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Biomedical subjects

G Bergmann

Publications and source records attributed to G Bergmann.

At least 37 records · Page 2Linked to original sources

A spinal fixation device for in vivo load measurement.

An instrumented spinal fixation device has been developed that allows in vivo measurement of the forces and moments acting on the implant. The telemetry is inductively powered, hermetically sealed by electron beam welding and is active only during the measurements. The instrumented fixateur interne is similar in size to the original Dick internal fixator implant and has the strength of the original implant. Laboratory tests with paired implants mounted in plastic vertebrae show that small changes in the position of the implants have a strong influence on the distribution of the loads on the implants.

Activities of Daily Living

[Telemetric transmission system for in vivo measurement of the stress load of an internal spinal fixator].

For stabilizing fractures of the spine, a number of implantable devices are available. However, not much is known about the loads acting on these devices. In order to measure the forces and moments within the implant, the Dick internal fixation device was modified and fitted out with a hermetically sealed inductively powered telemetry unit. An integrated 8-channel telemetry chip was specially developed to measure the signals of six strain gauge sensors, the temperature of the implant and the supply voltage. Since the internal fixation devices are always implanted in pairs, two telemetry units are operated at the same time. This article details the function of the implanted electronic circuit and the external system components.

Adult

[Effect of clamping tensile strength on load distribution in paired mounted spinal internal fixators].

Paired internal spinal fixation devices are not necessarily loaded symmetrically when the vertebrae are unable to support one another directly. A finite element model has been developed to predict the influence of clamping rigidity on the load distribution. If the stiffness of one clamping element is significantly reduced, the corresponding implant will bear only about 30 percent of the outer bending moment. The theoretical results were confirmed experimentally with sensor-loaded internal spinal fixation devices.

Biomechanical Phenomena

Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission.

Osteopenia is a typical finding in patients suffering from anorexia nervosa. Unfortunately, available longitudinal studies are limited by a relatively short follow-up period. Therefore cross-sectional long-term followup studies may help to determine both the outcome of this bone lesion and variables that influence its subsequent development. Of an initial 66 consecutive patients with anorexia nervosa, 51 (77.3%) could be further evaluated. After an average of 11.7 years following first admission, cross-sectional measurements of lumbar and proximal radial bone mineral density (BMD) were performed. The ability to predict BMD using variables obtained from anamnestic and clinical data was then determined by multiple-regression analysis. The BMD of both radial and lumbar bone in anorexic patients with poor disease outcome (as defined by the Morgan-Russell general outcome categories) deviated by -2.18 and -1.73 SD (Z score), respectively. In patients with a good disease outcome lumbar BMD was significantly less reduced compared with radial BMD (-0.26 versus -0.68 SD). Variables reflecting estrogen deficiency and nutritional status in the course of the disease, that is, relative estrogen exposure (for lumbar BMD) and years of anorexia nervosa (for radial BMD), allowed the best prediction of BMD. A marked reduction in cortical and trabecular BMD in anorexic patients with poor disease outcome suggests a higher risk of fractures in these patients. Furthermore, the finding of a persistently reduced cortical and a slightly reduced trabecular BMD, even in patients with good disease outcome, suggests that a recovery of trabecular BMD might be possible, at least in part. Recovery of cortical bone, if possible at all, seems to proceed more slowly.

Absorptiometry, Photon

Hip joint loading during walking and running, measured in two patients.

The resultant hip joint force, its orientation and the moments were measured in two patients during walking and running using telemetering total hip prostheses. One patient underwent bilateral joint replacement and a second patient, additionally suffering from a neuropathic disease and atactic gait patterns, received one instrumented hip implant. The joint loading was observed over the first 30 and 18 months, respectively, following implantation. In the first patient the median peak forces increased with the walking speed from about 280% of the patient's body weight (BW) at 1 km h-1 to approximately 480% BW at 5 km h-1. Jogging and very fast walking both raised the forces to about 550% BW; stumbling on one occasion caused magnitudes of 720% BW. In the second patient median forces at 3 km h-1 were about 410% BW and a force of 870% BW was observed during stumbling. During all types of activities, the direction of the peak force in the frontal plane changed only slightly when the force magnitude was high. Perpendicular to the long femoral axis, the peak force acted predominantly from medial to lateral. The component from ventral to dorsal increased at higher force magnitudes. In one hip in the first patient and in the second patient the direction of large forces approximated the average anteversion of the natural femur. The torsional moments around the stem of the implant were 40.3 N m in the first patient and 24 N m in the second.

Aged

[Stress measurements with an instrumented internal spinal fixator].

Little is known about the loads acting on internal spinal fixation devices. The effective forces and moments associated with different external loads have now been measured using instrumented implants. Measurements were obtained in intact cadaver spines and following vertebrectomy. The influence of the implant itself on the distribution of the loads was also investigated. It was found that the implants are not loaded symmetrically. Following vertebrectomy, the forces acting on the fixation device are significantly higher than in the case of an intact spine.

Biomechanical Phenomena

[Theory and model in psychosomatic medicine--a historical sketch].

Starting with "personal medicine" as it was formed by Ludolf von Krehl in the frame of a medical clinic at a university, psychosomatic medicine, in its narrow sense, is described in its historical development. Differences to the conception of behavioral medicine are noted. Some theoretical models following the conversion model of Freud like stress concept, life-event or coping are historically explained. Actual research such as change of paradigm towards a systemic approach describes the actual situation, the conception of the "Gestaltkreis" completes this. Practice of today's psychosomatic medicine can be outlined by the concepts of simultaneous diagnostic and simultaneous therapy.

Germany

Four-channel telemetry system for in vivo measurement of hip joint forces.

The long-term loosening of artificial hip joints remains a serious clinical problem. Optimization of implant design and material will improve the fixation, but it requires a detailed knowledge of the forces which act on the implant. A four-channel telemetric transmitter was developed and arranged completely inside a hermetically closed artificial hip joint. This permits long term in vivo measurements of the three-dimensional forces without endangering the patient. The external telemetry system consists of an inductive power supply, an RF receiver, a microcomputer with hardware extension and a VHS video system. The personal computer offers real-time data processing of three orthogonal force components as well as slow motion analysis of recorded measurements. After several years of animal tests, two instrumented prostheses were implanted in the first patient (male) in May and August of 1988. In March 1990 a third prosthesis was implanted in a second patient (female). Joint force measurements have regularly been performed from the first post-operative day until now for several kinds of activity.

Biomechanical Phenomena