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Hagemann C, Antoniadis G, Pham M, Bischoff C, Ghosh T, Grieser T, Naumann M, Holzapfel K. [Diagnostics and treatment of hourglass-like nerve constrictions and torsions in neuralgic amyotrophy]. Nervenarzt 2023; 94:1157-1165. [PMID: 37943327 DOI: 10.1007/s00115-023-01562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
Neuralgic amyotrophy is a disease of the peripheral nervous system characterized by severe neuropathic pain followed by peripheral paralysis. A distinction is made between a hereditary and an idiopathic form, which is assumed to have an autoimmunological origin. Conservative medicinal treatment mainly consists of nonsteroidal anti-inflammatory drugs (NSAID), opioids and glucocorticoids; however, despite treatment, symptoms in the form of pain or paralysis persist in over 50% of cases. Inflammation can lead to strictures and torsions of peripheral nerves, which can be visualized by imaging using nerve sonography or magnetic resonance (MR) neurography and confirmed intraoperatively during surgical exploration. Based on the currently available data, patients with strictures and torsions of peripheral nerves can benefit from neurosurgical treatment.
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Affiliation(s)
- Christian Hagemann
- Klinik für Neurologie und klinische Neurophysiologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.
| | - Gregor Antoniadis
- Sektion "Periphere Nervenchirurgie", Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
| | - Mirko Pham
- Diagnostische und interventionelle Neuroradiologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Christian Bischoff
- Neurologische Gemeinschaftspraxis am Marienplatz, Burgstraße 7, 80331, München, Deutschland
| | - Tanupriya Ghosh
- Klinik für Neurologie und klinische Neurophysiologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
| | - Thomas Grieser
- Diagnostische und interventionelle Radiologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Markus Naumann
- Klinik für Neurologie und klinische Neurophysiologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
| | - Korbinian Holzapfel
- Klinik für Neurologie und klinische Neurophysiologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
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Darmochwal S, Bischoff C, Thieme R, Gockel I, Tegtbur U, Hillemanns P, Schulze A, Voss J, Falz R, Busse M. Impact of home-based training and nutritional behavior on body composition and metabolic markers in cancer patients: data from the CRBP-TS study. Front Nutr 2023; 10:1152218. [PMID: 37794972 PMCID: PMC10546323 DOI: 10.3389/fnut.2023.1152218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Obesity and physical inactivity are known to affect cancer's development and prognosis. In this context, physical aerobic and resistance training as well as a Mediterranean nutrition have been proven to have many positive health effects. The aim of this study was therefore to investigate the effect of home-based training on body composition and certain metabolic laboratory parameters. Methods Patients with breast, colorectal and prostate cancer who underwent curative surgery at stages T1N0M0-T3N3M0 were eligible for this trial and randomized to an intervention and control group. In the intervention group the patients carried out online-based strength-endurance home training during the 6-month study period. Body composition was assessed via bioelectrical impedance analysis (baseline, 3 months and 6 months). Metabolic blood parameters were also analyzed and nutrition behavior determined using the Mediterranean Diet Adherence Screener (MEDAS). Results The intervention group's fat mass decreased while their lean body mass increased (time effect p = 0.001 and p = 0.001, respectively). We found no interaction effect in body weight (p = 0.19), fat mass [p = 0.06, 6-months estimates -0.9 (95% CI -1.8 to -0.1)] and lean body mass (p = 0.92). Blood samples also failed to show a statistically significant interaction effect between time × group for HbA1c% (p = 0.64), Insulin (p = 0.33), Adiponectin (p = 0.87), Leptin (p = 0.52) and Triglycerides (p = 0.43). Only Adiponectin revealed significance in the time effect (p < 0.001) and Leptin in the group effect (p = 0.03). Dietary behavior during the study period was similar in patients in the intervention and control groups (interaction p = 0.81; group p = 0.09 and time p = 0.03). Discussion Individualized online-based home training in postoperative cancer patients revealed only minor changes, with no group differences in body composition or metabolic laboratory parameters, which were predominantly in the reference range at baseline. More studies investigating effects of online-based home training on body composition and nutrition behavior are needed. Trial registration https://drks.de/search/en/trial/DRKS00020499, DRKS-ID: DRKS00020499.
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Affiliation(s)
- Sophia Darmochwal
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Johannes Voss
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
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Falz R, Bischoff C, Thieme R, Tegtbur U, Hillemanns P, Stolzenburg JU, Aktas B, Bork U, Weitz J, Lässing J, Leps C, Voß J, Lordick F, Schulze A, Gockel I, Busse M. Effect of home-based online training and activity feedback on oxygen uptake in patients after surgical cancer therapy: a randomized controlled trial. BMC Med 2023; 21:293. [PMID: 37553660 PMCID: PMC10408062 DOI: 10.1186/s12916-023-03010-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Exercise training is beneficial in enhancing physical function and quality of life in cancer patients. Its comprehensive implementation remains challenging, and underlying cardiopulmonary adaptations are poorly investigated. This randomized controlled trial examines the implementation and effects of home-based online training on cardiopulmonary variables and physical activity. METHODS Of screened post-surgical patients with breast, prostate, or colorectal cancer, 148 were randomly assigned (1:1) to an intervention (2 × 30 min/week of strength-endurance training using video presentations) and a control group. All patients received activity feedback during the 6-month intervention period. Primary endpoint was change in oxygen uptake after 6 months. Secondary endpoints included changes in cardiac output, rate pressure product, quality of life (EORTC QoL-C30), C-reactive protein, and activity behavior. RESULTS One hundred twenty-two patients (62 intervention and 60 control group) completed the study period. Change in oxygen uptake between intervention and control patients was 1.8 vs. 0.66 ml/kg/min (estimated difference after 6 months: 1.24; 95% CI 0.23 to 2.55; p = 0.017). Rate pressure product was reduced in IG (estimated difference after 6 months: - 1079; 95% CI - 2157 to - 1; p = 0.05). Physical activity per week was not different in IG and CG. There were no significant interaction effects in body composition, cardiac output, C-reactive protein, or quality of life. CONCLUSIONS Home-based online training among post-surgery cancer patients revealed an increase of oxygen uptake and a decrease of myocardial workload during exercise. The implementation of area-wide home-based training and activity feedback as an integral component in cancer care and studies investigating long-term effects are needed. TRIAL REGISTRATION DRKS-ID: DRKS00020499 ; Registered 17 March 2020.
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany.
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Institute of Sport Medicine, Hannover Medical School, Hannover, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | | | - Bahriye Aktas
- Department of Gynaecology, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich Bork
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - Jürgen Weitz
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - Johannes Lässing
- Institute of Exercise Science & Sports Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Christian Leps
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany
| | - Johannes Voß
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany
| | - Florian Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany
- University Cancer Center Leipzig, University Hospital Leipzig, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 30, Leipzig, 04103, Germany
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Lässing J, Maudrich T, Kenville R, Uyar Z, Bischoff C, Fikenzer S, Busse M, Falz R. Intensity-dependent cardiopulmonary response during and after strength training. Sci Rep 2023; 13:6632. [PMID: 37095279 PMCID: PMC10126007 DOI: 10.1038/s41598-023-33873-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/20/2023] [Indexed: 04/26/2023] Open
Abstract
Whereas cardiopulmonary responses are well understood in endurance training, they are rarely described in strength training. This cross-over study examined acute cardiopulmonary responses in strength training. Fourteen healthy male strength training-experienced participants (age 24.5 ± 2.9 years; BMI 24.1 ± 2.0 kg/m2) were randomly assigned into three strength training sessions (three sets of ten repetitions) with different intensities (50%, 62,5%, and 75% of the 3-Repetition Maximum) of squats in a smith machine. Cardiopulmonary (impedance cardiography, ergo-spirometry) responses were continuously monitored. During exercise period, heart rate (HR 143 ± 16 vs. 132 ± 15 vs. 129 ± 18 bpm, respectively; p < 0.01; η2p 0.54) and cardiac output (CO: 16.7 ± 3.7 vs. 14.3 ± 2.5 vs. 13.6 ± 2.4 l/min, respectively; p < 0.01; η2p 0.56) were higher at 75% of 3-RM compared to those at the other intensities. We noted similar stroke volume (SV: p = 0.08; η2p 0.18) and end-diastolic volume (EDV: p = 0.49). Ventilation (VE) was higher at 75% compared to 62.5% and 50% (44.0 ± 8.0 vs. 39.6 ± 10.4 vs. 37.6 ± 7.7 l/min, respectively; p < 0.01; η2p 0.56). Respiration rate (RR; p = .16; η2p 0.13), tidal volume (VT: p = 0.41; η2p 0.07) and oxygen uptake (VO2: p = 0.11; η2p 0.16) did not differ between intensities. High systolic and diastolic blood pressure were evident (62.5% 3-RM 197 ± 22.4/108.8 ± 13.4 mmHG). During the post-exercise period (60 s), SV, CO, VE, VO2, and VCO2 were higher (p < 0.01) than during the exercise period, and the pulmonary parameters differed markedly between intensities (VE p < 0.01; RR p < 0.01; VT p = 0.02; VO2 p < 0.01; VCO2 p < 0.01). Despite the differences in strength training intensity, the cardiopulmonary response reveals significant differences predominantly during the post-exercise period. Intensity-induced breath holding induces high blood pressure peaks and cardiopulmonary recovery effects after exercise.
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Affiliation(s)
- Johannes Lässing
- Department of Exercise Science and Sports Medicine, Martin Luther University Halle-Wittenberg, Von-Seckendorff-Platz 2, 06120, Halle (Saale), Germany
| | - Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sports Science, Leipzig University, 04109, Leipzig, Germany
| | - Rouven Kenville
- Department of Movement Neuroscience, Faculty of Sports Science, Leipzig University, 04109, Leipzig, Germany
| | - Zarah Uyar
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Sven Fikenzer
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany.
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Falz R, Bischoff C, Thieme R, Lässing J, Mehdorn M, Stelzner S, Busse M, Gockel I. Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 2022; 148:2187-2213. [PMID: 35695931 PMCID: PMC9349170 DOI: 10.1007/s00432-022-04088-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 12/13/2022]
Abstract
Purpose Functional capacity is an independent indicator of morbidity in colon and rectal cancer surgery. This systematic review describes the evaluated and synthesized effects of exercise prehabilitation depending on the duration of interventions on functional and postoperative outcomes in colon and rectal cancer surgery. Methods Three electronic databases (MEDLINE Pubmed, Web of Sciences, and Cochrane Registry) were systematically searched (January 2022) for controlled trials that investigated the effects of prehabilitation prior to colo-rectal cancer resection. Results Twenty-three studies were included in this systematic review and 14 in our meta-analyses assessing these outcomes: the 6 min walk distance (6MWD), postoperative overall complications, and length of stay (LOS). We observed a significant improvement in preoperative functional capacity as measured with 6MWD (mean difference: 30.8 m; 95% CI 13.3, 48.3; p = 0.0005) due to prehabilitation. No reductions in LOS (mean difference: – 0.27 days; 95% CI – 0.93, 0.40; p = 0.5) or postoperative overall complications (Odds ratio: 0.84; 95% CI 0.53, 1.31; p = 0.44) were observed. Prehabilitation lasting more than 3 weeks tended to lower overall complications (Odds ratio: 0.66; 95% CI 0.4, 1.1; p = 0.11). However, the prehabilitation time periods differed between colon and rectal carcinoma resections. Conclusion Prehabilitation while the patient is preparing to undergo surgery for colorectal carcinoma improves functional capacity; and might reduce postoperative overall complications, but does not shorten the LOS. The studies we reviewed differ in target variables, design, and the intervention’s time period. Multicenter studies with sufficient statistical power and differentiating between colon and rectal carcinoma are needed to develop implementation strategies in the health care system. Registration PROSPERO CRD42022310532
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany.
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Johannes Lässing
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany
| | - Matthias Mehdorn
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Sigmar Stelzner
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
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Schulte-Mattler W, Bischoff C. EMG und Neurografie – ein Update. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1759-9988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Elektromyografie (EMG) und Elektroneurografie (ENG) gelten als bewährte
Methoden, deren Anfänge aber schon Jahrzehnte zurückliegen. In
dieser Arbeit werden jüngere Entwicklungen beschrieben und die Rolle von
EMG und ENG in wichtigen Situationen diskutiert, nämlich bei
traumatische Nervenläsionen, Nervenkompressionssyndromen,
Polyneuropathien, Motoneuronerkrankungen, Myopathien, neuromuskulären
Transmissionsstörungen und bei muskulärer
Überaktivität.
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Schönlau L, Margold M, Buchner H, Bischoff C. SOP – N.radialis-Parese – Fallhand. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1734-2495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Die akut aufgetretene Fallhand kann Folge einer Läsion des N.radialis
oder eines Schlaganfalls sein. Mit der klinischen Untersuchung und der
Myografie kann die Differenzialdiagnose geklärt werden. Bei einer
Läsion des N.radialis gibt die Neurophysiologie für die
therapeutischen Entscheidungen notwendige Befunde. Die SOP gibt einen
Vorschlag zur rationalen Stufendiagnostik.
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Affiliation(s)
- Lars Schönlau
- Klinik für Neurologie, Uniklinikum Bochum
Knappschaftskrankenhaus, Bochum
| | - Michelle Margold
- Klinik für Neurologie, Uniklinikum Bochum
Knappschaftskrankenhaus, Bochum
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Schönlau L, Margold M, Buchner H, Bischoff C. SOP-Polyneuropathien (PNP). KLIN NEUROPHYSIOL 2021. [DOI: 10.1055/a-1585-9173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Polyneuropathien (PNP) sind Erkrankungen mehrerer peripherer Nerven. Von den unterschiedlichen klinischen Präsentationen ist der chronische, distal symmetrische Typ der häufigste. Standard zur Diagnose ist die Neuro-Myografie. Die SOP gibt einen Vorschlag zur rationalen Stufendiagnostik des chronischen, distal symmetrischen Typs einer PNP.
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Affiliation(s)
- Lars Schönlau
- Klinik für Neurologie, Uniklinikum Bochum Knappschaftskrankenhaus, Bochum
| | - Michelle Margold
- Klinik für Neurologie, Uniklinikum Bochum Knappschaftskrankenhaus, Bochum
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Fitz O, Bischoff C, Bauer M, Gentischer H, Birke KP, Henning H, Biro D. Electrolyte Study with in Operando pH Tracking Providing Insight into the Reaction Mechanism of Aqueous Acidic Zn//MnO
2
Batteries. ChemElectroChem 2021. [DOI: 10.1002/celc.202100888] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Oliver Fitz
- Battery Cell Technology Department of Electrical Energy Storage Fraunhofer Institute for Solar Energy Systems ISE Freiburg Germany
| | - Christian Bischoff
- Battery Cell Technology Department of Electrical Energy Storage Fraunhofer Institute for Solar Energy Systems ISE Freiburg Germany
| | - Manuel Bauer
- Battery Cell Technology Department of Electrical Energy Storage Fraunhofer Institute for Solar Energy Systems ISE Freiburg Germany
| | - Harald Gentischer
- Battery Cell Technology Department of Electrical Energy Storage Fraunhofer Institute for Solar Energy Systems ISE Freiburg Germany
| | - Kai Peter Birke
- Group Leader Electrical Energy Storage Systems Institute for Photovoltaics (ipv) University of Stuttgart Stuttgart Germany
| | - Hans‐Martin Henning
- Head of Fraunhofer Institute for Solar Energy Systems ISE Chair of Solar Energy Systems Institute for Sustainable Technical Systems (INATECH) University of Freiburg Freiburg Germany
| | - Daniel Biro
- Head of Department of Electrical Energy Storage Fraunhofer Institute for Solar Energy Systems ISE Freiburg Germany
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Schönlau L, Margold M, Buchner H, Bischoff C. SOP – N.ulnaris-Neuropathie am Ellenbogen (UNE) / Kubitaltunnelsyndrom (KUTS). KLIN NEUROPHYSIOL 2021. [DOI: 10.1055/a-1403-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Die Ulnarisneuropathie am Ellenbogen ist nach dem Karpaltunnelsyndrom das zweithäufigste Nervenkompressionssyndrom an der oberen Extremität. Etablierter Standard zur Sicherung der Diagnose ist die Neurografie. Die Sonografie des Nervens wird zur Ergänzung empfohlen. Die SOP gibt einen Vorschlag zur rationalen Stufendiagnostik.
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Affiliation(s)
- Lars Schönlau
- Klinik für Neurologie, Uniklinikum Bochum Knappschaftskrankenhaus, Bochum
| | - Michelle Margold
- Klinik für Neurologie, Uniklinikum Bochum Knappschaftskrankenhaus, Bochum
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Bischoff C. Motorische Neurografie und Reflexstudien: Wegweiser der klinischen Elektrophysiologie. KLIN NEUROPHYSIOL 2021. [DOI: 10.1055/a-1336-6688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Würdigung der Publikation: Electrophysiological studies of nerve and reflex activity in normal man I. Identification of certain reflexes in the electromyogram and the conduction velocity of peripheral nerve fibers
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Falz R, Thieme R, Tegtbur U, Bischoff C, Leps C, Hillemanns P, Kohlhaw K, Klempnauer J, Lordick F, Stolzenburg JU, Aktas B, Weitz J, Bork U, Wimberger P, Thomas C, Biemann R, Jansen-Winkeln B, Schulze A, Gockel I, Busse M. CRBP-TS - evaluation of a home-based training and health care program for colorectal, breast, and prostate cancer using telemonitoring and self-management: study protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:15. [PMID: 33622370 PMCID: PMC7901214 DOI: 10.1186/s13102-021-00244-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/07/2021] [Indexed: 01/19/2023]
Abstract
Background Physical training is recommended in various national and international guidelines for patients with cancer. Observational studies have shown that physical activity leads to reduced recurrence and mortality rates by 20–40% in colorectal, breast, and prostate cancer. Despite existing evidence, a systematic care structure is still lacking. The primary aim of this study is to implement and evaluate an online training platform to strengthen physical performance and patient empowerment after cancer surgery. Methods The evaluation will be conducted as a prospective multicenter randomized controlled trial with three subgroups (colorectal-, breast-, and prostate cancer). Each group will include 100 patients (total 300 patients including dropouts; clinical stages T1–3 and/or N+; M0 after surgery intervention) and the primary endpoint (13% increase in the maximal oxygen consumption during exercise) will be examined. The intervention group will receive a 6-month home-based online training (2–3 times per week strength-endurance training using video presentations), bidirectional activity feedback information, online communication, and online counseling. The control group (usual care) will be advised lifestyle improvement. In-hospital testing will be performed before, during, and after the intervention. In addition to cardiopulmonary capacity, tumor specific diagnostics (liquid biopsy, depression and fatigue assessment, metabolic and endothelial screening) will be applied. Discussion Due to the increasing incidence of cancer, associated with considerable mortality, morbidity and impaired quality of life, there is an imperative requirement for improved cancer care, of which structured physical training may become an integral component. Trial registration DRKS-ID: DRKS00020499; Registered 17 March 2020.
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Institute of Sport Medicine, Hannover Medical School, Hannover, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Christian Leps
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Kay Kohlhaw
- Department of Surgery, Sana Hospitals "Leipziger Land", Borna, Germany
| | - Jürgen Klempnauer
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Florian Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany.,University Cancer Center Leipzig, University Hospital Leipzig, Leipzig, Germany
| | | | - Bahriye Aktas
- Department of Gynaecology, University Hospital Leipzig, Leipzig, Germany
| | - Jürgen Weitz
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Ulrich Bork
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Pauline Wimberger
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Thomas
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Boris Jansen-Winkeln
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
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13
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Oliveira L, Pilz L, Tognolo CM, Bischoff C, Becker KA, Oliveira GG, Neves PJF, Fachin CG, Agulham MA, Dias AIBS. Comparison between ultrasonography and X-ray as evaluation methods of central venous catheter positioning and their complications in pediatrics. Pediatr Surg Int 2020; 36:563-568. [PMID: 32232550 DOI: 10.1007/s00383-020-04642-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This study evaluates the capacity of ultrasonography as a diagnostic method to confirm the proper positioning of central venous catheter (CVC) when compared to the current gold standard, chest radiography (CR). METHODS A prospective study was performed including children from 0 to 14 incomplete years, who underwent CVC placement between March and May 2018 at a teaching hospital in Brazil. A four-chamber view of the heart was performed with ultrasound during a rapid injection of saline solution to identify hyperechoic images and confirm the central position of the catheter. After that, a CR was performed. The diagnostic quality of ultrasound was evaluated based on accuracy, sensitivity, specificity, positive and negative predictive values. RESULTS A total of 21 patients were analyzed. The mean age was 3.95 ± 4.01 years. The preferred puncture site was the right internal jugular vein (71.4%). Ultrasound accuracy to detect CVC positioning was 81%. Sensitivity, specificity and positive and negative predictive values were 33%, 100%, 100% and 79%, respectively. CONCLUSION Ultrasound is a reliable method for detection of CVC positioning. Even so, with the four-chamber cardiac view, this method is unable to identify catheters inside heart chambers, therefore, needing to confirm the positioning with CR.
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Affiliation(s)
- L Oliveira
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil.
| | - L Pilz
- Medical Student, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - C M Tognolo
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - C Bischoff
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - K A Becker
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - G G Oliveira
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - P J F Neves
- Medical Student, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - C G Fachin
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - M A Agulham
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
| | - A I B S Dias
- Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil
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14
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Bischoff C, Schulte-Mattler W, Schminke U. SOP Kompressionssyndrome peripherer Nerven. KLIN NEUROPHYSIOL 2019. [DOI: 10.1055/a-0882-4611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Nervenkompressionssyndrome gehören zu den häufigsten neurologischen Störungen. Für die wichtigsten Kompressionssyndrome an Armen und Beinen werden typische Beschwerden und klinische Befunde sowie das standardisierte elektrophysiologische Vorgehen beschrieben. Neben den Mindestanforderungen und den dabei zu erwartenden pathologischen Befunden wird besonderer Wert darauf gelegt, die technischen Probleme und differenzialdiagnostischen Schwierigkeiten darzustellen.
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Abstract
ZusammenfassungTrotz des Vordringens der Bildgebung und der enormen Fortschritte der molekulargenetischen Diagnostik hat die Elektromyografie mit der (konzentrischen) Nadelelektrode einen festen Stellenwert in der Diagnostik und Differenzialdiagnostik neuromuskulärer Erkrankungen. Dies gilt insbesondere für die Frühdiagnostik (z. B. ALS, axonale PNP), den Nachweis einer axonalen Schädigung, von myotonen Serien, die Diagnostik von Myopathien, die zeitliche Zuordnung neurogener Schädigungen, die Differenzierung peripherer vs. zentraler Parese, und die frühzeitige Erfassung einer Reinnervation.
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16
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Schulte-Mattler W, Bischoff C. Neurografie. KLIN NEUROPHYSIOL 2019. [DOI: 10.1055/a-0918-4610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
ZusammenfassungBildgebende Verfahren machen der Elektroneurografie scheinbar Konkurrenz, scheinen sie manchenorts in den Hintergrund zu verdrängen. Dies ist zum Schaden der Patienten, da beide Methoden einander vortrefflich ergänzen. Besonders hilfreich ist die Elektroneurografie auch „heute noch“ zum Nachweis und zur Lokalisation von neurogenen Prozessen oder Nervenverletzungen, Nachweis von Demyelinisierung, bei der Ermittlung der Art einer Nervenläsion, Beurteilung des zeitlichen Verlaufs nach einer Nervenläsion, Objektivierung von Läsionen, Diagnostik neuromuskulärer Transmissionsstörungen.
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17
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Bischoff C, Völklein F, Schmitt J, Rädel U, Umhofer U, Jäger E, Lasagni AF. Design and Manufacturing Method of Fundamental Beam Mode Shaper for Adapted Laser Beam Profile in Laser Material Processing. Materials (Basel) 2019; 12:ma12142254. [PMID: 31337017 PMCID: PMC6678773 DOI: 10.3390/ma12142254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/07/2019] [Accepted: 07/09/2019] [Indexed: 11/22/2022]
Abstract
Many laser material processing applications require an optimized beam profile, e.g., ring shape or Top-Hat profiles with homogeneous intensity distribution. In this study, we show a beam shaping concept leading to a phase shifting element with binary height profile as well as a very low periodicity with near diffraction limited spot size. Further advantages of so-called Fundamental Beam Mode Shaping (FBS) elements are the simplified handling, and a high efficiency and homogeneity. The calculated height profile of FBS elements are transferred in fused silica substrates using a combination of microlithography technologies, reactive ion etching (RIE) and ion beam etching (IBE). The experiments demonstrated a linear relation between the etching depth after RIE and IBE. The optical evaluation of the manufactured FBS beam mode shaper confirmed the presented concept design.
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Affiliation(s)
- Christian Bischoff
- Topag Lasertechnik GmbH, Nieder-Ramstädter-Str. 247, 64285 Darmstadt, Germany.
- Institut für Fertigungstechnik, Technische Universität Dresden, George-Bähr-Str. 3c, 01069 Dresden, Germany.
| | - Friedemann Völklein
- Institut für Mikrotechnologien, Hochschule RheinMain, Am Brückweg 26, 65428 Rüsselsheim, Germany
| | - Jana Schmitt
- Institut für Mikrotechnologien, Hochschule RheinMain, Am Brückweg 26, 65428 Rüsselsheim, Germany
| | - Ulrich Rädel
- Topag Lasertechnik GmbH, Nieder-Ramstädter-Str. 247, 64285 Darmstadt, Germany
| | - Udo Umhofer
- Topag Lasertechnik GmbH, Nieder-Ramstädter-Str. 247, 64285 Darmstadt, Germany
| | - Erwin Jäger
- Topag Lasertechnik GmbH, Nieder-Ramstädter-Str. 247, 64285 Darmstadt, Germany
| | - Andrés Fabián Lasagni
- Institut für Fertigungstechnik, Technische Universität Dresden, George-Bähr-Str. 3c, 01069 Dresden, Germany
- Fraunhofer-Institut für Werkstoff-und Strahltechnik IWS, Winterbergstr. 28, 01277 Dresden, Germany
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18
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Grimm A, Allendörfer J, Bischoff C, Buchner H, Décard B, Kaps M, Schelle T, Schulte-Mattler W, Walter U, Witte O, Nedelmann M, Köhrmann M, Schminke U. Positionspapier der Deutschen Gesellschaft für klinische Neurophysiologie DGKN und der Deutschen Gesellschaft für Ultraschall in der Medizin DEGUM, Sektion Neurologie zur „Wertigkeit des Nerven- und Muskelultraschalls in der Diagnostik neuromuskulärer Erkrankungen“. KLIN NEUROPHYSIOL 2018. [DOI: 10.1055/a-0635-9584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Alexander Grimm
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Tübingen
| | | | | | | | - Bernhard Décard
- Departement für Neurologie, Universitätsspital Basel, Schweiz
| | - Manfred Kaps
- Klinik und Poliklinik für Neurologie Universitätsklinikum Gießen
| | | | | | - Uwe Walter
- Klinik und Poliklinik für Neurologie Universitätsklinikum Rostock
| | - Otto Witte
- Hans-Berger Klinik für Neurologie, Universitätsklinikum Jena
| | | | - Martin Köhrmann
- Klinik und Poliklinik für Neurologie Universitätsklinikum Essen
| | - Ulf Schminke
- Klinik und Poliklinik für Neurologie Universitätsmedizin Greifswald
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Bischoff C, Schulte-Mattler W. SOP Allgemeine Methodik der Myografie. KLIN NEUROPHYSIOL 2017. [DOI: 10.1055/s-0043-112044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDie Elektromyografie dient der Untersuchung von Patienten mit neuromuskulären Erkrankungen mittels konzentrischer Nadelelektroden. In dieser SOP wird eine standardisierte Verfahrensweise mit technischen Details vorgestellt. Ein Überblick über die wichtigsten elektromyografischen Befunde bietet Unterstützung bei der Interpretation der Messergebnisse. Abschließend werden Besonderheiten der Einzelfaser-EMG erläutert.
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20
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Heckmann J, Lang C, Urban P, Glocker F, Weder B, Reiter G, Bischoff C, Meier U, Guntinas-Lichius O. Therapie der idiopathischen Fazialisparese (Bell’s palsy). Akt Neurol 2017. [DOI: 10.1055/s-0043-118088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDie periphere Fazialisparese ist die häufigste Hirnnervenläsion und wird klinisch diagnostiziert. Neurophysiologische Zusatzuntersuchungen können ergänzend zur Differenzierung und Prognoseabschätzung herangezogen werden. Der Anteil idiopathischer Fazialisparesen beträgt 60 – 75 %. Die übrigen 25 – 40 % lassen sich mit einer definierten Ätiologie in Zusammenhang bringen. Am häufigsten sind dabei die Neuroborreliose und der Zoster oticus (Ramsay-Hunt-Syndrom), seltener andere Infektionen. Weitere mögliche Auslöser sind die Sarkoidose (Heerfordt-Syndrom), das Sjögren-Syndrom, eine Meningeosis carcinomatosa, das Melkersson-Rosenthal-Syndrom, das Guillain-Barré-Syndrom, raumfordernde Prozesse im Kleinhirnbrückenwinkel, Frakturen des Felsenbeins, Parotistumoren und otogene Prozesse.Patienten mit idiopathischer Fazialisparese sollen mit Glukokortikoiden behandelt werden. Steroide begünstigen die vollständige Rückbildung und verringern das Risiko von Synkinesien, autonomen Störungen sowie Kontrakturen (Number needed to treat [NNT] 10; 95 % KI 6 – 20). Eine zusätzliche virustatische Therapie kann bei nur dezentem zusätzlichen Nutzen (< 7 %) nicht generell empfohlen werden. Patienten mit Fazialisparesen durch eine definierte Ätiologie werden ursachenbezogen behandelt. In der klinischen Praxis bewährt hat sich die symptomatische Therapie (Dexpanthenol-Augensalbe, Uhrglasverband) zum Schutz der Hornhaut. Eine zusätzliche Übungsbehandlung ist aus psychologischen Gründen angeraten. Nach Defektheilung können Methoden der Lidbeschwerung oder eine Tarsorrhaphie zur Erzielung eines hinreichenden Lidschlusses durchgeführt werden. In Einzelfällen sind operative mikrochirurgische Behandlungsmöglichkeiten zur Reanimation des N. fazialis in Betracht zu ziehen. Bei Schwangeren gelten grundsätzlich die gleichen diagnostischen und therapeutischen Prinzipien.
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Affiliation(s)
| | | | - Peter Urban
- Neurologische Abteilung, Asklepiosklinik Barmbeck, Hamburg
| | | | - Bruno Weder
- Klinik für Neurologie, Kantonspital St. Gallen, Schweiz
| | - Gudrun Reiter
- Universitätsklinik für Neurologie, Universität Graz, Österreich
| | | | - Uwe Meier
- Grevenbroich, für den Berufsverband deutscher Neurologen (BDN)
| | - Orlando Guntinas-Lichius
- Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, als Vertreter des Faches Hals-Nasen-Ohren-Heilkunde
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21
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Bischoff C. Überblick über die Entwicklung und den aktuellen Stand der Analyse von Potenzialen motorischer Einheiten (quantitatives EMG). KLIN NEUROPHYSIOL 2017. [DOI: 10.1055/s-0043-115103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDer Artikel gibt einen Überblick über die Entwicklung der quantitativen Analyse der Potenziale motorischer Einheiten von den Anfängen bis zu den modernen Multi-MUP Analysesystemen. Besonderer Wert wird dabei auf die Darstellung der den Methoden immanenten Problemen und Fehlerquellen gelegt. Die Schwierigkeiten der Mittelwertbildung der deskriptiven Potenzialanalyse und der Lösungsansatz der Ausreißer-Methode bei der Beurteilung neuromuskulärer Prozesse werden diskutiert.
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22
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Bischoff C, Schulte-Mattler W. Sportverletzungen peripherer Nerven. KLIN NEUROPHYSIOL 2017. [DOI: 10.1055/s-0042-117610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Zadura M, Szigat F, Hejazin B, Szigat P, Bittner R, Bischoff C, Motz W. PS156 Ecls Instead of Iabp in Acute Coronary Syndrome and Cardiogenic Shock – Promising Preliminary Results After 2 Years of Single Center Experience. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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24
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Martin SW, Bischoff C, Schuller K. Composition Dependence of the Na+ Ion Conductivity in 0.5Na2S + 0.5[xGeS2 + (1 – x)PS5/2] Mixed Glass Former Glasses: A Structural Interpretation of a Negative Mixed Glass Former Effect. J Phys Chem B 2015; 119:15738-51. [PMID: 26618389 DOI: 10.1021/acs.jpcb.5b07383] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Steve W. Martin
- Department of Materials Science
and Engineering, Iowa State University, Ames, Iowa 50010-2300, United States
| | - Christian Bischoff
- Department of Materials Science
and Engineering, Iowa State University, Ames, Iowa 50010-2300, United States
| | - Katherine Schuller
- Department of Materials Science
and Engineering, Iowa State University, Ames, Iowa 50010-2300, United States
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25
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Bischoff C, Pöschl P, Dreger J, Schulte-Mattler W. Kontra – Bilduntersuchungen in der Diagnostik der Erkrankungen peripherer Nerven – nur in speziellen Ausnahmen sinnvoll und notwendig. KLIN NEUROPHYSIOL 2015. [DOI: 10.1055/s-0035-1549943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - P. Pöschl
- Klinik für Neurologie, Krankenhaus Barmherzige Brüder, Regensburg
| | - J. Dreger
- Klinik für Neurologie, Marien-Krankenhaus, Bergisch Gladbach
| | - W. Schulte-Mattler
- Neurologische Klinik und Poliklinik der Universität Regensburg, Regensburg
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26
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Bischoff C, Dengler R, Glocker F, Schulte-Mattler W. Ultraschalldiagnostik peripherer Nerven – Stellungnahme der EMG-Kommission der DGKN. KLIN NEUROPHYSIOL 2015. [DOI: 10.1055/s-0035-1549881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - R. Dengler
- Neurologische Klinik mit Klinischer Neurophysiologie, Medizinische Hochschule Hannover, Hannover
| | - F. Glocker
- Klinik für Neurologie und Neurophysiologie der Universität Freiburg, Freiburg
| | - W. Schulte-Mattler
- Neurologische Klinik und Poliklinik der Universität Regensburg, Regensburg
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27
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Assmus H, Antoniadis G, Bischoff C. Carpal and cubital tunnel and other, rarer nerve compression syndromes. Dtsch Arztebl Int 2015; 112:14-25; quiz 26. [PMID: 25613452 PMCID: PMC4318466 DOI: 10.3238/arztebl.2015.0014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 07/31/2014] [Accepted: 07/31/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Carpal tunnel syndrome is by far the most common peripheral nerve compression syndrome, affecting approximately one in every six adults to a greater or lesser extent. Splitting the flexor retinaculum to treat carpal tunnel syndrome is the second most common specialized surgical procedure in Germany. Cubital tunnel syndrome is rarer by a factor of 13, and the other compression syndromes are rarer still. METHODS This review is based on publications retrieved by a selective literature search of PubMed and the Cochrane Library, along with current guidelines and the authors' clinical and scientific experience. RESULTS Randomized controlled trials have shown, with a high level of evidence, that the surgical treatment of carpal tunnel syndrome yields very good results regardless of the particular technique used, as long as the diagnosis and the indication for surgery are well established by the electrophysiologic and radiological findings and the operation is properly performed. The success rates of open surgery, and the single-portal and dual-portal endoscopic methods are 91.6%, 93.4% and 92.5%, respectively. When performed by experienced hands, all these procedures have complication rates below 1%. The surgical treatment of cubital tunnel syndrome has a comparably low complication rate, but worse results overall. Neuro-ultrasonography and magnetic resonance imaging (neuro-MRI) are increasingly being used to complement the diagnostic findings of electrophysiologic studies. CONCLUSION Evidence-based diagnostic methods and treatment recommendations are now available for the two most common peripheral nerve compression syndromes. Further controlled trials are needed for most of the rarer syndromes, especially the controversial ones.
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Affiliation(s)
- Hans Assmus
- (Former Practice of Peripheral Nerve Surgery in Dossenheim/Heidelberg)
| | - Gregor Antoniadis
- District Hospital of Günzburg (Neurosurgical Department of the University of Ulm)
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Schulte-Mattler W, Kobor I, Baldaranov D, Khomenko A, Johannesen S, Bruun TH, Bischoff C, Bogdahn U. LP53: Electromyographic evidence for repair of motor neurons in patients with ALS. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50960-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Bischoff C, Schuller K, Martin SW. Short Range Structural Models of the Glass Transition Temperatures and Densities of 0.5Na2S + 0.5[xGeS2 + (1 – x)PS5/2] Mixed Glass Former Glasses. J Phys Chem B 2014; 118:3710-9. [DOI: 10.1021/jp411942t] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Bischoff
- Department of Materials Science
and Engineering Iowa State University Ames, Iowa 50011, United States
| | - Katherine Schuller
- Department of Materials Science
and Engineering Iowa State University Ames, Iowa 50011, United States
| | - Steve W. Martin
- Department of Materials Science
and Engineering Iowa State University Ames, Iowa 50011, United States
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Bischoff C, Schuller K, Dunlap N, Martin SW. IR, Raman, and NMR studies of the short-range structures of 0.5Na2S + 0.5[xGeS2 + (1-x)PS(5/2)] mixed glass-former glasses. J Phys Chem B 2014; 118:1943-53. [PMID: 24447260 DOI: 10.1021/jp4111053] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A nonlinear and nonadditive composition-dependent change of the ionic conductivity in mixed glass-former (MGF) glasses when one glass former, such as PS(5/2), is replaced by a second glass former, such as GeS2, at constant alkali modifier concentrations, such as Na2S, is known as the mixed glass-former effect (MGFE). Alkali ion conducting glasses are of particular interest for use as solid electrolytes in alkali-based all-solid-state batteries because sulfide amorphous materials have significantly higher alkali ion conductivities than their oxide glass counterparts. In this study of the ternary MGF system Na2S + GeS2 + PS(5/2), we report the careful structural characterization of these glasses using a combination of vibrational, infrared (IR), Raman, and nuclear magnetic resonance (NMR) spectroscopies. Our measurements of the 0.5Na2S + 0.5[xGeS2 + (1-x)PS(5/2)] MGF system show that this glass system exhibits a strongly negative MGFE and non-Arrhenius ionic conductivities. While this negative MGFE in the Na(+) ion conductivity makes these glasses less attractive for use in solid-state Na batteries, the structural origin of this effect is important to better understand the mechanisms of ion conduction in the glassy state. For these reasons, we have examined the structures of ternary 0.5Na2S + 0.5[xGeS2 + (1-x)PS(5/2)] glasses using Raman, IR, and (31)P MAS NMR spectroscopies. In these studies, it is found that the substitution of PS(5/2) by GeS2, that is, increasing x, leads to unequal sharing of the Na(+) in these glasses. Thus, in all MGF compositions, phosphorus groups are associated with a disproportionately larger fraction, f(Na(P)) > 0.5(1 - x), of the Na(+) ions while the germanium groups are found to be Na(+)-deficient relative to the total amount of Na(+) present in the glass, that is, f(Na(Ge)) < 0.5x. From the spectroscopic study of these glasses, a short-range order (SRO) structural model is developed for these glasses and is based on the germanium and phosphorus SRO groups in these glasses as a first step in understanding the unique negative MGFE and non-Arrhenius behavior in the Na(+) ion conductivity in these glasses.
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Affiliation(s)
- Christian Bischoff
- Department of Materials Science and Engineering, Iowa State University of Science & Technology , Ames, Iowa 50011, United States
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Leu BM, Zgierski MZ, Bischoff C, Li M, Hu MY, Zhao J, Martin SW, Alp EE, Scheidt WR. Correction to Quantitative Vibrational Dynamics of the Metal Site in a Tin Porphyrin: An IR, NRVS, and DFT Study. Inorg Chem 2014. [PMCID: PMC3993917 DOI: 10.1021/ic5001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leu BM, Zgierski MZ, Bischoff C, Li M, Hu MY, Zhao J, Martin SW, Alp EE, Scheidt WR. Quantitative vibrational dynamics of the metal site in a tin porphyrin: an IR, NRVS, and DFT study. Inorg Chem 2013; 52:9948-53. [PMID: 23962374 PMCID: PMC3787516 DOI: 10.1021/ic401152b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We used a newer, synchrotron-based, spectroscopic technique (nuclear resonance vibrational spectroscopy, NRVS) in combination with a more traditional one (infrared absorption, IR) to obtain a complete, quantitative picture of the metal center vibrational dynamics in a six-coordinated tin porphyrin. From the NRVS (119)Sn site-selectivity and the sensitivity of the IR signal to (112)Sn/(119)Sn isotope substitution, we identified the frequency of the antisymmetric stretching of the axial bonds (290 cm(-1)) and all the other vibrations involving Sn. Experimentally authenticated density functional theory (DFT) calculations aid the data interpretation by providing detailed normal mode descriptions for each observed vibration. These results may represent a starting point toward the characterization of the local vibrational dynamics of the metallic site in tin porphyrins and compounds with related structures. The quantitative complementariness between IR, NRVS, and DFT is emphasized.
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Affiliation(s)
- Bogdan M Leu
- Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439, United States.
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Heckmann JG, Lang C, Glocker FX, Urban P, Bischoff C, Weder B, Reiter G, Meier U, Guntinas-Lichius O. [The new S2k AWMF guideline for the treatment of Bell's palsy in commented short form]. Laryngorhinootologie 2012; 91:686-92. [PMID: 22961063 DOI: 10.1055/s-0032-1323685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A new S2k AWMF guideline for the treatment of idiopathic facial palsy has been published. An accurate differential diagnosis is indispensable as 25-40% of all facial palsy cases are of non-idiopathic origin. It is explicitly recommended to treat patients with idiopathic facial palsy with steroids. Steroids favour a complete recovery, decrease the risk of synkinesis, autonomic sequelae and contractures. Adjuvant antiviral therapy cannot be recommended. On current data there is not sufficient evidence that the combination of steroids with antiviral drugs has a benefit for the patients. Even when not supported by randomized trials, adjuvant symptomatic therapy to protect the cornea and to avoid complications is recommended. There is no scientific evidence that physical therapy has any benefit but it should be taken into account because of psychological reasons. A benefit of acupuncture has not been proven. If eye closure remains incomplete as result of defective healing, one therapeutic option is lid loading of the upper eye lid. Moreover, in case of severe persistent palsy, several well-established microsurgical nerve and muscle plasty procedures are available.
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Affiliation(s)
- J G Heckmann
- Klinikum Landshut, Neurologische Klinik, Landshut
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Bischoff C, Schuller K, Beckman SP, Martin SW. Non-Arrhenius ionic conductivities in glasses due to a distribution of activation energies. Phys Rev Lett 2012; 109:075901. [PMID: 23006384 DOI: 10.1103/physrevlett.109.075901] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Indexed: 06/01/2023]
Abstract
Previously observed non-Arrhenius behavior in fast ion conducting glasses [J. Kincs and S. W. Martin, Phys. Rev. Lett. 76, 70 (1996)] occurs at temperatures near the glass transition temperature, T(g), and is attributed to changes in the ion mobility due to ion trapping mechanisms that diminish the conductivity and result in a decreasing conductivity with increasing temperature. It is intuitive that disorder in glass will also result in a distribution of the activation energies (DAE) for ion conduction, which should increase the conductivity with increasing temperature, yet this has not been identified in the literature. In this Letter, a series of high precision ionic conductivity measurements are reported for 0.5Na(2)S + 0.5[xGeS(2) + (1-x)PS(5/2)] glasses with compositions ranging from 0 ≤ x ≤ 1. The impact of the cation site disorder on the activation energy is identified and explained using a DAE model. The absence of the non-Arrhenius behavior in other glasses is explained and it is predicted which glasses are expected to accentuate the DAE effect on the ionic conductivity.
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Affiliation(s)
- C Bischoff
- Department of Material Science and Engineering, Iowa State University, Ames, 50011, USA
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Assmus H, Antoniadis G, Bischoff C, Hoffmann R, Martini AK, Preissler P, Scheglmann K, Schwerdtfeger K, Wessels KD, Wüstner-Hofmann M. Cubital tunnel syndrome - a review and management guidelines. ACTA ACUST UNITED AC 2011; 72:90-8. [PMID: 21547883 DOI: 10.1055/s-0031-1271800] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cubital tunnel syndrome (CuTS) is the second most common peripheral nerve compression syndrome. In German-speaking countries, cubital tunnel syndrome is often referred to as sulcus ulnaris syndrome (retrocondylar groove syndrome). This term is anatomically incorrect, since the site of compression comprises not only the retrocondylar groove but the cubital tunnel, which consists of 3 parts: the retrocondylar groove, partially covered by the cubital tunnel retinaculum (lig. arcuatum or Osborne ligament), the humeroulnar arcade, and the deep flexor/pronator aponeurosis. According to Sunderland , cubital tunnel syndrome can be differentiated into a primary form (including anterior subluxation of the ulnar nerve and compression secondary to the presence of an anconeus epitrochlearis muscle) and a secondary form caused by deformation or other processes of the elbow joint. The clinical diagnosis is usually confirmed by nerve conduction studies. Recently, the use of ultrasound and MRI have become useful diagnostic tools by showing morphological changes in the nerve within the cubital tunnel. A differential diagnosis is essential in atypical cases, and should include such conditions as C8 radiculopathy, Pancoast tumor, and pressure palsy. Conservative treatment (avoiding exposure to external noxes and applying of night splints) may be considered in the early stages of cubital tunnel syndrome. When nonoperative treatment fails, or in patients who present with more advanced clinical findings, such as motor weakness, muscle atrophy, or fixed sensory changes, surgical treatment should be recommended. According to actual randomized controlled studies, the treatment of choice in primary cubital tunnel syndrome is simple in situ decompression, which has to be extended at least 5-6 cm distal to the medial epicondyle and can be performed by an open or endoscopic technique, both under local anesthesia. Simple decompression is also the therapy of choice in uncomplicated ulnar luxation and in most post-traumatic cases and other secondary forms. When the luxation is painful, or when the ulnar nerve actually "snaps" back and forth over the medial epicondyle of the humerus, subcutaneous anterior transposition may be performed. In cases of severe bone or tissue changes of the elbow (especially with cubitus valgus), the anterior transposition of the ulnar nerve may again be indicated. In cases of scarring, submuscular transposition may be preferred as it provides a healthy vascular bed for the nerve as well as soft tissue protection. Risks resulting from transposition include compromise in blood flow to the nerve as well as kinking of the nerve caused by insufficient proximal or distal mobilization. In these cases, revision surgery is necessary. Epicondylectomy is not common, at least in Germany. Recurrence of compression on the ulnar nerve at the elbow may occur. This review is based on the German Guideline "Diagnose und Therapie des Kubitaltunnelsyndroms" ( www.leitlinien.net ).
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Affiliation(s)
- H Assmus
- Praxis für, periphere Neurochirurgie, Dossenheim, Germany.
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Webendörfer S, Schiller A, Benoit D, Bischoff C, Limbacher K. Vitamin-D-Mangel: Behandelbare Mitursache chronischer Schmerzstörungen? - Eine Pilotstudie. Psychother Psychosom Med Psychol 2011. [DOI: 10.1055/s-0031-1272448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Araujo CCD, Bischoff C, Eckert H, Buksak A, Frischat GH. Structural Elucidation of Alkali Fluorozirconate Glasses Using High-Resolution Solid State NMR. Z PHYS CHEM 2009. [DOI: 10.1524/zpch.2009.6075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
The structure of two compositional series of ZrF4-LaF3-BaF2-MF (M = Li or Na) glasses has been examined by 19F magic-angle spinning (MAS)-NMR spectroscopy. From a detailed lineshape analysis, the fractions of corner-bridging (CBF) and non-bridging fluoride (NBF) species were extracted. With increasing LiF (or NaF) content, the fraction of NBF increases significantly, producing an increased spectral contribution of the low-frequency lineshape components. 19F{7Li} rotational echo double resonance (REDOR) experiments reveal that this part of the MAS-NMR lineshape interacts most closely with the 7Li nuclei. The compositional dependence of the NBF fractions is discussed in the context of various scenarios, describing the transformation of CBF units into NBF units, and affecting the average coordination number of the Zr ions. The results indicate that the evolution of the NBF fraction cannot be described by a single scenario over the entire composition range.
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Assmus H, Antoniadis G, Bischoff C, Hoffmann R, Martini AK, Preissler P, Scheglmann K, Schwerdtfeger K, Wessels KD, Wüstner-Hofmann M. [Diagnosis and therapy of cubital tunnel syndrome--state of the art]. HANDCHIR MIKROCHIR P 2009; 41:2-12. [PMID: 19224415 DOI: 10.1055/s-0029-1185287] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The cubital tunnel syndrome is one of the most widespread compression syndromes of a peripheral nerve. In German-speaking countries it is known as the sulcus ulnaris syndrome (retrocondylar groove syndrome), which is anatomically incorrect. The cubital tunnel consists of the retrocondylar groove, the cubital tunnel retinaculum (Lig. arcuatum or Osborne band), the humeroulnar arcade and the deep flexor/pronator aponeurosis. According to Sunderland it can be divided into a primary form (including the ulnar luxation and the epitrocheoanconaeus muscle) and a secondary form caused by deformation or other processes of the elbow joint. The diagnosis has to be confirmed by a thorough clinical examination and nerve conduction studies. Neurosonography and MRI are becoming more and more important with improving resolution and enable the direct identification of morphological changes. Differential diagnosis is essential in atypical cases, especially C8 syndrome and pressure palsy. Double crush (double compression syndrome) may occur. Operative treatment is more effective than conservative treatment, which consists primarily of the prevention of exposure to external noxes. According to actual randomised controlled studies the therapy of choice of the primary form in most cases is the simple in situ decompression of the ulnar nerve in the cubital tunnel. This has to be extended at least up to 5-6 cm distally of the medial epicondyle and can be performed in the open or endoscopic technique, both under local anesthesia. Simple decompression is also the therapy of choice in uncomplicated ulnar luxation and in most post-traumatic cases and other secondary forms. In cases of severe bony or tissue changes of the elbow (especially cubitus valgus) the volar transposition of the ulnar nerve may be indicated. This can be performed in a subcutaneous or submuscular technique. Risks of transposition are impairment of perfusion and, above all, kinking caused by insufficient proximal or distal mobilisation of the nerve has to be avoided. In these cases revision surgery is necessary. The epicondylectomy is not common in our country. Recurrences may occur.
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Affiliation(s)
- H Assmus
- Praxis für periphere Neurochirurgie, Dossenheim.
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Schulte-Mattler W, Bischoff C. Polyneuropathien: Differenzialdiagnose anhand des neurophysiologischen Befundes. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0028-1098829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schultze H, Bischoff C, v Pein A, Limbacher K. [Conception and evaluation of a group therapy intervention for patients with chronic pain disorders and applications for early retirement pensions]. REHABILITATION 2008; 47:211-8. [PMID: 18704870 DOI: 10.1055/s-2008-1076703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Patients with chronic pain disorder are generally thought to be difficult to treat in psychosomatic rehabilitation. On average, their disorders tend to take a more chronic course than those of other patients, and they develop a higher rate of additional socio-medical problems, all of which increase the probability of therapy failure. Most of the time, such failures are attributed solely to the desire for early retirement and disability pensions, that is, a characteristic of the patient. However, a lack of specific therapeutic offers for patients with predominant psycho-social problems has also to be considered. The project described was designed to evaluate a newly developed socio-medical therapy module. This module aimed at bringing more transparency to the process of assessing occupational capabilities and work performance, thus improving the patients' motivation to participate in the rehabilitation program as well as the overall therapy outcome. METHODS The project was implemented as a controlled, prospective evaluation study. A quasi-experimental 3-factorial design was employed, including two group factors (factor 1: socio-medical intervention [EG 1] vs. relaxation therapy module [EG 2]; factor 2: current application for premature pension vs. none; factor 3: repeated measurements [admission to inpatient therapy, discharge from the clinic, 6-months follow-up]). The treatment conditions for the experimental groups were realized according to an ABBA-scheme. Patients in both treatment conditions took part in pain disorder-specific coping groups and were also included in the regular inpatient treatment. At all three points of measurement, socio-demographic, socio-medical, symptomatic and motivational patient characteristics were obtained as dependent variables by use of well-established standardized patient surveys. In total, 206 patients suffering from a chronic pain disorder took part in the study (n [EG1]=100; n [EG2]=106). Both treatment groups were considered equal regarding relevant sample characteristics. RESULTS The socio-medical intervention was equally well accepted by all patients. Patients of the first experimental group turned out to be better informed about socio-medical issues than members of the second experimental group. The rehabilitation treatment program as a whole was--independently of treatment group affiliation--highly effective. Despite contrary expectations, the socio-medical intervention did not have an additional (differential) therapeutic effect on the patients at all points of measurement, not even on those participants currently applying for retirement pensions. Also, there were no significant differences between the treatment groups regarding the days of sick leave within six months after discharge from inpatient rehabilitation. CONCLUSIONS The original and possibly too ambitious goal of the project, namely to increase the rehabilitation success for patients with pain disorder and current pension applications by means of the therapeutic module labeled "social medicine", was not achieved. Nevertheless it is to be noted that this module was well received by the patients. Moreover, the authors consider it to be of high value in itself that this therapeutic module helps patients to become better informed.
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Affiliation(s)
- H Schultze
- Psychosomatische Fachklinik Bad Dürkheim, Bad Dürkheim.
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Bischoff C. C18 Late responses and reflexes: F-wave and A-wave. Clin Neurophysiol 2008. [DOI: 10.1016/s1388-2457(08)60251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bischoff C. Neurophysiologische Diagnostik bei radikulären Syndromen. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bischoff C. Bedeutung der Einzelfaser-Elektromyographie für die Diagnostik neuromuskulärer Erkrankungen. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bischoff C. Automatisierte quantitative EMG-Untersuchung: Analyseverfahren, Probleme der Referenzwertbestimmung und klinischer Stellenwert. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schulte-Mattler W, Bischoff C. Polyneuropathien: Differenzialdiagnose anhand des neurophysiologischen Befundes. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2006-952019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Assmus H, Antoniadis G, Bischoff C, Haussmann P, Martini AK, Mascharka Z, Scheglmann K, Schwerdtfeger K, Selbmann HK, Towfigh H, Vogt T, Wessels KD, Wüstner-Hofmann M. Diagnostik und Therapie des Karpaltunnelsyndroms. HANDCHIR MIKROCHIR P 2007; 39:276-88. [PMID: 17724650 DOI: 10.1055/s-2007-965464] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Evidence-based supradisciplinary guideline that deals with the epidemiology, pathogenesis, symptoms, clinical and electrophysiological diagnosis, supplementary imaging investigations, differential diagnosis, conservative and surgical treatments, prognosis and course along with complications and revision surgery. The recommendations on investigation and treatment are based on a comprehensive literature search with critical evaluation and two consensus methods (expert group and Delphi technique) within the participating specialist societies. Besides this long version, a short version and a patient version can be viewed through the AWMF platform. The development of the guideline and the methodological foundations are documented in a method report. MAIN STATEMENTS: Apart from an accurate history and clinical neurological examination (including clinical tests), electrophysiological investigations (distal motor latency and sensory neurography) are particularly important. Radiography, MRI, high-resolution ultrasonography can be regarded as optional supplementary investigations. Among conservative treatment methods, treatment with a nocturnal splint and local infiltration of a corticosteroid preparation are effective. Oral steroids, splinting and ultrasound showed only short-term benefit. Surgical treatment is clearly superior to all other methods. Open and endoscopic procedures (when the endoscopic surgeon has sufficient experience) are equivalent. A routine epineurotomy and interfascicular neurolysis cannot be recommended. Early functional treatment postoperatively is important.
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Affiliation(s)
- H Assmus
- Neurochirurgische Gemeinschaftspraxis, Ringstrasse 3, 69221 Dossenheim.
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Bischoff C, Schulte-Mattler W. Neues aus der Elektroneurografie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-977725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
| | - A. Pinner
- Universitäts‐Laboratorium XCVI, Berl
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Gönner S, Bischoff C, Ehrhardt M, Limbacher K. [Effects of therapy goal oriented cognitive behavioural aftercare measures on therapy transfer following inpatient psychosomatic rehabilitation]. REHABILITATION 2007; 45:369-76. [PMID: 17123219 DOI: 10.1055/s-2006-932614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE After discharge from inpatient psychosomatic rehabilitation patients often face problems to transfer and stabilize the modifications they have achieved in the clinic. Using targeted outpatient aftercare interventions up to eight weeks after discharge from the inpatient programme we tried to support this transfer, thus enhancing treatment effectiveness. METHOD The evaluation was carried out as a field experiment. Patients were matched into pairs and then allocated randomly to either a control or an experimental condition. The experimental group, which had participated in specific aftercare measures after inpatient therapy, was compared to the control group at "discharge from clinic" and "twelve weeks post-discharge" relative to a number of variables relevant in therapy outcome. RESULTS Twelve weeks post-discharge patients who had participated in aftercare measures show significantly better progress relative to their physical and psychological complaints than patients in the control group. Also, they are more capable of coping with psychosocial demands of their everyday life. They experience better control of their symptoms and they are more successful in attaining the goals they have set for themselves for the time after discharge. CONCLUSIONS The findings show that supplementing psychosomatic inpatient rehabilitation with specific aftercare measures will lead to better transfer and to increased effectiveness of psychosomatic rehabilitation. Also on account of our results, outpatient rehab aftercare programmes have in the meantime become a regular component of inpatient psychosomatic rehabilitation in Germany.
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Affiliation(s)
- S Gönner
- Psychosomatische Fachklinik Bad Dürkheim.
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