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Biomedical subjects
Publications and source records attributed to J Pfister.
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The splenius muscle of the rat was investigated with regard to its structure and innervation. The latter was compared with that of the quadriceps muscle. The results can be summarized as follows: The splenius muscles of both sides form a bipennate muscle plate connecting the occipital bone with the spinous process of the second thoracic vertebra. The lateral parts of both muscles are attached directly to this prominent bony process, whereas the medial parts end in a median raphe which forms a tendinous cranial extension of the second thoracic vertebra. This tendinous extension, showing no connection to the cervical vertebrae, serves also for the attachment of acromio-trapezius muscle fibers. The lateral part of the splenius muscle is divided into two parts by a tendinous intersection. The splenius muscle consists mainly of fast twitch fibers: 55% were characterized as IIB and 40% as IIA fibers by histochemical demonstration of myosin ATPase-activity. A high content of muscle spindles--57 spindles per gram of muscle tissue--was found. Comparing several aspects of the innervation of the splenius to that of the quadriceps muscle, the following results could be obtained: The ratio of motor end plate size to muscle fiber volume is significantly higher in the splenius than in the quadriceps muscle. As demonstrated by transganglionary HRP-transport, the main part of labeled splenius afferents to the spinal cord terminates in the central cervical nucleus. Quadriceps afferents, entering the lower thoracic and upper lumbar segments, mainly end in the area of Clarke's column. Several labeled fibers descend to the sixth lumbar and first sacral segments, where they terminate in the area of Stilling's nucleus. A group of primary afferents from both muscles--most probably III- and IV-afferents--projects to the dorsal laminae of the dorsal horn; terminals from the splenius are accumulated in the lateral parts of these laminae, whereas those of the quadriceps are more concentrated in the medial areas. Within the brain stem, most afferents from the splenius terminate in the external cuneate nucleus. Most of the quadriceps afferents course to the gracile nucleus. Terminals from both muscle nerves were found in the area of the spinal vestibular nucleus. In conclusion, the most conspicuous results were: 1) Besides the segmental projection to the dorsal horn there is an almost exclusive projection of splenius primary afferents to relay nuclei to the cerebellum. 2) The relatively high ratio: end plate size/muscle fiber volume, which is characteristic of finely adjusting muscles.(ABSTRACT TRUNCATED AT 400 WORDS)
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212 patients with calcareous tendinitis of the shoulder were retrospectively analysed with a pain questionnaire after treatment with needle irrigation. Age, sex, number of needle irrigations and the time interval between treatment and interview were recorded from a file-card, also the side of affection. 149 questionnaires could be analysed by relational data bank processing on a personal computer. The median pain duration previous to the irrigation was 24 months; the median time interval between chalk deposition in x-ray studies of the shoulders and irrigation was 6 months. The sex ratio was 2:1 with preference given to females. The mean age at intervention was 47 years among the females and 49 years among the males; this age difference was not significant. There was no relationship between the preferred hand for working and the side of subacromial chalk deposition. We found in 54.5% painful calcareous depositions in the right shoulder and in 33.5% in the left. Both sides were affected in 12%. The median interval between needle irrigation and questionnaire analysis was 5 years. At this time 60% of all patients were free of pain, 34% stated a marked relieve of pain and 6% were unchanged.
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To determine prevalence and risk factors for endocervical Chlamydia trachomatis infection in an urban midwestern population and to evaluate two non-culture direct tests for C. trachomatis, we studied 849 women attending two family planning clinics and a community health clinic in Milwaukee, Wisconsin. Adequate endocervical specimens were obtained from 751 women for chlamydial isolation in tissue culture and antigen tests using direct fluorescence (DFA) and enzyme immunoassay (EIA); 93 (12.4%) patients had cultures positive for C. trachomatis. Compared to culture, the DFA test had a 77.4% sensitivity, 96.8% specificity, and a predictive value positive (PVP) of 77%. For the EIA, these values were 83.9%, 97.0%, and 80%, respectively. No single historical, clinical, or laboratory variable, including the previously described cervicitis index and specific cytologic findings on Pap smear, had sufficient predictive value to be used as the only criterion for selective screening in this population. Criteria for selective screening were proposed that would result in screening 43% of patients and would identify 71% of infections. PVP of both non-culture tests was 89% in persons identified by these criteria to be at increased risk of C. trachomatis infection.
The effectiveness of selective screening for control of Chlamydia trachomatis is unknown. In 1986, a statewide screening program began in family planning clinics in Wisconsin after the prevalence of infection among women was found to be 10.7% in four nonurban clinics and 13.7% in an urban Milwaukee clinic. In 1990, endocervical specimens were obtained from 1,757 women attending these same clinics; 5.2% of women in the non-urban clinics and 6.9% in the Milwaukee clinic tested positive for C. trachomatis. Prevalence of infection had decreased similarly (by 53% overall) in both high- and low-risk groups in all five clinics. Although reported condom use increased from 16% to 31%, most other demographic and behavioral risk factors for infection did not significantly change; in contrast, the prevalence of clinical signs of infection decreased. The percentage of infections identified by selective screening criteria decreased from 77% to 55%. Selective screening and attendant activities, as well as an increase in condom use, were associated with a decrease in prevalence of C. trachomatis infection in this population.
An analysis using case reports, laboratory records of tests for C. trachomatis, and Hospital Discharge Summary data shows that, following implementation of a chlamydia prevention program in Wisconsin in 1985, statewide declines were observed in prevalence, incidence and complications of infection. In 1990, prevalence rates among teenage women peaked at 2,794 infections per 100,000 15-19-year-old females. Between 1987 and 1991 (a period of stable testing volume), the proportion of positive tests decreased in all age-groups for females (by 29-41%) and males (by 10-14%), and the incidence of new infections in women decreased in clinic populations by 27%-50%. Between 1986 and 1991, hospitalization rates declined by 33% for pelvic inflammatory disease and by 20% for ectopic pregnancy.
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