Plasmodium inui-like infection producing a presumably fatal illness in a leaf monkey Presbytis johnii--a previously undescribed host.
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Biomedical subjects
Publications and source records attributed to J M Strauss.
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We evaluated 48 patients arthroscopically treated for calcific tendinitis. All patients' were treated by removal of the calcific deposit whenever possible and resection of the coracoacromial ligament. Those cases showing evidence of subacromial stenosis by x-ray evaluation or intraoperative findings were treated with an arthroscopic arcromioplasty during the same procedure. For postoperative functional assessment we used the Constant score. After surgery the Constant score significantly improved. All patients who were treated by acromioplasty showed significant flattening of the bony configuration of the acromion. The x-ray review showed that none of the blurred calcific deposits regained sharper borders after operation and also that no transparent deposit was converted into a denser appearance after the procedure. Those patients with postoperative elimination or reduction of the calcific deposits had significantly better outcomes than those who had no radiographic change. Acromioplasty did not improve the results. The aim of arthroscopic treatment in calcific tendinitis is to remove the calcific deposit.
In 148 patients with impingement lesion type I or type II, we performed an arthroscopic subacromial decompression (ASD). 122 patients ran a follow up one to three years post-operatively. All patients were pre- and postoperatively documented by a 100 point shoulder score. The mean score was 57.9 (+/- 11.5) preoperatively. Postoperatively there was a significant increase to 80.7 (+/- 17.9) (p < 0.05). 15% of the patients with a postoperative score less than 70 points were determined as failures. Patients with a preoperative pain history of more than one year had a significantly worse result (79.1 +/- 8.4) compared to those patients with a preoperative course less than one year (88.8 +/- 11.6) (p < 0.05). Other significant factors were the patient's age, and calcific tendinitis, whereas sex, preoperative range of motion, muscle atrophy, and degeneration of the acromioclavicular joint did not significantly influence the result. Our results after ASD in patients with subacromial pathology without a rupture of the rotator cuff are encouraging. Therefore, ASD seems to be a reasonable alternative to open acromioplasty.
UNLABELLED: Based on the results of a retrospective study of 50 patients with mild lateral tracking and lateral compression of the patella (32 patients) and recurrent patellofemoral dislocation (18 patients), we present the technique, the results, the complications and the indications for the endoscopic lateral retinacular release and medial drawing tight of the capsule. The average age of the patients was 28.8 years (range: 10-53). At time of follow-up (m = 51 months) the patients were examined clinically as well as radiologically. The results were scored according to a score by Crosby and Insall. 73% of the patients with mild lateral tracking and lateral compression (lateral release) were satisfied with the operative results (visual analogue scale), as well as 66.6% of the patients with recurrent patellofemoral dislocation (lateral release and medial drawing tight of the capsule). Only 40% of the patients with patellofemoral arthritis (lateral release) reported about an improvement of this procedure. The score showed significantly good results but didn't raise the differences in between the groups of different indications. 28% of the patients showed an abnormal lateral tracking of the patella in active motion, the passive patella-glide-test (Hughston) raised a patella-hypermobility to the lateral side in 36% of the cases and to the medial side in 76%. X-rays of both knees showed an increased lateral patellofemoral angle of 10.8 degrees and an increased sulcus angle of 144 degrees. There was no progression in osteoarthritis in the operated side of the patellofemoral joint found. Complications revealed in a high number of hemarthrosis right after the operation, in 2 cases an open revision was necessary. CLINICAL RELEVANCE: According to our results patients with patella compression syndrome without patellofemoral arthritis and patients with recurrent luxation or subluxation of the patella are good candidates for endoscopic lateral release and eventually medial drawing tight of the capsule. In a young population the endoscopic lateral release is a relatively simple surgical procedure making an open technique in failed cases possible.
X-rays were reviewed after callus distractions (50 cases) and distraction epiphysiolysis (10 cases) in 45 patients. With the aid of a computerized digitization system for analogue films, the relative x-ray density of the distraction area was determined in the medial, lateral, ventral and dorsal surface areas, and in the median line of the callus tissue. Bone formation became evident within 21.7 +/- 3.7 days post-distraction in the thigh and 25.4 +/- 4.9 days in the shank. The lowest density values were found at the end of the distraction phase followed by a continual increase in x-ray density in the fixation phase. There was a significant decrease in callus x-ray density in the shank from lateral to medial and from dorsal to ventral, and in the thigh from medial to lateral and from dorsal to ventral. When the corticotomized callus distraction is compared to the distraction epiphysiolysis without corticotomy it becomes apparent that the differences between lateral-medial x-ray densities and dorsal-ventral x-ray densities were significantly greater in the group with callus distraction. The deminished bone formation in the ventromedial area of the shank and the ventrolateral area of the thigh seems to be due to soft tissue damage and disturbances in local bone blood supply after the operative approach for corticotomy.
Based on results of anatomical studies, we established an arthroscopic procedure to resect all degenerative changes within the joint without endangering the stabilizing structures. Since November 1989 we operated on 26 patients with this technique. There were no major complications. The mean score significantly increased from 64.9 (+/- 12.8) to 86.8 (+/- 11.5). Analysis of postoperative x rays revealed an average length of resection of 21.3 mm at the inferior border of the clavicle, of 15.4 mm in the middle, and of 10.2 mm at the superior border of the clavicle. 21 out of 26 patients were completely satisfied and would undergo the same procedure again. In two of the five unsatisfied patients the resected length of the clavicle was insufficient and these patients required open surgery for resection of the remaining bone. Our first experiences are encouraging. The surgical technique is standardized and reproducible. The short time results score not worse compared to the open conventional technique. With the 2 to 4 year long term follow up we have to prove, whether maintaining the passive stabilizers of the joint improves the long term results better than the open technique.