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Pre- and postoperative postural regulation following anterior cruciate ligament reconstruction
Thomas Bartels,Kay Brehme,Martin Pyschik,Stephan Schulze,Karl-Stefan Delank,Georg Fieseler,Kevin G. Laudner,Souhail Hermassi,René Schwesig 한국운동재활학회 2018 JER Vol.14 No.1
There are currently no longitudinal data describing the pre- and postop-erative postural regulation and stability of patients with anterior cruci-ate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilita-tion following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Inter-active Balance System pre-, 6, and at 12 weeks following surgical re-construction of the ACL using a hamstring tendon graft. The average period of time from injury to surgery was 27 days. Data were calculated with unifactorial and univariate analysis of variance. Significant effects were found for the somatosensory system (η2=0.115), stability indicator (η2=0.123), weight distribution index (η2=0.176), and synchronization (foot coordination) (η2=0.249). Involved side weight distribution (param-eter: left) increased significantly (patients with left-sided/right-sided in-jury: η2=0.234/0.272). Load distribution to the heel remained stable during all three examination periods (η2=0.035 and η2=0.071), although a remarkable load at forefoot was observed. In seven out of 10 parame-ters partial effects were seen during the first 6 weeks after surgery. The results of this study indicated that injury of the ACL and subsequent surgical reconstructions result in postural regulation, with improve-ments in somatosensory system function, postural stability, weight dis-tribution index, and foot coordination. Also, overloading of the injured side on the feet reduces significantly during rehabilitation. Thus, the ini-tial phase of rehabilitation (weeks 1 to 6) seems to be more effective than the second period (weeks 6 to 12) postoperatively.
Tatjana Gruber-Rouh,Clara Lee,Jan Bolck,Nagy N.N. Naguib,Boris Schulz,Katrin Eichler,Rene Aschenbach,,Julian L. Wichmann,Thomas. J. Vogl,Stephan Zangos 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.4
To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT). Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures. The phantom 1-LNS group showed a target point accuracy of 4.0 ± 2.7 mm (freehand, 6.3 ± 3.6 mm; p = 0.008), entrance point accuracy of 0.8 ± 0.6 mm (freehand, 6.1 ± 4.7 mm), needle angulation accuracy of 1.3 ± 0.9° (freehand, 3.4 ± 3.1°; p < 0.001), intervention time of 7.03 ± 5.18 minutes (freehand, 8.38 ± 4.09 minutes; p = 0.006), and 4.2 ± 3.6 CT images (freehand, 7.9 ± 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 ± 2.5 mm, entrance point accuracy of 1.4 ± 2.0 mm, needle angulation accuracy of 1.0 ± 1.2°, intervention time of 1.44 ± 0.22 minutes, and 3.4 ± 1.7 CT images. The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients. Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.
Lymphatic Malformations of the Orbit
Susanne Wiegand,Behfar Eivazi,Linda M. Bloch,Annette P. Zimmermann,Andreas M. Sesterhenn,Stephan Schulze,Jochen A. Werner,정호윤 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.1
Objectives. Lymphatic malformations of the orbit are rare lesions that constitute approximately 1% to 8% of all orbital masses. They are difficult to treat since they do not remain within anatomic boundaries and tend to penetrate into normal orbital structures. The aim was to analyze clinical courses and therapy options in patients with lymphatic malformations of the orbit. Methods. Thirteen patients with orbital lymphatic malformations confirmed by magnetic resonance imaging between 1998 and 2009 were enrolled in this study. Patients’ charts were retrospectively reviewed to analyze clinical courses and treatment options. Results. Four patients suffered from isolated intraorbital lymphatic malformations without conjunctival involvement, in three of them the masses were completely resected, in one patient close controls were performed. Three patients had isolated intraorbital lymphatic malformations with conjunctival involvement. Surgical volume reduction of the exterior parts of the lymphatic malformation were performed without any complications and satisfying outcome in these cases. Six patients suffered from intra- and periorbital lymphatic malformations. In 3 patients a watch-and-wait strategy was initiated. In the other 3 patients a surgical therapy was performed, one patient additionally received sclerotherapy with OK-432; however, these 3 patients suffered from residual lymphatic malformations. Conclusion. The presented cases underline the inconsistencies in the malformations behavior and underscore the inability to make specific recommendations regarding treatment. The treatment decision should be based on the size and location of the lymphatic malformation. The untreated patient must be watched for signs of visual detoriation, which may signal the need for therapeutic intervention.