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Biomedical subjects

D Kohn

Publications and source records attributed to D Kohn.

223 records · Page 13Linked to original sources
PubMedDate not supplied

Reconstruction of the anterior cruciate ligament. A new positioning and fixation technique.

A new technique for ACL reconstruction is presented. The middle third of the patellar tendon is anchored to the inner surface of the lateral femoral condyle under direct visual control. The transplant is fixed tibially beneath a bone block removed from the ventral tibial head. Thirty-three patients were evaluated preoperatively and 27 months (range, 24 to 30 months) postoperatively. The mean preoperative function score (Lysholm scoring scale) was 72 +/- 14 points; the mean postoperative score was 84 +/- 13 points. The Lachman test was positive for all patients preoperatively, but the test results in the postoperative follow-up examination were negative--1+ in 31 knees and 2+ in 2 knees. All 33 knees elicited a definite "hard" end point. The postoperative KT-1000 measurement for anterior tibial displacement showed no significant difference between the operated versus the unoperated knee. Before their knee injury all patients had been engaged in sports. At the follow-up examination, 13 patients had made a full return to their former sports activities, 13 were restricted in their sports activities, and 7 patients no longer participated in sports.

Adult↗
PubMedDate not supplied

Primary stability of interference screw fixation. Influence of screw diameter and insertion torque.

Interference screw fixation is frequently used in anterior cruciate ligament reconstruction with the bone-patellar tendon-bone graft. There have been no data available about the influence of screw diameter and insertion torque on primary stability. We designed a cadaveric study using paired knees to analyze the comparative effectiveness of 20-mm long screws of different diameters (9 mm versus 7 mm) and the significance of torque during screw insertion. Testing to failure was performed in a tensiometer with a crosshead speed of 200 mm/min. After slippage of a bone peg in the 7-mm screw specimens, the experiment was repeated in each specimen with a 9-mm screw fixation. Maximum tensile force was greater at the femoral insertion than at the tibial site. Results of refixations with 9-mm screws were only slightly inferior to the original 9-mm screw fixation specimens. Our results further showed that the torque can be used as a predictor of the stability of the bone block but cannot be used as an indicator for the strength of the reconstruction. The 7-mm screws are not recommended for tibial fixation. Failed 7-mm screw fixations can be replaced by 9-mm screws and refixations were successful in our study model.

Adult↗
PubMedDate not supplied

Sports injuries in team handball. A one-year prospective study of sixteen men's senior teams of a superior nonprofessional level.

One hundred eighty-six players of 16 teams in 2 male team handball senior divisions were observed prospectively for 1 season to study the injury incidence in relation to exposure in games and practices. Ninety-one injuries were recorded. Injury incidence was evaluated at 2.5 injuries per 1000 player-hours, with a significantly higher incidence in game injuries (14.3 injuries per 1000 game-hours) compared with practice injuries (0.6 injuries per 1000 practice-hours). Practice injury incidence was higher in the lower performance level group, and game injury incidence was higher in the high-level group. The upper extremity was involved in 37% of the injuries, and the lower extremity in 54%. The knee was the most commonly injured joint, followed by the finger, ankle, and shoulder. Knee injuries were the most severe injuries, and they were more frequent in high-level players. There was an increase in the severity of injury with respect to performance level. The injury mechanism revealed a high number of offensive injuries, one-third of them occurring during a counterattack. The injury pattern showed certain variations with respect to player position and performance level. Prophylactic equipment was used by a majority of players at the higher performance level.

Adult↗
PubMedDate not supplied

America speaks. Was anyone listening?

Town meetings are a uniquely American political device intended to allow citizens to have a voice in the course of the local or even national policymaking process. On January 14, 1992, Democratic members of the U.S. House of Representatives conducted 140 such meetings to discuss health care reform. While the discussions ranged from the ridiculous to the sublime, Americans made it clear that they are fed up with a current system that they believe costs too much and provides too little. But a key question remains: Who, if anyone, was listening? House Democrats appear determined to avoid specifics and to pin President Bush with an "anti-health" label. The strategy is a risky one; a riled up populace could well turn against those who convinced them to be concerned in the first place.

Attitude to Health↗
PubMedDate not supplied

Is preoperative fasting necessary?

The effects of fasting and of histamine (H2) antagonists on gastric volume and acidity were studied in 56 baboons undergoing various surgical procedures under general anesthesia and randomly allocated into 4 groups; group A--fasted for 14 hours; group B--given 100-120 ml of water 3 hours before surgery; groups C and D--also given 100-120 ml of water 3 hours before surgery; in addition, the former received cimetidine 10 mg/kg IM and the latter ranitidine 1.5 mg/kg IM 30-40 minutes before anesthesia. There were no significant differences between groups A and B with respect to the gastric volume and pH. Both ranitidine and cimetidine significantly (P < 0.02) reduced gastric volume and increased gastric pH. Thus, prolonged withholding of oral fluids does not reduce the gastric volume or increase gastric pH. H2-antagonists are effective in reducing both gastric residual volume and pH.

Animals↗
PubMedDate not supplied

[Ultrastructural findings of the muscles around lip clefts].

Our electron microscopic observations show alterations of the muscles near the cleft margins confirming the theory resulting from light microscopic and immunohistochemical findings that the myogenic structures surrounding cleft margins are inferior tissue that is capable neither of regeneration nor of normal function. The clinical implication derived from these observations is that the tissue in the vicinity of the clefts should be generously excised when doing cheiloplasties.

Cleft Lip↗