Search PubMed⌕ Search

Biomedical subjects

M Richter

Publications and source records attributed to M Richter.

At least 55 records · Page 3Linked to original sources
PubMed2004

[35-year old male with fever and round mass of the liver].

A 35 year old male suffered from fever till 39 degrees C and malaise since 6 months; infectious or neoplastic causes have been ruled out. Ultrasonography revealed a hypoechoic lesion of 75 mm diameter in the liver. The histologic examination of the needle biopsy showed an inflammatory process, and the final diagnosis was inflammatory pseudotumor. EBV specific LMP-1 protein was detected within the tumor immunohistochemically. A liver segment resection was performed, and the patient has been well and without fever since then for 18 months. Inflammatory pseudotumor is a rare but important differential diagnosis in cases of hypoechoic liver lesions associated by fever, if there is no abscess or malignancy. The diagnosis must be confirmed histologically, because imaging techniques cannot reliably classify the lesion.

Adaptor Proteins, Signal Transducing↗
PubMed2004

[Restoration of the ability to walk through bilateral triple arthrodesis in marked spastic pes equinovarus].

A tendon transfer is the method of choice in easily reducible pes equinovarus. However, in long-time persisting deformities with spasms, a plantigrade position can not be maintained with these procedures. Therefore, we perform an additional bilateral triple arthrodesis in a patients with such bilateral deformities. A 55-year-old woman developed, within the scope of several surgical procedures on the cervical spine, marked bilateral pes equinovarus and flexion contractures of the knees. The patient's ambulation was limited to a wheelchair for 3 years. Then, in an interval of 1 year, we performed an unilateral soft tissue release, z-tenotomy of the Achilles tendon, triple arthrodesis with correction of the deformity, and posterior tibial tenden transfer. At follow-up 5 years after the second procedure, the 61-year-old patient was able to walk alone with two walking sticks. In the case described, the correction of a marked pes equinovarus with spasms, which was achieved by an extensive soft tissue release, could be stabilized through a triple arthrodesis in such way that the plantigrade position of the foot could be controlled through a posterior tibial tendon transfer.

Arthrodesis↗
PubMed2004

[Volleyball sport school injuries].

INTRODUCTION: Ball sport school injuries account for a significant morbidity among children and adolescents. Volleyball is popular in school sport and leads frequent injuries in youth besides basketball and soccer. METHODS: During a school year 2234 school sport injuries have been reported to the Gemeinde Unfall Versicherung (GUV) from all schools in Niedersachsen, Germany. The major disciplines were ball sport injuries, accounting for 59.5 % (1330 accidents), Gymnastic sport injuries follow at second position accounting for 18 % (403 accidents), followed by athletics with 8.1 %. RESULTS: Regarding the non-gender-specific distribution of the ball sport disciplines, basketball leads with 32.4 % (431 injuries), followed by soccer (23.8 %, 316 injuries), volleyball (17.4 %, 232 injuries), small ball games (11.2 %, 149 injuries), handball (8.3 %, 110 injuries), and hockey (4.9 %, 65 injuries). In boys, volleyball accounts third among the ball sport injuries (10 %, 63 injuries), after soccer (38 %, 245 injuries), and basketball (28.5 %, 185 injuries). In girls, volleyball was the second major ball sport injury discipline (24.8 %, 169 injuries) after basketball (36.1 %, 246 injuries), followed by small ball games (12.9 %, 88 injuries), and soccer at 4 (th) position (10.4 %, 71 injuries). The analysis of the distribution of injury during volleyball accidents dominate upper extremity injuries (71.3 %), with special emphasis on finger injuries in 53 %, followed by lower extremity injuries (21.5 %) and head injuries (4.3 %). Spine injuries were rare (0.9 %). The type of injury during volleyball school sport injuries were predominantly sprains (21 %), ligament distorsions and ruptures (20 %), fractures (17 %), and bruise (16 %). Analyzing the circumstances of the injuries, most injuries during volleyball school sport occurred without a opponent contact during ball contact (59 %), followed during movements (9 %), the landing phase (9 %), and after a strike of the ball (7 %). CONCLUSION: Volleyball injuries account for a significant number of all school sport related injuries. Upper extremity injuries account for the vast majority of all injuries especially during individual game play. Blunt trauma and fractures are most prevalent among school sport injuries in soccer. Preventive measures such as preservation of a high level of attention when scheduling a sport lesson, safety measures, and awareness of the possible severe injuries and knowledge in basic life support are mandatory to implement in school sports, since ball sport is proven to be very valuable for the physical and psychological development of the children. The role of preventive finger taping in volleyball school sport has to be evaluated in prospective clininal trials.

Adolescent↗
PubMed2004

Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disorders.

OBJECTIVE: To determine prognostic factors for the duration and severity of acute symptoms in subjects with grade 1 or 2 whiplash injuries. METHODS: Collision victims presenting to a trauma centre with spinal pain or stiffness were assessed clinically (including a visual analogue scale (VAS)), radiologically, and psychologically (short form 36 (SF36), everyday life quality (EDLQ), pain control questionnaire (FSR)). Collision type and estimated DeltaV (change in velocity of the occupant's vehicle) were also assessed. Assessment at six months involved VAS symptom rating, SF36, EDLQ, depression scale (CES-D), and impact of event scale (IES). RESULTS: 43 consecutive collision victims (22 male, 21 female; mean age 29 years (range 19 to 72) with grade 1 or 2 whiplash associated disorders were assessed. Mean DeltaV, available for 36 of 43 collisions, was 13.9 (5 to 30) km/h. Thirty two (74%) of the subjects were available for follow up at six months. The mean duration of symptoms was 28 (1 to 180) days in this group. No correlation was found between severity and duration of symptoms and the DeltaV of collision or other collision parameters. Patients with initial pain VAS >5 or with duration of symptoms more than 28 days had significant changes in SF36, EDLQ, CES-D, and IES scores at six months, and had initial scores that were predictive of these outcomes. CONCLUSIONS: Psychological factors were found to be more relevant than collision severity in predicting the duration and severity of symptoms in collision victims with grade 1 or 2 whiplash associated disorders.

Accidents, Traffic↗
PubMed2003

Enhanced production of low-mass electron-positron pairs in 40-AGeV Pb-Au collisions at the CERN SPS.

We report on first measurements of low-mass electron-positron pairs in Pb-Au collisions at the CERN SPS beam energy of 40 AGeV. The observed pair yield integrated over the range of invariant masses 0.2 e(+)e(-) annihilation with a modified rho propagator. They may be linked to chiral symmetry restoration and support the notion that the in-medium modifications of the rho are more driven by baryon density than by temperature.

Journal Article↗
PubMed2003

Outcome assessment after arthrolysis of the elbow.

BACKGROUND: In the literature, the outcome after arthrolysis of the elbow is mainly assessed by range of motion (ROM). Our intention was to verify whether this parameter does sufficiently estimate the outcome after surgical arthrolysis. METHODS: We performed a retrospective study using the validated Disability of the Arm, Shoulder, and Hand Questionnaire (DASH) as our reference outcome parameter. This score was compared with other outcome parameters such as ROM, Mayo Performance Index (MPI) and SF-36. A total of 59 patients who underwent arthrolysis of the elbow was evaluated 53 months after surgery on average. RESULTS: The mean ROM was 101 degrees for flexion/extension with a relative gain of 60% and 134 degrees for pronation/supination with a relative gain of 58%. MPI was 84 points on average. The mean DASH was 17.6 and the mean SF-36 67.9. The correlation of these outcome parameters was calculated using Pearson's correlation (two-tailed, significance set at p<0.05). We found a high correlation between DASH and the physical function part of the SF-36 (Cov=-0.87, p<0.05). The correlation of DASH and MPI was moderate (Cov=0.71, p<0.05) and of DASH and ROM poor (Cov=-0.25, p<0.05). CONCLUSION: ROM as a single parameter does not sufficiently assess the outcome of arthrolysis of the elbow.

Adolescent↗
PubMed2003

[Navigated osteosynthesis of the proximal femur. An experimental study].

Screw position in femoral head has been considered the most important predictive factor for mechanical failure in pertrochanteric osteosynthesis, and correct positioning is assisted by fluoroscopic control. Although fluoroscopy leads to precise and reproducible results, it is associated with scattered radiation to the patient and surgical staff. Computer-assisted surgery (CAS) may be an alternative in means of achieving precise screw insertion with a low radiation dose. We designed a laboratory study in which artificial proximal femora were submitted to insertions of a dynamic hip screw (DHS) and an anti-rotational screw (ARS). Three set-ups were tested: (1) conventional implantation with two simultaneous C-arms using a guide wire; (2) drilling and implantation controlled by CAS solely with a 3.2-mm drill bit, then insertion of a guide wire and drilling for the dynamic hip screw; (3) after navigated drilling (3.2 mm) a fluoroscopic control was performed. Five variables were used comparing methods and surgeons: operation time, radiation time, tip-apex distance (TAD), and the insertion neck-shaft angles of DHS and ARS. Considering TAD as a precision parameter, CAS led to screw insertion as accurate as with fluoroscopic control, with a reduction of radiation time up to 93%.

Analysis of Variance↗
PubMed2003

Trauma care in Germany.

Trauma Care in Germany fulfils all requirements to deal with injured young and mobile individuals as well as with an increasing number of injured elderly patient. Furthermore, it is prepared to cope with mass casualties of injured. As a public task the Trauma System in Germany is well organized and follows clear cut demands. To perform technical and medical therapy at highest available level as soon as possible, a ground system of physician staffed ambulances is supported by a network of physician-staffed HEMS all over Germany. Therefore, enormous efforts in financing, basic research and quality management have been undertaken during recent years to create such a sophisticated rescue system.

Accidents, Traffic↗
PubMed2003

Infiltrating intramuscular lipoma of the temporal muscle. A case report with molecular cytogenetic analysis.

Intramuscular lipomas are uncommon benign mesenchymal tumors which infiltrate skeletal muscle and are exceedingly rare in the head and neck region. Because of the infiltrating nature of the lesion and a high propensity for recurrence, they are sometimes difficult to distinguish from well-differentiated liposarcomas (WDLS). We report, the first case of an infiltrating lipoma of the temporal muscle in a 62-year-old white man who presented with a slow growing mass in the left temporal region. The histopathological examination showed diffuse infiltration of the striated muscle fibers by mature adipocytes. There were no lipoblasts or cells with atypical nuclei as described in WDLS. We performed interphase fluorescence in situ hybridization (FISH) analyses using painting probes for chromosome 12 and a specific probe for the MDM2 gene and comparative genomic hybridization. The results did not identify MDM2 or 12q amplification and therefore confirmed the benign nature of the lesion.

Chromosomes, Human, Pair 12↗
PubMed2003

Antibody like peptidomimetics as large scale immunodetection probes.

Antibodies are often used to study the molecular basis of physiologic processes. Despite the widespread applications of monoclonal antibodies (mAb) from basic science to successful therapeutics in clinical settings their use is limited. Production of mAb is often cumbersome and creating diverse and therapeutic amounts of useful mAb is difficult. We have developed a methodology to reduce an antibody into much smaller peptidomimetics and have engineered the mimetics for increased serum half life and affinity. The novel species are termed "antibody like binding peptidomimetics" (ABiP). We developed the Anti-Her2/neu peptidomimetic (AHNP) which is a mimic of Herceptin, a mAb used for advanced breast cancer therapy. The AHNP has been used as a defining tool to develop immunodetection probes that exemplify a general process application. AHNP has been expressed as an oligomeric fusion protein with streptavidin. These Herceptin like ABiPs were used to detect the Her2/neu antigen at extremely low concentrations using the immunodetection amplification technique (IDAT) which our laboratory has also developed. A fully developed highly diverse library of ABiPs represents an alternative for panels of monoclonal antibodies and may also be useful for target validation, antigen detection, therapeutics and as a platform for drug development.

Animals↗
PubMed2003

[Sagittal split osteotomy of the mandibular ramus].

The sagittal ramus osteotomy is a versatile procedure, routinely performed for the correction of various dentofacial deformities. Despite the popularity of this operative approach some problems may occur related to several technical and anatomic aspects of this technique. Complications are in a large part avoidable with some tricks and little modifications of the original procedure.

Humans↗
PubMed2002

[Pediatric prehospital trauma care. A retrospective comparison of air and ground transportation].

OBJECTIVE: In contrast to prehospital care of adult trauma victims, prehospital care providers have only limited clinical experience of pediatric trauma cases as these are relatively infrequent. Literature reports on prehospital pediatric trauma care given by paramedics are frequently found in the literature, but there are few publications analyzing the quality of prehospital trauma care provided by emergency physicians in the care of injured children. It was the goal of this study to analyze the prehospital care of the pediatric trauma victims transported to a trauma center by physician-staffed ambulances and helicopters. METHODS: The study took the form of a retrospective 5-year review of pediatric trauma patients admitted to a trauma center. The inclusion criteria were age younger than 13 years and a NACA score higher than 3. In all, 104 patients were included, and these were divided into two groups, those transported to hospital by helicopter (RTH, n=87) and those taken to hospital by road ambulance (NEF, n=17). RESULTS: With a mean NACA score of 4.6 and a mean ISS of 15, no significant differences were found between the two groups in either severity of injury or length of hospital stay. The mortality of the total patient population was 15.4%, with no evidence of preventable deaths in patients who were admitted to the trauma center with vital signs. Analysis of prehospital therapy showed no differences in the volume of intravenous fluids administered (RTH 636 ml vs NEF 476 ml) or in the proportion of children with a GCS<9 in whom endotracheal intubation was implemented (RTH 39/44 vs NEF 7/7). Placement of more than one i.v. line and endotracheal intubation were associated with longer times at the scene of the accident before patients were taken to hospital (>one i.v. corresponded to 9 min longer, and endotracheal intubation, to 10 min longer). CONCLUSIONS: Prehospital pediatric trauma care delivered by physician-staffed ambulances or rescue helicopters is associated with a high rate of i.v. line placement (92%) and high intubation rates (90%) in patients with an altered level of consciousness (GCS<9). The prehospital care provided by helicopter or ground ambulance personnel was not different and was not associated with longer stays in the intensive care unit or longer overall stays in hospital. Scene times became longer with increasing number of i.v. line placements and with endotracheal intubation, but was not prolonged by a greater severity of injury as determined by the ISS. Preventable deaths were not observed in the patient population. In summary, owing to the the local infrastructure, pediatric trauma patients are more frequently transported to the trauma center by air (87 by air vs. 17 by road per 5-year time period). However, despite being less frequently involved in the case of pediatric trauma, the quality of care provided by road ambulance staff is similar to that in air ambulances.

Air Ambulances↗
PubMed2002

[Injury prevention in the elderly population].

Injuries in the elderly population have more considerable consequences (more difficult treatment, higher costs,worse outcome) than in the younger population. Therefore, the prevention is especially important. The majority of the injuries are caused by traffic accidents and falls. TRAFFIC ACCIDENTS: An analysis of the current injury situation in elderly road users (65 years and older) involved in road traffic accidents was intended to allow conclusions regarding future prophylaxis. FALLS: Falls are mostly caused by numerous factors. The most important predictors for falls are dementia,Parkinson-Syndrome and neurologic deficits after cerebrovascular insults. The most important symptoms, that indicate an increased risk for fall are gait abnormalities, balance lack and underweight. The most important anamnestic indications are more than one falls in the recent 90 days, need for assistance in daily living and prevailing medication. Another important factor is the residential setting (lighting, stairs, floor conditions,bath installations). The most affective protective interventions involve multiple factors. The incidence of falls could be reduced by 30%. The hip protector is an effective protection against proximal femur fractures. which is the most frequent fracture in the elderly population that requires treatment as an inpatient. Injury prevention in the elderly population is an interdisciplinary task as for example shown by the successful fall clinics in the anglo-american area.

Accident Prevention↗
PubMed2002

[Neon--a new angle-stable implant system for dorsal occipitocervical instrumentation. Biomechanical comparison with established systems].

Posterior instrumentation of the occipitocervical spine is well-established for different indications. The aim of this study was to evaluate whether posterior internal fixation of the occipitocervical spine with the new implant system improves primary biomechanical stability. Primary stability was significantly increased in all load cases with the new modular implant system compared to the other implant systems. Pedicle screw instrumentation tended to be stabler compared to lateral mass screws; nevertheless, significant differences could be observed only for lateral bending. As the experimental design precluded any cyclic testing, the data represent only the primary stability of the implants. In summary, this study showed that posterior instrumentation of the cervical spine using the new neon occipito-cervical system improves primary biomechanical stability compared to the CerviFix system and the Olerud cervical rod spinal system.

Aged↗
PubMed2002

[Computer navigation in dorsal instrumentation of the cervical spine--an in vitro study].

Transarticular C1/2 screws are widely used in posterior cervical spine instrumentation. Pedicle screws in the cervical spine remain uncommon until now. In view of improved biomechanical stability compared to lateral mass screws, pedicle screws could be used, especially for patients with poor bone quality or defects in the anterior column. Nevertheless, there are potential risks of iatrogenic damage to the spinal cord, nerve roots, or the vertebral artery related to both techniques of posterior cervical spine instrumentation. Therefore, the aim of this study was to evaluate whether C1/2 transarticular screws as well as transpedicular screws in C3 and C4 can be applied safely and with high accuracy using a computer-assisted surgery (CAS) system. C1/2 transarticular screws as well as transpedicular screws in the cervical spine can be applied safely and with high accuracy using a CAS system in vitro. Therefore, this technique may be used in the clinical setup due to improved accuracy and reduced radiation dose for the patient and medical staff. Nevertheless, to prevent iatrogenic damage, users should be aware of known sources of possible errors that cause inaccuracies. Small pedicles with a diameter below 4.0 mm may not be suitable for pedicle screws.

Aged↗