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Biomedical subjects

L Besch

Publications and source records attributed to L Besch.

11 recordsLinked to original sources
PubMed2006

Expression and regulation of human beta-defensin-2 in osteoarthritic cartilage.

Defensins are antibiotic peptides that are involved in host defence at epithelial and mesenchymal surfaces. Previous studies have shown the induction of human beta-defensin-3 (HBD-3) in osteoarthritic joints, suggesting that these molecules have functions in addition to their ability to kill microbes. The aim of this study was to investigate the production of a further human beta-defensin, named HBD-2, in osteoarthritis (OA) and to determine its regulation by inflammatory cytokines. Healthy and osteoarthritic cartilage was assessed for HBD-2 expression by RT-PCR, immunohistochemistry, and ELISA. C28/I2 chondrocytes, primary chondrocytes, and cartilage explants were cultured for in vitro studies. After 24 h of stimulation with tumour necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1) or IL-6, real-time RT-PCR and ELISA experiments were performed to evaluate the effect of these cytokines on the production of HBD-2. In contrast to healthy cartilage, HBD-2 expression was identified in most of the OA samples examined (eight of ten). Cytokines that are potentially involved in the pathogenesis of OA, namely TNF-alpha, IL-1, and IL-6, were transcriptional inducers of HBD-2 in cultured chondrocytes and cartilage explants in vitro, as measured by real-time RT-PCR and ELISA. These results illustrate the induction of HBD-2 in osteoarthritic cartilage and suggest that it is a further factor in the pathogenesis of OA. However, further studies are required to elucidate the role played by HBD-2 in osteoarthritic cartilage.

Adult↗
PubMed2004

[Injury pattern caused by aggressive inline skating].

In order to evaluate the special injury pattern of aggressive inline skating, a field study was conducted in a local, non-commercial skate park equipped with all the typical features like ramps, halfpipes, gully areas. 66 unselected aggressive inline skaters were randomly enrolled and interviewed concerning their skating habits and their skating injury history. Average age was 15 (10 to 41) years, skating was performed since 2.1 (0.1 to 6) years, as aggressive skating since 1.3 (0.1 to 4) years. Medical treatment in a doctor's practice or in a hospital had been necessary in 66 cases, averaging 1.4 times per skater and year, averaging one injury per 586 hours of aggressive skating. The injury pattern reflected the regions typically injured in fitness skating, too, with a higher percentage of injuries concerning knee, tibia and ankle region. The use of protective devices varied from 41 % (wrist guards) to 94 % (knee pads), with an average of 69 %. Only 32 % of skaters wore all protective devices. As the personal thrill is an important motivation for aggressive skating, safer skating campaigns are quite unlikely to decrease the risk of injury in aggressive skaters.

Adolescent↗
PubMed2002

[Treatment of rare talus dislocation fractures. An analysis of 23 injuries].

METHODS: Between 1980 and 1996 we treated 23 patients for dislocated fractures of the talus. The injury was caused by a car accident in 61% and a high fall in 22%. Five patients had open wounds (22%), two developed compartment syndrome of the foot (9%) at an early stage, and 11 patients had multiple injuries. We used the classifications of Hawkins and Marti/Weber. All fractures were surgically treated by fixation with screw osteosynthesis, percutaneous wire transfixation, and/or external fixation. Fifteen patients with dislocated fractures of the talus underwent clinical and radiological follow-up examinations using the Kiel score. RESULTS: Four patients had excellent and three good results. In five patients with moderate, two with adequate, and one with poor results, we found additional injuries to the ipsilateral foot or leg in 50%. Of those patients, 73% developed peritalar arthrosis and 39% talar necrosis. Due to bony defects, anatomical reconstruction was unsatisfactory in 48%. CONCLUSIONS: Even immediate anatomical reduction and sufficient stabilization cannot always decrease the rate of talar necrosis and peritalar arthrosis.

Adult↗
PubMed2000

[Treatment of intra-articular calcaneus fractures with a para-articular external fixator]].

Operative treatment of the calcaneus is still in discussion. For a better management of soft tissue problems an optimized fixator frame for primary treatment of calcaneus fractures was developed in the Dept. of trauma surgery University of Kiel. A one-plane bilateral construction with one insertion point in the tibia and two in the tuberosity of calcaneus is used. It allows efficient reduction by ligamentotaxis, stable fixation and active motion in ankle joint. We treated 40 patients with 45 calcaneus fractures. In 25 cases the fixator was definite and later plate or screw fixation was performed 20 times. 35 patients with 40 fractures were examined by means of the "Kiel score for calcaneus fractures". Patients who were treated definite reached better longterm-results on average than patients who underwent a secondary open osteosynthesis. Concrete guidelines for the therapy of intraarticular calcaneus fractures are presented.

Calcaneus↗
PubMed1999

[Internal knee injuries in children].

Although children are injured everyday through accidents, road traffic, leisure or sports activities, internal lesions of the knee joint due to the trauma are rare. Diagnose and therapy follow rather empirical than analytical patterns. A retrospective, controlled study evaluates and recommends ways of treatment. Traumatic internal lesions of the knee where analysed in 76 children up to age 16. The pattern of injury changed with increasing age, the trauma remaining the same. Most common where injuries to the anterior cruciate ligament (ACL). Main cause where sports activities. Operative treatment seems to be the appropriate treatment. Osseous avulsions of the cruciates and collateral ligaments showed good results after transosseous refixation with a suture. Suturing of intraligamentous ACL-ruptures as well as patellar ligaments plasty showed unsatisfactory results. Secondary lesions due to instability of the knee where also observed in children. Children cannot self estimate the severity of the injury so subjective statements are insecure. Trauma, surgery, pain and immobilisation cause a marked malfunction of the sensor-motor system which is effectively treated by physiotherapy.

Adolescent↗
PubMed1997

[CT of the talus: the importance of 2- and 3-dimensional reconstructions].

PURPOSE: To evaluate the clinical value of sagittal 2D- and 3D-reformations of the talus with and without electronic disarticulation compared to axial slices. MATERIAL AND METHODS: 23 patients with suspected traumatic lesions of the talus underwent 26 diagnostic CT examinations. Axial slices, sagittal reformations, and 3D-reformations without and with electronic disarticulation were performed. The sagittal 2D- and both types of 3D-reformations were compared to the axial slices with regard to their diagnostic information. RESULTS: Axial slices showed involvement of articular facets in 25 cases. Sagittal and 3D-reformations after electronic disarticulation depicted 23 fractures (23/25), 3D-reformations without electronic disarticulation showed none (0/23). Subluxation of the talocalcaneal joint was only visualised on axial slices three times. One complete luxation of this joint was shown on axial slices, sagittal and 3D-reformations without disarticulation. It was not visualised on 3D-reformations after disarticulation. CONCLUSION: The diagnosis must be made based on the axial slices, supported by sagittal reconstructions. 3D-reformations after electronic disarticulation provide a graphic, detailed and readily recognised image of the anatomy of transchondral fractures, and are very helpful in preoperative planning.

Adolescent↗
PubMed1997

[CT morphology of fractured thoraco-lumbar vertebrae after transpedicular spongiosaplasty and use of internal fixator].

PURPOSE: An analysis of the CT morphology of fractured thoraco-lumbar vertebrae after treatment with internal fixation and transpedicular spongiosaplasty (SP). MATERIAL AND METHOD: 30 patients were examined following trauma and surgery after about 12 and 30 months by means of CT. The following were evaluated: width of the spinal canal; height of the vertebra and intervertebral space; degree of kyphosis; position, size and appearance of the SP and of the vertebral body. RESULTS: The width of the spinal canal was reconstituted in 91%; in 83% the anterior vertebral margin and in 35% the intervertebral space was reduced. A kyphosis of 8.9 degree was found on the followup examination. The SP showed a reduction in size (18/30) or could no longer be defined (6/30). Hypodense areas (28/30) with cavitation (12/30) were found in the vertebral body and the SP could be identified by a sclerotic margin (22/30). CONCLUSION: Treatment by this form of therapy was successful, reaction of the vertebral body against the spongiosaplasty could be identified.

Adolescent↗
PubMed1994

[Analysis of 55 post-traumatic pseudarthroses after tibial fracture].

In a retrospective analysis of 1,300 lower leg fractures, treated by operative stabilization in the years from 1980 to 1992, we examined disturbances of bone healing. In 55 patients (4.2%) faults in indication and completion of internal or external stabilization, infections with consecutive instability (43.6%), and bone defects (63.6%) led to prevention of bone healing. Conservation of blood supply and medial cortical support should be ensured.

Adolescent↗
PubMed1992

[Patterns of injuries: a guideline for evaluation of multiple injuries?].

By means of 468 patients with polytrauma the pattern of injuries were analysed. Separated into body regions the combinations of injuries to skeleton/thorax and skeleton/thorax/abdomen were found most often. A high lethality was evaluated for the combination of skeletal and abdominal injuries. 362 patients of the examined collective survived, 106 patients died. Among the deceased patients with head-injuries intracranial bleeding could be seen much more than in the group of survivors. Patients who died had also more ruptures of liver and other gastrointestinal injuries. Concerning the skeletal patterns of injuries they surprisingly had more fractures of shoulder, forearm and lower leg than the survivor-group. The statistic demonstrates clearly that in pattern of head or abdominal injuries the single diagnosis determines the rate of lethality. This correlation could not be seen in skeletal injuries. The pattern of injuries cannot be used as a guideline for the assessment of therapy of the severe trauma patient.

Abdominal Injuries↗
PubMedDate not supplied

Efficacy and safety of abacavir plus lamivudine versus didanosine plus stavudine when combined with a protease inhibitor, a nonnucleoside reverse transcriptase inhibitor, or both in HIV-1 positive antiretroviral-naive persons.

PURPOSE: The combination of abacavir + lamivudine (ABC+3TC) versus didanosine + stavudine (ddI+d4T), each combined with other classes of antiretrovirals (ARVs) in ARV-naive patients, was compared for the combined endpoint of time to plasma HIV RNA >50 copies/mL (at or after the 8-month visit) or death (primary endpoint) in a nested substudy of an ongoing multicenter randomized trial. METHOD: The substudy enrolled 182 patients; mean HIV RNA and CD4+ cell counts at baseline were 5.1 log10 copies/mL and 212 cells/mm3, respectively. RESULTS: After a median follow-up of 28 months, rates of primary endpoint were 57.2 and 67.8 per 100 person-years for the ABC+3TC and ddI+d4T groups (hazard ratio [HR]=0.81, 95% confidence interval [CI] 0.58-1.14, p=.23). CONCLUSION: There was a trend for treatments containing ABC+3TC to be better than treatments containing ddI+d4T with respect to HIV RNA decreases, CD4+ cell count increases, and tolerability.

Anti-HIV Agents↗