Biomedical subjects

J Windolf

Publications and source records attributed to J Windolf.

At least 19 recordsLinked to original sources

PubMed1997

[Joint surface replacement of the lateral tibial plateau using patella transplantation].

A case of surgical reconstruction of the lateral tibial plateau after impression fracture (Type 41-B3.1) of an 47-year-old female is presented. Joint reconstruction was performed by using a free patellar graft. The 16-year follow-up shows a very good functional outcome without subjective complaints. This case underlines that performing patellar autografting for surgical reconstruction of severe injury of the tibial plateau seems to be a promising alternative especially considering young patients in spite of avoiding total knee replacement.

Female↗

PubMed1997

[Incidence and prognosis of postoperative jaundice in surgical intensive care patients].

Jaundice in critically ill patients may be difficult to explain. This study analyzes pathophysiologically relevant data, and discusses the prognostic value of hyperbilirubinemia. A total of 1275 patients were prospectively enrolled; 7.6% developed hyperbilirubinemia of at least 2 mg/dl. Mortality in icteric patients was significantly higher (29%) than in the non-icteric group. Sepsis, shock and the number of blood transfusions are very important in hyperbilirubinemia. Nevertheless, in critically ill patients, jaundice per se is not a sign of poor outcome; indeed it only reflects the underlying disease.

APACHE↗

PubMed1997

[Case report of primary chronic osteomyelitis].

We report 3 individually different cases of primary chronic osteomyelitis. Neither the plasmacellular nor the sclerosing forms caused diagnostic or therapeutic difficulties whereas the case of a 40-year old male patient with a Brodie abscess in the tibial head could not be diagnosed unless the untreated abscess had perforated into the knee itself and empyema of the knee leaded to operative treatment and finally diagnosis of the Brodie abscess. Follow-up X-rays in weekly periods or MRT could have been helpful to avoid delayed diagnosis.

Abscess↗

PubMed1996

[Autologous keratinocyte culture on hyaluronic acid ester membranes: an alternative in complicated wound management?].

Cultivation and transplantation of autologous keratinocytes has been used in the last 15 years to treat complicated wounds of different origin. In spite of excellent technical advancements and clinical experiences cultured keratinocyte grafting still is associated with practical limitations. Application of hyaluronic acid ester membranes as carrier substrate for the transfer of keratinocytes allows improved graft handling: reduces total time required for tissue cultivation and furthermore enhances vitality of the keratinocytes because of possible grafting at semiconfluence.

Aged↗

PubMed1995

[Electr(on)ic data processes in trauma surgery--"an old hat that still doesn't fit"].

Despite the application of data processing in medicine beginning almost 40 years ago and then employing the Hollerith-method until now no consent has been achieved to solve the problems that arise from the demands of jurisdiction concerning methodical proceedings and procedures in data processing in hospitals. Concerning this the hospitals' administrations are overstrained as are the clinical departments. The paper presented recalls empirical knowledge that has already been gathered long ago.

Electronic Data Processing↗

PubMed1994

[Prospective validation of PMN-elastase as a prognostic parameter in the surgical intensive care unit].

The study presented investigates prospectively the clinical value of the PMN-elastase as a sequel parameter in 954 patients of a surgical intensive care unit. The elastase-values measured discriminate highly significant between patients with and without complications (p < 0.001) as well as between survivors and non-survivors (p < 0.001). Furthermore in patients underlying shock-phases in the course of treatment significantly higher elastase values are measured as in the patients remaining (p < 0.001). The highest prognostic evidence is determined by the elastase at the 9th day of course of disease concerning the prediction of a patient's death (sensitivity 78%, specificity 75%, positive predictive value 63%, respectively negative predictive value 87%).

Adolescent↗

PubMed1994

[Electronic picture and data storage and processing with PC in trauma surgery--an anachronism?].

Acquisition, storage and processing of any images relevant in trauma surgery together or in combination with (alpha) numeric data nowadays are possible employing a personal computer. The computing speed that is achieved with 486 cpu's "inside" is sufficient to process images in motion as well as single images to be filtered. The display and process-resolutions required for processing of X-ray-images can be achieved with the PC's hardware as well as with the software available. That is why there is no need any longer for special configurations for X-ray-departments. Calculating the price of the process-environment proposed, about 25,000 DM should be enough including the video tape recorders and the CD-ROM-recorder that are required.

Computer Peripherals↗

PubMed1993

[Surgical intensive care of the elderly].

Intensive care treatment of elderly patients is discussed controversially. Especially the success of maximal therapeutic efforts is questioned in this group. Therefore, this paper analyses prospective data of 1572 patients of a surgical intensive care unit with respect to age-related outcome. Besides the anticipated high proportion of concomitant diseases and an associated increased mortality of aged patients, there are no specific age-dependent differences. Old patients benefit from maximal therapeutic efforts to the same extent like younger patients. The authors conclude from the data that the patient's age per se should not influence the indication for intensive therapeutic interventions.

Adult↗

PubMed1993

[CORSET, experience with a new method of graft saving tissue replacement in large soft tissue defects].

Following the proposal of Oedekoven we investigated the method of continuous and rapid skin enlargement by dynamic traction (which we named the CORSET-method) at the border of wounds, applied through elastic silicon rubber bands. Since March 1992 we operated more than 20 patients. By means of the "rubber bands" mentioned above soft tissues can be stimulated to grow, that is to say increase the area of skin that had to be treated with transplants priorily in order to close soft tissue defects following a compartment-syndrome or septic complications in the abdomic wall following operations in the abdomen. Applying the CORSET-method there is no risk of inflammation or soft tissue damage caused by the operation itself.

Adult↗

PubMed1992

[Roentgen studies of the skull in head injuries--a multicenter study].

The multi-center study presented reveals that 76% of the conventionally performed X-ray investigations of the skull can be avoided without any relevance concerning the non-diagnosis of severe injuries. Only in 3.2% of all patients investigated a skull X-ray had instantaneous therapeutically consequences. Thus routinely performed skull X-rays are no longer acceptable in the light of cost reduction and radiation load. The clinical-neurological investigations however are inevitable to perform the state of the art treatment of patients with head injuries today, leading to computerized tomography if necessary. A check-list of clinical findings is presented to get the indications for conventional X-rays of the skull and to manage an effective use of such investigations in appropriate clinical situations.

Adolescent↗

PubMed1992

[Multiple trauma management: reliable documentation of the 1st phase supplying a standardized, machine-readable encounter sheet for the emergency rescue team].

Adjust preclinical treatment is an inevitable compound of polytrauma-management. Instantaneously applied expert therapy of the traumatic shock and acutely performed diagnosis of the pattern and dignity of injuries often are crucial for the patients' outcome. Precise documentation of the first phase of treatment thus gains importance for clinical investigations to come and for questions put scientifically. Applying data processing with data input through an optical mark reader a standardized encounter sheet, that proved to be usable as a checklist, has been developed in our hospital for the emergency-rescue-team. Being simple to use and handy to fill out it serves as a clinical record as well as a means for direct data input to a personal computer. The encounter sheet is presented in this paper together with first results of the application in daily routine.

Adolescent↗

PubMed1991

[Electronic data processing in the hospital: current status, options, "branch packets", customer-specific software and users' needs].

Data management in hospitals used to be the data management of the hospital-management in the last 15 years, not however the data management the doctors performed. The acceptance for electronic means slowly rising more software is used in the clinics today but still by the doctors privately. Software specialists have registered the growing market available for their products. That is why the danger to accept even unusuable software rises every day, as unexperienced software-beginners as doctors mostly are often relied on offers without being told about their dignity and usefulness.

Electronic Data Processing↗

PubMed1991

["Scoring"--benefits and pitfalls].

Problems of calculations and predictions on more than two particles moving are known in mathematics and physics since a long time already. However in medicine as there is lack of knowledge about the complexity of the pathophysiological behaviour of "systems" doctors tend to invent scores, scales and indices to make parameters more intelligible to them without concern on underlying interdependencies and redundancies. There is nothing to say against this kind of proceeding as long as the resulting data are not processed statistically. However, since the personal computer was invented there was and especially today is no need to summarize data any longer to gain the degree of understanding, in the contrary, the only data that really count are those that are processed correctly according to statistics, and thus doctors do not have to keep an eye any longer on incomplete intermediate results.

Computer Graphics↗

PubMed1990

[Occupational accidents with possible HIV contamination].

From January 1st, 1984 until December 31st, 1988 586 employees of the University Clinic of Frankfurt, West-Germany, were treated after occupational accidents with potentially HIV-contaminated materials. The majority of the patients were admitted because of lacerations that occurred with used injection needles. Up to now the sero-conversion of a patient after this special kind of trauma has not been documented in West-Germany. In our clinic we found an infection in one employee, which is due to an occupationally acquired injury.

Accidents, Occupational↗

PubMed1990

[Digital computer arthrometry of the upper ankle joint using a personal computer. A new procedure].

The digital computerarthrometry (DCAM) was developed as a very cost-effective device to calculate the pathologic angles of injured joints. The joint's data are captured by a frame grabber-board installed in a personal computer after takeover from the X-rays by a video camera. Measurements are performed using a commercially available software package which displays the X-ray-photograph on a separate screen besides the one used to manipulate the computer. With this system the calculations of angles and distances of the injured joints are performed with considerably higher precision as it could be done before. As a further possibility bone density measurements may be done from the X-rays as it had been tried to before computers could be used. Our first results seem to present our system as an alternative to the costly workstations, that had to be used until now.

Ankle Joint↗

PubMed1990

[Categorization of clinical findings; reduction of data without loss of information].

Depending on the individual skill of doctors the results of clinical investigations and laboratory findings are weighted differently according to their reliability today. Dealing with medical data the statistical way they have to be handled differently as well depending on the degree of reproducability and thus reliability. The problem of safety and quality of data in medicine is known to every experienced doctor as long as he himself "processes" them, nevertheless data tend to be treated uncritically when "automatically" processed by a computer. A way out of this pitfall is given by standardization of data using check-lists without transfer to any kind of coding-system or thesauri because none of those systems exists today that is capable of regaining the input-informations as they were from the codes.

Databases, Factual↗

PubMed1990

[The application of an electronic data processing system in surgical intensive care].

To assure quality and progression of surgical intensive-care therapy appropriate equipment is mandatory to ensure documentation and quality-control. In our hospital data processing of any information concerning the patients treated in the intensive-care unit has become part of the daily routine. This paper presents and discusses the underlying concept.

Critical Care↗

PubMed1990

[HIV positive patients in routine surgical practice].

In our daily surgical practice we encounter increasingly HIV-infected and AIDS patients. From January 1 1987 until December 31 1988 119 outpatients and 35 hospitalized patients were treated in the surgical department. They belonged mainly to the known risk groups. Abscesses and diagnostic excisions were predominant in the outpatients while hospitalized patients presented the full scale of surgical diseases. The clinical course was not different from that of other patients. 181 members of the medical staff of our hospital were registered after contact with blood or body fluids of HIV-infected patients and followed. A seroconversion was not observed so far.

Abscess↗