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  • 1
    Electronic Resource
    Electronic Resource
    Good reinnervation of motoneurons but poor recovery of gait after delayed as well as immediate sciatic nerve transplant in rats (2005)
    Berlin, Germany : Blackwell Verlag GmbH
    Anatomia, histologia, embryologia 34 (2005), S. 0 
    Details
    ISSN: 1439-0264
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Surgeons agree that interrupted peripheral nerves should be reconstructed ‘soon’ to enable neural regeneration. Delayed nerve repair will result in impaired outcome, but experimental data on such detriment due to delay are scarce. In a quantitative study we transected the right sciatic nerve of 80 adult female Lewis rats (LEW/SsNHsd), transflected the proximal nerve stump into a muscle pouch and let the animals wait 0 (immediate repair), 3, 6, 9 and 12 months after axotomy, until reconstruction was performed with a 5-mm long allograft from congenic age-matched donors. All hosts were studied with two different methods. First, the functional outcome of sciatic nerve reconstruction was evaluated 4–12 weeks after transplant by walking track analysis, calculating de Medinaceli's Sciatic Functional Index (SFI). Second, 12 weeks after transplantation the fibular communal nerve and the soleus branch of the tibial nerve close to its muscle entry were cut and the proximal stumps labelled with the retrograde neuronal tracers DiI or Fast-Blue. Fourteen days later the rats were perfused with formaldehyde, and the numbers of fluorescently labelled motoneurons were counted in 50 μm serial vibratome sections of the spinal cord. All measurements were done on coded material and codes broken only at the end of the study. Our results are clear-cut and deeply disappointing. The SFI was around 0 (normal value) in all rats before transection of the sciatic nerve; expectedly dropped to −85 to −125 after denervation, but stayed at −108 to −130 up to 12 weeks after transplantation. No improvement of gait at all occurred after sciatic nerve transplant performed immediately or 3, 6, 9 or 12 months after denervation.This failure of functional recovery is not due to lack of regeneration, as the numbers of labelled motoneurons prove. In normal rats we have labelled 549 ± 83 motoneurons by DiI and Fast-Blue. After immediate nerve repair we counted 533 ± 95 labelled motoneurons; after repair delayed for 12 months we still counted 474 ± 108 motoneurons that had regenerated. In all rats the labelled motoneurons were randomly interspersed with a complete lack of myotopic distribution. This misdirection of reinnervation sadly prevents recovery of motor function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1439-0264.2005.00683.x
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  • 2
    Electronic Resource
    Electronic Resource
    The lateral calcaneal artery (1999)
    Springer
    Surgical and radiologic anatomy 20 (1999), S. 419-423 
    Details
    ISSN: 1279-8517
    Keywords: Lateral calcaneal artery ; Calcaneal fracture ; Flap ; Avascular necrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An anatomic study of the lateral extraosseous and intraosseous arterial supply of the calcaneus and the lateral soft tissue was carried out on 10 fresh lower adult cadaver legs using different anatomic and radiologic procedures (plastination, modified Spalteholz clearing technique, digital subtraction and rotational angiography and computed tomographic angiography). Consistent patterns of extraosseous and intraosseous lateral calcaneal vascular anatomy were demonstrated. The lateral calcaneal artery is a branch of the anterior tibial artery which crosses over the calcaneal tuberosity and forms a large lateral arch with the lateral tarsal artery which is a branch of the dorsalis pedis artery. The intraosseous circulation is supplied laterally by the lateral calcanear artery, medially via the short branches of the lateral plantar artery. Comparing magnet resonance images after fresh calcaneal fractures the lateral calcanear artery may be interrupted by the impacted lateral bulge, by the conventional lateral surgical approach, or by applying a lateral osteosynthesis plate. This may cause avascular bone necrosis. Furthermore the lateral calcanear artery can clinically serve as a vascular pedicle for a local rotational skin flap to cover soft tissue defects of the heel.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-998-0419-1
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  • 3
    Electronic Resource
    Electronic Resource
    The lateral calcaneal artery (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 419-423 
    Details
    ISSN: 1279-8517
    Keywords: Lateral calcaneal artery ; Calcaneal fracture ; Flap ; Avascular necrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'étude anatomique de la vascularisaiton artérielle extra et intraosseuse du calcanéus et des parties molles a été faite sur 10 jambes fraîches de cadavres d'adultes. Différentes techniques anatomiques et radiologiques ont été utilisées : plastination, diaphanisation (technique de Spaltholtz modifiée), angiographie numérisée par soustraction, angiographie rotationnelle et angiographie par tomographie computérisée. Les aspects habituels de l'anatomie vasculaire de la région latérale du calcanéus ont été décrits : l'ACL est un rameau de l'artère tibiale postérieure ; elle surcroise la tubérosité calcanéenne et constitue une large arcade latérale avec l'artère tarsienne latérale, branche de l'artère dorsale du pied. La moitié de la circulation intraosseuse passe par l'ACL, médialement par des rameaux courts de l'artère plantaire latérale. Lorsqu'on examine les images obtenues en IRM lors de fractures récentes du calcanéus, on constate que l'ACL risque d'être lésée par l'élargissement latéral du calcanéus écrasé. Elle peut l'être aussi lors de l'abord latéral classique de l'os ou lors de l'application d'une plaque d'ostéosynthèse. Le risque en est la nécrose ischémique de l'os. Enfin, l'ACL peut constituer un pédicule vasculaire intéressant pour un lambeau local de rotation, lors de la couverture des pertes de substances cutanées du talon.
    Notes: Summary An anatomic study of the lateral extraosseous and intraosseous arterial supply of the calcaneus and the lateral soft tissue was carried out on 10 fresh lower adult cadaver legs using different anatomic and radiologic procedures (plastination, modified Spalteholz clearing technique, digital subtraction and rotational angiography and computed tomographic angiography). Consistent patterns of extraosseous and intraosseous lateral calcaneal vascular anatomy were demonstrated. The lateral calcaneal artery is a branch of the anterior tibial artery which crosses over the calcaneal tuberosity and forms a large lateral arch with the lateral tarsal artery which is a branch of the dorsalis pedis artery. The intraosseous circulation is supplied laterally by the lateral calcanear artery, medially via the short branches of the lateral plantar artery. Comparing magnet resonance images after fresh calcaneal fractures the lateral calcanear artery may be interrupted by the impacted lateral bulge, by the conventional lateral surgical approach, or by applying a lateral osteosynthesis plate. This may cause avascular bone necrosis. Furthermore the lateral calcanear artery can clinically serve as a vascular pedicle for a local rotational skin flap to cover soft tissue defects of the heel.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01653134
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  • 4
    Electronic Resource
    Electronic Resource
    Candida spondylitis: case report and review of the literature (1998)
    Springer
    Der Unfallchirurg 101 (1998), S. 955-959 
    Details
    ISSN: 1433-044X
    Keywords: Key words Spondylitis • Candida • Hip • Endoprothesis • Spondylodesis ; Schlüsselwörter Spondylitis • Candida • Hüfte • ; Totalendoprothese • Spondylodese
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In zunehmendem Maße werden Candidaspezies Ursache für Infektionen des Menschen. Verschiedene Lokalisationen im Körper wurden in der Literatur beschrieben, aber nur wenige Fälle weisen eine Candidaspondylitis auf. Berichtet wird über eine Patientin mit einer Spondylitis der Lendenwirbelsäule und einer Candidakoxitis. Die Literaturübersicht umfaßt 31 Fälle von Candidaspondylitiden. Die Candidaspondylitis ist in den meisten Fällen eine Spätmanifestation einer Sepsis dieses Erregers. Die Spondylitis kann oft nicht durch die systemische Therapie mit Amphotericin B in der akuten Infektionsphase verhindert werden. Auch bei immunsupprimierten Patienten ist die Candidaspondylitis niemals Folge einer postoperativen Wundinfektion gewesen. Die lange Latenz zwischen Sepsis und Manifestation einer Candidaabsiedlung in der Wirbelsäule oder anderen großen Gelenken, wie der Hüfte, sowie der häufig falsch-negative Erregernachweis kann zu einer erheblichen Diagnose- und Therapieverzögerung führen. Die Diagnose kann durch eine offene Biopsie oder eine CT gesteuerte Punktion geschehen. Behandelt wird die Candidaspondylitis mit einer Kombination aus radikalem chirurgischen Debridement und einer medikamentösen antimykotisch Therapie (Amphothericin B oder Flukonazol). Chirurgisch wird eine ventrale und fakultativ dorsale Instumentation zur Stabilisierung der Wirbelsäule durchgeführt. Die Spondylitis wird in zunehmendem Maße Manifestation einer abgelaufenen Candidasepsis insbesondere bei immunsuppremierten Patienten sein.
    Notes: Summary Candida species have emerged as important pathogens in human infection. Although a variety of deep-seated candidal infections have been reported, Candida spondylitis has rarely been described. One patient with candida tropicalis spondylitis L I and L II in combination with candida coxitis is presented, and the 31 adult cases with vertebral involvement previously reported are reviewed. Candida spondylitis is noted as a simultaneous occurrence or late manifestation of hematogenously disseminated candidiasis. Spondylitis may not be prevented by a course of Amphotericin B adequate to control the acute episode of disseminated candidiasis, particularly in immune suppressed patients. Spondylitis does not present as a postoperative wound infection. The insidious progression of infection, the nonspecificity of laboratory data, and the failure to recognise Candida as a potential pathogen may lead to diagnostic delay. Diagnosis can be made by either open biopsy or CT controlled needle aspiration. Successful therapeutic regimes have employed combinations of antifungal therapy (Amphotericin B or fluconazole) with radical surgical debridement. Ventral and facultatively dorsal instumentation is required to stabilize the spine. It is anticipated that the spondylitis will become a more commonly recognised manifestation of hematogenously disseminated candidiasis. A increasing significance of candida species as etiologic agents of infection immune compromised humans has been recognised in the recent years. In those patients whom an antecedent Candida septicaemia was documented, a striking delay of 3.3 months was found between the septicaemia and the onset of symptoms as well as the time of diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050363
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  • 5
    Electronic Resource
    Electronic Resource
    Wirbelsäulenverletzung bei Jockeys Zwei Fallberichte und Literaturübersicht (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 688-692 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Jockey ; Pferderennen ; Wirbelkörperfraktur ; Pathomechanismus ; Reitunfall ; Key words Jockey ; Equestrian sports ; Vertebral fracture ; Pathomechanism ; Horse-racing-related injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Two cases of severe spinal cord injuries to professional horse-racing jockeys are presented. There is only one comprehensive study conducted to ascertain the nature and incidence of injuries in the literature. The pathomechanism and surgical therapy of vertebral trauma in jockeys was analysed.
    Notes: Zusammenfassung Es werden zwei schwere Wirbelsäulenverletzungen bei professionellen Jockeys vorgestellt. Der Pathomechanismus wurde anhand einer Videoaufzeichnung des Unfallhergangs analysiert. Die aktuellen Therapiekonzepte werden nach Darstellung der Literatur diskutiert. Die schwere Wirbelsäulenverletzung des Jockeys ist ein Arbeitsunfall und bedarf der interdisziplinären Diagnostik und Therapie.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050603
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  • 6
    Electronic Resource
    Electronic Resource
    The effect of additional brain injury on systemic interleukin (IL)-10 and IL-13 levels in trauma patients (2000)
    Springer
    Inflammation research 49 (2000), S. 524-528 
    Details
    ISSN: 1420-908X
    Keywords: Key words: Human - Trauma - Antiinflammation - Cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Objective: Besides interleukin (IL)-10, accumulating evidence from in vitro studies has indicated a strong antiinflammatory capacity for IL-13. A prospective clinical study was undertaken to assess the influence of additional brain injury on systemic IL-10 and IL-13 levels as markers for the antiinflammatory state in trauma patients.¶Material and methods: The course of IL-10 and IL-13 plasma levels from 32 patients with an isolated severe head trauma (SHT), 50 patients with multiple injuries and additional SHT and 39 patients with multiple injuries without SHT was detected using ELISA-technique. Blood samples from 37 healthy blood donors were analysed for control.¶Results: IL-10 levels were significantly elevated in all 3 injury groups within 3 h after trauma. The lowest initial release was detected in patients with an isolated SHT (Injury severity score; ISS: 18.1 ± 5.6). No difference could be demonstrated for the IL-10 levels from multiple injured patients with (ISS: 35.3 ± 9.6) or without additional SHT (ISS: 25.5 ± 11.7), though there were relevant differences in the ISS. In contrast, the IL-13 plasma levels were not elevated systemically after trauma.¶Conclusions: IL-10 but not IL-13 is a detectable antiinflammatory marker in trauma patients with or without brain injury and to a minor degree in patients with an isolated SHT.¶
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000110050626
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