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Biomedical subjects

M Karpf

Publications and source records attributed to M Karpf.

54 records · Page 3Linked to original sources
PubMed1980

[The demonstration of the cruciate ligaments by xerotomography (author's transl)].

Demonstration of the cruciate ligaments by xerotomography was attempted in 54 patients after double contrast arthrography of the menisci. The best results of lateral tomography were achieved in showing the middle and caudal portions of the anterior ligament. The ligaments close to the femur are not well demonstrated. Twenty-six patients underwent operation; of these, 13 had ruptured cruciate ligaments. The correct diagnosis was made by xerotomography in only 46%. The reasons for this are discussed. The present results do not suggest that Xerotomography is valuable in the diagnosis of abnormalities of the cruciate ligaments.

Evaluation Studies as Topic↗
PubMed1978

[A correlative retrospective study of the histological findings and arthrograms in degenerative disease of the meniscus (author's transl)].

The ability to diagnose degenerative changes of the menisci by means of arthrograms was studied retrospectively by correlating the histological and operative findings and arthrographic appearances in 45 cases. It was shown that degenerative changes, as indicated histologically, could be diagnosed by arthrography, but that the arthrogram gave no certain indication of its severity. On the other hand, it appears that fairly severe changes must be present before they become radiologically visible. In negative cases the presence of degenerative changes in bone and cartilage may indicate meniscus degeneration. Problems in the diagnosis of cartilage abnormalities in the arthrogram are discussed.

Adult↗
PubMed1976

[Ski boot rim fracture: tension-optical study].

Most of the models of ski-boots used today end up at the weakest area of the tibia. They should be disregarded for medical and statistical reasons because the maximal bending point lies at the minimal diameter of the tibia. A ski-boot with a joint, splinting more than the distal third of the calf and ending approximately at the mid-point of the tibia elasticity, offers an important safety to the skier. Together with a safety binding the risk of an accident of the so-called "fracture of the border of the ski-boot" can be further reduced.

Biomechanical Phenomena↗
PubMed1975

[Electromyographic changes in temporary tourniquet ischemia in man].

After inflating a tourniquet with 600 mm Hg around the thigh a total blockade of the n. peronaeus occurs. This blockade is due to ischemia and spreads from proximal to distal. It is an ischemic blockade as the delay of nerve conduction was measured distal of the tourniquet and therefore cannot be due to the pressure under the cuff.

Adult↗
PubMed1975

Lack of B lymphocyte depletion from murine spleen cell populations by a human gamma-globulin, anti-human gamma-globulin column system.

It has been reported previously that enriched populations of mouse thymus-dependent (T) lymphocytes could be prepared by the use of a column procedure that is believed to remove selectively cells with receptors for antigen-antibody complexes. In our hands, this procedure does not selectively remove B lymphocytes but rather masks the surface immunoglobulin. Analysis of the column-passed cells revealed an apparent decrease in the percentage of immunoglobulin-bearing cells but little decrease in either the percentage of complement receptor lymphocytes or the mitogenic response to lipopolysaccharide. Furthermore, rabbit immunoglobulin could be detected on the surface of 35 to 45% of the cells emerging from the columns prepared with rabbit anti-human gamma-globulin (HGG). After overnight incubation, 30 to 40% of the emerging cells reexpressed mouse immunoglobulin on their surfaces. Adsorption of the antisera used to make the columns with mouse gamma-globulin (MGG) diminished the depleting capacity of the columns. We conclude from these observations that antibodies in the anti-HGG sera, cross-reactive with mouse immunoglobulin, account for the spacious depletion of B lymphocytes observed when cells are passed over these antigen-antibody complex columns.

Animals↗
PubMedDate not supplied

The inter-rater reliability and internal consistency of a clinical evaluation exercise.

OBJECTIVE: To assess the internal consistency and inter-rater reliability of a clinical evaluation exercise (CEX) format that was designed to be easily utilized, but sufficiently detailed, to achieve uniform recording of the observed examination. DESIGN: A comparison of 128 CEXs conducted for 32 internal medicine interns by full-time faculty. This paper reports alpha coefficients as measures of internal consistency and several measures of inter-rater reliability. SETTING: A university internal medicine program. Observations were conducted at the end of the internship year. PARTICIPANTS: Participants were 32 interns and observers were 12 full-time faculty in the department of medicine. The entire intern group was chosen in order to optimize the spectrum of abilities represented. Patients used for the study were recruited by the chief resident from the inpatient medical service based on their ability and willingness to participate. INTERVENTION: Each intern was observed twice and there were two examiners during each CEX. The examiners were given a standardized preparation and used a format developed over five years of previous pilot studies. MEASUREMENTS AND MAIN RESULTS: The format appeared to have excellent internal consistency; alpha coefficients ranged from 0.79 to 0.99. However, multiple methods of determining inter-rater reliability yielded similar results; intraclass correlations ranged from 0.23 to 0.50 and generalizability coefficients from a low of 0.00 for the overall rating of the CEX to a high of 0.61 for the physical examination section. Transforming scores to eliminate rater effects and dichotomizing results into pass-fail did not appear to enhance the reliability results. CONCLUSIONS: Although the CEX is a valuable didactic tool, its psychometric properties preclude reliable assessment of clinical skills as a one-time observation.

Clinical Competence↗
PubMedDate not supplied

[Effectiveness of epicondylitis bandages from the biomechanical viewpoint--an experimental study].

QUESTIONS: During extension of the elbow joint (test measurement) and extension of the wrist (control measurement), maximal bandage pressure is desired on the extensor group of the forearm, especially of the M. extensor carpl radialis brevis (ECRB). Do the various commercial epicondylitis bandages produce a mechanical effect on the extensor group of the forearm and how do the maximal pressures of these bandages behave in direct comparison? Are the pressures produced clinically relevant? METHODS: Eleven different epicondylitis bandage constructions were examined for their biomechanical effects. The exerted pressure was measured continously during the above-mentioned movements. A fist-closing strength of ca. 30 N was maintained for the necessary pre-stressing of the forearm muscles. RESULTS: Strap-type bandages were the only bandages to produce adequately high pressures. Bands applied at pressures which approach those of the straps led to obstruction in bloodflow. Stocking designs showed no effect in respect to our study. CONCLUSION: Bandages which apply pressure to relieve the tendon insertion of the extensor muscles must, from a technical standpoint, be of a strap construction in order to build up adequate pressures to be effective.

Adult↗
PubMedDate not supplied

Superior vena cava syndrome: diagnostic procedures.

The hospital records of patients discharged from Presbyterian-University Hospital of Pittsburgh with the diagnosis of superior vena cava syndrome (SVCS) were reviewed in order to determine if diagnostic procedures were associated with an unacceptable risk of complications. Fifty-six cases were reviewed. Symptoms had been present for an average of five weeks. Forty-five patients underwent diagnostic tests including sputum cytology, lymph node biopsy, bone marrow biopsy, bronchoscopy, mediastinoscopy and thoracotomy. The diagnostic yield of these procedures ranged from 28% (cytology) to 100% (thoracotomy). Complications occurred only with mediastinoscopy and none of these were fatal or caused long-term morbidity. We conclude that most patients with SVCS (excepting those with neurologic or respiratory compromise) can tolerate a vigorous pursuit of a histologic diagnosis before therapy is instituted.

Bronchoscopy↗
PubMedDate not supplied

Health care cost containment: how Pittsburgh is addressing the challenge.

Rapidly escalating health care costs have the public and private sectors searching for methods to provide health care benefits in a more efficient manner. Efforts have also been underway at the community level with the development of health care coalitions created to build consensus toward a fair solution for all parties affected. With the assistance of the Robert Wood Johnson Foundation and many local co-sponsors, the Pittsburgh Program for Affordable Health Care (PPAHC) was organized to address health care cost containment issues in the greater Pittsburgh area. One of the means by which PPAHC chose to achieve this was through the development of a Model Utilization Management Program. This is a document containing community-sanctioned administrative and clinical standards for utilization review which take into consideration the needs and concerns of providers, purchasers, and consumers, and which have a goal of reducing medically unnecessary inpatient hospitalization while concurrently maintaining quality of and access to care. This article describes both the process and the product of PPAHC's efforts toward health care cost containment in Pittsburgh, specifically focusing on its utilization management component.

Community Participation↗