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Biomedical subjects

W H Castro

Publications and source records attributed to W H Castro.

At least 37 records · Page 2Linked to original sources
PubMed1996

Age-related magnetic resonance imaging morphology of the menisci in asymptomatic individuals.

In 82 asymptomatic subjects aged 8-62 years we evaluated the menisci by magnetic resonance imaging (MRI). Using a 1.0-tesla imager spin-echo sequences (SE 700/20), partial-saturation sequences (500/10), and short-time inversion-recovery sequences (1600/130/30) were performed. For grading the degeneration of the meniscus, a standard classification (grades 0-4) was used. Positive MRI findings correlated with the patients' age. In SE sequences, a grade 0 meniscus was found in 45.5% of all cases, grade 1 in 33.2%, grade 2 in 16.1%, grade 3 in 4.5%, and grade 4 in 0.7%. In PS sequences, we found grade 0 in 23.9%, grade 1 in 27.5%, grade 2 in 31.5%, grade 3 in 15.9%, and grade 4 in 1.1%. In STIR sequences, we found grade 0 in 56%, grade 1 in 25.4%, grade 2 in 11.1%, grade 3 in 6%, and grade 4 in 1.6%. Correlation of meniscus degeneration with subjects' age showed an increase of grade 3 and 4 lesions with advancing age. Subjects older than 50 years presented with grade 3 and 4 lesions in the SE sequence in 28.5% of the cases, in PS sequences in 40.7%, and in STIR sequences in 25%. In asymptomatic subjects, MRI shows an increasing prevalence of meniscal alterations which correlates with age. Especially in subjects older than 50 years, a significant number of meniscal tears must be expected. This shows the potential danger of the use of MRI alone as a basis for the determination of surgical intervention.

Adolescent↗
PubMed1996

Melanotic neuroectodermal tumor of infancy: report of a case.

The melanotic neuroectodermal tumor of infancy (MNTI) is an uncommon benign neoplasm frequently detected in young infants, which has a predilection for the head and neck region, particularly maxilla. The purpose of this article is to present a documented case of MNTI and discuss clinical, radiological and histopathological features of the disease. The biological behavior of the tumor is emphasized.

Alveolar Process↗
PubMed1996

Proprioception of knee joints with a lesion of the medial meniscus.

We assessed knee-joint proprioception in 23 patients with an isolated lesion of the medial meniscus. Thirteen patients were tested prior to their arthroscopic operation, and 10 patients were examined after partial arthroscopic resection of the injured meniscus. As a control group we evaluated 30 healthy volunteers with clinically normal knee joints. For documentation of the proprioceptive capabilities we performed a special angle reproduction test which was described in the literature. Additionally the subjects were tested with and without a knee bandage, to test its influence on knee-joint proprioception. Our results showed that preoperatively a significant deterioration in proprioception was present compared with the control group. We could not find any influence of the knee bandage on the proprioception of the injured knee. The postoperative group of patients showed a significantly better proprioceptive capability compared to the preoperative patients. The postoperative results also did not show any significant difference as compared to those of the control group.

Adult↗
PubMed1995

Haemodynamic changes in lumbar nerve root entrapment due to stenosis and/or herniated disc of the lumbar spinal canal--a magnetic resonance imaging study.

A prospective MRI study was carried out to assess the secondary changes in patients with stenosis and/or herniated disc of the lumbar spinal canal. The study covered 100 patients who had low back and leg pain due to such processes. Of these, 60 patients (group A) had a monoradicular pain pattern, average duration 2 months, due to a herniated lumbar disc. The remaining 40 patients (group B) had acute exacerbation of their chronic low back and leg pain, due to stenosis and herniated disc. As a control group, 5 asymptomatic volunteers with neither stenosis nor herniated disc on MRI were examined. All the patients and volunteers were examined by MRI with several sequences: partial saturation recovery with phase contrast PS (500/10), spin echo SE (500/20), short TI inversion recovery STIR (1900/135/30) and, for the dynamic study, field-gradient echo sequences FAST (50/15): 10 frames in 200 s. In all participants, Gd-DTPA was administered intravenously. In 8 of the patients of group B capillarisation in the protruded nucleus tissue was demonstrated on the PS sequence after Gd-DTPA administration. This tissue also showed decreased signal intensity on the STIR sequence. The capillarisation extended into the centre of the disc. Venous stasis could be verified in all of the 100 patients. An oedema could be verified in all patients of group A; in 20%, its size exceeded that of the herniated disc. In group B, an oedema was seen in only 12 patients. In the control group, no haemodynamic changes were seen. Using MRI, it is possible to define the border between herniated disc tissue and perifocal oedema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Thoracic fracture-dislocations without spinal cord injury: a case report and literature review.

Severe fracture-dislocation of the thoracic spine without neurological deficit is rare. Both translational and rotational deformity of the midthoracic spine makes transection of the cord almost inevitable due to the confined dimensions of the cord and spinal canal. Even though associated fractures of posterior elements are frequently seen, they seldom result in neural sparing. The case of a 24-year-old man who sustained a severe rotational fracture-dislocation of T9/T10 with considerable anterolateral displacement is reported. Due to a fractured left pedicle and a right-sided vertical fracture through the posterior aspect of the vertebral body, alignment of the posterior elements in the spinal canal was maintained and there was no neurological deficit. The patient was operatively treated with posterior segmental instrumentation, and was completely asymptomatic at follow-up 5 years later.

Adult↗
PubMed1995

Septic arthritis: Arthroscopic management with local antibiotic treatment.

In a retrospective study, the results of arthroscopic treatment of septic arthritis were evaluated in 12 patients. Ages ranged from 4 to 57 years. The knee joint was affected in 9 cases, the elbow in 2 cases, and the shoulder joint in one case. In 3 patients the infection was hematogenous. Four patients had a postoperative infection and in 5 patients the infection followed an intraarticular injection. The indication for arthroscopic treatment was based on clinical findings, an increased ESR and/or CRP, an increase in leukocyte count in the joint fluid and no bone involvement on x-ray. Arthroscopic management was performed according to the intraoperative findings (lavage, debridement, synovectomy). The procedure was completed by intraarticular placement of an antibiotic collagenous fleece. Additionally systemic antibiotics, active against staphylococcus aureus, were used for perioperative therapy before starting a specific antibiotic treatment according to the cultured organism. In 10 out of 12 cases the infection was cured by one operation. Because of the advantages of arthroscopic treatment, it should be performed as soon as joint infection is confirmed.

Adult↗
PubMed1995

Secondary effects of knee braces on the intracompartmental pressure in the anterior tibial compartment.

UNLABELLED: In 31 healthy volunteers aged 18 to 33 years we investigated the intracompartmental pressure in the anterior tibial compartment while running on a treadmill with, and without, a functional knee brace. All volunteers performed two test series with a constant running speed of 8 km/h. Prior to running, the pressure was documented in the supine, sitting and standing position as well as during running. The intracompartmental pressure in the supine position was significantly less without a brace compared to the pressure with a brace. This was also true for the sitting position and the standing position. While running on the treadmill the average pressure was also significantly higher with, than without, a brace. CLINICAL RELEVANCE: Running with a functional knee brace leads to increased intracompartmental pressure in the anterior tibial compartment and, as a consequence, may lead to a chronic compartment syndrome. Wearing a functional knee brace may cause secondary muscle ischemia and may be one reason for the increased incidence of injuries in athletes.

Adolescent↗
PubMed1995

Influence of the running shoe sole on the pressure in the anterior tibial compartment.

The objective of the study was to evaluate the influence of a negative shoe sole on the intracompartmental pressure in the anterior tibial compartment. In 35 volunteers, the compartment pressure was documented during a 20-min. run on a treadmill with conventional running shoes and with running shoes with a negative sole. Besides the documentation of the compartment pressure we also performed a gait analysis. The comparison of gait cycle between the conventional shoe and the shoe with a negative sole showed remarkable differences. With the conventional shoe, plantar flexion after initial contact was 16 degrees compared to 6 degrees with the special shoe. Duration of plantar flexion with the normal shoe was 0.17 sec. compared to 0.1 sec. with the special shoe. The intraindividual comparison of the individual pressure curves revealed evident differences in most of the subjects. The comparison of maximum pressures of each volunteer after running with the normal shoe as well as with the special shoe showed a decrease in the maximum pressure level when using the special shoe. The maximum pressures with the normal shoe (59.7 +/- 9.1 mm Hg) were significantly higher than with the special shoe (36.5 +/- 11.8 mm Hg) (p < 0.001). The comparison of the mean pressure showed similar results. With the normal shoe a mean pressure of 47.1 mm Hg (+/- 9.0 mm Hg) was measured compared to 29.8 mm Hg (+/- 11.0 mm Hg) with the special shoe (p < 0.001). Regarding the subjective comfort of the special shoe 18 subjects did not find any difference in comparison with the normal shoe.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Augmentation of ventral derotation spondylodesis according to Zielke with double-rod instrumentation. Preliminary report on two-year results of thoracolumbar curves.

The advantages of VDS according to Zielke with excellent 3-dimensional correction and shorter fusion levels in comparison to posterior instrumentation techniques are well known. A disadvantage is the necessity of long postoperative immobilization in a body cast or brace due to lack of primary stability. The aim of the VDS double-rod instrumentation is augmentation of the system with the possibility of postoperative treatment without plaster cast or braces. Following thoracolumbophrenotomy and ligation of the segmental vessels double-hole vertebra clamps are inserted. First VDS screws are placed in the posterior holes of these plates. With a 4-mm threaded compression rod correction is obtained by centripetal compressive forces on the nuts. Next VDS screws for the 5-mm threaded rod are inserted into the anterior holes of the vertebral clamps. The rod is implanted in a slightly compressive manner and augments the system. In a prospective study 8 patients, 4 with idiopathic and 4 with neuromuscular scoliotic deformities, underwent this surgical procedure and now have a follow-up of 2 years. Curves ranged from 45 degrees to 131 degrees Cobb angle. All patients were treated without plaster casts or braces postoperatively, but with only a semielastic vest for 4 to 6 months. Unusual intra- and postoperative complications have not been noted. Correction of the primary curve averaged 69.4% at follow-up. Tilt of the caudal end vertebra was corrected 75% to an average of 6.3 degrees. Spontaneous partial correction of the upper secondary curve was noted in all cases. Rod fracture of the 5-mm rod without fracture of the 4-mm rod at this level was seen in 1 patient without loss of correction. Solid fusion was achieved at every level in all patients. The sagittal plane was not adversely affected by the instrumentation. However, larger patient numbers and a longer follow-up are necessary.

Adolescent↗
PubMed1995

Sagittal plane correction in "King-classified" idiopathic scoliosis patients treated with Cotrel-Dubousset instrumentation.

INTRODUCTION AND AIM OF THE STUDY: Whereas Harrington instrumentation (HI) has demonstrated satisfactory frontal plane correction, sagittal plane realignment is difficult. Sagittal plane control is reported to be easier with Cotrel-Dubousset instrumentation (CDI). This study was undertaken to determine if in our series sagittal realignment was achieved with CDI in idiopathic curves classified according to King. MATERIAL AND METHODS: Ninety-seven patients with idiopathic scoliosis classified according to King and treated with CDI underwent coronal and sagittal plane analysis by an unbiased observer. The sagittal curves were measured with the Cobb method from T4-T12 (normals: +25 to +40 degrees) and L1-L5 (normals: -40 to -55 degrees). The thoracolumbar junction (TJ) was divided into an upper TJ (T10-T12) and a lower TJ (T12-L2) with normals between 0 and +10 degrees for the former and 0 and -10 degrees for the latter. RESULTS: In all types of scoliosis with associated thoracic hypokyphosis a significant realignment could be achieved, ranging from 8 degrees in King 1 and 3 curves to 19 degrees in King 4 curves. In normokyphotic curves no significant changes of the thoracic spine were measured postoperatively. Concerning the upper TJ, pathological lordosis was corrected by 7 degrees on the average, whereas correction of kyphosis ranged from 8 to 18 degrees Cobb. Pathologic kyphosis and hyperlordosis of the lower TJ showed a mean correction of 7 degrees and 11 degrees, respectively. There was no significant direct influence of CDI on the sagittal plane of the lumbar spine. CONCLUSION: The data from this study suggest that correction in the sagittal plane can be achieved with CDI in King-classified scoliotic deformities.

Follow-Up Studies↗
PubMed1994

Long-term changes in the magnetic resonance image after chemonucleolysis.

After treatment of a symptomatic herniated disc with chymopapain, 14 patients were re-examined by magnetic resonance imaging (MRI) at a mean follow-up of 72 months. Well-defined MRI findings before chemonucleolysis were compared with those after the procedure by an independent observer. Five MRI parameters were assessed. No significant change was noted in the signal intensity of the affected disc, the extent of osteochondrosis and endplate reaction of the affected segment. The height of the affected disc as well as the size of the disc herniation were reduced significantly. The loss of the height is seen as a direct result of chymopapain activity, whereas the alteration of the size of the herniation seems to depend on the natural history of a disc herniation and is probably not a simple result of the treatment.

Adult↗
PubMed1994

How reliable is lumbar nerve root sheath infiltration?

To determine the reliability of lumbar nerve root sheath infiltration, a prospective study was performed. Ninety-four patients were randomized into three groups. In the first group of 33 patients, 0.5 cc of dye (Telebrix N, 30 g) was applied at nerve root L4, in the second group of 30 patients, 1.0 cc, and in the third group of 31 patients, 2.0 cc. The infiltration was guided by computer tomography. The diffusion of the dye was documented with computed tomography of the affected segment L4-5. The images were evaluated by an unbiased observer. The results showed that in the first group the dye diffused to the adjacent ipsilateral nerve roots L3 and/or L5 in nine patients. In the second and third groups this diffusion was seen in 9 and 11 patients, respectively. A diffusion into the psoas muscle was documented in 4, 10 and 22 patients, respectively. These latter differences were statistically significant (P < 0.01). Diffusion into the psoas muscle is especially important because the nerve roots converge in this muscle to become a plexus, and they are no longer surrounded by their dural sheaths. Diagnostic lumbar nerve root sheath infiltration should be performed by an experienced examiner. To guarantee high reliability, the tip of the needle should be placed as near as possible to the affected nerve root. The amount of local anaesthetic should be as small as possible, 0.5 cc or preferably less.

Anesthetics, Local↗
PubMed1994

Cervical hyperostosis: a rare cause of dysphagia. Case description and bibliographical survey.

Dysphagia can be caused by disorders of the cervical spine. Very seldomly, prominent osteophytes of the ventral spine are responsible. The case of a 63-year-old patient with large anterior osteophytes from C3 to C7 is presented. The successful ablation of these spondylophytes relieved the patient of his swallowing difficulties. Up to now there have been many different opinions about the etiology of this disease. In this special case, a diffuse idiopathic skeletal hyperostosis, also known as Forestier's disease or diffuse idiopathic skeletal hyperostosis, seems to be the most likely cause.

Cervical Vertebrae↗
PubMed1994

[Does intravenous gadolinium-DTPA administration have advantages in magnetic resonance imaging of acute injuries or chronic damage to the knee joint?].

79 patients with acute or chronic lesions of the knee were evaluated by MRI prior to and after application of Gd-DTPA. The MRI examination was performed by a 1.0 tesla imager with SE as well as FEDIF sequences. These MR studies were compared prior to and after intravenous Gd-DTPA application, focusing on the visibility and the definition of a possible lesion, and scored with a 3-point score. Statistic analysis and case analysis revealed that in patients with meniscus degeneration without a tear, Gd application yields no additional diagnostic information. However, in patients with meniscus tears Gd-DTPA significantly facilitates the definition of the lesion. Furthermore, Gd-DTPA makes differentiation possible between the synovial fluid and the synovial membrane. Whereas in cases with capsule or collateral ligament tears Gd-DTPA facilitates the documentation of the lesion, we found no advantage in using Gd-DPTA in patients with ACL tears. In patients with chondropathia patellae Gd-DTPA application supports the visualization of the secondary synovial reaction.

Anterior Cruciate Ligament↗
PubMed1994

The application of modern imaging methods in orthopedic surgery.

In this paper the application of ultrasonography, computed tomography, magnetic resonance imaging and bone scintigraphy in the diagnosis of orthopedic diseases is discussed. Because of the advances in the diagnosis made possible by these investigations, diagnosis is often made earlier with the consequence that therapeutic modalities can be used in a better way. As a result, late complications of orthopedic diseases can be influenced in a positive way.

Bone Diseases↗
PubMed1993

Arthroscopic resection of the acromioclavicular joint (ARAC).

In 65 patients an arthroscopic resection of the AC-joint (ARAC) was performed. The data of 27 male and 24 female patients with a minimum follow-up of 6 months were available for analysis. 2 patients had bilateral procedures. Patients with rotator cuff tears were excluded from this series. The patients were aged between 22 and 69 years (average 48.4 years). The mean interval from the onset of pain to conservative treatment was 4.6 months and the average period of conservative management prior to surgery was 9.8 months. The indication for ARAC was pain which interfered with the patients' activities of daily living, work, or athletic activities and had not responded to conservative therapy for at least 6 months. Patients' data were recorded before and after surgery according to a 100-point score as well as with a visual analogue scale. The patients' mean preoperative score was 67.8 (+/- 14.6). After surgery, a significant improvement to 93.3 (+/- 12.3) was achieved. Comparing the different parameters we found significant differences in pain during shoulder movement, function, and active range of motion. Prior to surgery the other parameters already scored well, so they did not serve as good discriminators for these patients. The mean reaction length of the lateral clavicle was 23.2 mm inferiorly, 15.9 mm in the middle third, and 13.1 mm superiorly. No ectopic bone formation or postoperative spurs were identified in this series. We could not demonstrate regeneration of the resected parts of the lateral clavicle. No major complication was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromioclavicular Joint↗