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Biomedical subjects

T Böni

Publications and source records attributed to T Böni.

17 recordsLinked to original sources
PubMed2004

Hyperostosis frontalis interna: archaeological evidence of possible microevolution of human sex steroids?

Hyperostosis frontalis interna is a restricted bilateral thickening of the frontal endocranial surface, which is frequently found in postmenopausal females today. Surprisingly, this condition had a higher male prevalence in its rare archaeological records. This is again highlighted by the oldest known male European hyperostosis frontalis interna case in an adult Celtic from 100 BC presented here. This unique specimen supports earlier suggestions of the possible microevolution of human endocrine regulation, e.g. by sex steroids, and its pathoanatomical impact.

Anthropology, Physical↗
PubMed2002

[Idiopathic scoliosis and Scheuermann's kyphosis. Historical and current aspects of conservative treatment].

Although in practice since antiquity the nonoperative treatment of spinal deformities is still controversial. Giving preference to orthotic treatment and physiotherapy the historical development of nonoperative treatment will be demonstrated by the examples of idiopathic scoliosis and Scheuermann's kyphosis. It is surprising how early essential and still valuable principles of nonoperative treatment had been acquired and how many of the present-day concepts have remarkable forerunners in the 19th century. In the light of previous knowledge and personal experience the indication, practice and realistic capabilities of modern nonoperative treatment of idiopathic scoliosis and Scheuermann's kyphosis are pointed out.

Adolescent↗
PubMed2002

[Practical management of diabetic foot].

Prevention and the correct treatment of the diabetic foot have important social and economic consequences. Risk stratification is essential for choosing the appropriate treatment strategy. History and careful clinical examination identify the risk in each individual patient with diabetes. Peripheral neuropathy (PNP), foot deformation, peripheral arterial disease (PAD) and a history of previous ulcer or amputation are the most important risk factors. PAD must be diagnosed and treated by percutan transluminal angioplasty or bypass surgery where necessary. Primary foot deformation or secondary due to PNP require shoe modifications. Good metabolic control of diabetes and treatment of other cardiovascular risk factors (dyslipidemia, hypertension) delay or prevent the development of PNP and PAD. Therefore an early multidisciplinary approach is essential for each patient with diabetes and foot problems. In the presence of a foot ulcer, it's important to diagnose osteomyelitis by clinical or radiological examination. The choice and duration of antibiotic treatment and surgical intervention depends on the localisation and extension of infection around the ulcer and the presence of osteomyelitis. In case of limb threatening infection, the patient should be referred to a specialized treatment facility immediately.

Arthropathy, Neurogenic↗
PubMed2001

From cocaine to ropivacaine: the history of local anesthetic drugs.

In 1850, about three centuries after the conquest of Peru by Pizzaro, the Austrian von Scherzer brought a sufficient quantum of coca leaves to Europe to permit the isolation of cocaine. As suggested by his friend Sigmund Freud, descriptions of the properties of the coca prompted the Austrian Koller to perform in 1884 the first clinical operation under local anesthesia, by administration of cocaine on the eye. The use of cocaine for local and regional anesthesia rapidly spread throughout Europe and America. The toxic effects of cocaine were soon identified resulting in many deaths among both patients and addicted medical staff. Local anesthesia was in a profound crisis until the development of modern organic chemistry which led to the synthesis of pure cocaine in 1891. New amino ester local anesthetics were synthesized between 1891 and 1930, such as tropocaine, eucaine, holocaine, orthoform, benzocaine, and tetracaine. In addition, amino amide local anesthetics were prepared between 1898 and 1972 including nirvaquine, procaine, chloroprocaine, cinchocaine, lidocaine, mepivacaine, prilocaine, efocaine, bupivacaine, etidocaine, and articaine. All of these drugs were ostensibly less toxic than cocaine, but they had differing amounts of central nervous system (CNS) and cardiovascular (CV) toxicity. Bupivacaine is of special interest because of its long duration of action and history of clinical application. Synthesized in 1957, the introduction of bupivacaine on the market in 1965 paralleled the progressive and cumulative reports of CNS and CV toxicity, leading to the restriction of its use and the identification of a special therapy-resistant CV toxicity. Numerous experimental studies were conducted to identify the fine cellular mechanism of this toxicity, which refines our understanding of the action of local anesthetics. The identification of optically active isomers of the mepivacaine family led to the selection of ropivacaine, a pure S-(-) enantiomer, whose toxicology was selectively and extensively studied before its introduction on the market in 1996. During the rapid and extensive use of ropivacaine in the clinic, unwanted side-effects have been found to be very limited.

Amides↗
PubMed2000

[Crooked and short legs. Historical retrospect].

In the past rickets, poliomyelitis, and tuberculosis of the knee joint were the main causes for deformities and shortening of the children's legs. Orthotics played a major role in treatment and rehabilitation, and they were often used for life. In the nineteenth century orthopaedic surgeons developed procedures such as tenotomy, osteoclasis, osteotomy, excision of joints and arthrodesis, combined with conservative therapy or instead of it. In an incessant attempt to control wound suppuration--before Lister's antiseptic principle and aseptic practices were available--the "subcutaneous" approach was inaugurated for tendon and bone surgery.

Arthrodesis↗
PubMed2000

[From sciatica to intervertebral disk displacement. On the history of a disease concept].

Since antiquity low back pain spreading down to the buttock and the leg with or without neurological symptoms has repeatedly been described by medical authorities. To extract well defined nosological entities out of the medley of "sciatica" was a demanding process within a labyrinth of often misleading clues. Although the herniated intervertebral disk was recognised about the middle of the 19th century the causal nexus between intervertebral disk displacement and sciatica was only demonstrated in the thirties of the 20th century. The critical appraisal of pathomorphological lesions in patients suffering from sciatica was, as it still is, a challenging task even for experienced physicians. Key texts and their authors recall the main steps towards our modern concept of lumbar intervertebral disk displacement to the readers mind.

History, 18th Century↗
PubMed2000

[Changes in the concept of fracture healing and callus formation].

Although the treatment of fractures has repeatedly been documented throughout history, little attention has been paid to the historical development of the understanding of fracture healing and callus formation in itself. In antiquity, the capability of bone to regenerate was doubted, and Galen attributed the consolidation of a bone fracture to a sap (succus ossificus) that came from the food ingested. Later, in the eighteenth century, a haughty debate broke out as to the seat of the organ that controlled the by now accepted process of new bone formation. While Duhamel du Monceau (1700-1781) believed the periosteum was responsible for the callus formation--this idea being based on his observations of trees--Albrecht von Haller (1708-1777) and his scholars and disciples ascribed this function to the succus ossificus and to the bone marrow. The studies on experimental fracture healing that began during the seventeenth century resulted in the eighteenth-century discovery of the complex processes involved in the formation of callus with the aid of madder staining. The conciliation of the two major schools of thought was finally brought about when in the nineteenth century both periosteal and endosteal callus formation were shown to occur. The anatomical reposition of the fractured components and the stable fixation through osteosynthesis led to a novelty of the twentieth century: callus-free healing of bone fractures. Based on key texts and their authors, the zigzag course taken by our understanding of bone fracture healing and callus formation is illustrated.

Bony Callus↗
PubMed1998

Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography.

PURPOSE: To compare measurements of the sagittal diameter of the lumbar dural sac obtained at positional magnetic resonance (MR) imaging and at functional myelography and to assess the influence of various body positions on the dural sac and the intervertebral foramina. MATERIALS AND METHODS: Thirty consecutive patients referred for lumbar myelography were examined with an open 0.5-T MR imager, Sagittal T2-weighted fast spin-echo images were acquired with patients in the supine, upright flexion, and upright extension positions. The midsagittal diameter of the dural sac was measured at the level of the disks on MR images and myelograms. Foraminal sizes on the MR images were scored independently by two observers. RESULTS: Correlation between MR imaging and myelographic measurements was high (r = .81-.97). A small but statistically significant positional dependence of the dural sac diameter was found in the lower lumbar spine. Position-dependent differences in foraminal scores were uncommon. CONCLUSION: Quantitative assessment of sagittal dural sac diameters is comparable between lumbar myelography and positional MR imaging. In a selected patient population, only small changes in the sagittal diameter of the dural sac and foraminal size can be expected between various body positions, and the information gained in addition to that from standard MR imaging is limited [corrected].

Adult↗
PubMed1996

[Knee problems from a medical history viewpoint].

Knee-joint problems have worried our medical ancestors time and again and made them search for unconventional solutions. Four small case studies are meant to give the reader an insight into the paleopathology and medical history of knee-joint diseases. A grotesquely deformed knee-joint of a young ladies' tailor from the hospital cemetery of Basle (1846) has been investigated paleopathologically and led to the diagnosis of a severe knee-joint tuberculosis. Based on the rediscovered written legacy of the Zurich country doctor Felix Heusser (1817-1875), his significance as an up to now underrated pioneer of knee-joint resection is illustrated. The example of the first knee-endoprosthesis invented by Themistocles Gluck (1853-1942) demonstrates how an ingenious idea can very seriously affect the career of a very promising physician. Another milestone in knee surgery, the invention of knee arthroscopy by the controversial Argovian surgeon, military commander and politician Eugen Bircher (1882-1956), deserves once more our attention.

History, 18th Century↗
PubMed1995

Vittorio Putti.

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History, 20th Century↗
PubMed1994

Jean-André Venel.

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History, 18th Century↗
PubMed1992

[Clinical and radiologic long-term follow-up of Eden-Lang operation in habitual anterior shoulder dislocation].

The incidence of degenerative arthritis after Eden-Lange procedure is judged differently in literature, recently high rates of degenerative arthritis have been reported. 37 patients and the same number of shoulder joints have been evaluated clinically and radiologically after an average follow-up time of 14.9 years. Overall results can be considered as good. Recurrence of dislocation occurred only in one case. Most frequently we observed a limitation of external rotation and overhead performance in sports. The frequency of degenerative arthritis was 17%, clearly less than mentioned elsewhere. The Eden-Lange procedure still can be recommended as a treatment for recurrent anterior shoulder dislocation except for patients with high expectations in physical overhead activities.

Adolescent↗
PubMedDate not supplied

[Changes in technological orthopedics--function and esthetics].

A few famous historical examples of prosthetic and orthotic treatments of the upper and lower limbs are studied from the point of view of their function and aesthetics. For a long period the main emphasis was put on function. Since Ambroise Paré (1510-1590) aesthetics has been taken increasingly into consideration. In order to satisfy the growing functional and aesthetic expectations of our patients a close collaboration between physician and craftsman is essential. A hundred years ago Albert Hoffa (1859-1907) insisted that mechanical workshops be set up in Orthopaedic University Clinics. His demands are as actual as ever.

Artificial Limbs↗
PubMedDate not supplied

[The femoropatellar pain syndrome. Conservative and surgical therapy in a long-term comparison (10-20 years) and their therapeutic consequences].

Long term results in conservative and operative treatment (10-20 years) and their therapeutical consequences. There are many factors involved in the aetiology and pathogenesis of the patellofemoral pain syndrome. Increased pressure over the lateral facet with or without reduced pressure over the medial of the patella resulting from lateral positioning of the patella and different anatomical variants not of the patella, but of the condyles must be considered as well functional variants in the muscular and ligamentous system. Overviewing the literature we compare the long term results of operative versus conservative treatment. 75 patients, treated by the method of Maquet-Roux, and 150 patients, treated conservatively, showed satisfactory results in 72%, a Lysholm Score of 90.8 in the "Maquet"-group, but 89.9 points in the "conservative"-group with a follow-up of 23 years. In the "conservative"-group 52% had no signs of arthrosis, in the "Maquet"-group there are only 30% without signs of arthrosis. The X-ray examination had mostly shown a further stage of arthrosis not only in the femoropatellar, but also in the femorotibial compartment, especially in the "Maquet"-group.

Adolescent↗