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A Hagel

Publications and source records attributed to A Hagel.

3 recordsLinked to original sources
PubMed1994

[Ischemic or non-ischemic central artery occlusion. An explanation for the development or lack of development of neovascularization].

In a retrospective study we analyzed 29 central retinal artery occlusions (CRAO) with reference to the findings of ophthalmodynamometry (ODM) and fluorescein angiograms (FLA). We tried to find explanations for the relatively low rate of neovascularization in CRAO and predictive constellations for CRAO that will develop neovascularization. In 5 eyes the pathologic findings were classed as ischemic ophthalmopathy because of carotid or ophthalmic artery stenosis: 2 of these 5 eyes showed iris neovascularization (rubeosis iridis), while the other 3 "only" showed a CRAO with no clinical signs of ischemic ophthalmopathy. Of the remaining 24 eyes with CRAO there were 2 eyes with rubeosis iridis, which could be attributed to the CRAO itself (8.3%). FLA revealed ischemic perfusion of the retina in these 2 cases. ODM revealed reperfusion of the central artery (CRA) in 17 of 25 eyes with CRAO (71%) within the first 2 weeks. In 2 blind eyes that were re-examined 3 and 5 months after CRAO no iris or retinal neovascularization was found despite persisting malperfusion of CRA. In these 2 cases the minimal retinal perfusion needed because of complete retinal necrosis was sufficient explanation for the nonevolution of neovascularization. If ischemia is the essential condition for neovascularization, we can propose two explanations for non-development of neovascularization after CRAO: either there is adequate recanalization (majority of cases) or the need for perfusion is minimal or zero. Only in cases of persisting malperfusion and partially surviving retinal tissue (function!) will neovascularization perhaps develop. ODM is an adequate method of estimating the perfusion of CRA.

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[Advantages of minimal invasive total hip replacement in the early phase of rehabilitation].

UNLABELLED: In arthroplasty the term "minimal invasive" not only refers to the length of the skin incision but more so to its soft tissue and thereby muscle-protecting features. STUDY AIM: The aim of this study is to compare the early postoperative mobilisation and rehabilitation of the different surgical approaches in cementless total hip arthroplasty. METHODS: 27 patients underwent a total hip replacement (Trilogy cup, MAYO stem) via a ventral minimal invasive approach (one incision technique) (MIS group). 23 patients underwent a total hip replacement with the same implant via a anterolateral transgluteal approach (standard group). We evaluated the Harris Hip Score (HHS), the visual analogue scale (VAS) for pain and patient satisfaction preoperatively as well as 3 days, 10 days, 6 weeks and 3 months postoperatively. RESULTS: After 3 and 10 days the MIS group showed better scores for pain, gait and mobilisation as well as for the overall HHS compared to the standard group. These differences could not be shown 6 weeks postoperatively. The MIS group had a significantly higher rate of complications with 22 % transient impairment of the lateral cutaneous nerve. CONCLUSION: The patients of the MIS group showed a better mobilisation and rehabilitation during the early postoperative period. This can be attributed to the lessened intraoperative damage of to soft tissue and especially muscle damage. Due to the increased rate of nerve irritations, we modified our surgical approach. The minimal invasive approach to modern hip joint arthroplasty remains a non-standard technique. Compared to the standard approach it carries additional risks (like nerve damage and malpositioning of the implants and thus should remain in the hands of the experienced orthopaedic surgeon in specialised orthopaedic centres.

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