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  • 1
    Keywords: Forschungsbericht ; Drug-eluting Stent ; Kunststoff ; Beschichten ; Biokompatibilität ; Blutgefäß
    Type of Medium: Online Resource
    Pages: 1 Online-Ressource (231 Seiten, 9,48 MB) , Illustrationen, Diagramme
    Language: German
    Note: Förderkennzeichen BMBF 03ZZ0906A+C+E-J , Verbundnummer 01168933 , Unterschiede zwischen dem gedruckten Dokument und der elektronischen Ressource können nicht ausgeschlossen werden , Sonstige Körperschaften, die mit dem Werk in Verbindung stehen und Teilvorhaben teilweise dem Förderkatalog entnommen , Teilvorhaben "Innovative medizinische Systeme und Implantate im Blutkontakt - Konzepte für regenerative Polymerstents, Wirkstoffbeschichtungen und Biokompatibilität" , Teilvorhaben TP3: „Ionische Flüssigkeiten für Stentbeschichtungen“ , Teilvorhaben 5: Molekular-dynamische Prozesse an Grenzflächen zwischen Biomaterialien und humanen Zellen : hier zusammengefasst die AP 1.8 und 1.9 da diese thematisch zusammenhängen , Teilvorhaben „Innovative medizinische Systeme und Implantate im Blutkontakt (TP6), Kardio EMAU“ , TP7: Bioresponsive Hydrogel-Beschichtung für Gefäßstents , Teilvorhaben „Innovative medizinische Systeme und Implantate im Blutkontakt: Prüfung des Einsatzes von additiven Fertigungsverfahren zur Herstellung von neuartigen, geometrisch komplexen, abbaubaren Gefäßstützen“ , Teilprojekt am Institut für ImplantatTechnologie und Biomaterialien e.V. „In vitro Prüfungen und Abbau von Implementierungshürden“ , Teilvorhaben „Entwicklung bioabbaubarer Drug-Eluting-Scaffolds“
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  • 2
    Keywords: Forschungsbericht ; Chronisch-venöse Insuffizienz ; Geschwür ; Längsschnittuntersuchung ; Stent ; Nitinol ; Wärmebehandlung
    Type of Medium: Online Resource
    Pages: 1 Online-Ressource (132 Seiten, 10,81 MB) , Illustrationen, Diagramme
    Language: German
    Note: Förderkennzeichen BMBF 03ZZ0909A-D , Verbundnummer 01170211 , Enthält: Teilvorhaben der Universität Rostock "Epidemiologie der chronischen venösen Insuffizienz und Trägerwerkstoffe für Klappensegel-Trägerstruktur-Verbunde" - Förderzeitraum 01.03.2016-28.02.2019 , Enthält: Teilprojekt am Institut für Implantattechnologie und Biomaterialien e.V. "Entwicklung von Segelstrukturen und Prüfung von Venenklappenimplantaten" - Förderzeitraum 1.8.2016-31.7.2019 , Enthält: Teilvorhaben "Entwicklung stentbasierter Trägerstrukturen für Venenklappenimplantate" - Förderzeitraum 1.8.2016-31.7.2019 , Unterschiede zwischen dem gedruckten Dokument und der elektronischen Ressource können nicht ausgeschlossen werden
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 109 (1989), S. 34-38 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A comparison of the radiographical and functional results after displaced distal radius fractures in 41 patients treated by external fixation (EF), 36 patients treated by functional bracing in supination (FUSU), and 49 patients treated by dorsal plaster immobilization (DPI) was performed. The rate of initial complications after EF was 53%, compared with 22% after FUSU and 14% after DPI. The radiographical result after EF was significantly better than after nonoperative treatment, but the functional result after 3 and 6 months demonstrated no significant difference between the three series. Consequently, EF and FUSU do not restore wrist function faster than conventional plaster treatment (DPI), but EF improves the radiographical result, though the rate of complications is higher.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 103 (1984), S. 251-256 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über eine randomisierte prospektive Studie von dynamischer Schienenbehandlung in Supination (FUSU) gegenüber konventionellem dorsalen Gipsverband (DPI) bei 145 Colles-Frakturen berichtet. Die anatomischen Behandlungsergebnisse nach FUSU ergaben statistisch bessere Resultate als DPI (P〈0.05), insbesondere in Abhängigkeit von geringerer dorsaler Angulation (P〈0.001) und geringer radialer Verkürzung. Die funktionellen Behandlungsergebnisse zeigten keinen Unterschied 7 Wochen oder 3 Monate nach den Colles-Frakturen. Nach 6 Monaten wurden die funktionellen Ergebnisse bei 92% der mit FUSU behandelten Patienten als hervorragend oder gut beurteilt (P〈0.05). Der Vorteil der FUSU Behandlung zeigte sich besonders bei dislozierten, intraartikulären Frakturtypen.
    Notes: Summary A randomized clinical study of functional bracing in supination (FUSU) versus dorsal plaster immobilization (DPI) was conducted in 145 patients with Colles' fracture. A dynamic wrist unit was developed and used in 68 patients allocated for FUSU. The anatomical end result after FUSU was excellent or good in 80% of the patients versus 64% after DPI (P〈0.05), in particular due to less dorsal angulation (P〈0.001) and less radial shortening. The functional recovery was equal after 7 weeks and 3 months. At 6 months, 92% satisfactory results were achieved after FUSU versus 86% after DPI (P〈0.05). Both anatomical and functional benefits were recorded in Frykman type V, VI, and VIII fractures and in the group of displaced intra-articular fractures. The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European spine journal 5 (1996), S. 293-298 
    ISSN: 1432-0932
    Keywords: Anterior fusion ; Lumbar spine ; Dallas Pain ; Questionnaire
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Outcome after anterior spinal fusion has mainly been studied radiologically and reported fusion rates vary greatly. The aim of this study was to investigate radiological and long-term clinical outcome. The study comprised 120 consecutive patients, operated on during the period 1979–1987, with single-or two-level anterior interbody spinal fusion due to disc degeneration or isthmic spondylolisthesis with lumbar instability. In 64 patients a suplemental facet joint fusion was performed. Clinical outcome was evaluated 5–13 years after surgery using the patient-administered Dallas Pain Questionnaire (DPQ). Radiological outcome was determined on the basis of radiographs taken at a 2-year follow-up assessed by independent observers. The radiological follow-up rate was 98%. Complete fusion was found in 52%, questionable fusion in 24%, and definitive pseudoarthrosis in 24% of patients. Radiological results were poor in patients who had undergone previous spinal surgery (P〈0.05) and in those with two-level fusion (P〈0.05). The DPQ reply rate was 80%. Sixty-six patients claimed improvement in all functional groups. Patients with complete or questionable union had significantly better results than did those with non-union (P〈0.01). Poorer functional outcome was found in patients who had undergone previous spinal surgery (P〈0.01) or fusion at the L4/L5 level (P〈0.05), in those who had responded poorly to the preoperative test brace (P〈0.05), and in those above 45 years old at the time of surgery (P〈0.05). Radiological and functional outcome did not vary according to whether patients were treated postoperatively with a plaster jacket or with facet screw fixation. The study demonstrated a functional success rate of approximately 66% following anterior lumbar spinal fusion after a mean follow-up of 8 years. There was a clear tendency for poorer prognosis for patients who had undergone previous spinal surgery, those aged above 45 years, those operated at the L4/L5 level and those who had responded poorly to the preoperative test brace. DPQ scores correlated well with radiological outcome.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0932
    Keywords: Key words Pedicle screw ; Titanium ; Stainless steel ; Pull-out test ; Torsion ; Histomorphometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Several types of pedicle screw systems have been utilized to augment lumbar spine fusion. The majority of these systems are made of stainless steel (Ss), but titanium-alloy (Ti-alloy) devices have recently been available on the market. Ti-alloy implants have several potential advantages over Ss ones. High bioactivity and more flexibility may improve bone ingrowth and mechanical fixation, and the material also offers superior magnetic resonance imaging (MRI) and computed tomography (CT) resolution and significantly less signal interference. However, no data are available from loaded spinal constructs regarding bony ingrowth and mechanical fixation. The aim of this study was to analyse the effect of Ti-alloy versus Ss pedicle screws on mechanical fixation and bone ingrowth in a loaded mini-pig model. Eighteen adult mini-pigs underwent total laminectomy and posterolateral spinal fusion at L3-L4, and were randomly selected to receive either Ss (n = 9) or Ti (n = 9) pedicle screw devices. In both groups, the device used was compact Cotrel-Dubousset instrumentation (Sofamore Danek) of an identical size and shape. The postoperative observation time was ¶3 months. Screws from L3 were used for histomorphometric studies. Mechanical testing (torsional tests and pull-out tests) was performed on the screws from L4. The Ti screws had a higher maximum torque (P 〈 0.05) and angular stiffness (P 〈 0.07), measured by torsional testing. In the pull-out tests, no differences were found between the two groups with respect to the maximum load, stiffness and energy to failure. No correlation between removal torque and the pull-out strength was found (r = 0.1). Bone ongrowth on Ti was increased by 33% compared with Ss ¶(P 〈 0.04), whereas no differences in bone volume around the screws were shown. Mechanical binding at the bone-screw interface was significantly greater for Ti pedicle screws than for Ss, which was explained by the fact that Ti screws had a superior bone ongrowth. There was no correlation between the screw removal torque and the pull-out strength, which indicates that the peripheral bone structure around the screw was unaffected by the choice of metal.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0932
    Keywords: Key words Spinal fusion ; Autogenous bone graft ; Osteoblasts ; Prediction ; Culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The capacity of the individual patient to initiate osteoblast proliferation as a predictor for successful lumbar spinal fusion has not yet been reported. The objectives of this study were, first, to analyze the relationship between in vitro osteoblast proliferation and clinical bony fusion in the individual patient in order to predict the fusion outcome and, second, to measure the effect of preoperative tobacco smoking on osteoblast proliferation. Sixty-one patients (mean age 46 years) underwent posterolateral lumbar fusion in the period 1994–1995. Thirty-eight patients received CD pedicle screw implants and 23 received posterolateral fusions alone. During surgery, autogenous iliac bone was harvested and 1 g of trabecular bone without blood or bone marrow was then isolated for cell culturing. The cultures were classified as excellent (confluence within 4 weeks), good (confluence between 4 and 6 weeks) and poor (no or poor growth). Spine fusion was evaluated by two independent observers from plain anterior-posterior, lateral, and flexion/extension radiographs taken 1 year postoperatively, and the functional outcome was measured by the Dallas Pain Questionnaire (DPQ). Twenty-three patients had excellent, 19 good, and 19 poor in vitro osteoblast proliferation. Bony fusion was obtained in 77% of patients: 83% in the CD instrumentation group and 70% in the non-instrumentation group (NS). There was no significant correlation between osteoblast proliferation and spinal fusion or functional outcomes when analyzing the CD instrumentation and non-instrumentation groups together or separately. Elderly patients had a significantly poorer osteoblast proliferation than younger patients (P 〈 0.008). Preoperative tobacco consumption had no discernible effect on osteoblast proliferation, and no correlation between smoking and fusion was found. Further refinement of autologous osteoblast culturing may provide a biological tool for selection of patients who require biological enhancement of their bone fusion capacity. The poorer osteoblast proliferation related to advanced age supports the important negative biological influence of age on bony fusion. However, with more sensitive testing and better discrimination, other results are possible – or can in any event not be excluded.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0932
    Keywords: Key words Thoracolumbar burst fractures ; Recombinant human bone morphogenetic protein-7 ; Transpedicular transplantation ; Clinical results ; Bone graft ; substitute
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The study presented here is a pilot study in five patients with unstable thoracolumbar spine fractures treated with transpedicular OP-1 transplantation, short segment instrumentation and posterolateral fusion. Recombinant bone morphogenetic protein-7 in combination with a collagen carrier, also referred to as OP-1, has demonstrated ability to induce healing in long-bone segmental defects in dogs, rabbits and monkeys and to induce successful posterolateral spinal fusion in dogs without need for autogenous bone graft. Furthermore OP-1 has been demonstrated to be effective as a bone graft substitute when performing the PLIF maneuver in a sheep model. Five patients with single-level unstable burst fracture and no neurological impairment were treated with intracorporal OP-1 transplantation, posterior fixation (USS) and posterolateral fusion. One patient with osteomalacia and an L2 burst fracture had an additional intracorporal transplantation performed proximal to the instrumented segment, i.e. OP-1 into T 12 and autogenous bone into T 11. Follow-up time was 12–18 months. On serial radiographs, Cobb and kyphotic angles, as well as anterior, middle and posterior column heights, were measured. Serial CT scans were performed to determine the bone mineral density at fracture level. In one case, radiographic and CT evaluation after 3 and 6 months showed severe resorption at the site of transplantation, but after 12 months, new bone had started to fill in at the area of resorption. In all cases there was loss of correction with regard to anterior and middle column height and sagittal balance at the latest follow-up. These preliminary results regarding OP-1 as a bone graft substitute and stimulator of new bone formation have been disappointing, as the OP-1 device in this study was not capable of inducing an early sufficient structural bone support. There are indications to suggest that OP-1 application to a fracture site in humans might result in detrimental enhanced bone resorption as a primary event.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0932
    Keywords: Key words Lumbar fusion ; Pedicle ; screw ; Reoperation ; Functional ; outcome ; Dallas Pain ; Questionnaire ; Revision surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lumbar spinal fusion is a commonly performed surgical procedure, yet both the indications for its performance and its results remain controversial. It is generally believed that apart from situations where obvious measurable instability exists, a repeat surgical procedure such as spinal fusion does not improve the functional outcome in more than an average of 50% of cases. The aim of this study was to analyse functional outcome after posterolateral lumbar or lumbosacral spinal fusion, comparing primary and salvage procedures. It was designed as a prospective case/referent study with a 2-year follow-up. A total of 39 patients underwent a short posterior fusion with Cotrel-Dubousset (CD) pedicle screw fixation after earlier surgery of the lumbar spine. Two patients were erroneously omitted from the study at the index, so 37 patients were included in the salvage group. In the same period, 69 patients underwent lumbar fusion with pedicle screw fixation (CD) as primary surgery (referent group). Functional outcome was assessed by means of the Dallas Pain Questionnaire preoperatively and 1 and 2 years postoperatively. Fusion rates were determined by ordinary X-ray evaluation by two independent observers. Patients who had undergone previous spinal surgery had a significant improvement in functional outcome in terms of daily activity, work and leisure-time activities and anxiety/depression. With regard to social functioning, a significantly inferior outcome was found after the salvage procedure. The return-to-work rates at 2 years after surgery were 50% in the salvage group and 53% in the referent group. There was a significant correlation between radiological evaluation of the fusion mass and the functional outcome. The fusion rate was 76% in the salvage group and 72% in the referent group. This study demonstrates that a posterolateral spinal fusion can be effectively used as a salvage procedure. The functional and radiological outcome of the patients with revision surgery did not differ from those of the group of patients who underwent primary surgery. There was, however a clear indication of inferior social functioning after revision surgery.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 21 (1997), S. 176-180 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Au cours des années soixante et soixante-dix, certains auteurs émirent des inquiétudes au sujet du nombre de cas d’impuissance et de stérilité, complication postopératoire parmi les patients ayant subi une fusion intervertébrale antérieure lombaire (ALIF). Récemment, les techniques de fusion antérieure ont gagné en popularité, du fait de nouvelles méthodes. Dans ce contexte, la fréquence des dysfonctions des organes génitaux mâles n’a pas étéétablie. Notre but était donc d’étudier le taux et les conséquences fonctionnelles d’éjaculation rétrograde en tant que complication postopératoire. Cette étude contient un questionnaire postopératoire sur 6 à 13 ans, con*u pour analyser spécifiquement les complications concernant les dysfonctions des organes génitaux mâles, complications successives à une fusion retropéritonéale des vertèbres lombaires (ALIF). L’examen contient également une section rétrospective basée sur des dossiers de patients et sur l’étude postopératoire de 6 à 13 ans, étude basée sur un questionnaire – Le «Dallas pain questionnaire» (DPQ). Sur un total de 50 patients mâles, 41 patients, ce qui représente un taux de 82%, répondirent à ce questionnaire. Deux patients déclarèrent avoir souffert d’éjaculation rétrograde de fa*on permanente, suite à la fusion antérieure. Un patient a, pendant 6 mois, connu une impossibilité totale d’éjaculation, suivie d’une réduction de volume d’environ 50%. Les réponses au DPQ n’ont montré aucun effet négatif d’éjaculation rétrograde par rapport à des conséquences fonctionnelles. Cette étude montre que dans au moins 8% des cas, la dysfonction des organes génitaux mâles est considérée directement imputable à une fusion vertébrale antérieure.
    Notes: Summary. We have studied the incidence and functional outcome of retrograde ejaculation as a postoperative complication of anterior lumbar interbody fusion. A questionnaire, specifically designed to analyse this problem, has been used over a 6 to 13 year follow-up. Out of 50 men, 41 completed the questionnaire; 2 complained they had permanent retrograde ejaculation after the operation; one stopped ejaculating for 6 months, and thereafter had a 50% reduction. The Dallas pain questionnaire showed that retrograde ejaculation did not have a negative effect on the functional outcome, but male genital dysfunction was a complication of anterior spinal fusion in 8% of cases.
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