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H Arbes

Publications and source records attributed to H Arbes.

8 recordsLinked to original sources

Chronic osteomyelitis treated by cancellous homografts and fibrin adhesion.

Twenty-nine bone defects caused by chronic osteomyelitis have been treated by radical excision of necrotic bone followed by packing the cavities with cancellous homografts held in position by a fibrin sealant. At follow-up three years after operation all except one had healed, though one case had needed a repeat operation. Good incorporation and remodelling of the grafts was observed even when the osseous bed was severely sclerosed.

Adolescent↗

First clinical experience with heterologous cancellous bone grafting combined with the fibrin adhesive system (F.A.S.).

Heterologous bone grafts are mostly refused for bone transplantation because of the low osteogenic potency. The remodelling of the heterografts can be improved significantly by application of a fibrin-adhesive-system. Between 1977 and 1979 thirty-five bone defects caused by bone tumors resp. seven times by osteomyelitis were operated on and closed with cancellous Kiel-bone grafts (Braun, Melsungen) soaked thoroughly with fibrin-glue (Tissel/Tissucol TM, Immuno AG, Vienna). Postoperatively there were two infections, but none of them in our osteomyelitic cases. After an average follow-up period of 24.6 months (15-36), the highly satisfying, preliminary results were exactly analysed. Despite the relatively short postoperative time, in almost all cases the complete remodelling of the heterografts into new bone tissue could be observed. A formula to calculate the amount of fibrin-glue, necessary for the procedure, is given.

Adolescent↗

Experimental investigations of the effect of the fibrin adhesive on the Kiel heterologous bone graft.

The influence by a fibrin-adhesive on healing has been investigated in heterologous cancellous transplants in the rabbit ilum. After 8 and 12 weeks the radiologic and histologic results were evaluated. In the control group the fibrously surrounded transplants were resorbed and replaced by metaplastic bone only to a little degree. Applicating the fibrin-adhesive system (FKS) the transplants were osseously connected to the bone bearing. The trabeculae wre surrounded by newly built lamellar bone and resorbed during the following periods. The osteogenic potency of heterologous transplants resp. the efficiency of the bone bearing can be improved by application of the FKS.

Animals↗

[Is sonography justified within the framework of orthopaedics? (author's transl)].

The article discusses the possibilities of application and performance spectrum of the ultrasonic method when examining patients with space-occupying growths within the framework of orthopaedics. An analysis of 33 patients with inflammatory or neoplastic tumours showed that sonography promotes highly valuable information in respect of the presence and extension of a tumour of the soft tissues, besides supplying roughly outlined information on the structure of such tumours. Hence, sonography can supply valuable aid for the decision regarding further diagnostic measures, complementary to the basic x-ray examinations.

Adolescent↗

Methotrexate-citrovorum factor used alone and in combination chemotherapy for advanced hypernephromas.

Methotrexate-citrovorum factor (MTX-CF) therapy was administered to 20 patients with advanced renal cell carcinoma. Eight patients were treated with MTX-CF only. Two patients who received short-term rescue showed partial remissions along with severe toxicity including gastrointestinal symptoms and bone marrow depression. Twelve patients were treated with a combination of MTX-CF, vincristine, bleomycin, and an alkylating agent (either peptichemio or cyclophosphamide). In this latter group, patients with a glomerular filtration rate of greater than 70 ml/minute received 150-400 mg/m2/cycle of MTX. Patients with decreased renal function (less than 70 ml/minute) received 35-100 mg/m2/cycle of MTX. Two of seven patients with a decreased glomerular filtration rate showed partial remissions and four patients had static disease. One patient in the group of five with normal renal function showed static disease. None showed objective improvement. The median survival time was 25 months for patients with partial remission and static disease and 4.75 months for patients with progression. This difference is highly significant (P less than 0.0005). These results seem to justify further investigations of MTX-CF therapy in hypernephromas, even in the presence of impaired renal function.

Adenocarcinoma↗

[Clinical observations on the use of high-dose methotrexate treatment in osteogenic sarcoma (author's transl)].

Since January 1976 high-dose methotrexate (HDMTX) therapy has been used in the management of patients with osteogenic sarcoma at the Orthopaedic Department, University of Vienna. 7500 mg MTX/sqm body surface is administrated in a four-hour infusion with citrovorum factor rescue. This therapy is combined with dactinomycin, adriamycin, bleomycin, cyclophosphamide and vincristine in a multi-drug chemotherapeutic program as a prophylactic regimen after surgical treatment of the primary tumour, as well as in the management of metastases. So far, 12 patients have received a total of 46 infusions with HDMTX at montly intervals (6 patients already had widespread metastases). The use of several precautions such as adequate hydration 3 l/sqm body surface fluid), systematic alkalinization of the urine and regular control of the serum MTX level renders HDMTX therapy less hazardous. Five out of the 46 infusions were followed by mild toxic reactions consisting of mouth ulceration, fever and/or bone marrow depression. One out of the 6 patients with metastases and 5 out of the 6 patients receiving HDMTX as a prophylactic measure are without evidence of disease at present. In view of the short observation period, this report is limited to clinical observations only.

Adolescent↗

[Problems of hip arthrodesis (author's transl)].

A follow-up study of 84 hip arthrodesis is reported. Four methods of arthrodesis were applied: nailblock arthrodesis, double-nail, cross-plate and screw arthrodesis. Double-nail arthroplasty was abandoned in favour of total hip arthroplasty. Moreover application of the screw was given up on account of relatively bad results. Nail-block and cross-plate arthrodesis, when indicated, are still very valuable therapeutic methods, especially in the case of patients who are too young for a total hip arthroplasty and who are still actively working. The influence of an arthrodesized hip on the knee joint and lumbar spine are examined and discussed.

Adult↗

Tumor-specific immunity in sarcoma patients.

Stimulatory responses of 40 patients with bone [33] and soft tissue [7] sarcomas to autologous tumor cells were correlated with clinical data and prognosis. Although conclusive judgments for individual patients cannot be made, some genral features emerge: patients with stimulation indices greater than 1.5 have a 50 percent relapse-free interval after surgery of 22 months, patients with indices, below 1.5 have a 50 percent relapse-free interval of 5 months. 7 out of 10 responder patients are tumor-free 1 year after surgery as compared to 5 out of 19 (26 percent of non-responder pateints (p less than 0.05). Removal of the tumor is followed by an increase in the stimulatory response and by the dissappearance of blocking serum factors in patients with favourable prognosis. Responses return to baseline levels in tumor free patients 9-12 months after surgery. The results suggest that tumor-associated immune responses play a role in the development of human sarcomas. In addition, 47 lymphocyte samples of 25 patients were tested for stimulation by autologous tumor cells and for cell-mediated cytotoxicity against allogeneic sarcoma cell lines. Similar results were obtained in both test systems when pre-therapy lymphocytes were used. Discordant results were frequently seen at times after surgery. Both test systems may complement each other and may help clarify the tumor-specificity of certain lymphocytotoxic activities.

Adolescent↗