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Biomedical subjects

M Salzer

Publications and source records attributed to M Salzer.

At least 19 recordsLinked to original sources
PubMed1991

Girdlestone's modified resection arthroplasty.

Thirty-three patients were operated for septic (n = 20) and aseptic (n = 13) loosening of their hip prostheses using Girdlestone's operation over 10 years. An average of 46.6 months later, 22 of these patients were given a follow-up examination. Clinical evaluation according to Harris showed an improvement in mean values from 25 to 53 points, which can be attributed mainly to a marked reduction in pain, as function remained poor and the patients still depended on walking aids. The infection ceased in 92% of the patients with septic prosthesis loosening.

Aged↗
PubMed1991

Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients.

Seventy patients who had a rotationplasty for treatment of a malignant tumor in the region of the knee (the femur or the tibia) between 1974 and 1987 were followed for two to thirteen years (mean duration of follow-up, four years). Forty-seven patients had a stage-IIB osteosarcoma; the remaining twenty-three patients had a malignant fibrous histiocytoma, a chondrosarcoma, a Ewing sarcoma, or a giant-cell tumor. The most severe postoperative complication was occlusion of the reanastomosed vessels (seven patients), leading to amputation proximal to the knee in three patients. Other complications were problems with wound-healing (eight patients), transient nerve palsy (five patients), irreversible nerve palsy (two patients), pseudarthrosis (four patients), and rotational malalignment (one patient). Late complications included eight fractures, two infections, two delayed unions, and one lymphatic fistula. More than half of the patients were free of complications related to the operative procedure. Forty-four of the patients who had a stage-IIB osteosarcoma could be followed, and their data were analyzed for survival statistics. These patients had a 58 percent rate of disease-free survival and a 70 per cent rate of over-all survival. One patient had a local recurrence five years after the operation.

Adolescent↗
PubMed1990

A radiological analysis of uncemented PCA tibial implants with a follow-up period of 4-7 years.

A total of 63 uncemented PCA tibial implants were followed radiologically for a period of 4-7 years to establish whether primary fit, alignment, bone quality, age, and diagnosis have an effect on radiological results. Fifty-eight of the 63 tibial plateaus investigated (92%) showed excellent or good radiological results. In three cases the implant was rated radiologically endangered and in two cases radiologically loose. The results show that successful long-term anchorage depends principally on a primary stable fit. If implantation is inexact, poor bone quality, improper alignment, advanced age, and rheumatoid arthritis may be responsible for unsatisfactory radiological results. The authors conclude that particular importance must be attached to exact primary fixation when several unfavorable factors are encountered.

Aged↗
PubMed1990

Improved therapeutic index of cisplatin analogue: B-85-0040 by circadian timing.

1. B-85-0040 is a new cisplatin analogue with dose limiting myelosuppression. 2. The maximum tolerated dose ranges between 300 and 525 mg/kg for single i.p. bolus injection in mice. 3. Its toxicity is circadian-stage dependent with optimal tolerance between 16 and 17 hours after lights on. 4. B-85-0040 is active in L1210 leukemia. Anti-tumor activity seems to be unrelated to the circadian stage of treatment. Optimal drug timing can therefore increase its therapeutic index.

Animals↗
PubMed1989

[Education and guidance of the cancer patient].

Neither the naked truth nor a compassionate lie are appropriate in the case of incurable cancer patients. The prerequisite for the effective guidance of terminal cases is genuine communication--really entering into the needs of the patient. This requires a great deal of time--more than a doctor can spare in the day-to-day running of a hospital. It is therefore necessary to delegate patient guidance to a psychosocial team. It is only through co-operation with the medical team that a therapeutic team comes into being which is in a position to be of genuine assistance to a severely ill person.

Humans↗
PubMed1989

Biochemical effects and zonal heterogeneity of peroxisome proliferation induced by perfluorocarboxylic acids in rat liver.

Rats were treated for 5 to 14 days with perfluoroacetate, perfluorobutyrate and perfluorooctanoate. Alterations in hepatic morphology with special reference to the peroxisomal compartment were investigated by light and electron microscopy following cytochemical staining of catalase activity with the alkaline 3,3'-diaminobenzidine medium. All three compounds induced hepatomegaly and peroxisome proliferation. Perfluorobutyrate and perfluorooctanoate were found to be more active than perfluoroacetate. Perfluorooctanoate-induced peroxisome proliferation was more prevalent in centrilobular than in periportal hepatocytes. Peroxisomes in centrilobular liver cells frequently were of round shape, exhibited diameters of up to 1.5 microns and were predominantly located within smooth endoplasmic reticulum-glycogen areas. In periportal cells, however, clusters of polymorphous peroxisomes ranging from 250 to 1,100 nm in diameter were observed at the periphery of smooth endoplasmic reticulum-glycogen regions. Peroxisome proliferation was accompanied by a change of peroxisomal and mitochondrial enzyme activities, in particular an increase in peroxisomal palmitoyl-CoA oxidation. Significant alterations in the concentration of peroxisomal matrix and membrane polypeptides were also noted. Within the first 2 days, perfluorooctanoate treatment exerted a strong hypolipidemic activity and both compounds perfluorooctanoate and perfluorobutyrate raised the level of hepatic free acid-soluble CoA nearly 10-fold as compared with control livers. The results suggest perfluorinated carboxylic acids to be model substances suitable to correlate biochemical and morphological parameters with the zonal heterogeneity of the peroxisomal compartment in rat liver. Due to the manifold hepatic effects, contact of humans with perfluorinated carboxylic acids or their metabolic precursors may represent a severe health risk.

Animals↗
PubMed1988

Heterotopic ossification with total hip endoprostheses in various models of thrombosis prophylaxis.

The influence of thrombosis prophylaxis on the occurrence of heterotopic ossification after implantation of total hip endoprostheses was analyzed in a series of randomized studies. When low-dose heparin or dextran 40 was administered, the rate of ossification was comparatively high (30.1% and 65.1%). When a combination of acetylsalicylic acid and an antirheumatic (oxyphenbutazone) or low-dose heparin with an antirheumatic (indomethacin) was administered, the ossification rate became significantly lower (6.2% and 16.7%). No severe ossification (Arcq degree III) was observed in the groups given an antirheumatic in addition to thrombosis prophylaxis.

Aspirin↗
PubMed1987

Survival analysis of an uncemented ceramic acetabular component in total hip replacement.

Follow-up examinations of 67 implants of cement-free ceramic sockets show the need for an exact definition of failure, to warrant comparable evaluations of results. Statistical survival analysis offers the possibility of presenting both the incidence of failures and the dates of their occurrence. If only revision surgery with removal of the socket is considered to be a failure, our material shows the "survival quota" of the ceramic socket after 8 years to be 96.7% +/- 2.2%. If radiological signs of loosening are included in the evaluation of failures, the "survival quota" of the stable implants is reduced to 81.9% +/- 6.9%.

Acetabulum↗
PubMed1987

[Surgical tactics in malignant bone tumors].

In treating bone sarcomas two principles apply: 1) Oncologically radical removal of the tumor. 2) Maximum functional preservation and/or restoration of the extremity. Modern chemotherapy has clearly improved the prognosis for some sarcomas (e.g. osteosarcoma, Ewing's sarcoma), justifying even extensive surgery and lengthy rehabilitation. Primary malignant bone tumors are fairly rare. To optimize therapeutical results, supraregional and interdisciplinary treatment centers have to be established.

Bone Neoplasms↗
PubMed1986

[Experiences in the treatment of advanced nonseminomatous testicular tumor].

48 patients with nonseminomatous testicular tumours were treated between 1980 and 1984. 19 patients had bulky stage II c or disseminated disease; according the Royal Marsden staging classification 5 patients had stage II c, 2 patients III and 12 patients stage IV. The pT stage of the primary tumour showed no correlation to low stage disease, but pT was only found in advanced disease. In disseminated disease histological examination revealed more cases of malignant teratoma undifferentiated (MTU) and malignant teratoma trophoblastic (MTT) than malignant teratoma intermediate (MTI). Before therapy 14 patients had elevated serum markers, whilst in 5 patients markers were negative. Combination chemotherapy with Vinblastin, Bleomycin and Cisplatin (Einhorn) was given and afterwards 13 patients had to undergo operation to remove a residual mass. Scarring was found in 4 patients (31%), teratoma in 6 (46%) and active tumour in 3 (23%). At a median survival time of 3 years 16 of 19 patients (84%) are alive. The two patients with elevated tumour markers before operation are also alive and disease-free. Altogether out of 48 patients with advanced nonseminomatous testicular tumours 94% of the patients are alive.

Adolescent↗
PubMed1979

A bioceramic endoprosthesis for the replacement of the proximal humerus.

In patients with malignant tumors in the region of the shoulder, radical resection can avoid amputation in most instances. To improve the function of the arm, endoprosthetic replacement of the defect is desirable. A three-component endoprosthesis made of a bioceramic material (aluminium oxide) was designed, implanted without bone cement. Fast anchorage to bone is achieved by using a conical sleeve, fixed upon the previously conically reamed humerus shaft. A stable primary fit is always feasible. Subsequent bone in growth into grooves inside the conical sleeve provides a permanent anchorage of the endoprosthesis. The authors experiences are based on implantations of 38 endoprostheses. The original diseases were primary malignant bone tumors in 19 patients, one case of "solitary" plasmocytoma and metastases into the proximal humerus in 16 patients. In two women, resection was made because of posttraumatic subcapital humeral pseudarthrosis. The follow-up study includes only those 27 cases operated on at least one year ago. 12 of the 14 patients with primary tumors have been surviving for 12-55 months (range 27.4) without signs of metastases or recurrent disease. Seven patients with metastases died of their original diseases after 7.7 months on the average. Owing to extensive resection of the shoulder musculature the mobility in the shoulder joint is considerably reduced. All the patients have good movement of the elbow joint and free function of the hand.

Activities of Daily Living↗
PubMed1979

[The angiographic diagnosis and differential diagnosis of inflammatory disease of bones and soft tissues (a report concerning 40 cases) (author's transl)].

The angiographic appearances of inflammatory disease of bones and soft tissues was analysed in 40 patients. The angiographic findings in inflammation of bone (28 patients) differed greatly, from normal findings (14.2%), moderate angiographic changes corresponding to the severity of the inflammatory process (32.1%), marked changes in the arterial, capillary and venous beds (42.9%) and significant local staining with little peripheral reaction (10.7%). Soft tissue inflammation on the other hand showed increased vascularity in all cases. A typical angiogram was found in 50% of cases and shows the following characteristics: vascularity as compared with the surroundings is usually increased and may be extensive, far more so than is found surrounding vascular bone foci; the contrast staining is usually ill-defined and the veins in the late phase are increased in calibre. Early venous filling is common and should not be regarded as a sign of malignancy. In 17.5% of patients the angiogram simulated a tumour; in four patients (10%) a false positive diagnosis of tumour was made, in two (5%) a tumour could not be excluded and in one case a benign tumour was diagnosed because of localised staining. None of the angiograms which had been interpreted incorrectly showed typical pathological vessels, which are the most important tumour criteria.

Adolescent↗
PubMed1979

[Endoprosthetic replacement following resections of malignant tumors of the extremities (author's transl)].

Due to advances in chemotherapy and endoprothetics, amputation is increasingly being replaced by local resectioning in malignant tumors. While suitable implantations for bridging defects in the proximal humerus and proximal femur are available, prostheses for resectioned tumors in the knee area have not yet been fully developed. From 1966 to 1978, 77 endoprostheses were implanted in 29 primary bone tumors, 3 malignant soft-tissue tumors and 45 bone metastases. There were 43 endoprostheses of the proximal femur, 31 endoprostheses of the proximal humerus and 3 special endoprostheses of the knee region. In most cases, eliminating the tumor radically was successful and a functional extremity was retained.

Bone Neoplasms↗
PubMed1978

Extracortical attachment of bioceramic endoprostheses to long bones without bone cement.

Dense, highly pure A12O3 ceramic not only shows excellent wear resistance and tissue biocompatibility, but also has sufficient mechanical strength for loaded endoprostheses. The necessary diameter size of the material to sustain adequate shear stresses can be achieved, if the endoprosthesis is attached extracortically to the conically truncated long bone according to the principle of the conical sleeve. Extracortical attachment of the endoprosthesis causes minor nutritive damage since long bones derive their vascular supply mainly from the medullary cavity. In this way a primary stable and loadable connection is established, which is a prerequisite for permanent anchorage of the implant through new bone formation. After experiments in 12 dogs bioceramic endoprostheses were implanted in a total of 40 human patients using this technique of extracortical attachment (12 hip joints, 24 proximal humeri, 4 special constructions). Thirty-six of these implants were stable after observation periods ranging from one to 49 months. A stable anchorage of the prostheses to the pre-existing bone through new bone formation could be demonstrated histologically. The above preliminary results show that bioceramic endoprostheses can be "incorporated" in the skeleton and possibly also withstand the functional stresses.

Adult↗
PubMed1978

[Surgical treatment of the congenital femural defect by means of rotation plasty (author's transl)].

Experiences made in 5 cases with Borggreve's rotation plasty have shown that in cases of congenital femural defects and exceptionally also in malignant bone tumors of the distal femur this method should be suggested to the patient as a possible therapy. By rotating and shortening of the leg, the ankle joint is converted to a new knee joint. With this method an active movement of the knee joint can be obtained, so that the fitting with a below knee prosthesis becomes possible.

Abnormalities, Multiple↗