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Biomedical subjects

G Lob

Publications and source records attributed to G Lob.

At least 19 recordsLinked to original sources
PubMed1992

Injuries in paragliding.

In a retrospective study, 376 paragliding accidents have been analysed. Leg injuries were most common, but a large number of spinal injuries also occurred. The causes were either misjudgement by the pilot or the influence of weather and terrain. Improvements in the instructor's knowledge and the pilot's training could have prevented most of the accidents. Analysis of the mechanisms of the crashes and the pattern of trauma help to produce an efficient approach to diagnosis and treatment.

Accidents, Aviation↗
PubMed1992

[Experiences with the isoelastic prosthesis in treatment of humerus metastases].

39 patients with pathological fractures of the humerus were treated by isoelastic polyacetal endoprosthesis. Ten patients received a humeral-head-prosthesis and 32 a prosthesis of the humeral-shaft. The average survival time was nine months. Three times within the first group of twelve patients fracture of the cone of the prosthesis occurred. Therefore an additional stabilization of the contact zone between bone and prosthesis by plate-osteosynthesis was performed in the following 20 operations, preventing breakage of the material. In contrast to the conventional posterior approach to the humeral-shaft we chose a ventrolateral approach between the biceps and triceps muscle. This technique is less traumatic and leads to a shorter operation time. In patients with pathological humeral fractures a conception of treatment is demonstrated which provides an immediate stability by using endoprostheses to preserve the quality of life of oncological patients.

Bone Neoplasms↗
PubMed1992

Anterior transpedicular instrumentation of the lumbar spine: an anatomical study.

Lumbar burst fractures or massive tumorous destruction of the lumbar spine generally require a combined anterior-posterior surgical approach for adequate decompression and stabilization. Anatomical studies in 10 adult cadavers with 100 pedicle screw placements from a single strictly anterior approach showed that this new method represents a safe and promising way for stable lumbar spine instrumentation, avoiding the risks of a bilateral approach. The technique provides a stability comparable with bilateral instrumentation. Exact knowledge of the geometry of the corresponding vertebral bodies and the spinal canal by computed tomography scanning is a prerequisite for this surgical technique. First clinical applications using this technique reconfirm the experiences of the anatomical study.

Adult↗
PubMed1991

[Extension-distraction injury of the lumbar spine in Bechterew's disease].

Back-pain following trauma of the vertebral column in patients suffering from Bechterew's disease should be examined carefully. Instable spine fractures in those patients are recommended to be treated surgically to avoid the specific risks of long-time immobilisation. Further on surgical therapy eventually allows an intraoperative correction of the kyphosis angle. Due to the particular pathological alterations of the spine in Bechterew's disease a long-distance intervertebral fusion will usually be necessary. Therefore, internal stabilisation is proposed as therapy of choice.

Adult↗
PubMed1991

Compartment syndrome of the foot after intraarticular calcaneal fracture.

Seventeen patients with a total of 21 intraarticular calcaneal fractures were examined at up to 30 days after trauma for the development of tissue pressure in the central plantar muscle compartment. Twelve patients had a significant increase in tissue pressure with values greater than 30 mmHg because of primary fracture hematoma or interstitial fluid accumulation. This increase in pressure persisted for three to five days after trauma, so that ischemic damage to the short plantar foot muscles had to be suspected. Plantar muscle scarring and claw-toe formation were observed in seven patients with a total of 11 fractures during a mean observation period of 18 months. The plantar aponeurosis, which forms the constricting fascial envelope of the plantar muscles, is the anatomic structure responsible for the compartment syndrome that may develop after calcaneal fracture. Therefore, to avoid functional deficit, plantar compartmental pressures should be regularly measured after calcaneal fracture. Significantly increased plantar tissue pressure greater than 30 mmHg should be relieved by longitudinal incision of the plantar aponeurosis, preferably by a plantar incision as soon as the diagnosis is made.

Adolescent↗
PubMed1990

[Hanggliding--the Icarus syndrome].

Parasailing is a new sport resulting in an increasing number of severe injuries. The analysis of 152 accidents reveals typical trauma mechanisms for the different flight positions. 87 patients (57%) had their crash during the landing approach. 68 pilots (45%) were affected during their primary training course. Spine lesions were found in 30 patients. Lower limb injuries occurred in 44 cases. Detailed trauma evaluation can give a clue for systematic prophylaxis.

Accidents, Aviation↗
PubMed1990

[Tendon rupture in chronic kidney insufficiency--"uremic tendonopathy"? A literature-supported documentation of 3 cases].

This is a report on three cases with spontaneous ruptures of major tendons of the lower extremities. In two cases ruptures occurred in the quadriceps tendon, one of them bilaterally, and in one case in the Achilles' tendon. All patients suffered from chronic renal failure and were treated by long-term hemodialysis. Coincidentally secondary hyperparathyroidism was noticed twice. The pathophysiological relation between chronic renal failure and spontaneous tendon rupture is still unknown. An "uremic tendopathy" is discussed.

Achilles Tendon↗
PubMed1987

[Causes and pathophysiology of infection of the knee joint].

The origin of an infection of the knee joint can be of an endogenous/hematogenous nature or, in posttraumatic cases, of an exogenous nature. Hematogenous infections are found mostly in children, but also in patients with reduced immune functions, e.g. after organ transplantations. Posttraumatic joint infections are caused by open injuries, intraarticular injections, operations, or they can be transmitted from the surroundings. They are relatively rare after accident surgery and orthopedic surgery. Two statements are of special importance for pathophysiology: 1. An intraarticular infection will lead to lesions of the hyaline cartilage within a period of 24 to 48 hours. 2. The substrate exchange is reduced by the reflex immobilization which will result in a additional damage to the cartilage.

Arthritis, Infectious↗
PubMed1986

[Collection of autologous bone transplants].

For the collection of autologous cancellous bone transplants normally the anterior and posterior parts of the Os ilium are used. With proper techniques the conture of the pelvis and the muscle insertions can be conserved. All other collection places should only be used in unexpected situations and need of only small amounts of transplant. Serious complications are fractures and nervous lesions, which can be avoided by a careful procedure.

Bone Transplantation↗
PubMed1986

[Transplantation of bones in traumatic and posttraumatic septic conditions].

The treatment of acute and chronic osteitis should be standardized, using the following steps: débridement/sequestrectomy; stabilization; eradication of local infection; revascularization; filling-up defects--bone transplantation. The transplantation of bone is only successful if the defect area is prepared following steps 1-4 mentioned above. If possible, only autologous bone should be transplanted into an infected bone area. For the take of the transplanted bone, good vascularization of the infected area is of great importance. To obtain the best function possible, the Kinesitherapy should be carefully supervised by the surgeon.

Bone Transplantation↗
PubMed1985

[Therapeutic principles, organizational and technical implementation].

A minimum of organised measures is mandatory in every clinic, where posttraumatic or postoperative bone infection may occur. Technical principles in the treatment of osteomyelitis are: debridement, stability, local anti-infection procedures such as irrigation drainage, PMMA-chains or Taurolin gel, filling of the osseous defect and adequate vascularity (muscle flap, muscle transplant with microvascular anastomosis).

Asepsis↗
PubMed1979

Osteosarcoma: histological evaluation and grading.

With 60 cases of osteosarcomas a histological evaluation from + to +++ carried out for mitoses, osteoid formation, presence of multinucleated giant cells, and tumor necrosis. A subclassification in osteoblastic, chondroblastic, and fibroblastic type of osteosarcoma (according to Dahlin) and a histological grading from + to +++ based on degree of cellular atypism was also done. In our material no relations between these three types of osteosarcoma and chance for survival became evident. There was, however, a significant correlation between grade of atypism and rate of mitoses. Grading of oestosarcomas from + to +++ showed that cases with grade III osteosarcoma remained only seldomly without metastases during the course of the disease. Grade I osteosarcomas and also grade II tumors showed a higher number of patients with 2-year survival. However, neither correlation between tumor grade and incidence of metastases, nor with chances for survival were statistically significant. Nevertheless, characterization of osteosarcomas, by a histological grading from + to +++ based on cellular atypism and mitotic count is advisable, in addition to the TNM stages. This histological grading appeared to be more practicable than subclassifications of osteosarcoma by type which had been tested by us in a previous study (Konrad et al., in press).

Humans↗
PubMed1979

Microcirculation and blood volume in rats before and after spinal cord injury.

Blood flow, cardiac output, blood pressure, indicator mixing time and blood volume were measured in rats before and after spinal cord injury. After cutting off the spinal cord blood flow decreases markedly in the paraplegic area but also in the main organs of the animals. Only the blood supply of the lung increases by this manipulation. As blood volume and the blood pressure is decreased and the indicator mixing time delayed the situation of the spinal cord injury can be compared with the situation after acute blood loss. Therefore it is proposed to include circulatory disturbances into the conception of the acute spinal shock situation.

Animals↗