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Biomedical subjects

C Gerber

Publications and source records attributed to C Gerber.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Surgical treatment concepts in soft tissue tumors of the locomotor system].

Soft tissue tumors of the extremities require a definitive histopathological diagnosis and adequate treatment unless they are known to have been present for years without any clinical change. For lesions with a straightforward clinical diagnosis (ganglion of the wrist) and for superficial tumors smaller than 3 cm, excisional biopsy is adequate. For all other lesions an open incisional biopsy should be performed. If the lesion is potentially malignant, all the appropriate staging studies must be performed before biopsy; if the tumor has been biopsied without prior staging and unexpectedly reveals a malignant lesion, complete staging must be performed before definitive surgery is undertaken. Soft tissue sarcomas extend rapidly within the tissue of the compartment they originated in, but tend to respect compartmental boundaries. Radical resection of the entire compartment containing the sarcoma is thus the surgical treatment of choice. Adjuvant radio- and/or chemotherapy are necessary in the majority of these cases and should be integrated into the treatment strategy.

Biopsy↗
PubMed1988

[Critical study of the repair of the anterior cruciate ligament of the knee using a pediculated flap to the Hoffa pad taken from the middle 3d of the patellar tendon. 50 surgical knees with a 2-to-4-year follow-up].

A reconstruction of the anterior cruciate ligament of the knee has been devised on the anatomical principle of an intra-articular flap taken from the middle third of the patellar tendon and based on the sub-patellar fat pad. Fifty knees have been treated and assessed after a follow-up of two to four years to provide a critical analysis of the method. The technique of the operation is described in detail in relation to the isometric reconstruction of the course of the anterior cruciate ligament. With a mean follow-up of 33 months (minimum 24 and maximum 48 months), 98 per cent of the patients had a good result as regards stability together with a good anatomical result, with complete or almost complete elimination of the anterior drawer sign and the jerk test in 96 per cent. The subjective result described by the patient was good in 92 per cent but only 54 per cent returned to the same sporting activity. The main problem encountered with this method was loss of 10 degrees of extension in 40 per cent of patients and loss of more than 10 degrees in 22 per cent. This loss of extension arose on the one hand from an impingement of the fatty pedicle in a narrow intercondylar notch and on the other from an associated postero-lateral laxity which resulted in an intra-articular transplant which was too short despite its anatomical attachments. The pedicled transplant has not given better results than free transplants and has given rise to additional iatrogenic problems even with a meticulous operative technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1988

Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report.

Symptomatic irrepairable rotator cuff tears usually entail complete loss of the substance of the supraspinatus and infraspinatus tendons. Loss of external rotation control and cranial migration of the humeral head on attempted flexion or abduction of the shoulder are the functional hallmarks. Transfer of the latissimus dorsi tendon from the humeral shaft to the superolateral humeral head provides a large, vascularized tendon that can be used to close a massive cuff defect and that exerts an external rotation and head-depressing moment that allow more effective action of the deltoid muscle. This procedure was carried out in 14 patients without any significant complications. Pain relief and functional results in those four cases with a minimum follow-up period of one year (average, 14 months) compared favorably with alternative treatment methods and warrant further anatomic, electromyographic, and clinical investigation.

Adult↗
PubMed1987

Images of a lipid bilayer at molecular resolution by scanning tunneling microscopy.

The molecular structure of a fatty acid bilayer has been recorded with a scanning tunneling microscope operating in air. The molecular film, a bilayer of cadmium icosanoate (arachidate), was deposited onto a graphite substrate by the Langmuir-Blodgett technique. The packing of the lipid film was found to be partially ordered. Along one axis of the triclinic unit cell the intermolecular distance varied randomly around a mean of 5.84 A with a SD of 0.24 A. Along the other axis the mean distance was 4.1 A and appeared to vary monotonically over several intermolecular distances, indicating that a superstructure of longer range may exist. The molecular density was one molecular per 19.4 A2. The surprising ability of the scanning tunneling microscope to image the individual molecular chains demonstrates that electrons from the graphite can be transferred along the molecular chains for a distance of 50 A.

Arachidonic Acid↗
PubMed1987

[Diaphyseal resection and reconstruction in cases of tumors involving the long bones of the extremities. Apropos of 23 cases].

An analysis has been made of the records of 23 cases of resection-reconstruction of the shafts of long bones for a variety of tumours of bone. Four were in the humerus, four in the forearm bones, five in the femur and ten in the tibia. The reconstructed bone was stabilised by an intramedullary nail in thirteen cases and by a plate or blade-plate in five cases. In five cases, the grafts were simply held by screws. The bone was reconstructed by an autograft in thirteen cases and by allograft in ten cases, four of which were combined with an autograft. Resections in the upper limb gave rise to few complications. Conversely, reconstructions in the lower limbs, particularly of the tibia, were associated with a significant number of complications because of infection and delayed union. The best fixation, when it was technically possible, was an intramedullary nail surrounded by autografts. Allografts, and the vascularised fibular graft, were very liable to secondary fatigue fracture. A combination of autograft and allograft needs to be considered if a sufficient quantity of autograft is not available.

Bone Neoplasms↗
PubMed1987

The subcoracoid space. An anatomic study.

Soft tissue impingement under the coracoid process has recently been identified as a cause of painful shoulder disability. In this study the normal space between the humeral head and the coracoid process in two functional positions of the arm was measured in an attempt to delineate anatomic risk factors predisposing to subcoracoid impingement. Forty-seven normal shoulders were studied by computerized tomography (CT) in adduction, 20 additionally in forward flexion/internal rotation, which is the position most frequently causing subcoracoid impingement. The distance between the humeral head and the coracoid tip averaged 8.7 mm for the adducted arm and 6.8 mm for the flexed arm. Modifications of the coracohumeral relationship were found to affect the subcoracoid clearance roughly 1.5 times more in flexion than with arm at the side. Subcoracoid impingement appeared particularly likely during forward flexion of a shoulder with a coracoid tip close to the scapular neck and projecting far laterally.

Adult↗
PubMed1987

Glenoplasty for recurrent posterior shoulder instability. An anatomic reappraisal.

Posterior glenoplasty, as performed for the treatment of recurrent posterior shoulder instability, was shown to thrust the humeral head forward and was able to cause symptomatic impingement of the anterior cuff between the coracoid process and the humeral head. Such subcoracoid impingement is relieved by resection of the inferolateral part of the coracoid tip and of the coracoacromial ligament.

Adult↗
PubMed1986

Altered skeletal muscle ultrastructure in renal transplant patients on prednisone.

Treatment with glucocorticoids causes wasting of proximal skeletal muscles. The purpose of the present investigation was to quantify in the thigh muscle the areas of the different fiber types determined by histochemical methods, and the muscle ultrastructure by means of electron microscopy, in normal subjects (N = 41) and in renal transplant patients treated with prednisone (N = 12). The cross-sectional area of all three fiber types was reduced in renal transplant patients treated with prednisone (10.6 +/- 4.3 mg/day), the fast glycolytic fibers being most affected (slow oxidative fibers: 2642 +/- 625 vs. 3677 +/- 970 micron2, P less than 0.001; fast oxidative fibers: 3275 +/- 735 vs. 4443 +/- 1343 micron2, P less than 0.01; fast glycolytic fibers: 2305 +/- 802 vs. 3920 +/- 1522 micron2, P less than 0.001). This was mostly due to a decrease in the volume of myofibrils per unit volume of muscle fiber (-30%). The intracellular lipid content and the volume density of subsarcolemmal mitochondria were increased by more than 70% in prednisone treated patients. In conclusion, the decreased myofibril areas might account for the muscle weakness in renal transplant patients treated with prednisone, and the decrease in myofibrils is in part functionally compensated by an increase in subsarcolemmal mitochondria and intracellular lipid content.

Adult↗
PubMed1986

Specificity of leg power changes to velocities used in bicycle endurance training.

Increases in leg power production resulting from 8 wk of bicycle endurance training (30 min/day, 5 times/wk) were studied using an isokinetic dynamometer. In addition, biopsies of vastus lateralis were analyzed to characterize muscle ultrastructural changes. Performance increased on the dynamometer specifically near the estimated average knee angular velocity used during the bicycle training (200 degrees/s). Power measurements were made during the first 5 contractions (maximal power: Pmax) and last 5 contractions (final power: Pend) of 25 and 50 consecutive contractions (at 60 and 240 degrees/s, respectively). Pmax and Pend increased only at 240 degrees/s but not at 60 degrees/s. These increases in Pmax (86 W) and Pend (78 W) resulted primarily from longer torque maintenance but also from increased peak torque during each contraction and were close to the increase in mechanical power output maintained on the bicycle (Pb; 78 W) during the training sessions. The specificity of these changes to the angular velocities used in the bicycle training indicates a neural basis to these adaptations. We suggest that these neural adaptations, coupled with the observed enhancement of muscle mitochondrial and capillary density (+41 and +15%, respectively) underlie the increased ability to maintain power production on a bicycle after endurance training.

Adult↗
PubMed1985

The role of the coracoid process in the chronic impingement syndrome.

Symptomatic impingement of the rotator cuff between the humeral head and the coracoid process has been studied and three varieties recognised: idiopathic, iatrogenic and traumatic. In all three the clinical findings consisted of pain in front of the shoulder, referred to the upper arm and forearm, and especially felt during forward flexion and medial rotation; the pain could be reproduced by medial rotation with the arm in 90 degrees of abduction, or by adduction with the shoulder flexed to 90 degrees. Patients were relieved of their symptoms by restoring adequate subcoracoid clearance.

Adult↗
PubMed1985

The lower-extremity musculature in chronic symptomatic instability of the anterior cruciate ligament.

We studied the musculature of the lower extremity in forty-one patients with chronic symptomatic instability of the anterior cruciate ligament. Computed tomographic and clinical measurements of the limb were taken at levels fifteen and twenty-five centimeters proximal to the medial joint line and ten centimeters distal to it. Biopsy specimens from the vastus lateralis of both lower extremities were analyzed by histochemistry and electron microscopy. Computed tomography revealed a decrease in the muscle square area of the affected thigh of 8 per cent as compared with the control lower extremity. There was quadriceps atrophy of 10 per cent and hamstrings atrophy of only 4 per cent. The atrophy of the vastus medialis was significantly greater than that of the entire quadriceps. Histochemistry revealed a similar decrease in fiber size for all fiber types, and hence no shift in fiber type. Electron microscopy showed an increase in intracellular fat but no change in mitochondrial volume density or capillarization.

Adolescent↗