Search Results - (Author, Cooperation:C. Hopf)

2011-10-04

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Animals ; Cell Line, Tumor ; Chromatin/genetics/*metabolism ; Chromatin Immunoprecipitation ; Disease Models, Animal ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic/drug effects ; Heterocyclic Compounds with 4 or More Rings/pharmacology/therapeutic use ; Humans ; Leukemia, Myeloid, Acute/*drug therapy/genetics/*metabolism/pathology ; Mice ; Models, Molecular ; Multiprotein Complexes/chemistry/metabolism ; Myeloid-Lymphoid Leukemia Protein/*metabolism ; Oncogene Proteins, Fusion/*metabolism ; Protein Binding/drug effects ; Proteomics ; Transcription Factors/*antagonists & inhibitors/*metabolism ; Transcription, Genetic/drug effects

1089-7550

AIP Digital Archive

Physics

The surface loss probabilities of hydrocarbon radicals on the surface of amorphous hydrogenated carbon (C:H) films are investigated by depositing films inside a cavity with walls made from silicon substrates. This cavity is exposed to a discharge using different hydrocarbon source gases. Particles from the plasma can enter the cavity through a slit. The surface loss probability β is determined by analysis of the deposition profile inside the cavity. This surface loss probability corresponds to the sum of the probabilities of effective sticking on the surface and formation of a nonreactive volatile product via surface reactions. By comparing the deposition profiles measured in CH4, C2H2, C2H4, C2H6 discharges one obtains for C2H radicals β=0.80±0.05, for C2H3 radicals β=0.35±0.1, and for C2H5 radicals β〈10−3. The growth rate of C:H films is, therefore, very sensitive to any contribution of undersaturated C2Hx species in the impinging flux from a hydrocarbon discharge. © 2000 American Institute of Physics.

Electronic Resource

1077-3118

AIP Digital Archive

Physics

The surface loss probabilities of the dominant neutral growth species emanating from methane and acetylene discharges are investigated by depositing thin films inside a cavity. The walls of this cavity are made from silicon substrates. Particles from the plasma can enter the cavity through a slit. The surface loss probability is determined by analysis of the deposition profile inside the cavity. This surface loss probability corresponds to the sum of the probability for effective sticking on the surface and the probability for the formation of a nonreactive volatile product via surface reactions. In a methane discharge the surface loss probability is ∼0.65±0.15 and in an acetylene discharge ∼0.92±0.05, respectively. The dominant contribution in the neutral radical flux emanating from a methane discharge towards the surface consists of CH3 radicals, as known from experiments using mass spectrometry. Furthermore, it is known from literature that the upper limit for the reaction probability for CH3 is in the range of 10−2. This leads us to the conclusion that the CH3 radical is not the dominant neutral growth precursor in a methane discharge. This result refutes the widely accepted picture that CH3 radicals are the dominant neutral growth precursor in a-C:H growth from methane. From a comparison of the composition of the neutral flux towards the surface from methane and acetylene discharges, we conclude that in both cases C2Hy species are the dominant neutral precursors for film growth. © 1999 American Institute of Physics.

Electronic Resource

1437-2320

Anterior instrumentation ; CDH ; CDI ; Operative therapy ; Spondylodiscitis

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a study the results recorded in 34 surgically treated patients with specific or unspecific spondylodiscitis after dorsoventral one-stage instrumentation with CDI and anterior grafting (group 1) were compared with those obtained in a group of 38 patients treated with anterior CDH instrumentation in combination with anterior grafting (group 2). The mean observation periods were 48.4 (19–82) months in group 1 and 29.0 (8–54) months in group 2. In both groups the infection healed after fusion without a secondary operation. In group 1 the mean values for blood loss, operating time, length of hospital stay and fusion length (3.5 segments) were significant higher than those in group 2; in particular, the fusion length was shorter (1.3 segments) in group 2. Only 8 patients in group 1 were treated with postoperative external support. The mean preoperative segmental angle of 18.2° (group 1) was corrected by a mean of 11.9°, and the reposition loss during follow-up amounted to an average of 2.7°. Group 2 showed a mean preoperative segmental deformity angle of 13.4°, which was corrected by 11.6°, and the loss of reposition was 2.9° on average. Even in florid spondylodiscitis a short-range anterior fusion of the affected spinal segment can be performed with a primarystable implant, avoiding a second operation without an increased risk of infection-related dislocation. In the authors' own experience a secondary dorsal operation can be avoided except in the case segment L-5/S-1, the fast mobilization without external support allows a up-to-date treatment in this severe spinal disease.

Electronic Resource

1433-0431

SchlüsselwörterÜbersicht ; Stoßwelle ; Tendinöse Reaktion ; Osteoinduktion ; Tennisellenbogen ; Plantarer Fersenschmerz ; Tendinosis calcarea der Schulter ; Pseudarthrose ; Key words Review ; Shock wave ; Tendinous reaction ; Osseoinduction ; Tennis elbow ; Plantar fasciitis ; Calcifying tendinitis of the shoulder ; Pseudarthrosis

Springer Online Journal Archives 1860-2000

Medicine

Summary The purpose of our studies was to investigate experimentally the dose-dependent effects of extracorporeal shock waves on tendon and bone and to unveil therapeutic possibilities in tendopathies and pseudarthroses. In animal experiments, both positive and negative influences were exerted by shock waves, depending on the initial situation and on the power of the applied shock waves. In prospective clinical trials positive effects were found in the treatment of persistent tennis elbow, plantar fasciitis, calcifying tendinitis, and pseudarthrosis. Our data show that extracorporeal shock waves may provide analgesic, resorptive and osseoinductive reactions with nearly no side effects. However, the high cost of apparatus and staff prevents a routine application. Extracorporeal shock waves thus remain a last alternative before the indication is made for an operative procedure.

Zusammenfassung Ziel unserer Untersuchung war es, dosisabhängige Effekte der extrakorporalen Stoßwellentherapie (ESWT) bei der Behandlung von Sehnen und Knochen aufzuzeigen, Schädigungsmöglichkeiten darzustellen und so Einsatzmöglichkeiten sowohl bei den im orthopädischen Alltag häufigen Tendopathien als auch bei der Pseudarthrosenbehandlung zu beleuchten. Tierexperimentell konnten an Sehnen und an Knochen, in Abhängigkeit von der Ausgangssituation und der Stoßwellenstärke, sowohl positive als auch negative Effekte beobachtet werden. In prospektiven klinischen Studien wurden die Anwendungsmöglichkeiten extrakorporaler Stoßwellen unterschiedlicher Energiedichten untersucht. Positive Effekte wurden bei Patienten mit Tennisellenbogen, plantarem Fersenschmerz, Tendinosis calcarea der Schulter und bei Pseudarthrosen erzielt. Die dargestellten Ergebnisse zeigen, daß mit der extrakorporalen Stoßwellentherapie ein nebenwirkungsarmes Verfahren existiert, um einerseits analgesierend einzugreifen und um andererseits resorptive bzw. osteogenetische Prozesse einzuleiten oder zu beschleunigen. Der noch immer hohe apparative und personelle Aufwand steht einer Routineanwendung entgegen. So ist die ESWT in der Orthopädie derzeit weniger eine weitere konservative Behandlungsform, sondern vielmehr letzte Alternative vor einem operativen Eingriff.

Electronic Resource

1433-0466

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1433-0431

Schlüsselwörter Idiopathische Skoliose • Krümmungsprogredienz • Crankshaft-Phänomen • Risser-Stadium ; Keywords Idiopathic scoliosis • Curvature degree • Crankshaft phenomena • Risser stage

Springer Online Journal Archives 1860-2000

Medicine

Abstract The treatment of idiopathic scoliosis over 40 ° (Cobb) during the growth period is under discussion concerning the indication for conservative or surgical treatment. Curve progression depends on the degree of the frontal and sagittal deformity, vertebral rotation, rigidity of the curve, the skeletal age, the age and sex of the patient, the familial frequency of scoliosis and the location of the curve. In scoliosis over 40 ° progression is fast and the possibilities for successful conservative brace treatment are reduced during the growth period. Progression occurs more frequently in thoracic and double major scolioses, especially in young patients (Risser sign 0 and 1). Predictive factors of a successful brace treatment are the correction of scoliosis and rotation; deterioration of both during the brace treatment leads to poor results. Evaluating the flexibility of the sagittal profile is important, as is primary correction of 30–50 % in the brace during the 3 months. Operative correction of small primary curves reduces the fusion length, operation time, and blood loss and is followed by a reduction in loading on the adjacent vertebral segments in comparison to the long fusions necessary in more structural and double major scolioses. So far it is not possible to make an equivalent judgment of the frequency of the “crankshaft” phenomenon and the treatment necessary in young patients (Rissersign 0 and 1) treated by dorsal instrumentation alone, but temporary brace treatment may be considered in those cases.

Zusammenfassung Bei idiopathischen Skoliosen über 40 ° (COBB 1948) besteht bei hoher Progredienzrate und reduzierten konservativen Therapiemöglichkeiten im Wachstumsalter die Grenzindikation zur operativen Versorgung. Die Krümmungsprogredienz ist abhängig von dem Ausmaß der vorhandenen frontalen und sagittalen Wirbelsäulendeformität, der Wirbelsäulenrotation, der Krümmungsrigidität, der Skelettreife, dem Patientenalter, dem Geschlecht, der familiären Skoliosebelastung sowie der Krümmungslokalisation. Progredienzgefährdet sind thorakale und doppelbogige Skoliosen ebenso wie Patienten in den Risser-Stadien 0 und 1. Prädiktive Faktoren für eine erfolgreiche Orthesentherapie sind die Korrektur von Skoliosewinkel (30–50 % innerhalb von 3 Monaten) und Wirbelkörperrotation, deren mangelnde Änderung oder Zunahme während der Orthesentherapie zu einer erhöhten Rate an Behandlungsfehlschlägen führt. Beachtenswert ist die Beurteilung der sagittalen Krümmungsflexibilität. Die eingeschränkten konservativen Therapiemöglichkeiten bei Skoliosewinkeln über 40 ° lassen eine frühzeitige Operation einer flexiblen Krümmung als die Methode der Wahl erscheinen. Die Korrektur einer einbogigen Krümmung geht mit einer kürzeren Spondylodesenstrecke, einer kürzeren Operationszeit, einem geringeren Blutungsrisiko und einer Minderbelastung der verbleibenden Wirbelbogengelenke im Verhältnis zu der bei einer ausgeprägten Krümmung notwendigen, langstreckigen Fusion einher. Eine einheitliche Beurteilung der Häufigkeit des „Crankshaft-Phänomens“ bei jungen Patienten (Risser-Stadien 0 und 1) nach alleiniger dorsaler Instrumentation und den sich daraus ableitenden Therapiemaßnahmen ist gegenwärtig unmöglich. Hier ist eine Orthesenbehandlung bis zum Erreichen des Risser-Stadiums 2 in Kenntnis eines allenfalls temporären Therapieerfolgs erwägenswert.

Electronic Resource

1433-044X

Key words Delayed bone healing • Extracorporal shock waves ; Schlüsselwörter Gestörte Knochenheilung • Extrakorporale Stoßwellen

Springer Online Journal Archives 1860-2000

Medicine

Zusammenfassung Seit Ende der 80er Jahre wird mit der Beeinflußbarkeit der ungestörten und verzögerten Knochenheilung durch extrakorporale Stoßwellen hoher Energiedichte experimentiert. Tierexperimentell gibt es allerdings kein der humanen Pseudarthrosensituation vergleichbares Modell, so daß die widersprüchlichen, größtenteils negativen Ergebnisse nicht auf den Patienten übertragen werden können. Prospektive klinische Studien verschiedener Zentren haben Erfolgsraten von über 50 % ergeben. Zuvor waren die Patienten meist mehrfach erfolglos mit dem Goldstandard Reosteosynthese und Spongiosaplastik vorbehandelt worden. Nur in diesen verzweifelten Fällen sollten extrakorporale Stoßwellen heute zur Anwendung kommen, solange der Wirkmechanismus noch spekulativ ist.

Summary Since the late 1980s, experiments have been performed to influence physiologic and disturbed healing of bone. However, the mainly negative results of animal studies, cannot be applied to the human nonunion situation as long as there is no adequate animal pseudarthrosis model. Prospective clinical studies in various centres have resulted in success rates of more than 50 %, although the majority of patients had been treated repeatedly and ineffectively with the gold standard of re-osteosynthesis and grafting. Since the mechanisms are not yet understood, only such desperate conditions are an indication for the application of high-energy extracorporal shock waves.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract Seventy-two patients with neoplastic involvement of the vertebral column were operated on between 1986 and 1991. In the course of 79 operations anterior decompression and stabilization alone were performed in 3 cases, while ventrodorsal spondylodesis was carried out in 10 individuals. The remainder of the patients underwent exclusively dorsal decompression and stabilization, mainly with the Cotrel-Dubousset instrumentation (CDI). No external spinal support was required following posterior fixation by CDI alone or in combination with ventral spondylodesis. Forty patients suffered from neurological deficits preoperatively, 20 of them being unable to walk, in most cases owing to severe vertebral collapse. Neurologic symptoms improved in 18 patients postoperatively. Median postoperative survival time averaged 11.5 months. In palliative surgery of the spine, posterior decompression and fixation using CDI permit most patients to retain ambulation without requiring external orthotics. The rate of postoperative complications is reduced by the introduction of CDI.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract A retrospective study was performed of the surgical treatment of metastatic lesions of the proximal femur in 50 patients. In 25 consecutive cases a megaprosthesis was implanted; compound plate osteosynthesis was performed in another 25 consecutive patients. Indications for surgical treatment were pathological fractures or, for prophylactic treatment, lesions of the femoral cortex exceeding 2.5 cm in diameter or affecting half the diameter of the bone or more. In all patients capable of walking preoperatively mobility was regained. Immediate full weight-bearing stability was obtained in all patients. Group analysis showed that the functional rating of the hip joint was unchanged, i.e., good or excellent, in all patients with compound osteosynthesis, compared to only 68% in the endoprosthesis group. Pain relief was excellent or good in 84% and 88% respectively. Dislocation of the tumor prosthesis occurred in 3 patients. Closed reduction was possible in 2 cases. Local recurrence was higher in the patients undergoing plate osteosynthesis, as was the frequency of tumor-related implant failure. Postoperative survival averaged 14.7 months and 12.1 months respectively.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract The aim of this prospective single-blind pilot study was to explore the pain-alleviating effect of low-energy extracorporeal shock wave therapy (ESWT) in painful heel associated with inferior calcaneal spurs. Thirty patients who suffered from persistent symptoms for more than 12 months qualified for low-energy ESWT and were assigned at random to two groups, real or simulated ESWT. Before beginning the treatment, any other therapy was stopped for a period of 6 weeks. The shock waves were applied by an experimental device allowing exact localization through an integrated fluoroscopy unit. Patients were treated three times at weekly intervals. Each time 1000 impulses of 0.06 mJ/mm2 were given around the heel spur. Follow-ups were done after 3, 6, 12 and 24 weeks. Patients of the placebo group who did not improve at the 6-week follow-up were then offered ESWT therapy and were checked at 3, 6, 12 and 24 weeks after the last treatment. Whereas we noticed no significant differences between the groups before ESWT, there was a significant alleviation of pain and improvement of function at all follow-ups in the treatment group.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract Between January 1991 and January 1996, pseudarthroses of the legs were treated prospectively in 48 patients by application of high-energy extracorporeal shock waves with an experimental device. The mean duration of pseudarthrosis was 12 months. On average, 2.4 surgical interventions had previously been performed. A total of 3000 impulses with an energy density of 0.6 mJ/mm2 was applied to the pseudarthrosis. Bony union was achieved in 60.4% of our patients after an average of 3.4 months. Failures were found especially in the atrophic types of pseudarthrosis as well as in congenital bone disorders like fibrous dysplasia or osteogenesis imperfecta. No serious complications were observed. Even after numerous surgical interventions high-energy extracorporeal shock-wave therapy showed a fair success rate. A higher success rate of this non-invasive method for the treatment of bony non-unions may be expected by applying strict selection criteria.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract Between January 1991 and January 1996, pseudarthroses of the legs were treated prospectively in 48 patients by application of high-energy extracorporeal shock waves with an experimental device. The mean duration of pseudarthrosis was 12 months. On average, 2.4 surgical interventions had previously been performed. A total of 3000 impulses with an energy density of 0.6 mJ/mm2 was applied to the pseudarthrosis. Bony union was achieved in 60.4% of our patients after an average of 3.4 months. Failures were found especially in the atrophic types of pseudarthrosis as well as in congenital bone disorders like fibrous dysplasia or osteogenesis imperfecta. No serious complications were observed. Even after numerous surgical interventions high-energy extracorporeal shock-wave therapy showed a fair success rate. A higher success rate of this non-invasive method for the treatment of bony non-unions may be expected by applying strict selection criteria.

Electronic Resource

1434-3916

Key words Medial epicondylitis ; Shock-wave therapy ; Lack of effectiveness

Springer Online Journal Archives 1860-2000

Medicine

Abstract Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

Electronic Resource

1434-3916

Springer Online Journal Archives 1860-2000

Medicine

Abstract From 1987 to 1996, 106 consecutive patients with metastatic disease of the spine who underwent palliative decompression from a dorsal approach and subsequent stabilisation with Cotrel-Dubousset instrumentation (CDI) were followed prospectively, and independent of the surgeons. Parameters evaluated were neurological function, perioperative complications, survival and rehabilitation. Following the Frankel system for the assessment of neurological disorder, 33 patients had a major deficit (grade A, B or C), 23 a minor deficit (grade D) and 50 no deficit. If there was no neurological dysfunction, the only patients who underwent operation were those graded as class IV according to Harrington. Our surgical strategy combined posterior decompression of the spinal cord followed by CD stabilisation without bone grafting. Of 56 patients who had a neurological deficit preoperatively, 35 enjoyed complete or partial recovery within the first 3 months after the operation. Of the 50 patients without neurological dysfunction, 3 developed an incomplete transient paresis. The rate of survival was 72% (76 of 106) ¶at 6 months and 50% (53 of 106) at 12 months. At 12 months 42 of the 53 patients who were alive were still able to walk. All but 13 patients were able to return home. Overall survival time was 19.2 months, with 5 patients still alive. Six patients required re-operation for tumour recurrence at the same or at a new level. The results of this study show that neurological function, pain level and mobility can be enhanced by decompression and stabilisation through a posterior approach.

Electronic Resource

0022-5185

Theology and Religious Studies

INDEX OF ARTICLES AND NOTES AND STUDIES

0022-5185

Theology and Religious Studies

0022-5185

Theology and Religious Studies

0022-5185

Theology and Religious Studies

1432-0932

Discogenic paresis ; Lumbar discectomy ; Prognostic criteria

Springer Online Journal Archives 1860-2000

Medicine

Summary This discourse is aimed at elucidating prognostic criteria for the assessment of the course of a paresis in the case of lumbar disc herniation. Fourhundred and fifty patients were examined who had been operated on for lumbar disc herniation at the Orthopaedic University Clinic Mainz between 1986 and 1991. Of these, 240 showed radicular paralytic symptoms. They were examined prior to the operation, immediately afterwards and 1 year after the operation. The influence of the degree of intensity of the paresis, the time elapsed since the occurrence and other factors like nerve root affected, intraoperative findings, age, sex and weight of the patient were registered. It is obvious that the degree of intensity of a paresis is a good prognostic criterion for the assessment of the postoperative course. A paresis classified as grade III or IV receded in more than 70% of the cases within 6 months. For a paresis of grade 11, the recovery rate was 40%. In the case of a total paresis, no complete neurological recovery was registered. The period of time which had elapsed since the occurrence of the paresis, the weight of the patient, the nerve root affected and other factors did not show any significant influence. As a criterion for an emergency or postponed operation on a herniated disc, the duration of paralytic symptoms should therefore be attributed less importance than the progression.

Electronic Resource