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Horst Koch

Publications and source records attributed to Horst Koch.

26 records · Page 2Linked to original sources
PubMed2003

[Three-Dimensional Ultrasonic Gait Analysis in Schizophrenic Patients]

Schizophrenic disorders as well as neuroleptic treatment can affect locomotion. The study assessed the influence of neuroleptic treatment on human gait via ultrasonic topometric gait analysis. In a control sample the test system proved high test-retest-reliability. Spatial and temporal gait parameters were assessed in schizophrenic patients without neuroleptic treatment (n = 12) and under treatment with conventional neuroleptics (n = 14) and re-assessed after treatment change to the atypical neuroleptic olanzapine in a repeated measures design. After switch from conventional neuroleptics to olanzapine patients showed an increase of gait velocity (p </= 0.01) and step length (p </= 0.01) whereas the cadence remained stable. Significant differences between the untreated state and treatment with olanzapine were not detectable. We conclude that bipedal gait is affected by conventional neuroleptic treatment. The degree of impairment can be objectively measured by testing spatio-temporal and kinematic gait parameters via three-dimensional ultrasonic gait analysis.

Journal Article↗
PubMed2003

Influence of nerve stump transplantation into a vein on neuroma formation.

The objective of this animal study was to investigate the influence of nerve stump transposition into a vein on neuroma formation. In 24 rats the femoral nerve was severed and the proximal nerve stump was transposed into the lumen of the femoral vein on one side. On the other side, the nerve was severed and left in place. The distal nerve stump was shortened to knee level on both sides. In group 1, the bloodstream was released; in group 2, the segment of the femoral vein containing the nerve stump was excluded from circulation. Histological assessment was performed 8 months later. There were significant differences between the treatment and control sides with respect to neuroma size, endoneural architecture, neural-tissue-to-connective-tissue ratio, and myelination of axons. These data suggest that nerve transposition into a vein could inhibit the formation of classic neuroma.

Anastomosis, Surgical↗
PubMed2003

Treatment of painful neuroma by resection and nerve stump transplantation into a vein.

Twenty-three patients (14 men, 9 women) with 24 painful neuromas underwent resection of neuroma and transposition of the nerve stump into an adjacent vein. The neuromas resulted from amputations (N = 7), tumor excision (N = 5), laceration injuries (N = 4), different types of wrist surgery (N = 3), vein-stripping procedures (N = 2), open fracture of the radius (N = 1), and toe harvest for thumb reconstruction (N = 1). The duration of painful symptoms averaged 66.7 weeks at the time of operation. Average follow-up was 26.5 months. In 22 patients the symptoms improved permanently. Twelve patients experienced complete and permanent relief of pain; some mild degree of pain returned in 8 patients. Two patients experienced moderate pain, and pain recurred unchanged 2 months postoperatively in 1 patient. The results presented are consistent with results of animal experiments demonstrating that typical neuroma does not develop in nerve stumps transposed into veins. Further clinical use of this approach is encouraged.

Adolescent↗
PubMed2003

Reconstruction of combined defects of the Achilles tendon and the overlying soft tissue with a fascia lata graft and a free fasciocutaneous lateral arm flap.

A new approach to reconstruction of the Achilles tendon and overlying soft tissue is presented. A fascia lata graft is used to reconstruct the tendon and is enwrapped by the fascia that is included in a fasciocutaneous lateral arm flap. Five patients were treated with this technique; three of them after surgical Achilles tendon repair, rerupture, and consecutive infection, one after a full-thickness burn with loss of the tendon and one with a history of ochronosis and necrosis of the whole tendon and overlying soft tissue. There were no anastomotic complications and all flaps healed primarily. Functional evaluation with the Cybex II dynamometer was done at least 49 months after reconstruction. A good functional and cosmetic result was obtained in all patients and donor site morbidity was acceptable. These results are well within the results of other surgical treatment options reported in the literature.

Achilles Tendon↗
PubMed2003

[3-D ultrasound-assisted gait analysis of schizophrenic patients. Comparison between conventional neuroleptics and olanzapine].

Schizophrenic disorders as well as neuroleptic treatment can affect locomotion. The study assessed the influence of neuroleptic treatment on human gait via ultrasonic topometric gait analysis. In a control sample the test system proved high test-retest-reliability. Spatial and temporal gait parameters were assessed in schizophrenic patients without neuroleptic treatment (n = 12) and under treatment with conventional neuroleptics (n = 14) and re-assessed after treatment change to the atypical neuroleptic olanzapine in a repeated measures design. After switch from conventional neuroleptics to olanzapine patients showed an increase of gait velocity (p < or = 0.01) and step length (p < or = 0.01) whereas the cadence remained stable. Significant differences between the untreated state and treatment with olanzapine were not detectable. We conclude that bipedal gait is affected by conventional neuroleptic treatment. The degree of impairment can be objectively measured by testing spatio-temporal and kinematic gait parameters via three-dimensional ultrasonic gait analysis.

Adult↗
PubMed2002

Thoracic wall reconstruction using both portions of the latissimus dorsi previously divided in the course of posterolateral thoracotomy.

OBJECTIVE: Besides other factors, the choice of reconstructive method for full thickness thoracic wall defects depends on the morbidity of preceding surgical procedures. The pedicled latissimus dorsi flap is a reliable and safe option for reconstruction of the thorax. A posterolateral thoracotomy, however, results in division of the muscle. Both parts of the muscle can be employed to close full thickness defects of the chest wall. The proximal part can be pedicled on the thoracodorsal vessels or the serratus branch; the distal part can be pedicled on paravertebral or intercostal perforators. This retrospective study was undertaken to evaluate the reconstructive potential of both parts of the latissimus dorsi in thoracic wall reconstruction after posterolateral thoracotomy. METHODS: Between 1987 and 1999, 36 consecutive patients underwent reconstruction of full-thickness thoracic wall defects with latissimus dorsi-flaps after posterolateral thoracotomies. The defects resulted from infection and open window thoracostomy (n=31), trauma (n=3) and resection of tumours (n=2). The patients' average age was 57 years (range 22-76 years). Twenty-five patients were male, 11 were female. In 31 cases the split latissimus dorsi alone was employed; in five cases additional flaps had to be used due to the size of the defects, additional intrathoracic problems or neighbouring defects. RESULTS: In 34 cases defect closure could be achieved without major complications. Empyema recurred in the pleural cavity in one case and one patient died of septicaemia. The 15 patients who had required a respirator in the preoperative phase could be extubated 4.8 days (average) after thoracic wall reconstruction. Postoperative hospital stay averaged 16 days. CONCLUSIONS: Different methods are available for reconstruction of full thickness defects of the thoracic wall. After posterolateral thoracotomy in the surgical treatment of empyema, oncologic surgery and traumatology, the latissimus dorsi muscle still retains some reconstructive potential. Advantages are low additional donor site morbidity and anatomical reliability. As it is located near the site of the defect, there is no need for additional surgical sites or intraoperative repositioning. In our service, the split latissimus dorsi muscle flap has proven to be a valuable and reliable option in thoracic wall reconstruction.

Adult↗
PubMed2002

Plastic surgeons and the Internet: results of a worldwide survey.

To obtain information on the use of the Internet, 3,139 survey forms were sent out to plastic surgeons throughout the world. More than 90% of the 565 respondents have access to the Internet and 85.5% use electronic mail for professional matters. They use the World Wide Web to search the literature, to read scientific articles, and to obtain information on congresses. A substantial proportion of the contributors have a positive attitude toward virtual congresses on the Internet and most would welcome a newsgroup dedicated to plastic surgery. Perceived apprehensions include secure transmission of sensitive data, slow data transmission, and the lack of structure and of an authority to control the contents of the Internet. Virtual congresses and a newsgroup on plastic surgery seem to be worthwhile future goals. Some problems pointed out in this survey have already been solved, at least partially, and possible solutions for the rest are discussed.

Education, Medical↗