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Biomedical subjects

R A Berger

Publications and source records attributed to R A Berger.

At least 19 recordsLinked to original sources
PubMed1992

[Severe tricuspid valve insufficiency due to papillary anterior muscle infarction of the right ventricle secondary to neonatal hypoxia].

A fatal case of a stressed newborn baby who developed tricuspid insufficiency due to an anterior papillary muscle infarction of the right ventricle, related to perinatal anoxia is reported. The baby needed resuscitation management and had a systolic murmur soon after birth. The echocardiographic examination showed a flail anterior leaflet of the tricuspid valve due to an avulsed anterior papillary muscle. There was rupture of chordae tendineae between anterior and posterior leaflet. Necrosis and calcium deposit were found in the area. The conclusion was that the anoxia in perinatal period, in most cases, causes transient lesions, but in few cases might be severe and fatal. It is important a complete cardiac evaluation in every case of prolonged perinatal stress.

Echocardiography, Doppler↗
PubMed1991

Radioscapholunate ligament: a gross anatomic and histologic study of fetal and adult wrists.

The radioscapholunate ligament was studied using fifty-four dissected adult cadaver wrists. Four of these wrists had arterial perfusions with colored latex and serial sections were made of twenty-one wrists from fetuses ranging in size from 23 to 230 millimeters crown-rump length. The radioscapholunate ligament was consistently identified between the long and short radiolunate ligaments, emerging through the palmar capsule of the radiocarpal joint. It was found to be a neurovascular structure surrounded by synovial tissue with vascular origins from the anterior interosseous and radial arteries and a neural origin from the anterior interosseous nerve. On entering the radiocarpal joint it attaches proximally to the interfacet prominence on the articular surface of the radius and distally to form the proximal membrane of the scapholunate interosseous ligament system. We found no anatomic evidence that this structure should be considered a ligament in a traditional mechanical sense. However, this structure may be clinically important as the vascular supply of the scapholunate interosseous ligament, as well as a sensory pathway from the scapholunate articulation.

Adult↗
PubMed1990

The palmar radiocarpal ligaments: a study of adult and fetal human wrist joints.

The palmar radiocarpal ligaments were studied with use of fifty-four dissected adult cadaver wrists and serial sections on twenty-three wrists from fetuses ranging in size from 23 to 230 millimeters crown-rump length. Three palmar radiocarpal ligaments were clearly identified: the radioscaphocapitate, long radiolunate, and short radiolunate ligaments. The radioscaphocapitate ligament originates from the radial styloid process and inserts into the radial aspect of the waist of the scaphoid, hemicircumferentially around the distal pole of the scaphoid and interdigitates with fibers from the palmar aspect of the triangular fibrocartilage complex just palmar to the head of the capitate, with only a minor insertion distally into the body of the capitate. The long radiolunate ligament originates just ulnar to the radioscaphocapitate ligament, being separated from it throughout its course by the interligamentous sulcus. The long radiolunate supports, but is separate from, the palmar aspect of the scapholunate interosseous ligament, and inserts into the radial half of the palmar surface of the lunate. The short radiolunate ligament, previously not described, originates just palmar to the lunate facet of the distal radius articular surface and inserts as a flat sheet of fibers into the proximal margin of the palmar surface of the lunate. Each ligament is intracapsular, enveloped within a continuous superficial fibrous stratum and deep synovial stratum.

Adult↗
PubMed1990

Whole-body movements during rising to standing from sitting.

Rising to a standing position from a sitting position is one of the most important activities of daily life. We present a total-body analysis of rising from a chair as performed by nine healthy individuals under controlled conditions. We describe four phases of this activity. Phase I is a flexion-momentum phase used to generate the initial momentum for rising. Phase II begins as the individual leaves the chair seat and ends at maximal ankle dorsiflexion. Forward momentum of the upper body is transferred to forward and upward momentum of the total body. Phase III is an extension phase during which the body rises to its full upright position. Phase IV is a stabilization phase. Kinetics and kinematics of the phases are analyzed. The phases are differentiated in terms of momentum and stability characteristics. Clinical implications of the mechanics of rising are discussed.

Adult↗
PubMed1990

Calcium pyrophosphate dihydrate crystal deposition patterns in the triangular fibrocartilage complex.

To define the patterns of calcium pyrophosphate dihydrate (CPPD) crystal deposition in the triangular fibrocartilage complex (TFCC), we examined the wrists of five adult, fresh-frozen cadavers using light and scanning electron microscopy and the wrist radiographs of 10 patients with a clinical diagnosis of CPPD disease. The radiographs consistently showed mineral deposits near or on the proximal and distal surfaces of the radial half of the TFCC. Light and electron microscopy showed that CPPD crystals formed distinct clusters sharply demarcated from uninvolved fibrocartilage. The density of crystal packing within clusters varied with the sharpness of demarcation of the clusters from the surrounding tissue. TFCC defects were consistently found in the vicinity of CPPD crystals, and degeneration of the articular cartilage on the ulnar half of the proximal surface of the lunate was associated with CPPD crystal deposition in the radial half of the TFCC. These observations suggest that degenerative tears of the TFCC and degeneration of the articular cartilage of the lunate are associated with CPPD crystal deposits in the TFCC.

Adult↗
PubMed1989

A posterior surgical approach to the proximal part of the humerus.

At least eight centimeters of the posterior aspect of the proximal region of the humeral diaphyseal cortex can be exposed through the interval between the lateral head of the triceps and the deltoid muscle. No nerves or major blood vessels are exposed in the dissection, although care must be taken to protect the axillary and radial nerves during the exposure. The safety of this approach was confirmed in fourteen upper extremities of seven adult cadavera, and it was used successfully for an excisional biopsy of an osteoid-osteoma in the proximal third of the posterior part of the humeral cortex of an eleven-year-old boy.

Cadaver↗
PubMed1988

Isolation of a component from commercial coomassie brilliant blue R-250 that stains rubrophilin and other proteins red on polyacrylamide gels.

Commercially available Coomassie Brilliant Blue R-250 (C.I. 42660) is a popular and useful dye that stains most proteins blue on polyacrylamide gels. Some proteins from brain (rubrophilin), collagens, histones and parotid gland proteins are distinctly red when stained with Coomassie Blue. Commonly used Coomassie Brilliant Blue R-250 preparations may contain more than 30 distinct colored and fluorescent components that can be separated on silica gel chromatographic columns. A specific component has been isolated on silica gel columns that stains rubrophilin and other proline-rich proteins a reddish color. Fast atom bombardment mass spectrometry of the isolated rubrophilin staining principle indicates a molecular weight of 634 as compared to 826 for the major dye in the original Coomassie Brilliant Blue R-250. Infrared spectrometry is consistent with a difference between the rubrophilin staining principle and Coomassie Brilliant Blue R-250 of a toluene sulfonic acid residue.

Acrylic Resins↗
PubMed1988

Resultant forces and angles of twist about the wrist after ECRL to ECU tendon transfer.

This paper describes an experimental investigation to determine the biomechanical efficacy of the extensor carpi radialis longus (ECRL) to extensor carpi ulnaris (ECU) tendon transfer procedure used in rheumatoid hand reconstruction. Six normal cadaver specimens were tested in an apparatus that measured (a) the forces acting on the hand to restrain it in seven characteristic wrist configurations, and (b) the amount of hand pronation/supination that occurred as a result of loads applied to the tendons of the six major wrist muscles. Each specimen was tested with the ECRL tendon intact, surgically released, and transferred to the insertion point of ECU. In the intact and transferred states, the ECRL tendon was loaded sequentially while the remaining five wrist tendons were subjected to equal constant loads. In all three experimental ECRL test states, forces were also applied to all intact wrist tendons in a manner designed to represent physiologic load sharing. When the ECRL tendon was loaded sequentially, the transfer resulted in the predictable increase in the radially directed restraining force and the predictable supination of the hand relative to the forearm. When all intact tendons were loaded physiologically, the transfer also resulted in an increase in the radially directed restraining force. Significant differences between test states occurred generally only between the intact and release states of the ECRL tendon and not between release and transferred states.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Galactose ingestion increases vascular permeability and collagen solubility in normal male rats.

In view of the similarity of cataracts and neuropathy in galactose-fed and diabetic rats, the present experiments were undertaken to determine whether consumption of galactose-enriched diets (10, 25, or 50% by weight) also increases collagen crosslinking and permeation of vessels by 125I-albumin analogous to that observed in diabetic rats. The observations in these experiments: demonstrate that consumption of galactose-enriched diets for 3 wk selectively increases 125I-albumin permeation of the same vascular beds affected in diabetic rats and by diabetic vascular disease in humans (i.e., the aorta and vessels in the eye, kidney, sciatic nerve, and new tissue formed in the diabetic milieu); demonstrate that the susceptibility of the vasculature to aldose reductase-linked injury (increased permeability) varies greatly in different tissues; indicate that collagen solubility (crosslinking) changes in galactose-fed rats differ sharply from those in diabetic rats; and provide new evidence that consumption of galactose-enriched diets induces a hypogonadal state in male rats.

Aldehyde Reductase↗
PubMed1986

Analysis of inositol mono- and polyphosphates by gas chromatography/mass spectrometry and fast atom bombardment.

The electron ionization spectra of all of the positional isomers of myo-inositol monophosphate and of myo-inositol 1,2-cyclic phosphate were obtained by gas chromatography/mass spectrometry of the pertrimethylsilyl derivatives. The fragmentation pattern of pertrimethylsilyl myo-inositol-1-phosphate was studied using deuterium labeling. The phosphate moiety was found to direct fragmentation to produce fragment ions of useful intensity with specific carbon retention. The spectrum of pertrimethylsilyl myo-inositol-1,4-bisphosphate is also described. An electron impact gas chromatographic/mass spectrometric method for myo-inositol-1-phosphate has been developed, which has a sensitivity to a level of 0.1 pmol. The positive and negative ion fast atom bombardment spectra of myo-inositol hexakis(disodium phosphate) and myo-inositol hexakis(dihydrogen phosphate) are described. The lesser-phosphorylated inositol polyphosphates were also studied, including inositol pentakis and inositol tetrakis(dihydrogen phosphates) as well as D-myo-inositol-1,4,5-trisphosphate and D-myo-inositol-1,4-bisphosphate from human red blood cells. The sensitivity of fast atom bombardment for the measurement of the latter two substances allows their detection to a level of about 10 nmol. The fast atom bombardment spectrum of synthetic myo-inositol 1,2-cyclic phosphate revealed variable amounts of a dimer produced during its preparation.

Electrons↗
PubMed1986

Sex steroid dependency of diabetes-induced changes in polyol metabolism, vascular permeability, and collagen cross-linking.

The effects of castration on diabetes-induced increases in collagen cross-linking and vascular permeability and on polyol levels in new granulation tissue formed after induction of streptozocin (STZ) diabetes were examined in male Sprague-Dawley rats. New granulation tissue formation was induced by implanting sterile polyester fabric subcutaneously (s.c.) at the time of STZ injection 3 wk before assessment of vascular permeability and collagen cross-linking. Castration was performed 10 days before implanting the fabric. The characteristic increases in collagen cross-linking (manifested by decreased solubility in 0.5 M acetic acid) and in albumin permeation of the vasculature seen in intact diabetic rats were completely prevented by castration. Net collagen accumulation was not affected by diabetes or castration. Castration also markedly diminished diabetes-induced increases in tissue levels of sorbitol and completely prevented the decreases in tissue levels of myo-inositol and scyllo-inositol observed in intact diabetic rats, but had no effect on serum glucose levels, nonenzymatic glycosylation of plasma and granulation tissue proteins, or plasma somatomedin-C levels. The demonstration that castration prevents diabetes-induced increases in vascular permeability and collagen cross-linking as well as imbalances in tissue levels of sorbitol, myo-inositol, and scyllo-inositol in this model indicates that all of these changes are sex steroid-dependent phenomena. While the pathogenesis of these vascular permeability and collagen cross-linking changes is clearly multifactorial, these new findings: indicate that the role of sex steroids in the development of late complications of diabetes may be far more important than hitherto suspected, and suggest an explanation for the clinical observation that diabetic complications are uncommon in prepubertal diabetic subjects regardless of duration of diabetes.

Animals↗
PubMed1985

Arthrotomography of the wrist: an experimental and preliminary clinical study.

Experimental arthrotomography including posteroanterior and lateral projections was completed in 18 fresh-frozen wrists from cadavers with an average age of 65 years at death. Arthrotomographic findings were correlated with anatomic dissections. Three types of defects of the triangular fibrocartilage complex were clearly defined in 38% of wrists. Chondromalacia was present in 24% of wrists, in all cases on the ulnar half of the proximal surface of the lunate bone. The palmar radiocarpal ligaments (radiocapitate and radiotriquetral) were visible in all specimens. Experimental arthrotomography appears to be useful in defining the nature and location of soft tissue pathology in clinical practice. Clinical arthrotomography was performed in 16 patients, all with a syndrome of chronic wrist pain. Pathologic findings were observed in 11 wrists, including four perforations of the triangular fibrocartilage complex, two cases of chondromalacia of the lunate, one tear in each of the scapholunate and lunotriquetral ligaments, three occult palmar ganglia, and one recurrent dorsal ganglion. The soft tissues in five wrists were normal. The preliminary clinical experience with wrist arthrotomography has yielded results that have significantly affected the care of patients, including the planning of operative treatment and patient counseling.

Adolescent↗
PubMed1985

Inositol cyclic phosphates are produced by cleavage of phosphatidylphosphoinositols (polyphosphoinositides) with purified sheep seminal vesicle phospholipase C enzymes.

Previous studies have shown that metabolism of phosphatidylinositol by phospholipase C produces a mixture of two water-soluble products: inositol 1-phosphate and inositol 1,2-(cyclic)phosphate. In the present study, we demonstrate that the water-soluble products of phosphatidylphosphoinositol (polyphosphoinositide) cleavage by purified ram seminal vesicle phospholipase C enzymes also contain cyclic phosphates. Inositol cyclic phosphates were detected by 18O labeling. In the presence of acid, cyclic phosphates are rapidly hydrolyzed to phosphomonoesters, and when the hydrolysis is carried out in H2 18O, the resultant phosphomonoesters will contain 18O. The 18O content of the phosphomonoesters was measured following alkaline phosphatase treatment and conversion of the inorganic phosphate to a volatile derivative for gas chromatography/mass spectrometry. Inositol cyclic phosphates were found in the phospholipase C cleavage products of all three phosphoinositides, but the ratio of cyclic to noncyclic product was found to decrease in the order phosphatidylinositol greater than phosphatidylinositol 4-phosphate greater than phosphatidylinositol 4,5-bisphosphate. The formation of myo-inositol 1,2(cyclic)-4-bisphosphate was further substantiated by anion-exchange HPLC of the water-soluble products of [32P]phosphatidylinositol 4-phosphate metabolism by phospholipase C. Two peaks were detected one of which, on acid treatment, incorporated 18O from H2 18O into phosphate groups, consistent with this peak containing the cyclic phosphate product. These results suggest that polyphosphoinositide breakdown in stimulated cells may occur via a cyclic phosphate intermediate, as has been described for phosphatidylinositol. These cyclic phosphates contain a reactive bond that may play a role in phosphoinositide-derived signal transduction.

Animals↗
PubMed1984

The radioscapholunate ligament: a gross and histologic description.

The anatomic relationships of the carpal radioscapholunate ligament to its contiguous structures were analyzed by studying 1) 12 grossly dissected fresh adult wrists, and 2) multiple histologic sections from six adult wrists. Observations indicate that the radioscapholunate ligament originates from the prominence between the scaphoid and lunate articular facets on the distal articular surface of the radius, and from the palmar margin of the distal radius, deep and medial to the origin of the radiotriquetral and radiocapitate ligaments. The primary insertion of the radioscapholunate ligament is the medial margin of the proximal pole of the scaphoid. The ligament secondarily inserts into the lateral margin of the lunate and significantly contributes to the proximal portion of the scapholunate interosseous ligament. The radioscapholunate ligament is distinguished morphologically from the other palmar radiocarpal ligaments by its loosely organized collagen fibers and relatively high degree of vascularity. The radiotriquetral and radiocapitate ligaments are composed of densely fasciculated collagen fibers surrounded by perpendicularly oriented perifascicular and epiligamentous fibers. A fibrous capsular layer covers the most superficial aspect of each carpal ligament. On the deep surfaces of these ligaments, a condensation of epiligamentous fibers forms a synovial capsular layer. The palmar radiocarpal ligaments are truly intracapsular structures, as they are interposed between the fibrous and synovial capsular layers. No histologic evidence of elastin is present within the substance of these ligaments.

Aged↗
PubMed1984

Meniscotibial (coronary) ligament tears.

Preservation of the meniscus whenever possible is essential in maintaining knee stability and preventing premature osteoarthritis. Peripheral meniscal tears are the most amenable to surgical repair. This study evaluates the peripheral attachments of the medial meniscus and focuses on a specific tear limited to the meniscotibial ligament (coronary ligament). The diagnosis is made arthrographically when the medial meniscus floats above the tibial plateau without separating completely from the capsule. The lateral meniscus is rarely involved in this type of injury.

Adolescent↗
PubMed1984

Arthrotomography of the wrist. The palmar radiocarpal ligaments.

Twenty-one fresh cadaver wrists were studied by arthrography and arthrotomography. Arthrography was unreliable in accurately delineating the palmar radiocarpal ligaments. However, lateral arthrotomograms predictively and precisely outlined the radiolucent radiocapitate and radiotriquetral ligaments. The radial and more distant radiolucent area was the radiocapitate ligament, and the ulnar and more proximal area was the radiotriquetral ligament. A constant radiopaque invagination between the outlines of contrast material demonstrated the sulcus anatomically separating these two ligaments. When the ligaments were transected contrast material entered the substance of the ligaments, rendering them radiopaque and, thus, visible on the radiographs. The authors believe that arthrotomography may be a useful clinical tool in the evaluation of post-traumatic injuries to the palmar radiocarpal ligaments of the wrist.

Adult↗
PubMed1984

Maintaining the integrity of a biomedical communications department.

In a changing public economy, reductions in the number and size of awards for research, education, and public service in addition to government pressures to reduce Medicare and Medicaid health expenditures will have significant impact on levels of funds available to academic health sciences centers. As competition increases for shrinking financial resources the biomedical communications department must reshape itself to a broader market place if it is to survive. The development of a separate marketing corporation is proposed as one model to promote integrity.

Academic Medical Centers↗