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Biomedical subjects

U Steiger

Publications and source records attributed to U Steiger.

At least 37 records · Page 2Linked to original sources
PubMed1986

Arthroplasty of the elbow. Experience with the Mark III GSB prosthesis.

Forty-five total elbow replacements using the Mark III GSB prosthesis are reviewed. Average follow-up was 2.7 years. The overall results were good in 87% of cases, fair in 9%, and poor in 4%. Excluding the two poor results, which required prosthesis removal, 96% of cases had no significant pain. The flexion/extension are improved 24 degrees and the supination/pronation arc improved 22 degrees. No prosthesis was loose and only one had a significant radiolucent line. The overall complication rate was 25%. Disassembling of the two components, due to inadequate ligament tension, was the most frequent complication and this occurred in four elbows.

Adult↗
PubMed1985

[Results of tibia condyle osteotomy].

The subjective and objective results of infra-condylar tibia condyle osteotomy are presented, based on a study of 71 cases. Arthroplasty of the knee joint can often be avoided by performing an infra-condylar tibia condyle osteotomy, taking into consideration the contra-indications, in cases of painful (varus) gonarthrosis becoming mainly manifest in a joint compartment, combined with an axis shift. The gait capacity can be improved, the subjective pain symptomatology be diminished and progression of the arthrosis might be avoided. The good results correlate with an optimal correction of the axis condition; in cases of varus gonarthrosis a slight overcorrection beyond the physiological valgus position of 7 degrees and in cases of valgus gonarthrosis a physiological valgus position of 7 degrees should be aimed at.

Adult↗
PubMed1983

[Systemic chronic juvenile arthritis (Still's disease) in adults. Review of the literature].

UNLABELLED: The entire literature up to the present of 119 patients described as having adult Still's disease is reviewed. Clinical, laboratory, radiological and histological findings, treatment, follow-up and outcome are presented. 1. CLINICAL FINDINGS: All patients had arthralgias and/or myalgias. Seven did not fulfill strict diagnostic criteria as they did not have overt arthritis. All had fever, and 93% had septic fever with temperature peaks of greater than or equal to 39 degrees C. The characteristic maculo-papular rash was present in 89%. Other findings were sore throat, lymphadenopathy, splenomegaly (in about 50% each), weight loss, pericarditis, hepatomegaly, pleuritis (in 1/4 to 1/3 of the cases each). Less frequent were alopecia, pneumonitis and abdominal pain (in less than 10% each). 2. LABORATORY FINDINGS: The ESR was uniformly elevated. Over 90% of the patients exhibited neutrophilic leukocytosis. Anemia, hypoalbuminemia and pathologic liver function tests were found in 60-80%. IgM-RF and ANA were both negative in 95% of the patients and hence were not more frequently present than in the normal population. 3. X-ray findings: There were no pathognomonic radiological abnormalities of the joints. Nevertheless, the tendency to ankylosis, especially of the carpus, seems to be typical. A few patients developed severe destructive lesions, especially of the hip and shoulder joints. 4. Biopsies: Many biopsies were performed and did not reveal specific histologic abnormalities. Nonetheless, they sometimes are necessary in order to exclude other disease entities. 5. Treatment, follow-up, prognosis: Therapeutically high-dosage ASA and (if necessary) systemic steroids are recommended for the acute phase. The efficacy of this treatment is controversial. Even after successful control of the acute disease, exacerbations are frequent for many years. Despite the initial optimism, there is significant long-term morbidity due to recurrent disease flare-ups on the one hand, and articular destructions in some patients on the other.

Adult↗
PubMed1983

[Still's disease in adults. 2 case reports].

Two patients with adult Still's disease are presented. Both had high "septic" fever, weight loss, mild pharyngitis, evanescent maculo-papular rash, myalgias, arthralgias, splenomegaly and pericarditis, while one of the two patients also had lymphadenopathy and pleurisy. Arthritis, which is a sine qua non for the diagnosis, developed only 5 months after disease onset in one patient. Both ultimately developed severe destructive joint disease requiring hip arthroplasty. Laboratory findings were neutrophilic leukocytosis, normochromic normocytic anemia, elevated ESR, slightly elevated liver enzyme values, negative IgM-rheumatoid factor and antinuclear antibodies, and normal or slightly elevated complement factors. Several biopsies failed to reveal pathognomonic findings. It is of the utmost importance that the exclusion diagnosis of adult Still's disease be posed in order to avoid repeated hospitalizations with undue investigations and unnecessary therapeutic trials with antibiotics.

Adult↗
PubMed1980

[Functional backache].

Although functional pain must be accepted as a fact by the patient and his physician, the relevant somatic investigation is indicated. The localization of musculoskeletal pain always corresponds to intensified local strain on the locomotor system. By instruction regarding the connection of pain with strain the patient learns to keep his functional pains within tolerable limits by active control of the loads and stresses on his own body. Aggressive diagnostic or therapeutic measures often increase the problem.

Back Pain↗
PubMed1980

Hip arthropathy in ochronosis: anatomical and radiological study.

Anatomical and radiological studies of four cases of ochronotic arthropathy of the hip were based on the examination of a total of six surgically removed femoral heads. One of these had undergone a surgical biopsy 10 years previously. The impregnation of the articular cartilage by the ochronotic pigment causes it to break into small fragments in the weight-bearing zone. This results in a similar osteoarthrotic remodeling to that commonly attributed to the histologically different "degenerative chondropathy". The labelling of the cartilage in ochronotic arthropathies offers an opportunity for better understanding of the main nonspecific components of osteoarthrotic remodeling. An anatomico-pathological approach explains why their radiological images in the hip may simulate those of rheumatoid arthritis.

Adult↗
PubMed1980

[Management of the geriatric patients with osteoarthrosis (author's transl)].

A knowledge of the differential diagnosis of osteoarthrosis and its predicted natural course is essential in the management of patients with this disease. The prognosis is usually better than is generally accepted; osteoarthrosis is the remodelling of a joint defect rather than a progressive disease. An explanation of the origin of his pain is more important to the patient than medical treatment. He should be helped to strike a balance between protection of the diseased joints, thus preventing traumatisation and therefore new painful inflammation on the one hand, while maintaining active use of his joints which is important in their remodeling and adaptation on the other. Some pain on weightbearing has to be accepted as a physiological joint protection.

Aged↗
PubMed1979

[The role of ochronotic arthropathies in rheumatology].

In alkaptonuric patients, cartilage, fibrocartilage and tendons are slowly impregnated by homogentisic acid. This leads to pigment deposition between and on the surface of collagen fibres (ochronosis) which hardens the tissues as in leather tanning, and can render them breakable. Ochronotic intervertebral discs show a tendency of calcification and ossification, which produces a characteristic radiological picture. Ochronotic cartilage is rather often split off in the weight bearing zones of the knee, shoulder and hip. This is followed by osteoarthrotic changes with a synovial reaction frequently leading to an osteochondromatosis. The labelling of the pigmented ochronotic cartilage thus can support a didactic demonstration of the nature of osteoarthrotic remodelling. It underlines that such remodelling consists mainly of non specific changes developing independently of the cause of the original cartilage lesion.

Alkaptonuria↗
PubMed1977

Left ventricular contractile function in aortic stenosis evaluated by isovolumic and ejection phase indexes.

This study is to reappraise the usefulness of isovolumic as compared to ejection phase indexes for detecting abnormal left ventricular contractile function patients with a common hemodynamic abnormality, namely, chronic left ventricular pressure overload. In 41 subjects with pure or predominant aortic stenosis left ventricular pressure measurements were performed by micromanometry. Single-plane left ventricular cineangiograms were carried out in the right anterior oblique (RAO) and the A-P position. The isovolumic contractile indexes we used in this study were peak measured velocity of shortening of the contractile elements (Vpm) and Vmax obtained from linear extrapolation of total pressure-velocity curves. The end-diastolic and end-systolic RAO cineventriculograms served for the calculation of the ejection phase parameters mean velocity of circumferential fiber shortening (VCF) and mean normalized systolic ejection rate (MNSER). Of the 41 patients, Vpm was depressed in 16 (39 per cent), Vmax in 17 (42 per cent), VCF in 12 (29 per cent), and MNSER in 14 (34 per cent). When the isovolumic and the ejection phase parameters were combined, 24 patients (59 per cent) were found to have at least one of the four contractile indexes below normal. In 26 of the 41 patients the isovolumic and the ejection phase indexes provided the same conclusions as to normality of left ventricular function. In contrast, 15 patients showed discordant isovolumic and ejection phase indexes. An increased left ventricular end-diastolic pressure was only inconsistently related to an abnormal left ventricular function because in 7 of 28 patients with an end-diastolic pressure above 14 mm. Hg all contractile indexes were normal. Furthermore, a normal end-diastolic pressure was present in three of 24 patients with depressed myocardial function. It is concluded that in chronic left ventricular pressure overload from aortic stenosis neither the isovolumic nor the ejection phase indexes are superior in sensitivity for assessing contractile function. In this clinical setting the combination of both types of indexes appears to be the most reliable way for identifying patients with depressed contractile function of theleft ventricle in the basal state.

Adolescent↗
PubMed1976

[Left ventricular function at rest and during dynamic load before and after aortocoronary bypass. Preliminary report].

17 patients with coronary artery disease were studied before and 10 +/- 3 months (mean +/- 1 SD) after aortocoronary bypass surgery. Left ventricular performance was analyzed at rest and in 12 cases during dynamic exercise (work load 59 +/- 22 watts) with tip manometer pressure measurements. The degree of coronary artery obstruction was estimated pre- and postoperatively by vascularization index (VaI). Patients were separated into 2 groups (group A: 8 patients with postoperatively improved VaI, and group B: 9 patients with unchanged or worsened VaI). Apart from a significant fall in LVEDP (p less than 0.025) in group A, there was no significant change in left ventricular dynamics in either group at rest, while a significant improvement in mean LVEDP (p less than 0.05), max dP/dt (p less than 0.05), Vpm (p less than 0.005) and Vmax (p less than 0.005) during dynamic exercise was observed in group A, but no significant change in these terms in group B, after surgery.

Coronary Artery Bypass↗
PubMed1975

[HL-A B27 associated rheumatic disease].

Report on a HL-A B27 positive female patient with the typical cardiac lesion occasionally found inankylosing spondylitis, peripheral arthritis, and acute anterior uveitis but without clinical or radiological evidence of spine or sacroiliac joint involvement. The concept of "HL-A B27 associated disease", including ankylosing spondylitis as well as Reiter's disease or other forms of seronegative rheumatic diseases, is suggested.

Aortic Valve↗
PubMed1975

[Proceedings: Clinical findings and coronary morphology before and after aorto-coronary venous bypass].

37 patients (mean age 51+/-8 years) were clinically and angiographically investigated before and 11+/-5 months after implantation of an aortocoronary vein graft. The rate of bypass patency was 78%. Postoperatively 57% of the patients were free of symptoms, 35% were improved and 8% unimproved or worse. The reduced incidence of angina pectoris during exercise testing appears to be correlated with graft patency, an improved vascularization index and probably the absence of preoperative myocardial infarction. The systolic time intervals and the lung-ear time at rest are of no value for differentiation of improved and unimproved patients.

Adult↗