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Biomedical subjects

A Schreiber

Publications and source records attributed to A Schreiber.

At least 19 recordsLinked to original sources
PubMed1992

[Hip diseases in children].

In the orthopedic practice, the hip joint is of special importance at all ages. For the general practitioner and the pediatrician are those disorders of the hip of high importance, for which early diagnosis and initiation of treatment is critical for prognosis. The following disorders should be looked for in priority, if symptoms indicate a possible affection of hip: congenital dysplasia and dislocation of the hip, coxitis, slipped capital femoral epiphysis, and tumors. One should always be aware that especially in children disease of the hip need not necessarily present with symptoms directly located within the region of the hip. Especially the child often complains only about knee or vague leg pain, while having a disorder of the hip; therefore, the cause of any pain should always also be looked for proximal to the structure, where the pain may be localized by the patient.

Bone Neoplasms↗
PubMed1992

The effect of light fluence rate in photodynamic therapy of normal rat brain.

This paper reports the effect of incident light fluence rate on the depth to which necrotic lesions are produced by photodynamic therapy (PDT) in the brains of normal Fisher rats. The rats were injected intraperitoneally with Photofrin (12.5 mg kg-1) 48 h prior to PDT with a fixed incident fluence of 35 J cm-2. The treatment was performed at 10, 50, 100, and 200 mW cm-2 and also in a periodic manner (30 s "on" at 100 mW cm-2, 30 s "off"). The depth to which necrosis occurred was determined 24 h after treatment by microscopic examination of tissue sections. No differences were found in the depth to which necrosis was produced by any of the five irradiation schedules. This finding is discussed in the context of other published dose-rate experiments.

Animals↗
PubMed1992

Nervous and immune systems as targets for developmental effects of benzodiazepines. A review of recent studies.

Prenatal exposure to benzodiazepines (BDZ) can cause behavioral dysfunctions both in humans and in experimental animals. In addition, prolonged impairment of cellular immune functions is found in rats after low dose BDZ exposure (e.g., diazepam 1.25 mg/kg/day) during part of fetal life [gestational days (GD) 14-20]. Analysis of diazepam and its metabolites in maternal and fetal tissues revealed that in this rat model the drug is no longer present at birth, which excludes direct effects of diazepam during the postnatal period. The main target of BDZ in brain, the GABAA receptor complex, is structurally and functionally heterogeneous. Besides alpha- and beta-subunits, gamma 2- or gamma 3-subunit should be coexpressed for a fully functional BDZ response. Signals of mRNAs encoding for alpha 1, beta 2 and gamma 2 are detected in fetal rat spinal cord and lower brainstem by GD 14 and reach telencephalic regions in later fetal life, reminiscent of BDZ receptor ontogeny. Regional subunit distribution differs from the adult brain, one interesting feature being a preponderance of gamma 2 mRNA throughout fetal life. Since subunit composition influences the sensitivity to BDZ, these data suggest that prenatal effects of BDZ depend upon regional subunit compositions present at different developmental stages. The delayed depression of cellular immune responses in prenatally BDZ-exposed rat offspring during the first 2 postnatal months is accompanied by various changes in immune cell biology. Binding characteristics of the peripheral (omega 3) type BDZ receptor are altered until adulthood (8 weeks). Membranes of spleen cell preparations containing mainly lymphocytes exhibit a decrease of affinity for the peripheral ligand [3H]PK11195, splenic macrophage preparations a decrease of maximal binding capacity. Various defects in cytokine production by macrophages and T lymphocytes were observed: Mitogen-stimulated release of macrophage-derived tumor necrosis factor-alpha (TNF-alpha) and of the T cell-derived interleukin-2 (IL-2) was drastically reduced at 2 and 4 weeks of life and recovered in young adulthood, exhibiting the same time course of depression as lymphocyte proliferation in response to immune stimuli. Interleukin-6 (IL-6) release remained diminished until adulthood. In female offspring, additional alterations were found in splenic noradrenaline turnover after immune stimulation. The mechanisms underlying the breakdown of the cytokine network in prenatally diazepam-exposed offspring, and the long-term consequences are as yet unknown.

Animals↗
PubMed1992

[Endoscopy of the spine: minimally invasive therapy].

Since 1982 discoscopy has proved its value as a mean of continuous optic control of percutaneous intradiscal procedures. Thus, precisely oriented removal of disc tissue became possible for posterior decompression. Since 1989, discoscopy has opened the way for optically controlled intradiscal laser application. Besides decompressive procedures, since 1988 specific elaboration of the vertebral plates for percutaneous interbody fusion has also become available under discoscopic control. A most promising prospect is the technique of foraminoscopy introduced in 1991, which also opened the way to extradiscal exploration. The further development of versatile fine working scopes will be a bigger and bigger challenge to conventional techniques, as the concept of minimal intervention in spine surgery becomes more and more complete.

Endoscopes↗
PubMed1992

[Clinical and radiologic long-term follow-up of Eden-Lang operation in habitual anterior shoulder dislocation].

The incidence of degenerative arthritis after Eden-Lange procedure is judged differently in literature, recently high rates of degenerative arthritis have been reported. 37 patients and the same number of shoulder joints have been evaluated clinically and radiologically after an average follow-up time of 14.9 years. Overall results can be considered as good. Recurrence of dislocation occurred only in one case. Most frequently we observed a limitation of external rotation and overhead performance in sports. The frequency of degenerative arthritis was 17%, clearly less than mentioned elsewhere. The Eden-Lange procedure still can be recommended as a treatment for recurrent anterior shoulder dislocation except for patients with high expectations in physical overhead activities.

Adolescent↗
PubMed1991

[Physical therapy aspects of treatment following total hip prosthesis].

Our physiotherapy program after total hip arthroplasty is presented, and certain modifications in relation to cemented or cementless implantations are discussed. Three different stages must be considered: preoperative instructions of the patient, mobilization of the patient and his joints, water gymnastics to enable the patient to obtain total independence. During the first three months only partial weight should be put on the operated leg. In comparison to the cemented system, the biomechanical properties of the cementless prosthesis permit only a careful and delayed mobilization and charge of the operated leg, as long as a secondary stability of the implant has not been reached. In more complicated cases it is of importance that the whole planning of postoperative physiotherapy should be discussed individually and in detail with the surgeon concerned.

Bone Cements↗
PubMed1991

[Percutaneous nucleotomy with disk endoscopy--a minimally invasive therapy in non-sequestrated intervertebral disk hernia].

The conventional open surgical approach for the treatment of lumbar disc herniation, introduced over 50 years ago, is often followed by tenacious consecutive complaints due to segmental instability or epidural scarring: the so called post-laminotomy syndrome. Introduced since 1979, Percutaneous nucleotomy, for patients without free sequestration of disc tissue, forms a true alternative due to its minimal invasiveness. Via a dorsolateral approach, most sparing the dorsal musculo-ligamental apparatus, a precise decompression can be achieved without scar-prone irritation of the peridural space. Considering the precise range of indication, preoperative selection of patients deserves most attention. An analysis of the 174 patients operated by this technique in the first 10 years shows favourable outcome in over 85% of the controls.

Adolescent↗
PubMed1991

Epithelioid sarcoma mimicking angiosarcoma: the value of immunohistochemistry in the differential diagnosis.

Epithelioid sarcoma (ES) is a rare malignant tumour of young adults, usually presenting as a skin ulcer or subcutaneous nodule in the distal portion of the upper limb. Multiple recurrences and late metastases are typical, leading to fatality in a third to one-half of all cases. The slow evolution of the tumour is one reason for its delayed recognition. The other is its frequent histological misinterpretation, in particular, as a peculiar granulomatous reaction. In our case, the primary tumour presented a variant morphological pattern so closely mimicking a cavernous angiosarcoma as to mislead several reputable opinions. Later recurrences and metastases were typical of ES, while a focal angiomatoid pattern was maintained. The morphology and immunoreactivity to a wide spectrum of tumour markers is compared with that of six file cases of classical ES. Retrospectively, all neoplastic lesions in our patient were ES. In young adults, lesions of the upper extremity, even when angiomatoid or haemorrhagic, should raise a suspicion of ES. Once epithelioid sarcoma is suspected, the differential diagnosis can be elucidated on immunohistochemical grounds. Early diagnosis provides the best opportunity for radical surgery at a stage when the tumour has not spread locally or disseminated systemically.

Adult↗
PubMed1991

Percutaneous nucleotomy: technique with discoscopy.

In its first decade of use, percutaneous nucleotomy has proven its value in decompressive indications for lumbar disc disease. Indications include contained disc herniations as isolated pathology, or in combination with other lumbar pathology at risk for decompensation after open hemilaminotomy, eg, spondylolysis/olisthesis or former open operative procedures. The precise indications underline the need for conclusive preoperative screening, such as disco-scan and contrast-discomanometry. Overall results are 85% favorable. Percutaneous intervertebral fusion is also presented.

Adult↗
PubMed1991

[Prevention of recurrence of Sudeck's disease with calcitonin].

In patients suffering from, or with a history of, reflex sympathetic dystrophy (RSD), there is always a risk of exacerbation or reactivation of this disease after surgery or trauma. The use of calcitonin in the treatment of this type of disorder is well established. Starting in 1984, 18 patients with clinical symptoms of RSD or a history of this disease were given daily prophylactic treatment with salmon calcitonin (100 IU subcutaneously or as a spray). Ten of the patients underwent orthopaedic surgery and 8 received conservative treatment following trauma. The mean duration of prophylactic treatment was 4 days before and 23 days after surgery or trauma. Only one recurrence was observed (3 per cent). For comparison, a retrospective analysis of a group with the same inclusion criteria who underwent surgery or received conservative treatment after trauma, without prophylactic administration of calcitonin showed a recurrence of the underlying disease 28 per cent of the cases. It is therefore possible to recommend prophylactic administration of calcitonin, to patients with a history of RSD who are about to undergo orthopaedic surgery or conservative treatment following trauma.

Adult↗
PubMed1990

Artiodactylan phylogeny: an immunogenetic study based on comparative determinant analysis.

The phylogenetic relationships of major artiodactylan taxa were investigated by means of comparative determinant analysis (CDA). Monospecific antisera against taurine cattle albumin, transferrin, C3 and IgM were used to derive determinant formulas of their homologues in 21 species (plus 12 other mammals for outgroup comparison). Fifteen accepted mutations could be demonstrated in Artiodactyla, permitting recognition of nine immunologically defined species groups. Results with phylogenetically relevant implications include the clear immunogenetic separation of the vicugna from true ruminants, a complex pattern of accepted mutations rendering a genealogical analysis of the principal pecoran radiation difficult, one synapomorphic mutation combining the goitred gazelle with bovines but excluding Caprinae, and the immunological recognition of the three grades of wild cattle evolution. This study demonstrates the suitability of CDA as a tool of phylogenetic systematics above the level of genera.

Albumins↗
PubMed1990

[Percutaneous nucleotomy. 10 years' experience, modern concepts].

The article reviews the authors' ten-year experience with the technique of percutaneous nucleotomy in the treatment of lumbar disc herniation. During this period 174 operations were altogether performed in 148 patients by means of this technique. The existing experience shows that this technique has fully justified itself in the indicated cased. It can be applied for the protrusion and subligamentous extrusion of the disc. Subligamentous sequestrum represents relative indication. For the evaluation of the condition of the disc the authors use as a standard the technique of contrast discomanometry. This examination method they consider in the indication of percutaneous nucleotomy for "conditio sine qua non". Of vital importance for the final result of the operation is to evaluate also the stability of the segment operated on. In cases where this segment in unstable it is necessary to supplement percutaneous nucleotomy with intercorporal spondylodesis. The question of stability of spine in the disc herniation has not been fully solved, yet. The solution of this problem will be significant also for the solution of the so called failed back syndrome.

Adolescent↗
PubMed1989

[10 years of percutaneous disk surgery: results and developments].

The percutaneous nucleotomy via discoscopy for decompression of lumbar disk-prolapse is advantageous regarding segmental stability, is less invasive and can be performed in regional anesthesia. Preoperative evaluation of indication is important. Experiences with 148 patients operated 1979-1988 are reviewed. Immediate success was achieved in 70% (overall 85% favorable results). As further development the novel technique of percutaneous intercorporal spondylodesis is presented.

Anesthesia, Conduction↗
PubMed1989

[Experiences with the "Balgrist" cement-free, self-anchoring conical acetabular prosthesis--March 1982 to September 1988].

The advantage over other acetabular sockets for cementless fixation lies in the easier preparation of the acetabulum without endangering neighbouring structures, and in its self-locking ability which ensures firm fixation in the surrounding bone during the critical period of bone-remodelling which occurs during the first three months postoperatively. In over 90% of the 414 sockets, implanted over 6.5 years, with an average follow-up period of four years (3 to 78 months), we have had, clinically and radiologically, good results. Loosened sockets (3.6%) were observed with those made of polyethylene during the early stages mainly due to inadequate experience in implanting them. The titanium model which has been exclusively used from november 1987 has shown no signs of instability neither in the case of primary or revision sockets.

Acetabulum↗
PubMed1989

Metastatic bone disease from occult carcinoma: a profile.

To assess the general profile of metastatic bone disease from occult primary carcinoma, the records of 172 patients with skeletal metastases seen between 1965 and 1985 were reviewed. In 51 patients (30%), the origin of the primary could not be identified when bone metastases were first diagnosed. This group were predominantly male with a high incidence of spinal metastases, cord compression and pathological fractures, and a significantly shorter (P less than 0.1) survival compared with bony metastases when the primary was known. The site of the primary was established in 33 patients (65%), mostly at autopsy. Lung carcinoma was by far the most common primary tumour in 52% of the cases, while it accounted for only 7% of those with a diagnosed primary. We believe that the onset of bony metastases from an occult source must initially raise the possibility of lung carcinoma. If the primary remains undetected, it appears justifiable to assume it to be in the lung, since the probability of a missed lung tumour being responsible for the metastases is high.

Adult↗