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Biomedical subjects

K Weise

Publications and source records attributed to K Weise.

At least 55 records · Page 3Linked to original sources
PubMed1998

Distalization of the patella during tibial callus distraction.

Consecutive distalization of the patella is described in two patients undergoing segmental transportation after high tibial corticotomy. Revision surgery with loosening and proximal reattachment of a portion of the patellar ligament bridging the callus distraction zone could re-establish the correct patellar position. Despite excellent callus formation after tibial corticotomy just below the tibial tuberositas, this procedure should be performed more distally as the fibers of the patellar tendon spread laterally and distally.

Adult↗
PubMed1998

[Injuries in sledding].

Tobogganing is a very popular outdoor winter recreational activity. In order to elucidate the patterns of injuries associated with tobogganing all patients with an injury caused by falls from or collisions while on or being hit by a sled were sampled prospectively between the period of November 1996 and March 1997. 50 patients were included in this study, aged from 7 to 69 years (mean 25.5 years). Of these, 14 (= 28%) patients required admission to hospital lasting from 1 to 31 days (mean 13.5 days), 11 (22%) needed an operation. Over all we could register 55 injuries; the lower extremity was the region most commonly injured (63.6%), followed by upper extremity with 21.8%. The most common injury was the sprain of the knee. The most severe injuries could be found at the lower limb and at the vertebral column, including four fractures of the lower leg and 8 ankle-joint fractures as well as two fractures of the lumbar spine. The most common single procedure was the open reduction and internal fixation of a fibular fracture. In 48.6% of the cases the riders struck an object (tree, wall, post), while 32.4% fell from the toboggan caused by environmental conditions such as a bump or a ditch. The most important risk factor was an unadjusted speed referred to the environmental circumstances. Preventive strategies include tobogganing in adequate environmental conditions with no trees, no post or other stationary objects that could result in a collision. Speed should be adapted to the slope conditions.

Acceleration↗
PubMed1998

A modular system for cemented and cementless implantation of femoral stem prostheses.

A femoral stem [BiContact, Aesculap, Germany) has been developed which is suitable for both cemented and uncemented implantation. Thus a highly standardized procedure and a standard implant for any iritraoperative finding is available. While the cemented stems have a smooth surface, the cementless implants are proximally coated with a microporous titanium plasmaspray [Plasmapore]. The strategy based on the intraoperative choice of the surgeon to use either cemented or cementless implants after bone preparation turned out to be very successful in our institution. A consecutive series of 250 cases with cemented implantation and 250 cases with uncemented implantation was analyzed in a prospective follow-up study, Pollow-up time averaged 7 years for cemented and 6.5 years for uncemented THRs. The follow-up rate was 88.7% in cases treated with cemented stems and 93.1% in cases treated with uncemented stems. The rate of aseptic loosening was 1.2% for the cemented version and 0.4-% for the uncemented stem. Radiological loosening could be observed in another 1.2% of the cemented stems and was not to be found in the uncemented cases. Our data suggest an excellent midterm stability of both the cemented and the uncemented version of the BiContact hip system. The long-term results for both the cemented and uncemented prostheses of our series are still to be evaluated.

Journal Article↗
PubMed1998

Exogenously acquired Clostridium septicum gas gangrene--a case report.

We report on a 72-year-old woman suffering from gas gangrene of the right leg, which developed 3 days after getting injured while gardening. Due to rapid microbiological diagnosis-direct microscopical examination of muscle biopsies revealed numerous grampositive rods-, immediately performed amputation of the leg and antibiotic treatment with penicillin and metronidazole the patient survived. From the muscle biopsies Clostridium septicum, which is found ubiquitously, was isolated in pure culture.

Aged↗
PubMed1997

[The determinants of the quality of life after a type-III open tibial fracture. The results of a multicenter study].

This study investigated to what extent quality of life four years or more after the fracture is determined by initial staging (Gustilo subclassification, time from injury to arrival at hospital), by the therapeutic course (length of hospital stay, number of operations), by complications (amputation, infection) and by demographic factors (gender, age). A total of 197 patients after type III open tibial shaft fractures (type IIIA 70, type IIIB 85, type IIIC 42) from nine centers volunteered to participate in this study. During patients' follow-up appointments (mean duration of follow-up 50 months), therapeutic course, pre-surgical staging and demographic data were recorded by the surgeon. Patients were asked to rate quality of life on the Nottingham Health Profile and on a visual analogue scale. Multiple regression analysis (stepwise) identified two predictors for reducing overall quality of life (F-test: P = 0.007): number of operations (adjusted beta: -0.21) and age (adjusted beta: -0.17). Other factors showed no significant relationship with overall quality of life or with subscales of the Nottingham Health Profile. These findings indicate a dilemma between two therapeutic goals: good functional outcome, which often requires repeated operations, and quality of life, which suffers under prolonged surgical treatment.

Adult↗
PubMed1997

[Elbow injuries in childhood].

Fractures and dislocations of the elbow are some of the most common injuries in childhood and adolescence. The majority occur in sport and play activities, e.g., a fall from gymnastics apparatus or a bike, or from popular sports items, such as skateboards or in-line skates. The injuries can be divided into pure dislocations of the joint and fractures of the distal humerus, proximal radius and ulna, or combinations of both. In addition, extra- and intraarticular fracture types are defined, with the latter as partial or complete joint lesions. Dislocations of the elbow joint or the radial head can occur as single injuries or in combination with a fracture. Supracondylar fractures and avulsion fractures of the medial epicondyle are the most frequent extraarticular lesions of the distal humerus. Fractures of the lateral condyle prevail is incomplete intraarticular lesions. In the forearm, radial head and neck fractures are predominant while typical and atypical Monteggia injuries have a special status. The complex joint construction and the age-dependent appearance of the epiphyseal ossification centers sometimes make a correct radiological diagnosis difficult. The trauma history and an exact, clinical examination help to verify the injury, as do comparative X-ray studies of the uninjured side when necessary (but not routinely). Unlike other anatomical areas, most elbow injuries-even in the growing skeleton-are treated operatively. Hereby, the growth plates have to be respected using minimal amounts of small implants. Additional immobilization in a cast for 2-4 weeks is necessary in most cases but does not lead to a functional deficit-in contrast to adults. The implants should be removed as early as possible. Despite all therapeutic efforts, a significant number of late sequelae, such as malunions and functional impairment, can be seen. The rate of long-term complications increases in cases of untreated displacement of fragments or joint instability. Corrective measures are performed only in selected cases and after the growth plates are closed. Our own treatment regime is demonstrated using exemplary clinical cases of the different injuries and the results of a long-term follow-up study on sports injuries of the elbow in children. Errors in diagnosis and therapy, as well as possible complications, are pointed out.

Adolescent↗
PubMed1997

[Unreamed intramedullary nailing as minimal invasive palliative intervention in osteolysis and pathologic fractures of long tubular bones].

Pathological fractures and osteolyses with impending fractures of long bones impose a severe problem in patients with advanced cancer. For palliative treatment between June 1993 and October 1995 intramedullary nailing was performed in 19 patients with 13 femoral, 7 humeral and 1 tibial lesions; AO unreamed nails were used for this purpose (unreamed femur nail UFN with or with spiral blade for femoral lesions and unreamed tibia nail UTN for humeri and tibia). Stabilization was achieved without severe complications; full weight bearing of both femora and humeri (while using crutches) was allowed. Simultaneous and bilateral nailing was done. Follow-up until death due to advanced cancer demonstrated no implant failure and improved quality of life as well. Unreamed intramedullary nailing seems to be a minimally invasive procedure with a low complication rate for palliative treatment of (impending) pathological fractures in advanced cancer.

Adult↗
PubMed1997

[Diagnostic problems in juvenile Huntington chorea].

Huntington's disease (HD) may cause considerable diagnostic problems because of the highly variable clinical features, especially at the beginning of the illness. We report the case of a 21-year-old woman with definite HD whose main symptoms were psychopathological changes that were misinterpreted as schizophrenia for 7 years. One reason for this misdiagnosis was the unusual, very early onset and the remarkable earlier age of onset of HD compared with that of other affected relatives. The phenomenon of earlier onset within one affected family is well documented in the literature in cases with the paternally transmitted mutated gene. Diagnostic landmarks were consideration of the initially mild disturbances of movement and the once again repeated detailed examination of the family history.

Adult↗
PubMed1997

[Rehabilitation following hip fractures].

In the rehabilitation of patients with acetabular fractures, we try to achieve anatomical reconstruction of the joint as well as unlimited mobility. This is important for the patient's reintegration at work and in social life. These aims can only be reached with joint effort of the patient him/herself and all the different specialists concerned with the treatment. Functional physiotherapy should start as early as possible after trauma. Prophylaxis of joint stiffness, thrombosis, pneumonia and soft-tissue ulcers due to immobilization are not only important in the beginning. The restoration of circulation and resorption in the affected tissues, in addition to creation of global sensorimotor motion patterns, are the main aspects of this therapy. Definite long-term success should be ensured by concomitant ergotherapy and well-timed measures for the patient to regain his/her occupational abilities.

Acetabulum↗
PubMed1997

[Injuries due to inline skating].

In order to elucidate the patterns of injuries associated with in-line skating all patients with a inlineskate injury have been sampled prospectively during summer 1996. 58 patients were included in the study, aged 8 to 54 years (mean 22.2 years). The total number of injuries was 63, that is 1.1 injury in every injured skater. The upper extremity was the region most commonly injured (63.5%), with the distal radius fracture being the most common single fracture (25.4%). The most severe injuries, however, could be found in the lower extremity, including two femoral neck fractures and one pertrochanteric fracture in three patients aged more than 35 years. 22.4% of patients required hospitalization up to 54 days, and 36.2% of injuries had to be treated operatively. The most common single procedure was closed reduction and percutaneous wire fixation of displaced radius fractures. It is concluded that in-line skating imposes a risk of severe injuries especially on first-time skaters aged 35 years and up. The typical skating injury is the fracture of the wrist, a fact pointing out the necessity of the use of appropriate safety gear.

Adolescent↗
PubMed1997

[Group stability and open setting in psychiatric therapy groups].

Psychotherapeutical groups in Psychiatry--different to traditional Psychotherapy--are often carried out as open groups; the patient, not bound to a previous commitment to long-term and reliable attendance, is authorized to determine for himself how long he will take part in the group. Though in this way it is possible to decrease the threshold of participation in the group, on the other hand this may cause risk of an extreme high fluctuation. The analysis of a group of psychiatric patients shows that in spite of the open form, lack of a waiting list, and a faint motivation of newly admitted participants, considerable stability can be obtained.

Adult↗
PubMed1997

[Hip dislocations and hip fractures--acetabular fractures. Indication, technique and results of conservative treatment].

Despite the great number of publications during the last 10 years concerning the indication, technique and results of operative treatment of acetabular fractures, conservative treatment still has an important role when considering the therapeutic possibilities. Because of the modern techniques of radiological imaging and improvement of diagnostic facilities, a more defined indication for treatment becomes possible. Conventional X-rays, completed by special projections like the Ala and Obturator view, and a CT scan allow determination of the fracture type (the Letournel/Judet classification or the AO classification). The most suitable treatment can then be adapted to the individual circumstances of the patient, i.e., age, general condition and overall severity of traumatic impairment. Determination of the intact part of the weight-bearing dome is important in selecting the most adequate therapeutic procedure. The larger the intact roof arc, the better the prognosis. Together with the X-ray controls following axial and facultative lateral extensions, the indication for conservative treatment can be confirmed. Early active motion of the injured limb, followed by walking exercises with partial weight-bearing, are important aspects of nonoperative treatment. Conservative treatment is recommended in non-displaced fractures or in fractures with little displacement, transverse fractures of the lower region or severely comminuted acetabular fractures with no possibility of reconstruction. Our clinical and radiological follow-up of 97 patients with acetabular fractures from the years 1981-1990 showed that the majority were treated conservatively (approx. 70%). The functional result after an average observation period of more than 70 months was good or excellent (based on the Merle d'Aubigné score). We feel it is important to look at operative and conservative treatment of acetabular fractures as two complementary non-competitive therapeutic methods. The choice of treatment should be based on an exact diagnosis considering fracture type, the individual circumstances of the patient, and application of the necessary diagnostic facilities. Conservative treatment can lead to excellent long-term results.

Acetabulum↗
PubMed1996

Two mutations in gB-1 and gD-1 of herpes simplex virus type 1 are involved in the "fusion from without" phenotype in different cell types.

Previous studies have shown that certain strains of herpes simplex viruses type 1 (HSV-1) are able to induce "fusion from without" (FFWO) which means no transcription or translation of the viral genome happens. The main determinants for FFWO in BHK cells are mutations in the C-terminal part of gB-1. But single mutations in this part of the genome are not sufficient to transfer the FFWO phenotype also to Vero cells. Here, we report that FFWO of HSV strains indeed need additional mutations in the N-terminal part of gD in order to produce the FFWO phenotype in BHK and Vero cells. By marker transfer we are able to show that loss of mutations in the N-terminal part of gD influences the ability to induce FFWO in Vero cells but not in BHK cells. We assume that a mutated gD allows the entrance of a multiple number of virus particles into the cell and enhances therefore the fusion activity of the mutated gB. Mutations in gD alone are not sufficient for fusion activity of HSV.

Amino Acid Sequence↗
PubMed1996

Topical immunotherapy in alopecia areata: anamnestic and clinical criteria of prognostic significance.

BACKGROUND: Topical immunotherapy of alopecia areata (AA) is an effective but time-consuming treatment with unknown long-term risks. OBJECTIVE: The purpose of this study was to identify criteria which allow a selection of patients with a good prognosis for topical immunotherapy with diphencyprone. METHODS: The anamnestic and clinical data of 50 successfully and 55 unsuccessfully treated patients were compared by the Mann-Whitney test. RESULTS: Five factors were found to be of prognostic significance: type of AA (p < or = 0.001), presence of nail changes (p < or = 0.001), duration of AA before treatment (p < or = 0.005), age at onset (p < or = 0.01) and association with atopic eczema (p < or = 0.02). CONCLUSION: A selection of AA patients who are likely to respond to topical immunotherapy is possible on the basis of anamnestic and clinical data.

Administration, Topical↗
PubMed1996

[Role of intramedullary nailing in pseudarthrosis and malalignment].

Intramedullary stabilization can provide fast bone consolidation in cases of delayed fracture healing and hypertrophic non-unions. The indication for intramedullary nailing must be exactly adapted to the individual situation. An analysis of our own cases revealed bony healing in hypertrophic non-unions of femoral shaft fractures in 93% and in 94% of tibial shaft fractures after reamed intramedullary nailing. In selected cases of axial or rotational deformities or length discrepancy of the femur and the tibia, a correction osteotomy can be performed with intramedullary nailing. If it is necessary to expose the non-union and in axial or rotational deformities a rotation-stabilizing plate can be applied in addition to the intramedullary nail.

Adult↗