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Biomedical subjects

G Stutz

Publications and source records attributed to G Stutz.

18 recordsLinked to original sources
PubMed2007

The SLAP lesion as a reason for glenolabral cysts: a report of five cases and review of the literature.

INTRODUCTION: Cysts in the spinoglenoidal or supraglenoidal incisura can be a cause of compression of the suprascapular nerve. There is agglomerated appearance of these cysts in combination with SLAP lesions. Hypothesis is SLAP lesions can lead to cysts in this region and should be repaired. MATERIAL AND METHODS: MRI of five patients (all male, four 30-40 years, one 75 years) showed cysts in the supralabral region. All were in combination with lesions of the superior glenoidal labrum (Type II or more). RESULTS: In two cases, in addition to cyst resection, the SLAP lesion was also repaired and symptoms disappeared completely and no recurrent cyst was detected in postoperative MRI. Two patients without SLAP repair showed recurrent cystic formation in MRI with similar complaints compared to their preoperative status. One patient (75 years) was treated primarily by puncture and afterwards with open resection of the cyst. His outcome was good in terms of activities of daily living without major pain. CONCLUSIONS: Our results are based on the assumption that cysts in the region of the spinoglenoidal/supraglenoidal incisura can originate from SLAP lesions. If a patient is suspected of having cysts in this region, the question of a SLAP lesion should be clarified. SLAP lesions should be repaired to avoid relapse. Arthroscopic repair of SLAP lesion can lead to the disappearance of symptoms in younger patients. In older patients puncture or resection of the ganglion alone may be an adequate therapeutic strategy.

Adult↗
PubMed2006

[Knee ligament injuries].

Like no other joint of the human body the knee depends on intact ligaments. Knee instability due to ligament injuries will cause abnormal joint kinematics, and thereby is made responsible for secondary damage to other important knee joint structures. Diagnosis of knee ligament injuries is based on the detailed history with often typical injury patterns, as well as on the physical examination with specific knee ligament tests. In addition radiological evaluation is used. The range of knee ligament injuries is wide. Beginning with an isolated medial collateral ligament rupture which will heal with conservative treatment, they range to knee dislocation, a serious injury which needs emediate care and is associated with a high incidence of complications. Surgical procedures aim to reconstruct knee ligaments as anatomical as possible to provide for a long term stable knee joint.

Algorithms↗
PubMed2006

Tunnel placement in anterior cruciate ligament (ACL) reconstruction: quality control in a teaching hospital.

Correct placement of the femoral and tibial bone tunnels is decisive for a successful anterior cruciate ligament (ACL) reconstruction. Our method of tunnel placement was evaluated as part of quality control at a teaching hospital. The emphasis was placed mainly on investigating the influence of surgical experience on tunnel placement, and the effect of tunnel position on the clinical outcome. Seventeen surgeons with different levels of experience (between 0 and >150 ACL reconstructions) performed endoscopic ACL repair in uniform technique from August 2000 to August 2003 on 50 patients (18 women, 32 men, age range 18-43 years). The patients were available to clinical and radiological follow-up after an average of 19 months. The clinical outcome was classified according to the International Knee Documentation Committee (IKDC) standard evaluation form. The femoral tunnel was evaluated according to the quadrant method of Bernard and Hertel; the position of the tibial bone tunnel was assessed according to the criteria of Stäubli and Rauschnig. The IKDC score revealed 47 (94%) patients with a normal (A) or nearly normal (B) knee joint at follow-up. According to the quadrant method, the femoral canal was situated on average at 29% in the saggital plane. The tibial tunnel was situated on average at 43% of the a.p. diameter of the tibial condyle. Statistical analysis of our data showed no significant correlation between tunnel placement and surgical expertise. However, a highly significant correlation was found (alpha<0.01) between the femoral position of the tunnel in the sagittal plane and the IKDC score. The more anterior the femoral canal, the poorer the IKDC score. The method of tunnel placement in ACL reconstruction being investigated here only showed slight dependence on surgical experience, whereby good short-term clinical outcomes were achieved. Therefore, the method is suitable for application at a teaching hospital. A far too anterior femoral tunnel placement will probably lead to a decline in the clinical result.

Adult↗
PubMed2004

An inelastic X-ray scattering spectrometer at LNLS.

A high-resolution spectrometer aimed at performing experiments of inelastic X-ray scattering by electronic excitations is described. The spectrometer has been installed at the D12A-XRD1 beamline of the National Synchrotron Light Laboratory (LNLS), in Campinas, Brazil. Synchrotron radiation is monochromated to about 6 keV and focused horizontally onto the sample by a sagittally focusing Si(111) double-crystal monochromator in non-dispersive setting. The spectrometer operates in Rowland circle geometry and is based on a focusing Si(333) analyser in near-backdiffraction geometry for energy analysis of inelastically scattered photons. The analyser works at a fixed Bragg angle, so energy transfers are obtained by varying the incident photon energy. A relative energy resolution of the whole spectrometer of approximately 1.5 x 10(-4) at 5.93 keV has been achieved. As an example of application, inelastic X-ray scattering by plasmon excitation in polycrystalline Be was measured. Test results demonstrate that inelastic X-ray scattering experiments with eV energy resolution and an acceptable counting rate are feasible at the LNLS when focused on plasmon and particle-hole excitations.

Journal Article↗
PubMed2001

[Diagnosis and stage-related therapy of joint infections].

BACKGROUND: Our management of septic arthritis is a combination of a stage-related arthroscopic irrigation, debridement and antibiotic therapy. At the start of therapy x-rays of the infected joint, leukocyte rate with differentiation and C-reactive protein level are necessary and aspiration of the joint should be performed for gram strain and crystal analysis. Additional imaging and laboratory tests can be needed for special indications. An arthroscopic staging of the initial joint infection has been shown to have prognostic and therapeutic consequences. Antibiotic therapy should start after aspirates and biopsy specimen have been taken intraoperatively and has to be adapted to the final results of the microbiology. Overall, antibiotic therapy is necessary for a period of 4-6 weeks, unless clinical findings and laboratory tests have returned to normal. A transition to oral administration of antibiotics is possible prior to patient release. INTRAOPERATIVE TREATMENT: Intraoperatively, the synovial membrane should be left intact. There is no indication for the intra-articular use of antibiotics and antiseptics. Wound drains are not necessary. If symptoms of infection persist under antibiotic therapy, arthroscopic irrigation can be repeated with good results.

Anti-Bacterial Agents↗
PubMed2000

Arthroscopic management of septic arthritis: stages of infection and results.

Seventy-six patients with septic arthritis (78 affected joints) were treated with a combination of arthroscopic irrigation, debridement, and antibiotic therapy according to the tested bacterial sensitivity. There were 62 knee, 10 shoulder, 5 ankle joints, and 1 hip joint. No antibiotics were added to the irrigating solution. The arthroscopic and radiological stage of infection, treatment, and outcome in these patients was analyzed. The patients were classified into three groups according to initial stage of joint infection (stage I: 21 patients, 22 joints; stage II: 43 patients, 44 joints; stage III: 12 patients, 12 joints). Causes of infection were: hematogenous dissemination in 54%, postoperative wound infection in 28% (17% after open, 11% after arthroscopic procedures). Other causes were: 10% intra-articular steroid injections, 3% diagnostic punctures, and 3% open traumatic injury of the joint. In 78% of the infected joints the causative organism could be identified: Staphylococcus aureus was the most common organism found (42%), followed by streptococci (15%), pneumococci (6%), Escherichia coli (4%), Staphylococcus epidermidis (3%), Borrelia burgdorferi (3%), and others in 5%. In the stage I group only one patient needed repeated arthroscopic irrigation, in the stage II group 52%, and in the stage III group 75%. Open revision for eradication of the infection was necessary in one joint with stage II and in two joints with stage III infection (3%). Two joints of the stage III group needed additional surgery after successful treatment of the infection. The combination of arthroscopic irrigation and systemic antibiotic therapy was able to cure 91% of the affected joints. Open revision was necessary in 4% of joints. The number of arthroscopic procedures and the efficacy of treatment depended on the initial stage of the infection. It is concluded that an arthroscopic staging of the initial joint infection has prognostic and therapeutic consequences.

Adolescent↗
PubMed2000

Arthroscopic findings in acute fractures of the ankle.

We have evaluated prospectively the arthroscopic findings in acute fractures of the ankle in 288 consecutive patients (148 men and 140 women) with a mean age of 45.6 years. According to the AO-Danis-Weber classification there were 14 type-A fractures, 198 type B and 76 type C. Lesions of the cartilage were found in 228 ankles (79.2%), more often on the talus (69.4%) than on the distal tibia (45.8%), the fibula (45.1%), or the medial malleolus (41.3%). There were more lesions in men than in women and in general they were more severe in men (p < 0.05). They also tended to be worse in patients under 30 years and in those over 60 years of age. The frequency and severity of the lesions increased from type-B to type-C fractures (p < 0.05). Within each type of fracture the lesions increased from subgroups 1 to 3 (p < 0.05). The anterior tibiofibular ligament was injured with increased frequency from type-B.1 to type-C3 fractures (p < 0.05), but it was not torn in all cases. While lateral ligamentous injuries were seen more often in type-B than in type-C fractures (p < 0.05), no difference was noted in the frequency of deltoid ligamentous lesions. Our findings show that arthroscopy is useful in identifying associated intra-articular lesions in acute fractures of the ankle.

Acute Disease↗
PubMed1996

Comparison of augmented and non-augmented anterior cruciate ligament reconstruction combined with high tibial osteotomy.

In a follow-up study 27 patients were evaluated after anterior cruciate ligament (ACL-)reconstruction combined with high tibial osteotomy because of chronic rupture of the ACL, cartilaginous lesions of the medial compartment and varus malalignment. They were divided into two groups. In 14 patients (non-LAD group) ACL reconstruction was performed using the central third of the autologous patellar tendon modified according to Eriksson-Trillat. Thirteen patients (LAD group) underwent repair with the same technique, but a Kennedy ligament augmentation device (LAD) in "hot dog' technique and fixed over the top was added. The postoperative treatment was the same in both groups. All patients were examined according to IKDC criteria. KT-1000 arthrometer testing at maximum manual traction was performed. Although the mean follow-up interval was more than double in the non-LAD group (non-LAD: 127 months vs LAD: 58 months), the subjective and clinical results, IKDC evaluation and KT-1000 arthrometer testing results were similar, showing no statistically significant difference. Further, no complications due to the use of LAD occurred. In this study no evident functional or clinical advantage from the augmentation performed could be shown.

Activities of Daily Living↗
PubMed1995

Anterior cruciate ligament reconstruction combined with valgus tibial osteotomy (combined procedure).

We assessed the patients who were operated on in a combined procedure from 1980 to 1992 with anterior cruciate ligament (ACL) insufficiency, cartilaginous lesions of the medial compartment, lesion of medial meniscus and varus malalignment. The combined operative procedure was autologous intra-articular ACL reconstruction with the middle third of the patellar ligament--partially augmented with Kennedy-ligament augmentation device (LAD) in hot dog technique--and high tibial osteotomy. The patients were examined according to the criteria of IKDC including testing of anterior stability with the KT-1000 arthrometer. Radiographically we checked axis and arthritis according to a modified score of Kannus. Twenty-seven of 34 patients who fulfilled the inclusion criteria could be followed up in three categories (2-5 years post-operatively, 5-10 years postoperatively, over 10 years post-operatively). Total qualification was good in 37%; there were no perioperative complications. Rehabilitation was not prolonged. Eighty-nine percent practised their preoperative job, over 50% had a higher level of sports activities than preoperatively, and more than 25% regained their pretraumatic sports capacity. Two-thirds had no giving way and less than 3 mm translation difference in comparison to the contralateral knee. Seventy-five percent of patients would accept the operation again. Radiological findings had no correlation to overall qualification. The encouraging results with respect to many of the criteria suggest using the combined procedure in a young patient with ACL insufficiency, varus malalignment and medial compartment damage including medial meniscus lesion.

Adult↗
PubMed1981

Alcohol-induced decrease in uroporphyrinogen decarboxylase activity in rat liver and spleen.

Chronic alcohol consumption in rats leads to a decrease in uroporphyrinogen decarboxylase activity in liver and spleen, associated with a pathologic porphyrinuria. These findings show the toxic effect of alcohol in the biochemical pathogenesis of chronic hepatic porphyria. The results confirm experimentally the transition of symptomatic coproporphyrinuria to chronic hepatic porphyria as observed in man, and the progression of biochemical phases of chronic hepatic prophyria into the clinical phase, i.e., the development from latent to manifest stages under chronic alcohol ingestion.

Alcoholism↗
PubMed1978

[Clinical aspects of alcohol induced liver injury (author's transl)].

Chronic alcohol consumption results in early biochemical and ultrastructural alterations of the hepatocyte which in turn may lead to alcoholic fatty liver as well as alcoholic hepatitis and via the central hyaline sclerosis to fibrosis and cirrhosis of the liver. Already at the stage of the alcoholic fatty liver an isolated increase of serum gamma-glutamyltransferase activity can often be observed; it results from hepatic microsomal enzyme induction and may facilitate early recognition of alcoholic liver injury. To establish the diagnosis, however, a histological examination of the liver is necessary. The therapy of alcohol-induced liver injury is based upon an absolute alcohol abstinence since alcohol itself or one of its metabolites are hepatotoxic.

Albumins↗
PubMedDate not supplied

Functional activity of mouse sperm was not affected by low doses of aspirin-like drugs.

To investigate some possible effects of low doses of nonsteroidal anti-inflammatory drugs upon functional activity of mouse sperm, the authors injected lysine acetyl salicylate (im 14.3 mg/kg day(-1), ibuprofen (ip 5.6 mg/kg day(-1)), or piroxicam (ip 0.28 mg/kg day(-1) to pregnant females (the male cohort was sacrificed at adulthood) (A) or to adult males during 35 (B) or 60 (C) days. Parameters measured were motility, viability, acrosomal integrity, responses to hypoosmotic shock, in vitro fertilization index, and testosterone plasma levels. Salicylate evoked a slight reduction in the percentage of swollen gametes in A, and ibuprofen diminished testosterone plasma levels in B. The other parameters remained unchanged in all groups. Results are well supported by the low doses assayed, which are equivalent to the content of one tablet commercially available for each compound.

Animals↗
PubMedDate not supplied

Influence of pentoxifylline on sperm membrane functional integrity.

In epididymal mouse spermatozoa, the effects of dibutyryl cyclic adenosine monophosphate 1 mmol/L (dbcAMP), pentoxifylline 5 mmol/L (PX), and/or mastoparan 50 mumol/L (MT) were evaluated for the following parameters: percentage of motile cells and response to hypoosmotic shock (HOS). The gametes were incubated during 80 min (A) or 200 min (B) in Tyrode's medium, and the drugs were added during the last 20 min. In A, dbcAMP + PX (61.5 +/- 5.4%; n = 10) enhanced and MT decreased significantly the population of motile cells (13.4 +/- 5.4%; n = 6) (control: 47.6 +/- 3.9%; n = 11). In B, PX significantly increased this parameter and MT plus PX also exerted a significant detrimental effect. Responses to HOS dropped significantly in the presence of PX + MT in A or in B; in this latter condition a similar decrease was evoked by MT alone. A positive correlation between percentages of swollen and motile spermatozoa was detected in A or in B in samples incubated with PX (r = .58, n = 11 and r = .76, n = 10; p < .05, respectively). These results that support that, in mouse sperm tail, PX would preserve functional membrane integrity, a relevant condition for adequate motility.

Animals↗