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Biomedical subjects

S Piltz

Publications and source records attributed to S Piltz.

12 recordsLinked to original sources
PubMed2005

Biomechanical evaluation of a bioabsorbable expansion bolt for hamstring graft fixation in ACL reconstruction: an experimental study in calf tibial bone.

INTRODUCTION: The purpose of our study was to evaluate and compare the primary fixation strength of a novel bioabsorbable two shell expansion bolt (EB) with that of a well-established interference screw-fixation technique in hamstring reconstruction of the anterior cruciate ligament. MATERIALS AND METHODS: Thirty calf tibia plateaus (age 5-6 months) were assigned to three groups: In group I (n = 10) triple-stranded hamstring grafts were fixed with titanium interference screws (7 mm thread / 8 mm head x 25 mm). Specimens of group II (n = 10) received bioabsorbable poly-L-lactide interference screws (8 x 23 mm). In group III (n = 10), the grafts were fixed using bioabsorbable poly-D,L-lactide expansion bolts (5.8/8.5/10 mm x 35 mm). The tensile axis was placed parallel to the bone tunnel. The construction was then loaded until failure under a displacement rate of 1 mm per second. RESULTS: There were no significant differences concerning the maximum pullout force (group I: 357 N +/- 61; group II: 326 N +/- 92; group III: 343 N +/- 55). In case of the expansion bolt, we found the stiffness to be higher (61 N/mm) when compared to group I (48 N/mm), and group II (52N/mm) (P < 0.01 I vs. III). Using interference screws, we were able to demonstrate a strong correlation between torque and pullout forces (group I: r2 = 0.7; group II: r2 = 0.92). Ruptures of the suturing material occurred only in groups I and II. CONCLUSION: We conclude that hamstring graft fixation, using the presented expansion bolt, demonstrates fixation strength similar to the established screw fixation and can therefore be regarded as a reasonable alternative fixation method. Especially, since some specific disadvantages of screw fixation can be prevented by application of the bolt fixation.

Animals↗
PubMed2004

Bioabsorbable expansion bolt fixation in anterior cruciate ligament reconstruction.

The current study evaluated initial fixation strength of a bioabsorbable expansion bolt compared with interference screw fixation in anterior cruciate ligament reconstruction using a bone-patellar tendon-bone graft. Thirty calf tibial plateaus with adjacent patella and extensor ligaments were used. Bioabsorbable poly-L-lactide interference screws were used for graft fixation in Group I, titanium screws in Group II, and bioabsorbable poly-DL-lactide expansion bolts were used in Group III. The mean force-to-failure (+/- standard deviation) in the three groups was 487 +/- 205 N, 713 +/- 218 N, and 594 +/- 224 N, respectively. The differences between Groups I and II were significant. No statistical differences were found regarding stiffness. Graft damage was significantly less in Group III compared with screw fixation. The fixation concept of an expansion bolt shows similar fixation strength and less graft damage compared with the established interference screw fixation. Because of the total absence of torque forces in contrast to bioabsorbable screws, the risk of implant breakage is minimized.

Absorbable Implants↗
PubMed2003

[Surgical treatment of pulmonary metastases from renal cancer].

Based on a large single-center follow-up database, we evaluated the long-term results after curative resection of pulmonary metastases from renal cancer. During a 20-year period, 105 patients underwent a total of 150 resections with curative intention. Hospital mortality was 0.95%, 5- and 10-year survival rates were 40% and 33%, respectively. Significant prognostic relevance was shown for complete pulmonary resection, lymph node involvement upon primary resection as well as size of the resected lung metastasis. Our findings of low perioperative morbidity and mortality rates lead us to propose that in patients without additional metastases curative resection of pulmonary lesions should be considered. Moreover, recurrent pulmonary metastases should also be considered for surgical treatment since resection for cure significantly improves survival in these patients.

Adult↗
PubMed2000

[Treatment of per- and subtrochanteric femoral fractures by gamma nails and modular hip prostheses. Differential indications and results].

From January 1997 to August 1998 all stable and nonstable trochanteric femoral fractures (n = 72) were treated routinely by gamma nail using the correct operative technique. Patients showing additional osteoarthritis of the hip in radiographs hip replacement was performed by a cementless modular femoral hip prostheses from January 1996 to August 1998 (n = 28). Follow up period was 6 to 18 months. Operation time and blood loss were higher using the prostheses. However complications and lethality (< 5%) were not different during postoperative course. In each group three operative technical complications occurred. Using a modified Harris Hip Score (without range of motion, contractions) the score was decreased non significant comparing both groups first of all in unstable fractures until follow up. In each group one revision (loosening of prostheses, excessive shortening of femoral neck) was necessary. Using the correct operative technique, the gamma nail proved to be a save device with good outcome. Outcome using modular prostheses is comparable to gamma nail. Therefore the use of modular prostheses is justified in case of osteoarthrosis and in some cases of very unstable fracture.

Adult↗
PubMed2000

Endoscopic osteosynthesis after thoracic spine trauma: a report of two cases.

Modern concepts of treating thoracic diseases suggest more and more the use of minimally invasive thoracoscopic techniques to reduce morbidity and save costs. For treatment of specific lesions at the thoracic spine, several thoracoscopic procedures have been performed successfully. The present report examines the feasibility of thoracoscopic osteosynthesis in two patients with ventral hyperextension injuries and anterior instability of the thoracic spine. After initial correction of the anatomical deformity, autologous bone was harvested from the anterior iliac crest. Using a ventral, thoracoscopic approach, the main location of the ventral, damaged spinal segment was identified by the covering pleural haematoma. After endoscopic ventral bone grafting, osteosynthesis was performed, using dynamic compression plates, cardan drills and screw drivers. The perioperative course was uneventful, and follow up examinations after 3 years and 9 months, respectively, revealed an unchanged stable spinal segment. Our results show thoracoscopic osteosynthesis to be technically possible, with a potential for yielding satisfying long-term results.

Aged↗
PubMed1996

Kinetics of circulating adhesion molecules and chemokines after mechanical trauma and burns.

OBJECTIVE: To assess the role of circulating adhesion molecules and chemotactic cytokines within different settings of major trauma. DESIGN: Retrospective study. SETTING: Teaching hospitals, USA and Germany. SUBJECTS: Two groups of patients with multiple injuries (group I n = 155 and group II n = 12) with mean (SEM) injury severity scores (ISS) of 35 (4) and 32 (4) points, respectively, and 18 burned patients with a mean of ISS 38 (9) points. INTERVENTIONS: Serum samples were collected at the site of the accident and on admission to the (Group I) as well as during the post-trauma course in the hospital (Group II: days 1, 3, 5, 7, 10; Group III; weekly, up to week 10). MAIN OUTCOME MEASURES: Measurement of concentrations of soluble (s) adhesion molecules (sE-selectin, sP-selectin), and chemotactic cytokines (interleukin-8 [IL-8], epithelial cell derived neutrophil activating peptide 78 [ENA-78]) in serum after major mechanical trauma and burns. RESULTS: High concentrations of ENA-78 and sP-selectin were already present at the site of accident as well as one hour after injury. During recovery from the injuries, persistently high concentrations of IL-8, ENA-78, and sP-selectin were found, but sE-selectin was increased only during the first week after major trauma. CONCLUSION: Massive tissue trauma causes immediate activation of selected chemokines and adhesion molecules within minutes of the injury which will then persist depending on the type and severity of the injury for a substantial length of time. There was, however, no correlation between serum concentrations of the mediators investigated and susceptibility to complications or outcome.

Adolescent↗
PubMed1996

[Results of operative therapy in sequential liver and lung metastasis].

During the last 16 years, 15 patients with colorectal (n = 12), gastric (n = 1), renal cell (n = 1) and adrenal (n = 1) carcinoma underwent sequential resection of both hepatic and pulmonary metastases. Median survival after diagnosis of primary tumor was 80 months (range 23-183), after liver resection 23 (range 10-131), and after lung resection 18 months (range 5-87). Compared to patients with only hepatic (median survival: 38 months) or pulmonary metastases (median survival: 30 months) survival time was not significantly different (p = 0.18).

Abdominal Neoplasms↗
PubMed1995

Surgical treatment of tumor metastases: general considerations and results.

The prerequisite for a curative resection of metastases is their restriction to the key organs, the liver and lungs, in the sense of a limited dissemination. For long-term prognosis, the type of primary tumor as well as the radical resection of lung and liver metastases is essential. To improve the process of surgical indication and therapy of tumors, clear definitions for the terms "tumor recurrence" and "metastases" have been agreed upon. Research and clinical investigation have led to a better understanding of tumor-regulating factors, some of which are briefly described: Metastasis promoting factors include the lack of E-cadherin, which leads to a local penetration of basal membranes by tumor cells; CD44 seems to play an important role in cell-cell and cell-matrix interactions, apparently increasing the metastatic potential of tumors and reducing the long-term survival of patients. High levels of urokinase in primary tumors are also associated with a poorer prognosis, as well as plasminogen inactivator inhibitor PAI II, which plays a crucial role in tumor growth. Positive findings in bone marrow aspirates of patients with different malignancies, stained for cytokeratin 18, either are associated with higher recurrence rates in colon and breast cancer or can be correlated to the prognosis of patients with gastric cancer. Technical aspects of surgery for hepatic, pulmonary and skeletal metastases are presented and discussed with respect to curative and palliative indications.

Bone Neoplasms↗
PubMed1993

[Surgery of metastases--can surgery of metastases be radical?].

Resection of metastases gains more and more importance in day to day surgical work task. Mainly only liver- and pulmonary metastases can be resected with a curative aim, depending on the primary tumor and the metastasing cascade. According to tumor surgery a R0-resection is warranted. Whether a multimodal approach may improve long-term results by eliminating occult micrometastases should be answered by ongoing studies. Even in palliative situations complete resections of metastasis are preferred and in selected situations a multimodal approach may be chosen.

Bone Neoplasms↗
PubMed1993

[Surgical treatment strategies in femoral metastases].

Because of the increasing survival-time of tumor-patients bone metastasis is becoming an important subject in surgery. In the case of osteolysis of the femur a concept of treatment in consideration of various localisations is presented. In 81 patients with pathological fractures of the femur or osteolysis in this region from January 1987 to June 1992 96 stabilizing operations were performed. Almost one half of the patients suffered from breast carcinoma followed by hypernephroma, Plasmocytoma, bronchial-carcinoma and prostate-carcinoma. The average survival time after stabilization of the femur was 8.3 months. After the operation the condition of the patients improved on an average by 0.64 units of the modificated Karnowsky-Index. Surgical treatment of osteolysis in the femur is indicated either in pathological fractures or if instability is imminent. Moreover patients who suffer from severe pain should also receive palliative surgery. With regard to the site of the lesion various types of endoprostheses and osteosynthesic devices can be used. If the femoral neck or the intertrochanteric region is affected arthroplasty with cemented endoprosthesis may be performed. In subtrochanteric osteolysis long and thin endoprosthesis can be used as well as Gamma-nails. Pathological fractures in the shaft of the femur should be treated with intramedullary static locked nails, which can be strengthened by supplementary lateral plates. If the distal metaphysis of the femur is involved compound osteosynthesis with methylmethacrylate and dynamic condylar screws or angle plates can be used.

Female↗
PubMed1991

[The prognostic value of a mucin histochemical study for the detection of a elevated risk of recurrence after surgical therapy of colorectal carcinoma].

Increased sialomucin production may occur in mucosa surrounding malignant colorectal tumors. The authors examined the value of sialomucin production for prognostication of subsequent local tumour recurrence. Colorectal mucosa was evaluated from 73 patients who had undergone curative surgery for colorectal carcinoma. Sialomucin production was semi-quantitatively measured, using a high iron-diamine/alcian-blue staining technique. Significant increases in sialomucin production was recorded from mucosa, at least along resection margins, from 17 in 39 patients (44%) who did not develop any local recurrence. On the other hand, increased sialomucin synthesis was recordable from only 10 of 27 patients (37%) who did develop local recurrence. Moreover, only one of 7 patients who developed metachronous recurrence had exhibited sialomucins predominantly on resection margins. These findings are likely to suggest that evidence to increased sialomucin production is not conclusively indicative of high risk of local recurrence.

Colectomy↗