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T Somer

Publications and source records attributed to T Somer.

At least 19 recordsLinked to original sources

Experimental study of the hydrodynamic effects of irrigation suction drainage.

The function of irrigation suction drainage, as an additional method in the treatment of bone infection, is associated with hydrodynamic problems that can only be experimentally examined. The visualization of liquid movement in the experimental model was realized by adding a colored ink to the input drain of the drainage system. When only 2000 ml of liquid was used daily (80 drops/min), the ink penetrated the experimental cavity only through the most proximal holes in the input drain. It spread slowly and irregularly through the liquid in the experimental bottle, forming pocket deposits and leaving sediment. When 6000 ml of liquid was applied daily (240 drops/min), ink quickly penetrated the cavity through all holes in the drain, leading to turbulence and dispersing equally in the bottle. Decoloration of the model bottle was faster because the output drainage was more efficient. With an increased flow, i.e., with more liquid used in the drainage, a better result was achieved. This was manifested in a swift decoloration and rinsing of the cavity.

Drainage

Vasculitides associated with infections, immunization, and antimicrobial drugs.

Many pathogenic microbes can induce a complex series of immunologic, endothelial-cell, and hemorheological activation cascades and dysfunctions and can cause interactions of various components of the vessel wall with formed and noncellular elements of the blood. These interactions can result in manifold vasculitides. This article reviews the pathogenetic, clinicopathologic, and therapeutic aspects of infection-related vasculitides; it includes a brief discussion of parasitic, drug-related, and immunization-associated vasculitides as well as of the infection-related features of vasculitides of the central nervous system, retinal vasculitides, ecthyma gangrenosum, and erythema nodosum. Viruses are mainly associated with small-vessel vasculitides, whereas bacterial infections affect vessels of all sizes, including the aorta. The vasculitides associated with fungal infection usually are characterized by erythema nodosum and involve large vessels. The search for microbes as causes of or contributors to vasculitides should continue. Infectious vasculitides may become increasingly important as the number of immunocompromised patients grows.

Anti-Bacterial Agents

Disorders of blood viscosity.

In clinical situations associated with disturbed blood flow, the primary focus is usually on improving cardiovascular performance. However, during recent decades, both basic science and clinical literature reports have presented evidence that the flow properties of blood must also be considered in these situations. Thus, the relatively new fields of haemorheology and clinical haemorheology have evolved; the former deals with the flow and deformation behaviour of blood, plasma and the formed elements of blood, whereas the latter relates to alterations of their behaviour in various pathophysiologic states. This review therefore summarizes some of the salient aspects of clinical haemorheology and of the determinants of blood flow properties (flow rate, haematocrit, plasma viscosity, red cell aggregation, red cell deformability). In addition, it briefly describes several clinical disorders associated with abnormal blood, plasma or cell rheology ('hyperviscosity syndromes' occurring in polycythaemia, leukaemia, sickle cell disease, paraproteinaemias).

Blood Viscosity

Thrombo-embolic and vascular complications in vasculitis syndromes.

The vasculitides are relatively rare diseases characterized by inflammation and necrosis of vessel walls and, hence, often complicated by vascular and thromboembolic manifestations. The causes and pathogenesis of most vasculitides are only partially known. However, in many there are strong implications of both immune-complex and cell-mediated pathogenetic mechanisms. Tissue ischaemia, thrombosis as well as mediators and end-products of vascular endothelial inflammation are thought to cause most of the vasculitic manifestations. Thrombo-embolic and cardiovascular manifestations and complications are most commonly found in the vasculitides with necrotizing vascular inflammation, i.e. Behçet's disease, Buerger's disease, Kawasaki's syndrome, polyarteritis nodosa and vasculitis of rheumatoid arteritis. The granulomatous vasculitides are less frequently complicated by thrombo-embolic manifestations. Vasculitis may also be an iatrogenic complication of a therapeutic intervention, such as an IC-mediated hypersensitivity vasculitis after streptokinase treatment or an anti-endothelial cell antibody-associated coronary vasculitis after heart transplantation.

Arthritis, Rheumatoid

[Morphologic characteristics and static resistance of transplanted patellar ligaments after replacement of the cruciate ligaments in the knee--an experimental study in a dog].

An experimental study on transplantation validity of patella's ligament, when transplanting front crossed ligament, was performed on 106 knees in 53 grown-up dogs. The investigation had three stages. Three months after the transplantation of the front crossed ligament with the medial third part of the patella's ligament animals were sacrificed and in one group the static resistance and the resistance to elongation, by using special tweezers (Alfred Amsler Co., Schafhausen, Switzerland), was investigated. The results showed that the patella's ligament is very suitable for transplantation because its resistance and strength were almost identical with the same parameters of intact front crossed ligament. Revascularization of the new ligament using Spaltenholz's technique was done in the second group, and three months after the operation, complete revascularization of transplants took place. The synovial membrane which covers the new ligament represents the main source of fresh blood vessels on one side, while similar process takes place along the bone tunnels where the new ligament was fixed. The new ligament histologic analysis carried out in the third group of experimental animals showed that after three months the transplant acquires the structure which is very similar to the front crossed ligament. The obtained results of the investigation show that the patella's ligament is a very good biologic material for transplantation of the crossed ligament.

Animals

Fibrillar protein deposits with tubular substructure in a systemic disease beginning as cutis laxa.

BACKGROUND: The homogeneous material found in the skin is commonly identified as amyloid. We describe a previously unknown disease that is caused by proteinaceous deposits and that does not fulfill the criteria of the earlier recognized amyloid diseases. OBSERVATIONS: The unusual deposits, which were initially found in the dermis, were ultrastructurally composed of fibrillar material with a tubular substructure. Immunohistologically, the material was tested using a large panel of antibodies, and the results revealed that it was unlike any commonly known proteinaceous material. The deposits later spread to other organs and disturbed the vital functions of the body. CONCLUSIONS: We describe a unique syndrome characterized by fibrillar extracellular deposits that was recognized and differentiated from other similar clinical syndromes by ultrastructural examination. Further biochemical analysis is necessary to identify the origin of the material.

Cutis Laxa

Detailed anatomy of the antebrachiocarpal joint in dogs.

A comparative study of the anatomy of the antebrachiocarpal (AC) articulation was carried out in 30 adult dogs with 60 joints. Although a considerable degree of similarity was found between the AC joint in dogs and the corresponding wrist joint in humans, a number of differences between these two homologous joints were also noted. The distal end of the ulna in dogs directly articulates with the ulnar carpal and accessory carpal bones forming a specialized antebrachiocarpal arrangement more adapted to running. The accessory carpal bone in dogs is a massive, long bone and is strikingly different from its homologue in humans, the pisiform bone. The joint between the accessory and ulnar carpal bones, which corresponds to the piso-triquetral joint in humans, is always connected with the AC joint, whereas in humans this communication could be found occasionally. The large radial carpal bone in dogs, characteristic for carnivores, corresponds to the fused scaphoid and lunate bones in humans, in whom this type of fusion is very rarely found. The palmar ulnocarpal and radiocarpal ligaments in dogs are distinctly intra-articular, whereas in humans these ligaments are intracapsular. One of the controversies of the AC joint in dogs is a structure located between the distal-most parts of the radius and ulna forming a strong bond between these two bones and a part of the antebrachial articular surface. It is cartilage-like and is composed of typical fibrocartilaginous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

[Patellar height in patients with chondromalacia].

A radiogrametric assessment of the patellar height performed by three measurement methods, in the lateral views of radiograms of 136 patients with chondromalacia of the patella was aimed at the establishment of certain parameter values in the studied population and the assessment of the influence the altered patellofemoral ratio has upon the onset of the disease. The results of the study verified the remarkable advantages of the method by Insall and Salvati for the measurement of the patellar height and showed a significant involvement of patellofemoral incongruity in the development of chondromalacia, since in 15-16% of the cases the patella was not properly placed.

Adult

Histologic structure of the articular disk of the human distal radioulnar joint.

A histologic study of the structure of the articular disk of the distal radioulnar joint in humans was performed on 57 disks from 37 fresh cadavers that included fetuses and individuals up to age 65 years. The specimens were stained with hematoxylin and eosin, orcein, and Mallory and Mann-Dominici's methods, and studied with the light microscopy. It was found that the disks of adults were basically formed of the so-called fibrocartilagenous tissue composed of an intercellular substance in which there were interwoven wavelike collagen fiber bundles and between them three specific types of cells: (1) rather sparse fibrocytes mostly situated in dorsal and palmar margins, (2) predominant and constant chondroid cells dispersed throughout the disk, and (3) less-frequent real chondocytes distributed mostly in the central parts. This basic tissue is modified according to the age of the subjects and functional requirements. In fetuses and newborns, it is almost completely fibrous and very cellular, while in adults, it is more cartilaginous with significantly reduced cellularity. The structure of various parts of disks is adapted to the functional stresses exerted on them. In central parts exposed to pressure, the tissue is more cartilaginous, while peripheral, massive margins, subjected mostly to traction, are built in a ligamentlike pattern. The ulnar and carpal surfaces are adapted to the gliding movements of the ulna and carpus. It is concluded that the articular disk in humans, which is basically of fibrocartilagineous nature, is a dynamic structure biomechanically, predetermined and changing with aging.

Adolescent

Diagnostic significance of angiographically observed visceral aneurysms with regard to polyarteritis nodosa.

During a 10-year period, intraparenchymal aneurysms were found in 38 of 748 patients at selective abdominal angiography with magnification technique. According to strict criteria, 17 patients were classified as suffering from necrotizing vasculitis of the polyarteritis nodosa group (PAN), 7 from severe arterial hypertension, and 3 from rheumatoid arthritis. The diagnoses of 5 patients remained to be confirmed, and each of the remaining 6 patients suffered from various other diseases. PAN was diagnosed histopathologically in 2 patients without angiographic aneurysms. Based on the 156 patients in whom the indication for angiography was suspicion of arteritis, the angiographic diagnosis of PAN had a sensitivity of 89 percent and a specificity of 90 percent, a positive predictive value of 55 percent and a negative predictive value of 98 percent. The mean number of both renal and hepatic aneurysms was higher in patients with PAN than in the other patients (p less than 0.01 and p less than 0.05, respectively). Five PAN patients had numerous and large aneurysms, whereas the aneurysms of the other 12 PAN patients did not differ from those of patients with other diseases. Patients with PAN had renal infarcts more often than the other patients (p less than 0.05). Our findings suggest that visceral angiography is useful in establishing the diagnosis of PAN, but the angiographic finding of aneurysms is not pathognomonic.

Adult

[Early functional and anatomic results after total condylar knee prosthesis implantation].

The results of total knee replacement in 30 patients have been analyzed. Total knees were implanted during 1990, and the shortest follow-up time after the operations amounted to 6 months. All 30 total condylar prosthesis were of Insall-Burstein posterior stabilized design. The average age of the operated patients was 61 years. Osteoarthritis caused serious knee damage in 21 patients and was the indication for the operation; in 7 patients it was rheumatoid arthritis; in 1 patient synovitis villonodularis; and severe posttraumatic osteoarthrosis in 1 patient. In 18 patients axial knee deformity was noted prior to operation in the sense of valgus or varus. The continuous passive motion machine was used in the postoperative treatment of all patients. Clinically acceptable results were obtained in 90%. Wound healing complications were noted in 2 patients. Full axial deformity correction was achieved in all the patients with a full extension and flexion of over 90 degrees in the operated knees. Preliminary results after the implantation of this type of prosthesis are very encouraging and justify it's further routine use.

Adult