showing 17 related works from this author
Medial buttressing of the quadrilateral surface in acetabular and periprosthetic acetabular fractures
2020
Background In geriatric acetabular fractures, the quadrilateral plate is often involved in the fracture pattern and medially displaced. Open reduction and internal fixation (ORIF) includes reduction of the quadrilateral plate and securing its position. In this study, the concept of medial buttressing in acute and periprosthetic acetabular fractures is evaluated. Materials and methods Patients, who sustained an acetabular fracture between 2012 and 2018, in whom ORIF with a specific implant for medial buttressing was performed, were included in the study. Patients were divided in two groups; acute acetabular fractures (group 1) and periprosthetic acetabular fractures (group 2). Demographics,…
Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature
2014
AbstractFragility fractures of the pelvic ring (FFP) are increasing in frequency and require challenging treatment. A new comprehensive classification considers both fracture morphology and degree of instability. The classification system also provides recommendations for type and invasiveness of treatment. In this article, a literature review of treatment alternatives is presented and compared with our own experiences. Whereas FFP Type I lesions can be treated conservatively, FFP Types III and IV require surgical treatment. For FFP Type II lessions, percutaneous fixation techniques should be considered after a trial of conservative treatment. FFP Type III lesions need open reduction and in…
Retrograde Transpubic Screw Fixation
2017
In the vast majority of fragility fractures of the pelvis, fractures of the posterior and anterior pelvic ring occur combined. Fractures of the pubic rami above and below the obturator foramen are much more frequent than fractures of the pubic bone and fractures at the anterior lip of the acetabulum. Retrograde transpubic screw fixation is a minimally invasive technique for stabilization of pubic rami fractures. The anterior column corridor is a straight corridor between the anterior cortex of the superior pubic ramus near to the pubic tubercle and the external cortex of the ilium above the acetabulum. The minimal canal diameter, measured in 160 Japanese, was on average 13.5 mm for men and …
Screw‐in‐screw fixation of fragility sacrum fractures provides high stability without loosening—biomechanical evaluation of a new concept
2020
Surgical treatment of fragility sacrum fractures with percutaneous sacroiliac (SI) screw fixation is associated with high failure rates. Turn-out is detected in up to 20% of the patients. The aim of this study was to evaluate a new screw-in-screw implant prototype for fragility sacrum fracture fixation. Twenty-seven artificial hemipelvises were assigned to three groups (n = 9) for instrumentation of an SI screw, the new screw-in-screw implant prototype, ora transsacral screw. Before implantation, a vertical osteotomy was set in zone 1 after Denis. All specimens were biomechanically tested to failure in upright position. Validated setup and test protocol were used for complex axial and torsi…
Intestinal drug efflux: formulation and food effects
2001
The intestine, primarily regarded as an absorptive organ, is also prepared for the elimination of certain organic acids, bases and neutral compounds depending on their affinity to intestinal carrier systems. Several of the transport systems known to mediate efflux in the major clearing organs--liver and kidney--are also expressed in the intestine. Examples of secretory transporters in the intestine are P-glycoprotein, members of the multidrug resistance associated protein family, breast cancer resistance protein, organic cation transporters and members of the organic anion polypeptide family. In this communication, the P-glycoprotein mediated intestinal secretion of talinolol, a model compo…
Do We Need a Separate Classification for Fragility Fractures of the Pelvis?
2019
Fragility fractures of the pelvis are occurring with increasing frequency. These fractures, occurring in the geriatric patient population, are low-energy injuries and are dissimilar in many ways from those caused by high-energy trauma. For example, the mechanism of injury is different and emergency treatment is usually not necessary. Having diminished bone strength, fragility fracture lines follow areas of low bone mineral density and loss of pelvic stability may increase over time. Based on our clinical experience, we propose a comprehensive classification of pelvic fragility fractures separate from the existing pelvic ring injury classification to provide a framework for distinguishing th…
Complex radial head and neck fractures treated with modern locking plate fixation
2019
Background Internal fixation of complex radial head and neck (CRHN) fractures is difficult, and postoperative complications are common. This study evaluated elbow function and patient clinical status after internal fixation of CRHN fractures with modern locking plates. Methods We included 40 patients with 41 fractures (1 bilateral lesion). In 25 patients (61%), a concomitant injury was found. Patients were an average age of 46 years (range, 22-70 years). The mean follow-up time was 36 months (range, 2-70 months). Postoperative assessments included evaluation of range of motion, functional scores, and radiologic findings. We assessed fracture healing, surgical complications, revision surgery…
Osteoporotische Frakturen des Beckenrings
2012
Durch die Alterung der Bevölkerung sind wir mit einer Zunahme an osteoporotischen und Ermüdungsfrakturen des Beckenrings konfrontiert. Sie werden durch niedrigenergetische Traumen verursacht. Die konventionelle Diagnostik ist weniger aufschlussreich als bei Jugendlichen und Erwachsenen, eine CT- oder MRT-Diagnostik ist erforderlich. Die Erscheinungsformen sind multipel und bieten ein ganzes Spektrum von Instabilitäten. Die konventionelle Klassifikation trifft nicht auf alle Erscheinungsformen dieser Frakturen zu. Die Behandlung umfasst sowohl konservative als auch operative Verfahren. Entscheidend dabei sind der Grad und die Lokalisation der Instabilität. Die Osteosyntheseformen unterscheid…
Deep Learning Predicts Molecular Subtype of Muscle-invasive Bladder Cancer from Conventional Histopathological Slides.
2020
Abstract Background Muscle-invasive bladder cancer (MIBC) is the second most common genitourinary malignancy, and is associated with high morbidity and mortality. Recently, molecular subtypes of MIBC have been identified, which have important clinical implications. Objective In the current study, we tried to predict the molecular subtype of MIBC samples from conventional histomorphology alone using deep learning. Design, setting, and participants Two cohorts of patients with MIBC were used: (1) The Cancer Genome Atlas Urothelial Bladder Carcinoma dataset including 407 patients and (2) our own cohort including 16 patients with treatment-naive, primary resected MIBC. This resulted in a total …
Bone Mass Distribution in the Sacrum
2017
The trabecular architecture and bone mass distribution of each bone follows biomechanical principles and is an adaption to the stress exhibited during lifetime. In patients with osteoporosis, the bone mass decreases and the bone microarchitecture changes. A distinct bone mass distribution in non-osteoporotic and osteoporotic individuals is demonstrated using statistical modelling in the sacrum. The authors studied the sacral bone mass distribution using a 3D statistical model based on clinical CT scans of 92 Europeans. In the group with worse general bone mass (less than 100 Houndsfeld Units (HU) measured in the body of L5), there were large areas of negative HU in the sacral alae. These “a…
Fragility Fractures of the Pelvis.
2017
Fragility fractures of the pelvic ring (FFP) show an increasing frequency. Trauma mechanism, fracture morphology and degree of instability are different from those in high-energy pelvic ring lesions. Little is known about the optimal treatment strategy. A new comprehensive classification system with four categories of increasing instability is presented. It is connected with recommendations for type and invasiveness of treatment. FFP Type I are anterior instabilities only and can be treated conservatively. FFP Type II are non-displaced posterior lesions which can be treated conservatively or with percutaneous fixation. FFP Type III lesions are unilateral displaced posterior lesions which re…
Iliosacral Screw Osteosynthesis
2017
Fragility fractures of the anterior pelvic ring are very often combined with fractures of the posterior pelvic ring. The large majority of the posterior fractures is situated in the sacral ala. Non-operative therapy may be cumbersome in patients with a combination of an anterior with a posterior pelvic ring fracture. Any surgical therapy should be as less invasive as possible. Iliosacral screw fixation is a minimal invasive technique. Variations of the upper sacral anatomy make optimal iliosacral screw placement challenging. The vestibule or isthmus is the narrowest part of the bony corridor from the lateral ilium to the S1 sacral body. It always points towards anterior and superior. The wh…
Progress of instability in fragility fractures of the pelvis: An observational study.
2019
Abstract Fragility fractures of the pelvis (FFP) are an increasing entity among elderly persons. Characteristics are different from high-energy pelvic trauma. Little is known about the natural course of FFP in conservative and after operative treatment. Materials and methods Medical charts and radiologic data of 148 patients with an FFP, who were admitted in a 3-year period, were analysed retrospectively. Incidence and characteristics of fracture progression (FP) were noted. Results Patients presenting early after a traumatic event had more often non-displaced fractures, fractures with lower FFP Type classification and were more frequently treated conservatively. FP was observed in 21 cases…
Clinicopathological Significance of Syndecan-1 in Cholangiocarcinoma: A Study Based on Immunohistochemistry and Public Sequencing Data
2021
Background: Syndecan-1 (CD138
Different Dissolution Media Lead to Different Crystal Structures of Talinolol with Impact on Its Dissolution and Solubility
2003
During the performance of dissolution tests with immediate and controlled-release talinolol tablets it was detected that the type of the buffer used as dissolution medium had a strong influence on the solubility and the dissolution behavior of the drug. It was proven that talinolol appeared in different crystal structures with strongly differing solubilities when pure water, acetate, or phosphate buffers were employed as dissolution media. The resulting crystal structures were characterized by means of light microscopy, differential scanning calorimetry, and X-ray powder diffraction. All methods were adjuvant to detect changes in talinolol crystal structures. The different solubility and di…
Effects of controlled-release on the pharmacokinetics and absorption characteristics of a compound undergoing intestinal efflux in humans
2006
Abstract Objective The number of active pharmaceutical ingredients (API) undergoing inhibitable and saturable intestinal efflux is considerable. As a consequence, absorption and bioavailability may depend on the intestinal concentration profile of the drug and may vary as a function of dose and release rate of the drug from the dosage form. The impact of controlled versus immediate-release on the absorption of P-glycoprotein substrates is currently unknown. Thus, the main focus of the present study was a comparison of the pharmacokinetics of the P-gp model substrate talinolol following administration of immediate-release (IR) and controlled-release (CR) tablets to healthy human volunteers w…
CD15 immunostaining improves placental diagnosis of fetal hypoxia
2020
Fetal hypoxic events with unclear predictive value are a common indication for placenta examination. We evaluated whether the use of CD15 immunostaining can improve the assessment of severity and duration of fetal hypoxia.We compared placentas (37-42 gestational weeks) from stillborns/newborns with birth asphyxia (BA) and non-hypoxic newborns. Placental findings were studied in following groups: (1) acute BA (n = 11) due to placental abruption, (2) non-acute BA (n = 121) due to non-acute conditions, (3) non-BA (n = 46) in pregnancies with preeclampsia and gestational diabetes, and (4) controls (n = 30).A high expression of CD15 in feto-placental resistance vessels (FRVs) was present in non-…