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Biomedical subjects

M Flügel

Publications and source records attributed to M Flügel.

At least 19 recordsLinked to original sources
PubMed2005

[Dorsal capsulodesis versus triscaphe arthrodesis in patients with scapholunate dissociation. Do the results depend on the diagnosis or the operation?].

BACKGROUND: Dorsal capsulodesis and triscaphe arthrodesis are possible treatment modalities for patients with scapholunate dissociation. In light of overlapping indications for either operation for patients with carpal instability, it is important to compare the postoperative results. METHODS: From 1998 until 2002, we operated on 87 patients suffering from scapholunate dissociation. 52 patients were treated by dorsal capsulodesis after R. Berger and 35 patients were treated by triscaphe arthrodesis as published by Watson. Of these 87 patients, we managed to follow-up 77 patients (47 dorsal capsulodesis und 30 triscaphe arthrodesis) with a physical examination, X-ray of the wrists and Krimmer Score. RESULTS: In terms of grip-strength, range of motion, functional outcome (Krimmer Score), duration of the operation and hospitalisation, the dorsal capsulodesis group performed better (p < 0.05) than the triscaphe arthrodesis group at the time of follow-up. At follow-up, pain reduction was significant in both groups (p < 0.05). Krimmer Score (functional outcome) and the rate of complication was clearly better for the dorsal capsulodesis group as compared to the triscaphe arthrodesis group. CONCLUSION: In case of non-static scapholunate dissociation, dorsal capsulodesis should be the first choice treatment. In case of a young manually working man with static scapholunate dissociation, it should be a case-to-case decision whether performing a triscaphe arthrodesis or a dorsal capsulodesis. With this investigation we wanted to discuss and demonstrate the difficulties with the differential-indication for the two operations. Generally speaking the postoperative results did not depend on the type of scapholunate dissociation (dynamic versus static) but rather on the chosen surgical procedure.

Adolescent↗
PubMed2001

The Lly protein is essential for p-hydroxyphenylpyruvate dioxygenase activity in Legionella pneumophila.

The lly locus confers fluorescence, haemolysis, brown pigmentation and an increased resistance to light in Legionella pneumophila. In this study, we correlated the pigment production of two lly-positive L. pneumophila isolates and a recombinant lly-positive Escherichia coli strain with the presence of homogentisic acid (HGA) in the culture supernatant. The detection of HGA by high performance liquid chromatography and the data analysis of the deduced amino acid sequence of the lly gene indicate that the lly locus codes for a p-hydroxyphenylpyruvate dioxygenase (HPPD). This enzyme catalyses the transformation of p-hydroxyphenylpyruvate into HGA, which subsequently oxidises and polymerises into a melanin-like pigment. One open reading frame (ORF 1) in the lly region exhibited homologies with genes of Synechocystis sp., Petroselium crispum and Streptomyces mycarofaciens that code for methyltransferases. By screening a genomic library of L. pneumophila (serogroup 1) strain Corby with a monoclonal antibody against the legiolysin (lly), we identified two recombinant E. coli clones that did not produce the brown pigment and showed no haemolysis and fluorescence. DNA sequencing revealed that both clones contained 874 nucleotides of the N-terminal part of the lly gene. The recombinant strains expressed truncated legiolysin proteins of 39.5 and 35.7 kDa and did not produce HGA. Considering the highly conserved structure of legiolysin-like HPPD genes from other organisms, we suggest that the C-terminus of the legiolysin may be essential for the enzymatic activity that conferred pigmentation via HGA polymerisation, haemolysis and fluorescence.

4-Hydroxyphenylpyruvate Dioxygenase↗
PubMed1998

[Damage pattern caused by high pressure water jets and high pressure water abrasive jets to the hand].

Water and abrasive water jets have been developed as efficient tools for different purposes in industrial manufacturing, cleaning and dismantling, and--experimentally--in drilling and milling. In contrast to other high pressure techniques, these machines produce power densities up to 250 kW/mm2. In order to assess the range of destruction caused by water as well as abrasive water jets in human hands, cadaveric forelegs of pigs were targeted with constant nozzle geometry and working distance between cadaver and nozzle. Variable parameters investigated included pressure and time of exposure. Reproducible injury patterns were found in the forefoot of the pig, allowing for conclusions to be drawn with respect to damage assessment in the human hand.

Accidents, Occupational↗
PubMed1996

[Arthrodesis of the rheumatoid wrist].

In rheumatoid wrists surgical procedures are not indicated before non surgical measures have failed to restore comfortable function or even severe instability and joint disorganisation have developed. Primarily synovectomies and stabilisation measures have to be done. Arthrodesis of the rheumatoid wrist is not indicated as often. In case arthrodesis is required in the rheumatoid wrist quality of bones and soft tissues should be taken carefully into consideration. The arthrodesis of the wrist according to Mannerfelt has been proven as a simple and safe method.

Arthritis, Rheumatoid↗
PubMed1995

The Lly protein protects Legionella pneumophila from light but does not directly influence its intracellular survival in Hartmannella vermiformis.

The lly locus (legiolysin) mediates the browning of the culture medium of Legionella pneumophila in the late stationary growth phase, presumably as a result of synthesis of homogentisic acid. Mutagenesis of the lly gene of the L. pneumophila Philadelphia I derivative JR32 did not affect intracellular replication in the natural host Hartmannella vermiformis. The Lly-negative mutant, however, showed a markedly decreased resistance to ordinary light. The cloned lly gene conferred an increased resistance to light in recombinant L. pneumophila and Escherichia coli K-12, indicating a contribution of the Lly protein to ecological adaptation of Legionella species.

Animals↗
PubMed1994

Sequence determination and mutational analysis of the lly locus of Legionella pneumophila.

The lly (legiolysin) locus codes for a 39-kDa protein which confers hemolysis, pigment production, and fluorescence on recombinant Escherichia coli K-12 clones carrying the lly gene. The nucleotide sequences of the lly genes from two Legionella pneumophila isolates were determined. The lly loci exhibited identical nucleotide sequences. They contained open reading frames of 348 amino acid residues, encoding proteins with a deduced molecular mass of 38.9 kDa. N-terminal amino acid sequencing further confirmed that the Lly protein corresponds to the open reading frame sequenced. The amino acid sequence of the Lly protein exhibits a high degree of homology with the sequences of the MelA protein responsible for melanin production in the freshwater bacterium Shewanella colwelliana and the 4-hydroxyphenylpyruvate dioxygenase of Pseudomonas spp. 4-Hydroxyphenylpyruvate dioxygenase is involved in the degradation of aromatic amino acids in various organisms. An Lly-negative mutant of L. pneumophila Philadelphia I derivative JR32 and an Lly-positive transcomplementant were constructed. The Lly-negative mutant lost the ability to produce brown pigment and to confer fluorescence but retained hemolysis. Introduction of a plasmid carrying the lly locus restored pigment production and fluorescence. Intracellular survival of L. pneumophila in U937 macrophage-like cells and in Acanthamoeba castellanii was not affected by mutagenization of the lly locus.

Amino Acid Sequence↗
PubMed1993

[Lack of effectiveness of alternative non-surgical treatment procedures of Dupuytren contracture].

In the early stage of the disease a group of patients was treated with radiotherapy, later another group with injections of superoxid-dismutase. The results of follow-up examinations 7 years after radiotherapy and 3 years after treatment with superoxid-dismutase respectively do not differ clearly from spontaneous course of Dupuytren's contracture grade one. At present we cannot recommend an alternative treatment for early stage Dupuytren's contracture.

Adult↗
PubMed1993

[Filling up small bone defects with bone ceramics (hydroxylapatite)].

First clinical results using a bovine hydroxyapatite implant to fill up small bony defects after excision of enchondromas or cysts are reported in twelve patients. Incorporation without any problems was completed radiologically after six to eight weeks. Complications did not occur. Avoiding additional surgery harvesting cancellous bone chips at the iliac crest, the use of these bovine hydroxyapatite ceramic seems to be reasonable.

Adult↗
PubMed1990

[A comparison of arthrography and magnetic resonance tomography in painful limited movements of the hand].

In 18 patients with unclear pain in the wrist limiting hand movement, arthrography and magnetic resonance imaging (MRI) were compared. The FISP gradient echo sequence turned out to be superior to the T1 weighted spin-echo sequence in the imaging of the triangular fibrocartilage complex. MRI is very sensitive in detecting triangular fibrocartilage lesions and therefore represents a suitable non-invasive screening method. It is, however, not possible to assess the degree of the lesion. Ruptures in carpal tendons could only be diagnosed by means of arthrography.

Adult↗
PubMed1989

[Raynaud syndrome. A case report].

Symptomatology, diagnosis, treatment, and clinical course of a Raynaud syndrome in a sixteen-year old patient beginning in the second year of his life are described. He lost all distal phalanges of both hands and big toes at the age of nine. Remarkable was the laboratory finding of an extremely high serum IgE concentration. A combined therapy of plasmapheresis, immunosuppression and corticosteroids improved the clinical and laboratory findings.

Adolescent↗
PubMed1986

[Follow-up of 425 operated ganglion patients].

The etiology and pathogenesis of ganglion cysts have not yet been completely illucidated. After surgical intervention there are recurrence rates of more than 30% described in the literature. Out of 425 operated patients a total of 348 patients could be reexamined. Recurrence rates as well as pre- and postoperative complaints are discussed.

Adolescent↗
PubMed1985

[Primary pyogenic infections of the hand and their treatment].

314 of 814 patients with pyogenic infections of the hand were treated conservatively. In 500 cases surgical treatment was necessary. Bacteriological findings, the value of antibiotic treatment and the necessary surgical procedures are discussed.

Anti-Bacterial Agents↗
PubMed1984

[Apert syndrome--case report].

The Apert syndrome is a complex deformity. Blauth distinguishes three degrees of deformity in the hand; these are demonstrated in our patients. The functional results after operative treatment were satisfying.

Acrocephalosyndactylia↗
PubMed1984

[Epidermolysis bullosa hereditaria].

Two cases of epidermolysis bullosa hereditaria are presented. Their operative treatment is described. Distant flaps are necessary to bring resistant skin to the mechanically stressed areas of the hand. Specific after-care is essential to preserve the operative result.

Child↗