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Ergebnisse bei modularen Megaendoprothesen im Bereich der unteren Extremitäten, Literaturauswertung und eigene Kasuistik (MML-System)
Get PDFModulare Megaendoprothesensysteme dienen der Überbrückung sehr großer Knochendefekte und gehören mittlerweile in der Tumorbehandlung wie auch in der Revisionsendoprothetik zu etablierten Behandlungsmethoden in der Orthopädischen Chirurgie. Im ersten Teil dieser Ar-beit wird anhand der publizierten Literatur ein umfassender Überblick über wichtige Aspekte bei Megaendoprothesen gegeben (Geschichte, Indikationen, Charakteristika, Ergebnisse). Im zweiten Teil erfolgt im Rahmen der eigenen Erhebungen die Auswertung eines Patientengutes von 104 Patienten (114 Operationen), welche in den Jahren 1994–2011 in der Orthopädischen Universitätsklinik Leipzig mit dem modularen Megaendoprothesensystem MML (Modular-system München-Lübeck) an den unteren Extremitäten versorgt wurden. Die Ergebnisse wur-den anhand der Krankenakten ausgewertet und mithilfe eines Erhebungsbogens standardisiert erfasst. Bei den Indikationen dominierten Tumoren mit 39,5 %, gefolgt von Revisionsoperati-onen aufgrund von TEP-Lockerungen (33,3 %), periprothetischen Frakturen (21,9 %), pri-mären Frakturen (16,7 %), Pseudarthrosen (6,1 %) und Resektionen nach Infektionen (6,1 %). Die häufigste Lokalisation stellte der proximale Femurersatz dar (65,8 %). Insgesamt bewegte sich die Komplikationsrate mit 38,6 % im Bereich der Angaben der Literatur. Allerdings sind die Ergebnisse in der Literatur heterogen dokumentiert. Eine standardisierte Erfassung der Komplikationen würde zu einer deutlich besseren Vergleichbarkeit führen. In unseren Erhe-bungen war die Infektion die zweithäufigste Komplikation (12,3 %). Die Luxation nahm in unserem Patientengut mit 25,6 % den größten Stellenwert ein, war jedoch im Verlauf meist besser zu beherrschen als Infektionen. Des Weiteren kam es zu periprothetischen Frakturen (3,5 %), Lockerungen (3,5 %), einem Endoprothesenbruch (0,9 %) und einer deutlichen an-haltenden Bewegungsstörung (0,9 %). Bei der Versorgung mittels modularer Megaendopro-thesen handelt es sich um komplikationsträchtige Eingriffe. Gemessen an den oftmals schwie-rigen Ausgangssituationen bewegen sich jedoch die Komplikationsraten in einem akzeptablen Bereich. Insbesondere die Infektion der Megaendoprothese stellt eine schwerwiegende Kom-plikation dar und resultiert oft in komplizierten Verläufen, bis hin zum Verlust der Extremität. Somit muss der Infektprävention besonders große Beachtung geschenkt werden. Modulare Endoprothesen stellen eine wichtige und nützliche Therapieform dar, wobei die Indikation für einen solchen Eingriff angesichts der teils schwierigen Verläufe mit äußerster Sorgfalt gestellt werden sollte. Die Verwendung modularer Endoprothesensysteme sollte erfahrenen und spe-zialisierten Zentren vorbehalten sein.:Inhaltsverzeichnis ...................................................................................I
Tabellenverzeichnis ................................................................................V
Abbildungsverzeichnis ...........................................................................VI
Abkürzungsverzeichnis .......................................................................VIII
1 Einführung und Aufgabenstellung........................................................ 1
2 Modulare Megaendoprothesen ........................................................... 3
2.1 Definition ......................................................................................... 3
2.2 Geschichte ....................................................................................... 5
2.3 Indikationen ............................................................................................................... 8
2.4 Modulare Megaendoprothesen – Charakteristik und Ergebnisse..... 9
2.4.1 Modulares Endoprothesensystem München-Lübeck™ (MML-System)....................................................................................... 10
2.4.2 KMFTR™/HMRS™ (Kotz-Modular-Femur-Tibia-Reconstruction-System/Howmedica-Modular-Reconstruction-System) ............................................................................................................. 12
2.4.3 MUTARS™ (Modular Universal Tumor and Revision System) ............................................................................................................. 16
2.4.4 Megasystem C™, Tumor- und Revisionssystem ............................................................................................................. 19
2.4.5 HSS(Hospital for Special Surgery)-modular linked system™/FINN™ ............................................................................................................. 20
2.4.6 STANMORE™ ............................................................................... 20
2.4.7 GUEPAR™-Endoprothese ............................................................ 21
2.4.8 Weitere Megaendoprothesensysteme ........................................ 21
3 Eigene Untersuchungen ................................................................... 23
3.1 Materialien und Methoden ............................................................. 23
3.2 Ergebnisse...................................................................................... 23
3.2.1 Charakteristika des Patientengutes ........................................... 23
3.2.1.1 Alters- und Geschlechtsverteilung ........................................... 23
3.2.1.2 Seitenverteilung ...................................................................... 24
3.2.1.3 Body-Mass-Index .................................................................. .. 24
3.2.1.4 Indikationen ............................................................................ 25
3.2.1.5 Tumoren als Indikation ............................................................ 25
3.2.1.6 Voroperationen ........................................................................ 27
3.2.1.7 Lokalisation der Endoprothese ................................................ 27
3.2.1.8 Charakteristika der mehrfach mit einer MML-Endoprothese versorgten Patienten ... ....................................................................... 28
3.2.2 Stationärer Aufenthalt bei MML-Endoprothesenimplantation ...... 29
3.2.2.1 OP-Dauer ................................................................................. 29
3.2.2.2 Muskel- und Sehnenrefixation, Trevira-Anbindungsschlauch ... 29
3.2.2.3 Intraoperative Komplikationen ................................................ 29
3.2.2.4 Stationäre Liegedauer ............................................................. 30
3.2.2.5 Postoperative Komplikationen während des stationären Aufenthaltes ........................................................................................ 30
3.2.2.6 Keimbefunde ............................................................................ 30
3.2.2.7 Implantatlage .......................................................................... 31
3.2.2.8 Reoperationen während des stationären Aufenthaltes ........... 31
3.2.2.9 Mobilisation .............................................................................. 32
3.2.3 Poststationärer Verlauf ............................................................... 32
3.2.3.1 Poststationäre Komplikationen ................................................ 32
3.2.3.2 Erneuter Eingriff poststationär ................................................ 34
3.2.4. Ausführliche Übersicht über die Komplikationen ........................ 35
3.2.4.1 Chirurgische Komplikationen und ihr Verlauf ............................ 35
3.2.4.2 Endoprothesenkomplikationen und ihr Verlauf ........................ 36
3.2.4.3 Geschlechtsspezifische Unterschiede bei den Komplikationen (stationär und poststationär zusammengefasst) ................................ 36
3.2.4.4 Altersunterschiede beim Auftreten von Komplikationen ........... 37
3.2.4.5 Einfluss des BMI auf die Komplikationen .................................. 38
3.2.4.6 Zusammenhänge zwischen der Indikation und Komplikationen
............................................................................................................. 38
3.2.4.7 Zusammenhänge zwischen Voroperationen und Komplikationen (stationär und poststationär zusammengefasst) ................................ 39
3.2.4.8 Komplikationen und Lokalisation der eingesetzten modularen Endoprothese ...................................................................................... 39
3.2.5 Letzter Untersuchungsbefund .................................................... 40
3.2.5.1 Zeitpunkt der letzten Untersuchung ........................................ 40
3.2.5.2 Schmerzen ............................................................................... 41
3.2.5.3 Beweglichkeit .......................................................................... 41
3.2.5.4 Gehfähigkeit ............................................................................ 42
3.2.5.5 Röntgenbefunde ...................................................................... 42
4 Diskussion ........................................................................................ 43
4.1 Diskussion der Datenerhebung ..................................................... 43
4.2 Diskussion der Ergebnisse ............................................................ 43
4.2.1 Allgemeine Angaben ................................................................... 43
4.2.2 Präoperative Angaben ................................................................ 44
4.2.3 Intraoperative Komplikationen ................................................... 45
4.2.4 Postoperative Komplikationen .................................................... 46
4.2.5 Poststationäre Komplikationen ................................................... 48
4.2.6 Zusammenhänge ........................................................................ 52
4.3 Resümee ........................................................................................ 54
5 Zusammenfassung ........................................................................... 56
6 Literaturverzeichnis .......................................................................... 59
7 Anlage.............................................................. ................................ 65
Erklärung über die eigenständige Abfassung der Arbeit ...................... 73
Lebenslauf und wissenschaftlicher Werdegang ................................... 74
Danksagung......................................................................................... 7
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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