Biomedical subjects

H Böhm

Publications and source records attributed to H Böhm.

At least 19 recordsLinked to original sources

PubMed2006

[Direct osteosynthesis of instable Gehweiler Type III atlas fractures. Presentation of a dorsoventral osteosynthesis of instable atlas fractures while maintaining function].

This retrospective study evaluates eight patients with unstable fractures of the atlas vertebra, treated operatively in the Central Clinic Bad Berka between January 1995 and December 2001. In all cases, we were confronted with unstable and dislocated type III fractures according to Gehweiler, caused by an injured transverse ligament. Mean age was 34 years (range 20-49) in two women and six men. We introduce a new technique of direct reconstruction of the atlas vertebra. This technique leads to a stable ring construct that allows compression osteosynthesis of the fracture. Spinal fusion can be avoided, as can postoperative immobilization, since sufficient stability for functional postoperative treatment is achievable. The follow-up control 38 months (range 6-75) after surgery showed solid bony fusion in all cases, in one case after revision surgery. All patients showed good functional results, there was no need for analgesics and all patients could be reintegrated into their former occupation.

Bone Screws↗

PubMed2006

[Does timing of thoracic spine stabilization influence perioperative lung function after trauma?].

BACKGROUND: Proper timing of stabilization for spine injuries is discussed controversially. Whereas early repair of long bone fractures is known to reduce complications. PATIENTS AND METHODS: We investigated retrospectively 48 patients who were stabilized in a ventrodorsal approach for fractures of the thoracic spine. Patients were divided into three groups. All patients in groups I and II presented radiological or clinical signs of lung contusion. Patients were stabilized in the prone position via single-step dorsal stabilization with internal transpedicular fixation and ventral fusion with titanium cage or autologous bone graft using a minimally invasive video-assisted thoracotomy. RESULTS: The average duration of the procedures in group I was 213+/-40 min, in group II 250+/-75 min, and in group III 255+/-65 min (p: n.s.). Intraoperative blood loss did not differ significantly between the three groups. The PaO(2)/FiO(2) ratio improved in groups I and III, whereas in group II an significant impairment of lung function occurred perioperatively. Postoperative ICU stay was comparable in groups I and II (I: 10+/-5 days; II: 9+/-7 days); overall ICU stay tended to be shorter in group I versus II. The postoperative dependence on ventilator support did not differ significantly among the three groups. The mortality rate was 0% in this series. CONCLUSION: Our data provide further evidence that early stabilization of combined thoracic and thoracic spine injuries is safe, does not alter perioperative lung function, and results in a reduced overall ICU stay.

Adolescent↗

PubMed2006

[Recommendations for the management of ankylosing spodylitis after ASAS/EULAR. Evaluation in the German language area].

AIM: Our aim was to adapt and implement the evidence based recommendations for the management of ankylosing spodylitis (AS) of the "Assessments in AS" (ASAS) International Working Group together with the European League Against Rheumatism (EULAR) within the framework of a competence network (CN) in rheumatology in the German language area. METHODS: The ASAS/EULAR project calculated the effective size (ES), rate ratio, number of patients requiring treatment (number needed to treat, NNT) and the incremental cost-effectiveness ratio (ICER). The strength of the recommendations was determined through the evidence level found in the literature, the risk-benefit trade-off and the clinical experience of the experts. The recommendations were recently published in English. All of the centers taking part in the study area Spondyloarthritis (SpA) CN, as well as an additional 35 experts, were sent the English manuscript. All 35 participants were asked to evaluate the ten main management recommendations on a scale from 0 to 10. RESULTS: The recommendations encompass the use of drugs such as non-steroid anti-inflammatories (NSAR), which, along with conventional NSAR include coxibs and the parallel application of gastroprotectives, so called disease-modifying anti-rheumatic drugs, biologicals, simple analgesics, local and systematic glucocorticoids, non-drug therapies (such as patient training, medical training therapy and physiotherapy), in addition to surgical treatment methods. Moreover, three general recommendations were formulated and a therapy scheme created, taking into consideration the various clinical manifestations. The strength of the ASAS/EULAR recommendations was generally high. There was a marked consensus between the German speaking experts and the international proposal: a mean of 9.13 with relatively low variation between the recommendations. SUMMARY: Ten key recommendations for the treatment of AS were developed. These were strengthened by a systematic search of the literature and by expert consensus. The large group of German speaking experts were largely in agreement with the proposal. This can be seen as a starting point for the dissemination and implementation of the recommendations.

Analgesics↗

PubMed2005

ASAS/EULAR recommendations for the management of ankylosing spondylitis.

OBJECTIVE: To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the 'ASsessment in AS' international working group and the European League Against Rheumatism. METHODS: Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk-benefit trade-off, and clinical expertise. RESULTS: The final recommendations considered the use of non-steroidal anti-inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co-prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non-pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I-IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion. CONCLUSION: Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2005

Modulation of mechanical and muscular load by footwear during catering.

The BGN (Berufsgenossenschaft Nahrungsmithl und Gaststätten) reports 70% of job induced days off work to be connected with traumas of the ankle joint or overloading of the leg, knee and lower back, with an increased incidence in service areas outdoors (R. Grieshaber, personal communication). Workspace environments usually contain narrow passages, slopes or stairs and sudden changes between different surfaces. The aim of this study was to investigate the biomechanical load on the lower extremity and the low back during catering service when wearing different types of footwear. Thus, the potential for altering mechanical stress experienced during catering by variations in footwear was explored. Sixteen experienced waiters followed a course typical for a combined indoor-outdoor service area. Three different types of footwear were investigated using pressure distribution measurements, rearfoot goniometry and electromyography. A discriminant analysis revealed that the factors subject, shoe and surface affect rear foot movement or pressure distribution in different ways. A MANOVA demonstrated significant differences in loading parameters between footwear types. In general, these differences increased in magnitude in critical situations, such as climbing stairs or crossing slippery surfaces. The results of this study demonstrate that manipulations to footwear offer a great potential for modulating loads experienced during catering. Based on the results, the effects of constructional features are discussed. The method proposed can be applied to evaluate shoe modifications under realistic workplace conditions.

Adult↗

PubMed2004

[Mandibular reconstruction with autologous bone and osseoinductive implant in the Göttingen minipig].

BACKGROUND: Direct mandibular reconstruction with an autologous bone transplant was compared with an osteoinductive implant following an extensive continuity resection of the lower jaw in Göttinger mini-pigs. METHOD: In nine full-grown mini-pigs a one-sided continuity defect (5 cm) was created in the lower jaw. In four animals it was filled with a 50 x 25 x 15 mm(3) collagenous carrier enhanced by rhBMP-2 (400 micro g/cm(3) rhBMP-2). In two animals only the carrier was implanted as a control. Three animals received the resected autologous bone as a free transplant. Bone regeneration and consolidation of the defects was analyzed radiographically and histologically. RESULTS: Following implantation of the osteoinductive implant, complete osseous consolidation of the continuity defect in the lower jaw was observed in all animals. The defects were completely filled with a biomechanically stable bone which showed signs of functional adaptation. The replantation of the orthotopic autologous bone did not lead to functional stability quickly enough. In the periphery only an incomplete bony bridge was formed which was interrupted by large pseudarthrosis. No consolidation of the defects was found in the control group (carrier alone). CONCLUSION: Direct reconstruction of an extensive, biomechanically loaded defect with an osteoinductive implant proved to be the superior method. The osseous regeneration observed shows an immediate functional orientation. The necessity for extensive adaptive remodeling is thus minimized.

Animals↗

PubMed2004

Simple modeling of dipolar coupled 7Li spins and stimulated-echo spectroscopy of single-crystalline beta-eucryptite.

Stimulated-echo spectroscopy has recently been applied to study the ultra-slow dynamics of nuclear spin-3/2 probes such as 7Li and 9Be in solids. Apart from the dominant first-order quadrupolar interaction in the present article also the impact of the homonuclear dipolar interactions is considered in a simple way: the time evolution of a dipole coupled pair of spins with I = 3/2 is calculated in an approximation, which takes into account that the satellite transitions usually do not overlap. Explicit analytical expressions describing various aspects of a coupled quadrupolar pair subjected to a Jeener-Broekaert pulse sequence are derived. Extensions to larger spin systems are also briefly discussed. These results are compared with experimental data on a single-crystalline Li ion conductor.

Journal Article↗

PubMed2003

[Bimaxillary osteotomy with and without condylar positioning--a 1981-2002 long-term study].

PURPOSE: The introduction of the four-splint technique in our hospital in 1997 made possible the reproducible centric condyle positioning in bimaxillary osteotomies, while taking the auto rotation of the mandible into consideration and avoiding steps in the mandibular osteotomy line. PATIENTS AND METHODS: From 1981 to 2002 a total of 622 patients underwent bimaxillary osteotomy surgery. During 1981-1997 a total of 395 patients (63.5%) underwent surgery without or only with centric condyle positioning in sagittal ramus osteotomy of the mandible. During 1997-2002 a total of 227 patients (36.5%) underwent surgery with continuous centric condyle positioning with the four-splint technique. RESULTS: In patients with preoperative functional disorders, surgery with continuous centric condyle positioning resulted in statistically significant (p<0.05) improvement compared to those who underwent surgery without continuous centric condyle positioning. CONCLUSION: The results confirm the indication for continuous centric condyle positioning in bimaxillary osteotomies.

Dental Occlusion, Centric↗

PubMed2003

Hip pain related to femoral neck stress fracture in a 12-year-old boy performing intensive soccer playing activities--a case report.

We describe the rare case of a 12-year-old boy complaining of repetitive severe pain in the left thigh, during physical activity related to a femoral neck stress fracture. Even though stress fractures are common in the adult athletic population, they occur rarely in children, with the epiphyseal growth plates still open. Diagnosis is delayed as only unspecific changes are found when conventional radiography is performed. For adequate treatment, early diagnosis by MRT or bone scintigraphy is essential. Conservative treatment will be effective through prevention of overuse.

Arthralgia↗

PubMed2002

A new technique for the treatment of lumbar far lateral disc herniation: technical note and preliminary results.

A newly designed technique for a minimally invasive approach to the laterally herniated disc is presented. Fifteen patients suffering from far lateral disc herniation (extraforaminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinal muscles are spread by dilators, until a working channel of 9 mm inner diameter and 11 mm outer diameter can be placed. The next steps are done through this channel using the surgical microscope. No bone resections are necessary and the facet joints are left untouched. However, partial resection of the intertransverse ligament may be necessary. The mean follow-up period for these 15 patients was 11.5 months, and they were evaluated by using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The average surgical time was 43 min. The ODI improved from 30.6 (preoperative) to 14.3 (postoperative). The VAS of leg pain improved from 7 (preoperative) to 3.6 (postoperative), which represented a statistically significant improvement at the significance level of (P<0.01). No intra-operative or early postoperative complications occurred. However, one recurrence did occur, which was treated by the same technique. This technique combines the advantages of three-dimensional visual control (operating microscope) with the minimal surgical trauma of endoscopic techniques, while avoiding some of the shortcomings of both the microsurgical and endoscopic techniques.

Adult↗

PubMed2002

[The microscopic assisted percutaneous approach to posterior spine - a new minimally invasive procedure for treatment of spinal processes].

The aim of our attempts and trials was to develop a minimally invasive posterior approach to the spine which utilises the smallest access to the target without additional harmful effects on the stability of the spine and at the same time allows excellent dealing with the lesions depending on the advantage of the operative microscope in providing 3 dimensional view of the operative field. In the period between May 1998 and February 2001, 356 patients were treated for different spinal disorders using this approach. The approach was applied in 299 surgeries for lumbar disc herniation and we called the procedure: microscopic assisted percutaneous nucleotomy (MAPN). The approach was applied in another 34 patients with lumbar canal stenosis to perform what we called microscopic assisted percutaneous decompression (MAPD). The latter was applied for three cases with thoracic canal stenosis and six with cervical canal stenosis. The approach was also applied for other purposes and included myeloscopy in four cases, transpedicular biopsy in six, and transpedicular vertebroplasty in the remaining four. The 43 MAPN done in the early period were re-examined one year after the operation. We achieved 75% good and very good results regarding the relief of the sciatic pain and recovery of the neurological deficits. Re-surgery was necessary in only two cases (4.5%). The results with the use of this technique seem very promising. The minimal trauma induced by this approach allows rapid mobilisation of the patients and short hospital stay. A postoperative back orthoses is not necessary. The technique can also be done under local anaesthesia particularly when needed as in old people with severe co-morbidity.

Adult↗

PubMed2002

Ultrasound-induced physiological changes in cultured cells of Petunia hybrida.

Petunia hybrida cell suspension cultures were exposed to ultrasonic standing wave fields at 2.43 MHz for 40 min with mean sound pressures (within homogenous sound fields) varying from 0 (control) to ca. 1.1 MPa. Mean (+/- s.d.; n =6-9) cell viability was reduced to 87+/-10% at 0.6 MPa and to 59 +/- 23% at 1.1 MPa, compared to an initial control value of 92 +/- 6% (P <0.05). Mean (n = 3) cell alkaline phosphatase concentration increased linearly with sound pressure from a control value of 0.006+/-0.001 to 0.02+/-0.01 Sigma-Units microg(-1) protein at 1.1 MPa (P<0.05). Similarly, mean cell catalase activity increased from a control value of 0.020 +/- 0.003 to 0.026 +/- 0.008 arbitrary units at 1.1 MPa. In contrast, mean cellular lactate dehydrogenase concentration was unchanged. These observations indicate that cellular repair processes associated with increased alkaline phosphatase activity might be triggered by physical cell damage caused by ultrasound. The observed increase in catalase activity suggests increasing production of free radicals and other sonochemicals, which warrants further study. The absence of changes in lactate dehydrogenase indicates that there was no major damage to respiratory pathways or to overall cellular integrity.

Alkaline Phosphatase↗

PubMed2001

[Measuring corneal volume. A possible quality parameter in cataract surgery?].

BACKGROUND: Phacoemulsification of the lens induces changes in the inner corneal architecture. This study quantified the corneal pre- and postoperative volumes. METHODS: Corneal volume was measured by noninvasive corneal topography using Orbscan. Following phacoemulsification with lens implantation, 56 eyes of 55 persons were examined by three Orbscan tests: preoperatively and 6 h and 24 h after cataract surgery. Healon was used as viscoelastic medium. RESULTS: The mean corneal volume in the 3-mm central corneal diameter was 4.64 mm3 preoperatively, 5.36 mm3 6 h postoperatively, and 5.05 mm3 24 h postoperatively. Corneal volume thus increased by 0.72 mm3 within 6 h after phacoemulsification and decreased by 0.31 mm3 over the following 18 h. CONCLUSION: Orbscan offers a noninvasive method for obtaining useful and accurate information in defining the corneal volume. This method may represent a new parameter for describing the function of corneal endothelial cells in cataract surgery.

Adult↗

PubMed2001

Anatomy and in vivo activity of neurons connecting the crustacean stomatogastric nervous system to the brain.

In decapod crustaceans, the inferior ventricular nerve connects the cerebral ganglia (brain) with the stomatogastric nervous system (STNS). In the ivn of the crayfish, eight axons with diameters between 3.5 microm and 10 microm were found in close proximity to the oesophageal ganglion. Two of these axons terminate with their cell body within the ivn. The projections of the other six axons spread inside many neuropiles of the brain, mainly within the protocerebrum and the neuropils of the first and second antennae. Several fibers also send neurites via the circumoesophageal connectives toward the paired commissural ganglia and further down to the ventral nerve cord. The activity of motoneurons within the STNS and of axons in the ivn was recorded with implanted electrodes before, during and after times of feeding. At the beginning of feeding all tonically active ivn neurons accelerated their discharge rate and initially silent neurons also started to fire. Spike frequency was correlated with the quantity of food consumed. The ivn response was accompanied by a corresponding increase in pyloric frequency and an initiation of a gastric rhythm. The two motor rhythms showed a strong phasic interaction, but there was no phase coupling to the ivn activity.

Animals↗

PubMed2000

[Minimally invasive ventral release and endoscopic ventral instrumentation in scoliosis].

We report on three years of experience with a new method of a simultaneous endoscopically assisted anterior release in the prone position, combined with transpedicular posterior scoliosis correction and fixation. In 60 cases this simultaneous approach yielded substantial advantages. True derotation of the apex--even in the thoracic spine--is achieved. Because of resection of apical discs, the hypokyphosis can be corrected easily. Apical derotation, restoration of the kypotic profile and more effective correction of lateral translation add up to true three-dimensional correction of scoliosis. The disadvantages of insufficient anterior anchorage of fixation implants are avoided, since correction and fixation are achieved posteriorly. An additional advantage of this combined approach and the use of pedicular screws is the fact that in idiopathic scoliosis fusion that is no longer than from end- to end-vertebrae is sufficient. Thus, in most King II curves the thoracolumbar junction does not need to be fused.

Adolescent↗

PubMed2000

Anterior versus posterior plating in cervical corpectomy.

This is a prospective study comparing anterior and posterior plating in cervical corpectomy. Each group comprised 30 patients who were candidates for corpectomy. In the first group, anterior plating was done using Orosco-type titanium plates. In the second group, lateral mass plating was done. In all cases, titanium cages were used to replace the removed vertebral body or bodies. The mean follow-up was 12.68 months (SD 3.85 months). Pseudarthrosis was not encountered in either group. Posterior plating was better than anterior plating in terms of the stability of the construct and problems related to the hardware. Screw breakage was encountered in seven patients with anterior plating (23.33%). This complication was not seen in the group with posterior plating. The difference between the groups was statistically significant (chi-square = 7.92, p = 0.004). Screw loosening was encountered in 2 patients in the group with anterior plating and in only 1 patient in the group with posterior plating. The difference between the incidence of screw loosening in both groups was not statistically significant (chi-square = 0.35, p = 0.5). Sinking-in of the cage was encountered in 7 cases with anterior plating and in only 3 cases with posterior plating. However, the difference between the groups was not statistically significant (chi-square = 1.92, p = 0.16).

Adult↗

PubMed2000

Apophyseolysis of the fourth lumbar vertebra: an early postoperative complication following kyphectomy in myelomeningocele.

This is a report of a young girl with congenital kyphosis at the thoracolumbar spine in association with myelomeningocele. Kyphectomy and posterior stabilisation extending from the eighth thoracic to the fourth lumbar vertebra was done. Apophyseolysis occurred as an early postoperative complication at the level of the L4-L5 disc. This failure mode was treated by extending the fusion to the pelvis.

Child↗

PubMed2000

Viability of plant cell suspensions exposed to homogeneous ultrasonic fields of different energy density and wave type.

Exposure of Petunia hybrida cell suspensions to ultrasound at a frequency of 2.43 MHz in a standing wave field at an energy density of 70 Jm-3 (pressure amplitude of 0.78 MPa) decreased their mean viability to 35% after 20 min of sonication. A comparison of propagating wave and standing wave treatments at equal frequency (2.15 MHz) and energy density (8.5 Jm-3) showed, in the first case, a rapid decline in mean viability of cells (to 30% after 10 min of sonication) and, in the second case, a retaining of the initial viability (95%), respectively. Cells sonicated 4 days after subculture were more sensitive than cells sonicated 2 or 6 days after transfer to new culture medium. It was concluded that cellular viability depends primarily on the acoustic energy density, the exposure time, and the mechanical properties of the cells determined by age. As a consequence of the trapping of cells in the anti-node planes of the standing wave, propagating wave fields reduced cellular viability compared with standing wave fields at equal energy density.

Cell Survival↗