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Biomedical subjects

W Puhl

Publications and source records attributed to W Puhl.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Conservative therapy of activated gonarthrosis. Double-blind study of proglumetacine and piroxicam].

In a randomized double-blind clinical investigation, the efficacy and safety of proglumetacin 450 mg/day (150 mg in the morning, 300 mg in the evening) were compared to those of piroxicam 20 mg/day (placebo in the morning, 20 mg in the evening), in 50 patients with activated gonarthrosis. After decoding it was found that 25 patients had been treated with proglumetacin and 25 with piroxicam. Joint troubles, knee circumference, function tests were recorded at time 0 and after 3, 7, 14 and 21 days; on the same days an overall doctor's rating of efficacy was also given. The rating of efficacy was "good" in 70% of patients in the proglumetacin group compared to 60% for piroxicam. The efficacy of the two medicaments was not significantly different. The patients treated with proglumetacin did not report any adverse reactions. Conversely, 5 patients of the piroxicam group dropped out: 1 for epigastric pain, 1 for vomiting and epigastric pain, 1 for an increase of severity of knee pain, 1 for an allergic reaction, 1 for an exanthema. The difference in drop-out rate is statistically significant. A further patient complained of gastrointestinal upsets, but continued on the treatment. Hematology and laboratory parameters were not affected by the treatments. It is concluded that in activated gonarthrosis proglumetacin has an efficacy comparable to that of piroxicam, but is significantly safer for the patients.

Anti-Inflammatory Agents↗
PubMed1982

[Consequences of hemarthrosis for the knee joint (author's transl)].

The presence of an hemarthrosis generally is a sign of a particularly severe joint lesion. Arthrous alterations appearing post-traumatically can therefore be due to the extent of the joint lesion as well as to the accompanying hemarthrosis. A group of 24 young adult rabbits was submitted to morphologic examinations in order to find out in which way an isolated hemarthrosis can be responsible of degenerative cartilage alterations. At intervals of eight days each, 3 cm3 of their own blood were injected into both knee joints of the rabbits. One knee joint was immobilized, the other was mobile. The results prove that the hemarthrosis represents a considerable risk with regard to the trophism of the concerned joint. A direct enzymatic damage to the joint cartilage alone or in combination with trophical alterations appearing later on can lead to a formation and aggravation of arthrosis. The degenerative alterations are increased in an immobilized joint. Bearing in mind these alterations, the conclusion is drawn for clinical practice that the hemarthrosis has to be considered when establishing both diagnosis and therapy plan (punction, joint lavage, drainage, immobilization as early as possible).

Animals↗
PubMed1982

[The scintigraphic diagnosis of pseudo-arthroses following Harrington's spondylodesis (author's transl)].

The development of pseudo-arthroses is the most common complication following operative treatment of severe scoliosis. Early recognition of this event is important to prevent recurrence of the curvature. The diagnosis is not possible by radiological examination of the rigid spine. Routine reexploration implies a second operation, which is unnecessary in the majority of patients with stable fusion. In an attempt to develop a non-invasive method for the diagnosis of pseudo-arthroses, bone scintigrams were carried out in 29 patients with idiopathic scoliosis twelve months after a Harrington's spondylodesis. In 24 patients (82.8%) a definite conclusion could be drawn, either of stable fusion (65.5%) or pseudo-arthrosis formation (17.3%). No pseudo-arthroses were missed by scintigraphy. These results indicate that bone scintigraphy plays an important role in the post-operative care after Harrington's spondylodesis.

Adolescent↗
PubMed1982

[Limitation of heat loss in long-lasting paediatric operations by means of a metal foil--positive correlation between room and body temperature (author's transl)].

A controlled clinical prospective study in 80 children showed the efficiency of an aluminium-coated polyester foil as a protection against heat loss during long-lasting (greater than or equal to 2 h) orthopaedic correcting operations. A pronounced correlation between theatre temperature and the body temperature of the children wrapped in foil could be demonstrated. This method is recommended as a safe and low-cost routine preventive measure for a major part of anaesthetics in paediatric surgery. The foil effect could be completed further by infusion solutions warmed to body temperature and an operation theatre temperature raised to 22-24 degrees C.

Age Factors↗
PubMed1980

[Micromorphological studies in Dupuytren's disease].

Based on histological and scan electron microscopic investigations the morphology of Dupuytren's disease was studied. For comparison normal samples from the palm of the hand were used. Because scan electron microscopy permits a three dimensional observation of surfaces, cut as well as break preparations of cases in stages II, III and IV as well as from relapse cases were furnished and examined. The findings were as follows: 1) The border between cutis and underlying tissue was not distinct any more. 2) The subcutaneous fat tissue has been thrust aside and replaced by newly formed collagen. 3) Starting from the aponeurosis thickened net-like collagen fibers stretch across into the cutis causing skin retractions 4) Within the aponeurosis palmaris collagen bundles exhibit considerable deviation in diameter and structure. 5) A classification of different stages of the disease according to morphological findings proves to be impossible.

Adipose Tissue↗
PubMed1978

[The early radiological findings of idiopathic necrosis of the femoral head in adults (author's transl)].

Idiopathic necrosis of the femoral head in adults occurs in about 2 to 3% of all cases of degenerative hip disease. Advanced necrosis with collapse of the head offers a difficult therapeutic problem in younger patients. Early radiological diagnosis is therefore important. The typical, early radiological findings were studied in a hundred patients with idiopathic necrosis of the femoral head. They consist of an area of sclerosis at the junction of the head and neck, with a periosteal response on the inferior margin of the neck. The relationship of these changes with mechanical stress and defective blood supply is discussed. Signs of more advanced necrosis are band-like sclerosis at the point of demarkation and sub-chondral decalcification of the femoral head. Recognition of the early radiological features improves the chances of successful treatment, particularly in the lower age group.

Adult↗
PubMed1978

[The omovertebral bone--new possibility of preoperative examination by computed axial tomography (author's transl)].

After a brief review of literature a case of congenital high scapula with omovertebral bone is presented by conventional X-ray films (plain X-ray and a. p. tomography). The additional computed axial tomography is of great diagnostic value, giving the surgeon a good deal of preoperative information on the anatomy of the bony connection between cervical vertebrae and scapula. The possible pitfalls of this new diagnostic technique are discussed as well as its limitation.

Cervical Vertebrae↗
PubMed1978

[Metabolic diseases and idiopathic ischemic necrosis of the femoral head in adults (author's transl)].

100 patients suffering from osteonecroses (including 95 with necroses of the head of the femur) were subjected to comprehensive clinical, roentgenologic and chemical laboratory examination. A triangle was established from the range of factors considered as pathogenetically important by various authors. These three outstanding factors were: disturbance of lipid metabolism, found in 41% of the patients, deviation of the liver function data, and, finally, abuse of alcohol as discovered on the basis of the case history. The statistically significant correlation of these factors makes it probable that there is actually a pathogenetic chain abuse of alcohol--hyperlipoproteinemia--arteriosclerosis--osteonecrosis. No specific importance of the uric acid and glucose metabolism could be established, since the metabolic disturbances associated with these processes are mostly linked with the observed hyperlipoproteinemia. Deliberations regarding the genesis of necrosis of the head of the femur must also take into account, over and above the relation between metabolic disturbances and stenosing vascular processes, the presence of a locally predisposing factor, such as mechanical strain or the state of enzymatic supply of the osseous tissue.

Adolescent↗
PubMed1978

[Long-term follow-ups in adult idiopathic necrosis of head of femur (author's transl)].

28 patients were subjected to follow-up examination after having suffered for more than 10 years from idiopathic necrosis of head of femur. The high incidence of the bilateral affection of the hip joint as well as the occurrence of multiple osteonecroses are correlated with distrubances of lipid metabolism. Under conservative treatment the disease takes a progressive course, which, however, can remain subclinical for a long time. Good postoperative results can only be expected from intertrochanteric corrective osteotomy which often leads to a regeneration of the head of femur. Caution is recommended before confirming the indication for athrodesis or total endoprothesis because of the risk of disturbances of consolidation or loosening of the implant.

Arthrodesis↗