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Biomedical subjects

F Maurer

Publications and source records attributed to F Maurer.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Cystic bone changes. Etiology, diagnosis, therapeutic principles and personal results of treatment].

Various bone disorders become manifest as cystic lesions. The differential diagnosis must include benign and malignant tumors and also non-tumorous lesions, such as osteomyelitis. The most important and most frequent types of genuine bone cyst are juvenile bone cyst and aneurysmal bone cyst. When juvenile bone cysts occur in adults they are called solitary bone cysts. Despite intensive research the pathogenesis of bone cysts is still unknown to this day, so that successful causal therapy is impossible. The main problem in the treatment of bone cysts is their high rate of recurrence, rates ranging between 20% and 50% having been cited in the international literature. A critical review of the literature reveals few publications with helpful follow-up results. Most of the publications are case reports, and they frequently merely describe various forms of treatment. More recent reports are mainly concerned with such methods as curettage, steroid injections, and continuous decompression with perforated screws. Until the early 1980s, segmental bone resection was the treatment of choice. Because of its high complication rate it has since been abandoned. In the last analysis, the only well-established method for which long-term results obtained in studies of any size have been published, is curettage of the cyst and grafting with cancellous bone from the iliac crest. In our series, 41 patients were treated with this method, and we recorded a recurrence rate of 17.1%. Complications were rare. The risk of recurrence depended on the age of the patient. A higher recurrence rate must be expected in children under the age of 10 years. For this reason, operative treatment should not be performed until after that age if possible. Newer methods, such as steorid injections and continuous decompression by means of perforated screws, had better results in some studies, but only according to a few authors. Further research is needed to show whether our method will yield good results in the long term when applied in larger patient collectives.

Adolescent↗
PubMed1996

Multifocal extra-abdominal desmoid tumor--diagnostic and therapeutic problems.

The case of an 18-year-old girl is described who 1 year after surgical stabilisation of a spine injury developed a multifocal desmoid tumor in the scar region and another at a distance away from the scar in the area of the left scapula. After nononcological resection of both tumors subsequent diagnosis with magnetic resonance imagins (MRI) showed a questionable recurrence only in the scar; positron emission tomography failed to elucidate the local situation. Because a radical re-resection would mean mutilation, and local radiation may damage the spinal cord, a 'wait-and-see' strategy was chosen for further follow-up.

Adolescent↗
PubMed1996

Materiel management and internal audit: a team approach.

Materiel management and internal audit share common objectives--the promotion of organization efficiency, the prevention of fraud and abuse, and an interest in the creation of and adherence to policies and procedures. By working together, these two departments can help each other meet their objectives and, in the process, better serve their institution.

Contract Services↗
PubMed1996

[Pelvic fractures: epidemiology, therapy and long-term outcome. Overview of the multicenter study of the Pelvis Study Group].

Pelvic fractures are rare injuries (3-8%) when compared to fractures in other body regions. They are accompanied by high mortality (5-20%), and the survivors suffer from severe pain and pelvic-related handicaps. The German Pelvic Group (German Chapter of the AO-International & German Trauma Society) started a prospective multicenter study, including ten major trauma centers for collecting a high number of data in a short period of time (1991-1993). All pelvic injuries were documented consecutively using a special set of evaluation sheets. The study closed with 1,722 patients. A 2-year follow-up was completed for 486 patients injured in 1991 and 1992 after type B and C injuries, complex pelvic trauma, acetabulum fractures and a random 25% of A-type injuries (overall follow-up rate 73%). The follow-up included special "out-come" criteria. Of the pelvic ring injuries without significant peripelvic soft tissue involvement, 63.6% were A-type fractures, 21.0% B-type injuries and 15.5% C-type injuries. The rate of operative stabilization was 3.9% after A-type injuries, 37.3% after B-type injuries and 54.3% after C-type injuries. In isolated acetabular fractures ORIF was performed in 38.6%. The total lethality was 7.9% with a significant difference between "complex" pelvic trauma (21.3%) and patients without concomitant peripelvic injuries (7.2%). In 0.9% the pelvic injury was reported as the main cause of death. Pain at follow-up was observed in every classification group, the rate of completely "pain-free" patients being 55% after A-type, 41% after B-type and 27% after C-type fractures. Malfunction of micturia was reported by 7.6% of all patients, sexual malfunction by 11.6% of the males ("erectile dysfunction") and 2.2% of the female ("dysparneuria"). Scaled by the recently developed "outcome score", the radiological result showed anatomical healing after 90.8% of the B-type and 74.6% of the C-type injuries. On the other hand, the clinical result was rated as good or excellent in only 70% of the B-type and 54% of the C-type injuries. Although progress in indications and treatment techniques has shown improved radiological results after unstable pelvic ring injuries when compared to earlier studies, the clinical result still remains unsatisfactory. Further analyses and studies must be conducted to identify the prognostic factors for the late sequelae. Whether it is possible influence these factors by additional surgical intervention cannot be answered at present.

Acetabulum↗
PubMed1995

[Pathologic fractures: diagnostic and therapeutic considerations and results of treatment].

Compared with bone fractures caused by trauma, pathologic fractures due to diseased bone are rare events. A pathologic fracture is one that occurs without adequate trauma and is caused by a benign or malignant bone lesion. Diagnosis of the basic disease is important for the subsequent therapy. In cases of benign bone lesions the aim of treatment is total osseus healing with complete restoration of function. In malignant pathologic fractures surgery is an essential part of the overall oncologic treatment design. In most cases it is combined with adjuvant therapy. Various surgical procedures are available for fractures at different sites and depending on whether the operation is performed with curative or palliative intent. In cases of progressive neoplastic disease stabilization is necessary to attenuate pain and to maintain mobility. Between 1983 and 1993 we treated 131 patients with 143 pathologic fractures. Conservative therapy was possible in 10 cases, while 133 fractures had to be treated surgically. Most fractures were caused by skeletal metastasis (61), solitary bone cysts (19), osteoporosis (17) and plasmocytoma (16). The most frequent localizations of pathologic fractures were humerus and femur. The favoured methods of surgical stabilization were endoprosthesis and reinforced osteosynthesis. Most fractures appeared in adolescent patients up to the age of 19 and in adults between the 5th and the 7th decade, and 57.3% of the fractures were caused by a primary or secondary malignant tumour lesion. Surgical treatment was performed in all but 1 case of malignant pathologic fractures. Of 74 patients, with malignant bone lesions 6 (8.1%), are still alive. For 68 patients who died after stabilization, the average survival time was 11.6 months; individual survival time depended on the kind of the tumour present. In 55 patients with fractures in the area of benign bone lesions complete healing was achieved, in 9 cases with conservative therapy. The rate of recurrence for solitary bone cysts treated by curettage or segment resection was 23.5%. Compared with the recurrence rates published by other authors this is a very good result.

Adolescent↗
PubMed1995

[Primary total endoprosthetic hip joint replacement in acetabulum fractures].

Conservative treatment of acetabular fractures mean a long period with immobilisation followed by quite a few of complications that are life-threatening to old patients. Besides that these fractures often cause painful posttraumatic osteoarthritis of the hip joint. Open reduction and osteosynthesis is favored more and more, but the complications described cannot be avoided absolutely by surgical treatment. The sequelae are risky reoperations and the necessity for implantation of total joint prosthesis. As shown in the enclosed case reports, total hip replacement can be emphasized as first step and as definitive surgery. Implantation of an artificial joint allows postoperative remobilisation with full weight bearing and long lasting immobilisation can be avoided. Therefore this kind of therapy is justified for treatment of old and polymorbid patients as an out of rule therapy.

Acetabulum↗
PubMed1995

The sternocleidomastoid flap for treatment of a septic sternum defect.

After sternotomy for prosthetic repair of the ascending aorta and replacement of the aortic valve with a bioprosthesis in a 70-year-old woman local wound infection developed. Preliminary conservative treatment did not succeed. Because of the high risk for the patient due to local infection and partial exposure of the aortic prosthesis there was an indication for local flap surgery. Both healing of the infection and covering the prosthesis was achieved using a sternocleidomastoideus muscle flap.

Aged↗
PubMed1995

[Surgical therapy of Achilles tendon rupture].

From 1980 to 1991, 314 patients with acute rupture of the Achilles tendon were treated operatively in the "Berufsgenossenschaftliche Unfallklinik Tübingen" with suture of the tendon combined with a triceps surae tendon tip-over graft and subsequent cast immobilization for 6 weeks. Analysis of these cases revealed a significant reduction of severe soft tissue complications (3.2%), which were all controllable and a very low rerupture rate (0.3%) compared with the results obtained in the relevant literature. In 223 of these patients postoperative assessment according to the scale of Holz was carried out an average of 8.1 years after injury. The results were assessed as good in 87.4%, satisfactory in 11.2% and poor in 1.4%. Compared with conservative treatment with immobilization these results are significantly better than reported in the literature. The number of patients with Achilles tendon rupture who have received conservative functional treatment with a newly developed boot is still so small that reliable statistical statements are not yet possible. Therefore, operative therapy with an established procedure should still be regarded as the method of choice for treatment of Achilles tendon rupture; the tip-over graft is a valuable complement to the tendon suture.

Achilles Tendon↗
PubMed1994

[The monitor findings of digitalized conventional wrist x-rays].

The study aimed at proving the reliability of monitor systems with the matrix of 1024 x 768 for the detection of scaphoid fractures compared to conventional X-ray. Moreover, we were interested in the significance of procedures of digital imaging post processing, depending in particular on the experience of investigators. 5 investigators with different levels of experience analysed 57 X-rays of the wrist. They compared conventional X-rays with images on a high screen monitor system after the digitalisation of these X-rays by a CCD-scanner and analysed untreated and treated images. A 5-point scale ROC analysis was used for evaluation. The analysis covered a total of 1740 evaluations. The untreated images seen on the monitor system proved slightly better than conventional X-rays. Post-processing has no evident advantage over untreated images. Differing levels of experience had no effect whatsoever on the identification of findings.

Carpal Bones↗
PubMed1994

[Preserving the length of amputation stumps by microvascular flap transfer of the lower extremity].

With different case reports we want to show the role of microvascular tissue transfer in preservation of lower extremity amputation length. To salvage amputation stumps after traumatic amputation, as well as in case of chronic soft tissue problems after amputation, the radialis forearm flap is preferred for smaller defects, for example after transmetatarsal amputation, whereas with the latissimus dorsi muscle flap bigger areas can be reconstructed. But also the tensor fascia latae flap and the scapular flap can be used for soft tissue reconstruction. With microvascular soft tissue transfer amputation stump length can be preserved in order to have a better functional outcome, especially for prosthetic rehabilitation.

Adolescent↗
PubMed1993

[Acute cholecystitis in a traumatologic patient sample].

Among the patients of the Accident Hospital of the Co-operative Trade Association Tübingen, there were 11 cases of acute cholecystitis between 1985 and 1991. Acute cholecystitis occurred after polytrauma (n = 5), multiple fractures (n = 2), head injury (n = 1), fracture of femoral neck (n = 1) or elective hip surgery (arthrodesis, total hip replacement) (n = 2). The mean age was 57 (16-89) years, acute cholecystitis was confirmed 27 (6-54) days after trauma of surgery. 7 cases presented as acute acalculous cholecystitis, whereas in 4 cases of acute cholecystitis cholecystolithiasis was present. 9 patients were treated via cholecystectomy; one juvenile paraplegic recovered after conservative treatment, one 82-year old female was in too bad condition for surgery so that percutaneous cholecystostomy had to be performed prior to cholecystectomy. 10 patients recovered without complication, one 89-year old multi-morbid male died after cholecystectomy. Analysis of the clinical course prior to the occurrence of acute cholecystitis showed a high incidence of shock, frequent blood transfusion, long-time respiratory therapy and parenteral nutrition as well severe trauma, and high cumulation of opiate therapy in this group of patients. Diagnosis was confirmed by ultrasound in all patients, clinical symptoms and laboratory data being mostly unspecific.

Adolescent↗
PubMed1993

[Pelvic trauma--a diagnostic and therapeutic challenge].

Patients with pelvic trauma often have other multiple injuries that cause special problems. Therefore a quick and thorough diagnosis as well as therapeutic management according to the special situation and findings is necessary. Effective cooperation of all the different specialists concerned with the treatment of the patient is mandatory. Massive blood loss immediately after trauma is life-threatening to the patient. To cope with bleeding, all non-invasive measures available should be used. Stable injuries of the pelvis are treated conservatively. In cases of instability external fixation of the pelvis is usually performed first. Change over to internal stabilisation and osteosynthesis should be tried as soon as possible. The different procedures for treatment are associated with specific risks and complications.

Adult↗
PubMed1991

Molecular cloning and identification of a serine/threonine protein kinase of the second-messenger subfamily.

A partial cDNA was isolated that encoded a protein kinase, termed rac (related to the A and C kinases). This cDNA was subsequently used to screen libraries derived from the human cell lines MCF-7 and WI38 and led to the isolation of full-length cDNA clones. DNA sequence analysis identified an open reading frame of 1440 base pairs encoding a protein of 480 amino acids (Mr, 55,716). This result was supported by the synthesis of a Mr 58,000 protein in an in vitro translation system that used RNA transcribed from cloned cDNAs with SP6 RNA polymerase. The predicted protein contains consensus sequences characteristic of a protein kinase catalytic domain and shows 73% and 68% similarity to protein kinase C and the cAMP-dependent protein kinase, respectively. Northern (RNA) analysis revealed a single mRNA transcript of 3.2 kilobases that varied up to 300-fold between different cell lines. Specific antisera directed towards the carboxyl terminal of the rac protein kinase were prepared and used to identify that phosphorylated several substrates in immunoprecipitates prepared with the rac-specific antisera.

Amino Acid Sequence↗
PubMed1991

Structure and transcriptional regulation of protein phosphatase 2A catalytic subunit genes.

The alpha and beta isoforms of the human protein phosphatase 2A catalytic subunit are encoded by distinct genes whose expression appears to be differentially regulated. To obtain a better understanding of the mechanism(s) that regulate(s) the expression of these two transcripts, we have cloned the genes encoding both isoforms. Both genes (each approximately 30 kbp) are composed of seven exons and six introns which intervene at identical locations, suggesting that they were derived from a common ancestral gene. However, the 5' upstream regions as well as the regions encoding the 5' and 3' untranslated sequences of each mRNA are different. The promoters of both genes are very G+C rich and lack the TATA and CCAAT sequences typical of many housekeeping genes. The C alpha gene contains several potential Sp1 binding sites and a potential cAMP-responsive element. Northern analysis using RNAs isolated from several different human cell lines showed that the steady-state C alpha mRNA was, in general, more abundant than the C beta mRNA. To determine whether the promoters regulate the differential C alpha and C beta RNA expression, they were fused to the reporter gene chloramphenicol acetyltransferase and transiently expressed in HeLa cells. Expression from the C alpha promoter was 7-10 times stronger than that from the C beta promoter, which paralleled the endogenous C alpha and C beta mRNA levels in HeLa cells. These data suggest that the steady-state levels of the C alpha and C beta mRNAs, are due, at least in part, to different promoter activities.

Amino Acid Sequence↗
PubMed1990

alpha- and beta-forms of the 65-kDa subunit of protein phosphatase 2A have a similar 39 amino acid repeating structure.

Protein phosphatase 2A (polycation-stimulated protein phosphatase L) was purified from porcine kidney and skeletal muscle. The 36-kDa catalytic and the 65-kDa putative regulatory (hereafter termed PR65) subunits of protein phosphatase 2A2 were separated by reverse-phase HPLC. Partial amino acid sequence data (300 residues) was obtained for PR65. Molecular cloning showed that two distinct mRNAs (termed alpha and beta) encoded the PR65 subunit. The cDNA encoding the alpha-isotype spanned 2.2 kilobases (kb) and contained an open reading frame of 1767 bases predicting a protein of 65 kDa, which was in good agreement with the size of the purified protein. The cDNAs encoding the beta-isotype contained an open reading frame of size similar to that of alpha-form but lacked an initiator ATG. Northern analysis, using RNA isolated from several human cell lines, indicated that the alpha-isotype was encoded by a mRNA of 2.4 kb that was much more abundant than the beta mRNA of 4.0 kb. Comparison of the predicted amino acid sequences of the two isotypes revealed 87% identity. The deduced protein sequences of the alpha- and beta-isotypes were found to be made up of 15 imperfect repeating units consisting of 39 amino acids. This repeating structure was conserved between species.

Amino Acid Sequence↗