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Biomedical subjects

N Halperin

Publications and source records attributed to N Halperin.

At least 73 records · Page 4Linked to original sources
PubMed1985

Unusual fracture dislocation of the elbow joint.

A rare case of posterior dislocation of the elbow joint with an avulsion fracture of the medial humeral epicondyle and fracture of the capitulum humeri is presented. Closed reduction was insufficient. Excision of the comminuted segments of the fractured capitulum was imperative to allow an optimal return of elbow function.

Adolescent↗
PubMed1985

Hypercalciuric rickets: metabolic studies and pathophysiological considerations.

Extensive metabolic studies were performed in a 14-year-old boy suffering from the rare clinical entity known as childhood idiopathic hypercalciuria associated with dwarfism, renal tubular abnormalities and bone lesions. The salient features were: hyperphosphaturia with hypophosphatemia, hypercalciuria with normocalcemia, elevated serum 1,25-dihydroxycholecalciferol[1,25(OH)2D3] levels, marked intestinal hyperabsorption of calcium and phosphorus, with low serum parathyroid hormone (PTH) and urinary adenosine 3':5'-cyclic monophosphate (c-AMP). Bone biopsy confirmed the clinical and radiological diagnosis of rickets. It appears that the following pathophysiological sequence is operating: primary renal phosphate leak with hypophosphatemia, increased 1,25(OH)2D3 synthesis, enhanced intestinal calcium absorption which in turn inhibits release of PTH and c-AMP. Hypercalciuria is seen to be secondary to both avid intestinal calcium absorption and depressed PTH activity, and rickets the result of phosphate depletion. Treatment with oral phosphorus only resulted in an acceleration of growth rate, cure of rickets, and return of urinary calcium excretion to normal values.

Adolescent↗
PubMed1984

Local penetration of gentamicin into the femoral cortex of rats.

To investigate the extent of local penetration of antibiotic into the bone, a single dose of 10 mg/kg gentamicin sulphate was injected over the midshaft of the left femur in 12 young and 14 old rats. In some of the rats the injected gentamicin was dissolved in saline while in the others it was dissolved in dimethylsulphoxide (DMSO). Up to 120 minutes after the injection gentamicin concentrations were measured by the fluoroimmunoassay method in the serum, cortex and spongiosa of both femurs. In young rats gentamicin was shown to have penetrated directly into the bone and its presence was limited to the femoral cortex. In the old rats, on the other hand hematogenic was found to be the antibiotic spread in the femurs. No significant difference was observed between DMSO and saline as solvents in facilitating gentamicin penetration into the bone or capillaries in either age group.

Administration, Topical↗
PubMed1984

Abduction-traction injury of the knee.

Disruption of the major ligaments of the knee was seen in six young men, five parachutists and a house painter, after what we have termed abduction-traction injury. This unusual complaint results from the application of a sudden block to the ankle while falling head first, leading to traction and abduction of the knee. All the patients underwent operations, generally with unsatisfactory results. At operation tears of the anterior cruciate ligament, medial collateral ligament and posterior oblique ligament were seen in each case; in four patients the posterior capsule and in three the posterior cruciate ligament also were torn. In one patient the lateral collateral ligament was torn and the lateral meniscotibial ligament was avulsed. The compression component is absent in this type of injury and consequently the menisci and the osteochondral surfaces of the tibia and femur remained intact in each case.

Accidents, Occupational↗
PubMed1984

Multiple exostoses-mental retardation syndrome. A case report and review of the literature.

A girl seven years ten months of age with multiple exostoses-mental retardation (MEMR) syndrome was treated by bilateral supracondylar osteotomies at the age of six years 11 months for correction of severe genu valgum. The case is the 14th to be described in the English-language literature and seems to be the first on record in which the deformity was corrected by surgery. Typical findings in this syndrome include unusual facial features with bulbous nose, sparse scalp hair, large ears, microcephaly, mental retardation, cone-shaped epiphyses of the digital phalanges, and multiple exostoses. Each of these features may also appear in other constitutional and genetic disorders, and only their combination points to a definite diagnosis of MEMR syndrome. Other features, e.g., joint laxity and loose skin, are transient and may cause some confusion in diagnosis, sometimes leading to a mistaken diagnosis of cerebral palsy or Ehlers-Danlos syndrome. Thus, care must be taken in consecutive examinations to seek and identify each of the above mentioned typical features of the disorder.

Child↗
PubMed1983

A simple operation for correction of chronic lateral instability of the ankle.

Twenty-two patients underwent a simple operation for correction of chronic lateral instability of the ankle. During the procedure the function of the peroneus brevis was preserved and the anterior talofibular ligament was reconstructed. At follow-up only one patient reported that the ankle still felt unstable.

Adult↗
PubMed1983

Radiating leg pain and positive straight leg raising in spondylolysis in children.

Three children presented with low back pain radiating to the leg and with spasm of the hamstring and paravertebral muscles. Since the pain could not be ascribed to trauma, it was necessary to exclude the presence of infection or tumors. All the signs--localization of the pain, tenderness on one side of the back, X-ray film findings of unilateral or bilateral spondylolysis, and localized positive bone scan--pointed to spondylolysis as the cause of pain. All three children exhibited symptoms resembling those found in the facet syndrome described by Mooney and Robertson.

Adolescent↗
PubMed1983

Anterior cruciate ligament insufficiency syndrome.

Corrective surgery for anterior cruciate ligament (ACL) lesions was performed in 64 patients. Approximately two-thirds of the patients who presented with anteromedial instability were approached through the medial aspect of the knee. In all cases the instability was improved but not entirely eliminated. This was not in itself a disabling problem, as 44% of these patients had good subjective results. However, pivot-shift tests at follow-up examination clearly indicated the presence of anterolateral instability in most, if not all, of these patients. This did not necessarily preclude a self-evaluation of "good"; conversely, a self-evaluation of "fair" (33% of patients) was always related to a positive pivot-shift phenomenon. The authors' current surgical policy is, therefore, to regard the two types of instability as related aspects of a single ACL insufficiency syndrome, and to correct both the anterolateral instability (by the MacIntosh procedure) and the anteromedial instability (by suturing the posterior medial capsule to the semimembranosus tendon together with pes transfer). Poor subjective results (22% of patients) were always associated with the patellofemoral pain syndrome, which could be traced to rotational instability leading to patellar malalignment.

Athletic Injuries↗
PubMed1982

The lumbosacral ligament (LSL), with special emphasis on the "lumbosacral tunnel" and the entrapment of the 5th lumbar nerve.

The lumbo-sacral ligament (LSL) was studied in 42 specimens. It extends from the L5 vertebra to the ala of the sacrum and forms, with the structures to which it is attached, an osteofibrotic tunnel as an extension of the intervertebral foramen. The 5th lumbar nerve root passes through the tunnel over the ala of the sacrum and behind the LSL. A branch of the 4th lumbar nerve root passes in front of the LSL to join the 5th below the ligament to form the lumbo-sacral trunk. The sympathetic ramus communicans to the L5 root always penetrates the LSL at its superior border and reaches the nerve inside the tunnel. Branches of the ilio-lumbar vessels accompany the L5 root. Large osteophytes on the inferior border of L5 and tightness of the LSL were often found to cause entrapment and compression of the L5 nerve root against the ala of the sacrum.

Adult↗
PubMed1982

Painless root compression following disc extrusion. A report of three cases.

Three cases of painless root compression following disc extrusion are reported. Each patient showed the typical course of disease with the neurological deficit appearing at the same time as the sciatic pain disappeared. At operation the nucleus pulposus was found in the spinal canal. It is suggested that disappearance of the pain is related to the perforation of the anulus fibrosus and posterior longitudinal ligament by the nucleus pulposus. The operative findings justified early operation in these patients, and prompt surgery is recommended for similar cases.

Adult↗