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Biomedical subjects

Thomas Bauer

Publications and source records attributed to Thomas Bauer.

At least 19 recordsLinked to original sources
PubMed2006

Arthroscopic treatment of a juvenile tillaux fracture.

Tillaux fractures are relatively uncommon fractures of the anterolateral tibial epiphysis that are observed in adolescents during the 18-month period when the distal tibial physis has begun to fuse centrally. The case of a 16-year-old boy with a juvenile Tillaux fracture treated successfully by reduction and percutaneous fixation under arthroscopic control is presented. The procedure is technically feasible, allows accurate reconstruction of the weight bearing surface of the joint and secure internal fixation of the fracture. The authors describe the principles of the procedure and discuss its advantages compared to open surgery.

Adolescent↗
PubMed2006

Arthroscopic treatment of chronic anterior instability of the shoulder in Marfan's syndrome.

We present a case of recurrent anterior shoulder dislocation in a patient with Marfan's syndrome who presented with hyperlaxity that has been treated arthroscopically. We discuss abnormal findings at arthroscopic evaluation, including complete absence of the mid anterior capsule, which left the subscapularis uncovered, and we hypothesize that repetitive trauma to the capsule was not followed by a normal process of remodeling because of a lack of competent elastic fibers and a poor capacity for soft tissue healing. The inferior insertion of the labrum and the inferior glenohumeral ligament seemed normal through the large volume of the pouch. We performed arthroscopic reconstruction of the capsule through dissection of its anteroinferior part with a radiofrequency wand from the glenoid rim and the subscapularis, followed by superior drift of the capsule. The Weitbrecht foramen was then closed with 2 nonresorbable No. 4 sutures, and the capsule was reinserted to the labrum with 2 anchors. A final suture closed the remaining hole in the rotator interval. At 16-month follow-up, the patient emphasized her satisfaction with the results; she was able to keep up with her regular schedule of leisure sports and swimming, painlessly, with no limitations or new episodes of instability.

Adult↗
PubMed2006

Wrist arthroscopy and intra-articular fractures of the distal radius in young adults.

UNLABELLED: The difficulty on treatment of articular fractures of the distal radius comes from their comminutive character and frequency of ligamentous lesions associated, turning diagnosis and assessment always subject to discussion. Fracture reduction and fixation under arthroscopic control, along with ligamentous injury treatment, provides the Surgeon with a valuable tool in order to achieve best results on follow-up. Eighteen fractures of the distal radius on 18 young adults (average age of 28.6 years), all intra-articular and 9 with ligamentous lesions associated, were operated on under arthroscopic control. Results from an average distance of 12.2 months were appraised following the score of Green and O'Brien modified by Cooney. They were excellent in five cases, good in eight cases, average in four cases and bad in one case. Recovery was best for fractures with weak comminution and when articular congruence was restored. Arthroscopy, allowing control of fracture reduction, to diagnose and possibly treat associated ligamentous lesions, constitutes a good alternative to open surgical treatment. LEVEL OF EVIDENCE: case series (level IV).

Adolescent↗
PubMed2006

Synapse formation and function is modulated by the amyloid precursor protein.

The amyloid precursor protein (APP) is critical in the pathogenesis of Alzheimer's disease. The question of its normal biological function in neurons, in which it is predominantly located at synapses, is still unclear. Using autaptic cultures of hippocampal neurons, we demonstrate that hippocampal neurons lacking APP show significantly enhanced amplitudes of evoked AMPA- and NMDA-receptor-mediated EPSCs. The size of the readily releasable synaptic vesicle pool was also increased in neurons lacking APP, whereas the release probability was not affected. In addition, the analysis of spontaneous miniature synaptic currents revealed an augmented frequency in neurons lacking APP, whereas the amplitude of miniature synaptic currents was not found to be altered. Together, these findings strongly indicate that lack of APP increases the number of functional synapses. This hypothesis is further supported by morphometric immunohistochemical analysis revealing an increase of synaptophysin-positive puncta per cultured APP knock-out neuron. In conclusion, lack of APP affects synapse formation and transmission in cultured hippocampal neurons.

Action Potentials↗
PubMed2006

Transverse femoral fixation in anterior cruciate ligament (ACL) reconstruction with hamstrings grafts: an anatomic study about the relationships between the transcondylar device and the posterolateral structures of the knee.

Iatrogenic risks concerning femoral cross pin devices for anterior criciate ligament (ACL) reconstruction using hamstrings grafts have not been evaluated. The aim of the study was to state anatomic relationships between the epicondylar cross pin hole and the posterolateral attachments of the knee, and to settle safe zones and technical improvements for its use. It is a descriptive anatomical study. Dissections were performed and measurements taken on 20 (2x10) fresh frozen cadaveric knees after standard arthroscopic and femoral ACL reconstruction procedure using the Transfix cross pin femoral device (Arthrex, Naples, FL, USA). In group I, femoral tunnel was performed through the tibial tunnel. In group II, an anteromedial portal technique was used. Group I: no iatrogenic injury. The cross pin was at 36.5+/-2.8 mm (33-41) from the femoral inferior articular area, and at 12.3+/-3.2 mm (7-17) from the lateral collateral ligament (LCL) insertion. Group II: in a half cases, there was an injury of the LCL, close to its insertion. The cross pin was at an average of 5.6+/-5.4 mm (0-15) from the LCL, and significantly closer in group II than in group I (P<0.01). In group I, there is a high correlation between cross pin to LCL distance and knee flexion obtained to drill the femoral tunnel (r (2)=0.75, P<0.01). In conclusion, there is a specific iatrogenic risk of transverse femoral fixation using the anteromedial portal approach, whereas the transtibial approach seems to be safe. Nevertheless, it can decrease with a correct femoral tunnel depth and an operative knee flexion over 130 degrees , in order to move LCL insertion and posterior cortical wall away.

Aged↗
PubMed2006

Arthroscopic treatment of glenoid fractures.

The patient was placed in the lateral decubitus position. The arthroscope was introduced through the posterior approach. The probe hook was introduced through a working cannula through the anterosuperior portal performed in an inside-out technique. The mobilization possibilities of the osteochondral fragments were then assessed. The use of a shaver was always necessary to clean the fracture site and evacuate clots. A nonabsorbable suture was passed through the labrum and the capsule tissue of the displaced articular fragment in its superior edge. The first suture was used as a traction stitch and allowed replacing the fragment in its original position and maintaining it during the placement of others sutures. A hole was made in the anterosuperior edge of the nonfractured glenoid and then a long drill was passed backward according to the transglenoid suture technique of Caspari or Morgan. Stitches were passed through the glenoid to the infraspinatus fossa. When articular congruity was judged satisfactory, the stitches were tied on the fascia of the infraspinatus muscle. The patients were immobilized in a sling for 3 weeks.

Adult↗
PubMed2006

Decubital ischemic fasciitis: clinical, pathologic, and MRI features of pseudosarcoma.

OBJECTIVE: The purpose of this report is to describe clinical, pathologic, and MRI findings on decubital ischemic fasciitis, which is a rare soft-tissue tumor sarcoma simulator. CONCLUSION: Decubital ischemic fasciitis is a reactive, nonneoplastic lesion typically seen in older debilitated patients at pressure points. Because this lesion simulates soft-tissue sarcoma, both clinically and histologically, it is important to recognize the MRI features and limit misdiagnosis of sarcoma.

Aged↗
PubMed2005

Gracilis muscle flap for aesthetic reconstruction in the head and neck region.

Microsurgical tissue transfer has constantly improved the therapeutic options for reconstruction in the head and neck region, but the ideal flap has yet to be found. The purpose of this study is to discuss the aesthetic potential of the free gracilis muscle flap in difficult head and neck reconstruction. We report our experience with the free gracilis muscle flap in seven patients who underwent reconstruction in the head and neck region for a variety of indications. In all seven patients, the transplanted muscle flaps healed well, with no flap loss. Postoperative complications consisted of skin-graft loss in one patient requiring a second split-thickness skin graft. Donor-site morbidity was minimal in all patients. For difficult reconstruction in the head and neck region, the free gracilis muscle flap offers a number of advantages, including reliable vascular anatomy, relatively great plasticity, and a concealed donor area. Thus this type of flap offers a valuable option whenever an aesthetically pleasing result is sought.

Adult↗
PubMed2005

Lung cancer screening.

It has been demonstrated that 85% of all lung cancers are associated with previous or current smoking. A group of patients has been identified that is at a higher risk for lung cancer, stroke, and heart disease. This article reviews previous reports, current consensus statements, problems that are associated with current screening programs, and hopes for the future.

Humans↗
PubMed2004

Regulation of human auto- and alloreactive T cells by indoleamine 2,3-dioxygenase (IDO)-producing dendritic cells: too much ado about IDO?

Although dendritic cells (DCs) strongly stimulate the immune response, they can also induce unresponsiveness. Recently, a human monocyte-derived DC subpopulation was described that constitutively expresses indoleamine 2,3-dioxygenase (IDO). These DCs were defined as nonadherent CD123+/CC chemokine receptor 6+ (CCR6+) cells that suppress the allogeneic T-cell response. In the present study, we generated nonadherent, mature DCs from human blood monocytes. As expected, in addition to the classic markers, these cells expressed CD123 and CCR6. Reverse transcription-polymerase chain reaction (RT-PCR), however, did not show IDO gene transcription, nor did we detect enzymatic IDO activity. Treating the cells with interferon-gamma (IFN-gamma) resulted in significant IDO production. Subsequently, we studied the regulatory properties of IDO-producing DCs on autologous and allogeneic T-cell responses. Neither OKT3-stimulated T cells of healthy donors nor myelin basic protein (MBP)-specific T cells of patients with multiple sclerosis (MS) were suppressed by autologous IDO DCs. However, whereas IDO(neg) DCs supported further stimulation of preactivated MBP-specific T cells of an MS patient, IDO(pos) DCs had lost this capacity. The allogeneic T-cell response was only marginally suppressed by IDO DCs. Our findings show that nonadherent CD123+/CCR6+ human DCs do not constitutively express IDO, and, even if they express the enzyme after IFN-gamma treatment, they possess only limited T-cell regulatory function.

Antineoplastic Agents↗
PubMed2004

Analysis of publications in three plastic surgery journals for the year 2002.

The goal of this study was to analyze the publications in the plastic surgery literature for the year 2002. Contents of these articles, authors' information (such as nationality affiliation of the first author), type of institution, presence of grant support, and previous presentation were analyzed. For inclusion in this study, the publications had to be original articles from the three most frequently read general plastic surgery journals: Annals of Plastic Surgery, British Journal of Plastic Surgery, and Plastic and Reconstructive Surgery. With this approach, 533 articles were included in the study. To give a cross-sectional analysis of the content of all articles, 11 distinct categories were created in which all the articles were subsummarized. The categories were based on anatomical regions and specific plastic surgical areas. A summary is given for each of the categories to provide an overview of the field in which most of the research in plastic surgery was taking place in 2002 and which topics were focused on. The authors found that only 7 percent of all articles had grant support, whereas 36 percent of articles were presented previously during a scientific meeting. Most of the articles came from university-based institutions (68 percent), followed by non-university-based institutions (29 percent) and private practice (3 percent). Regarding nationality affiliation, most of the articles came from the United States (n = 229) and Europe (n = 128); in Asia, Turkey (n = 39) and Japan (n = 36) were the countries with the most published articles.

Bibliometrics↗
PubMed2003

Arthroscopic resection of an extra-articular tenosynovial giant cell tumor from the ankle region.

This report describes the case of a 31-year-old man with a tenosynovial giant cell tumor in the left ankle region. The tumor developed over a period of 5 months. A conservatively treated fracture of the leg in the patient's history was important. The presurgical magnetic resonance imaging (MRI) examination allowed a specific diagnosis and the exclusion of infiltrative properties of the tumor. The tumor was excised using an exclusively arthroscopic technique. The procedure included treatment of intra-articular pathologies and the removal of 2 loose bodies. The excision was complete and no recurrence or complication was seen in 5 months' follow-up. In view of the possible recurrence (in about 50% of patients) and the unknown development of malignant tumors, arthroscopic excision can be advantageous. This procedure includes small scars and lower risks of infection and necrosis. Therefore, arthroscopic treatment of soft tissue tumors near the ankle joint may by an alternative to open excision.

Adult↗
PubMed2003

[Elephantiasis of the thoracic wall within the scope of von Recklinghausen neurofibromatosis, case report].

Neurofibromas are benign tumors arising from neuroectodermal tissues. They may occur as solitary lesions, or multiple, in which case they are referred to as neurofibromatosis, or von Recklinghausen's disease. We report about a 17-year-old patient with neurofibromatous elephantiasis located in the lateral aspect of the left hemithorax. CT showed massive chest wall infiltration and retroperitoneal tumor growth, but no abnormalities of the cranium. Our surgical treatment consisted of a two-stage, palliative tumor debulking and defect coverage with a splitthickness skin graft. The operative and postoperative course was uneventful.

Adolescent↗
PubMed2003

Modified free paraumbilical perforator flap: the next logical step in breast reconstruction.

The free paraumbilical perforator flap that was developed with only the perforator penetrating the rectus abdominis muscle seems nearly ideal from the donor-site perspective, because it reduces morbidity virtually to that of an abdominoplasty. However, it requires "supermicrosurgery" skills for suturing of vessels with diameters of 0.7 mm or less, making the procedure technically demanding and risky. Another significant disadvantage of that technique is that the flap has very short vascular pedicles. To overcome the disadvantages of the free paraumbilical perforator flap, a minor modification in flap harvesting that improves the vessel size and length is described. Results for a total of 15 patients who underwent breast reconstruction with modified free paraumbilical perforator flaps are presented, and the advantages and disadvantages of this flap are discussed.

Adult↗