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Biomedical subjects

M Maier

Publications and source records attributed to M Maier.

197 records · Page 11Linked to original sources
PubMedDate not supplied

[Open surgical procedures in calcifying tendinitis of the shoulder - concomitant pathologies affect clinical outcome].

AIM OF THE STUDY: Open surgical removal of calcifications in chronic courses of calcifying tendinitis of the shoulder can be combined with acromioplasty. Independent of the surgical procedure not all patients achieve satisfactory surgical results. The aim of the study was to investigate whether preoperatively known epidemiologic, social, clinical and radiologic factors or intraoperative findings might influence the therapeutic outcome. METHODS: Following diagnostic arthroscopy, open removal of the calcifications was done as an isolated procedure (group A, n = 12) or combined with open acromioplasty (group/B, n = 24). Follow-up was 33 months for both groups. RESULTS: Clinical outcomes were comparable in both groups (Group A, 74.9 points; Group B 73.4 points, Constant-Murley score) and independent of gender, age, profession, duration of anamnesis, hospital-stay period, follow-up period, dominance of arm, preoperative Constant-Murley score, calcification morphology and size and acromial type. 20 patients in total achieved a clinical outcome of </= 75 points (Constant-Murley score). 12 of these demonstrated lesions of the rotator cuff and joint cartilage combined with synovialitis. In 6 patients an adverse preoperative Constant-Murley score or the wish to receive a pension was recorded. CONCLUSION: Both surgical procedures lead to overall good and satisfactory clinical results. Below average clinical outcomes are associated with pathologic findings of the glenohumeral joints, adverse preoperative clinical situation or the wish to receive a pension.

Acromion↗
PubMedDate not supplied

[Detection of bone fragments in pulmonary vessels following extracorporeal shock wave application to the distal femur in an in-vivo animal model].

AIM: In urology, single cases of lethal pulmonary embolism following extracorporeal shock wave application to renal concrements have been reported. Therefore, lungs of rabbits were histopathologically investigated following extracorporeal shock wave application to the femur. METHOD: In 8 mature Chinchilla-Bastard rabbits, shock wave application to one distal femur was performed with energy flux density of 0.9 mJ/mm2. In another 6 rabbits, sham-treatment (0 mJ/mm2) to one distal femur was performed. 6 weeks later, the animals were sacrificed and their lungs were blindly investigated by an independent pathologist. RESULTS: In 7 out of the 8 treated animals (0.9 mJ/mm2) but in none of the sham-treated controls, patchy discolorations of the surface of the lung were observed. Furthermore, in 6 out of the 8 treated animals but in none of the sham-treated controls, bony fragments with signs of resorption were observed in lung vessels. CONCLUSION: Application of extracorporeal shock waves with energy flux densities higher than 0.9 mJ/mm2 has been recommended in the literature for the treatment of aseptic non-unions. In this procedure, the possibility of the occurrence of bone fragments in the lung with the potential risk of pulmonary embolism should be regarded.

Animals↗
PubMedDate not supplied

[Resection-interposition arthroplasty in symptomatic hallux valgus: a revision of indication and technique].

AIM: Popularity of resection-interposition-arthroplasty is decreasing due to more specific procedures in hallux valgus surgery. Therefore we analysed the influence of preoperative parameters and technical details to reevaluate this classic procedure. METHOD: In a retrospective, clinical and radiological long-term study (mean 9.6 years) 62 operated feet were examined and the assessed parameters were analysed, with focussing on the negative results. For comparison negative and positive outcome was defined by a hallux-metatarsal-interphalangeal scale (HMIS) and a subjective rating score (SRS). RESULTS: Negative outcome, 34 % according to HMIS and 24 % according to SRS, was characterised in both scoring systems by pain (visual analogue scale), functional deficit (walking distance) and negative cosmetic result (hallux-valgus-angle) (p < 0.01 each). As negative predictive factors we observed an early degenerative arthritis (p < 0.05, HMIS) and a positive metatarsal index (p < 0.05, SRS). Unsatisfactory results were related to an increased resection level of the first phalanx when compared with good results (p < 0.01 in HMIS, p < 0.05 in SRS). CONCLUSION: Resection-interposition arthroplasty in symptomatic hallux valgus seems an inadequate procedure in cases with early arthritis or a positive metatarsal index. However, in accordance with these criteria good results are probable, if resection of the first phalanx does not exceed one third of length.

Adult↗
PubMedDate not supplied

[The architecture of the subacromial space after full thickness supraspinatus tears].

AIM: The etiology of rotator cuff tears is multifactorial. An important factor is the damage of the rotator cuff by narrowing of the subacromial space. The purpose of this investigation was to estimate the influence of various metrical parameters on the size of the subacromial space. METHOD: We investigated 161 human macerated scapulae, 36 of them had a known tear of the supraspinatus tendon. All scapulae were photographed in two standard positions from the front and the lateral side. Defined distances and angles were measured using an image analyzing system followed by statistical analysis. RESULTS: Shoulders with a tear of the supraspinatus tendon showed a trend towards higher incidences of hooked acromions. Furthermore we found a significant higher incidence of elongated oval shaped glenoids in the group with supraspinatus tendon tear. In comparison to normal shoulders a significantly smaller distance from the top of the glenoid to the tip of the acromion and a greater distance from the top of the glenoid to the tip of the coracoid process was measured. In addition there was a significantly smaller coracoid angle and a smaller glenoid-spinal angle in this group. CONCLUSION: The width of the subacromial space depends on various parameters. Our data suggest that besides the acromion type the shape of the coracoid, the acromial angle, the spine-scapula angle and the cavitas-spine angle should be taken into account for diagnostic and therapeutic decisions.

Acromion↗
PubMedDate not supplied

[Pathologic glenohumeral stress distribution in calcific tendinosis of the supraspinatus].

AIM: Based on hypothesis that calcific tendonitis of the supraspinatus tendon (CTSSP) could be associated with glenohumeral imbalance, glenohumeral stress distribution was analyzed. METHODS: 26 patient shoulders with CTSSP, unsuccessfully treated by non-operative measures, were examined. A group of 26 macroscopically normal shoulder specimens served as controls. Analysis of glenohumeral stress distribution was indirect evaluating glenoid subchondral bone mineralization by computed tomography osteoabsorptiometry. Density distribution of glenoid subchondral bone mineralization and the position of the two most frequent density maxima were analyzed. RESULTS: Patterns of subchondral mineralization and position of the anterior density maximum were significantly different between both groups. CTSSP mostly presented with a monocentric, anteriorly increased mineralization indicative for a regional increase of stress. The inferior shift of the anterior density maximum demonstrates a parallel shift of glenohumeral stress distribution. CONCLUSION: Mineralization patterns indicate that glenohumeral stress distribution is not physiologic in CTSSP. Moreover, it is comparable with glenohumeral stress distribution as observed in atraumatic antero-inferior glenohumeral instability. Relevance of this observation should be proven for etiology of CTSSP.

Calcification, Physiologic↗
PubMedDate not supplied

Long-term results of high tibial osteotomy for medial osteoarthritis of the knee.

We reviewed retrospectively the results in patients who had undergone one hundred and four high tibial lateral osteotomies. The operations were all performed between 1985 and 1993. Each one of fifty men and forty nine women demonstrated a varus deformity of the knee with a coexistent medial osteoarthritis. Results were reviewed in 49 patients (62 knees) with an average follow-up of 10.2 years (range 6-14 years). Of the remaining 42 patients, 8 were lost to follow-up, 10 had died, and 24 were subsequently treated with total knee arthroplasty at an average 4.7 years after having had a high tibial osteotomy. Clinical results were evaluated using the Hospital for Special Surgery Score (HSS) and the Knee Society Score. Radiographs were systematically analysed to evaluate osteoarthritis and leg axis. Forty four (90 per cent) of the forty nine patients stated the results met their expectations and given the same circumstances, they would have the operation once again. In these patients the knee score results were excellent. The same patients had excellent HSS and Knee Society Scores. Five patients (10 per cent) had a poor result and twenty four patients were treated later by total knee arthroplasty because of pain. The following factors set these patients apart from those with more favorable results: previous arthroscopic debridement, obesity, lateral knee osteoarthritis, insufficient valgus correction, and an age of more than 55 years. High tibial valgus osteotomy provides good pain relief and improved function in carefully selected patients. Our results support this conclusion.

Adult↗
PubMedDate not supplied

The influence of the implant size on the outcome of unconstrained total knee arthroplasty.

INTRODUCTION: The influence of implant size on the results in unconstrained total knee arthroplasty has never been investigated before. PATIENTS AND METHODS: 133 patients with unconstrained total knee arthroplasty were examined (HSS Score, Knee Society Score) with consideration of the different sizes of femoral and tibial components and the thicknesses of the tibial inlays. The medium follow up was 41.2 months (8 months to 74 months). RESULTS: Although the different component sizes gained different results, the differences were not significant. The combination of two component sizes did not lead to a significant change of the results. The results of the Knee Society Score seemed to become worse with thinner polyethylene tibial inlays although these differences were not significant. CONCLUSIONS: In conclusion, implant size had no significant influence on the outcome of total knee arthroplasty. The combination of two implant sizes showed no disadvantage.

Adult↗
PubMedDate not supplied

Inhibition of (cytosine C5)-methyltransferase by oligonucleotides containing flexible (cyclopentane) and conformationally constrained (bicyclo[3.1.0]hexane) abasic sites.

Pseudorotationally locked sugar analogues based on bicyclo[3.1.0]-hexane templates were placed in DNA duplexes as abasic target sites in the M. HhaI recognition sequence. The binding affinity of the enzyme increases when the abasic site is constrained to the South conformation and decreases when it is constrained to the North conformation. A structural understanding of these differences is provided.

Bridged Bicyclo Compounds↗
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Effect of the protease inhibitor aprotinin on renal hemodynamics in the pig.

Aprotinin, the serine protease inhibitor that also inhibits glandular (urinary) kallikrein, or vehicle was infused into the aorta above the renal arteries of anesthetized pigs. Renal hemodynamic and functional parameters were followed over time and during hemorrhagic hypotension. Both renal cortical blood flow and glomerular filtration rate were maintained in vehicle-treated animals at mean arterial pressures as low as 70 mm Hg. As long as renal cortical blood flow and glomerular filtration rate were maintained during the progressive hypotension, urinary excretion rate of kallikrein (as defined by kinin-generating activity) was increased. In contrast, all aprotinin-treated animals had a decreased excretion rate, and the renal cortical blood flow declined with the mean arterial pressure during hemorrhage. The pattern of glomerular filtration rate and plasma renin activity was comparable in both aprotinin-treated and vehicle-treated hemorrhaged animals. Our findings suggest that the endogenous renal kallikrein-kinin system is required for functional renal vasodilatation to maintain renal cortical blood flow during hemorrhage and is therefore directly or indirectly responsible for adjustment of preglomerular resistance.

Analysis of Variance↗
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[Histometric studies of placentones of the human placenta].

Regionally different structures of placental terminal villi in the placentones have been shown in earlier publications. In this study the earlier results should be tested by means of histometry. The earlier results could be proved. It was shown that the villi in the centers of the circulation units are less differentiated than those in the peripherie of the placentones. The results were statistically significant. The reasons for the regionally different architecture of the placental villi are discussed with respect to the results of other authors working in the same field.

Chorionic Villi↗
PubMedDate not supplied

Endoscopic stenting in obstructive jaundice due to liver metastases: does it have a benefit for the patient?

BACKGROUND/AIMS: The goal of this report is to describe our experience with the palliative endoscopic treatment of jaundice occurring in the setting of liver and hilar metastases of a distant primary malignancy. MATERIAL AND METHODS: We retrospectively analyzed the clinical course of 29 consecutive patients with metastatic tumors not originating in the hepatobiliopancreatic area, who were treated by endoscopic retrograde cholangiopancreatography with endoprostheses insertion. RESULTS: We achieved a complete follow-up in 24 out of the 29 patients (11 women, median age 69 years). The primary tumor site was the colorectum in 15 patients, stomach in 4, lung in 2, breast and prostate in 1 and one patient had a lymphoma. The median bilirubinemia before therapy was 16 (1.8-31) mg/dl and the median minimum serum bilirubin reached after stenting was 2.6 (0.3-11.5) mg/dl. Stent dysfunction was observed in 33.5% of the patients and stent change was necessary 13 times. The median survival after therapy was 4 (2.5-19) months for patients with colon tumors and 3 (0.5-12) months in patients with other cancers. An improvement in the quality of life was obtained in 75% of the patients after endoscopic treatment. CONCLUSIONS: Endoscopic stenting should be attempted even on patients with obstructive jaundice due to liver metastases.

Aged↗
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[Endoscopic laser lithotripsy for difficult calculi after unsuccessful extracorporeal shock wave lithotripsy].

INTRODUCTION: More than 97% of common bile duct stones can be successfully managed by endoscopic papillotomy, mechanical lithotripsy and extracorporeal shock-wave lithotripsy. In this study, we evaluate the role of laser lithotripsy after failure of the above mentioned endoscopic methods. PATIENTS AND METHODS: Eighteen patients (15F, 3M; median age = 69 (28-83) years) were treated by endoscopic laser lithotripsy after ESWL failure. We employed a Rhodamine-6 G laser with a stone-tissue recognizing system. The laser fibers were cholangioscopically (direct vision) or blindly (under plain fluoroscopic control) placed. RESULTS: Seventeen patients were treated endoscopically and one was successfully managed percutaneously after failure of the transpapillary approach. Fourteen (78%) were stone-free after a mean of 1.56 laser therapy sessions alone. Two additional patients were successfully managed after partial fragmentation with combined treatment (mechanical lithotripsy: n = 1, electrohydraulic lithotripsy: n = 1). Overall, 89% of the patients were freed from their calculi. Cholangitis occurred once and the mortality was zero. CONCLUSIONS: We conclude that laser lithotripsy is an effective and safe treatment alternative in a highly selected patient population with difficult bile duct stones and considerable surgical risk.

Adult↗
PubMedDate not supplied

Molecular typing of avian Escherichia coli isolates by random amplification of polymorphic DNA.

Escherichia coli is a common inhabitant of the gastrointestinal tract of most animals. Like most pathogenic E. coli, avian isolates cannot be distinguished biochemically from the normal commensals inhabiting the gastrointestinal tract of birds. Using a molecular approach, we were able to identify genetic differences among avian E. coli isolates by restriction fragment length polymorphism (RFLP) and random amplification of polymorphic DNA (RAPD) by the polymerase chain reaction (PCR). Several different RFLPs were observed among avian E. coli isolates using DNA probes for 16S ribosomal RNA genes (rrn) and insertion sequence elements (IS2). We were also able to observe differences in DNA banding patterns generated by RAPD analysis. Similarities and differences among avian E. coli were discernible using RFLPs and RAPD analysis, whereas conventional bacteriological methods failed to differentiate these isolates. Based on RAPD patterns, avian E. coli appear to be genetically diverse. Of 16 different RAPD types (RT) encountered, 84% of E. coli fell into seven major RTs. One RT was present in clinical isolates but absent from the commensals isolated in this study. Many of these different E. coli RTs were not geographically restricted to northern Georgia but were also observed in other southern states in the United States. Resistance to various antibiotics was randomly associated with different E. coli RTs. Sarafloxacin resistance was present among different E. coli RTs, suggesting that antibiotic usage is not selecting for a clonal population in avian E. coli. RAPD provides a rapid and powerful tool to study the epidemiology of avian E. coli.

Animals↗