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Biomedical subjects

H Seitz

Publications and source records attributed to H Seitz.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Ethylene glycol poisoning and brain injury--a dangerous combination].

We report on a patient after brain injury additionally showing signs of ethylene glycol intoxication. CT-scan showed a subdural hematoma, which in spite of increasing neurological deficit didn't show any enlargement. Metabolic acidosis with an increased anion gap and osmolar gap led to the diagnosis of ethylene glycol intoxication. Then intensive hemodialysis and i.v. ethanol were administered and the intoxication could be treated successfully.

Aged↗
PubMed1998

[Concomitant intra-abdominal injuries in pelvic trauma].

A pelvic fracture combined with abdominal injury and soft tissue damage, defined as complex pelvic trauma, is an expression of severe trauma and requires specific procedures in terms of diagnosis and treatment. The clinical course and outcome of 75 patients (56 males and 19 females) with complex pelvic injuries from 1985 to 1996 are presented in this follow-up study. There were 33 (44%) Type A (stable pelvic ring fracture), 10 (13%) Type B (rotationally unstable pelvic ring fracture) and 32 (43%) Type C (rotationally and vertically unstable pelvic ring fracture). Concomitant abdominal injuries included: 14 liver lacerations (19%), 28 splenic lesions (37%), 7 ruptures of the kidney (9%), 18 ruptures of the bladder (24%), 13 urethra lesions (17%), 13 intestinal lesions (17%) and 16 ruptures of the diaphragm (21%). The mean Hannover polytrauma score was 22 points. Twelve patients (16%) died within 6 hours after associated head and/or chest injury with hemorrhage, and 3 patients (4%) died in the intensive care unit from sepsis and multiorgan failure within 2 weeks after injury. The priority of the steps taken is of utmost importance in the diagnosis and treatment of such injuries. Immediate control of hemorrhage by surgical or minimally invasive radiological techniques, stabilization of pelvic fractures and inter-disciplinary cooperation are important requirements for management and successful treatment.

Abdominal Injuries↗
PubMed1997

Tibial avulsion fracture of the posterior cruciate ligament: K-wire or screw fixation? A retrospective study of 26 patients.

Although the posterior cruciate ligament (PCL) is not frequently injured, a greater understanding of its role in stabilizing the knee joint, mechanism of injury and treatment has developed. Isolated avulsion injuries constitute only a subgroup of PCL injuries, but nevertheless several operative techniques have been described for the fixation of the avulsed bony fragment. In order to investigate whether K-wire or screw fixation yields better long-term results, we examined 26 patients at an average of 10.5 years after the initial operation. Clinical examination, activity level, radiographic evaluation and instrumented measurements did not reveal any significant differences. All the patients had an excellent functional result. Thus, both K-wire and screw fixation are recommended for bony PCL avulsion injuries.

Adult↗
PubMed1997

Vascular anatomy of the ovine anterior cruciate ligament. A macroscopic, histological and radiographic study.

Sheep are being extensively utilized in animal models for orthopaedic research, but the vascular anatomy of their anterior cruciate ligament (ACL) has not yet been thoroughly described. This study demonstrates the blood supply to the ACL. Vascular injection with plastogen G, lead oxide and India ink was performed in 12 back limbs of Styrian mountain sheep, and gross observations, microradiography and routine histology were done. The large vessel and the microvascular anatomy are similar to those described for humans. The middle genicular artery and the descending genicular artery contribute vessels that supply the ACL. Epiligamentous vascular plexuses give off capillaries which penetrate the ligament substance and supply numerous, longitudinally oriented intraligamentous vessels. These findings make the Styrian mountain sheep a potential animal model for biologic investigations of ACL pathology.

Animals↗
PubMed1996

[Meniscus lesions after isolated anterior cruciate ligament rupture].

In this retrospective study the meniscal status of 34 patients with untreated complete anterior cruciate ligament (ACL) tears is reported. The anterior cruciate ligament injury was initially documented by examination under anesthesia and arthroscopy. Treatment in all cases consisted of a standard protocol of early rehabilitation and bracing. The mean follow-up was 7.3 years. Twenty-two (65%) patients showed signs of meniscal pathology at an average of 2.5 years after the ACL injury during the follow-up period. Rearthroscopy was performed and showed a higher incidence of medial meniscus tears (53%) than lesions of the lateral meniscus (41%). The most common tear of the medial meniscus was the bucket-handle type, followed by the flap tear and the single longitudinal split of the posterior horn. Secondary reconstruction of the ACL was necessary in 18 patients (82%) complaining of symptoms indicative of permanent anterior instability of the knee. The remaining 4 patients had rearthroscopy 3.5 years after the ACL injury and a partial meniscectomy and ACL reconstruction was performed. 12 patients (35%) had no symptoms or signs of joint instability or meniscal pathology during the follow-up period, but discontinued their sporting activities. This study indicates the increasing incidence of meniscal tears during ACL insufficiency. We recommend that patients with ruptures of the anterior cruciate ligament should be investigated for meniscal tears and that early ligament reconstruction of the knee and meniscal repair or partial meniscectomy should be considered simultaneously.

Adolescent↗
PubMed1996

[Alloplastic augmented femoral reinserted anterior cruciate liganent. Value of 2 channel augmentation for postoperative rehabilitation].

The rupture of the anterior cruciate ligament (ACL) near its femoral origin is a common injury of the knee and can lead to lesions of the meniscus due to instability and to early gonarthrosis. One procedure applied in current orthopaedic practice to prevent such impairment of knee joint function is ACL repair reinforced with a synthetic intraarticular ligament. In this study we used twelve knees of cadavers and after sectioning the ACL in each repaired it according the Marshall technique with USP 1 PDS II sutures. We augmented the repair in each case with a 3-mm PET (Trevira hochfest) band inserted by the through-the-condyle (TTC) procedure and attached without preload to the femoral and tibial condyle with a 4-mm staple. We then measured the length of the ACL, the length of the Marshall sutures-ACL complex, the partial lengths, and the deviation angles and adherence-friction force of the 3-mm PET augmentation device, and applied the law of Hooke to calculate the load-sharing between the USP 1 PDS II sutures-ACL complex and the 3-mm PET band and between the ACL and the 3-mm PET band, respectively. We also evaluated the load on the femoral and the tibial fixation of the augmentation device. The results showed that the 3-mm PET band took over 60% of an externally applied load on the knee during the hypothetic period of ACL healing and 27% of the force acting on the knee thereafter. It was calculated that a maximum of 75% of the load taken over by the augmentation device was at the tibial staple and only up to 45% of the force at the femoral one. With due consideration for the requirement for absolute protection ("stress shielding") of the healing ACL but also for the aim of early postoperative accelerated functional rehabilitation without casts, splints or other restrictions of joint movement, we believe that a pretensioned 3-mm PET band is the best choice, since augmentation without preload cannot fulfil these requirements.

Anterior Cruciate Ligament↗
PubMed1996

Capture and RT-PCR of hepatitis C virus RNA with safety primers.

The principle and practice of the polymerase chain reaction (PCR) has had a major impact on medical research. This is a powerful method but it does have its limitations, especially for clinical diagnostic work. We describe some improvements of hepatitis C virus (HCV) amplification such as simplification of specimen preparation, elimination of false negative reactions influenced by point mutations, and fluorimetric detection. The aim of the method is to make the procedure as easy and as inexpensive as possible for routine laboratories and for blood screening. After rapid chemical denaturation of the clinical specimen with guanidine thiocyanate and simultaneous hybridization of biotinylated primers to template HCV RNA, the product was fixed to streptavidin-coated magnetic beads and potential inhibitors were removed in easy washing steps. To eliminate the influence of point mutations within the primer binding sites, primer sets with different lengths at their 3'-end were developed for capture, reverse transcription, and amplification of genomic fragments by PCR. Positive results were identified by fluorescence staining. The low cost of the method allows the quantitation of templates by testing of dilution series as is common in microbiological laboratories.

DNA Primers↗
PubMed1996

Load sharing in augmented anterior cruciate ligament repair: a mathematical analysis based on in vitro measurements.

OBJECTIVE: To quantify the stress on a reinserted anterior cruciate ligament (ACL) we studied the load sharing between the ACL and a 3.7 mm polyethylene terephthalate (PET) band in 10 knees of fresh human cadavers. DESIGN: The load sharing between the Marshall sutures-ACL complex and the PET band and between the ACL and the PET band was calculated by means of a mathematical model. BACKGROUND: Augmentation of a reinserted ACL with a synthetic band is an accepted treatment for a ruptured ACL. METHODS: After transsecting the ACL at its femoral origin and reinserting it with four sutures using the Marshall technique we augmented it with the PET band. The augmentation device was inserted by the through-the-condyle (TTC) procedure and attached without preload to the femoral and the tibial condyle with 4 mm staples. Then the length of the ACL, the lengths of the Marshall sutures, the partial lengths and the angles between the different directions, and the adherence-friction force of the PET band were measured. RESULTS: In the beginning the Marshall sutures-ACL complex takes over 40% of an externally applied load and the PET band 60%. After the hypothetical ACL healing phase the PET band takes over 27% and the ACL 73% of the load. CONCLUSIONS: An external force of 40 N acting on the knee will therefore lead to an elongation of the Marshall sutures-ACL complex and result in movement of the proximal end of the ACL away from the femoral condyle of at least 0.5 mm, which is highly undesirable in the early postoperative healing phase.

Journal Article↗
PubMed1996

Anterior instability of the knee despite an intensive rehabilitation program.

To investigate if an intensive rehabilitation program has a positive influence on the late course of an old, isolated anterior cruciate ligament rupture, patients were evaluated at an average of 8 years after injury. Seventy-five percent had acquired the injury during sporting activities. After diagnostic arthroscopy, which was done at an average of 163 days after the injury, the patients immediately were assigned to an intensive rehabilitation program. At the followup examination, none of the patients had an excellent result as determined by the Swiss Knee Group Score; 6 patients had a good result; 13 had a fair result; and 8 had a bad result. Fourteen patients had a partial meniscectomy during the followup period, and 4 had positive signs for meniscal lesions at the followup examination. In 52% of the patients gonarthrosis had advanced 2 stages, and in 26% it had advanced 3 stages. There was a significant correlation between worsening of gonarthrosis and previous meniscectomy, poor evaluation scores, and clinical signs of instability. Even an intensive rehabilitation program cannot prevent secondary lesions of the meniscus with ensuing joint degeneration. Thus, immediate operative reconstruction of old ruptured anterior cruciate ligaments is recommended.

Adolescent↗
PubMed1996

[Biocompatibility of polyethylene terephthalate--PET--(Trevira strong)--an in vivo study of the sheep knee].

The anterior cruciate ligament was transected at the femoral origin in the right stifle joint of 25 sheep. The ligaments were re-inserted using the Marshall technique, and reinforced with a 3 mm band made of polyethylene terephthalate--PET--(Trevira hochfest) using the through-the-condyle (TTC) procedure, and re-attached--with a preload of 20 N--to the femoral and tibial condyle with two 4 mm staples. To assess the biocompatibility of the augmentation band, the synovial fluid was analysed for total protein and glucose concentration 2, 6, 24, and 56 weeks after implantation, and a total and differential cell count performed. No significant differences were found before and after implantation of the PET band. No pathological increase in the total protein concentration occurred after implantation (normal range: > 3.0 g/dl), and no significant differences vs. the preoperative analysis were found. No synovitis-signalling decrease in the glucose concentration (normal range: > 40 mg/dl) was observed. The preoperative glucose concentration of 87 +/- 12.84 mg/dl showed no significant difference from the postoperative concentration of 95 +/- 13.58 mg/dl. The cytological examination revealed no increase in the leucocyte counts (normal range: 3 leucocytes/HPF). Neither free nor phagocytosed wear particles were seen.

Animals↗
PubMed1996

[Borderline indications for locked intramedullary nailing of femur and tibia].

The borderline indications of locked intramedullary nailing of the femur and the tibia, based on Küntscher nailing, are defined by the location of the fracture, the associated soft tissue injury, the appearance of infection and the patient's pulmonary status. From 1975 to 1995 at the Department of Traumatology, Vienna University School of Medicine, 551 patients with 559 femoral fractures and 536 patients with 548 tibial fractures were stabilized using locked intramedullary nailing. A total of 135 (24%) proximal femoral fractures were stabilized using intramedullary locking nails in 54 cases, and using long gamma nails in 81 cases. Ninety-one distal femoral fractures (16%) were stabilized in 82 cases with intramedullary locking nails and in 9 cases using retrograde nailing. In open fractures predominantly a reamed technique was used. Fifty-two of these fractures were femoral fractures and 101 were tibial fractures. Seventy-two femoral fractures (13%) were associated with compromised pulmonary function and polytrauma. Procedural changes from external fixation to the intramedullary locking nail technique were performed in 21 cases of femoral fractures and in 21 cases of tibial fractures. Six tibial fractures diagnosed as having compartment syndrome were treated using unreamed nailing and fasciotomy. The overall infection rate of femoral fractures was 1.7% and 1.9% for all tibial fractures; the nonunion rate of both femoral and tibial fractures was 0.5%. Because of the success rate observed in the treatment of borderline indications for locked intramedullary nailing of femoral and tibial fractures and the improvement in equipment, training and techniques, we have expanded the indications for treatment of these fractures by intramedullary nailing.

Adult↗
PubMed1996

[A simple method for removal of percutaneous endoscopically implanted gastrostomy tubes].

Percutaneous endoscopic gastrostomy (PEG) has become an accepted technique for providing longterm enteral nutrition. So far the PEG tubes have been removed by a second gastroscopy procedure. Extrusion of the PEG tube and fistula formation have been described as unusual complications. We report about 26 patients with severe brain injuries whose PEG tubes were removed percutaneously by applying constant traction force to the tubes. The soft internal bolsters collapsed and the PEG tubes could be pulled out through the gastrostomy site within 5-7 days. The gastrocutaneous fistulae closed spontaneously within 4 days. In one patient the internal bolster got caught in the external layer of the rectus muscle sheath and had to be removed through a small incision. There were no other complications and 21 patients rated their well-being as unimpaired. Thus we believe the "traction procedure" to be a simple, safe and cost-effective alternative to endoscopic removal of PEG catheters.

Adult↗
PubMed1996

Changes in cardiac signal transduction systems in chronic ethanol treatment preceding the development of alcoholic cardiomyopathy.

Chronic alcohol consumption has been postulated as an important pathogenetic mechanism for the development of alcoholic cardiomyopathy. This form of chronic heart failure shares with other forms of cardiomyopathy the pronounced alterations of the adrenergic signal transduction systems. These alterations include a significant reduction of beta-adrenergic receptors and a reduced responsiveness of the adenylyl cyclase. Changes of other receptor systems such as alpha-adrenergic and muscarinic receptors have not been studied extensively so far. To address the question if changes of the adrenergic signal transduction systems may occur early in the development of alcoholic cardiomyopathy and if alpha 1-adrenergic receptors and muscarinic receptors may be subjected to an altered expression even before severe impairment of the left ventricular function becomes obvious, rats were chronically fed with an alcohol diet containing 35% of total calorie intake as ethanol. In cardiac plasma membranes beta-adrenergic receptors, alpha 1-adrenergic receptors, muscarinic receptors and adenylyl cyclase activities were determined after 4 and 8 weeks of chronic alcohol treatment. After these periods of chronic alcohol diet no signs of overt heart failure such as pleural effusion or increased lung wet weight as parameters for congestion were present. Body weight gain was comparable in the controls and under chronic alcohol treatment in these adolescent rats. Both after 4 and 8 weeks of chronic alcohol treatment the density of cardiac beta-adrenergic receptors remained unchanged and all adenylyl cyclase activities remained fully responsive. In contrast, after 8 weeks of alcohol treatment the developmental increase of cardiac muscarinic receptors in the adolescent rats was greatly impaired resulting in a significantly reduced expression of these receptors even before clinical signs of heart failure. In contrast the density of cardiac alpha 1-adrenergic receptors were significantly reduced already after 4 weeks of chronic alcohol treatment with an additional impairment of the developmental increase after 8 weeks of alcohol treatment. These data characterize for the first time early changes of cardiac receptor system in chronic alcohol treatment which precede the development of overt heart failure. These changes include alpha 1-adrenergic and muscarinic receptors, but in contrast to severe heart failure, leave the beta 1-adrenergic system and the responsiveness of the adenylyl cyclase intact. Additionally these data show the developmentally increased expression of cardiac alpha 1-adrenergic and muscarinic receptors in rat heart.

Adenylyl Cyclases↗
PubMed1995

Purification and Characterization of Hydroxyquinol 1,2-Dioxygenase from Azotobacter sp. Strain GP1.

Hydroxyquinol 1,2-dioxygenase was purified from cells of the soil bacterium Azotobacter sp. strain GP1 grown with 2,4,6-trichlorophenol as the sole source of carbon. The presumable function of this dioxygenase enzyme in the degradative pathway of 2,4,6-trichlorophenol is discussed. The enzyme was highly specific for 6-chlorohydroxyquinol (6-chloro-1,2,4-trihydroxybenzene) and hydroxyquinol (1,2,4-trihydroxybenzene) and was found to perform ortho cleavage of the hydroxyquinol compounds, yielding chloromaleylacetate and maleylacetate, respectively. With the conversion of 1 mol of 6-chlorohydroxyquinol, the consumption of 1 mol of O(inf2) and the formation of 1 mol of chloromaleylacetate were observed. Catechol was not accepted as a substrate. The enzyme has to be induced, and no activity was found in cells grown on succinate. The molecular weight of native hydroxyquinol 1,2-dioxygenase was estimated to 58,000, with a sedimentation coefficient of 4.32. The subunit molecular weight of 34,250 indicates a dimeric structure of the dioxygenase enzyme. The addition of Fe(sup2+) ions significantly activated enzyme activity, and metal-chelating agents inhibited it. Electron paramagnetic resonance data are consistent with high-spin iron(III) in a rhombic environment. The NH(inf2)-terminal amino acid sequence was determined for up to 40 amino acid residues and compared with sequences from literature data for other catechol and chlorocatechol dioxygenases.

Journal Article↗
PubMed1994

[Long-term results of replacement of the anterior cruciate ligament in comparison with conservative therapy].

Between January 1980 and February 1987 92 patients (group I) with chronic anterior instability of the knee joint underwent anterior cruciate ligament reconstruction using midthird patellar tendon autografts (BTB). 39 patients (group II) with the same injury were treated conservatively. The patients were followed up postoperatively within a mean period of 8.5 years and stability, grade of postoperative arthrosis, subjective view of patients and ability to sport were evaluated. In group I the clinical examination showed in 77% the same stability on both sides, whereas in group II no cases of bilateral stability of same grade were found. Pivot shifting was repaired in 91% of group I and only in 17% of group II patients. The apparative examination of the stability (KT 2000-arthrometer testing) measuring the anterior drawer phenomenon on both knees showed stable joint conditions (anterior tibia displacement < or = 3 mm) in 86% of operatively treated and only in 8% of conservatively treated patients. Postoperative x-rays showed no arthrotic changes in 55% of group I patients. All patients of group II showed signs of progredient arthrosis in their postoperative x-rays. Subjective clinical results were good to excellent in all group I patients. Only 50% in group II had a good to excellent result. 67% of group I and only 25% of group II patients practiced their former sports activities again. In our retrospective review we could observe significant better clinical results of surgically treated old isolated anterior cruciate ligament (ACL) tears with patellar tendon autografts (BTB) compared to those with conservative treatment.

Adult↗
PubMed1993

Coeliac plexus block with bupivacaine reduces intestinal dysfunction in neurosurgical ICU patients.

Coeliac plexus block, an established method of treatment for pain associated with pancreatitis and cancer, was used in neurosurgical patients with gastrointestinal dysfunction. The study was performed in 16 patients whose gastric reflux volume exceeded 600 ml per day for 3 consecutive days. Patients were allocated to a block group (n = 8) or a control group (n = 8). Coeliac plexus block was accomplished with a modified Moore technique using 50 ml bupivacaine 0.25%. In the block group, gastric reflux volumes for 3 days preceding coeliac plexus block and 3 consecutive days following coeliac plexus block were analysed. In the control group, gastric reflux volumes were observed over a period of 6 days. Mean (SEM) gastric reflux volume decreased significantly following coeliac plexus block from 770 (50) ml to 60 (30) ml (p < 0.01). In the control group, gastric reflux remained unchanged over the corresponding periods (730 (60) ml c.f. 670 (50) ml). The response of gastric reflux volume to coeliac plexus block suggests that the mechanism is related to inhibition of sympathetic activity in patients whose sympathetic drive is increased due to the underlying neurological disease, and possibly due to sedation withdrawal symptoms.

Adult↗