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Biomedical subjects

W Ruf

Publications and source records attributed to W Ruf.

At least 91 records · Page 5Linked to original sources

Sulfur isotope effects associated with oxidation of sulfide by O2 in aqueous solution.

Normal sulfur isotope effects averaging epsilon = -5.2 +/- 1.4% (s.d.) were consistently observed for the oxidation of sulfide in aqueous solution. Reaction products were sulfate, thiosulfate and sulfite at pH 10.8-11 in distilled water; S0 was formed in two experiments with synthetic seawater at pH 8-9.5. Because the -5.2% normal isotope effect differs significantly from the previously measured +2% inverse effect associated with anaerobic oxidation of sulfide by photosynthetic bacteria, stable sulfur isotopic measurements are potentially useful for distinguishing aerobic vs. anaerobic sulfide oxidation in marine and freshwater sulfureta.

Bacteria, Anaerobic↗

[The diagnostic certainty of various methods of evaluating recent trauma to knee ligaments].

The prognosis of knee ligament injury is mainly dependent on early diagnosis. In a prospective trial comprising 108 patients with fresh injury of the knee ligaments, the prognostic value of clinical non-invasive examination were assessed in awake and anesthetized patients. As a result the merely clinical examination without anesthesia gave only in 48% a diagnosis reliably enough for operation indication. Examination under anesthesia detected more than 83% of injuries with need for operation and 90% of ruptures of the anterior cruciate ligament. Lachman-test proved to be very reliable (more than 90%) and lateral pivot-shift-phenomenon almost provable (more than 86%) for ligament rupture. Arthroscopy in our hands is playing only a minor role at the event of fresh injury of the knee ligaments. In only 10% it was the decisive tool for operation. In our opinion the indication for narcosis examination should be put widely due to its high sensitivity. Since in approximately 90% on additional arthroscopy can be resigned, the entire ischemia time during pneumatic blood circulation blockage (110 to 120 min) is available for operative reconstruction of the knee joint.

Adolescent↗

[Life-threatening hemorrhage in pelvic fractures of polytraumatized patients. Diagnostic issues and embolization treatment].

Between 1984-1987 6 multiple trauma patients with pelvic fractures and bleeding from pelvic vessels were treated by transcatheter embolization. Although diagnosis and therapy were early in two cases, there was an overall time delay of median 17 hours (1-38 h) until localisation of bleeding lesions. In this period multiple transfusions (median: 33.7 units of packed erythrocytes, 14.5 units of fresh frozen plasma) could not control hemorrhage. After successful transcatheter embolization circulation stabilized immediately and durably. 4 patients died, 2 of them from septic-toxic multi-organ-failure.

Adolescent↗

[The value of clinical aspects, laboratory and circulatory parameters in blunt abdominal trauma].

Within seven years 506 patients with blunt abdominal trauma were included into a prospective trial. The aim of the study was checking of the validity of clinical parameters, routinely performed laboratory examinations and of the initial circulatory situation in relation to an abdominal organ lesion. Three groups were separated out of the total collective: Group 1: Patients without abdominal lesion (N = 274). Group 2: Patients with abdominal lesion, verified by operation, sonography or CAT scan (N = 232). Group 3: Patients with rupture of the spleen (N = 107) (subgroup of 2). Among the clinical parameters: spontaneous abdominal pain, contusions marks, abdominal tenderness, shoulder pain, and abdominal palpation, the latter does have a high validity (92%). However, in group 1, more than half of the cases also had palpation pain. Shoulder pain has a high sensitivity. Of the laboratory parameters: hemoglobin, hematocrit and leucocytes, only the leucocyte count provided a certain importance: 83% of group 2 had values above 10,000. The circulatory parameters blood pressure and pulse as initial spot picture are of minor validity. Continuous registration of these values at clinical observation has much higher relevance indicating trends towards improvement or deterioration.

Abdominal Injuries↗

[Load capacity and deformation of unstable pertrochanteric osteotomies following 145 degree angle plate osteosynthesis and Ender nailing].

In 24 femora an unstable intertrochanteric osteotomy was performed. In twelve an endernail osteosynthesis and in the other twelve a 145 degree-plate osteosynthesis was performed. Eight femora were tested as control. The loading capacity was 500 N higher in the endernail group. In four cases after 145 degrees-plate osteosynthesis but only in one case after endernailing the osteosynthesis becomes unstable under an alternating load of 2000 N. In femora with pronounced osteoporosis the maximal loading capacity is higher in the endernail osteosynthesis group. The loading capacity increase with the CCD-angle. The deformation after alternating load of 500 N is significantly lower in the 145 degree-plate osteosynthesis group. At higher alternating load the deformation of the 145 degree-plate osteosynthesis exceeds that of the endernail osteosynthesis.

Biomechanical Phenomena↗

[Study of the correlation between early and late changes in the roentgenologic and functional status following conservative and surgical treatment of the head of the tibia].

Between 1976 and 1980 161 patients were admitted to our department with condylar fractures of the tibia. 60% of the patients were treated conservatively, 40% underwent surgery. The patients follow-up was analysed three to seven years after therapy and an examination of a representative group of patients was performed 1983. A direct comparison of therapeutic results between the conservative and operative treatment groups is not possible, since fractures with a particularly poor prognoses including depression and impression fractures of the articular surface were more frequent in the operative treatment group. It is noteworthy, however, that the patients' activity at work and in their leisure time was increased in the operative group. Additionally in this group the remaining complaints were less and the final results more favourable according to the patients' self-judgment. Unchanged irregularities of the joint surface following initial therapy were found in 40.5% of conservatively treated patients and in 6.9% of operated patients respectively. At the time of reassessment, however, differences of radiological findings could not be seen between the two treatment groups. Whereas in the conservative treatment group a difference in length of the two legs of 2 cm or more were observed in 16% of cases, not a single case was found in the operative treatment group. There was a correlation of the functional and the result of the radiological examination, although considerable exceptions from this correlation were also seen. Therefore it is not possible from the individual X-ray findings to predict the functional results of the patient.

Arthritis↗

[Rupture of the tibiofibular syndesmosis without osseous fibular injury].

Within 3 years 12 injuries of the anterior fibulo-tibial ligament without fracture of the fibula were recorded prospectively. In relation to the total number of the ankle joint fractures during the same period the incidence is 3.3%. The rupture of the ligament arose in all cases from a forced eversion combined with supination or pronation of the foot. Clinical characteristics are the circumscribed painful palpation of the area of the ligament together with eversion pain of the foot. Arthrography is the most sensitive diagnostic procedure, which, however, may be avoided if the clinical situation is absolutely clear. Differential diagnosis consists mainly in the rupture of the fibulo-talar ligament including a tear of the anterior capsule of the ankle joint. Treatment should always be surgical - suture of the ligament, reinforcement of the syndesmosis by means of a positioning screw. Aftercare is functional without external fixation.

Ankle Injuries↗

[Experimental studies of the effectiveness of the sliding principle in dynamic hip screw osteosynthesis and its value in managing unstable pertrochanteric femoral fractures].

54 human corpse femora were tested. In 18 unstable pertrochanteric osteotomies were performed, in other 18 femora valgisation osteotomies were performed. 18 femora served as control. In the unstable pertrochanteric osteotomy-group 135 degrees-DHS-osteosynthesis was performed. In the valgisation-osteotomy-group a 150 degrees-DHS-osteosynthesis was performed. Half of the femora were tested under physiological load, the other femora were tested with the load acting from cranial-lateral (50 degrees difference to the physiological load direction). Under physiological condition the load capacity was 5769 N in the 135 degrees-DHS-group and 7261 N in the 150 degrees-DHS-group, and so 8 to 10 times higher as the body weight. In the groups with the false loading direction the mean stability of the osteosynthesis was 2937 N in the 135 degrees-DHS-osteosynthesis-group and 3942 N in the 150 degrees-DHS-osteosynthesis-group. The load capacity of the control femora was 7451 N. The deformation under physiological load was similar in both groups. Under unphysiological load the deformation was 2-3 times higher in the 135 degrees-DHS-group because of the higher bending compared with the 150 degrees-DHS and because of the medical cortical defect. The results demonstrate the effectivity of the sliding osteosynthesis technique of the DHS. After DHS-osteosynthesis of unstable pertrochanteric fractures with limited medial defect in all cases full weight bearing after operation is possible. Valgisation osteotomy is not necessary in this type of fracture.

Biomechanical Phenomena↗

[Injuries of the iliac and femoral vessels--a life-threatening emergency situation in hip prosthesis surgery].

The pattern of operation injuries of the arterial vessels which may occur during hip surgery is illustrated by this summary of our own cases. Injuries of the femoral vessels seem to be preventable if the Hohmann-retractor is carefully placed on the anterior margin of the acetabular rim under digital control. Furthermore drilling damage of the iliac vessel appears to be avoidable. However, the replacement manoeuvre of the artificial acetabulum can be associated with massive bleeding despite greatest care. Under these circumstances immediate surgical intervention through an inguinal retroperitoneal approach is mandatory.

Aged↗

[Functional results following conservative and surgical therapy of pathologic fractures in malignant diseases].

From 1972-1982 149 pathological fractures in 91 patients were treated. 134 of these were caused by malignant disease. With 78% metastases were the most common cause for fractures. 59% of the patients were women. The most frequent fracture localisation was the femur followed by ribs and humerus. 62% of the fractures but 100% of the leg fractures were treated operatively. The best functional results were achieved after compound osteo-synthesis. The mean survival time of the patients was 10.7 months. The one year survival rate was 24.6% and the two year survival rate was 9.2%. The best survival rates were observed in women, patients with breast cancer metastases, femur shaft- or subtrochanteric fractures. The lowest survival rate was found in male patients, patients with unknown primary tumour and femur neck fractures.

Bone Neoplasms↗

Regional myocardial blood flow in experimental myocardial infarction after pretreatment with aspirin.

The effects of aspirin on myocardial blood flow in an area of ischemia were studied in 12 baboons. In each, a diagonal branch of the left anterior descending coronary artery was ligated. Six of the baboons received aspirin (2 X 600 mg orally, 12 hours and 1 hour before ligation); the other six did not receive aspirin and served as a control group. The extent of myocardial ischemia was delineated with an electrode wire grid on the surface of the anterior left ventricular wall. The maximal area circumscribed by electrodes with 2 mV or more ST segment elevation was compared with the area of reduced myocardial blood flow. Myocardial blood flow was measured with the radioactive microspheres method using strontium-85-labeled carbonized spheres. Two areas of reduced myocardial blood flow were noted, one with severely reduced flow in the center of the myocardial infarct (0 to 49% of noninfarcted myocardium) and another with mild to moderately reduced myocardial blood flow at the border of the myocardial infarct (50 to 90% of noninfarcted myocardium). Myocardial blood flow in the border area (margins of ST elevation area) for the total wall was 85 +/- 8% of normal in the aspirin-treated animals and 40 +/- 4% in the control group (p less than 0.01); for the epicardium it was 67 +/- 10% of normal in noninfarcted myocardium after aspirin and 37 +/- 5% for the control group (p less than 0.05); and for the endocardium it was 78 +/- 8% of normal in noninfarcted myocardium after aspirin and 39 +/- 6% in the control group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Compound double plate osteosynthesis in subtrochanteric pathologic fractures. A clinical and experimental study].

A subtrochanteric resection was performed in 12 human corpse femora. In an experimental study stabilisation was achieved with a compound double plate osteosynthesis (condylar and medial intramedullar plate). 18 femora served as control. The loading capacity after double plate compound osteosynthesis is similar to that of normal femora. Due to the relatively rigid osteosynthesis device the plastic deformation was reduced significantly after compound osteosynthesis. The clinical evaluation comprises 26 fractures of the subtrochanteric region (out of a total of 208 pathological fractures). In 5 cases we performed a double plate compound osteosynthesis. In all patients a good or very good functional result was observed. Ten patients were treated by simple compound osteosynthesis.

Biomechanical Phenomena↗

Anion sensitive ATPase in human cornea.

In human cornea an anion sensitive ATPase is present. The highest specific activity was found in the endothelium, whereas the epithelium contained the highest total activity. The enzyme was stimulated by bicarbonate and sulfite and inhibited by thiocyanate. the majority of the enzyme was localized in the mitochondria but some activity was also detected in the plasma membranes. Atractyloside inhibited only the mitochondrial anion ATPase.

Adenosine Triphosphatases↗

[Indications for surgery of carotid artery stenosis with contralateral carotid occlusion].

In a retrospective study the course of 69 patients of the Surgery Department of the University of Heidelberg (66 men, 3 women, mean age 60 years) with carotid artery stenosis with contralateral carotid occlusion has been reported. 10% of the patients with carotid artery stenosis had a contralateral occlusion. Corresponding to the side of occlusion most patients had a preoperative neurological stage IV (55%, 19% stage II, 26% stage I) and corresponding to the side of stenosis most patients had a stage I (57%, 28% stage II, 4% stage III, 12% stage IV). In addition to the stenosis the occlusion had been operated on in 7 patients, in 5 of them the revascularisation was not possible. In 88% the arteriotomy could be closed using a venous patch and in 97% a intraluminal shunt was used. All operations were done under general anesthesia. The early lethality rate was 10%, in one patient a postoperative neurological deficit occurred. The late mortality rate was 21%, in 5% a new neurological deficit could be found (n = 57, mean follow-up: 3.0 years). In relation to the preoperative neurological stage corresponding to the side of stenosis the highest mortality rate was found in patients with stage IV. In a separate analysis of two periods (1962-1978 and 1979-1981) it can be demonstrated that the high early mortality rate is nearly entirely found in the first period with a low operative frequency. In the second period 1979-1981, 33 carotid endarterectomies in patients with contralateral occlusion were operated with a mortality rate of 3%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗