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31.
Bartzela T Katsaros C Rønning E Rizell S Semb G Bronkhorst E Halazonetis D Kuijpers-Jagtman AM 《Clinical oral investigations》2012,16(4):1313-1324
In this longitudinal study, the craniofacial morphology and evaluated soft tissue profile changes, at 6 and 12 years of age in patients with complete bilateral cleft lip and palate (CBCLP) were compared. Lateral cephalograms from 148 patients with CBCLP, treated consecutively at three European cleft centers, Gothenburg (n (A) = 37), Nijmegen (n (B) = 26), and Oslo (n (C) = 85), were evaluated. Eighteen hard tissue and ten soft tissue landmarks were digitized. Paired t test, Pearson's correlation coefficients, and multiple regression models were applied for statistical analysis. ANOVA and Tukey-B, as a post hoc test, were used to evaluate the increments and compare centers. Hard and soft tissue data were superimposed using the generalized Procrustes analysis. For Nijmegen, the increments of the variables SNA, ANB, SN-NL, SN-ML, NL-ML, Snss, and Snpg were significantly different than the two other centers (p = 0.041 to <0.001). SNPg increments were significantly different between Nijmegen and Oslo (p = 0.002). The three cleft centers followed different treatment protocols, but the main differences in craniofacial morphology until 12 years of age were the growth pattern and the maxillary and upper incisor variables. Follow-up of these patients until facial growth has ceased, which may elucidate components for improving treatment outcome. 相似文献
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We report the outcome in 32 patients operated on for advanced periacetabular metastatic destruction, where all but 2 had Harrington class III destruction. The patients were operated on using the Harrington reconstruction technique, where threaded pins and cement and a total hip replacement are used to reconstruct the acetabulum and ilium. The median survival was 11 (0-106+) months. 13 patients lived for a year or more. At follow-up after 1 year, 10 of the 13 were free of pain at rest and weight-bearing, 6 were walking with and 7 without support, and 11 lived outside a health care facility. 2 patients died within 2 weeks of surgery, both of excessive peroperative bleeding. 2 patients had dislocations, 1 developed a deep infection, and 2 patients deep vein thrombosis. There were no complications caused by erroneous pin placement or intraoperative thromboembolic incidents. There were no mechanical failures, or radiographic signs of loosening, of the pelvic components. The Harrington reconstruction technique is an effective and long-lasting method to relieve pain and restore function in patients with advanced periacetabular metastatic destruction. 相似文献
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Cathérine Ruther Carolin Gabler Hartmut Ewald Martin Ellenrieder Maximilian Haenle Tobias Lindner Wolfram Mittelmeier Rainer Bader Daniel Kluess 《Journal of orthopaedic research》2014,32(4):606-612
Implant osseointegration can currently only be assessed reliably post mortem. A novel method that relies on the principle of acoustic sound analysis was developed to enable examination of the longitudinal progress of osseointegration. The method is based on a magnetic sphere inside a hollow cylinder of the implant. By excitation using an external magnetic field, collision of the sphere inside the implant produces a sound signal. Custom‐made titanium implants equipped thusly were inserted in each lateral femoral epicondyle of 20 New Zealand White Rabbits. Two groups were investigated: Uncoated, machined surface versus antiadhesive surface; and calcium phosphate‐coated surface versus antiadhesive surface. The sound analysis was performed postoperatively and weekly. After 4 weeks, the animals were euthanized, and the axial pull‐out strengths of the implants were determined. A significant increase in the central frequency was observed for the loose implants (mean pull‐out strength 21.1 ± 16.9 N), up to 6.4 kHz over 4 weeks. In comparison, the central frequency of the osseointegrated implants (105.2 ± 25.3 N) dropped to its initial value. The presented method shows potential for monitoring the osseointegration of different implant surfaces and could considerably reduce the number of animals needed for experiments. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:606–612, 2014. 相似文献
36.
Albrecht Waschke Christin Hartmann Jan Walter Pedro Dünisch Falko Wahnschaff Rolf Kalff Christian Ewald 《Acta neurochirurgica》2014,156(2):235-244
Background
Different studies have shown that atrophy of paraspinal muscles arises after open dorsal lumbar fusion, and the reasons for this atrophy are still not yet fully clarified. This prospective study investigates the extent of atrophy of the lumbar paraspinal muscles after open lumbar interbody fusion, its possible causes, and their association with clinical outcome measures.Methods
Thirty consecutive patients were prospectively included (13 male, 17 female, median age 60.5 years, range 33–80 years). Mono or bisegmental, posterior lumbar interbody fusion and instrumentation was performed applying a conventional, open lumbar midline approach. Clinical outcome was assessed by the Short Form (36) Health Survey (SF-36) questionnaire and visual analogue scale. Needle electromyography of paraspinal muscles was performed preoperatively, at 6 and 12 months. Serum values of creatine kinase, lactate dehydrogenase and myoglobin were determined preoperatively, at day 2 after surgery and at discharge. Paraspinal muscle volume was determined by volumetric analysis of thin-slice computed tomography scans preoperatively and 1 year after surgery.Results
There was a significant increase of electromyographic denervation activity (p =0.024) and reduced recruitment of motor units (p?=?0.001) after 1 year. Laboratory studies showed a significant increase of CK (p?<?0.001) and myoglobin (p < 0.001) serum levels at day 2 after surgery. The paraspinal muscle volume decreased from 67.8 to 60.4 % (p < 0.001) after 1 year. Correlation analyses revealed a significant negative correlation between denervation and muscle volume (K = -0.219, p = 0.002). Paraspinal muscle volume is significantly correlated with physical outcome (K = 0.169, p = 0.020), mental outcome (K = 0.214, p = 0.003), and pain (K = 0.382, p < 0.001) after 1 year.Conclusions
Atrophy of paraspinal muscles after open, posterior lumbar interbody fusion seems to be associated with denervation, as well as direct muscle trauma during surgery. While muscle atrophy is also correlated with a worse clinical outcome, it seems to be a determining factor for successful lumbar spine surgery. 相似文献37.
Christian Ewald Pedro Duenisch Jan Walter Theresa Götz Otto W. Witte Rolf Kalff Albrecht Günther 《Neurocritical care》2014,20(1):91-97
Background
Autologous bone flap reinsertion follows as a second surgical intervention after decompressive craniectomy in patients with malignant middle cerebral artery (MCA) infarction. In addition to surgery-related short-term complications, aseptic resorption of the reimplanted bone flap is a possible long-term problem which has not yet been sufficiently elucidated in these patients.Methods
A total of 109 patients who had undergone decompressive hemicraniectomy for malignant MCA infarction in our institution between September 1994 and December 2011 were included in the study. Clinical and radiological findings were retrieved retrospectively. Aseptic bone necrosis was classified into two categories based on computer tomographic features.Results
A total of 76 patients received their own cryoconserved bone flap (mean age 54.34 ± 10.73 years; 49 males). The overall short-term complication rate was 9.2 %. Bone flap necrosis occurred in 26 patients (22.8 %) with 7 flaps showing signs of surgically relevant type II necrosis after a median time of 14 months (interquartile range [IQR] 4–22).Conclusions
There is a noticeable complication rate in patients undergoing bone flap reinsertion after hemicraniectomy due to malignant MCA infarction. Aseptic bone necrosis represents a significant complication during long-term follow-up. The pathophysiological mechanisms remain unclear and more efforts should be undertaken to understand and possibly prevent this complication in these patients. 相似文献38.
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Ursula Friedrich Ole Mors Henrik Ewald 《American journal of medical genetics. Part A》1996,67(1):58-62
Systematic and detailed chromosome analysis, combined with a semistructured interview, was performed in 2 families with schizophrenia and in 2 families with manic depressive illness. Prometaphase technique did not reveal any subtle structural chromosome abnormalities. However, in standard techniques, gain and loss of sex chromosomes were observed. This occurred in patients at a younger age than in unaffected persons. This gives rise to the suspicion that sex chromosome aneuploidy may somehow be related to the development of psychosis. But since the data set is small, especially with respect to schizophrenia, further studies are needed to elucidate this observation. In one family, cosegregation of the disease locus with a marker on chromosome 21 was seen. Therefore, further research should determine if chromosome 21 contains a gene for manic depressive illness. © 1996 Wiley-Liss, Inc. 相似文献