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Biomedical subjects

J Harms

Publications and source records attributed to J Harms.

At least 73 records · Page 4Linked to original sources

[Primary management of fresh injuries of the thoracic and lumbar vertebrae].

Results of conservative treatment of vertebral body fractures and of repositioning and internal fixation, are compared with those obtained by dorsoventral repositioning and fusion. The results achieved with patients treated by dorsoventral fusion were statistically significantly better than those obtained with the other two treatment methods. Consequently, we modified the treatment concept of thoracic and lumbar vertebral body fractures. Every vertebral disk showing irreversible damage is now resected and the mobility segment involved is fused. The fracture is treated conservatively only in case MR does not reveal any lesion of the vertebral disk, or it is stabilised only from the dorsal approach.

Adult↗

[The diagnostic value of quantitative Doppler ultrasound signal analysis in diagnosis of postoperative organ dysfunction following orthotopic liver transplantation].

As hepatic transplantation becomes more successful, there is increasing demand on noninvasive methods for studying graft dysfunction during the postoperative period. Duplexsonography now is a routine investigation with the possibility of quantitative description of changes in hepatic blood flow during graft dysfunction. Serial quantitative doppler measurements of hepatic artery, portal vein and hepatic veins were obtained in 20 adult patients during hospitalisation after transplantation and retrospective correlated to clinical datas. The resistive index of hepatic artery was maximal elevated in the initial period after graft reperfusion. There was no correlation with acute rejection. The angle independent damping index (minimum frequency shift/maximum frequency shift) calculated for portal- and hepatic vein showed significant changes during acute rejection, chronic rejection and cholangitis.

Graft Rejection↗

Correction and stabilization of angular kyphosis.

Reconstruction of normal geometric relationships, regardless of original pathology, has to be the goal when treating angular kyphosis. Since anterior and posterior spinal structures are involved, successful decompression, correction, and stabilization require both dorsal and ventral surgery. By using segmental transpedicled and ventrolateral Instrumentation System implants, permanent fixation can be achieved. As a result, the length of the compression spondylodesis and fusion time are short. pedicular anchorage and implant design leave the joints and ligamentum flavum of healthy neighboring segments untouched. In the last five years, over 570 kyphotic deformities, including congenital kyphosis, spondylitis, tumors, and acute and neglected fractures, have been treated with this method. During a three- to five-year follow-up period of 40 patients with posttraumatic kyphoses, no additional neurologic damage, pseudarthrosis, or substantial loss of correction occurred.

Female↗

[Comments on the contribution: initial results of surgical treatment of scoliosis with the Cotrel and Dubousset CD instruments by Ch. Hopf, H. H. Matthiass and J. Heine. Z. Orthop. 125 (1987) 347].

It really must be appreciated that in the above mentioned publication of Hopf, Heine and Matthiass the authors were brave enough-against normal habits-to publish their bad results. In demonstrating their cases they render the CD system a destructive rebuff. Not in one of their demonstrated cases they were able to show that there are convincing advantages of this surgery compared to other already wellknown and sufficiently proven methods. We still have to acknowledge the opinion of Nachemson (1986) that the CD method is yet in the experimental stage. The authors show in their selective cases how it should not be done. They sacrifice in favor of a primary stability functionally important segments of the spine cranially as well as caudally and thus mutilate young human beings to an irresponsible extent. Of course it is astonishing when the authors in spite of their actually crushing experiments with this system in summary arrive at positive results without reasons indeed. For example they comment positively on the attained derotation, although they had shown with their results that no derotation could be achieved at all. Remarks about diminishing the rib hump, which should after all be a result of a good derotation are missing. Exact measurements in CT scans of the apical vertebra, as demonstrated in an extraordinary way by Giehl, have not yet been made in Münster. Otherwise the authors would have clearly recognized that a derotation with resection of the discs is not possible using the CD method. The authors present the system-in spite of their very bad results-as a universal spinal system for correction and stabilization and at the same time they doubt the value and extent of anterior surgical methods according to Dwyer or Zielke, even though these methods have internationally shown how the optimal corrections have resulted in fewer mutilations by using shorter fusion areas on the spine provided that the surgeon knows how to use the instruments. We spine surgeons should always be aware that we can cause an irreversible condition on the spine of the human being with our spinal fusion operation this could have grave results for the patient for his whole life. No doubt, there are advantages in the CD method, but they rather result in better stability than in better corrections.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

[Spinal traction syndrome].

The causes of Spinal-Traction-Syndrome are discussed in a case of marked Spinal-Traction-Syndrome, that appeared after correction of a thoracal scoliosis, instrumented according to Harrington. On account of our case we tend to support the opinion, that the cause for the Spinal-Traction-Syndrome is to be seen rather in the mechanical obstruction of the flexura duodeno-jejunalis than in the overstretching of vagus nerve.

Adolescent↗

Tissue reaction to ceramic implant material.

The biocompatibility of alumina ceramic was tested by means of macrophage cultures, intraperitoneal (i.p.) and intramuscular (i.m.) application of powdered particles in rats, and by implantation of solid samples in the paravertebral muscles and the condylus femur. No acute cytotoxicity was found in macrophage cultures. The i.p. and i.m. application of powdered particles in the beginning showed a granulocytic reaction, later followed by a histiocytic reaction. Also, the morphological changes in the organs of reticulo histiocytic system (RHS) are shown. In the solid samples implantation, the fibrogenetic stimulus is measured by morphological analysis of the connective tissue membrane around the sample. The importance of the individual cell observation by transmission-electron microscope (TEM) examination is evidenced. The experimental results are compared to the environmental reaction of smaller animal-adapted prostheses and prostheses having been implanted in human patients. Good biocompatibility is confirmed by these investigations; also regarding central position of the macrophages, the environmental reaction due to implant material is shown.

Aluminum↗

[Results of resection, analogous bone grafting and osteosynthesis of juvenile bone cysts (author's transl)].

Drawing the conclusions from the results we can say on the basis of the material presented that in the treatment of the solitary bone cyst the total resection of the cyst is more advisable than the excochleation. If the cysts are closely located to the epiphyseal cartilage it will, however, not always be possible to avoid relapses, even if a total resection has been carried out, since the simultaneous resection of the epiphyseal cartilage would result in defective growth. Here the final correction is, however, possible by a second operation, when the cyst has grown further away from the epiphyseal cartilage. The shortening of extremities observed by us are to be attributed to partial damages of the epiphyseal cartilage on account of the operation and may be avoided by a more careful operation procedure. On the whole, the total resection with analogous bone grafting and osteosynthesis can be recommended as a well-tested method of operation with the purpose of obtaining a complete and lasting recovery.

Adolescent↗