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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S86 
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Ellbogeninfektion ; Offenes zweizeitiges Vorgehen ; Gelenkfunktionserhalt ; Bakteriologie der Ellbogeninfektion ; Spätkomplikationen ; Nachuntersuchungsergebnisse ; Key words ; Elbow infection ; Open two-stage-approach ; Maintenance of joint function ; Bacteriology of elbow infection ; Late complications ; Follow-up results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Infection of the elbow is a rare complication of fracture treatment: it is occasionally seen as a primary complication, but also after injections, soft tissue defects, bursectomies and ulcerogenic lesions. It may spread by the haematogenous, lymphogenic or metastatic route. The onset of symptoms is often mild, so that patient and physician are deceived and treatment even of severe infections is delayed. Conservative treatment of joint infection or a limited surgical approach is seldom sufficient. The aim of treatment should be the restoration of joint movement, at least to an extent allowing pro- and supination of the hand. In case of an acute infection a transarthroscopic approach with debridement and irrigation of the joint can yield good results if repeated daily until the symptoms of the infection subside. Because of the prolonged course of the disease we prefer a two-stage approach at our institution. The first stage is a bilateral arthrotomy of the joint, involving a synoviectomy and insertion of local antibiotics (Septopal®, Miniseptopal®). The joint is left open, and the patient receives careful hydrophysical therapy with limited joint movement. Antibiotics are administered perioperatively, and the wounds are dressed daily with iodine ointment. Once there is no further pustulent secretion, the arthrotomy is closed after 7–12 days, at the same time as a thorough debridement is performed in a second-stage operation. Intensive physical rehabilitation, including ergotherapy and mobilisation with transposition of the joint, begins immediately after this procedure, augmented in most cases by administration of intravenous analgesic medication. From 1979 to 1997, we treated 27 cases of empyema of the elbow. Surgical therapy consisted in primary arthrodesis ¶because of severe joint destruction ¶in 2 patients (7.4%). In 4 patients (14.8%) a one-stage-approach was considered, but the treatment was unsuccessful in 2 cases. In 21 patients (77.8%) a two-stage-approach was undertaken as the primary procedure. No complications were found in 19 patients (82.6%), while in ¶4 cases soft-tissue defects were closed in a second operation. Late complications included 2 recurrent infections. Long-term follow-up was possible in 20 of 25 patients with preservation of joint function. These included 5 patients (20%) who had a free range of motion (ROM), while ¶6 patients (24%) were limited to one quarter ROM, 4 patients each (16%) to a half and three quarters ROM compared with the contralateral joint, and 1 patient (4%) had a stiff elbow.
    Notes: Zusammenfassung Die Ellbogengelenkinfektion ist glücklicherweise eine relativ seltene Komplikation der Frakturbehandlung, gelegentlich auch eine primäre Erkrankung nach Injektion, Bursektomie, nach Defekten oder Ulzera, hämatogen, lymphogen, metastatisch oder postoperativ. Die Symptomatik ist nicht selten wenig dramatisch, so daß auch die ausgedehnte Gelenkinfektion häufiger über längere Zeit übersehen, fehlgedeutet oder sowohl vom Patienten als auch vom Arzt bagatellisiert werden kann. Die Gelenkinfektion kann nur selten allein konservativ oder mit begrenztem chirurgischem Vorgehen erfolgreich therapiert werden. Ziel sollte stets der Wiedergewinn der Funktion sein, dabei ist auch der alleinige Erhalt der Umwendbewegungen der Hand durchaus von wesentlicher Bedeutung. Bei der akuten Infektion kann durchaus allein transarthroskopisch vorgegangen werden, wobei ein intensives Débridement (Shaving) unter reichlich Spülung vorgenommen werden sollte und das Vorgehen bis zur definitiven Infektionsberuhigung möglichst täglich wiederholt wird. Wegen des gehäuft langwierigen Verlaufs hat sich bei uns das zweizeitige chirurgische Vorgehen bewährt, wobei im ersten Eingriff möglichst nach zweiseitiger Arthrotomie eine totale Synovialektomie unter Schonung der Gelenkstrukturen mit Einlage von Septopal ® (meist Miniseptopal ® ) ausgeführt wird. Die Arthrotomien verbleiben nach diesem Eingriff offen. Im postoperativen Verlauf werden unter gleichzeitiger perioperativer systemischer antibiotischer Behandlung vorsichtige Bewegungsübungen im Armbad und tägliche Verbandwechsel mit Betaisodonasalbe ausgeführt. Sistiert die Sekretion, werden die Arthrotomien nach 7–12 Tagen in einem 2. Eingriff nach erneutem radikalem Débridement verschlossen. Anschließend wird unverzüglich ein intensives Mobilisationsprogramm unter Umlagerung, Krankengymnastik, Ergotherapie, anfangs meist unter i.v. Schmerztherapie begonnen. Von 1979–1997 wurden bei uns 27 Ellbogengelenkempyeme behandelt. Zur Infektionsberuhigung wurde bei uns 2mal (7,4%) eine primäre Arthrodese wegen Gelenkzerstörung ausgeführt, bei 4 Patienten (14,8%) wurde ein einzeitiges operatives Vorgehen geplant, 2mal verlief es erfolglos. Bei 21 Patienten (77,8%) wurde primär das zweizeitige operative Vorgehen vorgenommen. Bei 19 Patienten (82,6%) verlief die zweizeitige Behandlung komplikationsfrei, 4mal mußten weiterbestehende Hautdefekte sekundär verschlossen werden. Als Spätkomplikation wurden bislang 2 Infektionsrezidive beobachtet. 20 von 25 Patienten mit Gelenkerhalt konnten mindestens 1–2 Jahre nach der Behandlung nachuntersucht werden: 5 Patienten (20,0%) hatten fast freie Gelenkfunktion, 6 (24,0%) Einschränkungen zu 1/4, je 4 Patienten (16,0%) Einschränkungen zur Hälfte bzw. zu 3 / 4 der Gegenseite, während das Gelenk bei 1 Patienten (4,0%) sekundär eingesteift war.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of sol gel science and technology 3 (1994), S. 189-197 
    ISSN: 1573-4846
    Keywords: nanocomposites ; sol-gel ; heteropolymetalates ; photochromics ; electrochemical properties
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract New nanocomposites materials have been synthesized. They present electrochemical and photochromic properties. They are based on a hybrid organic-inorganic network, in which tungsten heteropolyoxometalates (PW12O 40 3− , SiW12O 40 4− , W10O 32 4− , polymeric tungstate) are entrapped. High tungsten ratios could be reached and films or bulk materials have been obtained. The structure of these materials is described on the basis of multi-spectroscopic investigations (IR, EPR, NMR). Electrochemical redox reactions have been observed in thin films. Dark blue reversible coloration of the materials is obtained under UV irradiation. The photochromic mechanism has been investigated and shows the reversible formation of carbonyl group.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of sol gel science and technology 8 (1997), S. 927-929 
    ISSN: 1573-4846
    Keywords: organic-inorganic hybrids ; sol-gel ; photochromic performance ; spirooxazine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Organic-inorganic hybrid materials synthesized via sol-gel processing are excellent solid matrices for photochromic dyes like spirooxazine, and the photochromic performance can be further enhanced by introducing suitable additives. This work describes the effects of additives on the photochromic intensity (Δ A 0), decolouration rate (k) and photostability of spirooxazine in sol-gel derived organic-inorganic hybrid matrices. They include fluoro-alkylsilane (FAS), bisphenol A (BPA) and methyl-imidazole (MI). FAS enhances both Δ A 0 and photostability, but has little effect on k. The higher the content of BPA, the higher the Δ A 0 and the higher the photostability, but the lower the k. The effect of MI on Δ A 0 and k is not so considerable as that of BPA and is a little complicated, while significant improvement in photostability is achieved by the addition of MI at an optimum concentration with the presence of BPA at a higher content.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of sol gel science and technology 8 (1997), S. 927-929 
    ISSN: 1573-4846
    Keywords: organic-inorganic hybrids ; sol-gel ; photochromic performance ; spirooxazine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Organic-inorganic hybrid materials synthesized via sol-gel processing are excellent solid matrices for photochromic dyes like spirooxazine, and the photochromic performance can be further enhanced by introducing suitable additives. This work describes the effects of additives on the photochromic intensity (ΔA 0), decolouration rate (k) and photostability of spirooxazine in sol-gel derived organic-inorganic hybrid matrices. They include fluoroalkylsilane (FAS), bisphenolA (BPA) and methyl-imidazole (MI). FAS enhances both ΔA 0 and photostability, but has little effect onk. The higher the content of BPA, the higher the ΔA 0 and the higher the photostability, but the lower thek. The effect of MI on ΔA 0 andk is not so considerable as that of BPA and is a little complicated, while significant improvement in photostability is achieved by the addition of MI at an optimum concentration with the presence of BPA at a higher content.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    New York, NY [u.a.] : Wiley-Blackwell
    Advanced Materials for Optics and Electronics 7 (1997), S. 123-133 
    ISSN: 1057-9257
    Keywords: nanocomposites ; sol-gel ; heteropolymetallates ; photochromics ; holographic data storage ; amplitude grating ; two-wave-mixing recording ; Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Electrical Engineering, Measurement and Control Technology , Physics
    Notes: This paper describes the properties of some new organic-inorganic photochromic layers. They are based on a hybrid organic-inorganic matrix in which tungsten heteropolyoxometallates (SiW12O4-40, PW12O3-40) are entrapped in a network obtained from the reaction of 3-glycidoxy-propyltrimethoxysilane. The high homogeneity of these materials on the nanoscale leads to transparent monoliths and layers of controlled thicknesses up to 40 μm. The optical properties of the blend are emphasised and the construction of amplitude gratings in the materials by two-wave-mixing experiments is described. The results of the optical experiments and the comparison with the theoretical background are used as a model for photochromic holographic storage processes. © 1997 John Wiley & Sons, Ltd.
    Additional Material: 9 Ill.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1435-1285
    Keywords: Key words Coarctation of the aorta ; patent ductus arteriosus ; ventricular function ; heart failure ; surgical repair ; Schlüsselwörter ; Aortenisthmusstenose ; offener Ductus Botalli ; Ventrikelfunktion ; Herzinsuffizienz ; operative Korrektur
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wir beschreiben den Krankheitsverlauf einer 36-jährigen Frau mit unbehandelter Aortenisthmusstenose und offenem Ductus Botalli, die aufgrund einer ausgeprägten linksventrikulären Dysfunktion eine therapierefraktäre Herzinsuffizienz entwickelte. Nach operativer Korrektur der Aortenisthmusstenose und Ductusresektion normalisierte sich die linksventrikuläre Pumpfunktion, sodass davon ausgegangen werden kann, dass auch schwere linksventrikuläre Dysfunktionen auf dem Boden langjähriger Druck- und Volumenbelastung durch angeborene Herzfehler nach operativer Korrektur reversibel sein können.
    Notes: Summary We report on the history of a 36-year-old woman with untreated coarctation of the aorta and patent ductus arteriosus who developed refractory heart failure due to severely impaired left ventricular function. After coarctation repair and duct resection, left ventricular function improved to normal. Even in the presence of longstanding left ventricular pressure and volume overload, subsequent severe myocardial failure may be reversible by surgical repair.
    Type of Medium: Electronic Resource
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