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Biomedical subjects

A Junge

Publications and source records attributed to A Junge.

68 records · Page 4Linked to original sources
PubMed1994

[Pathomorphology, stability and classification of wedge compression fractures of the thoracolumbar spine].

Compression fractures with anterior wedging of the vertebral body are the most frequent fractures of the thoraco-lumbal spine. As yet, there is no fracture classification that has achieved general clinical acceptance. A classification is presented that defines fractures as A, B, and C types, according to their pathomorphology and mechanical stability. The main types are subdivided into A1-A2, B1-B2 and C1-C2. The A fractures incorporated a compression lesion of the anterior column with minimal or moderate loss of anterior height of the vertebral body. An intact intervertebral disc defines the A1 lesion. With loss of disc function through disc rupture into the fractured body, the vertebral segment is biomechanically destabilized and the lesion is classified as A2. The B-type wedge compression fracture defines a disc and bone lesion of the anterior column with severe wedging combined with a distraction lesion of the posterior column involving mostly ligaments. Not infrequently, the middle column presents with a dorso-cranial wall fragment, which may be dislocated into the spinal but without endangering the cord. Isolated lesions of the anterior and posterior columns are considered B1 lesions. B2 lesions incorporate an additional stable osseous lesion of the middle column. Wedge compression fractures of the C type are mechanically and neurologically unstable three-column lesions producing cord compression by way of dislocated fragments of the dorso-cranial vertebral body, which compromises the spinal canal. C1 fractures are like B fractures in the degree of severity of the anterior and posterior column lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1994

[Surgical management of a dens fracture in a 3-year-old child. Clinical case report and discussion with reference to the literature].

Because of the special features of subdental synchondrosis, fracture of the odontoid process in childhood can be seen as a separate entity. Among the rare fractures of the cervical spine in children this type is the most common. Ontogenetically, the subdental synchondrosis must be regarded as an intervertebral disc and not as a growth plate. Usually conservative treatment with a halo fixateur or minerva jacket leads to consolidation. We report on the case of a 3-year-old boy with a fracture of the odontoid process who was treated operatively with anterior log screw fixation because of extensive anterior dislocation and tetraplegia. Five months after the operation bony consolidation was achieved and the screws could be removed. Full neurological recovery had occurred by this time.

Bone Screws↗
PubMed1992

[Indications, technique and results of monosegmental dorsal spondylodesis in wedge compression fractures (grade II) of the thoracolumbar spine].

The management of wedge compression fractures of the thoracolumbar spine remains a controversial subject. Although there is an increasing tendency for operative intervention of spinal injuries, non-operative treatment of compression fracture has been the method of choice. The compression fracture is a fracture occurring during compressive forces of the anterior column due to flexion mechanisms. The more severe the compressive fracture, the more likely it will be to present, in an addition to anterior wedging, a failure of the posterior column indicating tension forces at that level. These fractures, defined as mechanically unstable and classified as compression fractures Grade II, are concentrated in the thoracolumbar region. Between June 1987 and July 1990 14 patients with compression fractures Grade II were treated posteriorly with one level internal fixation. Of the 14 patients, 9 had stabilization with plates and cerclage wire, 5 with an internal fixator. All patients received a localized fusion. In order to permit a more reliable analysis of the results of our stabilizing procedures, a comparison was made with a series of 11 cases with equivalent fractures treated non-operatively between 1986 and 1989. At clinical and radiographic follow-up evaluation, the results in the operative group were much more favourable, both subjective and objective, than in the non-operative group. We derive from these results that in thoracolumbar compression fractures Grade II, posterior one level stabilization and fusion is a recommendable surgical procedure.

Adult↗
PubMed1991

[Cytogenetic study of peripheral lymphocyte culture in couples with habitual abortion].

We report on a cytogenetic investigation of lymphocytes in 241 couples and six women with at least three abortions. We found a balanced reciprocal translocation three times (1.2% of couples) and a balanced Robertsonian translocation twice (0.8% of couples). Four numerical aberrations of the gonosomes were detected (three of them as a mosaic), and one deletion Xq- as a mosaic. The heterochromatic region of the chromosomes 1, 9 or 16 was enlarged in 12 couples (4.9%). There was no couple with a pericentric inversion of the chromosomes 1 or 9. The enlarged Y-chromosome (five males) according to our results does not play any important role for the reproduction. Five translocations and one supernumerary chromosome each in one cell only indicate an enlarged frequency of breakage events in couples with habitual abortion.

Abortion, Habitual↗
PubMed1990

Low status control, high effort at work and ischemic heart disease: prospective evidence from blue-collar men.

An inverse relation between socio-economic class and occurrence of ischemic heart disease (IHD) in advanced societies is an often replicated finding from empirical studies. Yet, the processes which produce these effects remain an open question. One promising explanation concerns the prevalence of stressful working life, especially of distinct 'job strain' occupations. Based on these considerations, we develop a refined concept of work-related socio-emotional distress which considers a mismatch between high workload and low control over occupational status (e.g. job insecurity, poor promotion prospects, status inconsistency) as crucial distress-provoking conditions. Moreover, we assume that the effect of this condition on IHD risk is substantially increased by the presence of a distinct individual pattern of coping with work demand ('need for control'). Based on data from a 6.5 years prospective study on IHD incidence (n = 21) in a cohort of 416 middle-aged blue-collar men this concept is tested using logistic regression analysis. Results indicate that status inconsistency [multivariate odds ratio (o.r.): 4.4], job insecurity (o.r. 3.4), work pressure (o.r. 3,4) and 'need for control' (o.r. 4,5) independently predict IHD occurrence after adjusting for major confounding somatic and behavioral coronary risk factors. In conclusion, a refined model of work-related socio-emotional distress substantially contributes to the explanation of high IHD incidence among blue-collar men.

Adaptation, Psychological↗
PubMed1990

Measuring the social dimension of subjective health in chronic illness.

This contribution discusses the social dimension of treatment-related subjective health in chronically ill patients. In its first part, it introduces two basic concepts, 'social performance' and 'social well-being'. These terms are further specified and discussed in the broader context of the notions of 'social support' and 'social adjustment'. The second part gives a selective, critical overview of currently used methods in the field. It is concluded that the existing gap between theory and measurement needs to be closed before substantial advancements in a comprehensive assessment of subjective health can be expected.

Activities of Daily Living↗
PubMed1989

Conceptual and methodological problems in research on the quality of life in clinical medicine.

This introductory paper discusses three issues: theory, validity of measurement and benefits of assessment. It is argued that the conceptual entity 'quality of life' remains ill-defined, although researchers commonly agree on its multi-dimensional nature. The selectivity of dimensions under study is illustrated by referring to recent work on the quality of life in cancer and in cardiovascular disease. Despite conceptual weaknesses, promising developments are apparent in research methodology. The issue is discussed with special reference to the convergent and discriminant validity of some widely used research methods. Improvements in therapy and patient-physician relationships are considered among the major benefits of assessing the quality of life in clinical practice. In conclusion, this field of research, if based on appropriate theory, opens important opportunities for cross-fertilization between advanced medicine and the social sciences.

Behavioral Research↗
PubMed1987

[Quality of life in antihypertensive therapy].

It is well known that distinct antihypertensive drugs have a different impact on compliance and on quality of life of patients. Therefore, we must ask under what conditions a refusal of antihypertensive medication can be justified and what its consequences are with regard to cardiovascular morbidity and mortality. An aspect of this latter question is answered by a prospective study on cardiovascular risks in a cohort of 416 middle-aged male blue-collar workers followed over three years: In the subgroup of 94 workers with mild or manifest hypertension few aspects of quality of life only were improved in the untreated (54%) as compared to the treated (46%) hypertensives. On the other hand, longterm cardiovascular risk was considerable: every third worker with untreated mild hypertension (140 to 160/90 to 100 mmHg; n = 30) exhibited signs of early left ventricular hypertrophy, as assessed by one- and two-dimensional echocardiography. The most impressive difference was found with regard to the diameter of left atrium (T = 3.02; p less than .01). The second part of the paper presents first results of a test-statistical evaluation: a German version of a well known measurement approach to quality of life in the United States is applied in 50 hypertensives and 56 normotensives. Internal consistency, stability and discriminant power of the questionnaire were very satisfying. Hypertensives compared to normotensives and treated hypertensives compared to untreated hypertensives showed significant differences on several subscales (esp. "general wellbeing", "vitality"). Results indicate that this measurement approach can be reliably used in further studies.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

[What questions are appropriate for predicting the risk of chronic disease in patients suffering from acute low back pain?].

AIM: The objective of the study was to develop a brief questionnaire to determine the risk of chronification for patients suffering from lumbar (low) back pain who are consulting a physician for the first or second time. METHOD: At the outset, and again after six months, a questionnaire with 167 valid items for chronification was distributed to patients in orthopedic offices. After six months, patients were contacted by mail to inquire whether they were still suffering from back pain. Based on outcome (persistence of back pain/absence of back pain) and by means of logistic regression analysis, those variables were determined that could predict actual chronification. RESULTS: The following items were predictive: "How strong was your back pain during the last week when it was most tolerable?" and "How much residual pain would you be willing to tolerate while still considering the therapy successful?" (Acceptance value, beta = 0.61), patient's educational level (beta = - 0.44), massage is experienced as bringing relief (beta = 0.44), 5 items of the Zung scale for depression (beta = 0.42), items of the scale for catastrophizing thoughts (beta = 0.41) and items of the scale for feelings of helplessness (beta = - 0.39) of the Kiel pain inventory; duration of the back pain for longer than 1 week (beta = 0.38), pain in other parts of the body (beta = 0.37); and female gender (beta = 0.25) CONCLUSION: Based on these questions, it was possible to predict the chronification of back pain with a probability of 78.05 %. A corresponding questionnaire and an evaluative table were developed.

Acute Disease↗
PubMedDate not supplied

An assessment of player error as an injury causation factor in international football.

OBJECTIVE: To quantify the frequency of injury in football as a function of tackle parameters. METHOD: Video recordings of 123 international matches in three Federation Internationale de Football Association tournaments were used to analyze tackle parameters, and team physicians provided reports of postmatch medical attention to players. RESULTS: A total of 8572 tackles were assessed, of which 3464 (40.4%) were fouls. There were 299 incidents of on-pitch medical attention, of which 131 (44%) resulted from foul tackles, and 200 postmatch team physicians' reports, of which 96 (48%) resulted from foul tackles. The cases of on-pitch medical attention resulted in 76 (25%) postmatch physicians' reports, but 124 (62%) of the postmatch physicians' reports were not associated with on-pitch medical attention. Tackled players received 74% of the postmatch medical reports. Tackle types with the greatest probability of requiring medical attention were from the side in terms of tackle direction, jumping vertically in terms of tackle mode, and a clash of heads in terms of tackle action. CONCLUSION: Human error on the part of players during the process of tackling and inadequacies in the laws of football and/or their application by match referees were equally responsible for the high levels of injury observed.

Adolescent↗
PubMedDate not supplied

The influence of tackle parameters on the propensity for injury in international football.

PURPOSE: To understand how tackling leads to injury in football, to develop a framework for classifying tackles, and to identify tackles with the greatest propensity to cause injury. METHOD: Video recordings of 123 matches in three FIFA tournaments were used to identify tackling parameters. Team physicians prepared reports of postmatch medical attention to players. RESULTS: Tackles from the side were twice as likely to require postmatch medical attention as tackles from behind. Injuries to the head/neck of tackled and tackling players and the torso of tackling players were more likely to receive on-pitch medical attention than other injuries. Injuries to the foot for tackled and tackling players and the lower leg and thigh for tackling players were less likely to receive on-pitch medical attention than other injuries. Tackles with the greatest propensity for causing injury involved clash of heads and two-footed tackles for tackled players and clash of heads, two-footed tackles, jumping vertically, and tackles from the side for tackling players. CONCLUSION: The laws of football relating to tackling should be reviewed to provide greater protection from injury by reducing the overall level of risk and, in particular, by protecting players from tackles with the highest propensity for causing injury.

Athletic Injuries↗
PubMedDate not supplied

An assessment of football referees' decisions in incidents leading to player injuries.

PURPOSE: To assess whether match injuries to footballers occurred as a result of players' noncompliance with the rules of the game, match referees could reliably identify the legality of incidents leading to injury, and the rules of football were adequate to protect players from injury. METHODS: Video recordings of incidents leading to injury in 12 FIFA tournaments were used to identify parameters. Team physicians reported the details of match injuries. Two panels of FIFA referees reassessed the legality of incidents from these tournaments that resulted in injuries. RESULTS: In total, 148 general injuries and 84 head/neck injuries were assessed. For the general injuries, the match referees identified 47% and the referees' panel identified 69% as fouls. For head injuries, the match referees identified 40% and the referees' panel identified 49% as fouls. CONCLUSIONS: Decisions made on the legality of tackles leading to injury indicated that the current rules of football were adequate for the majority of tackle situations, although the reliability with which referees could identify fouls during some match conditions was low. For incidents leading to head/neck injuries, the match referees and the referees' panel both identified a smaller proportion of injury situations as fouls.

Adolescent↗
PubMedDate not supplied

Experimental investigation of intraoperative ultrasound in anatomically precise liver resection.

A new technique of segmental liver resection by use of intraoperative ultrasound (IOUS) and injection of methylen blue was evaluated in 15 sheep to study anatomical precision and alterations of the biochemical profile. The results were compared with those of a bisegmentectomy (n = 15) in which segmental boundaries were identified by IOUS alone. In a third group (n = 10) a sham operation (laparotomy without resection) was performed to study the intrahepatic vascular architecture of the liver by IOUS. The quality of the resections and of the ultrasound study was assessed by use of corrosion casts of the livers. The intrahepatic course of the liver veins and their confluence as well as the portal vein and its branches up to the segmental portal pedicles could be detected in all livers. Anatomically precise bisegmentectomies were achieved in 70% of IOUS combined with coloring of the segments versus only 27% in IOUS alone (p < .05). Biochemical and clinical parameters did not reveal any advantage of anatomically precise resection. The results show that intraoperative ultrasound is reliable in visualizing the intrahepatic anatomical characteristics of the liver, but it is imprecise in identifying segmental boundaries or in localizing a segment exactly. Anatomically precise liver resections are technically feasible by use of IOUS plus selective staining of the segments.

Animals↗