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  • 1
    ISSN: 0340-1855
    Keywords: Schlüsselwörter Diclofenac ; in vitro ; Osteoblasten ; stromale Knochenmarkzellen ; Hüftprothektik ; Key words Diclofenac ; in-vitro ; osteoblasts ; bone marrow cells ; hip arthroplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Introduction: Results of animal experiments have demonstrated that the osseous integration of non-cemented prostheses can, at the very least temporarily, be impaired by the application of non-steroidal antiphlogistic agents (such as diclofenac). It is the objective of this study to examine whether there is a direct influence of diclofenac used in usual clinical dosages (3 times 50 mg daily) on bone cells and their progenitor cells which would explain the observed slow integration of the prostheses. Methods: To investigate this, cultivated human in vitro osteoblasts and stromal bone marrow cells were incubated with increasing doses of the medications. Our study focused on the effect of diclofenac application on proliferation and functional metabolism in both cell lines. The measurable maximal plasma concentration 2h after the application of one tablet Voltaren 50® reached 1.6μg/ml. This correlated with diclofenac concentrations between 1 and 10 ml found in our experiments. The detected values were correlated to the control group (0 μg/ml diclofenac). Results: The drug effect upon osteoblasts was higher than on progenitor cells. The proliferation of in vitro stromal bone marrow cells, compared to untreated cells, was found to be decreased. We observed a decrease to 82% at a diclofenac concentration of 1 μg/ml, Osteoblasts exhibited a decrease to 97,5% at the same concentration. The DNA synthesis increased to 118% in stromal bone marrow cells, in osteoblasts to 144%. In contrast, we detected a neglectible decrease to 92% in the collagen synthesis of osteoblasts compared to untreated cells. The synthesis of osteocalcin by osteoblasts increased to 119%. The alkaline phosphatase activity was found to be decreased to 88% in stromal bone marrow cells and increased in osteoblasts to 111%. Conclusion: Temporary inhibiting effects on osseous integration in non-cemented prosthesis by diclofenac could be caused by a disturbance in the anabolic bone metabolism, exhibited by an increase of osteoblastic osteocalcin expression. Osteocalcin as a known negative regulator of the osteoneogenesis is most likely inhibiting the collagen matrix deposition.
    Notes: Zusammenfassung Einleitung: Nichtsteroidale Antiphlogistika (NSAR, z.B. Diclofenac) können das knöcherne Einwachsen nicht zementierter Prothesen zumindest vorübergehend beeinträchtigen. Es wird untersucht, ob ein direkter Einfluß von Diclofenac, in üblicher klinischer Dosierung (3×50 mg), bzw. der dadurch maximal erreichbaren Plasmakonzentration auf Knochenzellen und ihre Progenitoren besteht. Methoden: In-vitro kultivierte humane Osteoblasten und stromale Knochenmarkzellen wurden mit steigenden Medikamentendosierungen inkubiert und deren Wirkung auf das Proliferationsverhalten sowie Funktionsstoffwechsel gemessen. Die, durch Einnahme eines Dragees Voltaren 50®(Diclofenac) im Mittel nach 2 Stunden meßbare maximale Plasmakonzentration beträgt 1,6 μg/ml (26). Dies entspricht Diclofenackonzentrationen von etwa 1 μg/ml in unseren Experimenten. Die ermittelten Werte werden auf die Kontrollgruppe (0 μg/ml Diclofenac) bezogen. Ergebnisse: Die Wirkung von Diclofenac auf Osteoblasten ist bei allen Versuchen ausgeprägter als auf Vorläuferzellen. Die Proliferation stromaler Knochenmarkzellen wird bei Diclofenackonzentrationen von 1μg/ml auf 82%, bei Osteoblasten auf 97,5% reduziert. Die DNA-Synthese stromaler Knochenmarkzellen erhöht sich bei 1 μg/ml Diclofenac auf 118%, bei Osteoblasten auf 144%. Die Kollagensynthese der Osteoblasten wird auf 92% gesenkt. Die Osteocalcinsynthese der Osteoblasten steigt auf 119%. Die Aktivität der Alkalischen Phosphatase sinkt bei stromalen Knochenmarkzellen auf 88%, bei Osteoblasten steigt sie auf 111%. Schlußfolgerungen: Die zumindest während der Medikamentengabe verminderte Implantat-Knochen-Haftung könnte in einer Störung des anabolen Knochenstoffwechsels begründet sein, was sich in einer signifikanten Zunahme der spezifischen Osteocalcinexpression zeigt. Osteocalcin inhibiert als Negativ-Regulator der Osteogenese vermutlich die kollagene Matrixablage.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 352 (1980), S. 621-621 
    ISSN: 1435-2451
    Keywords: Osseous birth injuries ; Geburtstraumatische Knochenverletzungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die geburtstraumatischen Knochenverletzungen des Neugeborenen sind als Grenzgebiet zwischen Gynäkologie, Pädiatrie und Orthopädie bis heute Stiefkind der Literatur geblieben. Wir haben das Patientengut der Orthopädischen Universitätsklinik Würzburg aus den Jahren 1949-1979 auf knöcherne Geburtsverletzungen nachgeprüft. An geburtstraumatischen Knochenverletzungen wurden erfaßt: 19 Claviculafrakturen, 16 Humerusfrakturen, 3 Femurfrakturen, 1 proximale Humerusepiphysenlösung, 4 proximale Femurepiphysenlösungen, 1 Radiusköpfchenluxation, 1 Rückenmarkabriß.
    Notes: Summary In order to elucidate the complexity of this problem we have reviewed the clinical records of the patients of the Orthopaedic Hospital of the University of Würzburg collected during the years between 1949 and 1979 with regard to the birth injuries of bones. Osseous birth injuries encountered consisted of the following: 19 fractures of the clavicle, 16 fractures of the humerus, 3 fractures of the femur, l proximal epiphyseolysis of the humerus, 4 proximal epiphyseolysis of the femur, 1 luxation of the radial head, 1 spinal cord transection.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0827
    Keywords: Key words: Heterotopic osteoblast-like cells — Colony formation — Differentiation — Alkaline phosphatase — Osteocalcin.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. In this study, a characterization of human bone-forming cells responsible for heterotopic ossification was carried out in vitro. The biological and biochemical cell characteristics of the heterotopic osteoblast-like (HOB) cells were compared with those of orthotopic osteoblast-like (OB) cells from normal bone and stromal bone marrow cells believed to contain a subpopulation of osteogenic precursor cells. We found that HOB's from the spongiosa of heterotopic ossification required less time until the beginning of migration and the achievement of confluence in vitro compared with OBs from femoral shaft spongiosa. The fraction of mitotically active cells assessed by a clonogenic assay was higher as well in HOB cells. The in vitro studies of mitogenesis and the efficiency of colony formation of osteogenic cells indicate that with increasing differentiation and relative age they become more dependent on growth factors in the medium, otherwise the morphology of osteoblast-like cells changes and they pass irreversibly into the postmitotic stage of the cell cycle. The activity of the alkaline phosphatase is distinctly higher in the HOB than in the OB cells, HOB cells exhibit a lower level of osteocalcin expression compared with OB cells. No significant difference was found between OB and HOB cells in the amount of procollagen of type I sequestered by the cells. After 30 days, HOB and OB cells formed a mineralized matrix on exposure to 2 mM β-glycerophosphate. Since HOBs were isolated from heterotopic bone that had developed within 3–6 months after hip surgery, the differences in cellular behavior compared with OBs may be attributed to the relatively young age of HOB cells.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 17 (1993), S. 2-6 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le procédé VDS de correction de Zielke comporte deux étapes: dérotation à l'aide d'un matériel spécial, puis compression de la convexité par voie antérieure. Les deux composantes ont été analysées par des mesures per- et post-opératoires afin d'évaluer comment la technique VDS fonctionne dans les trois plans. Dans les interventions dorsales et lombaires, après dérotation isolée, on constate pendant l'opération une lordose notable et l'amélioration de la courbure atteint déjà 50% du résultat définitif. La compression terminale de la convexité aboutit à une cyphose dans le rachis dorsal et à une lordose au niveau des courbures lombaires où des greffes intersomatiques sont utilisées.
    Notes: Summary The Zielke correction technique (VDS) has two parts, derotation and ventral convex-side compression. Both were studied by measurements made during and after the operation. Ventral derotation always creates lordosis. Lordosis can be maintained during compression by insertion of intervertebral bone blocks, or kyphosis created by omitting them.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 16 (1992), S. 140-145 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Nous avons évalué, dans un essai prospectif, randomisé, à double insu, l'action du Diclofénac sur les ossificacions hétérotopiques après arthroplastie de hanche, Le produit, ou un placebo, a été administré par voie orale à 158 patients, à la dose de 50 mg×3 pendant six semaines. Le Diclofénac a permis d'obtenir une importante amélioration par rapport au groupe de contrôle (p〈0.0001) sans entraîner d'effets secondaires notables. Les ossifications hétérotopiques ont diminué jusqu'à 15%, contre 55% dans le groupe placebo. Aucune ossification sévère n'a été observée chez les malades traités. La mobilité post-opératoire de la hanche a été considérablement augmentée. Nous recommandons l'usage prophylactique du Diclofénac vis-à-vis des ossifications hétérotopiques en raison du retentissement clinique défavorable de cette complication et de sa fréquence, comprise entre 15% et 80%.
    Notes: Summary In a double-blind prospective randomised study we examined the effects of Diclofenac on heterotopic ossification after hip arthroplasty. Either the drug, or a placebo, was given by mouth to 158 patients in doses of 3×50 mg for 6 weeks. Diclofenac resulted in highly significant improvement (p〈0.0001 versus controls) without severe side-effects. Heterotopic ossification decreased from 55% in the placebo to 15%. Significant degrees of heterotopic ossification did not occur with the drug. Movement of the hip was considerably increased after operation. We recommend Diclofenac prophylaxis against heterotopic ossification after hip operations in view of the serious clinical effects of this complication and its quoted incidence of 15% to 80%.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 15 (1991), S. 169-177 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le potentiel ostéogénique de l'os et de la matrice osseuse a été longtemps caractérisé uniquement par ses effets biologiques et les paramètres qui l'influencent. Récemment la capacité ostéo-inductrice de la matrice osseuse a été définie chimiquement par l'identification d'une protéine osseuse morphogènétique (POM) et des facteurs ostéogéniques de différents types ont été individualisés. L'état actuel de l'isolement, de la purification, et de la caractérisation de ces facteurs est résumé dans cette mise au point. On y rapporte les aspects généraux de l'isolement et de l'appréciation des préparations de POM ainsi que les résultats de l'application d'implants de POM, y compris en clinique.
    Notes: Summary The osteogenic potential of bone and bone matrix has been characterised only by its biological effects and the parameters influencing it. Recently, the osteoinductive ability of bone matrix had been defined chemically by the description of a bone morphogenetic protein (BMP), and the parameters of osteogenic factors from different species have now been recognised. The current state of isolation, purification and characterisation of these factors is summarised in this review. General aspects of the isolation and testing of BMP preparations, and the results of orthotopic application of BMP implants, including clinical cases, are reported.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 19 (1995), S. 263-264 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 74 (1972), S. 91-104 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über Behandlungsverfahren und Nachuntersuchungsergebnisse bei suprakondylären, bikondylären und diakondylären Oberschenkelbrüchen Erwachsener berichtet. Während die konservative Behandlung bei supra- und diakondylären Oberschenkelbrüchen gute Ergebnisse bringt, stellt der bikondyläre Oberschenkelbruch eine Domäne der Osteosynthese dar. Dabei sollte eine Übungsstabilität angestrebt werden. Wenn dem Verletzten ein größerer operativer Eingriff nicht zugemutet werden kann, bietet die Minimalosteosynthese mit percutan gekreuzten Bohrdrähten oder Spongiosaschraube in Verbindung mit der Extensionsbehandlung die besten Ergebnisse.
    Notes: Summary Management and follow-up results of supracondylar, bicondylar and dicondylar fractures of the femur are reported. Conservative treatment of supracondylar and dicondylar fractures can produce good results. Rigid internal fixation is the method of choice for treatment of bicondylar fractures. Patients with bicondylar fractures who cannot undergo maior surgery because of bad physical conditions should be treated by percutaneous internal fixation using Kirschner wires or cancellous screws combined with skeletal traction through the upper end of the tibia.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 84 (1976), S. 1-12 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Verhütung der postoperativen Verwachsungstendenz, besonders nach sehnenchirurgischen Maßnahmen, ist seit jeher Anliegen der Handchirurgie. Neben zahlreichen Modifikationen ausgefeilter handchirurgischer Techniken werden vereinzelt im Tierexperiment und der Klinik Versuche unternommen, auf hormonellem Wege Verwachsungen zu verhüten. Wegen der erforderlich hohen Dosierung des Cortisons wird es meist abgelehnt. Nach Erprobung einer eigenen Technik der postoperativen Ruhigstellung nach Beugesehnennaht im Tierversuch wird die Möglichkeit einer „hormonellen Tendolyse“ durch Cortison bei allerdings ungewöhnlich hoher Dosierung bestätigt. Mit Hilfe von Reißversuchen soll in einer weiteren Studie die obere Grenze des therapeutischen Bereichs bei der Cortisonmedikation gefunden werden.
    Notes: Summary To prevent tendons from postoperative proliferation and adhesion to surrounding structures is still a main problem in handsurgery. In addition to numerous modifications of atraumatic handsurgical techniques which have been developed some sporadic attempts are made by animal experiments and clinical trials in order to avoid postoperative adhesive tenosynovitis by hormone therapy. Because of the high doses of cortisone which are required this method of treatment is generally not accepted. Using a new method of postoperative fixation of flexor tendon sutures in rabbits the possibility of a “hormonal tenolysis” by extremely high doses of cortisone could be confirmed. In a following study it is planned to perform breaking experiments on tendons after hormone therapy in order to determine the upper limit of the therapeutical range of cortisone medication.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 86 (1976), S. 211-217 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über 2 Fälle von Femurgabelung berichtet, ein Krankheitsbild, von dem aus der Literatur bisher nur 11 weitere Fälle bekannt sind. Es wird die Ätiologie dieses Krankheitsbildes diskutiert.
    Notes: Summary Reduplication of femur has been reported previously in literature only in 11 cases. Two more cases are described and the etiology of this disease is discussed.
    Type of Medium: Electronic Resource
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