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Biomedical subjects

S Rupp

Publications and source records attributed to S Rupp.

90 records · Page 5Linked to original sources
PubMed1986

[Behavior of glucosephosphate isomerase in children with malignant diseases].

The normal range of glucose-phosphate-isomerase (GPI) in the plasma of children during the first month of life is up to 80 U/l; until the end of the second year of life between 11 and 50 U/l; thereafter the upper limit is 46 U/l. In osteogenic sarcoma or medulloblastoma there is a good correlation between activity of GPI in plasma and clinical tumor stage. In a lot of other tumors sensitivity of this enzyme is either very low as in Ewing-sarcoma or myeloic leukemia or there is no consistent relation to the extent of the tumor. High activities of GPI are equally obtained in children suffering from cystic fibrosis, diabetes mellitus or muscular dystrophy. GPI is not valid as a tumor marker even being raised in sarcoma and medulloblastoma as mentioned. So it is not necessary to check GPI activity as a part of routine enzyme chemistry.

Adolescent↗
PubMed1979

Unusual electromyographic findings in a patient with polymyalgia rheumatica.

A case of polymyalgia rheumatica (PMR) with biopsy-proven giant cell arteritis (GCA) is described in which there were marked abnormalities noted on electromyography (EMG). Spike potentials, positive waves, and fibrillation potentials were seen in the proximal musculature of the upper and lower extremities as well as in the erector spinae muscles. Investigation failed to reveal abnormalities in either creatinine phosphokinase (CPK), aldolase, or muscle obtained at biopsy. The presence of these EMG findings in the PMR-GCA syndrome is unusual. Response to therapy with systemic corticosteroids and normalization of the EMG are documented.

Creatine Kinase↗
PubMedDate not supplied

Cortical versus cancellous interference fixation for bone-patellar tendon-bone grafts.

The objective of this study was to evaluate the initial fixation strength of a metal interference screw (9 x 25 mm; Arthrex, Naples, FL) with respect to its position relative to the bone plug in anterior cruciate ligament reconstruction using a bone-patellar tendon-bone graft. Porcine lower limbs were used. In group 1 (n = 20) the screw was placed adjacent to the cortex of the bone plug. In group 2 (n = 20) the screw was placed between the cancellous surfaces of the tibial tunnel and the bone plug. Specimens were loaded to failure using an universal material testing machine. Failure mode was defined by visual analysis of the specimens after loading. Primary fixation strength was not significantly different for both groups. Maximum force was 779 +/- 179 N (group 1, cortical side) and 743 +/- 143 N (group 2, cancellous side). There was a difference in failure modes. In group 1, testing resulted predominantly in tendon ruptures and bone plug fractures (70%). In group 2, bone plug pullouts were predominant (75%). From these data we conclude that the position of the screw relative to the bone plug influences failure mode but not the initial fixation strength.

Animals↗
PubMedDate not supplied

Preoperative ultrasonographic mapping of calcium deposits facilitates localization during arthroscopic surgery for calcifying tendinitis of the rotator cuff.

Calcifying tendinitis is a relatively common disorder of the rotator cuff. For symptomatic patients, excision of the calcium deposits offers reliable pain relief. The arthroscopic technique is demanding. Arthroscopic localization of the deposit is frequently demanding. The technique described in this article facilitates the localization of calcium deposits based on preoperative ultrasonography. Knowing the exact topography of the deposit relative to the visible landmarks allows the surgeon to localize the site of the deposit from the intra-articular view. Probing the rotator cuff with a spinal needle and looking for calcific material at the tip of the needle is an important step in verifying the location of the deposit.

Arthroscopy↗
PubMedDate not supplied

Age-related prevalence of rotator cuff tears in asymptomatic shoulders.

To determine the prevalence of rotator cuff tears in asymptomatic shoulders we conducted a prospective clinical and ultrasonographic study of 411 volunteers. We anticipated an age-dependent outcome and divided the patients into 4 age-groups. Overall, we found evidence of a rotator cuff tear in 23% of the patients. In group 1 (aged 50 to 59 years), 13% (22 of 167) of the patients had tears; in group 2 (aged 60 to 69 years), 20% (22 of 108) of the patients had tears; in group 3 (aged 70 to 79 years), 31% (27 of 87) of the patients had tears; and in group 4 (age > 80 years), 51% (25 of 49) of the patients had tears. An astonishingly high rate of rotator cuff tears in patients with asymptomatic shoulders was thus demonstrated with increasing patient age. At this stage it remains unclear, however, which parameters convert an asymptomatic rotator cuff tear into a symptomatic tear. As a result, rotator cuff tears must to a certain extent be regarded as "normal" degenerative attrition, not necessarily causing pain and functional impairment.

Aged↗
PubMedDate not supplied

Cyclic testing of meniscal sutures.

Suturing the meniscus has become a standard procedure for repairable tears. Studies investigating the outcome of meniscal sutures report a considerable rate of failures. Regarding the indications, which have been extended to the avascular zones, and regarding some accelerated rehabilitation protocols, the need for further in vitro investigations has become obvious. The aim of this study was to compare different meniscal suture types (vertical and horizontal mattress sutures) and materials (absorbable monofilament PDS 2-0, and nonabsorbable braided Ethibond 2-0 [Ethicon, Somerville, NJ]) under standard and cyclic loading conditions. Testing was performed on medial porcine menisci. In group A, specimens were tested to failure at a cross-head speed of 50 mm/minute. In group B, cyclic testing (100 cycles) was performed first within different load intervals (5 to 20 N and 5 to 40 N). Finally, the specimens were loaded until failure. In both groups, the failure loads were recorded and the failure modes were analyzed. In group A, there was no difference between suture type or suture material, with a mean failure load of 60 N. The failure modes were significantly different for vertical (100% suture failure) and horizontal sutures (50% suture failure) (P <.0001). In group B, 13% of the sutures failed under cyclic loading (7 with 40-N load, 1 with 20-N load). The gap of the sutured tear that appeared within the first load cycles was broader in horizontal sutures (P <.001). During the first cycles, the thread cut through the meniscus tissue and disappeared from the surface (partial tissue failure). There was no difference according to suture material. The ultimate failure loads after cyclic loading did not differ from the values of group A. These results show that meniscal sutures may fail under repetitive loading conditions and that a gap appears between the meniscal margins within the first loading cycles irrespective of the suture type and suture material used. The appearance of the gap and suture disappearance on the meniscal surface because of partial tissue failures (which were more pronounced in the horizontal sutures) confirmed the superior resistance of meniscal tissue to vertical sutures.

Animals↗
PubMedDate not supplied

[Significance of the hypoechoic area around the long biceps tendon in shoulder sonography--underlying pathology].

OBJECTIVE: The objective was to evaluate the sonographic sign of a hypoechoic area ("halo-sign") around the long biceps tendon as an equivalent of intraarticular effusion. METHODS: Part 1: Ten patients scheduled for shoulder arthroscopy underwent ultrasonography immediately before surgery. If there was no hypoechoic area around the long biceps tendon 30 ml of NaCl-solution (0.9%) were injected into the joint. After repetitive passive motion the patient underwent a second ultrasonography. Part 2: Ten consecutive patients with a hypoechoic area around the long biceps tendon underwent shoulder arthroscopy. During this procedure they were examined for intraarticular effusion. Patients with rheumatoid disease were excluded from the study. RESULTS: Part 1: In 9 of 10 patients a hypoechoic area around the long biceps tendon was induced by injection into the joint. The area was 1.07 +/- 0.13 cm2. In one case we could not induce the described phenomenon. Part 2: In all patients with a hypoechoic area around the long biceps tendon an intraarticular effusion was found at arthroscopy. CONCLUSION: A hypoechoic area around the long biceps tendon correlates with fluid in the synovial sheet and indicates effusion within the glenohumeral joint.

Arthroscopy↗
PubMedDate not supplied

[Cruciate ligament injuries with knee joint effusion--why can the Lachman sign not be elicited?].

In acute anterior cruciate ligament (ACL) lesions with effusion of the knee joint it is often difficult to realize a positive Lachman sign. It was suggested that the tension of the joint capsule may reduce tibial displacement although the ACL is completely disrupted. In 10 cadaver knee joints the ACL was dissected and the capsule was closed again. By a canula the knee joints were filled with isotonic saline solution in steps of 20 ml up to 100 ml. Before and after dissection of the ACL and during filling the joint we measured the anterior tibial displacement by use of the MEDmetric KT 1000 arthrometer. In a second series we examined 5 patients with acute effusion of the knee joint before and after puncture of the effusion. We detected the electromyographic activity of the quadriceps muscle end and the hamstrings during the KT 1000 test and patellar reflex. In the cadaver tests we found no reduction of the anterior tibial translation while filling the joint with saline solution. The electromyographic examinations showed a reflectory action in the quadriceps muscle and in the hamstrings when the Lachman test was performed. In the quadriceps muscle the electromyographic amplitude was reduced after puncture; the hamstrings showed a drastically reduced amplitude and duration of the signal. When patellar reflex was performed we recorded an electromyographic action in both muscle groups, too. Puncture could only reduce the signals of the hamstrings. Our results suggest that the reduction of the anterior drawer and the Lachman test in acute effusion is caused not mechanically by the tension of the capsule but by a reflectory muscle action of the hamstrings.

Anterior Cruciate Ligament↗
PubMedDate not supplied

[Extracorporeal shockwave therapy in tendionosis calcarea of the rotator cuff: comparison of different treatment protocols].

AIM OF THE STUDY: Extracorporeal shock wave therapy (ESWT) is a new therapeutic procedure for chronically painful calcifying tendinitis of the rotator cuff. The therapy may vary with the number of applied impulses or with impulse energy. Shock waves with an energy of 0.04 to 0.12 mJ/mm2 define low-dose ESWT, in contrast to high-dose ESWT (> 0.12 mJ/mm2). The aim of the study was to verify the hypothesis that either high-dose or low-dose ESWT could be effective if the total amount of applied energy was similar. METHOD: Fifty patients were assigned at random to 2 groups. The treatment consisted of 3 x 5000 low-dose impulses without anesthesia (group 1) and 1 x 5000 high-dose impulses with intravenous analgesia (group 2). The patients were examined at 6 weeks, 3 and 6 months after treatment. X-rays were performed at each visit. RESULTS: The Constant Score improved from 64.5 to 77.5 (group 1) and from 67.2 to 79.4 (group 2) before and 6 months after treatment (p < 0.05). The values on the visual analog scale which ranges from 0 (no pain) to 100 (maximal pain) improved from 76.8 to 48.8 (group 1) and from 75.4 to 45.6 (group 2) before and 6 months after treatment respectively. The final results for both Constant Score and visual analog scale were obtained after 3 months. X-rays showed a complete or subtotal calcific resorption in 8 (group 1, 32%) and 12 (group 2, 48%) patients. CONCLUSION: Extracorporeal shock wave therapy may be an alternative treatment of calcifying tendinitis of the shoulder. Both treatment protocols gave equivalent results.

Adult↗
PubMedDate not supplied

[Spontaneous osteonecrosis of the iliac crest. Description of a formerly unverified location].

In a 27-years old male a radiographically well defined and compact area with some lucent sections was found incidentally at the top of the left iliac crest. The resection and the following histomorphologic examination of this tissue brought the diagnosis: spontaneous osteonecrosis of the iliac crest. To our knowledge this is the first time that the iliac crest has been proved as a localisation of the spontaneous osteonecrosis by histomorphologic examination.

Adolescent↗
PubMedDate not supplied

Sports injuries in team handball. A one-year prospective study of sixteen men's senior teams of a superior nonprofessional level.

One hundred eighty-six players of 16 teams in 2 male team handball senior divisions were observed prospectively for 1 season to study the injury incidence in relation to exposure in games and practices. Ninety-one injuries were recorded. Injury incidence was evaluated at 2.5 injuries per 1000 player-hours, with a significantly higher incidence in game injuries (14.3 injuries per 1000 game-hours) compared with practice injuries (0.6 injuries per 1000 practice-hours). Practice injury incidence was higher in the lower performance level group, and game injury incidence was higher in the high-level group. The upper extremity was involved in 37% of the injuries, and the lower extremity in 54%. The knee was the most commonly injured joint, followed by the finger, ankle, and shoulder. Knee injuries were the most severe injuries, and they were more frequent in high-level players. There was an increase in the severity of injury with respect to performance level. The injury mechanism revealed a high number of offensive injuries, one-third of them occurring during a counterattack. The injury pattern showed certain variations with respect to player position and performance level. Prophylactic equipment was used by a majority of players at the higher performance level.

Adult↗
PubMedDate not supplied

Comparison of initial fixation strength between biodegradable and metallic interference screws and a press-fit fixation technique in a porcine model.

The objective of this study was to evaluate the initial fixation strength of a biodegradable interference screw compared with press-fit fixation and a titanium interference screw in anterior cruciate ligament reconstruction using a bone-patellar tendon-bone graft. Porcine lower limbs were used. The specimens underwent 500 loading cycles between 60 and 250 N. This corresponds to loads in the graft during aggressive rehabilitation. Thereafter, intact specimens were loaded to failure. Failure mode was defined by visual analysis. Under cyclic loads none of the interference screw fixations failed. In the press-fit group (angle between load axis and tunnel axis 80 degrees), five specimens failed. The mean maximal load to failure was 945 N (+/- 87) for the titanium screw, 797 N (+/- 60) for the biodegradable screw, and 708 N (+/- 211) for the five press-fit specimens that did not fail during cyclic loading. With respect to primary fixation strength, biodegradable screws are a reasonable alternative to titanium interference screws. The press-fit fixation did not provide a secure fixation in all cases. Five press-fit specimens failed under cyclic loads comparable with those seen under conditions of accelerated rehabilitation.

Absorbable Implants↗