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1.
Thomas Ruffing Tilmann Rückauer Frederic Bludau Alexander Hofmann Markus Muhm Arnold J Suda 《Injury》2019,50(2):607-612
Introduction
Compression fractures of the cuboid bone in children and adolescents are rare. Fracture morphology, associated lesions, treatment options and long-term outcomes of this very rare injury are published in a few case reports. This study with review of the literature aims to support the understanding of fracture pattern and optimize pathways of decision making.Material and Methods
A retrospective two-center study was performed in a patient cohort treated between 2001 and 2016. All patients aged less than 18 years who sustained a cuboid fracture were included. Age, gender, mechanism of injury, fracture morphology, amount of displacement, associated injuries, and therapy were analyzed. In the follow-up (FU), the AOFAS Midfoot Scale was investigated.Results
Fractures of the cuboid bone were diagnosed in 7 boys and 9 girls. The mean age of the patients was 10 years (range: 2.2–16.1 years). According to the classification of Fenton we detected 11 (69%) type 2, 2 (12%) type 3 and 3 (19%) type 5b fractures. Other fracture types according to Fenton were not observed. All children under 10 years sustained a type 2 fracture. Open reduction and internal fixation was performed in 5 (31%) patients. Bone grafting was not necessary. FU was performed in 14/16 patients on average after 9 years (mean; range: 1.4–16.2 years). The mean AOFAS Midfoot Scale at FU for extra-articular type 2 fractures was 100 points, whereas in intra-articular fractures (Type 3) and fractures associated with mid-tarsal disruption (type 5b) worse results were found (95 and 66 points, accordingly).Conclusion
This rare injury shows inhomogenous morphologies and offers different treatment approaches. Extra-articular Fenton type 2 lesions are the most common type of cuboid fracture in children (69%). A potential loss of length of the lateral column must be considered. In contrast to adults, type 1, 4, and 5a fractures were not found in our cohort of children and adolescents. Lower scores of the AOFAS Midfoot Scale were found with either intra-articular involvement or associated midfoot lesions. 相似文献2.
Jan Stulik Tobias Rainer Pitzen Jan Chrobok Sabine Ruffing Jörg Drumm Laurentius Sova Ravel Kucera Tomas Vyskocil Wolf Ingo Steudel 《European spine journal》2007,16(10):1689-1694
Anterior cervical plate fixation is an approved surgical technique for cervical spine stabilization in the presence of anterior
cervical instability. Rigid plate design with screws rigidly locked to the plate is widely used and is thought to provide
a better fixation for the treated spinal segment than a dynamic design in which the screws may slide when the graft is settling.
Recent biomechanical studies showed that dynamic anterior plates provide a better graft loading possibly leading to accelerated
spinal fusion with a lower incidence of implant complications. This, however, was investigated in vitro and does not necessarily
mean to be the case in vivo, as well. Thus, the two major aspects of this study were to compare the speed of bone fusion and
the rate of implant complications using either rigid- or dynamic plates. The study design is prospective, randomized, controlled,
and multi-centric, having been approved by respective ethic committees of all participating sites. One hundred and thirty-two
patients were included in this study and randomly assigned to one of the two groups, both undergoing routine level-1- or level-2
anterior cervical discectomy with autograft fusion receiving either a dynamic plate with screws being locked in ap - position
(ABC, Aesculap, Germany), or a rigid plate (CSLP, Synthes, Switzerland). Segmental mobility and implant complications were
compared after 3- and 6 months, respectively. All measurements were performed by an independent radiologist. Mobility results
after 6 months were available for 77 patients (43 ABC/34 CSLP). Mean segmental mobility for the ABC group was 1.7 mm at the
time of discharge, 1.4 mm after 3 months, and 0.8 mm after 6 months. For the CSLP- group the measurements were 1.0, 1.8, and
1.7 mm, respectively. The differences of mean segmental mobility were statistically significant between both groups after
6 months (P = 0.02). Four patients of the CSLP-group demonstrated surgical hardware complications, whereas no implant complications were
observed within the ABC-group (P = 0.0375). Dynamic plate designs provided a faster fusion of the cervical spine compared with rigid plate designs after prior
spinal surgery. Moreover, the rate of implant complications was lower within the group of patients receiving a dynamic plate.
These interim results refer to a follow-up period of 6 months after prior spinal surgery. Further investigations will be performed
2 years postoperatively. 相似文献
3.
Chronic lymphocytic leukemia B cells are endowed with the capacity to attract CD4+, CD40L+ T cells by producing CCL22 总被引:6,自引:0,他引:6
4.
Summary. SV40 and/ or DNA sequences indistinguishable from SV40 have been detected in several types of human tumours. The oncoprotein
of Simian virus 40, SV40 large T-antigen (Tag), is known to bind and inactivate tumour suppressor proteins, such as members
of the retinoblastoma family and p53, thereby promoting cell transformation. In this study, we used the yeast two-hybrid system
to investigate whether the Simian virus 40 (SV40) large T-antigen is able to interact with p73, a noval discovered putative
tumour suppressor, that is homologous both structurally and functionally to p53. The yeast two-hybrid system is a genetic
method to detect protein-protein-interactions in vivo. Our results suggest that the SV40 large T-antigen is not able to bind
p73 in yeast although both proteins are expressed in the transformed yeast strain as was shown by western blot analysis.
Received May 20, 1998 Accepted September 28, 1998 相似文献
5.
Reticulocytes bearing C4d as biomarkers of disease activity for systemic lupus erythematosus 总被引:1,自引:0,他引:1
Liu CC Manzi S Kao AH Navratil JS Ruffing MJ Ahearn JM 《Arthritis and rheumatism》2005,52(10):3087-3099
OBJECTIVE: There is an urgent need for biomarkers with which to monitor disease activity in patients with systemic lupus erythematosus (SLE). We recently showed that abnormal levels of C4d, an activation-derived fragment of complement component C4, are deposited on the surface of erythrocytes from patients with SLE. This study focused on reticulocytes, the youngest and shortest-lived erythrocytes (lifespan 24-48 hours), with the objective of testing our hypothesis that when reticulocytes emerge from the bone marrow, they are immediately exposed to and acquire C4d at levels proportionate to the extent of complement activation at that time, thereby reflecting disease activity in SLE. METHODS: We conducted a cross-sectional study of 156 patients with SLE, 140 patients with other diseases, and 159 healthy controls. Levels of C4d on the surface of reticulocytes were examined using a 2-color flow cytometric assay. The results were analyzed for correlations with SLE disease activity. RESULTS: A wide range of increased levels of reticulocyte C4d was specifically detected in SLE patients. These levels fluctuated in SLE patients and correlated with clinical disease activity, as determined by the Safety of Estrogens in Lupus Erythematosus: National Assessment (SELENA) version of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus Activity Measure (SLAM). Specifically, in cross-sectional analyses, patients with reticulocyte C4d levels in the highest quartile compared with those in the lowest quartile had significantly higher SELENA-SLEDAI (P = 0.00002) and SLAM (P = 0.02) scores. Longitudinal observation demonstrated that the reticulocyte C4d levels changed in relation to the clinical course in individual patients. CONCLUSION: These findings support our hypothesis that C4d-bearing reticulocytes may serve as biomarkers of disease activity in patients with SLE. 相似文献
6.
M. Muhm G. Arend T. Ruffing H. Winkler 《European journal of trauma and emergency surgery》2013,39(3):267-275
Introduction
Studies yield conflicting results from the effect of early surgery on mortality. Some observed a positive, others a negative and some did not find any effect of early operation. In this study, mortality and quality of life in relation to time until surgery as well as reasons for delay were observed prospectively.Material and methods
Data of 138 patients (>65 years) with proximal femoral fractures and consecutive surgery were observed. Demographic data as well as mortality rate, survival time and Barthel Index up to 1 year in relation to different time frames were observed. Reasons for operative delay were divided into being administrative or patient-related.Results
Three-month mortality was 10.1% and 1-years was 23.9%. Neither time from injury until hospital admission nor from injury until surgery or from hospital admission until surgery up to 48 hours had any effect on mortality and survival time. The age of patients dying in the follow-up period was significantly higher than the age of patients surviving (86.8 vs. 84.4 years). No influence of any delay in time until surgery on the Barthel Index was observed.Conclusion
In proximal femoral fractures, a delay of surgery up to 48 hours did not influence mortality and Barthel Index negatively, nor did other associating factors. Only the patients age at the time of injury influences mortality rate, survival time, and Barthel Index significantly. The older the patient at the time of injury; the higher the mortality rate, the shorter the survival time and the lower the Barthel Index. 相似文献7.
Thomas Ruffing MD Markus Muhm Hartmut Winkler 《European journal of trauma and emergency surgery》2010,36(4):392-396
This is a case report of a 14-year-old girl with a triplane fracture of the distal fibula. The fracture showed displacement
and was treated by open reduction, internal fixation, and 5 weeks of external immobilization. The follow-up 5 months after
injury yielded an excellent clinical result. Triplane fractures are also seen in locations other than the growth plate of
the distal tibia. Due to the occurrence close to the end of the growth period, the potential for growth deformity is negligible.
There has been no previous report of a transitional fracture in this location. 相似文献
8.
9.
Intraarterielle Lyse der A. cerebri media: ein Überblick 总被引:3,自引:0,他引:3
Zusammenfassung Bis 1996 bedeutete Schlaganfalltherapie die Verhinderung weitere ischämischer Insulte. Durch die Entwicklung der intravenösen und intraarteriellen Lysetherapie mit rt-PA wurde erstmals eine kausale Therapie möglich. In diesem Beitrag soll der Stand der intravenösen Lysetherapie kurz dargestellt werden, um dann den Stellenwert der lokalen intraarteriellen Lysetherapie zu bewerten. 相似文献
10.
With increased capitation and managed care competition, health care systems must demonstrate effective health services with predictable costs, timing, transitions, and health outcomes. By involving patients, payers, and multiple providers, a health care system can design integrated clinical and support processes across the continuum for defined populations. The goals are lower costs, increased payer and patient satisfaction, and improved health status. This article shares examples and experiences from four health care systems that teamed with Premier, Inc., to design an integrated services sequence for defined populations. 相似文献