Biomedical subjects
Publications and source records attributed to C Carstens.
The partial aplasia of the spine is a rarely seen syndrome. Describing 6 cases their clinical and radiological appearance is shown. With respect to the 4 cases mentioned in the literature until now one can distinguish 4 types. The differentiation between the partial aplasia of the spine and the syndrome of caudal regression is discussed.
140 of 937 patients (14.9%) with myelomeningocele have vertebral and rib abnormalities. Vertebral deformities were found in 128 cases (13.6%) and rib deformities in 43 cases (4.5%). This is a frequency, which is in comparison with the general population incidence relatively high. Therefore the conclusion is drawn, that roentgenograms showing the entire spine should be done routinely in every case of myelomeningocele. Theories, which try to explain the formation of these osseous deformities, are discussed.
Thiemann's disease is a hereditary necrosis of the epiphysis of the basal limb of the big toe. This paper describes its synchrone occurrence in monozygotic twins. The course is seen as being concurrent with the findings in literature. The etiopathology of Thiemann's disease is discussed showing the dominant heritage by this examination of twins.
Congenital deformities of the sacrum are relatively rarely described syndromes. In this report, 16 cases of sacral deformity with resultant obliquity of the sacral plateau are described. With respect to morphological criteria 5 different types can be distinguished. Development of static scoliosis results from congenital deformity of the sacral plateau. Longterm results of up to 17 years in 8 of the 16 cases are presented. Operative and conservative treatment possibilities are discussed.
This study reports of 191 infections that occurred after 14807 primary clean operations from 1982 to 1986. The spectrum of organism and the resistancy of bacteria has been analysed. 5 groups of organisms (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcen, Enterococcen and Pseudomonas aeruginosa) are responsible for 82% of the infections. 88% of the bacteria in monoinfections were sensitive to Cefazedon. The development of resistancy against this type of Cefalosporin could not be seen.
28 myelomeningocele patients (aged 2-30 years) with clinical symptoms of acute UTI participated in this open uncontrolled clinical trial at the Orthopedic University Hospital of Heidelberg (Dir.: Prof. Dr. H. Cotta). 4 patients were treated with 200 mg cefixime tablets bid, 24 patients received 4 mg/kg body weight cefixime suspension bid, according to age and weight of the patients. The duration of treatment was 6-10 days. Clinical and microbiological examinations were carried out before therapy as well as 1 day and 5 to 9 days after the end of treatment. The data of 25 patients could be evaluated for bacteriological and clinical efficacy. 5-9 days after treatment in 22 patients (88%) complete recovery was stated. In 3 patients a reinfection occurred. In 24 patients (96%) the baseline pathogens were eliminated under cefixime therapy. 5-9 days after the end of treatment in 3 patients reinfection was observed. Clinical side effects could be detected in 1 patient (vomiting). These results indicate that the oral cephalosporin cefixime is efficient and well tolerated in complicated UTI of myelomeningocele patients.
A joint between the pelvis and the minor trochanter on the right hip of a 87 year old female will be investigated. The investigation includes the joint between the femoral head and the secondary socket. An analyse of the cartilage and the cancellous bone structure shows, that the joint pressure will be transmitted not only by the hip joint but also by the new joint.
Osteophytes of forty femoral heads with degenerative arthritis (dissecting room material) are investigated histologically and roentgenologically. The analysis of the covering cartilage and the cancellous bone structure supports the view that osteophytes are subject to pressing forces. It is discussed that osteophytes have an influence of the degree of stress in the joint. There are no morphological indications of a traction force acting upon the osteophytes.
UNLABELLED: Since 1979 prenatal ultrasonography is a screening method in Germany. The examination of head, thorax and femur is now established as a routine method. AIM OF THE STUDY: The evaluation of the effectiveness and the consequences of an early prenatal diagnosis of foetal limb deficiencies. METHOD: From 1989-1994 we had 403 children with 207 minor or 196 major limb deficiencies. Questionnaires were sent to those 196 parents of children with major diseases 134 cases (68%) of children with limb deficiencies could be analysed. The average age of the mother at birth was 27.5 years and the age of the father was 30.5 years. RESULTS: 61 children had deficiencies of the upper limb. another 61 of the lower limbs and 12 had combined defects of the limbs. The mothers had 5.6 (1-15) prenatal ultrasounds examinations. In 63% (n = 82) these were performed by the obstetric practitioners, in 30% in departments of obstetrics and 7% in a university hospital. In 5.2% only, the limb deficiency was diagnosed antenataly. CONCLUSION: If there are any unclear findings the women should be sent to a centre of prenatal diagnostics. In cases of congenital deficiencies of the limbs there is the possibility] for the parents to combined to combined consultation of the obstetrician, the human genetic and the orthopaedic to plan the treatment and talk about all consequences.
Thirteen patients with myelomeningocele who required operation for scoliosis were tested for changes in pulmonary function 1 month before and an average of 13 months after spinal stabilization. The average age at the time of operation was 12 years 11 months. Ten patients had restrictive changes in pulmonary function preoperatively. Owing to the severity of scoliosis, an anterior approach to the spine including resection of ribs and division of the diaphragm was necessary for eight children. Postoperatively, despite these procedures, eight patients had an increase in vital capacity and six patients had an increased forced expiratory volume in 1 s.
Medial aplasia of the spine is a rarely recognized malformation characterized by isolated absence of spinal segments, with vertebrae present cranially and caudally. We analyzed six patients and the five cases described in the relevant literature. The extent of defect ranges from one to 11 segments and leads to spinal instability with resulting kyphosis. All patients have a thoracic or high lumbar level of paralysis and, in varying degrees, typical contractures of hips, knees, and feet. The differentiation between medial aplasia of the spine and the syndrome of caudal regression is discussed.
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