Spondyloenchondrodysplasia. A rare cause of short-trunk syndrome.
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Anthropometry↗
Biomedical subjects
N Halperin
Publications and source records attributed to N Halperin.
Long-term follow-up of the fate of xenogeneic transplants of chondrocytes implanted into joint surfaces.
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Animals↗
Regenerating hyaline cartilage in articular defects of old chickens using implants of embryonal chick chondrocytes embedded in a new natural delivery substance.
Partial and full thickness defects were created mechanically in articular cartilage and subchondral bone of the tibiotarsal joint condyles of 3-year-old chickens. The wounds were then repaired using embryonal chick chondrocytes embedded in a new biocompatible, hyaluronic acid-based delivery substance. Controls were similarly operated on but received either no treatment or implants of the delivery substance only. Animals were killed from 1 week to 6 months postoperatively. Sections from the two groups were examined and compared macroscopically, histologically, and histochemically. Results of 6-month follow-up showed that only the defects of the experimental chickens were completely filled with reparative hyaline cartilage tissue, with no signs of inflammation or immunologic rejection. Initially the entire defect cavity, whether partial thickness or full thickness up to the deep regions in the subchondral bone, was filled with cartilaginous reparative tissue. Relatively rapid maturation occurred under the tidemark; chondrocytes hypertrophied, were invaded with vascular elements and ossified. In the superficial areas, the reparative tissue remained cartilaginous and matured as typical hyaline cartilage tissue. These results indicate that aged chicken cartilage and its accompanying thin and spongy osteoporotic bone offer a favorable host environment for embryonal cell implants.
Animals↗
Hereditary chondrocalcinosis in an Ashkenazi Jewish family.
A hereditary chondrocalcinosis is described for the first time in an Ashkenazi Jewish kindred. Of 34 family members in five generations, seven had medical history suggesting the disease. Five of 25 members of generations III-V had direct evidence for their disease. Characteristically, symptoms started at a fairly early age (third decade) while radiological evidence of chondrocalcinosis was delayed to the fourth decade. Joints commonly affected were knees, wrists, and elbows. The course was chronic with acute, exercise induced exacerbations.
Adult↗
Spondyloepiphyseal dysplasia associated with progressive arthropathy. An unusual disorder mimicking juvenile rheumatoid arthritis.
A family is presented with three affected siblings suffering from a rare form of spondyloepiphyseal dysplasia with progressive arthropathy affecting most joints of the body except for the craniofacial skeleton. This syndrome, probably of autosomal recessive inheritance, clinically presents diffuse and chronic joint involvement and should be differentiated from juvenile rheumatoid arthritis and other rheumatic disorders.
Adolescent↗
Fate of allogeneic embryonal chick chondrocytes implanted orthotopically, as determined by the host's age.
Chondrocytes derived from chick embryos can be successfully implanted in defects of adult chick articular cartilage surfaces. Such implants thrive in their implantation site and create a new articular surface. The chondrocytes mature and hypertrophy in the orthotopic site without invoking an immune response. Eventually a steady state is reached in which mature chondrocytes resurface the defect while in the deeper areas spongy bone replaces the hypertrophic chondrocytes. Time schedules of these repair events have been studied in hosts of different ages. We compared 4-month-old chicks with 3-year-old chickens. The embryonal chondrocytes implanted in the latter group underwent an accelerated aging process. The defects were completely filled-up after 1 month as compared with 2-3 months in the younger age group. Endochondral ossification in the older group was evident as early as 2 months post implantation and was completed after 6 months. This contrasts with the situation in the younger group where the chondrocytes only began to hypertrophy after 6 months. At this stage endochondral ossification was hardly seen at all. A unique response to the cartilaginous implants is seen in the old group only in the vicinity of the reparative tissue, accumulation of hematopoietic centers. This study seem to indicate that the host's environment affects the "biological clock", i.e. rate and degree of aging of the implanted cells, as well as their matrices.
Age Factors↗
An overlapping pubic dislocation treated by closed reduction: case report and review of the literature.
An overlapping dislocation of the symphysis pubis is a rare injury caused by either side-to-side compression or hyperextension. We hereby describe a case of such injury sustained during parachuting and reduced by closed means. This case appears to be the first described in the literature where no damage to the urogenital tract was observed. The patient is asymptomatic 1 year later.
Adult↗
The treatment of carpal tunnel syndrome caused by hypertrophied lumbrical muscles. Case reports.
Three cases of manual workers suffering from carpal tunnel syndrome caused by a hypertrophied lumbrical muscle are presented. Results of auxiliary diagnostic tests are presented and the differential diagnosis is discussed. We conclude that release of the transverse carpal ligament should be accompanied by release or excision of the muscle belly to obtain permanent cure.
Adult↗
Multicentric giant-cell reparative granuloma. A case in the foot.
A case of multicentric giant-cell reparative granuloma in the foot of a 17-year-old boy is reported. Initially, there was a calcaneal lesion and 6 months later, three additional lesions in the forefoot. The calcaneal lesion was treated by curettage and bone grafting, and those in the forefoot by wide excision. The patient has now been free of disease for 18 months.
Adolescent↗
Nocardia asteroides infection of an Austin-Moore hemiarthroplasty in a nonimmunocompromised host. A case report.
A case of Nocardia asteroides infection of a hip prosthesis in a nonimmunocompromised patient is presented. The infection developed soon after the operation, and did not respond to empiric treatment by multiple antimicrobial drugs. Reoperation and removal of the prosthesis was necessary. The authors found no previous cases of nocardiosis complicating arthroplasty reported in the literature.
Aged↗
Microbiologic flora contaminating open fractures: its significance in the choice of primary antibiotic agents and the likelihood of deep wound infection.
A clear understanding of the significance of wound contamination as well as knowledge of the microbial flora that could be expected are needed in order to administer a rational and effective antibiotic treatment for open fractures. We have conducted a prospective study of the contaminating microbial flora in 89 open fractures. In addition, two more cultures were taken of all wounds not primarily closed. Wound and fracture healing were followed in all patients. Most fractures were Gustilo grade II (58.4%) caused by work-related accidents. Wound cultures were positive in 83% of all fractures, and a total of 84 strains of bacteria were isolated. In 39.3% of cultures, various species of aerobic Gram-negative rods (most commonly Pseudomaonas aeruginosa) were retrieved, followed by Staphylococcus epidermidis (34.5%) and Staphylococcus aureus (26.1%). Repeat cultures were mostly either negative (59.5%) or grew saprophytic organisms that were usually nonpathogenic (such as various species of saprophytic Bacillus bacteria). The only cases that developed deep wound infection were those where a repeat culture 1 day after debridement grew the same organisms as the initial organisms. We conclude that (a) most open fractures are already contaminated upon the patient's arrival at the emergency department, in many cases by potentially pathogenic staphylococci and Gram-negative organisms; (b) contaminating organisms are community acquired and, as such, are sensitive to most routine antibiotics; and (c) persistence of the same organisms in a repeat culture taken 1 day after debridement signifies technical failure of debridement and a subsequent very high risk of infection. Therefore, achieving adequate wound asepsis immediately following debridement is of the utmost importance.
Adult↗
Ulnar tunnel syndrome caused by an accessory palmaris muscle.
A case of ulnar nerve compression at the wrist caused by an accessory palmaris brevis muscle is presented. At operation, the muscle belly was excised and both Guyon's and the carpal tunnels released. The patient experienced complete relief of symptoms.
Adult↗
Anterior interosseous nerve palsy following closed fracture of the proximal ulna. A case report and review of the literature.
Complete paralysis of the anterior interosseous nerve was seen in 32-year-old army officer 5 weeks after he sustained a minimally displaced fracture of the proximal ulna. The fracture was immobilized in an arm cast. Thirteen weeks after injury, the cast was removed following evidence of bone union. Complete recovery of the flexor pollicis longus was noted 17 weeks after the injury, while recovery of the flexor profundus to the index finger to grade four lasted 10 months. To the best of our knowledge, this is the first case reported in the English language literature in which anterior interosseous nerve palsy follows isolated fracture of the proximal ulna.
Adult↗
An unusual loose body hidden in a sealed suprapatellar pouch.
A 20-year-old soldier presented with pain and swelling in his right knee, both of which became aggravated with activity. An unusual loose body was found in a sealed suprapatellar pouch in the knee. All symptoms disappeared following removal of the loose body.
Adult↗
Traumatic anterior dislocation of the hip joint with fracture of the acetabulum: a case report.
A 67-year-old woman sustained a pubic-type anterior dislocation of the hip associated with a comminuted fracture of the anterosuperior part of the acetabulum and the anteroinferior iliac spine following a fall on the knee. Because of interposition of the iliopsoas tendon, closed reduction followed by skeletal traction failed to achieve reduction of the acetabular fragment. An abnormally high degree of anteversion of the femoral neck is suggested as a possible predisposing factor in this injury.
Acetabulum↗
Pigmented villonodular synovitis of the talus in a child.
An unusual case of localized pigmented villonodular synovitis of the ankle joint in a 3-year-old boy is described. The child was brought to the hospital because of abrupt onset of pain and joint effusion. A soft tissue mass eroding the talar dome was seen in roentgenograms. Exact diagnosis was established by excisional biopsy. Curettage of the lesion resulted in healing without recurrence at 10-year follow-up examination.
Ankle Joint↗
Semimembranosus tenosynovitis: operative results.
Semimembranosus tenosynovitis is a common knee problem in the over-50 age-group, occurring mainly in women. It affects the reflected portion of the tendon of the semimembranosus muscle as well as the bursa below it. The tendon becomes inflamed as a result of friction at the entrance to the bony canal (semimembranosus groove), especially if osteophytes are present on the edges of the groove. Conservative treatment includes anti-inflammatory drugs, ultrasound, and friction massage. If necessary, nonresponders may be given local injection of 40-80 mg methylprednisolone acetate with 1% Xylocaine. Between 1979 and 1983 we operated on 16 patients who had not obtained relief even after three or four injections. The approach in each case was through a posterior medial oblique incision. The semimembranosus osteofibrotic tunnel was revealed and the fibrous sheath surrounding the tendon was excised. Good results were obtained in eight patients in whom the inflammatory process had been localized to only the semimembranosus insertion area: eight patients in whom the knee joint or the pes anserinus insertion was also involved achieved fair or poor results. The operation is not advised for young athletes because of the important function of the reflected head of the semimembranosus muscle.
Diagnosis, Differential↗
Computerized tomography in the diagnosis and treatment of osteoid osteoma.
Thirteen cases of osteoid osteoma demonstrated with computerized tomography are reported. Twelve patients underwent definitive surgery and were relieved of their symptoms. The histological examination confirmed the preoperative diagnosis in 11 cases. Six lesions were located in the proximal femur, three in the neck of the talus, two in the proximal tibia, and one each in the proximal humerus and the calcaneus. Radionuclide technetium 99m MDP scans were performed in 11 cases and showed an increased uptake in the vicinity of the lesions. Computerized tomography showed the precise location of the nidus, thus helping in the preoperative planning of the surgical approach and enabling us to perform a precise and economic resection.
Adolescent↗