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Biomedical subjects

J Petermann

Publications and source records attributed to J Petermann.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Rupture of the anterior cruciate ligament in the athlete].

Athletic trauma is the main cause for rupture of the anterior cruciate ligament (ACL). In order to regain joint stability and return to unrestricted sports activities operative management is indicated. The patella tendon autograft with bone plugs on each end is presently the most commonly used graft to reconstruct the ACL. The concept of synthetic augmentation was developed for protection of the biological tissue during revascularization and remodeling. We use as augmentation device the TETRA-L3, which is a 3-mm-wide and 1-mm-thick Trevira braid. The function of the composite graft, which is sufficiently strong to allow early stress, is based on the principle of load-sharing. Isometric placement of the graft without impingement is achieved by using the miniarthrotomy technique and specially designed drill guides. Graft fixation is performed with ligament staples. An accelerated rehabilitation program emphasizing full extension and weight bearing follows. The total rehabilitation program we recommend--preoperative rehabilitation, a reliable surgical procedure, postoperative rehabilitation, and the patient's return to activity--is a team effort. A detailed follow-up evaluation of 41 athletes with ACL reconstruction using a central patellar BTB graft and synthetic augmentation with the TETRA-L3 showed that restoration of stability (KT 1000 testing, maximum manual excursion, < 3 mm difference) and full ROM, muscle strength and power (> 85% of the uninvolved knee) and functional capacity (Hop index > 90%) are the main prerequisites for sports activities at the desired level.

Anterior Cruciate Ligament↗
PubMed1993

Non-operative treatment of acute medial collateral ligament lesions of the knee joint.

From 1985 to 1990 102 patients with isolated lesions of the medial collateral ligament of the knee were managed non-operatively with early protected motion and physical therapy. Eighty-six returned to a follow-up examination. The mean follow-up time was 44.2 months. The knees were stable in all but two cases and showed good or excellent results. Ninety-seven percent of the patients returned to their earlier activity level.

Adult↗
PubMed1992

[Reconstructive interventions of the posterior cruciate ligament--experimental studies of isometric aspects. Part I: Studies of a string model].

In six intact cadaveric knees, we measured how the distance between six selected points in and around the femoral and tibial attachment area of the posterior cruciate ligament (PCL) changes with knee flexion. After complete removal of the PCL, 2-mm drill holes were made at the selected points. Each femoral point was measured against each tibial point using a heavy suture that was passed through the drill holes. The proximal end of the suture was fixed to the lateral aspect of the femur. The distal end of the suture was attached to a measuring unit. The changes in femorotibial distance were measured during flexion from 0 degrees to 110 degrees in 10 degrees steps. The tibial drill hole locations had only a minor effect on the changes in femorotibial distance. The most isometric point was located in the centre of the posterior intercondylar area. The femoral locations of the drill holes were the primary determinant of whether the distance increased, decreased or remained nearly constant. According to our results the most isometric femoral point is located at the posterosuperior margin of the anatomical PCL attachment. Using the tibial isometric point as a reference, the femoral points positioned anterior or posterior to the isometric point produced considerable changes in the femorotibial distance upon knee flexion. The anterior point led to an increase of about 7-8 mm at 110 degrees of flexion, the posterior point to a decrease of the same extent. Much smaller changes in femorotibial distance resulted from the points located superior or inferior to the femoral isometric point.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Reconstructive interventions of the posterior cruciate ligament--experimental studies of isometric aspects. Part II: Studies of the posterior cruciate ligament replacement model].

Isometric positioning of the posterior cruciate ligament (PCL) graft is important for successful reconstruction of the PCL-deficient knee. This study documents the relationship between graft placement and changes in intra-articular graft length during passive range of motion of the knee. In eight cadaveric knees the PCL was identified and cut. The specimens were mounted in a stabilizing rig. PCL reconstruction was performed using a 9-mm-thick synthetic cord that was passed through tunnels 10 mm in diameter. Three different femoral graft placement sites were evaluated: (1) in four specimens the tunnel was located around the femoral isometric point, (2) in two specimens the tunnel was positioned over the guide wire 5 mm anterior to the femoral isometric point, (3) in two specimens the tunnel was positioned over the guide wire 5 mm posterior to the isometric femoral point. In all knees only one tibial tunnel was created around the isometric tibial point. The location of the isometric points was described in part I of the study. The proximal end of the cord was fixed to the lateral aspect of the femur. Distally the cord was attached to a measuring unit. The knees were flexed from 0 degree to 110 degrees, and the changes in the graft distance between the femoral attachment sites were measured in 10 degrees steps. Over the entire range of motion measured the femoral tunnels positioned around the isometric point produced femorotibial distance changes of within 2 mm. The anteriorly placed tunnels produced considerable increases in femorotibial distance with knee flexion, e.g. about 8 mm at 110 degrees of flexion.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Exocrine function of a heterotopically transplanted pancreas segment in humans].

Pancreatic secretion is involved in circadian regulation of the whole organism. This observation was obtained in animals and humans with pancreatic fistulas. We report on three patients in whom the pancreas was removed totally or subtotally because of chronic pancreatitis with severe pain. A segment of the removed gland was transplanted into the thigh in order to preserve endocrine function. The pancreatic duct was drained by a polyethylene tube until pancreatic duct occlusion. Postoperatively juice volume increased within 3 days and remained constant afterwards with 300 ml in 24 hours. Secretin, cholecystokinin and food intake are able to stimulate the transplanted segment in a typical manner. The secretion showed circadian changes. In all patients the pancreatic juice content of protein, amylase, trypsinogen, calcium, and zink decreased till 11 p.m. After 11 p.m. the content of all substances increased and reached maximal values at 6 a.m. Flow rates and therefore output per minute decreased greatly till 6 a.m. The large juice volume of 300 ml in 24 hours is perhaps the consequence of a break down of the feedback mechanism between intraduodenal trypsin activity and CCK-release. The changes during the night may be of pathogenetic relevance. In the early morning pancreatic juice is highly concentrated and the flow rate is very low. High protein concentrations, high calcium concentrations, and reduced flow rates may lead to protein and calcium carbonate precipitates. This mechanism is under discussion in the pathogenesis of chronic pancreatitis.

Adult↗
PubMed1990

[Computer-assisted analysis of the pressure behavior of the esophagogastric junction during increase in intragastric pressure].

Two factors are to determine increasing lower esophageal sphincter pressure during intragastric pressure rising mainly: 1. the active intrinsic muscle tone and 2. the efficiency of the law by La Place. The purpose of the study was to estimate the part of both of them in this measurable phenomenon. We investigated 15 healthy volunteers and 5 patients post Nissen fundoplication. A simultaneous manometric examination of gaster and LES was carried out during gradual compression of abdominal wall. Analysis of dependence of LES-pressure on intragastric pressure, based on computer usage, was established. A linear equation described this dependence with the best correlation coefficient (r = 0.98) followed by potential and exponential equation. Fundoplication caused a steeper ascent without any changing of linear character of function. Considering linear equation is compatible with the law by La Place out not with a simultaneous pressure depending change of intrinsic muscle tone, these results indicate that the law by La Place has major importance in the measurable rising of high pressure zone during intragastric pressure increasing.

Adult↗
PubMed1988

[Use of surgical staplers in gastrointestinal surgery].

Reported in this paper is the use of staplers in gastro-intestinal surgery. Three soviet-made types of staplers, UO 40/60, NShKA, and SPTU (comparable to TA 30/55/90, GIA, and EEA) were used on the upper part of the gastro-intestinal tract in 237 cases and in colorectal surgery on 66 patients. The UO stapler worked well, when used for closure of uncomplicated duodenal stumps, though no absolute indication can be claimed for such application. The SPTU type, on the other hand, proved to be an ideal solution in cases of oesophago-jejunostomy with intrathoracic localisation of the anastomosis. Another, nearly absolute indication for the use of the SPTU can be claimed for anterior rectum resection (especially in male patients) with narrow pelvis and tense pelvic floor.

Colonic Diseases↗
PubMed1987

[Surgical indications, timing and method in acute pancreatitis].

Treatment for acute pancreatitis was received by 462 patients at the Surgical Hospital of Greifswald University, between 1976 and 1986. Surgical therapy was applied to 117 of 141 patients with necrotising pancreatitis. Lethality rates were 46 per cent in a group with partial necrosis and 86 per cent in another with total necrosis. The Ranson approach was used in operations on 63 of 90 patients with partial necrosis. Their lethality amounted to 23 per cent. 27 patients were given surgical treatment, in spite of unfavourable prognosis, only up to ten days from onset of acute pancreatitis. Lethality in this group was 78.5 per cent. Proper localisation of the necrotic focus is important to prognosis, just as good timing of surgical intervention. Lethality rates were 25 per cent for resection in the caudal region and 38 per cent for necrosectomy of the pars lienalis. Necrosis in the head region entailed a lethality rate of 90 per cent in response to necrosectomy and a rate of 64 per cent with additional lavage. The prognosis of pancrease necrosis is affected by timing and method of surgery. Timing should depend on the clinical pattern, laboratory parameters as well as on findings recorded by computed tomography and ultrasound. Aetiological aspects and location of the process must be considered for choice of surgical techniques. Necrectomy, lavage, and revision of bile ducts seem to be adequate surgical methods.

Acute Disease↗
PubMed1986

Simultaneous release of several tachykinins and calcitonin gene-related peptide from rat spinal cord slices.

Superfusion of slices of the dorsal half of rat spinal cord in vitro with 10 microM capsaicin or 60 mM potassium lead to the simultaneous release of substance P (SP)-, neurokinin A (NKA)- and calcitonin gene-related peptide (CGRP)-like immunoreactivities (LI). The ratio between capsaicin-stimulated and basal release was higher for CGRP-LI than for SP-LI, indicating that relatively more CGRP is released from sensory nerves, whereas SP is not only released from afferent neurons. High-performance liquid chromatography of NKA-LI revealed several immunoreactive components. One major peak had the retention time of synthetic NKA. A second peak eluted close to the position of synthetic eledoisin. In conclusion, capsaicin releases several bioactive peptides from sensory neurons which may mediate the acute algetic effect of chemical irritants.

Animals↗
PubMed1983

[Selective proximal vagotomy and truncular vagotomy - comparison based on animal models].

After high-selective vagotomy without pyloroplasty and after transthoracic truncular vagotomy in combination with pyloroplasty serum gastrin and gastric acid secretion were checked in short time intervals. The stimulation was produced by a standard test meal and by insulin induced hypoglycemia before and after vagotomy. The changes observed in serum gastrin levels before and after both kinds of vagotomy indicate a temporary influence on the emptying of the stomach. The decrease in gastric acid output following selective or truncular vagotomy demonstrates a delay of therapeutic effect.

Animals↗
PubMed1982

[Serum gastrin and gastric acid level following vagotomy without pyloroplasty and partial gastrectomy (BI) (author's transl)].

The course of gastric acid secretion and serum gastrin level before and after operation was studied in 41 patients suffering from a gastroscopically determined ulcer disease. In 15 patients suffering from duodenal ulcer, a highly selective vagotomy without pyloroplasty was performed and in 26 patients suffering from peptic ulcer (duodenal or gastric ulcer) a partial gastrectomy (Billroth I). After a highly selective vagotomy without pyloroplasty a reduction in the secretory response to pentagastrin and a significant rise of the basic and postprandial gastrin concentration could be observed. Both methods are suitable to determine the completeness of vagotomy. The estimation of the course of serum gastrin level after vagotomy only reveals a temporary disorder of the antrum-pylorus mechanism. In our opinion a pyloroplasty is not necessary.

Adult↗
PubMed1981

[Liver tumours in pregnancy, following previous intake of hormonal contraceptives (author's transl)].

Liver tumours developed in two women during pregnancy which followed discontinuation of hormonal contraception. Liver cell adenoma developed in a secundipara, 24 years of age, and its rupture during puerperium led to death by bleeding, after surgical intervention had failed. Hepatocellular carcinoma was recorded from a secundipara, 22 years of age, and surgically treated, following premature delivery. Problems of diagnosis and the need for interdisciplinary cooperation are discussed and compared with literature data. The pathogenesis of liver tumours in the wake of exogenous hormone inflow and in the context of subsequent pregnancy is another topic of discussion.

Adult↗
PubMed1980

[Disorders of haemostasis in postoperative septicaemia (author's transl)].

In 27 patients suffering from postoperative septicaemia blood coagulation was analysed. All these patients had chronic consumption coagulopathy, which could be demonstrated under controlled heparin medication. The high fibrinogen concentrations detected immunologically or by heat coagulation had to be revised compared with a method which only recorded clottable fibrinogen. This difference has to be explained by the existence of fibrinolytic split products, fibrin monomers and its complexes with fibrinogen. In all courses an extreme decrease of antithrombin III could be noticed. The results obtained make the necessity of long time heparin therapy dubious.

Adolescent↗
PubMed1977

[Histological and immunohistochemical investigations on the transplanted isolated islets of Langerhans in diabetic rats (author's transl)].

Isologous isolated islets of LANGERHANS were transplanted in the peritoneum and through the portal vein in the liver of diabetic rats. With the help of histological and immunohistochemical investigations, estimation of blood sugar and glucose tolerance tests was tested over a period of 12 month, whether the peritoneum or the liver is more suited as transplantation site for isolated islets of LANGERHANS. After transplantation of islets of LANGERHANS in the peritoneum of diabetic rats the blood glucose decreased and this effect could be maintained over a period of three months. The histological investigations showed strong periinsulinar reactions and the immunohistochemical insulin and glucagon proofs prospered over a period of three months. After transplantation of isolated islets in the liver it resulted in a normalization of blood glucose levels up to 12 months after transplantation and in this time prospered the immunohistochemical insulin and glucagon proof. These results have suggested, that the liver is more suited as transplantation site for isolated islets of LANGERHANS than the peritoneum.

Animals↗
PubMed1976

[Transplantation of isolated islets of Langerhans into the liver of diabetic dogs (author's transl)].

Isolated islets of Langerhans were transplanted through the portal vein in the liver of 8 diabetic dogs; In 4 dogs a homologous transplantation was performed and another group of four dogs received isolated islets from their sisters or brothers. In both groups, there was an immediate effect on the blood glucose level. After pancreatectomy and injection of Alloxan the blood glucose rose to between 350 and 420 mg per 100 ml and after islet implantation the blood glucose decreased between 80 to 160 mg per 100 ml. The iv GTT'S were after islet implantation clear better than in the diabetic control animals. These results could maintained in the recipients with homologues islets over a period of 6 to 8 weeks and in the other group of dogs over a period of 6 to 12 months. We were able to show, that the islet implantation in the liver of diabetic dogs did not disturb the microscopic architecture of the liver. No signs of portal hypertension, hepatic congestion and embolism were found.

Animals↗