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Biomedical subjects

U Dorn

Publications and source records attributed to U Dorn.

At least 19 recordsLinked to original sources
PubMed2004

Factors influencing the revision rate of Zweymueller acetabular cup.

Between January 1986 and December 1988, we implanted 220 conical-shaped Zweymueller threaded cups in 202 patients whose average age was 65 (33-83) years. The average thickness of the polyethylene (PE) insert was 8.0 (5.4-11.9) mm. In 142 cases, the corresponding femoral head was a 32 mm Al2O3 head. We followed 157 patients for a mean of 9.2 (1-16) years. Nine cups were revised and ten PE inserts replaced after an average of 11.9 (10-13.3) years. With cup revision alone considered as failure, the survival rate after 13 years was 89%. When both cup and insert revisions were considered failures, the survival rate decreased to 72% after 13 years. Patients younger than 60 years had a significantly higher rate of insert revision. Cup size 55 showed significantly more revisions in comparison to larger sizes. Using Cox regression model, neither gender, body mass index, nor material were risks factors leading to cup revision.

Acetabulum↗
PubMed2001

Miller-Galante total knee arthroplasty: the importance of material and design on the revision rate.

We have reviewed 142 Miller-Galante I (MG I) total knee arthroplasties (TKAs) with a follow-up of 56 months, and compared these with the outcome of 219 Miller-Galante II (MG II) TKAs with a follow-up of 36 months. In the MG II TKAs we found markedly lower revision rates, higher postoperative Hospital for Special Surgery (HSS) scores, less retropatellar pain and better patellar centring without patellar resurfacing. The higher revision rate in MG I TKAs was mainly due to the need to revise the metal-backed patellae.

Arthritis↗
PubMed2001

A model for assessing the rotational stability of uncemented femoral implants.

Permanent secondary stability of the uncemented femoral stem of hip prostheses can only be achieved once primary rotational and axial stability has been ensured. Rotational stability means that the stem is resistant to the articular forces that induce rotation around the implant's longitudinal axis. The 10-year survival rates of two uncemented conical shaped stems with decisively different proximal shapes were significantly different (Schenker SK 63.9%, Zweymüller SL 97.0%). The shapes were analyzed biomechanically by testing rotational stability in a silicone model. A reduction in the mediolateral height of the metaphyseal part by one-third led to a 20% smaller angle of ascent (P < 0.01), which indicated lower resistance. The proximally broader (mediolateral) prosthesis therefore proved to have better rotational stability. The study confirms that aseptic stem loosening is attributable to the design of the proximal part of the prosthesis.

Arthroplasty, Replacement, Hip↗
PubMed2001

Postoperative aneurysm of the popliteal artery after arthroscopic meniscectomy.

We report a case of a 14-year-old girl who underwent arthroscopic subtotal meniscectomy after a bucket-handle tear of the lateral meniscus followed by a pseudoaneurysm of the popliteal artery. A revision surgery and reconstruction of the artery with a saphena magna patch was necessary to repair the defect. At 1-year follow-up, excellent range of motion, function of the knee, and a normal quality of life was achieved.

Adolescent↗
PubMed1999

Ultrasonography in the diagnosis of transient synovitis of the hip and Legg-Calvé-Perthes disease.

Ultrasonography was used to establish the diagnosis of transient hip synovitis and the onset of Legg-Calvé-Perthes disease. A total of 115 patients presenting with 119 painful hips and the preliminary diagnosis of transient hip synovitis were reviewed. Hip effusion, resulting in capsular distension, was documented accurately with ultrasound. In nine patients, capsular distension persisted longer than 6 weeks and was associated with the onset of Legg-Calvé-Perthes disease.

Child↗
PubMed1998

[Cementless hip prosthesis in patients with rheumatoid arthritis].

From 1986 to 1996, we implanted a total of 92 hip arthroplasties (86 cementless, 4 hybrid and 2 cemented) in 65 patients with rheumatoid arthritis. Of the 89 uncemented cups, 59 were threaded cups (Hofer-Imhof n = 45, Zweymüller n = 7, Mecring n = 5, PM n = 2) and 30 were hemispherical cups of the Harris Galante type I and II. 87 stems were implanted without cement (Zweymüller SL n = 58, Uni n = 16, Schenker n = 9, Zweymüller I n = 4) and 5 with cement. One patient died postoperatively and three (4 implants) within the first year. To date, one cup of each threaded type had to be revised because of loosening (revision rate approx. 6.8%); Up to now, three of 87 (approx. 3.4%) stem revisions (1 x Zweymüller I, 1 x Schenker, 1 x Zweymüller SL) have been undertaken. Ten patients with twelve hip arthroplasties did not return for follow-up; some of them had a poor general health status. The clinical and radiological results of the arthroplasties of 52 patients showed a Harris Hip Score averaging 72 after an average of 54 months (min. 12-max. 132). Ten patients had minor complaints in the hip region. 79% of the uncemented implants (70 out of 89 cups, 69 out of 87 stems) were assessed radiologically. Two threaded cups showed slight migration after cancellous bone grafting in the presence of acetabular protrusion that was present in a total of 13 hip joints. This subsided markedly after filling with cancellous bone and recentering of the hip joint. Homogeneous incorporation of the bone grafting und thus remodelling of the medial wall was achieved, with the bone graft exhibiting marked reduction. At final follow-up, approx. 75% of the cementless cups had complete bone ingrowth without any evidence of radiolucency (type I), approx. 19% had near-complete bone ingrowth with minimal radiolucencies in one zone or in a maximum of 50% of the bone contact area (type III) and approx. 6% had radiolucencies in more than 50% of the bone contact area (type II). The radiographic evaluation of the most frequently used stem (Zweymüller SL) showed approx. 47% with only slight remodelling of the calcar (type I), approx. 33% with moderate loss of femoral density (type II) and approx. 20% with severe bone loss and thinning of cortical bone (type III).

Arthritis, Rheumatoid↗
PubMed1998

Indomethacin for prevention of heterotopic ossification after hip arthroplasty. A randomized comparison between 4 and 8 days of treatment.

In a randomized, parallel group study, we evaluated the efficacy of a 4-day versus an 8-day course of indomethacin (50 mg, 3 times per day), given as prophylaxis against heterotopic ossification after cementless total hip arthroplasty in 209 patients with arthrosis. Patients receiving the prophylaxis for 8 days had less (p = 0.03) severe heterotopic bone formation.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

[Seroprevalence of antibodies to human herpesvirus 6 (exanthema subitum; critical 3-day fever-exanthema in young children) in the population of Northern Germany].

We tested 989 sera of all age groups (patients and blood donors) from north eastern Germany (West Pomerania and Mecklenburg) and found 820 cases (82.9%) of specific human herpes virus type 6 (HHV 6) antibodies (IgG) gy indirect immunofluorescent assay. The seroprevalence rose to 83.6% when the 7 HHV 6-IgM positive results (0.7%) were included; moreover a further 23 sera (2.3%) showed specific HHV 6 antibodies of both classes (IgM and IgG). The antibody prevalence was constantly high at 90% from the age of 8 months up to the 71-80 years group, and it only decreased in the age group over 80. 93.2% of the newborn infants showed HHV 6-IgG antibodies (of maternal origin) in the cord blood; this prevalence is identical with that for females of reproductive age (92.7% in the 3rd decade, 93.7% in the 4th decade). No sex differences in seroprevalence were observed. The main immunization occurs in the first year of life but infection with HHV 6 at a later age is also well documented. We found the lowest seroprevalence in the 3rd and 4th postnatal months (when maternal immunity had disappeared); later the seroprevalence of specific antibodies rose very rapidly and by the 8th month the rate was the same as for the adult group. The theoretical possibility of prenatal infection due to HHV 6 exists, but the real risk of a first infection during pregnancy is very low, because only 7-8% are susceptible in this group.

Adolescent↗
PubMed1991

The eosinophilic granulocyte count in the respiratory secretions of children with chronic nonspecific respiratory diseases.

We performed cytologic evaluations of 6116 nasal and/or bronchial smears from 4510 patients (average age: 7.6 years; 3 months--17 years) suffering from different kinds of chronic nonspecific respiratory diseases (CNSRD); in 137 children (average age: 4.8 years) undergoing bronchologic examinations under general anesthesia we compared the findings with those for bronchoalveolar lavage (BAL). Nasal smears of 77 healthy children at a day care center (control group) were analysed four times per year for "significant secretory eosinophilia" (SEE; i.e. more than 13% eosinophils). We found: 1. Healthy children do not have such "SSE" in contrast to children with CNSRD who show different frequencies of "SSE" depending on the age of the child and the specific kind (diagnosis) of CNSRD. 2. 4.6% of infants (first year of life) were found to have SSE with a statistically significant correlation to increase in the following 10 years up to 50% of all children (p less than 0.001). 3. We found SSE in 4.41% of cases with relapsing bronchitis, in 7.14% (8.3% resp.) with chronic bronchitis, in 6.49% (9.2% resp.) with relapsing or chronic obstructive bronchitis and in 46.05% (55.3% resp.) with bronchial asthma (p less than 0.001). 4. The intensity of obstructive symptoms (nose: rhinitis; bronchus: dyspnoea) did not correlate with the number of eosinophils in the secretions. 5. Only the smear cytograms (nose/bronchus) enabled us to detect "SSE" whereas BAL cytograms were too insensitive (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Hip screening in newborn infants. Clinical and ultrasound results].

A routine orthopaedic examination of each newborn was performed at the Salzburger Landesfrauenklinik (Department for gynaecology and obstetrics) since 1964. The results of these examinations were stored in an electronic database since 1978 and were now evaluated in a retrospective analysis. The examinations were performed by 8 orthopaedic surgeons between I/1978 and IX/1984. 5.9 percent of all newborns had a limited abduction and 13.2 percent a lax hip. Hips with limited abduction and lax hips were not classified as pathological but were recommended for strict observation and X-ray control at an age of four months. A similar rate of instable hips such as subluxatable (= 2.11%) and luxatable (= 0.63%) hips were also observed by other authors, whereas quite lower rates of instable hips in newborns were reported from several other European parts. Mau indicated the limited value of clinical examinations particularly when evaluating data in a multicenter study was concerned. In our study each examiner had a statistically significant variation of his results which we found by establishing an examiners ratio (Formula: see text). Since October 1984 the clinical routine newborn screening was completed by an obligatory hip sonography in the first days of life. The sonographic examination and classification was done according to Graf's method. Real-time ultrasound machines with linear 5 MHZ-transducer were used. 8.221 newborns were examined between X/1984 and XII/1988. 72.51 percent were type Ia, b. 25.63% were categorized as type IIa; 1.66 percent were classified type IIc, D; 0.16 percent were type IIIa hips. Only one hip was classified as type IV, this was a teratological dislocated hip. 1.31 percent of all hips showed a pathologic sonogram (= type IIc, D, IIIa) without having shown abnormalities, when clinically examined a few days before. In our opinion these results emphasize the value of a sonographic newborn screening. The majority of hips with distinct abnormalities only (= lax hips, limited abduction) was type Ia, b, or IIa, whereas the majority of clinical instable hips had pathologic sonograms (= IIc, D, IIIa). Newborns delivered by breech presentation had a significant higher percentage of clinically abnormal hips (= 7.48 subluxatable and luxatable hips). The percentage of pathologic sonograms (8.81%) and type IIa-hips (= 42.78%) was significantly higher compared to the normal delivered group. 336 premature newborns were found to have a statistically significant higher percentage of type Ia, b-hips (= 82.73%) and a statistically equal percentage of sonographically pathologic hips (= 0.89%) in comparison to the mature newborns.(ABSTRACT TRUNCATED AT 400 WORDS)

Austria↗
PubMed1990

[Clinical and immunologic effects following oral immunization against influenza in children in day care and infection susceptible young children].

57 infants and small children (9 months - 3.1 years) were orally immunized by an inactivated influenza vaccine (Mississippi 1/85; dosage: 110 micrograms HA); the control group (n = 15) received placebo. After three months the influenza specific Ig-concentrations of serum and secretions demonstrated a controverse course: Specific IgG (serum) decreased and specific IgA (nasale secretions) increased statistically significant (p less than 0.025), especially in children suffering from frequently relapsing respiratory infections (n = 31). Moreover the immunized children had also a better clinical outcome in the following 3 months: the number of days with cough, febrile symptoms and the antibiotics therapy were significantly decreased. Recommendations are given for an improvement of the orale influenza vaccine and its indicated administration in small children.

Administration, Oral↗
PubMed1987

[Initial experience using routine hip sonography in newborn infants].

933 newborn infants were subjected to routine hip screening by means of ultrasound in the first week of life, along with usual clinical investigations. The sonographic examinations were performed according to the technique and classification laid down by Graf. 68.2% of the investigated hips were of type I, 30.6% of type IIa. 20 hips (1.1%) were classified as IIg and 3 hips as type IIIa. The results of the clinical investigation during the first week were compared with the ultrasonographic findings. It is remarkable that some of the type IIg and type IIIa hips displayed no clinical signs. These hips should be controlled or treated at an early date.

Austria↗
PubMed1981

Glutaconate CoA-transferase from Acidaminococcus fermentans.

1. Glutaconate CoA-transferase catalyses the transfer of CoAS- from acetyl-CoA preferentially to (E)-glutaconate, but glutarate, (R)-2-hydroxyglutarate, acrylate and propionate are also good acceptors. No reaction was observed with (Z)-glutaconate and C4-dicarboxylic acids. 2. The product of the reaction of acetyl-CoA with (E)-glutaconate is the 1-isomer of glutaconyl-CoA, i.e. the thiol ester is conjugated with the double bond. Other results indicate, however, that with (R)-2-hydroxyglutarate as substrate both possible isomers are generated. 3. Glutaconate CoA-transferase was purified from cell-free extracts of Acidaminococcus fermentans to apparent homogeneity and crystallized. The relative molecular mass of the enzyme is approximately 275000. It consists of two different polypeptide chains (M, 32000 and 34000). On the catalytic pathway a thiolester is formed between CoASH and a carboxylate of the smaller polypeptide chain. 4. The structural and functional relationships between glutaconate CoA-transferase and other CoA-transferases are discussed. 5. Glutaconate CoA-transferase is also present in other bacteria fermenting glutamate via hydroxyglutarate. Experiments with an antiserum against the enzyme indicate that the transferase is necessary for the decarboxylation of glutaconate but not for the dehydration of (R)-2-hydroxyglutarate.

Acyl Coenzyme A↗
PubMed1980

[Diastrophic dwarfism].

Description of a male and six female patients with diastrophic dwarfism. In one case the observation was possible since birth. The typical clinical features and roentgenographic characteristics of this epi-, metaphyseal dysostosis with an autosomal recessiv mode of inheritance are summarized and compared with reported cases in the medical literature. It is important to establish the diagnosis early in order to apprise the parents of the prognosis and the likelihood of subsequent children being affected. This demonstrates our report of two affected siblings in one family and three affected siblings in another family. In one case we found an aplasia of both patellae, this finding was not described in the combination with this entity until now.

Adolescent↗
PubMed1978

[Diagnosis of tuberculosis of the spine (author's transl)].

An analysis is presented of the case histories of 302 patients, admitted with tuberculosis of the spine to the Orthopaedic Department of the University Clinic, Vienna for surgical or conservative treatment. The average time between the onset of pain and the diagnosis was 13 months. Two thirds of the patients had no preceding history of healed or active tuberculosis. The average age of the patients was 40 years. Most of the patients showed tuberculous infection of only two vertebral bodies, mainly affecting the 8th thoracic to the 5th lumbar vertebrae. The diagnosis is made in most cases on the basis of the case history, clinical examination and, in particular, the radiological findings.

Adolescent↗
PubMed1978

[X-ray dose reduction in examination of infant's hip with image-intensifier-fluoroscopy-system (author's transl)].

An image intensifier--70mm camera--fluoroscopy system combined with a conventional X-ray tube is used for routine examination of the infant's hip. The high quality of 85% of these 70mm exposures makes immediate diagnostic interpretation possible. An even higher percentage can be achieved by most exact positioning of the patients. Apart from the radiation protection of the gonades, the X-ray skin dose of the primary beam is reduced by 90-95% compared with full size radiography using film screen combinations. This exposure technique can certainly be used not only for the examination of the infant's hip.

Fluoroscopy↗
PubMed1978

[The vertebrotomy as additional therapy at spondylitis tuberculosa (author's transl)].

One hundred and three patients with spondylitis tuberculosa were treated with 104 vertebrotomies, without deaths. The results of 71 cases, one until 24 years after the operation, were evaluated. Most of them showed bony healing, only one had a soft tissue rezidivism. Through the modern antituberculous therapy the time of immobilization (plaster-bed and cast) could have been shortened in the last 13 years from 38,4 to 20,3 months.

Adolescent↗