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  • 1
    ISSN: 0009-2614
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0932
    Keywords: Key words Lumbar spine ; Metastases ; Corpectomy ; Vertebral body replacement ; Biomechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Metastatic spine lesions frequently require corpectomy in order to achieve decompression of the spinal cord and restoration of spinal stability. A variety of systems have been developed for vertebral body replacement. In patients with prolonged life expectancy due to an improvement of both systemic and local therapy, treatment results can be impaired by a loosening at the implant-bone interface or mechanical failure. Furthermore, early detection of a metastatic recurrence using sensitive imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) is possible in these patients without artefact interference. The aim of our pilot study was to evaluate the clinical applicability and results of a new radiolucent system for vertebral body replacement in the lumbar spine. The system consists of bone-integrating biocompatible materials – a polyetherurethane/bioglass composite (PU-C) replacement body and an integrated plate of carbon-fibre reinforced polyetheretherketone (CF-PEEK) – and provides high primary stability with anterior instrumentation alone. In a current prospective study, five patients with metastatic lesions of the lumbar spine were treated by corpectomy and reconstruction using this new system. Good primary stability was achieved in all cases. Follow-up (median ¶15 months) using CT and MRI revealed progressive osseous integration of the PU-C spacer in four patients surviving more than 6 months. Results obtained from imaging methods were confirmed following autopsy by biomechanical investigation of an explanted device. From these data, it can be concluded that implantation of the new radiolucent system provides sufficient long-term stability for the requirements of selected tumour patients with improved prognosis.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Halswirbelsäule ; Verletzung ; Spondylodese ; Instabilität ; Keywords Cervical spine ; Trauma ; Instability ; Preservation of motion segment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The anterior interbody fusion with instrumentation seems to be the standard procedure in unstable traumatic lesions of the lower cervical spine. The goal of this study was to objective the outcome of patients, treated by only temporary stabilisation of the injured motion segment (without bone – graft fusion). Between 1990 and 1998 155 patients with traumatic lesions of the cervical spine were treated operatively, in 22 cases transfixation of the injured level without bone – graft application was performed, an implant – removal was carried out in 12 patients so long. Only patients were included into the study, who were less then 45 years old at trauma and who had no trauma related osseous or disc encrouchment of the spinal canal. Not included were patients with degenerative formations of the cervical spine at time of trauma. Until follow up all patients with implantat removal returned back to work in their former profession, 11 of 12 patients classified their result as excellent or good. No secondary instabilities or postraumatic disc prolapse were observed. Restmobility in flexion/extension of the injured level was demonstrated in 8 patients. The preservation of traumatized motion segments may reduce the incidence of degenerative alterations and hypermobilities in adjacent levels. The transfixation technique in anterior procedures leads to a reduced time of spinal exposure, complications as a result of spinal graft manipulation, pseudarthrosis or donor graft site problems are no more relevant.
    Notes: Zusammenfassung Die ventrale interkorporelle Spondylodese und Instrumentation gilt als Standardverfahren in der Versorgung instabiler Verletzungen der HWS. Ziel der Untersuchung war die Erhebung der Behandlungsergebnisse bei temporärer Stabilisation verletzter Bewegungssegmente der HWS. In der Zeit von 1990–1998 wurden an der Universität Ulm wegen Verletzungen der Halswirbelsäule insgesamt 155 Patienten operativ versorgt. Bei 22 Patienten erfolgte eine überbrückende Instrumentation des Bewegungssegmentes ohne Fusion, eine Implantatentfernung konnte inzwischen bei 12 Patienten vorgenommen werden. Eingangskriterien waren eine Altersbegrenzung von unter 45 Jahren sowie ein Verletzungstyp mit fehlender frakturbedingter knöcherner Spinalkanaleinengung. Übersichtsradiographisch darstellbare degenerative Veränderungen zum Verletzungszeitpunkt stellten ein Ausschlusskriterium dar. Bei der Nachuntersuchung waren alle Patienten beruflich rehabilitiert, 11 von 12 Patienten waren mit dem Behandlungsergebnis sehr zufrieden oder zufrieden. Sekundäre Instabilitäten sowie posttraumatische Bandscheibenvorfälle waren in keinem Fall aufgetreten. Eine Restmobilität im verletzten Bewgungssegment konnte bei 8 Patienten nachgewiesen werden. Der Verzicht auf eine Fusion bei ventralem Vorgehen führt zur Verkürzung der Operationszeit, Komplikationsmöglichkeiten von Seiten der Spaninterposition und der Spanentnahme entfallen.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 103 (2000), S. 115-121 
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Aneurysmatische Knochenzyste ; Primäre Knochentumoren ; Chirurgische Therapie ; Lokalrezidiv ; Diagnostik ; Key words Aneurysmal bone cyst ; Primary bone Tumours ; Surgery ; Recurrence ; Imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The aneurysmal bone cyst represents a tumorlike lesion, which does not occur frequently. Every site of the skeleton may be involved. Although it can be observed at any age, it distinctly predominates from 10 to 20 years of age. Distinction of aneurysmatic bone cysts from certain benign or malignant bone tumours requires subtle imaging techniques and an experienced bone tumour pathologist. Since the lesion shows a heterogeneous biological behaviour and typically occurs in the growing skeleton, a wide range of surgical procedures must be provided concerning tumour resection and defect reconstruction. In the current retrospective study results of 41 surgically treated aneurysmal bone cysts, thereof 5 latent, 31 active, and 5 aggressive lesions, were investigated. While morbidity due to the therapeutic measures was comparatively low even in extended lesions and demanding reconstructions, a recurrence rate of 19.5% had to be observed in our series. Taking into consideration the biological activity of the lesion, analysis of the recurrences revealed inappropriate surgical margins had been chosen at the primary operation in all of these patients. Since the risk of a local relapse is linked both to aggressiveness of the primary lesion and to surgical radicality, therapy of aneurysmal bone cyst requires preoperative staging and stage-dependent surgical procedures.
    Notes: Zusammenfassung Die aneurysmatische Knochenzyste ist eine seltene tumorähnliche Erkrankung, die jeden Skelettabschnitt involvieren kann und sich überwiegend im Kindes- oder Jugendlichenalter manifestiert. Differentialdiagnostische Schwierigkeiten bei der Abgrenzung gegenüber bestimmten benignen und malignen primären Knochentumoren erfordern neben dem Einsatz differenzierter bildgebender Verfahren häufig die histopathologische Beurteilung durch ein Knochentumorregister. Bedingt durch eine sehr heterogene biologische Aktivität und den Umstand, daß die Erkrankung überwiegend das wachsende Skelett betrifft, muß bei der chirurgischen Therapie sowohl hinsichtlich der Resektion als auch der Defektrekonstruktion auf ein breites Spektrum an Behandlungsmaßnahmen zurückgegriffen werden können. In einer retrospektiven Studie wurden die Behandlungsergebnisse bei 41 operierten Tumoren, davon 31 aktive und jeweils 5 latente bzw. aggressive Läsionen, untersucht. Während die therapieassoziierte Morbidität auch bei ausgedehnteren Destruktionen sowie aufwendigeren Rekonstruktionen vergleichsweise gering war, lag die Rezidivrate bei 19,5%. Die Analyse der Lokalrezidive zeigte, daß– unter Berücksichtigung der biologischen Aktivität des Primärtumors – jeweils ein inadäquates Resektionsverfahren zu Grunde lag. Der Umstand, daß das Lokalrezidivrisiko sowohl mit der Aggressivität der Primärläsion als auch mit der chirurgischen Radikalität korreliert, macht ein präoperatives Staging und eine stadiengerechte Therapie erforderlich.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Cellular and molecular life sciences 53 (1997), S. 842-849 
    ISSN: 1420-9071
    Keywords: Key words. Trypsin; PAR-2 membrane receptor; desensitization; chloride current; G protein; Ca2+ fluorescence; Xenopus oocyte.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. The effects of the protease trypsin, externally applied to full-grown oocytes of Xenopus laevis, were studied using electrophysiology and fluorometry. The following results were obtained trypsin in concentrations of 0.1 μg/ml to 1 mg/ml liberated Ca2+ from internal stores and evoked large transient currents of up to 5 μA in bath solutions containing 1 mM or no Ca2+. The response desensitized for 50 minutes and recovered at longer times. Transient currents could also be elicited by tryptic impurities in commercially available collagenase used for defolliculation of oocytes. Application of chymotrypsin (0.01 or 1 mg/ml) or of thrombin (3.4 ng/ml or 0.34 mg/ml) neither evoked currents nor desensitized trypsin responses. Incubation with 1 μg/ml Pertussis toxin for 20 to 25 hours prevented the Ca2+ release from internal stores and the activation of transient currents by trypsin. We propose that endogenous receptors in the oolemma, specific for trypsin, are linked to internal Ca2+ stores via Pertussis toxin-sensitive G proteins. Thus, receptor activation by external trypsin raises internal Ca2+ and thereby opens Ca2+-activated Cl− channels in the oolemma.
    Type of Medium: Electronic Resource
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