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Biomedical subjects

P Grützner

Publications and source records attributed to P Grützner.

At least 19 recordsLinked to original sources

[Computer-assisted surgery for pelvic injuries].

For pelvic fractures, pre- and postoperative imaging includes spiral computed tomography, providing high resolution and accuracy. In conventional pelvic operations, these image data cannot be used directly. Intraoperative imaging is limited with fluoroscopy and visualization by the approaches. One solution in terms of precision and reduction of radiation exposure could be computer-assisted surgery (CAS). This method can be divided into navigation, which requires active registration, CT based navigation and registration-free fluoroscopy-based or Iso-C-3D-based navigation. Applications for CAS in the pelvis include sacroiliac screw osteosynthesis in pelvic ring fractures, navigated periacetabular screw fixation, and correction operations for malhealed pelvic ring fractures. Nowadays, CAS is still costly and frequently requires additional staff. However, it helps to reduce complications caused by implant placement. With the introduction of new health care requirements in Germany, this may be an economic argument as well. Current developments focusing on accurate navigated reduction will provide new indications for CAS, further decrease complication rates, and help to reduce the invasiveness of pelvis operations.

Acetabulum↗

[Determination of torsion angle after shaft fractures of the lower extremity--clinical relevance and measurement techniques].

In the treatment of femoral and tibial fractures the frontal and sagittal planes are controlled and documented by conventional X-ray films. Computed tomography permits exact measurement of the coronal plane. Between June 1993 and December 1997, 161 computed tomographic measurements of femoral torsion and 55 of tibial torsion after shaft fracture were carried out. The results were analyzed in a clinical study. A CT examination was carried out if the clinical examination aroused suspicion of a difference in torsion. 28.5% of the patients examined with femoral fractures and 23.8% of those with tibial fractures and torsion differences of more than 20 degrees. Between June 1993 and June 1997, 30 corrective derotating osteotomies of the femur and 9 of the tibia were carried out. The average preoperative difference of torsion of the femur was 29 degrees and of the tibia 25 degrees. After the operation the average femur difference was 7 degrees and of the lower leg 6.5 degrees, which are inside normal physiological limits. The osteotomies were carried out in the metaphysis near the fracture. Additional corrections in other planes were necessary on the femur in 27% and on the lower leg in 46%. With the aim of avoiding torsion differences, or at least to recognize them at an early stage, CT measurements of torsion after osteosythetic treatment of fresh unilateral femur-shaft fractures were carried out in 49 patients between October 1996 and December 1997. The torsion measurements during the operations had to be carried out clinically. No sufficiently exact method of measurement is available in the operating room. Three patients with increased differences of 28 degrees, 26 degrees or 19 degrees had their osteosyntheses corrected. The measurements after correction were inside the normal spread.

Adult↗

Higher order multiple births: natural wonder or failure of therapy?

Data of 601 families with triplets and higher multiples have been collected. Since about nine years the number of higher-order births has been increasing enormously. The average pregnancy duration and the average birthweight of these mostly premature children have been declining from year to year. Despite the progress in neonatology, the death rate and the rate of handicapped children is very high. To prevent such disastrous outcomes, treatments for infertility should be performed only by physicians in centers with strong controls. Selective abortions are no regular solution to the problem of higher multiple gestation.

Birth Weight↗

[Higher order multiple births in the course of time].

There has been an increase of multiple births since 1980. 601 families with multiples were interviewed. The answers from 289 mothers with multiples indicate, that, nowadays, in the majority of cases treatment with fertility drugs is the cause. Most of these pregnancies end too early. Moreover, the average time of gestation and the median birth weight of the children decline from year to year. The rate of dead or disabled children is high. Nevertheless, we know many happy families with healthy multiples. Nobody can predict the result of a multiple gestation. For this very reason, selective abortions are not the solution to the problem. Extreme caution is advised in the use of hormones to avoid inducing a pregnancy with higher order multiples.

Birth Weight↗

[Tuberculosis of the conjunctiva and eyelids].

A diagnosis of unilateral tuberculosis of the conjunctiva was established in a 75-year-old female patient eight years after the first manifestations of disease. It was clearly a case of exogenous infection. Generalized infection only became apparent months after the bulb had been removed together with the lids and the anterior portions of the orbital tissue.

Aged↗

[Compound Hurler-Scheie disease in 3 siblings].

The present paper describes 3 out of a total of 9 siblings, aged 9, 17, and 18, with the following symptoms: gargoyle-like facial features, clouding of the cornea in both eyes, dysostosis multiplex, slightly impaired intelligence, hepatosplenomegaly, umbilical hernia, and increased secretion of mucopolysaccharides in the urine, in particular dermatan and heparan sulfate. Some of the symptoms are mid-way between those of Hurler's and Scheie's syndromes, both having the same deficiency of the enzyme alpha-1-iduronidase. McKusik developed the theory that the genes responsible for the clinical pictures of Hurler's and Scheie's syndromes are alleles and hence cases such as those described here should be considered as allelomorphic compounds.

Adolescent↗

Congenital hereditary stromal dystrophy of the cornea.

Cornea from patients in two separate pedigrees showing dominant inheritance of a congenital nonprogressvie corneal clouding were examined by light and electron microscopy. The characteristic changes of abnormal corneal lamellae were widely and rather uniformly distributed throughout the stroma. The remaining corneal layers were normal. The findings are consistent with a diagnosis of congenital hereditary stromal dystrophy of the cornea, which differs greatly on both histologic and clinical grounds from the entity known as congenital hereditary endothelial dystrophy of the cornea.

Adolescent↗

[Plastics or glass for children's eyeglasses?].

Up to +5 dpt glass should be used in spectacles for children. There is more protection for the eye than danger of injury. Glasses out of plastic material are scratched very quickly, also they are more expensive.

Child↗

[Evidence for reduced colour vision in carriers of congenital colour vision deficiencies (author's transl)].

The ability to recognize small spots of coloured light in parafoveal regions of the retina was investigated in women heterozygous for protanopia (2 subjects), deuteranopia (2 subjects), or deuteranomaly (1 subject) and in 3 normal subjects. The homozygous colour normals had excellent discrimination up to 8 degrees excentricity, whereas in heterozygous carriers of congenital colour vision deficiencies the ability to differentiate colours varied from point to point within the retina. The results may be explained by assuming the existence of alternating patches of trichromatic and dichromatic cell populations with the retina of the heterozygous carriers.

Color Perception↗