meckel's cave and involving the proximal V2 and V3 branches of the trigeminal nerve. The patient underwent an extradural frontotemporal craniotomy with middle fossa exposure of the cavernous sinus to diagnose and treat the presumed malignant cavernous sinus tumor. A reddish mass involving the lateral dural wall of the cavernous sinus was resected. The gasserian ganglion, V2, and V3, the latter of which was biopsied, were enlarged. Permanent histopathological studies showed microscopic eosinophilic, amorphous material, which stained positive for Congo red, and an absence of neoplastic cells. The final diagnosis was amyloidoma. Thus, amyloidomas can involve the trigeminal nerve or ganglia and should be considered in the differential diagnosis of a cavernous sinus lesion mimicking a tumor. Patients may have symptomatic improvement of trigeminal neuropathy with resection of the amyloidoma outside the nerve capsule that is compressing the nerve, while resection of the lesion from within the capsule may result in permanent trigeminal nerve dysfunction. 相似文献
2.
Thomas Schoeller Gottfried Wechselberger Judith Roger Heribert Hussl Georg M Huemer 《Journal of plastic, reconstructive & aesthetic surgery》2007,60(5):524-528
The deep inferior epigastric perforator (DIEP)-flap continues to be the standard treatment in microsurgical breast reconstruction. Reasons for the popularity of the DIEP-flap include the availability of a large amount of tissue for the reconstruction of large breasts, a reliable vascular anatomy and an aesthetically pleasing donor site scar. However, the DIEP-flap is not considered the optimal choice as the donor tissue in all patients. Previous abdominal surgeries with resulting scars may threaten the success of a free DIEP-flap due to compromised vascularity within the flap. We elaborated a technique to increase the safety of breast reconstruction with the DIEP-flap in the presence of an infraumbilical vertical scar. After raising the DIEP-flap in a traditional manner on one side with harvesting of a considerate length of the inferior epigastric vessels, a segment of the superior epigastric vessels is left attached to the main pedicle. This stump of the superior epigastric vessels is now anastomosed under the microscope to a paraumbilical perforator on the contralateral side of the flap for in-flap microvascular augmentation. The above-mentioned technique was applied in five patients who presented with an infraumbilical vertical scar and were reconstructed with a DIEP-flap because of breast cancer. In three of the five patients there was an additional risk factor present such as smoking or diabetes mellitus. In all five patients no major complication due to marginal perfusion of the contralateral side of the flap was encountered. In two patients there was minor breakdown of fatty tissue that was managed conservatively in both cases. In-flap microvascular augmentation of DIEP-flaps is a valuable tool for the plastic surgeon in microvascular breast reconstruction. It permits usage of the lower abdominal tissue even if perfusion is compromised due to midline scarring. We recommend this technique as a safe alternative in patients seeking autologous breast reconstruction in the presence of a midline abdominal scar. 相似文献
3.
S Kimel L O Svaasand M Hammer-Wilson V Gottfried S Cheng E Svaasand M W Berns 《Lasers in surgery and medicine》1992,12(4):432-440
The chick chorioallantoic membrane (CAM) model was used to study vascular effects of photodynamic therapy (PDT) and hyperthermia (HPT) and the synergism of these modalities. The CAM is a convenient medium for monitoring the modifications of the vasculature. It is possible to view the CAM and to examine structural changes of individual blood vessels in real time. Moreover, the CAM is a closed system which lends itself to mathematical modeling of the temporal and spatial temperature profile and in which HPT can be performed quantitatively and to a selected depth, using different lasers. A porphyrin-type photosensitizer solution was applied to areas of the CAM, defined by teflon O-rings placed on the surface. Uptake dynamics of the sensitizer into the CAM was determined by analyzing its fluorescence in vivo. The CAM area was irradiated with a dual-wavelength laser system composed of a dye laser at 644 nm (to induce PDT) and a CO2 laser at 10.6 microns (to bring about HPT). Damage to the CAM vasculature, due to combined PDT+HPT, was compared to the outcome of the separate modalities, and a synergistic effect of about 40% was observed. 相似文献
4.
A convenient approach to the new 2-aminobenzophenone analogue 4 is reported. Condensation reactions of 4 with ortho esters or amide acetals, respectively, followed by intramolecular cyclisations were found to provide smooth access to (4-pyridazinyl)-substituted quinolines 10, 13a,b , and the quinazoline derivative 15 . 相似文献
5.
Guillaume Duhamel Gottfried Schlaug David C Alsop 《Magnetic resonance in medicine》2006,55(3):514-523
Measurement of the arterial input bolus shape is essential to the quantification of mean transit time and blood flow with dynamic susceptibility contrast (DSC) MRI. Input functions derived from the echoplanar signal intensity within or near arteries are highly nonlinear, yet such input functions are widely used. We employed a physical model for the echoplanar signal intensity from an artery as a function of contrast agent concentration, artery size, and angle to the magnetic field to test approaches for the measurement of the arterial input function. The simulated results confirmed the strong nonlinearity of signal in the neighborhood of vessels. Of the input function measurement methods considered, the simulations suggested that measurement of signal near but not within a large vessel is most accurate, but mean transit times (MTT) calculated with these input functions are highly sensitive to peak bolus concentration. Input functions determined from voxels demonstrating the shortest first moment overestimated the MTT but the measured MTTs were more robust to changes in peak concentration. Characteristics of the measured in vivo input functions were consistent with the simulations. Our results emphasize the important contribution of input function errors to the uncertainty in MTT and blood flow imaging with DSC MRI. 相似文献
6.
Gottfried Schatz 《Medizinische Klinik》2002,78(10):756-759
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H. W. Gottfried S. Maier E. Brändle K. Kleinschmidt R. Hautmann 《Der Urologe. Ausg. A》1997,36(5):413-419
Summary
Minimally invasive treatment of urinary incontinence has become a subject of major interest in recent years. We examined the
use of transurethral collagen injection for incontinence treatment. A total of 48 patients were selectet for this procedure
from April 1993 to February 1997 – 26 male patients (19 post-RPX incontinence and 7 post-TUR incontinence) and 22 female patients
(all after previous incontinence surgery) were treated by injection of collagen into the continence region. The whole group
underwent an average of 1.8 sessions, and a mean collagen injection volume of 14.5 ml was delivered per session. Mean follow-up
was 9.2 months. Of the female population, 68.2 % were cured or greatly improved. In the male population only 47.3 % of the
post-RPX patients and 6/7 of the post-TUR patients benefited from the procedure. In males, treatment outcome depends on the
degree of pretreatment incontinence, because all grade III incontinence patients did worse. Therefore we conclude: transurethral
collagen injection is an interesting method in the treatment of urinary incontinence if proper patient selection is assured.
相似文献
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