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Biomedical subjects

M G Ehrlich

Publications and source records attributed to M G Ehrlich.

At least 55 records · Page 3Linked to original sources
PubMed1984

Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures.

We studied the late results after bimalleolar and trimalleolar ankle fractures in thirty-four patients after an average follow-up of four years. Twenty-one patients had had open reduction and internal fixation of the medial malleolus only and thirteen, internal fixation of both the medial malleolus and the lateral malleolus. Twenty-four lesions were supination-external rotation fractures; six, pronation-external rotation; and four, supination-adduction fractures. All initial and post-reduction roentgenograms were evaluated, and the patients were re-evaluated two to seven years after fracture. Re-evaluation included physical examination as well as standardized and stress roentgenograms of both ankles. Criteria were developed for measuring the width of the syndesmosis and assessing the late roentgenographic, subjective, and objective results, as well as any late instability of the syndesmosis and osteoarthritis. Significant correlations were found between: (1) the adequacy of the reduction of the syndesmosis and late arthritis, (2) the adequacy of the initial reduction of the syndesmosis and the late stability of the syndesmosis, (3) the late stability of the syndesmosis and the final outcome, and (4) the adequacy of the reduction of the lateral malleolus and that of the syndesmosis. Based on the findings in this small series and on the evidence published in the literature, we concluded that adequate reduction of the syndesmosis is necessary to achieve a stable ankle following supination-external rotation and pronation-external rotation fractures of the ankle, and that the reduction of the syndesmosis will be unsatisfactory if the lateral malleolus is not well reduced.

Adult↗
PubMed1984

Analyzing forearm fractures in children. The more subtle signs of impending problems.

Poor results with pediatric forearm fractures, while infrequent, do occur. Systematic analysis is required to identify this relatively rare, evolving problem. The purpose of this retrospective study was to identify and organize factors that would help in this process. Sixty-nine patients aged one-17 years with displaced forearm fractures were identified retrospectively. Pre- and postreduction radiographs were analyzed in comparison to standards for displacement, angulation, bow, shortening, and rotation. Those patients who seemed most likely to have problems following treatment were recontacted. Even with the use of stringent criteria in a group weighted toward more severe fractures, 85% of the patients achieved satisfactory results. With careful analysis of fractures for changes in angulation, bow, and disruption of the proximal or distal radioulnar joints, these problems should be avoidable. Analysis relative to standard radiographs aids in the identification of subtle malalignments that would otherwise be easily overlooked.

Adolescent↗
PubMed1983

Slippage of the distal tibial epiphysis.

Three cases of valgus slippage of the distal tibial and fibular epiphysis that masqueraded as severe idiopathic flatfoot are described. These occurred in patients with renal osteodystrophy and were treated by osteotomies of the reverse dome type without internal fixation. All the osteotomies healed well.

Child↗
PubMed1983

Hematoma-induced febrile response in the pediatric patient.

Frequently there is a temperature elevation in children following operative procedures or trauma involving the long bones. A combined clinical and laboratory study investigated the possibility that this was secondary to blood resorption. A clinical study was conducted by reviewing the records of all children admitted to the hospital over a 10-year period with closed femoral or tibial fractures. All these patients demonstrated a temperature elevation to at least 101 degrees F. In the laboratory study, rabbits of different ages were bled, and this blood was reinjected into their quadriceps muscle to create hematomas. Control rabbits were hemorrhaged and either were not reinjected with their blood or were injected intramuscularly with lactated Ringer's solution. Those rabbits that received the intramuscular blood injections developed significant temperature elevations, and the younger the rabbit the more pronounced the temperature rise.

Adolescent↗
PubMed1983

Matrix synthesis in high density cultures of bovine epiphyseal plate chondrocytes.

Bovine epiphyseal plate chondrocytes were cultured by a method combining both suspension culture and high density monolayers. The matrix synthesized by the cultured cells was analyzed at fifteen days for glycosaminoglycan, proteoglycan, and collagen content. In the cell culture product glycosaminoglycan distribution was: 65% chondroitin-6-sulfate, 18% chondroitin-4-sulfate, 15% keratan sulfate, and less than 2% dermatan sulfate. Essentially all the radioactive sulfate in labelled specimens was present in high molecular weight aggregates. The collagen which was synthesized co-migrated with Type II collagen standard. Parallel analysis showed the matrix of cultured cells to be similar to that of intact epiphyseal plate tissue. This study demonstrates the ability to grow epiphyseal plate chondrocytes in a cell culture system which allows matrix synthesis similar to that seen in vivo.

Animals↗
PubMed1983

Transaxial tomography: an alternative to computerized tomography in pediatric orthopedic problems.

Because of the information it provides, computerized tomography has gained wide acceptance. However, the radiation delivered is considerable, and the gonads cannot be shielded effectively. Transaxial tomography also produces a cross-sectional image. While the image has less resolution, it is obtained at a fraction of the exposure. The use of transaxial tomography in several clinical situations is outlined here.

Bone Diseases↗
PubMed1982

The association of septic thrombophlebitis with subperiosteal abscesses in children.

An association of septic thrombophlebitis with acute osteomyelitis in four children is described. Each patient presented with physical findings consistent with thrombophlebitis. Venography, done in two, demonstrated significant acute thrombophlebitis, and another had an infected venous cutdown. A subperiosteal abscess was the predominant bony involvement found in all three patients who underwent surgical drainage. The initial radiographs were normal in each case. Bone scans showed diffuse increase in activity in the extremity, consistent with hyperemia, but no focal areas of increased uptake to suggest osteomyelitis. Computerized tomography, done in two patients, failed to reveal any bony abnormality, although subperiosteal abscesses were drained within 48 hours of each study. The existence of reverse collateral venous flow through the bone, associated with a rise in intramedullary pressure, may be responsible for these findings.

Abscess↗
PubMed1982

Patterns of proteoglycan degradation by a neutral protease from human growth-plate epiphyseal cartilage.

The hypothesis is widely held that proteolytic degradation of proteoglycans in the lower hypertrophic zone of the growth plate may be involved in the initiation of mineralization in the zone of provisional calcification. However, a neutral protease that is responsible for the degradation of proteoglycans in the growth plate has not been identified, isolated, and characterized. In the work reported here, neutral protease activity in the growth plate is demonstrated for the first time, and some of the properties of the enzyme are described. Proteoglycans subunits were prepared from bovine nasal cartilage and calf costal cartilage by equilibrium density-gradient centrifugation under dissociative conditions. The proteoglycan subunits were labeled with 14C-formaldehyde. Homogenates from human growth plates were examined for neutral protease activity using the proteoglycan subunits as substrates. Following incubation of the proteoglycan subunits with growth-plate homogenates at pH 5.3 and at pH 7.5 in the presence and absence of ten-millimolar magnesium chloride and calcium chloride, the digestion products were examined by gel chromatography on Sepharose-2B and 6B columns. Column eluants containing proteoglycan-subunit degradation products were monitored for uronic acid, hexose, and radio-activity. Maximum extensive degradation of proteoglycan subunits occurred at pH 7.5 in the presence of ten-millimolar magnesium chloride and calcium chloride.

Animals↗
PubMed1982

Growth-plate behavior in whole joint replantation in the rabbit.

We studied the behavior of the distal femoral and proximal tibial physes after whole knee-joint replantation in skeletally immature New Zealand White Rabbits. We developed an operative model in which a rabbit's knee was isolated on a vascular pedicle and was then replanted using microvascular technique. In a short-term study (three weeks or less) of ten rabbits, the patency of the vascular repairs and the resumption of metabolic activity of the cells in the growth plates were assessed. A long-term study (ninety days) of eight rabbits was designed to monitor growth after replantation. The results indicated that in rabbits, the femoral and tibial growth plates could be removed and returned to place during whole-joint replantation. If the blood supply was successfully re-established, metabolic function of the cells in the physes remained normal during the early postoperative period, and at ninety days (near the time of skeletal maturity) bone growth in the limb that was operated on was about equal to that of the opposite limb which was not operated on.

Angiography↗
PubMed1982

Degradative enzyme activity in isolated chondrocyte populations.

Chondrocytes from adult and immature articular cartilage were separated on the basis of size by rate-zonal centrifugation in a Ficoll density gradient. Lysozomal enzyme activity (acid phosphatase and beta-glucuronidase) was determined in gradient fractions containing chondrocytes of different sizes. Acid phosphatase and beta-glucuronidase activity in mature articular cartilage was greatly increased in small sized cells, located in the superficial tangential zone. In cells from immature calf articular cartilage, there were two peaks of increased activity, on in the superficial tangential zone, the other in the deep radial zone, close to the cartilage bone junction. It is speculated that the small surface cells, with thier high degradative enzyme levels, may explain why the osteoarthritis process starts at the surface.

Acid Phosphatase↗
PubMed1982

Isolation of proliferating chondrocytes from bovine growth-plate cartilage by rate-zonal centrifugation in a Ficoll density gradient.

UNLABELLED: A method has been developed for the isolation of growth-plate chondrocytes with different biochemical properties by rate-zonal centrifugation in a Ficoll density gradient. Bovine calf growth plates were first incubated in F-12 medium in the presence of 3H-thymidine to label proliferating chondrocytes. The tissue was then digested with collagenase and the isolated cells were fractionated in a Ficoll density gradient. The chondrocytes, which sedimented into eleven fractions, were analyzed for 3H-thymidine and inorganic pyrophosphatase activity. Chondrocytes that were maximally labeled with 3H-thymidine and contained maximum pyrophosphatase contents were separated in the most dense, bottom fractions of the gradient. These chondrocytes, which were apparently derived from the zone of proliferating chondrocytes, remained viable. This procedure should be applicable to the study of the biochemical properties of chondrocytes from the different zones of normal and diseased growth plates. CLINICAL RELEVANCE: A procedure has been developed to separate proliferating chondrocytes from hypertrophic chondrocytes and to isolate the proliferating chondrocytes in a viable state. This procedure should make it possible to study in vitro some of te biochemical processes that are involved in normal endochondral ossification, the regulation of these processes, and the alterations that occur in these processes in the presence of growth disorders and disturbances in endochondral ossification.

Animals↗
PubMed1980

Characterization of chondrocytes from bovine articular cartilage: I. Metabolic and morphological experimental studies.

Articular chondrocytes were enzymatically isolated from mature bovine cartilage and separated by density zone-velocity sedimentation in a gradient. For cells from different levels of the gradient, size and staining characteristics were determined and rates of incorporation of tritiated cytidine and radiosulphate were measured as indicators of RNA and sulphated glycosaminoglycan synthesis, respectively. The data clearly show that the chondrocyte population is composed of cells that vary continuously in size and metabolic activity from one limit to another. The largest cells also demonstrated the greatest RNA production while the smallest cells had the least. There was, however, no such differentiation of sulphated proteoglycan production.

Animals↗
PubMed1980

Association of glycosaminoglycan depletion and degradative enzyme activity in scoliosis.

Although several theories have been advanced about etiology of idiopathic scoliosis, the pathogenesis still remains unknown. One study detected a decrease in the glycosaminoglycan content of the nucleus pulposus in idiopathic scoliosis, and it was theorized that this represented increased degradation. The present study was designed to investigate degradative enzyme activity in scoliotic intervertebral disks. Twenty-three disks from 5 patients with idiopathic scoliosis and 18 disks from 3 patients with scoliosis resulting from myelomeningocele were obtained at surgery (Dwyer procedure). Five disks were obtained during 2 postmortem examinations. Analyses of hydroxyproline, hexosamine and acid phosphatase were performed separately on the annulus and nucleus of each disk. Hexosamine was decreased in idiopathic scoliotic nuclei versus controls (p less than 0.001) by approximately 25%. Hydroxyproline was proportionately increased (p less than 0.05). Similar changes of a greater magnitude were seen when comparing myelomeningoceles to controls. In both types of scoliosis, acid phosphatase was elevated in nuclear and annular tissue. Acid phosphatase activity and hexosamine varied inversely in the nucleus. Finding similar biochemical patterns in idiopathic and neurovascular scoliosis raises the possibility that these changes may be secondary.

Acid Phosphatase↗
PubMed1979

Lateral hamstring transfer and gait improvement in the cerebral palsy patient.

A retrospective analysis of twenty-three spastic patients who underwent forty-three transfers of the semitendinosus muscle to the lateral intramuscular septum and of the semimembranosus muscle to the biceps is presented. Decreased knee-flexion deformity as well as improved walking function were achieved in 91 per cent. An unsatisfactory result was associated with complications of the procedure. Only one knee of the forty-three that were operated on showed late genu recurvatum. This procedure appears to be both effective and relatively free of late comlications.

Adolescent↗
PubMed1979

Early diagnosis of disk space infection with 67Ga in an experimental model.

Both 67Ga and 99mTc scans become positive in experimental disk space infection, but 67Ga does so earlier than 99mTc. The radiologic features of experimental disk infection are similar to those seen clinically. Disk infection commences primarily in the disk and not in the vertebral body. Gallium-67 is useful in diagnosis of the disease under circumstances when the diagnosis is in doubt.

Animals↗
PubMed1978

Early diagnosis of disc-space infection using Gallium-67.

A 4-year-old boy had had progressive central lumbar pain and hamstring spasm. He had a normal lumbar-spine x-ray except for minimal L-5, S1 spondylolysis, but gave an abnormal gallium-67 scan in the region of the low lumbar spine. Eight weeks following intensive antibiotic therapy, confirmation of the diagnosis of disc-space infection was established by roentgenographic studies that demonstrated narrowing of the L 4-5 intervertebral disc space. A technetium-99m diphosphonate bone scan, performed concurrently with the gallium-67 study, was normal.

Bacterial Infections↗