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Biomedical subjects

M Walther

Publications and source records attributed to M Walther.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Hip dislocation without fracture--a trauma surgery emergency].

Between 1968 and 1990, 26 patients (medium age 24.2 years) with a traumatic hip dislocation without fracture were treated at the Dept. of Trauma Surgery of the University Erlangen-Nuremberg. Only 26.9% of the patients had no further injuries beside the hip dislocation. An early closed reduction was carried out whenever possible. In 96.0% of the cases, radiological acceptable results have been achieved with the closed reduction. In 4.0% an open reduction became necessary. After a period of three to four weeks of extension, the patients had been mobilized to nonweight bearing status. Stress on the injured leg was increased progressively, that full weight bearing capacity was achieved after three months. It was possible to examine 12 of the 26 patients. Good and very good results based on the Merle d'Aubigné score and on the Thompson and Epstein score were obtained in 11 of the 12 patients. The complication seen most often was posttraumatic coxarthritis of the hip. We have not seen any necroses of the head of femur in our patients to date. All our results indicate, that the immediate and careful reposition under anaesthesia seems to be the most important factor in preventing a necrosis of the head of femur.

Adolescent↗
PubMed1994

[The Erlangen Support Ring for management of congenital and acquired acetabular defects. Intermediate term results of 43 implantations].

Between January 1987 and December 1989, at the Department of Trauma Surgery of the University of Erlangen 41 patients were treated at one or both hips with the uncemented hip replacement "Erlanger Modell" including a special supporting ring because of the bad condition of the bone surrounding the acetabular region. In 41 cases the implantation was a revision. 2 patients have not been operated on before. They suffered from congenital hypdysplasia with severe bone destruction at the area of the acetabulum. The supporting ring and the cup are made of the titanium alloy TiAl5 Fe2.5. Using the supporting ring, it is possible to fix the socket within the bone graft and to diminish the pressure exerted on the socket by transferring a lot of stress directly to the iliac bone and the oubic bone. The results of 41 patients (43 joints) ranging from 21 to 57 postoperative months giving an average of 32 months, are very encouraging. 76.6% of the patients feel no or not much pain, 67.4% can walk without hooked stick and 79% can walk a distance of more than 1000 m. The range of movement of the hip joint could be improved, especially abduction and extention. Good results based on patients satisfaction were obtained in 95.4%.

Acetabulum↗
PubMed1993

[Eight years experience with the "Erlangen Model" titanium prosthesis--results of cementless implantation of 250 hip prostheses].

Between March 13, 1984 and March 28, 1988, 233 patients (age range from 21 to 73 years) with osteoarthritis of one or both hips were treated with the uncemented hip replacement "Erlanger Modell" (Prof. H. Beck/P. Brehm Chirurgie-Mechanik GmbH). The cause of the osteoarthritis was variable. Hip replacement was carried out for the following conditions: rheumatoid arthritis including ankylosing spondylits (n = 29), aseptic necrosis of the femoral head including posttraumatic and idiopathic forms (n = 17), osteoarthritis of unknown origin (n = 111), osteoarthritis following dysplasia or subluxation of the hips (n = 56) and loosened cemented hip prostheses (n = 37). Full weight bearing was not permitted for 50 days postoperatively, but mobilization and isometric exercises began 2 days after operation and isotonic exercises are introduced later. Complications included fracture of the femoral shaft during operation (3.3%), fracture of the femoral shaft postoperative (1.6%), dislocation (0.8) and infection early after operation (0.4%) and aseptic loosening (3.7%). Our results of 233 patients (250 joints), ranging from 4 to 8 postoperative years giving an average of 5.3 years, are encouraging. Good results based on patients satisfaction were obtained in 95.2% (83.8% after revision) and poor results in 1.0% (2.7% after revision). 3.8% (13.5 after revision) judged their situation as unchanged. 93.3% of the patients can walk without hooked stick (53.3% after revision), 90.2% of the patients can walk more than 1000m (69.4% after revision).

Adult↗
PubMed1993

[Results of cementless implantation of 150 "Erlangen Model" hip prostheses of titanium alloy Ti Al5 Fe2.5].

Between March 17, 1984 and August 20, 1987, 142 patients with osteoarthritis of one or both hips were treated by joint replacement with the uncemented "Erlangen" hip prosthesis (Prof. H. Beck/P. Brehm Chirurgie-Mechanik GmbH). The causes of the osteoarthritis varied. Hip replacement was carried out for the following conditions: rheumatoid arthritis including ankylosing spondylitis, aseptic necrosis of the femoral head, including posttraumatic and idiopathic forms, osteoarthritis of unknown origin, osteoarthritis following dysplasia or subluxation of the hips, and loosened cemented hip prostheses (131 primary implantations and 19 revisions). Full weight-bearing was not permitted for 50 days postoperatively, but mobilization and isometric exercises were started 2 days after operation and isotonic exercises were introduced later. Complications included fracture of the femoral shaft during operation and aseptic loosening. Our results in the 142 patients (150 joints) at 32-65 months (average 44 months) after surgery are encouraging. Good results based on patient satisfaction were obtained in 92.7% (81.3% after revision) and poor results in 7.3% (18.7% after revision). Most (90.2%) of the patients can walk without a stick (50.0% after revision), and 90.2% of the patients can walk more than 1000 m (68.8% after revision).

Alloys↗
PubMed1992

["Erlangen Model" titanium socket. Study of the biomechanics of the "Erlangen Mode" titanium socket with and without supporting ring].

A multitude of prostheses are available for the reconstruction of severely arthrotic hip joints--especially for revising total arthroplasty. In order to find out more about the biomechanical efficiency of these special implants, we carried out computerized analyses on how the distribution of stress within the pelvis changes when employing the titanium socket component "Erlanger Modell" [TiAl 5 Fe 2.5], which can be used with a supporting ring in order to transfer the stress on the hip joint to the iliac bone and to the pubic bone in case the acetabulum should not be able to provide the stability needed by the socket. In a procedure described by Herzog, strain gauges are attached to the pelvis of freshly slaughtered cattle at the following sites, transmitting the relative bone expansion and torsion to a multipoint measuring instrument (Linseis L2100) and on-line to a computer: (1) superior ramus of the pubic bone; (2) front edge of the socket at the iliopubic eminence; (3) iliac bone on the outside of the pelvis; (4) socket roof, pars ossis ilei in the small pelvis; (5) socket roof, pars ossis ischii in the small pelvis. The quality of the implantation was monitored by the non-delayed force transmission from the femur through the hip arthroplasty onto the pelvis. With stress varying from 0 to 500 N in steps of 125 N we carried out four complete readings in order to ensure the reproducibility of the measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMed1991

Von Hippel-Lindau (VHL) disease: distinct phenotypes suggest more than one mutant allele at the VHL locus.

As part of an attempt to locate the von Hippel-Lindau locus (VHL) on chromosome 3, we evaluated 41 families with von Hippel-Lindau disease from the United States and Canada. One large family was identified whose disease phenotype was distinct from typical VHL. The most common disease manifestation was pheochromocytoma occurring in 57% (27/47) of affected family members. Few (4/47) affected family members had symptomatic spinal or cerebellar hemangioblastomas; no affected family member had renal cell carcinoma (0/47) or pancreatic cysts (0/24). Previously, genetic analysis demonstrated that the disease manifestations in this family were linked to RAF1 and D3S18, markers shown to be linked to typical VHL. These results suggest that there are mutant alleles at the VHL locus associated with distinct tissue specificities.

Adrenal Gland Neoplasms↗
PubMed1990

Purification of an antigen from the Taenia crassiceps metacestode vesicular fluid highly sensitive in detecting IgG-antibodies (ELISA) in calves with experimental cysticercosis.

This study reports on the purification of an antigen predominant within the vesicular fluid (VF) of T. crassiceps metacestodes and shown to share identity with the major vesicular fluid protein of the T. saginata larval stage. Purification was achieved by gel filtration of the VF on Sephacryl S-300 superfine, followed by ion exchange HPLC. The antigen represents a single polypeptide chain (Mr appr. 37,000) with carbohydrate moieties without affinity to ConA. Isoelectric focusing of the electrophoretical and immunological homogeneous antigen resulted in five bands focusing at pH 4.0, 4.2, 4.4, 4.6 and 4.8, respectively. In ELISA, the purified antigen detected serum IgG-antibodies in all 21-35 weeks old calves (n = 10) with experimental cysticercosis (70 to 6,000 viable larvae recovered). When compared to T. saginata metacestode VF the antigen was the better reagent for discriminating between infected and non-infected animals. As shown by immunodiffusion and ELISA the antigen is also common to the T. saginata adult stage and obviously to other taeniid metacestodes where it is accumulated in the VF or hydatid fluid.

Animals↗
PubMed1989

Endocrine disturbances in suprasellar germinomas.

The authors have investigated hypothalamic-pituitary function in 8 patients (aged 9-27 years) with surgically and histologically proven suprasellar germinomas. Diabetes insipidus was found in 7 patients. All the patients had hypogonadism and hypocortisolism as judged by dynamic endocrine testing. Hypothyroidism was found in 6. Moreover, growth hormone secretion, as assessed by insulin-induced hypoglycemia, was defective in all patients. Comparison of results of insulin-induced hypoglycemia testing and stimulation tests by CRH and GHRH suggested that all patients had a primary suprahypophyseal lesion rather than a primary pituitary defect. The authors conclude that suprasellar germinomas, although uncommon, should be included in the differential diagnosis of juvenile suprasellar tumours and in cases suggestive of idiopathic diabetes insipidus, even if neuroradiological investigation fails to demonstrate a discrete tumour.

Adolescent↗
PubMed1987

The role of vesicostomy in the management of anterior urethral valves in neonates and infants.

We performed vesicostomy as the initial form of management in 2 male newborns and 1 infant with anterior urethral valves associated with proximal urethral diverticula and bilateral hydronephrosis. Prompt improvement in the degree of hydronephrosis was noted after vesicostomy in all 3 patients along with improvement in renal function in 2 who had presented with renal insufficiency. Subsequently, 2 patients have undergone vesicostomy closure and transurethral valve fulguration, and 1 also required ureteral reimplantation for persistent vesicoureteral reflux. The use of vesicostomy in the newborn period rather than transurethral fulguration prevented the potential complications of urethral stricture and inadequate valve resection that can occur owing to the small size of the neonatal urethra. Furthermore, a period of vesicostomy drainage before eventual ureteral reimplantation for severe vesicoureteral reflux obviated the need for ureteral tailoring.

Diverticulum↗
PubMed1986

[Extrapuerperal discharge of the breast (so-called galactorrhea)].

In a study to explore the incidence and cause of breast discharge, 153 of 6697 outpatients of the Senology Department, University Women's Hospital, were investigated for nipple discharge in a retrospective study from January 1980 to May 1983. The effectiveness of paraclinical investigation methods (radiology, histology, cytology and serum prolactin) was also compared. For the symptom described the authors suggest an investigation plan which offers savings in time and cost.

Adolescent↗
PubMed1986

Condylomata acuminata and verrucous carcinoma of the bladder: case report and literature review.

Condylomata acuminata and verrucous carcinoma are 2 lesions rarely seen in the bladder. Condylomata of the bladder can be treated successfully by local therapy but underlying carcinoma must be considered if the lesion is extensive or progressive in nature. Vigorous biopsies of the base of the lesions are necessary to eliminate the possibility of malignancy. If verrucous carcinoma is found the patient should be treated surgically. A case of condylomata acuminata of the bladder undergoing malignant change to verrucous carcinoma is reported.

Adult↗
PubMed1985

Xanthogranulomatous cystitis.

Xanthogranulomatous lesions have been reported in many anatomical sites but only 10 cases involving the bladder have been described, 7 of which were associated with urachal adenoma. To our knowledge, we report the first instance of xanthogranulomatous cystitis in the English literature.

Adult↗