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Suhl, Germany

Schummer W.,Friedrich - Schiller University of Jena | Schlonski O.,Zentralklinikum Suhl | Breuer M.,Friedrich - Schiller University of Jena
British Journal of Anaesthesia | Year: 2014

We report on a rare complication of poly(methyl methacrylate) (PMMA), injected into the spine, which then inadvertently leaked into the venous system. This resulted in an embolism of PMMA and produced a mass surrounding a triple lumen central venous catheter located in the superior vena cava. The catheter as well as the attached mass of PMMA was retrieved safely by cardiothoracic surgery. This case emphasizes the importance of prompt diagnosis and treatment and illustrates the need for close monitoring of patients undergoing any spinal surgery that includes vertebroplasty. © The Author [2013]. Source

Buntzel J.,Head & Neck Surgery | Buntzel J.,German Study Group Trace Elements and Electrolytes in Oncology AKTE | Krauss T.,Zentralklinikum Suhl | Buntzel H.,Palliative Care Unit | And 10 more authors.
Trace Elements and Electrolytes | Year: 2012

Objective: Is there a relation between nutritional status and the prognosis of head and neck cancer patients? Which diagnostic procedures gives us sufficient information about the malnutrition of the individual? Material and methods: A first retrospective study analyzes the outcome of 110 patients in relation to initial weight loss and weight loss at the end of radiotherapy. A second study investigated the changing bioimpedance (BIA) data of 27 survivors and 39 patients who died between their first and last measurement during nutritional therapy (at least 4 weeks). Results: A critical initial weight loss is 10 kg or more at the point of diagnosis. At the end of radiotherapy the body mass reduction should be lower than 15 kg. Raw data of BIA reflects the changing nutritional status at the end of life. We observed a stabilized phase angle in survivors (4.7° to 5.2°) whereas dying patients have shown a significant decreased phase angle (4.6° to 3.7°, p < 0.05). Conclusion: The prognosis of head and neck cancer patients is tightly related to their nutritional status. Specific nutritional anamnesis (initial weight loss, total weight loss, BMI) and additional biophysical measurements are recommended to observe the individual status during the follow up. ©2012 Dustri-Verlag Dr. K. Feistle. Source

Assmus B.,Goethe University Frankfurt | Rolf A.,Kerckhoff Klinik Bad Nauheim | Erbs S.,Herzzentrum Leipzig | Elsasser A.,Klinikum Oldenburg | And 12 more authors.
Circulation: Heart Failure | Year: 2010

Background-The aim of this study was to investigate the clinical outcome 2 years after intracoronary administration of autologous progenitor cells in patients with acute myocardial infarction (AMI). Methods and Results-Using a double-blind, placebo-controlled, multicenter trial design, we randomized 204 patients with successfully reperfused AMI to receive intracoronary infusion of bone marrow-derived progenitor cells (BMC) or placebo medium into the infarct artery 3 to 7 days after successful infarct reperfusion therapy. At 2 years, the cumulative end point of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (hazard ratio, 0.58; 95% CI, 0.36 to 0.94; P=0.025). Likewise, the combined end point death and recurrence of myocardial infarction and rehospitalization for heart failure, reflecting progression toward heart failure, was significantly reduced in the BMC group (hazard ratio, 0.26; 95% CI, 0.085 to 0.77; P=0.015). Intracoronary administration of BMC remained a significant predictor of a favorable clinical outcome by Cox regression analysis when adjusted for classical predictors of poor outcome after AMI. There was no evidence of increased restenosis or atherosclerotic disease progression after BMC therapy nor any evidence of increased ventricular arrhythmias or neoplasms. In addition, regional left ventricular contractility of infarcted segments, as assessed by MRI in a subgroup of patients at 2-year follow-up, was significantly higher in the BMC group compared with the placebo group (P<0.001). Conclusions-Intracoronary administration of BMC is associated with a significant reduction of the occurrence of major adverse cardiovascular events maintained for 2 years after AMI. Moreover, functional improvements after BMC therapy may persist for at least 2 years. Larger studies focusing on clinical event rates are warranted to confirm the effects of BMC administration on mortality and progression of heart failure in patients with AMIs. Clinical Trial Registration-clinicaltrials.gov. Identifier: NCT00279175. © 2010 American Heart Association, Inc. Source

Ruf M.,Zentralklinikum Suhl | Voigt A.,Zentralklinikum Suhl | Kupczyk-Joeris D.,Clinic for Abdominal Surgery | Merk H.R.,University of Greifswald
European Spine Journal | Year: 2011

A case of late dislocation of a disc spacer L5/S1 with perforation of the sigmoid colon and transanal passage 4 years after implantation is reported. The objective is to describe an uncommon complication of anterior endoscopic spondylodesis L5/S1. To our knowledge, this is the first report on this rare complication. A 39-year-old patient suffering from a spondylolisthesis L5/S1 (Meyerding grade 2) with bilateral lysis L5 was operated with posterior instrumentation L5/S1 and anterior endoscopic insertion of two disc spacers. 4 years after surgery the patient noticed one of the spacers in the toilet. Radiographic examination of the colon with contrast dye revealed a perforation at the distal sigmoid colon. At the lumbosacral junction there was a bony defect at the site of the absent spacer and an anterior dislocation of the second spacer. A partial resection of the colon at the perforation site with end-to-end anastomosis was performed. The second spacer was removed, and the defect was packed with autologous cancellous bone and local antibiotics. The further course was uneventful. 2 weeks postoperatively the patient was discharged without signs of infection. The radiographic examination after 6 months showed healing of the bone graft with bony fusion L5/S1. In case of incomplete or absent bony fusion the dislocation of intradiscal spacers may arise even years after the primary surgery. In consequence periodical radiographic examinations of spinal instrumentations are recommended until complete bony fusion occurred. Unclear abdominal symptoms following anterior spine surgery require immediate examination. © Springer-Verlag 2011. Source

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