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Biomedical subjects

C Wurnig

Publications and source records attributed to C Wurnig.

31 records · Page 2Linked to original sources
PubMed1991

Serum-erythropoietin concentration during acute cardiogenic pulmonary edema.

Reduced oxygen tension is regarded as the primary physiologic signal for the production of erythropoietin (EPO). There is little information available about early changes of EPO production in man due to severe hypoxia. The purpose of the present study was to examine the time course of EPO in serum of patients with acute cardiogenic pulmonary edema (ACPE). In 29 patients (seventy-five +/- six years, mean age +/- SEM) who were hospitalized within two hours after onset of symptoms of ACPE, serum EPO concentrations were monitored for up to seventy-two hours. At the moment of admission all patients showed significantly increased EPO concentrations of 121 +/- 64 mU/mL (mean +/- SEM) compared with a healthy population (15-35 mU/mL). Twenty-three patients who recovered within thirty minutes (group A) exhibited a quick return of their EPO serum levels to normal. The remaining 6 patients (group B) had a protracted clinical course and their EPO concentration showed a further increase up to the end of the observation period. The comparative monitoring of concentrations of alpha-1-proteinase inhibitor, antithrombin III, C-reactive protein, fibronectin, hapotoglobin, and transerrin in serum and plasma revealed no significant changes. Thus a major contribution of fluid shifts into or from the intravascular compartment to the observed changes in EPO concentration seems to be unlikely. The data suggest that the production and release of EPO in the kidneys due to altered oxygen delivery is a fast-responding mechanism.

Acute Disease↗
PubMed1991

Parosteal osteosarcoma. 2-23-year follow-up of 33 patients.

In a study of the working group for bone tumors of the German Orthopedic Society, 33 patients with a histologically confirmed parosteal osteosarcoma at reexamination underwent clinical and radiographic follow-up. Local recurrence occurred in all the cases after intralesional surgery and in 4 of 8 cases after marginal excision. The grade of differentiation was decisive for the prognosis. Despite intralesional surgery, the prognosis for Grade 1 tumors was good. Metastases developed in 1 of 23 patients with a Grade 1 tumor and in 4 of 9 patients with a Grade 2 tumor. The single patient with a Grade 3 tumor was treated with adjuvant chemotherapy and was free of disease after 5 years.

Adolescent↗
PubMedDate not supplied

[Physical activity after total knee replacement].

AIM: The aim of the study is to find out to what extent patients can do sports after total knee replacement and how patients change their activities compared to the preoperative situation. METHOD: 167 patients, not older than 65 years at time of surgery, who had total knee replacement during the years 1988 to 1998 were asked about their physical activity habits before and after surgery and 112 of them were seen for follow-up examination. RESULTS: 138 (83%) patients correctly answered the questionnaire about their activities. The average age at time of surgery was 55.3 years (21 - 65 yrs), at time of follow-up examination or questioning it was 63.8 years (24 - 78 yrs). The preoperative activity rate was 80.4%. Postoperatively it sank to 75.4%. 99 of the 111 (89.2%) patients returned to some kind of activity after surgery. Walking proved to be the most popular activity (92.8%), followed by swimming (34.2%) and cycling (18.0%). Follow-up examination was done after an average of 74 months (24 - 156) postoperatively and revealed an average Knee Society Knee Score for all patients of 84/70. With a score of 83.4/55.7 the less active group lay under the more active group with a score of 85.2/72.3. CONCLUSION: A tendency towards low impact physical activities could be seen after total knee replacement. Even so, the percentage of patients participating in physical activities was not reduced in a strong way by surgery.

Activities of Daily Living↗
PubMedDate not supplied

[Arthroscopic menisectomy in older patients: assessing health-related quality of life].

AIM: Little information is available on partial arthroscopic menisectomy in patients 60 years of age or older. Due to the co-morbidity of meniscal tears and osteoarthritis in this age group, the effectiveness of this procedure is controversial. The purpose of this study was to evaluate the outcome of this procedure in terms of function and mobility in patients 60 years of age or older. METHOD: Between 1990 and 1999, 1920 arthroscopies of the knee were performed in a single primary care institution, and 51 patients, 60 years of age or older, had a partial arthroscopic menisectomy done. Outcomes were rated using the SF-36 Health Survey and a specially designed questionnaire including items of published scores. RESULTS: The mean age at surgery was 67 years (range: 60.3 - 78.9) and the mean follow-up was 5 years (range: 2 - 12). Due to persistent pain, 4 patients underwent a second operation including knee replacement in 3 cases and a high tibial osteotomy in 1 case. 41 patients (87.1 %) stated the arthroscopy had improved their quality of life. In terms of pain and daily life activities, the majority of the subjects showed an improvement after surgery. The SF-36 showed no clinically relevant difference compared to the control in all but one subscale. CONCLUSION: Despite of the presence of osteoarthritis in this age group, arthroscopic partial menisectomy can improve pain, function and mobility in the mid-term course.

Aged↗
PubMedDate not supplied

[Translation and psychometric testing of the Western Ontario Rotator Cuff Index (WORC) for use in Germany].

AIM: At the moment a specific subjective measurement tool for evaluation of German-speaking patients with a pathology of the rotator cuff is lacking. Following international guidelines, the German translation and the psychometric testing of the 21-item, multidimensional Western Ontario Rotator Cuff Index (WORC) is the aim of the study. METHOD: After translation and cross-culture adaptation of the English original, the reliability, validity, practicability and the acceptance of the German version of the WORC were tested on 102 patients with an impingement syndrome. Additionally the SF-36, the Constant and UCLA score were evaluated. RESULTS: The Pearson correlation coefficient showed with 0.96 an excellent result for the test-retest reliability. The internal consistency showed a high homogeneity with a Cronbach alpha coefficient of 0.96. A Pearson correlation coefficient between 0.66-0.81 registered a high correlation with the physical subscales of the SF-36, the Constant and the UCLA score. The mean time required for filling out the WORC was 7.5 minutes, the mean time required for evaluation was 10 minutes. The acceptance and the understanding were very high. CONCLUSION: After successful translation and psychometric testing of the German version of the Western Ontario Rotator Cuff Index (WORC), a patient-based measurement tool for evaluating the quality of life of German-speaking patients with pathology of the rotator cuff is available.

Adult↗
PubMedDate not supplied

[Prevention of heterotopic ossification after THA with indomethacin: analysis of risk factors].

AIM: Several risk factors are associated with heterotopic bone formation following total hip replacement. All these risk factors were defined in cohorts without any treatment against postoperative ectopic bone. The aim of this prospective study was to reveal risk factors for the development of postoperative ossifications in patients who underwent a 7-day course of indomethacin therapy. METHODS: 211 consecutive patients with 217 cementless total hip arthroplasties were included. Patients were given 100 mg indomethacin daily in a 7-day course. RESULTS: Grade 2 or 3 ossifications were observed in 13 (5%) of the male and 3 (2%) of the female Individuals postoperatively (p = 0.0043; odds ratio = 0.45). Older individuals (p = 0.0021; odds ratio = 1.03) as well as patients with primary osteoarthritis (p = 0.0307; odds ratio = 0.28) also showed a higher risk for developing ectopic bone formations. CONCLUSION: With a 7-day course of indomethacin after total hip arthroplasty, male and elderly individuals, as well as patients with primary osteoarthritis, are considered to be at high risk to develop heterotopic ossifications postoperatively. Indomethacin reduces the incidence of postoperative ectopic ossifications, but not the patient's risk.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

[Significance of transverse forefoot stabilization in the treatment of hallux valgus. Comparative study of clinical/radiologic short-term results].

72 feet of 56 patients were treated by Brandes operation, modified by using a distally attached capsular-periosteal flap from 1984 till 1986 at the Orthopedic Clinic of the University of Vienna. On 41 of these feet an additional cerclage fibreuse according to Lelievre was done. This group had a significantly better correction of the hallux valgus angle with 17 degrees as compared to 8 degrees in the group without cerclage fibreuse. The correction of the intermetatarsal angle was also significantly better with 5 degrees as compared to 1 degree. Only through cerclage fibreuse was it possible to stabilize the sesamoids in the transversal as well as in the longitudinal direction. We found no improvement of subjective well-feeling after the cerclage fibreuse, but a significantly better correction and mobility in the metatarsal-sesamoid joint and the metatarsal-phalangeal joint.

Adult↗
PubMedDate not supplied

[The limits of saving the extremity--amputation versus resection].

On the basis of the extensive data contained in the Vienna Bone Tumor Register, i.e. 839 primary malignant bone tumors, as well as of 554 cases treated at the Orthopedic Department of the University of Vienna Medical School, a comparison between the methods of surgery applied at pelvis and extremities during the past two decades can be drawn. Resectional therapy had been performed in twice as much patients as amputation therapy, and barely 20%, mostly with multiple metastases, had been merely treated with palliative surgery or were just biopsied and underwent chemo- and radiotherapy. An analysis of amputations and resections, subdivided into pelvis and sacrum resections, resectional reconstructions and resectional reimplantations at the extremities, shows approximately the same low incidence of local recurrences in the groups amputation versus resection, but a significantly higher involvement of pelvis and sacrum resections as well as no local recurrences in the group of 48 resectional reimplantations. As regards the oncologic radicality of surgical margins, in cases of resections, as compared to amputations, about twice as much inadequate operations had to be accepted, though. The fact that the local recurrences did not increase to the same degree, but were approximately equilibrated, seems to be due to the new chemotherapeutic treatment which had been initiated at the same time as the frequent application of resectional therapy. The conservation of extremities contains twice as high a risk of inadequate operation, but it is, in cases of effective chemotherapy, comparable with the former results of amputations, as regards local recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

Amputation, Surgical↗
PubMedDate not supplied

[Sonography of the biceps tendon].

641 patients who had undergone ultrasonic investigation of the shoulder joint were reviewed retrospectively. Thirty-four cases (5.3%) with sonographic abnormalities of the biceps tendon or the soft tissue surrounding the biceps tendon were found. In 15 cases a synovitis or effusion of the bicipital (convexity of the transverse ligament) groove was found. Four times a mineralization of the transverse ligament (high echogenic zone with interruption of the humerus coticalis) was observed. In 10 cases rupture of the tendon (sagging of the transverse ligament) was diagnosed. One case was diagnosed as a subluxated biceps tendon (tendon riding on the lesser tubercle) and was misdiagnosed. Four cases with cysts of the biceps tendon were seen (well defined zone of low echogenity). Seven patients underwent surgery following unsuccessful conservative treatment and in all cases but one the ultrasonic diagnosis was confirmed. According to the experience of this investigation ultrasonic examination of the biceps tendon turned out to be an ideal imaging technique for screening of lesions of the long head of the biceps.

Adult↗
PubMedDate not supplied

[Algodystrophy in pregnancy].

Algodstrophy during pregnancy occurs very seldom. Indeed there are only 28 exactly described cases on record and not one of these in German. The symptoms are, however, very severe and considerably affect the well-being of the patients. According to the most recent findings, the MRT examination should be the most suitable diagnostic procedure; a biopsy is not necessary. The focus of the therapy is the treatment of the symptoms. The etiology is still obscure. From the analysis of the described cases, however, the combination of hormones during pregnancy seems to be the most significant factor.

Adult↗
PubMedDate not supplied

Subcutaneous low-dose epoetin beta for the avoidance of transfusion in patients scheduled for elective surgery not eligible for autologous blood donation.

This randomized, multicentre, parallel-group study assessed the efficacy of epoetin beta in reducing the transfusion frequency in patients ineligible for autologous blood donation prior to surgery. The patients (n = 194) received either epoetin beta (125 or 250 IU/kg, once weekly) or no therapy for 3-4 weeks before surgery. The pre-operation haemoglobin levels were markedly increased in the epoetin beta groups (125 IU/kg: +1.1 g/dl; 250 IU/kg: +1.6 g/dl), but not in the control group. The transfusion frequency was significantly reduced in both epoetin groups as compared with the control group (p = 0.046). Epoetin beta was well tolerated, and no serious adverse events were observed. Low-dose administration of epoetin beta before elective surgery reduces the transfusion frequencies in patients not eligible for autologous blood donation.

Blood Transfusion↗