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Biomedical subjects

A Schuh

Publications and source records attributed to A Schuh.

At least 55 records · Page 3Linked to original sources
PubMed2003

[Rupture of the gluteus medius tendon].

AIM: Rupture of the gluteus medius tendon is a rare, even neglected condition. Typical findings include local tenderness and weakness of hip abduction. This pathologic condition is very seldom analysed in the literature, there is no report about the meaning in primary total hip replacement (THR). PATIENTS: Between 1/1/1995 and 12/31/2000 we found 13 cases (3,5 %) with a tear of the gluteus medius tendon in 372 primary THR using the lateral approach. In all cases the rupture was seen in the ventral and lateral part of the gluteus medius tendon. Furthermore, a valgus position of the proximal femur was detected. Transosseous refixation of the tendons was performed in all cases. 3 months after operation local tenderness near the greater trochanter disappeared and full strength of the pelvitrochanteric muscles was achieved in 11 out of 13 cases and in the remaining cases after one year. CONCLUSION: When a valgus position of the proximal femur in primary THR is found, one has to be aware of a simultaneous rupture of the gluteus medius tendon. This pathologic finding has to be ruled out preoperatively by means of ultrasound or MRI and an adequate approach to the hip joint has to be selected to examine the pelvitrochanteric muscles and to treat the rupture.

Aged↗
PubMed2003

[Impingement of the iliopsoas muscle after revision of a loosened acetabular cup with an acetabular reinforcement ring].

Impingement of the iliopsoas muscle due to a protruding acetabular component is an uncommon cause of pain after total hip arthroplasty. We report the case of a 59 year old female patient who developed groin pain one year after revision arthroplasty and reconstruction of the acteabular defect with an acetabular reinforcement ring due to a loosened cup. THERAPY AND FOLLOW UP: After revision of the right hip via an anterior approach we used bone cement to smooth the anterior edge of the acetabular reconstruction ring and created a smooth rim for the iliopsoas tendon. At follow up 2 years later the patient was satisfied with the result, she complained about very rare recurrent groin pain, without any need for further treatment.

Acetabulum↗
PubMed2003

[Our experiences with change of osteosynthesis from external fixator to internal fixation in fractures of the lower limb].

INTRODUCTION: In polytrauma patients and fractures with severe soft tissue damage of the lower limb the use of external fixator is indicated. To show the possibilities and limits of change of external fixation to internal osteosynthesis we performed a retrospective analysis. PATIENTS AND METHODS: Between 1.1.1993 to 30.6.1997 671 cases were primarily treated with external fixator. After a mean of 16.5 days a change of osteosynthesis was performed in 75 cases. RESULTS: 5 infections of the pin tracks, 3 infections of the wound, two thromboses, one case of thromboembolism and one osteomyelitis were seen in these 75 cases. One patient died due to severe brain damage after head injury. No further operations were necessary, all fractures showed primary healing. Taking the severe soft tissue damages and severe multiple trauma into account only few complications were observed. CONCLUSION: The main problems and risks of internal fixation occur in the early phase of treatment, whereas complications after external fixation are more likely to occur in later stages. By a change from external fixation to internal osteosynthesis the advantages of both methods can be combined.

Accidents, Traffic↗
PubMed2003

[Delayed neuropathy of the sciatic nerve after total hip replacement with an acetabular reinforcement ring].

AIM: Lesions of the sciatic or femoral nerve after THR are typical complications. Delayed neuropathies of the sciatic or femoral nerve are rare conditions. CASE REPORT: We report the case of a delayed neuropathy of the sciatic nerve after THR with reconstruction of the acetabulum with an acetabular reinforcement ring. After electrophysiologic evaluation we performed a revision of the sciatic nerve. Intraoperatively we found an impingement of the sciatic nerve between the dorsal aspect of the acetabular reinforcement ring and scar tissue. After revision of the nerve, resection of the scar tissue and interposition of a fat pad the patient was out of any complaints but reported some sensory deficits of the first toe. CONCLUSION: Using acetabular reinforcement rings for reconstruction of acetabular defects care has to be taken of the correct position. In anatomically cramped positions a protruding of the dorsal edge of the ring may cause a lesion of the sciatic nerve.

Acetabulum↗
PubMed2003

[Effect of tourniquet use on blood loss in total knee arthroplasty].

AIM: To reduce blood loss in total knee arthroplasty various physical measures including the use of a tourniquet are recommended. The question of an early tourniquet release is still unsettled. PATIENTS AND METHOD: To confirm our theory that blood loss and need of blood transfusions might be reduced while removing the tourniquet for meticulous hemostasis before wound closure we analysed 70 (41 male, 29 female) consecutive patients with total knee arthroplasty for osteoarthritis performed by a single surgeon in a prospective-randomized study between 1/1996 to 6/1998. In group I the tourniquet was released before, in group II after wound closure. RESULTS: We couldn't find any significant differences in the estimated blood loss, the decrease of hemoglobin and hematocrit level, and the transfusion need. In Group II we observed two cases of deep vein thrombosis. This difference was not significant. CONCLUSION: We conclude that tourniquet release for hemostasis is not an effective tool in reducing blood loss or transfusion need in total knee arthroplasty.

Aged↗
PubMed2003

[The LSP test for determining oscillation resistance of spinal implants].

QUESTION: New spinal implants need to be tested for primary stability in vitro under standardized laboratory conditions. To ensure the reliability of the test procedures, quality assurance standards in accordance with ISO 9000 were introduced to standardize testing including experimental set ups, loading and test frequency. These standards, however, require a relatively long time to implement. METHOD: The LSP test was used to compare various surface treatments by different shot peening processes applied to spinal rods for dorsal spine implant systems. 6 rods made of two different cp-Titanium materials (Ti-2 and Ti-4) were tested. Dynamic tests were performed with the MTS 810 mono-axial servo-hydraulic test equipment. Beginning with a load of 200 N the rods were subjected to tensile and compressive loads, which were increased in steps of 100 N after every 50.000 cycles until rod failure. RESULTS: Results were available after one to two weeks. The best results (LSP 167 million) were achieved with Ti-4 rods shot peened with steel balls and glass beads. In comparison, the lowest LSP value of 81 million was found with Ti-2 rods shot peened with glass beads only. CONCLUSION: This high speed testing method has reduced the development time from two years to 6 months.

Biomechanical Phenomena↗
PubMed2002

Genotyping for platelet-specific antigens: techniques for the detection of single nucleotide polymorphisms.

Accurate typing of patients for platelet-specific (human platelet) antigens (HPA) is required in several different clinical situations, and blood services need to maintain panels of HPA-typed apheresis platelet donors and whole-blood donors to support HPA alloimmunized patients. Six clinically relevant HPA alloantigen systems have been described and, in addition, a significant number of HPA alloantigens with a highly skewed allele frequency or of very low immunogenicity have been reported. Certain well-characterized biallelic systems such as Gov have not as yet been included in the HPA nomenclature but are included in this review. Biochemical studies have identified the platelet membrane proteins on which the HPA antigens are localized. Cloning of the genes encoding these proteins and the realization that there is adequate mRNA in fresh platelets has led to identification of the molecular basis of HPA antigens over the last decade. All but one of the biallelic platelet-specific alloantigen systems are based on a single nucleotide polymorphism in the DNA sequence, corresponding to a single amino acid substitution in the encoded primary protein sequence. The discovery of the genetic basis of the alloantigens has allowed the development of polymerase chain reaction-based techniques for HPA genotyping using genomic DNA. The genetic basis of the HPA alloantigens, the most commonly used genome typing techniques and their pitfalls, and future developments, are discussed in this review.

Antigens, Human Platelet↗
PubMed2002

[Experiences with 925 outpatient operations of carpal tunnel syndrome].

In the era of cost containment in our health care system the demand is made of increasing outpatient surgery e. g. for carpal tunnel syndrome. To show the possibilities of carpal tunnel release performed under outpatient conditions we analysed 925 consecutive cases during 1. 1. 1981 to 30. 4. 2001. A tourniquet was used in all cases. In 814 cases we used axillary plexus anaesthesia. 107 surgical interventions were done under local anesthesia. Two of these patients could not tolerate the tourniquet. Analgesia was complete in all but two cases. In two cases revision due to after bleeding was necessary. There were no further complications seen. The mean time for return to work was 21.3 days (min: 14, max: 36 days). The mean follow-up for these patients was 36 months. Numbness and paresthesias were relieved in 98 %, pain was relieved in 90 %, motoric weakness was relieved in 95 % of the hands. The overall satisfaction rate was 94 %. Carpal tunnel release can be performed safely and unexpensively under outpatient conditions.

Adolescent↗
PubMed2000

[Difficulties in evaluating follow-up outcome in calcaneus fracture managed with plate osteosynthesis. Is there a reliable score?].

A huge amount of publications is existing dealing with topics of operative or nonoperative treatment, results and follow-up of fractures of the os calcis. Comparing the different studies one can see that there are a lot of different scores applicated for follow-up and outcome. Therefore it's difficult or impossible to compare the results of the different publications. The problems are discussed while evaluating own results of operative treated fractures of the os calcis. Between 1993 and 1996 we treated 27 fractures with ORIF (open reduction and internal fixation). 25 of the patients could be followed-up after a mean of 22.1 months. For follow-up three recently published scores, the AOFAS Ankle-Hindfoot Scale (AOFAS), the Calcaneal Fractures Scoring System (CFSS) according to Kerr and the Functional Outcome Assessment-Score (FOA) according to Thordarson were used. The mean AOFAS-Score was 76.52 +/- 14.22, the mean CFSS was 77.40 +/- 15.22 and the mean FOA was 70.08 +/- 18.53 points. The differences between the AOFAS and the FOA-Score were significant (p = 0.017). The differences between the CFSS and the FOA-Score were significant (p = 0.004), too. These different values elucidate the need of uniform structured follow-ups of fractures of the os calcis. To compare different national or international studies uniform scores should be used. In anglo-american literature the AOFAS Ankle-Hindfoot Scale is well established. This scoring-system proved to be quite useful in our own analysis. We suggest that the AOFAS Ankle-Hindfoot Scale also should be taken into account in german literature, especially in follow-up of calcaneal fractures.

Activities of Daily Living↗
PubMed2000

Prevention of worsening of severe thrombocytopenia after red cell transfusions by the use of leucocyte-depleted blood.

Platelet counts were measured before and after red cell transfusions in 30 patients with anaemia and severe thrombocytopenia resulting from haematological diseases. There was a mean reduction of 1.1 x 109/l (P = 0.43) in the platelet count after transfusions of 2-3 units of leucocyte-depleted red cell concentrates (20 patients). However, there was a mean reduction of 2.7 x 109/l (P = 0.03), approximately 10%, in the platelet count after transfusions of non-leucocyte-depleted red cell concentrates (10 patients). The findings suggest that the forthcoming introduction of universal leucocyte depletion of red cell concentrates will minimize the worsening of thrombocytopenia that occurs in severely thrombocytopenic patients receiving standard non-leucocyte-depleted red cell concentrates.

Adult↗
PubMed1999

Encephalopathy complicating high-dose melphalan.

High-dose melphalan (HDM) with peripheral blood stem cell transplant (PBSCT) is a common treatment for patients with multiple myeloma (MM) and more recently also with AL amyloidosis (ALA). We report two female patients with severe renal failure who underwent treatment with HDM for MM (patient 1) and ALA (patient 2). Both patients developed severe encephalopathy with generalised tonic-clonic seizures and a Glasgow Coma Scale (GCS) of 3/15. Causes for coma such as infections, metabolic disturbances, cerebral ischaemia or haemorrhage were excluded. Patient 1 died on day 25 post transplant while comatose. Patient 2 recovered from her comatose state 18 days after transplantation. To our knowledge this is the first report on a possible role of high-dose melphalan in the development of encephalopathy.

Amyloidosis↗
PubMed1993

Climatotherapy.

For successful climatotherapeutic treatment the body has to be exposed daily over several weeks under an exact dosage regime, to the biometerological conditions. For doing this--to provide rest, or to apply stimuli--four different methods are described: climatic terrain treatment, fresh air rest-cures, air baths and heliotherapy. Climatotherapy is conducted in a marine climate, in upland and in alpine regions. These three zones differ in the intensity of their climatic stimuli. Today, climatotherapy has become more differentiated, and has been newly structured following objective parameters. It always refers to specific diseases.

Acclimatization↗
PubMed1988

GM-CSF induces human neutrophil IgA-mediated phagocytosis by an IgA Fc receptor activation mechanism.

Immunoglobulin A is the primary immunoglobulin isotype in tears, saliva, breast milk and other mucosal secretions, constituting between 6% and 15% of the total serum immunoglobulins. Human peripheral blood neutrophils have IgA receptors, but these cells do not normally participate in IgA-mediated phagocytosis. The haematopoietic factors granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) prime neutrophils to be more responsive to a variety of stimuli. We therefore studied their effect on IgA-mediated phagocytosis. GM-CSF and G-CSF both induce a change from low to high-affinity neutrophil IgA Fc crystallizable fragment receptors within 30 min; a change which is associated with the development of IgA-mediated phagocytosis. Human IL-3, which does not affect neutrophil function, is inactive in this system. These results define a new mechanism for CSF-augmented host defence whereby neutrophil function can be modulated by CSF-mediated IgA Fc receptor activation.

Caseins↗
PubMed1988

[Training and conditioning in atopic patients following high altitude climate therapy].

The subjective and objective values have changed after a four weeks treatment in high mountain areas under cool climatic conditions. "Terrainkuren" (mountain walking under guidance of a therapist) under cool climatic- and body temperature conditions show besides training results (in sport medicine) also favourable thermoregulatory adaptations. Improvements of the endurance training can be objectivated by means of the reduced heart frequency and the decrease in lactit acid under standardized physical exercises. The simultaneous changes of thermoregulation can be looked upon as part of the reaction of the whole body (also called inurement). Both, the improvement of the training condition and the thermoregulatory change seem to support each other. Thus patients can train more effectively under the same standardized physical training, but cooler conditions. The decrease of comfort temperature of patients is due to the thermoregulatory adaptation. There is a considerable decrease in the sensibility to cold. The training in high mountain areas causes an improvement in the well being and behaviour of the atopic patients which can still be manifested three months after the therapy.

Acclimatization↗
PubMed1976

Surveying rods.

Explore the source record for details and available documents.

Dental Instruments↗
PubMedDate not supplied

Binding of monoclonal anti-interleukin 2 antibody to nucleoli in acute leukemia blast cells.

Neutralizing anti-IL-2, anti-IL-3, and anti-IL-6 monoclonal antibodies (MAbs) were used for the immunoenzymatic detection of the respective cytokines in blast cells of 38 patients with acute myeloid (AML) and lymphoid (ALL) leukemias by the APAAP-technique. In 20/24 AML-cases (83%) blast cells showed intranuclear staining with MAb anti-IL-2 (DMS-1). In 17 cases reaction was restricted to the nucleoli, in 4 cases additional cytoplasmic staining was observed. Only 2/13 (15%) of the ALL cases showed anti-IL-2 staining. In contrast to IL-2, neither IL-3, IL-6 nor IL-2R alpha-chains were detected in any of the acute leukemias tested. The anti-IL-2 staining of nucleoli in AML cells is distinct from the cytoplasmic staining which is observed in PHA-activated normal lymphocytes and in a minority of AML cells.

Antibodies, Monoclonal↗