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Lobenhoffer P, Kriegsmann J, Hackl W. Synoviale Erkrankungen. Arthroskopie 2022. [DOI: 10.1007/s00142-022-00532-8] [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: 11/28/2022]
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Riechelmann F, Hackl W, Schmitz K, Henninger B, Keiler A. Primäre synoviale Chondromatose. Arthroskopie 2022. [DOI: 10.1007/s00142-022-00536-4] [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: 11/09/2022]
Abstract
Zusammenfassung
Hintergrund
Die primäre synoviale Chondromatose (SC) ist eine seltene Erkrankung der Synovialmembran unklarer Ätiologie. Der aktuelle Wissensstand zu dieser Erkrankung soll in einer kurzen Übersicht dargestellt werden.
Methoden
Übersichtsarbeiten und rezente Fallberichte zur SC wurden systematisch ausgewertet und mit Daten eigener Fälle in Kontext gesetzt.
Ergebnisse
Auf Grund neuer genomischer Daten wird die SC als benigne Neoplasie eingestuft. In 60 % der Fälle liegen Mutationen im Fibronektin-1-Gen (FN1) und/oder im Gen für den Activin-A-Typ-II-Rezeptor (ACVR2A) vor. Diagnoseweisend ist die Magnetresonanztomographie (MRT) und die meist arthroskopische Biopsie der Synovia. An einem Fallbeispiel soll gezeigt werden, dass die Knorpelaggregate der SC radiologisch nicht immer schattengebend sein müssen. Differenzialdiagnostisch kommen Monarthritiden anderer Ursachen, andere Gelenk- und Muskelerkrankungen mit Mineralisierung sowie weitere von der Synovialmembran ausgehende Erkrankungen in Betracht. Die Entartungsrate liegt bei 2–4 %. Therapeutisch hat sich in den letzten Jahren das arthroskopische Vorgehen durchgesetzt, das an die Ausdehnung der Erkrankung adaptiert wird.
Schlussfolgerung
Genomische Untersuchungen sowie Fallserien und Fallberichte aus jüngerer Zeit werfen ein neues Licht auf die SC. Therapeutisch wird in jüngeren Arbeiten überwiegend arthroskopisch vorgegangen.
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Luen SJ, Asher R, Lee CK, Savas P, Kammler R, Dell'Orto P, Biasi OM, Demanse D, Hackl W, Thuerlimann B, Viale G, Di Leo A, Colleoni M, Regan MM, Loi S. Identifying oncogenic drivers associated with increased risk of late distant recurrence in postmenopausal, estrogen receptor-positive, HER2-negative early breast cancer: results from the BIG 1-98 study. Ann Oncol 2020; 31:1359-1365. [PMID: 32652112 DOI: 10.1016/j.annonc.2020.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/08/2020] [Accepted: 06/28/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In postmenopausal, estrogen receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer, the risk for distant recurrence can extend beyond 5 years of adjuvant endocrine therapy. This study aims to identify genomic driver alterations associated with late distant recurrence. PATIENTS AND METHODS Next generation sequencing was used to characterize driver alterations in primary tumors from a subset of 764 postmenopausal estrogen receptor-positive/HER2-negative patients from the BIG 1-98 randomized trial. Late distant recurrence events were defined as ≥5 years from time of randomization). The association of driver alterations with distant recurrence-free interval in early and late time periods was assessed using Cox regression models. Multivariable analyses were carried out to adjust for clinicopathological factors. Weighted analysis methods were used in order to correct for over-sampling of distant recurrences. RESULTS A total of 538 of 764 (70%) samples were successfully sequenced including 88 (63%) early and 52 (37%) late distant recurrence events after a median follow up of 8.1 years. In univariable analysis for late distant recurrence, PIK3CA mutations (58.8%) were significantly associated with reduced risk [hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.20-0.82, P = 0.012], whereas amplifications on chromosome 8p11 (10.9%) (HR 4.79, 95% CI 2.30-9.97, P < 0.001) and BRCA2 mutations (2.3%) (HR 5.39, 95% CI 1.51-19.29, P = 0.010) were significantly associated with an increased risk. In multivariable analysis, only amplifications on 8p11 (P = 0.002) and BRCA2 mutations (P = 0.013) remained significant predictors. CONCLUSIONS In estrogen receptor-positive/HER2-negative postmenopausal early breast cancer, PIK3CA mutations were associated with reduced risk of late distant recurrence, whereas amplifications on 8p11 and BRCA2 mutations were associated with increased risk of late distant recurrence. The characterization of oncogenic driver alterations may aid in refining treatment choices in the late disease setting, and help identify potential drug targets for testing in future trials.
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Affiliation(s)
- S J Luen
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - R Asher
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - C K Lee
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - P Savas
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - R Kammler
- International Breast Cancer Study Group, Coordinating Center, Central Pathology Office, Bern, Switzerland
| | - P Dell'Orto
- International Breast Cancer Study Group Central Pathology Office, Department of Pathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - O M Biasi
- Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - D Demanse
- Novartis Pharma AG, Basel, Switzerland
| | - W Hackl
- OncogenomX Inc., Allschwil, Basel, Switzerland
| | - B Thuerlimann
- Breast Center, Cantonal Hospital, St Gallen, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - G Viale
- Department of Pathology, University of Milan, Milan, Italy; IEO European Institute of Oncology IRCCS, Milan, Italy
| | - A Di Leo
- Sandro Pitigliani Department of Medical Oncology, Hospital of Prato, Prato, Italy
| | - M Colleoni
- Division of Medical Senology, European Institute of Oncology, Milan, Italy
| | - M M Regan
- International Breast Cancer Study Group Statistical Center, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia.
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Abstract
Zusammenfassung
Humanes Spendergewebe stellt einen integralen Bestandteil der Versorgung von muskuloskeletalen Erkrankungen des Menschen dar, wie beispielsweise die Rekonstruktion von Bandverletzungen, ausgedehnten osteochondralen Defekten oder ossären Defektaufbauten. Hierbei kommen verschiedene Gewebearten, Knochen, Sehnen, Bänder, Knorpel in zellfreier und vitaler zellbasierter Darreichungsform zur Anwendung. In vielen Ländern der Welt haben sich diese Verfahren als Standardtherapie in der rekonstruktiven arthroskopischen Chirurgie etabliert. In deutschsprachigen europäischen Ländern ist deren Anwendung jedoch limitiert, da hier Rechtsvorschriften existieren, die der Sicherheit des Patienten dienen, den Einsatz dieser Gewebe allerdings teilweise erschweren. Dieser Beitrag soll einen Überblick über die aktuellen Anforderungen und Voraussetzungen in Österreich, Deutschland und der Schweiz geben sowie dem Kliniker eine Anleitung für die aktuellen Möglichkeiten der rechtskonformen Nutzung von humanem Spendergewebe zu therapeutischen Zwecken bieten.
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Hackl W, Pinet D, Demanse D. Abstract P3-08-06: A novel integrated, clinical-pathologic and genomic classification method segregates early from late relapsing invasive ductal luminal breast cancers (IDLBC) of the METABRIC study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-06] [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: 11/16/2022]
Abstract
Abstract
Background and Objectives
Endocrine therapy is one of the most effective anti-cancer treatments for HR-positive breast cancers. However, in a significant proportion of patients the disease will relapse irrespective of the treatment modality (SERM, SERD, AI). Despite the progress made with multigene signatures for molecular classification of luminal breast cancers, predicting sensitivity towards endocrine modalities remains challenging. With the help of invasive ductal luminal breast cancers (IDLBC) from the METABRIC study we have developed an integrated clinical-pathologic and genomic classification method, identifying three distinct groups (IDLBC1, -2 and -3) [1, 2]. The 3 groups differ by DNA damage load, predominant lesion type, characteristic lesion patterns and oncogenic driver mechanisms [1, 3]. Here we present characteristic gene expression profiles of IDLBCs and discuss their biologic and clinical implications.
Methods
Gene expression profiles based on cDNA microarray data of 1.104 IDLBCs on the METABRIC study were examined (EGAS00000000083) [3]. To identify differentially expressed genes across IDLBC1-3 groups (52%, 23%, 25%), we compiled a gene list (N=2034) from 34 gene signatures reported to be predictive of ER, PR, GATA3, FOXA1 and/or AR signalling. A multiclass significance analysis of microarrays with 100 iterations and a false discovery rate of 0.05 was used to extract differentially expressed genes.
Results
Of 2034 steroid receptor signalling associated genes 36 exhibited differential expression in the IDLBC1/2 and -3 groups. The IDLBC1/2 specific set included 2 ER-associated genes (WLS, SPARCL1), 1 FOXA1-associated gene (NTN4) and 2 PR-associated genes (ZBTB16, CRY2). The IDLBC3 overexpressed set included 31 genes, amongst them regulators of mitotic fidelity, as well as effectors of centromere and kinetochore functioning. Eight of these genes have been reported as ER-associated (POLR2H, ECE2, SCL7A5, KIF11, FAM83D, GPSM2, MASTL, POLE2). Additional IDLBC3 hallmarks included high proliferation activity, defect apoptosis, epithelial-mesenchymal-transformation (EMT), BRCA-ness, multiple-drug resistance (MDR) and early relapse. The estimated relapse-free-survival rate at 5 years in the IDLBC3 group was 77% [95%CI 72; 82], significantly lower than in IDLBC1/2 tumours (91% [95%CI 89; 93]) and comparable to triple negative IDLBCs on the METABRIC study (70% [95%CI: 65; 76]).
Conclusions
We have shown that our integrated classification method has the potential to segregate early relapsing luminal breast cancers (IDLBC3) from tumours with favourable prognosis (IDLBC1/2). The data presented here and in the abstract by Demanse et al [4] provide also an intuitive hypothesis why IDLBC3 tumours are sensitive towards Letrozole but not Tamoxifen. Prospective clinical studies will be required to validate this hypothesis and to demonstrate the value of the IDLBC classification approach.
References
1. Demanse, manuscript in preparation (2018)
2. Pereira, Nat Commun (2016)
3. Curtis, Nat (2012)
4. Demanse, SABCS, abstract submitted (2018)
5. Loi SABCS, Oral Presentation (2016)
6. Luen, JAMA Oncology (2018)
Citation Format: Hackl W, Pinet D, Demanse D. A novel integrated, clinical-pathologic and genomic classification method segregates early from late relapsing invasive ductal luminal breast cancers (IDLBC) of the METABRIC study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-06.
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Affiliation(s)
- W Hackl
- Novartis Institutes of Biomedical Research, Basel, Switzerland; Novartis Pharma AG, Basel, Switzerland
| | - D Pinet
- Novartis Institutes of Biomedical Research, Basel, Switzerland; Novartis Pharma AG, Basel, Switzerland
| | - D Demanse
- Novartis Institutes of Biomedical Research, Basel, Switzerland; Novartis Pharma AG, Basel, Switzerland
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Ianosi B, Gaasch M, Rass V, Huber L, Hackl W, Kofler M, Schiefecker AJ, Addis A, Beer R, Rhomberg P, Pfausler B, Thomé C, Ammenwerth E, Helbok R. Early thrombosis prophylaxis with enoxaparin is not associated with hematoma expansion in patients with spontaneous intracerebral hemorrhage. Eur J Neurol 2018; 26:333-341. [DOI: 10.1111/ene.13830] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022]
Affiliation(s)
- B. Ianosi
- Institute of Medical Informatics; UMIT - University for Health Sciences, Medical Informatics and Technology; Hall
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - M. Gaasch
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - V. Rass
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - L. Huber
- Institute of Medical Informatics; UMIT - University for Health Sciences, Medical Informatics and Technology; Hall
| | - W. Hackl
- Institute of Medical Informatics; UMIT - University for Health Sciences, Medical Informatics and Technology; Hall
| | - M. Kofler
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - A. J. Schiefecker
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - A. Addis
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - R. Beer
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - P. Rhomberg
- Department of Neuroradiology; Medical University of Innsbruck; Innsbruck
| | - B. Pfausler
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - C. Thomé
- Department of Neurosurgery; Medical University of Innsbruck; Innsbruck Austria
| | - E. Ammenwerth
- Institute of Medical Informatics; UMIT - University for Health Sciences, Medical Informatics and Technology; Hall
| | - R. Helbok
- Neurological Intensive Care Unit; Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
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Scott PJ, Rigby M, Ammenwerth E, McNair JB, Georgiou A, Hyppönen H, de Keizer N, Magrabi F, Nykänen P, Gude WT, Hackl W. Evaluation Considerations for Secondary Uses of Clinical Data: Principles for an Evidence-based Approach to Policy and Implementation of Secondary Analysis. Yearb Med Inform 2017; 26:59-67. [PMID: 28480477 PMCID: PMC6239220 DOI: 10.15265/iy-2017-010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches. Results: We present important considerations in the evaluation of secondary uses of clinical data from the angles of governance and trust, theory, semantics, and policy. We make the case for a multi-level and multi-factorial approach to the evaluation of secondary uses of clinical data and describe a methodological framework for best practice. We emphasise the importance of evaluating the governance of secondary uses of health data in maintaining trust, which is essential for such uses. We also offer examples of the re-use of routine health data to demonstrate how it can support evaluation of clinical performance and optimize health IT system design. Conclusions: Great expectations are resting upon "Big Data" and innovative analytics. However, to build and maintain public trust, improve data reliability, and assure the validity of analytic inferences, there must be independent and transparent evaluation. A mature and evidence-based approach needs not merely data science, but must be guided by the broader concerns of applied health informatics.
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Affiliation(s)
- P. J. Scott
- University of Portsmouth, Centre for Healthcare Modelling and Informatics, Portsmouth, United Kingdom
| | - M. Rigby
- Keele University, School of Social Science and Public Policy, Keele, United Kingdom
| | - E. Ammenwerth
- UMIT, University for Health Sciences, Medical Informatics and Technology, Institute of Medical Informatics, Hall in Tyrol, Austria
| | - J. Brender McNair
- Aalborg University, Department of Health Science & Technology, Aalborg, Denmark
| | - A. Georgiou
- Macquarie University, Australian Institute of Health Innovation, Sydney, Australia
| | - H. Hyppönen
- National Institute for Health and Welfare, Information Department, Helsinki, Finland
| | - N. de Keizer
- Academic Medical Center, Department of Medical Informatics, Amsterdam, The Netherlands
| | - F. Magrabi
- Macquarie University, Australian Institute of Health Innovation, Sydney, Australia
| | - P. Nykänen
- University of Tampere, School of Information Sciences, Tampere, Finland
| | - W. T. Gude
- Academic Medical Center, Department of Medical Informatics, Amsterdam, The Netherlands
| | - W. Hackl
- UMIT, University for Health Sciences, Medical Informatics and Technology, Institute of Medical Informatics, Hall in Tyrol, Austria
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Hackl W, Lechner R, Liebensteiner M. Künstlicher Meniskusersatz. Arthroskopie 2017. [DOI: 10.1007/s00142-017-0122-5] [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: 11/29/2022]
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Faleschini J, Mayer H, Bielz M, Hackl W, Schulz T. Early warning against airborne radioactivity in Bavaria: Measuring network for radioactive immissions. KERNTECHNIK 2013. [DOI: 10.3139/124.110032] [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: 11/20/2022]
Abstract
Abstract
During the Chernobyl accident it became evident that there was no up to date information of the radiological situation in Bavaria as a whole. Therefore an online measuring network was implemented, which provides radioactivity data around the clock from all over Bavaria. It comprises measuring devices for gamma-dose rate, airborne aerosol and iodine activity and precipitation. The data are processed in accessory computers and transferred to the main network computers in Augsburg by means of a subcenter computer at the site of the IfR-station. Alarm levels are low in order to have an early warning against airborne radioactivity. New techniques for remote maintenance of the measuring devices and nuclide identification are being planned and tested.
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Affiliation(s)
- J. Faleschini
- Bayerisches Landesamt für Umwelt, Ref. 42, Bürgermeister-Ulrich-Str. 160, 86179 Augsburg. E-mail:
| | - H. Mayer
- Bayerisches Landesamt für Umwelt, Ref. 42, Bürgermeister-Ulrich-Str. 160, 86179 Augsburg. E-mail:
| | - M. Bielz
- Bayerisches Landesamt für Umwelt, Ref. 42, Bürgermeister-Ulrich-Str. 160, 86179 Augsburg. E-mail:
| | - W. Hackl
- Bayerisches Landesamt für Umwelt, Ref. 42, Bürgermeister-Ulrich-Str. 160, 86179 Augsburg. E-mail:
| | - T. Schulz
- Bayerisches Landesamt für Umwelt, Ref. 42, Bürgermeister-Ulrich-Str. 160, 86179 Augsburg. E-mail:
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Markman B, Tabernero J, Krop I, Shapiro GI, Siu L, Chen LC, Mita M, Melendez Cuero M, Stutvoet S, Birle D, Anak Ö, Hackl W, Baselga J. Phase I safety, pharmacokinetic, and pharmacodynamic study of the oral phosphatidylinositol-3-kinase and mTOR inhibitor BGT226 in patients with advanced solid tumors. Ann Oncol 2012; 23:2399-2408. [PMID: 22357447 DOI: 10.1093/annonc/mds011] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [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: 12/13/2022] Open
Abstract
BACKGROUND This phase I dose-escalation study investigated the maximum tolerated dose (MTD), safety, pharmacokinetics, pharmacodynamics (PDs), and preliminary antitumor activity of BGT226, a potent, oral dual phosphatidylinositol-3-kinase (PI3K)/mammalian target of rapamycin inhibitor. PATIENTS AND METHODS Fifty-seven patients with advanced solid tumors received BGT226 2.5-125 mg/day three times weekly (TIW). Dose escalation was guided by an adaptive Bayesian logistic regression model with overdose control. Assessments included response per RECIST, [18F]-fluorodeoxyglucose uptake, and phosphorylated-S6 in skin and paired tumor samples. RESULTS Three patients (125 mg cohort) had dose-limiting toxic effects (grade 3 nausea/vomiting, diarrhea). BGT226-related adverse events included nausea (68%), diarrhea (61%), vomiting (49%), and fatigue (19%). BGT226 demonstrated rapid absorption, variable systemic exposure, and a median half-life of 6-9 h. Seventeen patients (30%) had stable disease (SD) as best response. Nine patients had SD for ≥16 weeks. Thirty patients (53%) achieved stable metabolic disease as assessed by [18F]-fluorodeoxyglucose-positron emission tomography; however, no correlation between metabolic response and tumor shrinkage according to computed tomography was observed. PD changes suggested PI3K pathway inhibition but were inconsistent. CONCLUSIONS The MTD of BGT226 was 125 mg/day TIW, and the clinically recommended dose was 100 mg/day TIW. Limited preliminary antitumor activity and inconsistent target inhibition were observed, potentially due to low systemic exposure.
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Affiliation(s)
- B Markman
- Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - G I Shapiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - L Siu
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada
| | - L C Chen
- Nevada Cancer Institute, Las Vegas
| | - M Mita
- Cancer Therapy and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - M Melendez Cuero
- Oncology Translational Medicine, Novartis Pharma AG, Basel, Switzerland
| | - S Stutvoet
- Oncology Translational Medicine, Novartis Pharma AG, Basel, Switzerland
| | - D Birle
- Novartis Institutes for Biomedical Research, Cambridge, USA
| | - Ö Anak
- Oncology Translational Medicine, Novartis Pharma AG, Basel, Switzerland
| | - W Hackl
- Oncology Translational Medicine, Novartis Pharma AG, Basel, Switzerland
| | - J Baselga
- Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Bottino D, Tabernero J, Burris HA, Britten C, Chen LC, Bendell JC, Chiparus O, Duval V, Di Tomaso E, Sarr C, Hackl W, Baselga J, Rodon Ahnert J. Clinical pharmacokinetic-pharmacodynamic (PK/PD) modeling study of the novel dual PI3K/mTOR inhibitor BEZ235. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pieper R, Hackl W, Korn U, Zeyner A, Souffrant W, Pieper B. Effect of ensiling triticale, barley and wheat grains at different moisture content and addition of Lactobacillus plantarum (DSMZ 8866 and 8862) on fermentation characteristics and nutrient digestibility in pigs. Anim Feed Sci Technol 2011. [DOI: 10.1016/j.anifeedsci.2010.11.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [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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Nuciforo P, Burzykowski T, Lambertini C, Gardner H, Liu WH, Lee B, Barzaghi-Rinaudo P, Rheinhardt J, Barrett C, Linnartz R, Dugan M, Hackl W, Eiermann W, Pienkowski T, Crown J, Robert N, Pawlicki M, Martin M, Finn R, Lindsay MA, Slamon D, Press M. Abstract P3-10-24: Fibroblast Growth Factor Receptor 1 Amplification and Overexpression in Breast Cancer Tissue Microarrays Using Chromogenic In Situ Hybridization and Immunohistochemistry. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-24] [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: 11/16/2022]
Abstract
Abstract
Fibroblast growth factor receptors 1 (FGFR1) belongs to a subfamily of receptor tyrosine kinases (RTKs), which are involved in proliferation and apoptosis. FGFR1 amplification and mRNA overexpression occurs in ∼10% of breast cancers and has been associated with poor outcome. However, studies assessing FGFR1 amplification and protein overexpression in a large collection of breast tumors are lacking. In this prospective, we examined a series of primary breast cancers samples derived from the BCIRG trials assembled into 15 tissue microarrays. FGFR1 gene amplification was studied using chromogenic in situ hybridization (CISH) and evaluated with respect to association with level of protein expression and clinicopathological parameters. FGFR1 gene amplification was significantly associated with high protein levels as determined by immunohistochemistry (P<0.0001, 3294 pts with available matched CISH and IHC records). Overall, the incidence of FGFR1 amplification found was 9.7% (160 out of 1646 pts. with available clinicopathological records) without a statistically significant difference between Her2- (78 out 720 pts., 11%) and Her2+ (82 out of 926 pts., 9%) cancers. In both cohorts, the hormone receptor-positive (ER+/PR+) cancers showed statistically significant higher levels of FGFR1 amplification compared to hormone receptor-negative tumors. In the analysis of the association of FGFR1 and the presence of PIK3CA mutations, the incidence of FGFR1 amplificationwas greatly reduced in mutant vs. wt PI3KCA tumors. In these cohorts, a clear relationship between FGFR1 amplification status and clinical outcome was not detected. Data from this large study confirms recently reported incidences of FGFR1 amplification in breast cancer and shows for the first time an association between FGFR1 gene amplification and protein overexpression. Moreover, the lower incidence of FGFR1 amplification in PIK3CA mutated cancers suggests that these are largely exclusive molecular events that could benefit from different targeted therapies.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-24.
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Affiliation(s)
- P Nuciforo
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - T Burzykowski
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - C Lambertini
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - H Gardner
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - WH Liu
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - B Lee
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - P Barzaghi-Rinaudo
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - J Rheinhardt
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - C Barrett
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - R Linnartz
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Dugan
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - W Hackl
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - W Eiermann
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - T Pienkowski
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - J Crown
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - N Robert
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Pawlicki
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Martin
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - R Finn
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M-A Lindsay
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - D Slamon
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Press
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
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16
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Hackl W, Pieper B, Pieper R, Korn U, Zeyner A. Effects of ensiling cereal grains (barley, wheat, triticale and rye) on total and pre-caecal digestibility of proximate nutrients and amino acids in pigs. J Anim Physiol Anim Nutr (Berl) 2010; 94:729-35. [DOI: 10.1111/j.1439-0396.2010.01032.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Azad A, Natoli A, Jackson S, Maira S, Hackl W, Cullinane C, McArthur G, Solomon B. 87 BEZ235, a dual PI3K/mTORC inhibitor, targets the DNA damage response leading to radiosensitization and senescence. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71792-4] [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: 11/29/2022] Open
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18
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Burris H, Rodon J, Sharma S, Herbst RS, Tabernero J, Infante JR, Silva A, Demanse D, Hackl W, Baselga J. First-in-human phase I study of the oral PI3K inhibitor BEZ235 in patients (pts) with advanced solid tumors. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3005] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Hackl W, Goldmann S, Otto E, Poppe S, Wiesemüller W, Behm R. Untersuchungen zum leistungsabhängigen Lysinbedarf von Mastsauen. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/17450397909424296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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20
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Hennig U, Hackl W, Priepke A, Tuchscherer A, Souffrant W, Metges C. Comparison of ileal apparent, standardized and true digestibilities of amino acids in pigs fed wheat and lupine seeds. Livest Sci 2008. [DOI: 10.1016/j.livsci.2008.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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21
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Hohlrieder M, Hinterhoelzl J, Ulmer H, Hackl W, Schmutzhard E, Gassner R. Maxillofacial fractures masking traumatic intracranial hemorrhages. Int J Oral Maxillofac Surg 2004; 33:389-95. [PMID: 15145043 DOI: 10.1016/j.ijom.2003.10.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2003] [Indexed: 11/22/2022]
Abstract
Maxillofacial trauma may mask intracranial injuries prompting intensive care treatment. The purpose of this study was to identify whether craniofacial fracture patterns predispose patients with maxillofacial fractures to different types of intracranial hemorrhages. Within 7 years, 6649 patients with craniomaxillofacial injuries were admitted for treatment. The charts of the patients were analyzed according to age, sex, cause and mechanism of injury, type and location of facial injury, and intracranial trauma; 2195 sustained maxillofacial fractures. Statistical analyses were followed by logistic regression analyses for the four main types of intracranial hemorrhage to determine the impact of the different maxillofacial fractures. Intracranial hemorrhages in 212 patients (9.7%) occurred as epidural (2.5%), subdural (4.3%), subarachnoid (5.3%), and intracerebral hemorrhages (6.3%). Le Fort, orbit, nose, zygoma, and maxillary fractures increased the risk for accompanying intracranial hemorrhage by two- to fourfold (P < 0.05). Basal skull fractures caused a multiplication of the risk up to 17-fold, while fractures of the cranial vault were associated with a risk up to 14-fold. Nearly 10% of patients with craniomaxillofacial fractures sustain intracranial hemorrhages requiring frequently immediate neurosurgical intervention. Those patients, suffering from central midface fractures and skull base fractures, are prone to highly significant elevated risks of intracranial hemorrhage.
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Affiliation(s)
- M Hohlrieder
- Department of Anesthesiology and Critical Care Medicine, University of Innsbruck, Anichstrasse 35, A-6020, Tirol, Austria
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22
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Sailer R, Lutz M, Zimmermann R, Hackl W, Gabl M, Blauth M. Minimalinvasive Therapie der dislozierten distalen metaphysären Radiuskompressionsfraktur: klinische und radiologische Ergebnisse nach gedeckter Reposition, Stiftfixation und stabiler Defektauffüllung mit einer porösen Hydroxylapatitkeramik. ACTA ACUST UNITED AC 2003. [DOI: 10.1055/s-2003-37883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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23
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Hackl W, Gabl M, Gadner K, Zimmermann R, Sailer R. [Delayed radial paralysis after Monteggia fracture--a case report]. Unfallchirurg 2002; 105:569-71. [PMID: 12132198 DOI: 10.1007/s00113-002-0414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/27/2022]
Abstract
Concomittant lesions of neural structures represent a rare type of complications in Monteggia's fractures. In acute fractures spontaneous neurological remission usually occurs after reduction of the dislocated radial head. In the presented case a 33-year old man experienced a trady palsy of the posterior interosseus nerve 27 years after a Monteggia's fracture with the radial head left dislocated. Following a minimal trauma in badminton a neurological deficiency probably caused by distraction occurred and resulted in impairment of wrist extension and extension of the fingers. Initiated conservative treatment including intensive physiotherapy and electrotherapy for 4 months was unsuccessful. Consecutively the radial nerve was surgically exposed and released from an entrapping and thickened arcade of Frohse. The radial head was left dislocated. Full neurological recovery was obtained 9 months after surgery.
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Affiliation(s)
- W Hackl
- Universitätsklinik für Unfallchirurgie Innsbruck, Anichstrasse 35, 6020 Innsbruck, Osterreich.
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24
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Rosenberger RE, Bale RJ, Fink C, Rieger M, Reichkendler M, Hackl W, Benedetto KP, Künzel KH, Hoser C. [Computer-assisted drilling of the lower extremity. Technique and indications]. Unfallchirurg 2002; 105:353-8. [PMID: 12066474 DOI: 10.1007/s00113-001-0351-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [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: 10/27/2022]
Abstract
Computer assisted navigation-based surgery is a novel and interesting challenge for todays surgeons. One must however keep in mind, that the indications for these techniques (a) should be carefully considered, (b) used only if morbidity is not increased and (c) when previously problematic or inacurate surgical methods can be improved upon. This study reports that, using a non-invasive fixation method (FISCOFIX-Cast), lesions between the ankle- and knee-joints can be precisely localized, registered and treated. Due to the difficult access to lesions especially in the posterior areas of the talus, using conventional arthroscopic methods this procedure is very useful. Percutaneous retrograde drilling (cf. [6, 7, 9, 15, 20, 21]) spared the joint's cartilage in all cases. At the level of the knee joint we see the usefulness of this method for complex situations (cf. [12, 13]) requiring precise drilling.
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Affiliation(s)
- R E Rosenberger
- Universitätsklinik für Unfallchirurgie Innsbruck, Anichstrasse 35, 6020 Innsbruck, Osterreich
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25
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Abstract
In 1997 six patients with posttraumatic ankle arthritis aged 54 (45-71) years were treated with a LINK S.T.A.R. ankle prothesis. The average follow up was 29 (21-36) months. Results were evaluated according to the ankle score of H. Kofoed [7]. Two patients had an excellent outcome and 1 patient had a fair result. In three patients secondary arthrodesis had to be performed, due to loosening of the implant. Based on our experiences we cannot recommend this implant for patients with posttraumatic arthritis at this time.
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Affiliation(s)
- R Sailer
- Universitätsklinik für Unfallchirurgie, Anichstrasse 35, 6020 Innsbruck, Osterreich.
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26
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Hackl W, Hausberger K, Sailer R, Ulmer H, Gassner R. Prevalence of cervical spine injuries in patients with facial trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92:370-6. [PMID: 11598569 DOI: 10.1067/moe.2001.116894] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Injuries to the spine may accompany facial trauma. By using a large computerized database the goal of this case control study was to assess the association between facial and cervical spine injuries among patients sustaining facial trauma. STUDY DESIGN During a period of 4 years (1995 to 1998) 3083 patients, 10 years or older, with facial injuries were admitted to the University Hospital of Innsbruck's Department of Oral and Maxillofacial Surgery for facial trauma. Records were analyzed for cause of injury, age and gender distribution, frequency and type of injury, and frequency of cervical spine injuries in relation to facial trauma and concomitant injuries. Two hundred six (6.7%) of these patients had experienced a concomitant cervical spine injury (case group). All other patients (2877) were assigned to the control group of facial trauma only. RESULTS Facial trauma patients with concomitant cervical spine injuries were significantly older (mean age, 42 vs 34 years); no difference existed for the female/male ratio of 30:70. Sports trauma was the main cause of facial trauma in the control group (37.4%), yet traffic accidents accounted for 43.7% of combined facial and cervical spine injuries in the case group. Central mid face fractures dominated in the case group and lateral mid face fractures in the control group. In the case group cervical spine fractures and dislocations occurred in 19.2%. None of them showed evidence of paralysis. Concomitant brain injuries occurred in 21.6% of the case group and 8.8% of the control group. For patients sustaining facial trauma, logistic regression analysis revealed reduced risks for additional cervical spine injuries in younger patients, female patients, absence of brain injury, and in patients with facial soft tissue lesions alone (58.2%) or dental trauma alone (77.5%). CONCLUSION The results of this study underline the importance of proper clinical and computed tomographic evaluation in cases of facial fractures for recognition of additional cervical spine trauma. Detection of cervical spine trauma can be missed, especially when pain or symptoms from other parts of the body dominate. The typical patient with concomitant neck and facial trauma is male, 40 years old, and usually involved in a traffic accident.
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Affiliation(s)
- W Hackl
- Department of Trauma Surgery, University of Innsbruck, Austria
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27
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Hackl W, Riedl J, Reichkendler M, Benedetto KP, Freund M, Bale R. [Preoperative computerized tomography diagnosis of fractures of the tibial plateau]. Unfallchirurg 2001; 104:519-23. [PMID: 11460457 DOI: 10.1007/s001130170115] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [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: 11/25/2022]
Abstract
Within the last decade computed tomography has become an important instrument for skeletal diagnosis. In this study the value of helical CT-scan was compared with plan X-rays and conventional tomography in 45 patients having sustained an intraarticular tibia plateau fracture. Between plan roentgenogramms and CT-scan the fracture classification according to the AO-classification was changed in 40% of all patients, in 39 cases the amount of impression or dislocation increased with a mean of 4.2 mm. Especially tiny fragments were better visible and therefore responsible for the shift of many B1 fractures to group B3. The difference between conventional tomography and computed tomography was less impressive, a change of fracture classification could be observed in only 6.7% of all cases.
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Affiliation(s)
- W Hackl
- Universitätsklinik für Unfallchirurgie Innsbruck, Anichstrasse 35, 6020 Innsbruck, Osterreich.
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28
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Hoser C, Fink C, Brown C, Reichkendler M, Hackl W, Bartlett J. Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage. ACTA ACUST UNITED AC 2001. [DOI: 10.1302/0301-620x.83b4.0830513] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We evaluated the outcome of partial lateral meniscectomy of 31 knees in 29 patients whose knees were otherwise normal. The mean follow-up was 10.3 years. According to the Lysholm score, 14 knees were rated as excellent, four as good, five as fair and eight as poor, with a mean score of 80.5 points. Radiologically, only one lateral compartment was classified as grade 0, eight as grade 1, nine as grade 2, 11 as grade 3, and two as grade 4 according to Tapper and Hoover. No significant (p < 0.05) correlation was found between the amount of tissue resected and the subjective, clinical and radiological outcome. Although early results of lateral meniscectomy may be satisfactory, we have demonstrated that in the long term there was a high incidence of degenerative changes, a high rate of reoperation (29%) and a relatively low functional outcome score.
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Affiliation(s)
- C. Hoser
- Universität Klinik für Unfallchirurgie, Anichstrasse 35, 6020 Innsbruck, Austria
| | - C. Fink
- Universität Klinik für Unfallchirurgie, Anichstrasse 35, 6020 Innsbruck, Austria
| | - C. Brown
- Auckland Hospital, Auckland, New Zealand
| | - M. Reichkendler
- Universität Klinik für Unfallchirurgie, Anichstrasse 35, 6020 Innsbruck, Austria
| | - W. Hackl
- Universität Klinik für Unfallchirurgie, Anichstrasse 35, 6020 Innsbruck, Austria
| | - J. Bartlett
- Orthopaedic Unit, Austin and Repatriation Medical Centre, 3084 Heidelberg, Victoria, Australia
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29
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Fink C, Hoser C, Hackl W, Navarro RA, Benedetto KP. Long-term outcome of operative or nonoperative treatment of anterior cruciate ligament rupture--is sports activity a determining variable? Int J Sports Med 2001; 22:304-9. [PMID: 11414676 DOI: 10.1055/s-2001-13823] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.7] [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: 10/17/2022]
Abstract
The purpose of this study was to evaluate the long-term clinical outcome of operative versus nonoperative treatment of anterior cruciate ligament (ACL) deficiency and to define its relationship with sports activity. Forty-six patients (37 male, 9 female, mean age, 33.6 +/- 8.0 years) who underwent open ACL reconstruction using patellar tendon autograft and 25 patients (18 male, 7 female, mean age, 32.3 +/- 9.9 years) who were treated nonoperatively were evaluated by the same two examiners at 5 - 7 and 10 - 13 years following injury. The evaluations included objective and subjective scoring (Lysholm, OAK, IKDC), instrumented testing (Cybex, KT 1000), radiographic evaluation, and assessments of sports activity, with respect to type, frequency and associated symptoms. According to Lysholm, OAK and IKDC scores, the operative group performed significantly (p < 0.05) better and was able to maintain increased involvement in sports, although both groups participated less over time. However, risks for degenerative joint changes were similar for both the operative and the nonoperative group. A significant (p < 0.05) correlation between participation in high-risk pivoting sports, such as soccer or basketball and osteoarthritic changes could be found for the nonoperative group, only. Sports activity represents an important variable not only affecting the outcome, but also influencing treatment decisions following ACL injuries.
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Affiliation(s)
- C Fink
- University Hospital for Traumatology, Innsbruck, Austria.
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30
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Hoser C, Fink C, Brown C, Reichkendler M, Hackl W, Bartlett J. Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage. J Bone Joint Surg Br 2001; 83:513-6. [PMID: 11380121 DOI: 10.1302/0301-620x.83b4.11364] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We evaluated the outcome of partial lateral meniscectomy of 31 knees in 29 patients whose knees were otherwise normal. The mean follow-up was 10.3 years. According to the Lysholm score, 14 knees were rated as excellent, four as good, five as fair and eight as poor, with a mean score of 80.5 points. Radiologically, only one lateral compartment was classified as grade 0, eight as grade 1, nine as grade 2, 11 as grade 3, and two as grade 4 according to Tapper and Hoover. No significant (p < 0.05) correlation was found between the amount of tissue resected and the subjective, clinical and radiological outcome. Although early results of lateral meniscectomy may be satisfactory, we have demonstrated that in the long term there was a high incidence of degenerative changes, a high rate of reoperation (29%) and a relatively low functional outcome score.
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Affiliation(s)
- C Hoser
- Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
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Seemann N, Kuhn D, Wrocklage C, Keyvani K, Hackl W, Buchfelder M, Fahlbusch R, Paulus W. CDKN2A/p16 inactivation is related to pituitary adenoma type and size. J Pathol 2001; 193:491-7. [PMID: 11276008 DOI: 10.1002/path.833] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [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: 11/09/2022]
Abstract
p16 (CDKN2A, MTS1, INK4A) status at genomic and protein levels was analysed and correlated with clinico-pathological features in 72 pituitary adenomas. Methylation of CpG islands of promoter/exon 1 sequences was found in most gonadotroph, lactotroph, plurihormonal, and null cell adenomas (36 of 44, 82%), but it was rare in somatotroph (1 of 13 cases, 8%) and corticotroph adenomas (1 of 15 cases, 7%). Homozygous CDKN2A deletion was restricted to rare somatotroph (15%) and corticotroph adenomas (13%). Immunohistochemical p16 protein expression was observed in the normal adenohypophysis, whereas it was absent in 60 of 72 (83%) tumours and reduced in another ten (14%) tumours. Staining for p16 was only seen in 5 of 15 (33%) corticotroph, 3 of 13 (23%) somatotroph, 3 of 5 (60%) plurihormonal, and 1 of 19 (5%) null cell adenomas. p16 immunonegativity without CDKN2A methylation or deletion occurred in 22 tumours, including most somatotroph and corticotroph adenomas (15 of 28, 54%). Both CDKN2A alterations and p16 negativity were related to larger tumour size. Patients with p16-negative tumours were older than patients with p16-positive tumours. These data suggest that p16 down-regulation is common in all adenoma types. The mechanisms of p16 down-regulation probably involve CDKN2A methylation in most types, but remain to be determined in somatotroph and corticotroph adenomas. These findings also suggest that p16 down-regulation is usually not an initial event, but is acquired during adenoma progression.
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Affiliation(s)
- N Seemann
- Institute of Neuropathology, University of Münster, Domagkstrasse 19, D-48129 Münster, Germany
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Fink C, Zapp M, Benedetto KP, Hackl W, Hoser C, Rieger M. Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft. Arthroscopy 2001; 17:138-43. [PMID: 11172242 DOI: 10.1053/jars.2001.21509] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to prospectively evaluate changes in the tibial bone tunnel following endoscopic anterior cruciate ligament (ACL) reconstruction with patellar tendon autograft. We used computed tomography (CT) sequentially to monitor the time course of these changes over a 2-year period and correlated the results to clinical outcome and instrumented laxity measurements. TYPE OF STUDY Case series. METHODS Thirty-four patients (11 women, 23 men; mean age, 26.4 +/- 4.5 years) who underwent endoscopic patellar tendon ACL reconstruction, were evaluated clinically according to IKDC, Lysholm, and Tegner scores as well as with respect to changes in tibial tunnel morphology over a 2-year period. Subsequent CT scans were performed at 1 and 6 weeks and at 3, 6, 12, and 24 months postoperatively. The tibial bone tunnel was measured in the sagittal and coronal planes at 5 different levels (L1 to L5). RESULTS The diameters of the tibial tunnel increased an average overall by 30.6% in the sagittal plane and 16.4% in the coronal plane within 2 years. The enlargement was significantly higher (P <.05) in the mid portion of the tunnel (L 2/3: 44.0% and 47.9% in the sagittal and 29.8% and 29.9% in the coronal plane, respectively), which resulted in a uniform cavity-type appearance. The percentage of change in tunnel size was significantly higher (P <.05) within the first 6 weeks following surgery compared with all other time intervals. No correlation between the amount of tunnel enlargement and the clinical results or between tunnel enlargement and KT-1000 measurements could be detected. CONCLUSIONS Endoscopic ACL reconstruction is associated with tibial tunnel enlargement, which is already present within weeks following surgery. However, no negative effects on the clinical results were found over a 24-month period in our study population.
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Affiliation(s)
- C Fink
- University Hospital for Traumatology, Innsbruck, Austria.
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Abstract
BACKGROUND The association between facial and cervical spine injuries has been documented. However, only severe spinal injuries were included in previous analyses. It was the purpose of this study to evaluate the incidence of and risk factors for these injury combinations including the complete injury spectrum. METHODS Between 1995 and 1997, 4,907 patients with cervical spine injuries were treated at our hospital. One hundred five (2.14%) of these patients had suffered a concomitant facial injury. This group was compared with the group of patients with cervical spine injury but without facial trauma. RESULTS The majority of cases (98%) consisted of minor lesions to both regions. With increasing severity of cervical spine trauma, the risk for facial injury increased. Age and male gender represent significant (p < 0.05) risk factors for combined injuries. CONCLUSION Patients sustaining cervical spine trauma have a small but real chance of injuring their face as well. The cervical spine must be examined carefully, whenever facial injuries are present.
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Affiliation(s)
- W Hackl
- Department of Traumatology, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Fink C, Rosenberger RE, Bale RJ, Rieger M, Hackl W, Benedetto KP, Künzel KH, Hoser C. [Computer-assisted retrograde drilling of osteochondral lesions of the talus]. Orthopade 2001; 30:59-65. [PMID: 11227354 DOI: 10.1007/s001320050574] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Treatment principles of osteochondral lesions of the talus usually consist of debridement of the chondral part and methods that attempt to stimulate revascularization of the necrotic bony part of the lesion. The latter is mostly achieved through multiple drilling of the subchondral zone. Dorsomedial talar dome lesions are frequently inaccessible with antegrade drilling techniques. In addition, if the cartilage surface over the bony lesion is still intact, it can be injured by antegrade drilling. To overcome these potential problems, retrograde drilling techniques have been developed using drill guides or intraoperative fluoroscopy. Our proposed method of computer-assisted retrograde drilling is an advancement of these techniques. The use of 3D navigation provides the possibility for placing a guide wire exactly in the center of the lesion defined on preoperative MRI or CT scans. This guide wire can then be overreamed with cannulated reamers followed by retrograde bone grafting of the lesion or allows multiple retrograde drilling of the subchondral plate using a parallel drill guide. We found that computer-assisted retrograde drilling could improve precision, avoid misplacement of guide wires, and reduce the time of surgery and intraoperative fluoroscopy.
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Affiliation(s)
- C Fink
- Universitätsklinik für Unfallchirurgie Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Osterreich.
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Spittler A, Razenberger M, Kupper H, Kaul M, Hackl W, Boltz-Nitulescu G, Függer R, Roth E. Relationship between interleukin-6 plasma concentration in patients with sepsis, monocyte phenotype, monocyte phagocytic properties, and cytokine production. Clin Infect Dis 2000; 31:1338-42. [PMID: 11095999 DOI: 10.1086/317499] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/1999] [Revised: 04/24/2000] [Indexed: 11/03/2022] Open
Abstract
Monocyte phenotype, their phagocytic capacity as well as the cytokine production from 10 patients with sepsis with low interleukin-6 (IL-6) serum concentrations (<1000 pg/mL) and 8 patients with sepsis with high IL-6 (> or = 1000 pg/mL) plasma concentrations were investigated within 24 hours of fulfilling the criteria for sepsis. Monocytes from patients with high IL-6 levels had higher levels of human leukocyte antigen (HLA)-DR, HLA-ABC, CD64, and CD71, and the production of tumor necrosis factor-alpha (TNF-alpha) and IL-8, as well as the capacity of monocytes to phagocytose, was significantly elevated. Of 8 patients with high levels of plasma IL-6, 4 patients died. In contrast, all 10 patients with low plasma IL-6 concentrations survived until day 28. Patients who died had constant high IL-6 concentrations during the first 3 days, whereas IL-6 levels in patients who survived decreased by 88%. Our data indicate that IL-6 levels are a better prognostic parameter in the early phase of sepsis than the monocyte HLA-DR expression.
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Affiliation(s)
- A Spittler
- Department of Surgery, Research Laboratories, University of Vienna, Vienna, Austria.
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Hackl W, Benedetto KP, Hoser C, Künzel KH, Fink C. Is screw divergence in femoral bone-tendon-bone graft fixation avoidable in anterior cruciate ligament reconstruction using a single-incision technique? A radiographically controlled cadaver study. Arthroscopy 2000; 16:640-7. [PMID: 10976126 DOI: 10.1053/jars.2000.4825] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Interference screw fixation of patellar tendon bone-tendon-bone grafts for anterior cruciate ligament reconstruction has proven to be a method with high pullout strength if screw divergence is avoided. Twenty-four fresh-frozen cadaveric human knees were used to identify the ideal position for a portal and an optimal knee flexion angle to obtain parallel placement of screw and bone block. On all specimens, anterior cruciate ligament reconstruction was performed using a single-incision technique. In the first part of this study, screw placement was analyzed in the frontal plane. In the second part, screw placement was investigated in the sagittal plane, measuring the additional flexion required between femoral tunnel drilling (at 60 degrees of knee flexion) and screw insertion to obtain parallel screw placement. For both part I and II, image intensification was used. In the third part, femoral screw placement was carried out through a paraligamentous approach and with additional flexion of 10 degrees, 20 degrees, 30 degrees, 40 degrees, 50 degrees, and 60 degrees. This study shows that screw placement with minimal divergence in the frontal and sagittal planes can be achieved by inserting the screw through a nearly central portal and flexing the knee an additional 35 degrees to 40 degrees.
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Affiliation(s)
- W Hackl
- University Hospital for Traumatology, the Institute of Anatomy, University of Innsbruck, Innsbruck, Austria
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Fink C, Benedetto KP, Hackl W, Hoser C, Freund MC, Rieger M. Bioabsorbable polyglyconate interference screw fixation in anterior cruciate ligament reconstruction: a prospective computed tomography-controlled study. Arthroscopy 2000; 16:491-8. [PMID: 10882444 DOI: 10.1053/jars.2000.4633] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE It was the purpose of the study to evaluate a new polyglyconate bioabsorbable interference screw for graft fixation in anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY Prospective randomized. MATERIALS AND METHODS Forty patients who underwent endoscopic ACL reconstruction were included in the study and randomized intraoperatively. Group A consisted of 20 patients (6 women, 14 men; mean age, 29.6 years) who had femoral bone block fixation with a bioabsorbable interference screw and tibial fixation with a titanium interference screw. Group B included 20 patients (5 women, 15 men; mean age 29.6 years) who had fixation of both femoral and tibial bone blocks with titanium interference screws. There was no significant difference between the groups with regard to age, gender, height, weight, time from injury to surgery, activity level, and concomitant injuries. RESULTS Clinical results (using IKDC, Lysholm, Tegner scores) of the 2 groups as well as instrumented laxity measurements (KT-1000) did not show significant (P >.05) differences at any stage of follow-up. No complications with respect to graft fixation could be found. Computed tomography scans, performed within the first postoperative week, at 6 weeks, and at 3, 6, 12, and 24 months postoperatively revealed a uniform picture for all patients within the groups, showing completed screw degradation at 12 months in group A. CONCLUSION Polyglyconate interference screw fixation for patellar tendon grafts has not been found to be associated with increased clinical complications or significant osteolysis. It provided equivalent fixation and clinical results compared with titanium screws. However, replacement of the screw with bone did not take place for up to 3 years postoperatively.
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Affiliation(s)
- C Fink
- University Hospital for Traumatology, Innsbruck, Austria.
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Hackl W, Fink C, Benedetto KP, Hoser C. [Transplant fixation by anterior cruciate ligament reconstruction. Metal vs. bioabsorbable polyglyconate interference screw. A prospective randomized study of 40 patients]. Unfallchirurg 2000; 103:468-74. [PMID: 10925649 DOI: 10.1007/s001130050567] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 10/27/2022]
Abstract
To overcome some of the potential problems (e.g. hardware removal during revision surgery) of metal interference screws used for patellar tendon anterior cruciate ligament reconstruction, bioabsorbable screws have recently been introduced. Forty patients who underwent endoscopic ACL reconstruction using patella tendon autograft were included in the study, they were randomized intraoperatively to either Group A (femoral bone block fixation: polyglyconate screw; tibial: metal screw) or Group B (both bone blocks fixed with metal interference screws). The patients were evaluated clinically preoperatively as well as 6 weeks, 3 months 12 months and 24 months post op. Lysholm Score at 24 months was 98.1 +/- 2.3 for Group A and 97.7 +/- 3.0 for Group B. Tegner Score was 7.4 +/- 1.1 for Group A and 7.5 +/- 0.8 for Group B. Two years post op overall IKDC-Score for group A was 5.6% normal, 88.8% nearly normal and 5.6% abnormal. The result for group B was 11.1%, 77.8% and 11.1%, respectively. KT-1000 (at 89 N) at two years revealed a side to side difference of 1.5 +/- 0.3 mm (Group A) and 1.6 +/- 0.7 (Group B). The results of the two groups did not show significant differences at any stage of follow up. In our study polyglyconate interference screw fixation for patellar tendon grafts has not found to be associated with increased clinical complications. It provided equivalent fixation and clinical results compared to metal screws.
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Affiliation(s)
- W Hackl
- Universitätsklinik für Unfallchirurgie Innsbruck, Osterreich
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Hackl W, Benedetto KP, Fink C, Sailer R, Rieger M. Locked lateral patellar dislocation: a rare case of irreducible patellar dislocation requiring open reduction. Knee Surg Sports Traumatol Arthrosc 2000; 7:352-5. [PMID: 10639652 DOI: 10.1007/s001670050179] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Irreducible patellar dislocations are rare injuries, but those that do occur are mainly directed intra-articularly. In this case, a 53-year-old woman sustained a locked lateral patellar dislocation when falling from a chair. A preoperative CT-scan revealed bony avulsions at the insertion of the vastus medialis muscle, the medical retinaculum, and partial disruption of the ligamentum patellae from the apex patellae. Open reduction was necessary and the torn structures were reattached with anchor systems and sutures. Postoperative management included intensive physiotherapy. At 1 year after surgery, the patient was without swelling or pain and had a normal gait, but flexion was restricted to 120 degrees. All postoperative radiographs showed the patella correctly placed in the femoral groove.
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Affiliation(s)
- W Hackl
- University Hospital Innsbruck, Department of Trauma Surgery, Austria
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40
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Nürnberg K, Küchenmeister U, Nürnberg G, Ender K, Hackl W. Influence of exogenous application of n-3 fatty acids on meat quality, lipid composition, and oxidative stability in pigs. Arch Tierernahr 1999; 52:53-65. [PMID: 10548976 DOI: 10.1080/17450399909386151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The effect of dietary n-3 fatty acids on the fatty acid composition and lipid peroxidation of different tissues in pigs were studied. 20 castrated male pigs were included in this investigation, one half was fed daily a diet containing 1.3 g n-3 fatty acids/kg diet (control) and 10 pigs were fed a diet containing 14 g n-3 fatty acids/kg diet (n-3 diet) at the growing-finishing period. The intake of dietary n-3 fatty acids increased the concentration of these fatty acids in backfat, and the neutral and polar fractions of skeletal muscle and heart homogenates. The polar fraction showed an increased relative concentration of n-3 fatty acids in comparison to control, while the n-6 fatty acid content was reduced. In heart homogenates there was an enlargement of n-3 fatty acids both in polar lipids and in neutral lipids whilst n-6 fatty acids were decreased. Feeding n-3 fatty acid enriched diet had no influence on meat quality parameters drip loss, meat colour or pH value. The lipid peroxidation (measured as malondialdehyde equivalents) was in the order liver > heart > skeletal muscle with higher values in the n-3 group. However, by stimulation of oxidation by Fe2+/ascorbate for 3 hours the order of oxidative products in the n-3 group was muscle > liver > heart, whereas in the control group the order was liver > heart = muscle. Summarized, feeding a highly n-3 fatty acid enriched diet caused an incorporation of these fatty acids and increased the susceptibility to peroxidation in all investigated tissues.
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Affiliation(s)
- K Nürnberg
- Research Institute for the Biology of Farm Animals, Division of Muscle Biology and Growth, Dummerstorf, Germany
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Abstract
BACKGROUND Bicyclists and mountainbikers are prone to facial trauma. In the current study, we present a large series of cycling-related sports trauma to the face in an effort to identify the injury pattern among mountainbikers compared with bicyclists. METHODS The medical records of a single pediatric and adult Level I trauma center were evaluated from January 1, 1991, through October 31, 1996. All admissions with injuries caused by cycling-related sports were reviewed, analyzed, and compared according to age and sex distributions, causes of accidents, injury types, frequency, and localization of fractures and associated injuries. The injury types were divided into three categories: fractures, dentoalveolar trauma, and soft-tissue injuries. RESULTS Five hundred sixty-two injured bicyclists (10.3% of all trauma patients) were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria, during the study period, accounting for 31% of all sports-related or 48.4% of all traffic collisions, respectively. The review of the patient records revealed especially more severe injury profiles in 60 mountainbikers, with 55% facial bone fractures, 22% dentoalveolar trauma, and 23% soft-tissue injuries, compared with 502 street cyclists showing 50.8% dentoalveolar trauma, 34.5% facial bone fractures, and 14% soft-tissue lesions. The dominant fracture site in bicyclists was the zygoma (30.8%), whereas mountainbikers sustained an impressive 15.2% Le Fort I, II, and III fractures. Condyle fractures were more common in bicyclists, with 18.8% opposing 10.8% in mountainbikers. CONCLUSION Appropriate design of helmets with faceguards will reduce the incidence of facial injuries caused by cycling-related accidents and incentives are needed for making helmet use compulsory for all cyclists, particularly for mountainbikers.
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Affiliation(s)
- R J Gassner
- Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria.
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42
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Benedetto KP, Fink C, Hackl W, Brieglauer C. Mittel- bis langfristige Ergebnisse nach arthroskopisch assistierter Behandlung der Schienbeinkopffrakturen. Arthroskopie 1999. [DOI: 10.1007/s001420050085] [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: 10/28/2022]
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43
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Hanelt S, Karner J, Peichl P, Hackl W, Klimpfinger M. [Hypersensitivity vasculitis causing an acute abdomen]. Wien Klin Wochenschr 1999; 111:226-9. [PMID: 10234776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The members of a family of four persons suffered acute gastroenteritis after eating a meal consisting of chicken. While three of them recovered rapidly, the 18-year old son developed an acute abdomen which had to be treated surgically and led to a complicated stay at the intensive care unit. Intraoperatively, a mild insignificantly inflamed appendix and an obscure segmental inflammatory process of the small bowel with local peritonitis were seen; this required an appendectomy and a peritoneal lavage. The development of bacterial peritonitis with multiple organ dysfunction required several surgical revisions with an open abdominal toilet treatment. Histological examination of the resected appendix specimen showed a severe primary fibrinoid necrotizing vasculitis with epitheloid-granulomatous reaction. Diseases such as Panenteritis nodosa, Wegener's disease and Churg-Strauss's syndrome were excluded by negative serology. By a process of exclusion, a hypersensitivity vasculitis was diagnosed and treated successfully with a high-dose cortisone regime.
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MESH Headings
- Abdomen, Acute/drug therapy
- Abdomen, Acute/etiology
- Abdomen, Acute/surgery
- Adolescent
- Appendicitis/surgery
- Appendix/pathology
- Appendix/surgery
- Churg-Strauss Syndrome/diagnosis
- Cortisone/therapeutic use
- Diagnosis, Differential
- Gastroenteritis/surgery
- Humans
- Intraoperative Complications
- Male
- Peritonitis/microbiology
- Peritonitis/surgery
- Vasculitis, Leukocytoclastic, Cutaneous/complications
- Vasculitis, Leukocytoclastic, Cutaneous/diagnosis
- Vasculitis, Leukocytoclastic, Cutaneous/drug therapy
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Affiliation(s)
- S Hanelt
- Abteilung für Chirurgie, Kaiser-Franz-Josef Spital der Stadt Wien, Osterreich
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44
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Abstract
In the last 2 decades, reports of skiing injuries have shown an increasing number of skiers with severe trauma. This article provides an account of a retrospective study of 549 patients with 1155 facial injuries sustained while skiing who received treatment at the Department of Oral and Maxillofacial Surgery at the University Hospital in Innsbruck, Austria between 1991 and 1996. The study was based on a questionnaire answered by the patients and on case report forms. Most of the patients were male (65.2%) and were aged between 3 and 81 years (average 28.4 years). A simple fall while skiing was the main type of accident (45.9%), followed by collisions with other people (23.5%). Injuries were classified into 1 of 3 groups: (i) lesions of the soft tissue (32.2% of all injuries); (ii) dentoalveolar traumas (24.3%); and (iii) fractures of facial bones (43.5%). Lacerations and haematomas were the most frequent lesions in patients with injuries to the soft tissues. The group of patients with dentoalveolar trauma mainly presented with fractures of tooth crowns. Fractures involving the mandible and the zygomatic bone were predominant in patients in the third group. Concomitant injuries mainly included injuries to the brain and skull fractures. Treatment was ambulatory, or by admission and surgery. We did not observe an increase in the number of skiing accidents causing facial injury in the last 5 years. Facial injuries represented 4% of all skiing injuries, a lower proportion than in other sports.
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Affiliation(s)
- R Gassner
- Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria.
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45
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Abstract
After successful centralization of laboratory analyses since more than 30 years, advances in biosensors, microprocessors, measurement of undiluted whole blood and miniaturization of laboratory analyzers are leading nowadays more and more to a re-decentralization in the laboratory medicine. Point-of-care-testing (POCT), which is defined as any laboratory test performed outside central or decentralized laboratories, is becoming more and more popular. The theoretical advantages of POCT are faster turn-around-times (TAT), more rapid medical decisions, avoidance of sample identification and sample transport problems and the need of only small specimen volumes. These advantages are frequently mentioned, but are not associated with a clear clinical benefit. The disadvantages of POCT such as incorrect handling and/or maintenance of the analyzers by nontrained clinical staff, inadequate or even absent calibrations and/or quality controls, lack of cost-effectiveness because of an increased number of analyzers and more expensive reagents, insufficient documentation and difficult comparability of the obtained POCT-results with routine laboratory results, are strongly evident. According to the authors' opinion the decision for the establishing of POCT has only to be made in a close co-operation between physicians and laboratorians in order to vouch for necessity and high quality of the analyses. Taking the local situation into consideration (24-h-central laboratory, etc.) the spectrum of parameters measured by means of POCT should be rigorously restricted to the vital functions. Such analytes should be: hemoglobin or hematocrit, activated whole blood clotting time, blood gases, sodium, potassium, ionized calcium, glucose, creatinine, ammonia and lactate.
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Affiliation(s)
- M M Müller
- Institut für Labordiagnostik, Kaiser-Franz-Josef-Spital, Wien
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46
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Winkler M, Mauritz W, Hackl W, Gilly H, Weindlmayr-Goettel M, Steinbereithner K, Schindler I. Effects of half the tidal volume during cardiopulmonary resuscitation on acid-base balance and haemodynamics in pigs. Eur J Emerg Med 1998; 5:201-6. [PMID: 9846246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The effects of half the tidal volume during cardiopulmonary resuscitation (CPR) on haemodynamics, acid-base balance, and oxygenation were studied in anaesthetized pigs. The animals were ventilated with a mean tidal volume of 12.5 +/- 0.5 ml/kg at a rate of 14/minute resulting in a mean arterial pCO2 of 40 +/- 3 mmHg. They were randomly assigned to two groups: in one group ventilation was performed with half the pre-arrest tidal volume (50% group; n = 9), in the other group ventilation remained unchanged during CPR (100% group; n = 10). After 8 minutes of CPR attempts were made to restore spontaneous circulation with epinephrine and countershocks. There were no differences in advanced life support requirements, haemodynamic parameters, and resuscitability between the two groups. During CPR up to 5 minutes after restoration of spontaneous circulation (ROSC) dead space ventilation was significantly higher in the 50% group compared with the 100% group (p < 0.05). During CPR (at 3 and 7 minutes) arterial pO2 values were significantly lower (218 +/- 136 and 221 +/- 120 mmHg vs. 381 +/- 130 and 352 +/- 147 mmHg; FiO2 1.0) and hyperventilation was less pronounced (34.4 +/- 7.3 and 31.3 +/- 7.7 mmHg vs. 26.2 +/- 5.6 and 26.9 +/- 6.3 mmHg) in the 50% group. Our results suggest that half the tidal volume during CPR is likely to establish a more physiological acid-base balance and has no adverse effects on haemodynamics in intubated pigs ventilated with pure oxygen.
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Affiliation(s)
- M Winkler
- Ludwig Boltzmann Institute of Experimental Anaesthesia and Research in Intensive Care Medicine, Vienna, Austria
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Mauritz W, Hackl W, Winkler M. Malignant hyperthermia: state of the art. Acta Anaesthesiol Scand Suppl 1998; 111:310-2. [PMID: 9421058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- W Mauritz
- Department of Anaesthesia and Critical Care Medicine, Trauma Hospital Lorenz Böhler, Vienna, Austria
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48
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Kuhn G, Ender K, Hackl W, Küchenmeister U, Nürnberg K, Rehfeldt C. Effects of porcine somatotropin on the chemical body composition and fat quality in growing-finishing pigs. Z Ernahrungswiss 1997; 36:294-8. [PMID: 9467219 DOI: 10.1007/bf01617801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Seventy eight growing-finishing pigs (male castrates and females) of the cross-breed Pietrain x (Large White x German Landrace) were used to investigate the effects of pST treatment on the chemical composition of the body, the growth of adipocytes, and the fatty acid profile of the backfat. Intramuscular injections (1 or 3 mg pST) were administered daily from an average weight of 65 kg up to slaughter. After pST treatment significant changes in all studied characteristics were observed in barrows, whereas the females exhibited very small responses. The pST caused an increase of water and protein contents and a simultaneous decrease of lipid content especially in body parts rich in fat. Furthermore, the proportion of unsaturated fatty acids increased and the fat cell diameter decreased in the backfat.
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Affiliation(s)
- G Kuhn
- Research Institute for Biology of Farm Animals, Department of Muscle Biology and Growth, Dummerstorf, Germany
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Karner J, Klimpfinger M, Peichl P, Hackl W. Das akute Abdomen. Eur Surg 1997. [DOI: 10.1007/bf02619917] [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: 11/24/2022]
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50
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Hackl W, Regal W, Lichtenberger M, Donner E, Strasser K, Watzak-Helmer M. Intraoperative complications: aspiration. Acta Anaesthesiol Scand Suppl 1997; 111:308-310. [PMID: 9421057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- W Hackl
- Prim. Univ. Doz. Dr. W. Hackl, Dept. of Anesthesia & Intensive Care Medicine, Kaiser Franz Josef Spital, Vienna, Austria
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