Biomedical subjects
Publications and source records attributed to K Tillmann.
The necrotising sialometaplasia is a rare disease of the orofacial system. The minor salivary glands of the palate are the main localisation. It's clinical importance consists in the possibility of confusion with squamous cell carcinoma or the mucoepidermoid tumor. The authors report on 3 cases and discuss the etiology and the diagnostic of this disease.
UNLABELLED: This study examines changes in sexual behaviour in the context of the fear of being infected with the HI-Virus and, in particular, considers the influence of a relationship and of sexual orientation. The population studied included 72 homosexual and 54 heterosexual male students. RESULTS: (1) Only 7% of the heterosexuals, but 68% of the homosexuals report changes in their sexual behaviour pattern. (2) Among the homosexual group practice-oriented alterations (avoiding oral and anal sex or using condoms for these practices) and relationship-oriented alterations (reducing the number of sex partners) occur likewise. (3) Practice-oriented changes are less frequent among homosexuals with partners than those without. (4) Those homosexuals questioned who are in conflict with their homosexuality have less confidence in potential sex partners. They are more inclined to have "monogamous" relationships.
Arthritis surgery in the Federal Republic of Germany is an established subspecialty of orthopedic surgery. The scientific organization Arbeitgemeinschaft für Rheumaorthopädie (Association for Rheumatic Orthopedics) is an official section of the Deutsche Gesellschaft für Orthopedics and Traumatology) and has very close connections with the European Rheumatoid Arthritis Surgical Society. There are many common activities within this group, especially regarding uniform documentation, which began with the elbow. Furthermore, there are standardized procedures in operative synovectomy, including new trends, e.g., arthroscopic synovectomy. Another special interest is focused on alternatives to endoprosthetic replacement, in particular on resection interposition arthroplasty. With regard to endoprosthetic replacement, the question of cementing or not is controversial; however, there are strong arguments for cementless fixation, especially for hip endoprostheses. Arthritis surgery in Germany reflects modern trends all over the world where rheumatology is a subspecialty bridging the gap between internal medicine and orthopedics.
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Long-term results of 100 cemented finger joint replacements (endoprosthesis) of the "St. Georg" design are presented. Good reduction in pain and swelling was noted. There was only a little improvement in motion of the replaced metacarpophalangeal joint, but more in the proximal interphalangeal joint; the latter decreasing from radial to ulnar. Approximately one half of the preoperative ulnar deviation was corrected. Mechanical failures occurred in approximately 30% of the implants. Without changing the design, this demanding technique cannot be recommended routinely.
The concentration-time curves of azapropazone in synovial fluid and tissues have been studied in arthritic patients after an i.v. bolus (600 mg) and under steady-state conditions. Synovial fluid and tissue samples were taken intraoperatively 0.45-60 h after administration. The azapropazone concentrations in synovial fluid, synovial tissue and plasma were correlated. The levels in synovial fluid were usually lower than corresponding plasma levels. Under steady-state conditions azapropazone did not accumulate in synovial tissues.
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The clinical importance, incidence and clinical appearance of foot deformities as a result of rheumatism are described. The pathomechanics of rheumatic deformities and the connection with inflammatory changes in the anterior and posterior parts of the foot are described. The possible types of conservative treatment are introduced briefly. The operative form of therapy is presented in detail and subdivided according to preventive and reconstructive measures in various parts of the foot. The peculiarities and subsequent requirements of the therapeutic procedure are addressed.
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In rheumatoid arthritis (RA) we find a high rate of foot involvements, especially in progressive cases when we see patients submitted for hospital treatment. In about 50% of these patients the ankle joints are involved (25), in juvenile RA even in two thirds of all cases. More than half of all progressive cases show also joint affections of the forefoot. Mainly the metatarsophalangeal joints are involved, especially the first MTP joint. We also can find a high involvement rate of the interphalangeal joint of the big toe. In RA the peripheral toe joints II-V are less frequently involved. Changes in these joints are very much likely to be caused by other inflammatory rheumatic diseases. Even more often than in the ankle joints we can find changes in the tarsal joints, as well as in the tarsometatarsal joints. As we know, in RA the incidence of surgery does not refer to the affection rate. The indication for surgery depends mainly on the amount of functional disability, pain, and the efficacy of conservative treatment. The need of these therapies can differ very much in various countries. E.g. in the Rheumatism Foundation Hospital, Heinola more than one third of all operations were foot surgery, whereas in our clinic, organised in a very similar way to Heinola, we have "only" 20%. Apart from tenosynovectomies and synovectomies at the ankle joint, the operations are nearly exclusively of reconstructive character.
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Early results of the KESSLER-Implant in 11 patients are presented. 7 patients suffered from rheumatoid arthritis, 1 from psoriatic arthropathy. For technical reasons this endoprosthesis seems to be especially suitable for patients with rheumatoid disease. By remodelling the articular surface of the trapezium corresponding to the implant, it is possible to reestablish stability even in cases with severe destruction and subluxation of the CM joint.
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The alterations of form and function of the rheumatoid foot are derived from the pathomechanical conditions. The latter are used as a measure for the treatment. Type and frequency of inflammatory alterations are studied by x-ray examination and new aspects are stressed. The deformities of the rheumatoid foot can be explained conclusively through the interaction of functional, gravitational, inflammatory and anatomical influences. The deformities of the toes are induced to a great extent by the deformities of the proximal part of the foot. The possibilities of surgical treatment are discussed in detail and systematically. The results of partially own methods are compared with those of other authors, and conclusions regarding the indication are drawn. The conservative treatment is considered under the aspects of the enlarged surgical possibilities. The need of a close cooperation between the different specialists is emphasized.
From a logical basis, it is reasonable to postulate that a synovectomy must be maximally as complete as possible. The indications and operative technique of radical synovectomy of the dorsal part of the knee joint are presented. The statistically significant improvement of the results of knee synovectomy by an additional dorsal approach is referred to.
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