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Biomedical subjects

A Schreiber

Publications and source records attributed to A Schreiber.

At least 55 records · Page 3Linked to original sources
PubMed1996

Low blood protein heterozygosity in zoo-bred hamadryas baboons.

An electrophoretic study of erythrocyte allozymes and serum proteins representing 32 genetic loci in 32 hamadryas baboons (Papio H.hamadryas) from Cologne and Frankfurt zoos revealed biallelic polymorphism in phosphoglucomutase (PGM), mannose phosphate isomerase (MPI) and transferrin (Tf). Polymorphism amounted to P = 0.097 over 31 loci and observed heterozygosity to H(o) = 0.011, indicating significant reduction from the respective gene diversity parameters encountered in free-living hamadryas baboons. Polygynous mating reduced numbers of heterozygotes at the Tf and the PGM-II loci significantly below Hardy-Weinberg expectations. This results support the importance of active genetic management in programmes for captive breeding and species conservation.

Alleles↗
PubMed1996

Hyperostotic and destructive osteoarthritis in a patient with vitamin A intoxication syndrome: a case report.

The authors present a case report of a 59-year-old female suffering from hyperlipidemia who developed chronic vitamin A intoxication syndrome after ingestion of 30,000 IU retinol/daily over a period of six years. The patient's main complaints included severe headaches, morning nausea, myalgias and disability around the hip, knee, and ankle joints. Radiologically, hyperostosis of the acetabular circumference and the spine was demonstrated. Because of rapidly increasing pain, total hip replacement was performed. Histology of cross sections from the femoral head revealed destructive osteoarthritis. Since no other causative reason was found, retinol may not only be responsible for hyperostotic bone and soft tissue formations but may perhaps also account for rapid progressing of degenerative joint disease. Despite the cessation of vitamin A intake the clinical symptoms persisted due to hyperlipidemia. The enlarged number of chylomicrons and the higher fraction of very low density lipoproteins may represent a second retinyl ester pool in case of overloaded fat storing Ito-cells in the liver. Therefore, rheumatological treatment reducing risk factors such as hyperlipidemia is mandatory.

Chronic Disease↗
PubMed1996

Incidence of deep sepsis in uncemented total hip arthroplasty using clean air facility as a function of antibiotic prophylaxis.

Eight hundred and twenty two uncemented primary total hip arthroplasties (THAs) were performed between September 1980 and December 1992. The population that underwent uncemented THA can be divided into two groups based on the perioperative antibiotic prophylaxis: group 1 contains 439 primary THAs from September 1980 to September 1987 without antibiotic prophylaxis; group 2 contains 383 primary THAs who received short-term cefamandole prophylaxis from October 1987 to December 1992. Laminar air-flow and whole-body exhaust suits were used during the whole period of this study. Both groups consisted of relatively young patients with a mean age of 53.8 years in group 1, and 54.3 years in group 2. Using Kaplan-Meier survivorship analysis, the estimated survival rate of sepsis-free hips in group 1 was 97.9% at one year, 97.6% at two years, and 97.4% at three and up to eleven years. In group 2 with antibiotic prophylaxis no deep infection occurred; the rate of sepsis-free hips at five years is 100%. Under clean air conditions, antibiotic prophylaxis significantly decreased the incidence of deep sepsis (p log-rank 0.004).

Adolescent↗
PubMed1996

The Balgrist hip socket for fixation without cement: analysis of 387 primary total hip replacements.

The results of 387 primary hip arthroplasties in which an uncemented Balgrist hip socket had been used in 346 patients were reviewed after a maximum of six years. The mean age of the patients at the time of operation was 54.3 years. Acetabular deficiency according to the AAOS classification was found in 21% of these primary arthroplasties. Three acetabular components (0.77%) had been revised. Using Kaplan-Meier survivorship analysis, with the use of prosthesis revision as the endpoint of failure, the survival rate at five years was found to be 99%. Four acetabular components (1%) had migrated and lysis of bone around the component in zone III occurred in one patient (0.26%). The data suggest that the unique socket design of the Balgrist hip socket (consisting of two tapered parts: an expansive outer titanium-alloy split ring and an insert of polyethylene) provides very satisfactory clinical results with various acetabular defects.

Adolescent↗
PubMed1996

Percutaneous disc surgery at Balgrist since 1979--from discotomy to interbody fusion.

In 1979 percutaneous intervertebral surgery was introduced as an alternative to conventional open disc surgery. In 1982, discoscopy was developed for intraoperative monitoring of the selective removal of disc tissue at the site of herniation. The indication remains restricted to subligamentous contained herniations. In a series of 240 patients with a mean follow up of 53 months, 88% reached an at least satisfactory overall outcome. Newly developed endoscopic instrumentation demonstrate promising results for their use in the spinal canal as well as in the extradiscal spinal area. Since 1988, by means of new, specially adapted instrumentation, endoscopically controlled interbody fusion was introduced with temporary pedicular external fixation. In a series of 35 cases with monosegmental percutaneous fusion, at a mean follow-up of 25 months, the fusion rate--including initial pitfalls-- reached 29/35 (83%). The technique does not require blood transfusions, no remaining internal fixation is left. This minimally invasive approach facilitates functional rehabilitation. Some of the techniques presented in this article concerning percutaneous external fixation and percutaneous interbody fusion must be considered as experimental according to American FDA standards.

Adult↗
PubMed1995

[Use of high-resolution algorithms and thick sections in computerized tomography staging of bronchial carcinoma].

The purpose was to determine whether 8 mm slice sections with high resolution algorithms would prove superior to standard methods for the CT staging of bronchial carcinomas. The raw data from CT examinations in 50 patients using standard methods and the high resolution method was calculated, documented and compared. Within the lung parenchyma, small foci or metastases, peritumorous infiltrates, bronchial narrowing, bronchial outlines, vessels and areas of poor aeration were significantly clearer. Pleural thickening and subpleural fat stripes were also better seen. Abnormalities in the mediastinum were equally well shown. High resolution algorithms with 8 mm slice sections are recommended for routine staging of bronchial carcinomas, particularly if the calculations can be done quickly, as is possible on modern apparatus, without increasing the duration of the examination.

Algorithms↗
PubMed1994

[Reconstruction of segmental bone defects using massive osseous and osteocartilaginous allograft].

The reconstruction of large segmental defects after the resection of malignant bone tumors is usually done with modular or custom-made endoprostheses, so far, they appear to work well. From the experience with other indications for endoprostheses it must be admitted that failures will be a matter of time only. With the improved prognosis for patients with primary malignant bone tumors with regard to relapse-free survival and increased chances for permanent cure, the trend for reconstruction procedures should be directed to more 'biological' techniques. The reconstruction of osseous and osteocartilaginous defects with massive allografts is somewhere between the use of autologous bone and artificial replacement. From the experience with 14 allograft reconstructions in primary malignant bone tumors (osteosarcoma, malignant fibrous histiocytoma, leiomyosarcoma, chondrosarcoma, lymphoma) or other aggressive lesions (aneurysmal bone cyst, recurring giant-cell tumor, solitary metastasis) of the humerus (one osteoligamentous graft in combination with an endoprosthesis, one intercalary graft), the femur (three intercalary grafts, two osteoarticular distal femurs, one combination with an endoprosthesis), and the proximal tibia (four osteocartilaginous, two intercalary grafts) in patients aged 10 to 64 years, we feel that this type of reconstruction allows for a reconstruction without sacrificing more bone and soft tissue than needed for the surgical margins. Fusion between the patient's bone and the allograft has been seen after 6 to 18 months. From this small series it is concluded that using allografts might allow for the preservation of joint structures that need to be resected for the implantation of an endoprosthesis, increasing the possibilities for salvage procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Valgus tibial osteotomy in a patient with benign dominant osteopetrosis (Albers-Schoenberg disease). A case report.

Operation in osteopetrosis, or Albers-Schoenberg disease, needs careful technique because of the brittleness of the bone. We report a patient with autosomal-dominant osteopetrosis (MIM 166600)18 and unicompartmental osteoarthritis of the knee which was treated by a valgus tibial osteotomy. Our experience, and a review of the literature, shows that external fixation is a valuable form of treatment because it is noninvasive and ensures perfect interfragmentary compression.

Aged↗
PubMed1994

Late complications after total hip replacement in renal allograft recipients.

Seventy nine hips in 53 recipients of renal allografts were treated by cemented total hip replacement for avascular necrosis of the femoral head between 1972 and 1992. Eight hips in 6 patients required revision for aseptic loosening after a mean of 11.2 years. Three replacements in 3 patients became infected with salmonella enteritidis after a mean of 6.2 years. One was revised, one had a disarticulation of the hip, and the third was treated with long term antibiotics. Survivorship analysis for total hip replacement and the renal allografts showed a hip reoperation rate of 9.9% at 10 years and 54.6% at 15 years with mortality rates of 32.2% and 42.2% respectively. Thus patients surviving 15 years are at a higher risk of failure of the prostheses than of dying.

Adult↗
PubMed1994

Reduced vitamin A tolerance in a hyperlipidaemia patient with rapid destructive and hyperostotic osteoarthritis of the hip.

A 59-year-old patient suffering from hyperlipidaemia developed a chronic vitamin A intoxication syndrome after ingestion of 30000 IE retinol/daily over a period of six years. Functional disability of the right hip was caused by radiologically documented hyperostosis of the acetabular circumference. Finally, a prosthesis had to be implanted because of rapid destructive osteoarthritis of the right hip. Implications of vitamin A for rheumatological management are discussed.

Drug Tolerance↗
PubMed1994

The Balgrist hip socket for cementless fixation in primary total hip replacements and in acetabular revisions.

The results of 532 hip arthroplasties in which an uncemented Balgrist hip socket had been used in 387 primary total hip replacements and in 145 acetabular revisions were reviewed after a maximum of six years. The socket consists of two tapered parts, namely an expansive outer titanium-alloy split ring and an insert of polyethylene. The mean age of the patients at the time of operation was 54.3 years in primary hip replacements, and 64.7 years in acetabular revisions. Acetabular deficiency according to the AAOS classification was found in 21% of the primary arthroplasties, and in 80.7% of the acetabular revisions. Using Kaplan-Meier survivorship analysis, with the use of prosthesis revision as the endpoint of failure, the survival rate at five years was 99% in primary arthroplasties, and 88.7% in acetabular revisions. Our data suggest that the unique socket design of the Balgrist hip socket gives very satisfactory clinical results not only in primary hip replacements but also in acetabular revisions even with various acetabular defects.

Adolescent↗
PubMed1994

[Relevance of proton spin tomographic meniscus diagnosis in correlation with arthroscopy].

Arthroscopy of the menisci is considered the gold standard by which all noninvasive imaging procedures of the knee are measured. In a prospective study we evaluated the use of MRI in 50 patients in whom a disorder of the meniscus was suspected clinically; this was followed by an arthroscopic examination by an experienced arthroscopist. The MR studies were performed after clinical evaluation and were interpreted by an experienced radiologist, who had no knowledge of the clinical findings. The accuracy of the diagnosis from MRI was 78% for the medial meniscus (sensitivity 79% and specificity 78%) and 94% for the lateral meniscus (sensitivity 50% and specificity 98%). The average age of the patients was 34 years, with a range of 3-73 years. The imaging studies revealed 9 false-positive tests and suggested that the meniscus was either degenerated or torn in the horizontal plane. In all 9 menisci the abnormal MR imaging signal was limited to the posterior horns. The positive predictive value was 59% and the negative predictive value was 94%, representing a moderate level of diagnostic certainty both in patients who had a positive result and in those who had a negative result. The high predictive negative value of MRI indicates that a negative MRI is quite reliable for meniscal lesions. The problem areas in MR imaging are the popliteal tendon sheath and the transverse ligament. This ligament is seen in association with a large branch of the lateral inferior geniculate artery and may be mistaken for a grade 3 signal intensity in the anterior horn of the lateral meniscus.

Adolescent↗
PubMed1993

The self-locking Balgrist hip socket for cementless fixation: biomechanical principles and clinical results.

The Balgrist hip socket, initially made entirely of HDPE (high molecular weight polyethylene), now made of outer titanium alloy shell that faces the bone of the acetabulum has been in clinical use for 10 years. The purpose of this presentation is to illustrate the biomechanical principles that have governed this unique design and to present the clinical results that we have obtained until the end of 1991 with 717 implants. From 1982 to 1987 Balgrist HDPE sockets had been implanted for 346 hips, from 1984 to 1991 Balgrist Titanium alloy sockets have been implanted for 371 hips. The number of revision are 55 of 717 hips. 48 hips out of 55 were with Balgrist HDPE sockets. On the contrary, only 7 hips were with Balgrist titanium socket. The greatest benefit of Balgrist Titanium socket is the excellent mechanical lock with subchondral bone of the acetabulum.

Biomechanical Phenomena↗
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↗