[Electron microscopic analysis of the osmium-zinc-iodide method].
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Animals↗
Biomedical subjects
J Graf
Publications and source records attributed to J Graf.
An analysis of BET1, BET2, and BOS1. Three factors mediating ER to Golgi transport in yeast.
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Animals↗
[Diagnosis of coxitis fugax, the most frequent hip disease in childhood].
After a review of the history, clinical features, laboratory findings, imaging techniques and the treatment of coxitis fugax, the authors inform about 131 own cases. In this disease of the hip joint, which is most commonly encountered in childhood, differential diagnosis is of the utmost importance. In the present study, the initial diagnosis had to be changed in eleven cases affected with this condition, which is also referred to as "observation hip". The patients ultimately contracted severe diseases such as leukaemia, juvenile polyarthritis or Perthes' disease.
Anti-Inflammatory Agents↗
[Intra-articular oxygen partial pressure measurements under functional conditions].
Oxygen partial pressure is directly related to the vascularisation of different tissues. Different investigations in tissue (muscle, kidney, brain, heart, bone etc.) proved this correlation. The development of a special flexible microcatheter named Licox enables us to do measurements of intraarticular oxygen partial pressure under physiological and pathological conditions for the first time. The aim of this study was to examine the influence of different knee joint stresses on the intraarticular oxygen partial pressure under normal conditions and in osteoarthritis. The results showed that the different exercise patterns influence the intraarticular oxygen partial pressure. Patients with osteoarthritis showed a lower increase of the intraarticular oxygen partial pressure compared to the control group. This phenomenon is directly correlated to degree velocity of the isokinetic exercises. The same findings occur under ergometric conditions. The method permits functional, intraarticular in vivo measurements under different exercise patterns. For the very first time we were able to measure the influence of the joint movement on the intraarticular process of nutrition under physiological and pathological conditions. Different therapy concepts in osteoarthritis can be evaluated directly in vivo for the first time.
Adult↗
[Mechanism of action of hyaluronic acid in gonarthrosis of both knee joints in a right/left comparison. Study with dynamometry, oxygen partial pressure, temperature and Lequesne score].
In a controlled prospective randomized study we evaluated the effectiveness of intraarticular injected hyaluronic acid regarding the changes in the parameters dynamometry, synovial oxygen partial pressure, intraarticular temperature and the knee joint function (Lequesne score). We examined 18 patients with osteoarthritis in both knee joints (Kellgren classification II or III according to x-ray) in right/left comparison. The evaluated parameters were measured before and after a 5-week treatment phase with 5 intraarticular injections (one injection per week). With regard to the efficacy results changes in dynamometric measurement for flexion and extension (for all angular velocities) and Lequesne-score indicate a marked improvement after treatment with hyaluronic acid. The differences between treated and untreated knee were significant. In extension the p-value was 0.0008 and in flexion p = 0.0015. The p-value of the Lequesne-index between the verum and control group was p = 0.0002. After treatment values for oxygen pressure were higher than at baseline and for the intraarticular temperature a small decrease at the end of the treatment phase was documented. The intraarticular injection of hyaluronic acid is effective and safe in the treatment of patients with gonarthrosis. The treatment resulted in a functional improvement of the knee joint and had a good pain-lowering effect in patients suffering from gonarthrosis.
Aged↗
[The Holt-Oram syndrome. Review of the literature and current orthopedic treatment concepts].
PROBLEM: The clinical manifestation of the Holt-Oram-syndrome (HOS) shows congenital heart-disease and anomalies of the upper limb. The inheritance of this syndrome is autosomal dominant. The question arise, as to whether a contemporary orthopedic concept of treatment could developed based on own experiences and data from the literature. METHODS: We revised data from five patients with HOS treated at the Clinic for Orthopaedics of the University of Heidelberg. The review of the literature revealed a comprehensive and detailed picture of the clinical syndrome and, furthermore, information in respect to a comparative analysis of methods of treatments. RESULTS: Our patients showed characteristic cardiac anomalies, i.e. atrio and ventricular septal defects, and persisting Botall's duct (three cases). The types of malformation of the upper limb corresponded with those found in the literature. Furthermore the indication for amputation of rudimentary or hypoplastic fingers in the Heidelberg clinic was in accordance with the clinical treatments described worldwide. CONCLUSION: The type of treatment of the clubhand in cases with HOS depends on (1) the age and (2) the pattern and degree of accompanying malformations of the upper limb. For patients with aplasia of the thumb or amputation of a rudimental one we recommend pollicisation of the index finger to improve its function.
Child↗
[Exchange of endoprosthesis using a proximal femur resection prosthesis].
Total hip arthroplasty (THA) with the use of a Mega prosthesis was performed on 24 patients with significant loss of bone stock in revision THA. A clinical and radiological examination was carried out according to the Enneking evaluation scheme on average 7 years after THA. Pain, active hip motion and strength of hip muscles, walking ability, and activities of daily living rated excellent or good and compared well with the results following conventional THA. Limp and positive Trendelenburg sign were common to all except one after Mega prosthesis implantation and were independent on the type of refixation of the hip abductors. Dislocation of the prosthesis occurred in 16.6% of cases and depended on the type of cup implanted. Remarkable was a periprosthetic callus formation surrounding the stem of the femoral implant.
Aged↗
[Demonstration of the blood supply of human cruciate ligaments using the plastination method].
The blood supply of the attachment regions of the anterior and posterior cruciate ligament is demonstrated in 14 cadaver knees by the plastination method. Our findings demonstrate the blood supply by vessels of the synovium. The direct attachment to the bone is free of vessels. Anastomoses between the synovium and the periosteum could be found. In conclusion the surgical coverage of ligament reconstruction and of ligament transplantation by synovium is recommended when ever possible to permit the ingrowth of revascularisation vessels.
Adult↗
[Patellar hypertension syndrome--nomenclature, diagnosis and therapy].
PURPOSE: Complaints in the area of the patella have been abundantly described in the literature. However, a uniform nomenclature with regard to either diagnosis or therapy does not exist. METHODS: With the help of a standardized measuring method (intrapatellar pressure measurement and provocation test), it is possible to describe and classify patellar pain. An intrapatellar pressure increase over 25 mmHg and/or a positive provocation test defines the term of Patella Hypertension Syndrome. RESULTS: Within a prospective study we carried out a special intraosseous drilling in 20 cases with the typical symptoms of the Patella Hypertension Syndrome. The drilling, which was carried out via the Hoffa fat body from distal, resulted in a distinct alleviation of symptoms in all cases and even in a complete absence of pain in most cases. This phenomenon was objectified by a pressure-check-up after 6 weeks, 6 months and 1 year following the drilling. In all 20 cases so far examined a decrease of between 40-70% of the original pressure level was achieved. In all cases the postoperative artificial pressure increase (provocation test) of the intraosseous pressure did not lead to the typical pain symptoms. CONCLUSION: We therefore have a relatively minor operation at our disposal enabling us to achieve an impressive therapeutic success, in cases where conventional treatment was neither causal nor successful.
Adolescent↗
[Hyperphalangia in Pierre-Robin syndrome].
Pierre Robins syndrome associated with symmetric hyperphalangia of the index fingers is called Catel-Manzke syndrome. Connate radial deviation of the index fingers is caused by an odd bone. The deformity is demonstrated by two personal cases. The deviation is progressive and because of increasing functional limitation the operative correction of the index fingers at the age of 2-3 years is advised. Surgical technique and success of treatment are presented.
Child, Preschool↗
[Chondromalacia of the patella and intraosseous pressure. A study of 43 patients].
There are some hints concerning a relationship between the intraosseous pressure and degenerative changes in hyaline cartilage. With a specially constructed cannula we evaluated the intraosseous pressure in 43 patients in relation to the joint position (Extension/Flexion). In two groups we compared patients with and without degenerative changes in the hyaline cartilage, diagnosed by arthroscopy. Our results show, that patients with a chondromalacia have an increase of intramedullary pressure. These changes were discussed in the possible role of the pathology of chondromalacia patellae and retropatellar arthrosis.
Adult↗
[Transient hip joint inflammation (coxitis fugax)].
The transient coxitis is the most common hip disease in the childhood. Etiology is unknown. Questioning the history you will often find an infection in the neck, nose, ear area. Clinical, radiological findings and serological testing are unspecific. In the arthrosonography normally you will find an effusion. The positive diagnosis of the transient coxitis is only possible by observing the mostly benign course of the disease. The treatment is bed rest and non weight bearing. The most important differential diagnosis is the Perthes disease. The principal aspects of the transient coxitis are described and discussed in literature and by own experience.
Adolescent↗
[Intraosseous pressure measurement in Kienboeck's disease--initial findings].
Intraosseous pressure was measured under standardized and different functional conditions in 11 necrotic lunates in different stages of the disease and in 11 viable lunates. Both the viable and the necrotic lunates show a significant increase of the pressure, if the wrist is brought into dorsiflexion. Both groups do not differ significantly, but the mean value of the necrotic group exceeds that of the viable group clearly. There might have some technical problems in measuring. Venous stasis by tourniquet provoked increase of pressure, too. The increase of pressure both in dorsiflexion and in venous stasis is evidence of venous drainage. Dorsiflexion impairs the venous drainage of the lunate, which promotes necrosis. The increase of intraosseous pressure in necrotic lunates can be understood as a failure of the physiologic regulation of the intraosseous pressure by moving the wrist and cause of necrotic changes.
Humans↗
[Aortographic findings in children with myelomeningocele and lumbar kyphosis].
The findings in abdominal aortography performed preoperatively in 21 children with myelomeningocele (MMC), which underwent kyphectomy due to congenital kyphosis of the lumbar spine, are reported. In no case did the aorta follow the kyphotic radius of curvature. It rather seemed to be strung over the kyphosis like a tendon over a bow. An intraoperative lesion of the aorta seems rather unlikely, and this is why we believe, that a routinely performed preoperative abdominal aortography is not necessary. We found a remarkable number of anomalies of the intercostal and segmental arteries, which were only in part associated with deformities of the vertebral bodies. The kidneys seemed to be imbedded in the kyphotic concavity, partially with the inferior pole, partially in whole. In these cases the risk of intraoperative lesion seems higher. We found a number of cases with unilateral agenesis of the kidneys in the patients examined by us. Therefore we suggest the use of noninvasive methods prior to surgery in order to evaluate the presence of malpositions or malformations of the kidneys.
Abnormalities, Multiple↗
[A new punch technique of cartilage-bone tissue for morphological studies in orthopedics].
A new technique is presented for the analysis of tissues which allows an exact, detailed comparison of light and electron microscopy. For this purpose, the previous techniques required the cutting of tissue pieces from the original tissue compound and the preparation of drawings as a rough localisation of the tissue pieces removed for analysis. Due to the processes of cutting and drawing, only an approximate localisation of the tissue investigated by electron microscopy was practicable. Specifically, the exact analysis of fetal cartilage-bone-tissue was mostly not possible due to the complicate arrangement of both tissue components. Therefore, the assessment of electron microscopic analyses was severely limited. The new technique, presented in this study, is characterised by a removal of punches 1 mm in diameter from the original tissue for electron microscopy. The remaining tissue with its exact defined punch-punctures is prepared for standard histology. Thus, the specific advantage of this new method is the precise attribution of the punched tissue to the original tissue group. Human fetal cartilage-bone-tissue has been used to demonstrate this punch-technique and the specific light- and electron microscopic preparations.
Bone and Bones↗
[Definition of patellar chondropathy and patellar chondromalacia].
In the course of a review of the literature the definition, etiology, diagnosis and treatment of the disease entities chondropathy and patellar chondromalacia are compared. Without exception, the descriptions found are inconsistent and inaccurate. A new classification--chondromalacia, patellar and peripatellar syndrome--is proposed. Possible causes of these diseases in the subchrondral vascular system are mentioned explicitly ("patellar migraine", "patellar claudication").
Cartilage Diseases↗
[Effectiveness of intra-articular application of hyaluronic acid on early forms of femoropatellar arthrosis--an experimental study in dogs].
PURPOSE: We investigated the effects of intraarticularly applied hyaluronic acid on the cartilage-integrity with early-forms of retropatellar cartilage degeneration (chondromalacia patellae) in dogs. METHODS: We used the Pond-Nuki model (tenotomy and resection of the anterior cruciate ligament = ACL) in 27 dogs (foxhounds) (3 groups of 9 animals) PILOT STUDY: ACL-tenotomy and resection, no therapy, specimens retrieval after 3, 6, 12 weeks (3 animals each period). VERUM: ACL-tenotomy and resection, hyaluronic acid (start after 3, 6, 12 weeks), 5 injections in 4 weeks, specimens retrieval after 5 weeks following final injection (12, 15, 21 weeks postoperatively, 3 dogs each period). PLACEBO: same procedure as verum, but saline-injections. Specimens were taken from the medial/lateral patellar pole from both, the operated and the normal knee and examined histologically using various staining methods (HE, Azan, Toluidin, Masson-Goldner, Safranin-O). A modified Mankin score was used to grade cartilage degeneration. RESULTS: Our results demonstrate that the Pond-Nuki model is suitable to experimentally induce chondromalacia patellae. There were significantly less degenerative cartilage changes in the knees treated with hyaluronic acid compared to the placebo-group. CONCLUSION: Our results let assume that hyaluronic acid could be indicated i.e. after arthroscopically diagnosed early cartilage-degeneration, the final conclusions concerning the actual mechanisms and therapeutical effectiveness need however further prospective clinical and experimental investigations.
Animals↗
Cell volume regulation in liver.
The maintenance of liver cell volume in isotonic extracellular fluid requires the continuous supply of energy: sodium is extruded in exchange for potassium by the sodium/potassium ATPase, conductive potassium efflux creates a cell-negative membrane potential, which expelles chloride through conductive pathways. Thus, the various organic substances accumulated within the cell are osmotically counterbalanced in large part by the large difference of chloride concentration across the cell membrane. Impairment of energy supply leads to dissipation of ion gradients, depolarization and cell swelling. However, even in the presence of ouabain the liver cell can extrude ions by furosemide-sensitive transport in intracellular vesicles and subsequent exocytosis. In isotonic extracellular fluid cell swelling may follow an increase in extracellular potassium concentration, which impairs potassium efflux and depolarizes the cell membrane leading to chloride accumulation. Replacement of extracellular chloride with impermeable anions leads to cell shrinkage. During excessive sodium-coupled entry of amino acids and subsequent stimulation of sodium/potassium-ATPase by increase in intracellular sodium activity, an increase in cell volume is blunted by activation of potassium channels, which maintain cell membrane potential and allow for loss of cellular potassium. Cell swelling induced by exposure of liver cells to hypotonic extracellular fluid is followed by regulatory volume decrease (RVD), cell shrinkage induced by reexposure to isotonic perfusate is followed by regulatory volume increase (RVI). Available evidence suggests that RVD is accomplished by activation of potassium channels, hyperpolarization and subsequent extrusion of chloride along with potassium, and that RVI depends on the activation of sodium hydrogen ion exchange with subsequent activation of sodium/potassium-ATPase leading to the respective accumulation of potassium and bicarbonate. In addition, exposure of liver to anisotonic perfusates alters glycogen degradation, glycolysis and probably urea formation, which are enhanced by exposure to hypertonic perfusates and depressed by hypotonic perfusates.
Animals↗