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Biomedical subjects

W Röder

Publications and source records attributed to W Röder.

14 recordsLinked to original sources
PubMed1995

[Does the "Bergetrokar" decrease the rate of intraoperative complications in laparoscopic cholecystectomy?].

Several international surveys have proved the laparoscopic cholecystectomy as a safe surgical technique. In spite of the good results there still exist operation-specific technical problems. The perforation of the gallbladder during dissection or while extracting it from the abdominal cavity can lead to severe complications. We analysed retrospectively 352 extractions of the gallbladder carried out with our 'Bergetrokar'. In 1.4% occurred perforation of the gallbladder and in 0.85% we had trouble with the healing. In 3.5% extraction could not be performed with the 'Bergetrokar'. Regarding these results our rates have been lower as compared in literature. In our opinion the extraction of the gallbladder through the lateral incision using the Bergetrokar represents a further step toward a safe extraction of the stonefilled gallbladder. Further the infection rate at the umbilical incision is reduced.

Cholecystectomy, Laparoscopic↗
PubMed1994

[A concept for decreasing postoperative pain after inguinal hernia operation].

In Germany approximately 150,000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. The results suggest that the intraoperative anesthesia reduces pain after surgery both on the day of the operation and afterwards, when the effect of the local anesthetic has decreased. An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.

Adult↗
PubMed1994

Detection of human immunodeficiency virus-1 nucleic acid on inactivated filter paper disks by polymerase chain reaction and microtiter plate assay.

Human immunodeficiency virus type 1 (HIV-1) in cultured cells, peripheral blood samples and sera were adsorbed on filter paper disks and inactivated by heat or ethanol. Two procedures, the polymerase chain reaction (PCR) and microtiter plate assay (HMPA) were used to detect the nucleic acid. The sensitivity after different heat treatments with nested PCR for HIV-1 DNA (or nested reverse transcription-PCR for HIV-1 RNA) was identical regardless of whether the samples were examined immediately or one month later. Inactivation by ethanol treatment resulted in a slight loss of sensitivity. The HMPA proved to be as reliable and specific as the conventional PCR technique. We conclude that the heat-treated filter paper disk assay is suitable for identifying HIV nucleic acid in clinical samples sent to the laboratory from a distance, e.g. in an envelope.

Base Sequence↗
PubMed1994

[Possibility for detecting HIV-1 in bone transplant by PCR using the HIV-1 microtiter plate assay].

It is known that HIV can be transmitted by allogenous bone transplantation. Hitherto neither chemical nor physical methods have existed to allow reliable disinfection and sterilization of bone specimens without reducing osteogenetic potency. Only demonstration or exclusion of the presence of HIV-1 in a bone specimen guarantees that infection will not occur. The method now presented for HIV detection is based on a polymerase chain reaction (PCR). This HIV microtiter-plate assay combines amplification of DNA molecules with a staining reaction. In cultures containing HIV-infected cells definite detection of viruses was possible when 50-100 cells per specimen were infected. Examination of 137 HIV-negative and 25 HIV-positive bone specimens showed sensitivity of 96% and specificity of 97.8% for the test. In subsequent studies, after drying on filter paper viral DNA was again demonstrable by the PCR. This means safe handling and uncomplicated transportation of non-infectious specimens to a central analysis laboratory are possible. This HIV test offers the possibility of quick and safe demonstration that specimens are free of HIV and is therefore likely to enhance the safety of bone transplantation considerably.

Bone Transplantation↗
PubMed1994

[MRI monitoring of reconstruction of ligaments of the upper ankle joint after injury].

The therapy of fibular ligament ruptures is still a controversial subject. Reports on healing processes following operative or conservative treatment have been verified hitherto by means of clinical examinations and stress tests. The MRT, as a highly sensitive non-invasive method, allows exact documentation of the ligament structures in the ankle joints. This technique was used in a randomized clinical trial over a 6-month period. The 29 patients (ages 17-51 years) had recent ligament rupture [admission criteria: clinical signs of trauma, talar tilt in anteroposterior stress radiographs (15 kp) > or = 10 degrees, talar shift > or = 10 mm] were examined with regard to ligament healing during functional therapy with AIRCAST pneumatic leg braces. Within the first week an MRT was done for verification of ligament injury. Treatment was conservative and functional: lower leg cast for 2 weeks and subsequent mobilization with protection provided by an AIRCAST brace. Follow-up examination was 3 months after injury, taking the form of clinical examination, a-p-radiographs with stress tests, and MRT. In all patients both clinical and radiological examination confirmed that ligament structures had healed, as was also verified by MRT.

Adolescent↗
PubMed1994

[2- to 7-year results of cement-free and cemented joint replacement in femoral neck fractures and coxarthrosis].

In 43 patients with cementless and 43 patients with cemented hip prosthesis (S+G hip system) a clinical and radiological follow up was performed 2-7 years after total hip replacement. In average the follow up period was 43 or 48 months. We found good or excellent results in 88% after cementless and 95% after cemented fixation. The results after cementless hip replacement were caused by loosening in the early postoperative period in 3 cases and more frequently thigh pain. In conclusion of our results and the expected later results after 10 years follow up we prefer the cementless fixation in patients under 60 years and cemented fixation in the group over 70 years. Patients between 60 and 70 years seems to benefit from a fixation with an cementless acetabular component and an cemented stem (hybrid prosthesis).

Adult↗
PubMed1993

[The value of the radiologic Lachman test in anterior cruciate ligament ruptures].

A radiologic Lachman test of both knees was performed in 35 patients with surgically verified tears of the anterior cruciate ligament (ACL). We found a mean anterior drawer of 3.2 mm for uninjured joints, 4.5 mm for isolated ACL-tears and 10.8 mm for complex ACL-injuries. Sensitivity of the radiological Lachman test was 95% for complex ACL-injuries as only 23% in case of isolated ACL-ruptures. Failure of diagnosis due to clinical investigation in case of ACL-ruptures could not be proved by means of radiological Lachman-test. Technical requirements and radiation exposure are further disadvantages. Clinically doubtful cases of acute knee injuries should therefore be investigated with other diagnostic procedures.

Adolescent↗
PubMed1992

[HIV detection in the bone transplant with polymerase chain reaction].

In trauma surgery, bone transplantation was needed in nearly 15% of all operations for reconstruction of defects. A high risk of viral infection remains in transplantation, however, cocultivation procedures have shown that human immunodeficiency virus (HIV-1) resides in bone of HIV-infected persons. Safety guidelines for running bone banks were not always easy to follow, and physical or chemical procedures applied for disinfection failed to inactivate HIV-1. In the present study we show that the polymerase chain reaction technique is an appropriate and sensitive means of detecting the HIV-1 genome in bone material prior to transplantation and-used in this way-can help to diminish the risk of HIV-1 transmission via bone transplantation.

Bone Transplantation↗
PubMed1991

[Determination of HIV infection in human bones].

The human immunodeficiency virus type 1 (HIV-1) is harboured not only in lymphocytes and macrophages but also in other cells, e.g. brain cells. Hence, it is not surprising that HIV-1 is also present in bone of HIV-infected individuals. Here we present an assay system for detection of the virus in human bone pieces in vitro. Bone pieces (i) from uninfected individuals, which had been incubated with cell-free virus preparations or cells producing the virus, or (ii) from and AIDS patient were used. These specimens were coincubated with CEM cells, which in turn became infected; the infection was traced immunocytochemically and enzymatically. In addition, we show that infection of CEM cells by HIV-1 from bone of an AIDS patient in vitro can be blocked by Sulfoevernan, a compound recently discovered by our group.

Bone Transplantation↗
PubMed1991

[Is ozone suitable for sterilization of HIV infected bones?].

HIV infection can be transferred by blood, blood products and organ transplantation. In traumatic surgery allogeneic bone transplantation is commonly used for reconstruction in severe bone injuries. This technique has been abandoned since the appearance of reports of infections with HIV. In an experimental in vitro study we showed that ozone treatment cannot inactivate HIV in bone for transplantation.

Bone Transplantation↗