Biomedical subjects

A Karbowski

Publications and source records attributed to A Karbowski.

At least 19 recordsLinked to original sources

PubMed2001

Antibodies to PECAM-1 and glucocorticoids reduce leukocyte adhesion in adjuvant arthritis of the rat knee synovium in vivo.

OBJECTIVE AND DESIGN: To demonstrate the effect of monoclonal antibodies to the adhesion-molecule PECAM-1 (CD31) and of prednisolone on leukocyte adhesion in rat adjuvant arthritis. MATERIAL: Adjuvant arthritis was induced in male CD-rats (five groups of n = 6) 18 days prior to measurements. TREATMENT: Mouse-monoclonal antibody to rat CD-31 at 200 microg/kg or prednisolone at 24 mg/kg were administered i.v. 15 minutes prior to measurements. METHODS: Venules within the intact rat-knee synovium were focused by confocal laser scanning microscopy. Numbers of rolling and adherent leukocytes were assessed in vivo. RESULTS: Induction of arthritis significantly increased rolling and adherent leukocytes compared to healthy controls. Both monoclonal antibodies to PECAM-1 and prednisolone significantly reduced adherent, but not rolling leukocytes in arthritic animals. CONCLUSIONS: The method used is well suited for in vivo quantification of leukocyte adhesion under the influence of antiadhesive therapies. PECAM-1 might be an interesting target for novel therapies in rheumatoid arthritis.

Animals↗

PubMed2000

Experience with Bailey-Dubow rodding in children with osteogenesis imperfecta.

AIM: The current report presents our experience with the use of Bailey-Dubow elongation rods in children with osteogenesis imperfecta. MATERIAL AND METHODS: 63 patients with osteogenesis imperfecta underwent a total of 186 primary intramedullary fixations with Bailey-Dubow rods during period 1984-1996. Most of them were inserted into the femur (54.3 %), followed by the tibia (38.2%) and the humerus (7.9%). Patients' age at operation ranged from 1-12 years and treatment-period varied from 1-10 years. RESULTS: Insertion into the femur showed the lowest complication rate (21.0%). Patients either suffered from knee-joint migration of the distal nail (3.9%), proximal nail migration (7.9%), detached T-pieces from the sleeve (7.9%) or chronical nail infection (1.0%). Complication rate after tibia rodding was markedly higher (52.1%). Knee joint migration appeared in 8.5% and the distal piece of the rod migrated proximally in 38.0%, in 31.0% accompanied by recurrent antecurve deformity. Growth arrest and no elongation occurred in 5.6%. Results after humerus operation were by far least satisfying. None of the nails elongated adequately. 8 of the 14 Bailey-Dubow rods (57.1 %) required reoperation caused by migration and chronic nail infection, whereas reoperation rates amounted to 17.8% after femur and 29.6% after tibia insertion. However, just one refracture happened after adequate trauma (road accident), so that an extraordinary success of fracture prevention has to be scored. CONCLUSIONS: We concluded that the use of Bailey-Dubow rods in early childhood can be recommended for the femur, whereas insertion into the tibia or humerus is associated with a considerable complication rate.

Child↗

PubMed1999

Periprosthetic bone remodelling after total knee arthroplasty: early assessment by dual energy X-ray absorptiometry.

The present investigation aims to evaluate periprosthetic bone remodelling after total knee arthroplasty by the use of dual-energy X-ray absorptiometry (DXA). Twelve patients affected by osteoarthrosis of the knee joint underwent primary total knee arthroplasty at an average age of 70.5 years. None of them had received a knee prosthesis before on the contralateral side. Anteroposterior and lateral DXA measurements of the femur, tibia and total knee (both sides) were taken 2 weeks, 3 and 9 months postoperatively. The 2-week measurement was used as an individual reference value to be compared with the 3- and 9-month findings. In addition, the contralateral knee was investigated also in order to estimate how far bone mineral loss was due to implantation or to an individual decline in bone mineral density (BMD). The comparison of BMD values after knee arthroplasty revealed a conspicuous decrease of bone density within 9 months. Bone mineral loss amounted to an average of 9.2% in anteroposterior and 17.8% in lateral DXA measurements. Lateral femur shots showed an average decrease of density of even 21.5%. In contrast, the BMD values of the contralateral knees remained almost unchanged. DXA, especially lateral shots of the femur, promises to be a suitable method for early assessment of periprosthetic bone remodelling after total knee arthroplasty.

Absorptiometry, Photon↗

PubMed1999

Confocal laser scanning microscopy of leukocyte adhesion in the microcirculation of the inflamed rat knee joint capsule.

OBJECTIVE: The aim of the study was to develop a model of intravital microscopy of the microcirculation of the rat knee joint capsule in acute inflammation with the help of confocal laser scanning microscopy (CLSM). METHODS: The microvascular architecture of the joint capsule was investigated by the use of corrosion casting techniques. Knee joint capsule microcirculation of anesthetized rats could be visualized by dissection of the ligamentum infrapatellare rectum and application of a CLSM. Rhodamine 6G was used as a leukocyte marker. An acute arthritis was induced by intraarticular injection of 0.1 mL of 1% Carrageenan solution. Each experiment lasted for 3 h. Leukocyte adhesion (LA) was measured in 100 microns of vessel length. Leukocyte-rolling velocity (Vwbc), systemic leukocyte count (WBC), and differential blood count (DBC) were monitored in defined intervals. Finally, myeloperoxidase (MPO) activity in frozen-tissue homogenate served as a parameter of neutrophil content. RESULTS: Leukocyte adhesion in carrageenan-treated animals was 9.9 +/- 0.2 leukocytes/100 microns vessel (mean +/- SD; n = 6), while sham- treated animals had 2.8 +/- 0.2. Monoclonal antibodies (MAb) to alpha 4 integrin (0.2 mg/kg) reduced LA to 2.6 +/- 0.1 (p < 0.01). Vwbc/gamma quotients were 0.37 micron s/s in control animals and 0.53 micron s/s in anti-alpha 4-treated animals (p < 0.01). Changes in DBC were marked by lymphopenia and granulocytosis after 180 min. At this time point-control animals had 5.1 G/L LC and 2.6 G/I PMN. Animals treated with unspecific antibody had 4.7 G/L LC and 4.9 G/L PMN, while anti-alpha 4-treated animals had 10.6 G/L LC and 2.4 G/L PMN. Photometrically determined extinction of oxidized tetramethylbenzidine (TMB; measure for MPO content) was 1.058 +/- 0.555 in control animals and 0.245 +/- 0.093 in sham-treated animals. Tissue homogenate from unspecific IgG treated group had 0.776 +/- 0.140 and from anti-alpha 4-group 0.334 +/- 0.155 (p < 0.05). CONCLUSIONS: Confocal laser scanning microscopy is a tool for the study of the microcirculation in nontransparent organs. The microcirculation of the acutely inflamed rat knee joint capsule can serve as a model of integrin-mediated LA in vivo. Antiadhesive treatment of animals can reduce the tissue infiltration with inflammatory cells.

Animals↗

PubMed1998

Time-dependent clinical and roentgenographical results of Coventry high tibial valgisation osteotomy.

We analyzed the time-dependent results after Coventry osteotomy in 118 patients (129 cases) with uni-compartmental osteoarthrosis of the knee. The median follow-up was 11.6 years (range 0.7-17 years). Data were noted according to the time since surgery. Group I (> 2 years) consisted of all 129 cases, group II (> 4 years) of 41 cases and group III (> 8 years) of 15 cases. The HSS knee score (max. 100 points) improved from 33.2 +/- 20.4 (range 17-60) to 68.3 +/- 25.3 (range 30-90) in group I, to 54.7 +/- 18.9 (range 29-90) in group II and to 43.7 +/- 20.9 (range 23-85) in group III. The improvement started 4.6 +/- 7.8 months (range 0-60 months) after the operation and persisted for 4 years +/- 37.4 months (range 0-125 months). The functional knee score (max. 100 points) changed from 61.7 +/- 14.1 (range 41-70) to 71.7 +/- 13.1 (range 53-87) in group I, to 70.0 +/- 11.8 (range 54-88) in group II and to 64.2 +/- 8.0 (range 42-90) in group III. The initial loss in knee flexion was 5.6 degrees (range 0 degree-20 degrees) and for extension 1.0 degree (range -5 degrees-25 degrees). Anteroposterior ligament stability (max. 10 points) decreased from 9.2 +/- 2.1 (range 2-10) to 5.6 +/- 1.7 (range 2-9) in group III. Lateral ligament stability (max. 15 points) was relatively constant, from 12.6 +/- 1.9 (range 4-15) to 9.7 +/- 1.9 (range 2-14). Complications included one tibia fracture, one infection, six peroneus pareses, four haematomas and one pseudarthrosis. The mechanical axis was corrected to an average knee valgu2 of 5.2 degrees +/- 7.4 degrees, which deteriorated over time. Radiographic evidence of arthrosis appeared independent of the operation.

Adult↗

PubMed1998

Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings.

Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease. Computed tomography showed a calcified rim of the lesion which may be a useful feature to rule out osteosarcoma in this condition.

Adult↗

PubMed1998

[Oxaprozin versus diclofenac retard in treated of activated arthrosis].

AIM: The present study should elucidate the efficacy, patient acceptability, and side effect profiles of Oxaprozin and Diclofenac retard when given to patients with active primary osteoarthrosis. METHODS: 80 outpatients with active primary osteoarthrosis with a radiological grade of II or III in the hip or knee joint (mean duration 4 years) were distributed randomly and equally to each treatment group. Patients age ranged from 40-66 years (mean age 51 years). After a washout period, they received one of the preparations for 6 weeks. Efficiency assessments consisted of pain, disturbance of sleep, individual and general functional impairment scales, laboratory determinations, and patients global evaluation. For statistical analyses Mann-Whitney-U-, Wilcoxon-, and chi 2-tests were applied. RESULTS: 74 Patients completed the study successfully, whereas 3 patients of each group withdrew due to adverse events. Significant differences favoring Oxaprozin were found for the individual and functional impairment scale and the patients' global evaluation of treatment at the final visit (6 weeks). Improvement compared to baseline visit was significant for both treatment groups. CONCLUSIONS: The results suggest that Oxaprozin is more effective than Diclofenac retard, a recognized standard therapy, when given for 6 weeks to patients with active osteoarthrosis.

Adult↗

PubMed1998

Revision resurfacing knee arthroplasty for aseptic loosening.

This re-investigation presents our experience with revision resurfacing knee arthroplasty caused by aseptic failure. The evaluation of the results should elucidate the benefit of revision, its complications as well as the impact of the implant type used. The study involved 36 patients whose primary resurfacing knee prostheses failed by aseptic loosening. The rather elderly patients (average 68.3 years) underwent revision 6 years later on average. In 30 cases (83.3%), arthroplasty could be repeated with resurfacing implants, whereas the use of hinge prostheses was unavoidable in 6 knees (16.7%). After an average of 7 years later, 30 knees were re-investigated according to the Hospital for Special Surgery (HSS) scoring system. Results were compared with the HSS values prior to revision. Complications and revised implant survivorship were reported chronologically. The revision knees had a 80% incidence of improved HSS score. In 73.3% the outcome was graded as good or even excellent. In contrast, scoring values before revision were dissatisfying without exception. The early complication rate after operation was 25%. Persisting pain, instability and limited mobility led to repeated revision in two cases and arthrodesis of one of the knees. The outcome of revision after 7 years revealed a remarkable early complication rate. Nevertheless, good or excellent results could be scored after implantation of PFC, PFC-modular, TC and TCIII prostheses.

Adult↗

PubMed1998

[Measurement of migration of acetabular components in cementless hip replacement].

PURPOSE: Migration measurements of acetabular components using a special computer aided method (EBRA = abbreviation for the German term "Ein-Bild-Röntgenanalyse") were performed to evaluate early results of the implants and predict aseptic loosening. METHODS: Standard ap-radiographs of the pelvis were marked, specific points were digitised. Simulating the spatial situation the programme computes longitudinal and vertical migration of the cup. 74 acetabular components in 71 patients could be studied by migration measurements. RESULTS: 14 patients showed migration of more than 1 mm, which is the confidence limit of this method. Each of these patients showed diverse reasons for the migration, i.e. osteoporosis of the acetabular bone stock or problems concerning the surgical technique which means malposition of the cup or insufficient reaming of the bone. There were some patients with severe congenital dysplasia of the hip and in some cases the inclination angle of the cup was too great. CONCLUSION: The technique applied for measuring migration of acetabular components can be useful for evaluating early instability of the implant and can be helpful in detecting problems concerning the surgical technique.

Acetabulum↗

PubMed1998

Hallux valgus in young patients: comparison of soft-tissue realignment and metatarsal osteotomy.

Two procedures of hallux valgus correction in young patients were compared by long-term results: soft-tissue realignment (McBride) and Mitchell osteotomy. From 1970 to 1990, 33 hallux valgus deformities of 17 patients were corrected with one of these procedures at the Orthopaedic Department of the University of Mainz. Patients' age at operation ranged from 9 to 20 years and average follow-up was 16 years later. Reevaluation consisted of subjective criteria, such as pain, shoe-fitting, functional disability and cosmetics and objective parameters (hallux-valgus and intermetatarsal angle, osteoarthrotic changes and range of motion of the metatarsophalangeal joint). They were assessed by report, interview, radiograph and physical examination and determined the overall outcome. McBride procedure showed 59% good, 12% satisfying and 29% dissatisfying long-term results, whereas outcome after Mitchell osteotomy was graded as good in 69%, satisfying in 12% and dissatisfying in 19% of the cases. Critical analysis emerged, that each procedure has its own bounds of indication. Successful hallux valgus correction can be achieved by an individual approach consisting of careful study of the indications, well-performed surgery and appropriate postoperative care.

Adolescent↗

PubMed1998

Long-term results after Mitchell osteotomy in children and adolescents with hallux valgus.

The current study elucidates the quality of long-term results after hallux valgus correction by Mitchell osteotomy in children and adolescents. Eight female and 1 male hallux valgus patient with a total of 16 bunion deformities underwent a Mitchell procedure in the period 1970 to 1985, and were reinvestigated in December 1994 (at an average of 16 years later). Their ages at operation ranged from 9 to 20 years (average 16 years). Patients' data were subdivided into subjective and objective criteria. Subjective parameters such as pain, shoe fitting, mobility and cosmesis were assessed by interview. Objective data were obtained from reports, radiographs and physical examination. Owing to the lack of established and recommended scores, we developed our own evaluation pattern. Overall outcome was judged as good in 69%, satisfying in 12% and dissatisfying in 19% by both patients and surgeon. In our experience, Mitchell osteotomy is an appropriate method for young hallux valgus patients, especially in forefeet with rigid malformation or moderately severe hallux valgus and metatarsus primus varus. Extensive metatarsal shortening should be excluded preoperatively in order to avoid postoperative metatarsalgia.

Adolescent↗

PubMed1998

[Experiences with different telescope nails in treatment of pediatric osteogenesis imperfecta].

OBJECTIVE: The present study aims to examine and compare results after intramedullary rodding of long bones with the original Bailey/Dubow-nail and two modifications. PATIENTS AND METHODS: During the period 1985 to 1995 21 patients with an average age of 6.3 years (2-11 yrs) underwent intramedullary rodding of 83 long bones. Therefore 38 original Bailey/Dubow-nails, 36 nails with distal screws and 9 nails with distal K-wires were used. The mean observation period amounted to 5.7 years after insertion. Operation success was judged by bone growth, rod elongation, complications, implantation period, revision- and refracture rate. RESULTS: Bone growth was about 90.6% of the normal value accompanied by an elongation of 71.4%. Best results could be achieved by the use of conventional nails, whereas nails with distal screw or K-wires showed most disturbance. Complications had to be scored in 33.7% and mainly consisted of rod migration with cortical perforation (15.7%), metaphyseal position of the distal screw (9.6%) or no elongation (6.0%). Average implantation period was 4.6 years with a 66.3% revision rate. Refractures after inadequate trauma happened in 3 cases (3.6%) after insertion of the screw-type nail. CONCLUSIONS: The use of elongation rods in children with osteogenesis imperfecta promises successful fracture prevention and a comparably long implantation period. However, the original Bailey/Dubow-nail showed best results although the modified nails had been expected to be superior.

Bone Nails↗

PubMed1998

Arthroplasty of the forefoot in rheumatoid arthritis: long-term results after Clayton procedure.

The present study aims to evaluate long-term results after Clayton resection arthroplasty in patients with symptomatic arthritis of the forefeet. From 1970 to 1995, 109 patients with a total of 184 rheumatoid forefeet underwent Clayton's procedure at an average age of 60 years. Forty-seven of them returned with 82 operated feet for follow-up by means of patient history, physical examination and radiograph an average of 12.8 years later. Overall outcome was judged as successful in 60 of the 82 cases with complete pain relief, remarkably improved gait capacity and use of normal shoes. Sixteen of the feet were definitely improved, but slight to moderate pain, inadequate balance and contact with the ground, limited walking distance and use of large shoes were signs of decreased operation success. The remaining 5 feet showed recurrent splay-foot deformity with intolerable pain, functional disability and restricted gait capacity even though specially made surgical shoes were used. The Clayton procedure appears to be a suitable method for surgical correction of symptomatic rheumatoid forefeet.

Adult↗

PubMed1997

Hallux valgus in young patients: long-term results after McBride operation.

The development of symptomatic hallux valgus deformities at an early age is rather uncommon and usually treated non-operatively. However, if surgical treatment is indicated, only so-called physiological procedures, especially e.g. McBride's soft-tissue realignment, should be considered. From 1970 to 1990, 11 patients aged 12-20 years underwent McBride's procedure, giving a total of 21 feet. For 9 of these patients (17 feet), the average follow-up was 14 years and consisted of patient's history, radiographs and physical examination. All in all, the outcome was judged as good in 10 of 17 feet, satisfying in 2 of 17 feet and dissatisfying in 5 of 17 feet by both patients and surgeon. This conspicuous variation in success rate will be discussed by means of two examples.

Adolescent↗

PubMed1997

Complexity of IL-1 beta induced gene expression pattern in human articular chondrocytes.

The mRNA fingerprinting technique, differential display reverse transcription polymerase chain (DDRT-PCR), was used to detect changes in the overall pattern of gene expression in human articular knee chondrocytes-induced by interleukin-1 beta (IL-1 beta), the prototypical inducer of catabolic responses in degenerate joint diseases. One hundred different primer combinations generated approximately 10,000 different PCR fragments for IL-1 beta treated, as well as for untreated human chondrocytes, cultivated in alginate beads. This represented 53% of all expressed chondrocyte genes as based on statistical considerations. Side by side comparisons of differential display patterns originating from two different donor tissues yielded 44 reproducibly, differentially-displayed cDNA fragments, which were subcloned and sequenced. Sequence homology searches revealed sequence identities to the human necrosis factor alpha (TNF-alpha) and IL-1 regulated gene TSG-6, fibronectin, osteopontin, calnexin, and the DNA repair enzyme ERCC5. The differential expression was confirmed with Northern and quantitative PCR analyses. The known function of these genes and their known IL-1 responsiveness indicate that the employed model system reflects the pleiotropic effects of IL-1 on the overall gene expression in human articular chondrocytes and identifies genes involved in very different biochemical pathways. Twenty-seven cDNAs lacked sequence homologies to known genes and may represent novel genes.

Aged↗

PubMed1997

[Radiological changes after implantation of 2 different cementless hip prostheses].

PURPOSE: Of the study was to evaluate radiological alterations of the femoral bone after implantation of two different prostheses. METHODS: 81 patients with 87 hips underwent total hip arthroplasty by using the Zweymüller-stem fixating in the medullary canal, and 175 patients with 182 ABG-stems with a proximally fixating, anatomical design were followed up clinically and radiologically. RESULTS: Adaptive bone remodelling in Zweymüller-stems showed in some patients thickening of the cortex of the femur and proximal bone-stock loss; reactive lines were seen in the proximal areas surrounding the prosthesis. Radiographs of patients with ABG-stems showed these lines in the distal, smooth part of the prosthesis and cancellous densification occurred in the area of load transfer distal to the trochanteric region. CONCLUSION: Typical x-ray findings due to various stem designs were identified and can be transferred to other cementless prostheses and should be considered if there is a suspicion of aseptic loosening.

Biomechanical Phenomena↗

PubMed1996

Clinical and ultrastructural findings in three patients with geleophysic dysplasia.

Geleophysics dysplasia, a rare disorder with autosomal-recessive inheritance, is characterized by short stature with a "happy-looking" facial appearance. Nonskeletal findings, particularly in an advanced stage, include hepatosplenomegaly and valvular cardiopathy. Based on the clinical picture and the detection of lysosome-like inclusions in hepatocytes, the underlying cause of the condition is considered to be a storage defect in the metabolism of glycoproteins. The clinical course, with progressive worsening of the condition favors this hypothesis. We report on 3 further cases, in which light and electron microscopic studies of iliac crest biopsies and cultured skin fibroblasts provided additional evidence that geleophysic dysplasia represents a lysosomal storage disease. The additional discovery of storage vacuoles in chondrocytes and skin fibroblasts strongly suggests that the condition is a generalized storage defect. To date, it has not yet been possible to identify the presumed biochemical defect in the metabolic pathways of glycoproteins.

Bone and Bones↗

PubMed1995

Hydroxylation of collagen type I: evidence that both lysyl and prolyl residues are overhydroxylated in osteogenesis imperfecta.

The composition of the collagens secreted into the media of fibroblast cultures of 39 patients with osteogenesis imperfecta (OI) was the same in controls and OI cultures. An abnormal migration pattern of collagens upon SDS-PAGE was evident in one third of the cultures investigated. Lysyl and prolyl hydroxylation of HPLC-purified alpha 1(I) chains was elevated in about 60% of cultures. The degree of hydroxylation was highest in the lethal forms. The extent of lysyl and prolyl hydroxylation showed a strong correlation (r = 0.74, P < 0.001). While high levels of hydroxylation are frequently observed in OI patients, a direct correlation between lysyl or prolyl hydroxylation and fracture rate or growth retardation could not be established.

Adolescent↗