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Biomedical subjects

D Kohn

Publications and source records attributed to D Kohn.

At least 145 records · Page 8Linked to original sources

Thrombotic thrombocytopenic purpura with a subacute course: remission after steroids and high-dose plasma exchange.

A case of thrombotic thrombocytopenic purpura with an unusual subacute course is described. Treatment was initiated after the patient had been ill for four weeks. Low-dose plasma exchange (10 ml/kg body weight per day) was associated with a sharp drop in the reticulocyte count and a transient reduction of lactate dehydrogenase activity to within the normal range. The administration of corticosteroids was followed immediately by the disappearance of neurological symptoms, and after high-dose plasma exchange (25 ml/kg body weight per day) all the symptoms of disease remitted. The remission has lasted for 10 months; we suggest that each of the therapeutic measures employed played a role.

Adrenal Cortex Hormones

Iron loading and endocrine functions in nontransfused patients with beta-thalassemia intermedia or sickle-cell thalassemia.

Body iron stores and endocrine functions were determined in eight patients with chronic hemolytic anemia who had received only small amounts of blood and no iron preparations. Four patients had beta-thalassemia intermedia (BTI) and four had sickle-cell thalassemia (SCT). Hemoglobin levels and degrees of hemolysis were similar in both groups of patients. The patients with BTI showed clear evidence of iron overload, whereas there was no evidence of iron accumulation in the patients with SCT. The three patients with BTI who had endocrinologic evaluations showed endocrine dysfunctions. Two patients with SCT had no endocrine abnormalities and the other two probably had some degree of primary hypogonadism. Iron overload in patients with thalassemia probably results from excessive intestinal iron absorption and can damage various parenchymal and endocrine organs, even in the absence of an external source of iron.

Adult

Semiquantitative cytochemical estimation of beta-glucuronidase activity in peripheral lymphocytes in healthy human subjects.

A semiquantitative cytochemical evaluation of beta-glucuronidase activity in peripheral lymphocytes in 123 normal sybjects was made. It was found that the enzymatic activity was influenced by age but not by sex. Activity was weak in newborn infants but increased with age and reached maximal values in old subjects. Age should therefore be taken into consideration when the enzyme activity is evaluated.

Adolescent

Preoperative ultrasonographic mapping of calcium deposits facilitates localization during arthroscopic surgery for calcifying tendinitis of the rotator cuff.

Calcifying tendinitis is a relatively common disorder of the rotator cuff. For symptomatic patients, excision of the calcium deposits offers reliable pain relief. The arthroscopic technique is demanding. Arthroscopic localization of the deposit is frequently demanding. The technique described in this article facilitates the localization of calcium deposits based on preoperative ultrasonography. Knowing the exact topography of the deposit relative to the visible landmarks allows the surgeon to localize the site of the deposit from the intra-articular view. Probing the rotator cuff with a spinal needle and looking for calcific material at the tip of the needle is an important step in verifying the location of the deposit.

Arthroscopy

Benign giant-cell tumor of the patellar ligament.

We report the symptoms, clinical findings, and treatment of a patient with an extra-articular benign giant-cell tumor of the patellar ligament. Between the years 1966 and 1996 no similar case has been found to be documented by a Medline search. On palpation, a soft, mobile lesion, the size of a pigeon's egg, was felt in the lateral region of the patellar ligament. There was no set of laboratory values to determine the diagnosis. In addition, there were no typical findings in diagnostic imaging procedures and it seems that the most important fact is that the clinician is aware of this type of synovial tumor. A clear diagnosis is only possible by means of a pathological investigation. The choice of therapy for giant-cell tumors is local excision. Arthroscopy is recommended exclusively for the diagnosis and therapy of a localized intra-articular giant-cell tumor.

Adult

[Significance of the hypoechoic area around the long biceps tendon in shoulder sonography--underlying pathology].

OBJECTIVE: The objective was to evaluate the sonographic sign of a hypoechoic area ("halo-sign") around the long biceps tendon as an equivalent of intraarticular effusion. METHODS: Part 1: Ten patients scheduled for shoulder arthroscopy underwent ultrasonography immediately before surgery. If there was no hypoechoic area around the long biceps tendon 30 ml of NaCl-solution (0.9%) were injected into the joint. After repetitive passive motion the patient underwent a second ultrasonography. Part 2: Ten consecutive patients with a hypoechoic area around the long biceps tendon underwent shoulder arthroscopy. During this procedure they were examined for intraarticular effusion. Patients with rheumatoid disease were excluded from the study. RESULTS: Part 1: In 9 of 10 patients a hypoechoic area around the long biceps tendon was induced by injection into the joint. The area was 1.07 +/- 0.13 cm2. In one case we could not induce the described phenomenon. Part 2: In all patients with a hypoechoic area around the long biceps tendon an intraarticular effusion was found at arthroscopy. CONCLUSION: A hypoechoic area around the long biceps tendon correlates with fluid in the synovial sheet and indicates effusion within the glenohumeral joint.

Arthroscopy