Konservative Therapie der „frozen shoulder“

Die Unfallchirurgie - Die idiopathische Schultersteifigkeit (Frozen shoulder, FS) ist eine häufige Pathologie des Glenohumeralgelenks, die durch ein plötzlich einsetzendes Schmerzsyndrom...     

Veränderungen in der Alterstraumatologie

The increasing average age in the industrialized nations is leading to an increasing number of elderly traumatized patients. Against this background, an analysis of the age-specific characteristics of geriatric traumatized patients is necessary. In this study, 14,869 patients >/= 18 years were analysed, who were prospectively documented in the registry of the German Trauma Society (DGU) between 1996 and 2005. Patients between 18 and 59 years were defined as the control group; their proportion declined from 81.1% in 1996-2000 to 75.4% in 2001-2005. The average age rose from 41.0 years (1996) to 45.3 years (2005). With increasing age a significant increase in severe head injuries of up to 58.9% (>/= 80 years) could be observed. Older patients stayed for a significantly shorter time in hospital and on the ICU. With a comparable injury severity, the lethality after trauma increased with age (18-59 years 13.8%, 60-69 years 24.1%, 70-79 years 35.5%, >/=80 years 43.6%). The multiply traumatized geriatric patient is different from the normal group in regard to type of injury, therapy and outcome and should therefore be treated taking this fact into consideration.     

Die Veränderungen der Magensekretion bei der experimentellen Lebercirrhose

Ohne Zusammenfassung     

Physiologische Veränderungen in der Schwangerschaft

The physiological state of a woman experiences multiple changes in the body during pregnancy. These alterations could be of particular importance in the medical care of pregnant women. This review article highlights the physiological developments of various organ systems throughout gestation with a focus on endocrinology, the cardiovascular system, hematology, the respiratory system and water balance.     

Bronchographische Veränderungen bei Pleuraschwarten

Ohne Zusammenfassung (a. G.)     

Morphologische Veränderungen bei Arterienrupturen

The historical opinion that the intima layer of a ruptured artery of muscular type could stop bleeding by "rolling in" should be controlled experimentally. Five segments of human femoral/popliteal artery (3-4 cm long) were overstretched until complete rupture occurred. Furthermore a longitudinally split and a partially oblique incised segment were ruptured. As morphological finding a sandclock deformity was observed in the region of rupture. This phenomenon was induced by adventitia layer, which closed the ends of ruptured media layer like a Chinese finger trap. In the longitudinally split segment a transverse rupture of the media layer could be observed, while the fibers of adventitia layer were pulled out when the traction was continued. Neither macroscopical nor microscopical signs could be found for "rolling in" of intima or media layer. The reason for spontaneous hemostasis after arterial rupture is more likely the activation of platelets by collagenous fibers of adventitia layer than "rolling in" of intima or media layer. If there is no finger trap mechanism of adventitia layer like in shot- or stab wounds a massive blood loss must be expected.     

Ueber die Veränderungen der Gelenke bei dauernder Ruhe

Ohne Zusammenfassung (Hierzu Tafel VI und VII.)     

Die Veränderungen der Beckenverbindungen bei Beckenbrüchen

Ohne Zusammenfassung Mit 6 Textabbildungen Inauguraldissertation G?ttingen 1935. Auf Veranlassung und unter Leitung von Priv. Doz. Dr. W. Putschar.     

Morphologische Veränderungen der synovialen Gelenkkapselanteile bei Arthrosis deformans

Zusammenfassung Morphologische Veränderungen an Gelenkkapseln bei arthrotisch veränderten Gelenken ließen sowohl im Semidünnschnitt wie auch im elektronenmikroskopischen Bild Zweifel an der bisherigen Vorstellung über die Kausalgenese der Arthrosis deformans aufkommen. Es fanden sich in allen durchgemusterten sowie in den dargestellten Abbildungen neben teilweise normalen Kapselabschnitten alle Übergänge zwischen leichten regressiven Veränderungen bis hin zu massivsten proliferativen Veränderungen des interstitiellen Gefäßbindegewebes sowie der Deckzellschicht. Auffallend waren die teilweise stark erweiterten, mit Erythrozyten vollgepfropften Gefäße, teilweise eine massive Einengung durch konzentrisch gelagerte, von kollagenen Fasern durchtränkte Substanzen. Häufig fanden sich neben vollständig obliterierten Gefäßen Gefäßneubildungen. In keinem Fall fanden sich Rundzellanhäufungen, Granulozyten oder sonstige Hinweise auf eine entzündliche Synovitis. Die ständig angesprochenen und für die Arthrose als charakteristisch herausgestellten enzymatischen Reaktionen an der Knorpelmatrix können somit auch im Zusammenhang mit der normalen Zellzahl in der Synovia nicht die Ursache der Knorpeldegradation sein. Es wird die Frage diskutiert, inwieweit Substrate des Knorpelstoffwechsels selbst direkt oder indirekt einen Einfluß auf das interstitielle Bindegewebe ausüben mit Induktion einer starken Bindegewebsproliferation. Die Änderungen der Transitstrecke wären dann sekundär, ihre Auswirkungen auf die Deckzellschicht würde wiederum die Progression des Arthrosegeschehens verstärken.

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Human joint capsule in osteoarthrosis (morphological changes)

Summary Morphological investigations of the joint capsules in osteoarthrotic-changed joints have given rise to doubts about the present theory of the causal aetiology of the osteoarthrosis. In every inspected and demonstrated illustration beside the partly normal capsules segments could be found every transition between mild regressive alterations and most massiv proliferative changes of the conective tissue and the lining cell layer. It was extraordinary, that the strongly dilated vessels were filled with red blood cells. In another part of the same case was found a massive stricture caused by concentrically deposited substances, which were impregnated with collagenous fibers. Regeneration of the vessels frequently happened adjacent to totally obstructed ones. Round-cell infiltrations, granulocytes or other indications of an inflammatory synovitis are found only in a few cases. The intracartilaginous enzymatic reactions, which have been much talked of and which were explained as characteristic of the osteoarthrosis cannot be the cause of the degradation of the cartilage, particularly, because of the normal cell count which is to be found in the synovial fluid. We can answer this problem, if we can prove that the substrates of the chondral metabolism themselves exert a direct or indirect influence on the interstitial connective tissue with induction of the powerful proliferation of the same tissue. The changes in the transit zone would be secondary and their effect on the lining cell layer would increase the progression of the arthrotic events.

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Mit Unterstützung durch die Deutsche Forschungsgemeinschaft, Schwerpunktprogramm Biomechanik und Biopolymere des Bindegewebes     

Lokale und allgemeine Veränderungen bei der experimentellen Pankreatitis

Ohne ZusammenfassungDie Ergebnisse entstammen experimentellen Untersuchungen einer Arbeitsgruppe, an der Mitarbeiter der nachstehend aufgeführten Institute beteiligt waren: Chirurgische Universitätsklinik Heidelberg (Direktor: Prof. Dr.F. Linder), Pathologisches Institut der Universität Heidelberg (Direktor: Prof. Dr.W. Doerr), Medizinische Universitätsklinik Heidelberg (Direktor: Prof. Dr.G. Schettler) und Physiologisch-Chemisches Institut der Universität Heidelberg (Direktor: Prof. Dr.W. Kutscher).     

Über die Veränderungen der Raphe palatina bei der Skoliose

Ohne Zusammenfassung Mit 6 Textabbildungen.     

Ultrastrukturelle Veränderungen der Altersblase

Recent prospective, comparative ultrastructural/urodynamic studies on geriatric voiding dysfunction, including its natural evolution, have revealed that abnormalities of detrusor behavior have specific correlates in detrusor microstructure represented by distinctive electron-microscopic patterns. Each electron-microscopic pattern comprises a constellation of features in two or all three tissue compartments of the detrusor (smooth muscle, interstitium, intrinsic nerves). The pattern characteristic of each dysfunction is the same in detrusors of men and women. The electron-microscopic patterns are additive when multiple abnormalities coexist. All distinctive patterns of various clinical voiding dysfunctions can readily be defined qualitatively in endoscopic biopsies of the detrusor. These observations, including those on material studied for the natural evolution of geriatric voiding dysfunction, have led to the proposal of a clinical/structural definition of the normal aging detrusor and the development of an algorithm for pathologic diagnosis of geriatric voiding dysfunction.     

Veränderungen der Muskarinrezeptoren der alternden Harnblase

The prevalence of the overactive bladder syndrome (OAB) increases with age. Unfortunately, treatment of the condition is still unsatisfactory. Since muscarinic receptor antagonists are the only effective drug treatment to date, it is logical to assume that muscarinic receptors play an important role in the pathogenesis of OAB. Muscarinic receptors are involved in both the normal and overactive detrusor contraction, and age-dependent changes in muscarinic receptor functions have been found in both animals and human detrusors. In animals as well as humans, two components of detrusor contraction have been demonstrated, the dominating one mediated by muscarinic receptors and the other by ATP (atropine-resistant component). The muscarinic receptor-mediated component decreases with age, and the ATP (purinergic) part increases. However, the clinical consequence of this is unclear, since no major age-dependent changes in the efficacy of antimuscarinic agents in the treatment of OAB have been demonstrated.     

Molekulargenetische Veränderungen in Nierenzellkarzinomen

Over the last decade several genetic alterations involved in the pathogenesis and progression of renal cell carcinoma have been identified. These findings will have a wide implication for the diagnosis and management of renal cell carcinomas. This review provides a discussion of general principles of tumor development as well as the specific mechanisms underlying renal carcinogenesis.     

Die Veränderungen des Blutvolumens und der Blutzusammensetzung bei hirnchirurgischen Eingriffen

Ohne ZusammenfassungMit 2 TextabbildungenHerrn Professor Dr. E. Freiherrvon Redwitz zum 75. Geburtstage.     

Neuroendokrine Veränderungen und Maladaptationen bei Fibromyalgie

This contribution presents the psychosocial, psychopathological, psycho- and elektrophysiological as well as endocrine results in the aetiopathogenesis of fibromyalgia syndrome (FMS). Three subgroups could be differentiated based on psychosocial learning processes. They differ in pain intensity and interference, affective distress, activity and spouse responses. They influence pain behavior and CNS activity in the sense of operant conditioning. The relationship between dysregulated pain modulation in the CNS and endocrine dysregulation of the HPA-axis, which seems to be relevant for the autonome hyporeaction of muscle and blood pressure, are discussed. The "dynamic processing model for FMS" is presented.     

Charakteristische Veränderungen des Verteilungsmusters der Muskarinrezeptoren in der ekstrophen Blasenwand

Ohne Zusammenfassung Die Studie wurde durch F?rdermittel des ELAN-Fonds der Friedrich-Alexander-Universit?t Erlangen-Nürnberg unterstützt.     

Frühzeitige Veränderungen der Proteinexpression im Gehirn der Ratte bei Sepsis

Introduction

Sepsis still has a high mortality in critically-ill patients. Here, analysis of early alterations in cerebral proteome may lead to a better understanding of the molecular basis of cerebral dysfunction. The aim of the present study was therefore to analyze cerebral protein dynamics during emerging sepsis in an established rat model.

Material and methods

To induce sepsis, an established coecal ligature and double puncture (coecal ligature and puncture, CLP) model was used on Wistar rats. After 12 hours, surviving rats (sepsis: n=6 and sham: n=6) were decapitated and their brains prepared for gel electrophoresis (2DE) and subsequent mass spectrometry. Biological function of differentially regulated proteins (t-test, p<0.01) was then analyzed using bioinformatic network analysis (ingenuity pathways analysis, IPA).

Results

Mortality was 40 % in the sepsis-group and no rat of the sham-group died. Altogether, nine significantly regulated proteins were identified (4 up-regulated, 5 down-regulated). IPA then detected eight network proteins and interpreted them in the context of established protein alterations for sepsis.

Conclusion

The combination of proteomics and IPA could identify proteins in rat brain, whose expression was significantly regulated during sepsis. The methodological approach applied in the present study may facilitate the quest for novel sepsis-induced protein alterations in the future.