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Biomedical subjects

A Karbowski

Publications and source records attributed to A Karbowski.

47 records · Page 3Linked to original sources
PubMedDate not supplied

[Intraoperative hyperpyrexia in patients with osteogenesis imperfecta].

The aim of this study was to evaluate the influence of different types of anesthesia upon the intra- and postoperative body temperature in osteogenesis imperfecta patients. The development of an intraoperative hyperpyrexia of unknown origin is a typical phenomenon in patients with osteogenesis imperfecta. Body temperatures of up to 40 degrees C are known to complicate the operation. Therefore, in a retrospective study, the pre-, intra- and postoperative body temperature curves of 45 operations under different anaesthesias were measured. Group A underwent a common balanced anaesthesia with the volatile anaesthetic Enfluran in combination with Fentanyl, while group B was operated on under total intravenous anaesthesia (TIVA) with Propofol and Alfentanil. The preoperative temperatures were not different in the two groups. The intraoperative curves showed a constant body core temperature or even an increase under Enfluran, while the temperature always decreased under TIVA. This could be confirmed by intraindividual studies in 5 patients.

Adolescent↗
PubMedDate not supplied

[Scoliosis in patients with osteogenesis imperfecta: a federal nation-wide cross-sectional study].

OBJECTIVE: Quite different prevalence of scoliosis in patients with Osteogenesis imperfecta is reported, not at least owing to the difficult recruitment of patients. The present study aims to investigate Osteogenesis imperfecta-patients with scoliosis by means of a cross-section study. PATIENTS AND METHODS: A total of 102 patients (46 males, 56 females) with an average age of 24.6 years (3-71 yrs.) were investigated in 1995 supported by the "Gesellschaft für Osteogenesis imperfecta Betroffene e.V.". Physical examination included pain and range of motion. Localisation and expanse of the curvature as well as attendant deformities of the spine were assessed by radiograph. RESULTS: Scoliosis was observed in 76 patients (74.5%). Most of them showed thoracal or thoracolumbar localisation with 36 cases of right and 40 cases of left convexity. The curvature was mainly mild (56 pat. < 40 degrees), while 8 patients showed moderate (< 60 degrees), 7 patients severe (< 80 degrees) and 5 patients very severe deformity (> 80 degrees). Average expansion amounted to 6.7 vertebrae (3-12) with an average rotation of 2 (1-4). Attendant deformities were distributed as follows: codfish (59 pat.) or wedge-shaped vertebrae (42 pat.), platyspondylia (16 pat.), thoracal cyphosis (5 pat.), flat back (1 pat.) or lordosis (2 pat.) and lumbar lordosis (10 pat.) or vertical position (14 pat.). 69 scoliosis patients complained about pain with an average VAS-value of 4.3. They also showed moderate to severe impairment of the range of motion. CONCLUSIONS: Our cross-section study with 102 Osteogenesis imperfecta-patients showed scoliotic deformity in 74.5% of cases. 69 patients suffered from remarkable pain and impaired range of motion, which was not only attributable to scoliosis alone, but also to concomitant spinal deformities.

Adolescent↗
PubMedDate not supplied

[Long-term treatment outcome in ventral and combined ventrodorsal spondylodesis in the surgical therapy of scoliosis].

We report on 48 patients with a mean postoperative follow-up of 7.7 years. 9 patients underwent simple anterior derotation spondylodesis (VDS), 31 patients were additionally fused with posterior Harrington spondylodesis. In 7 of 8 patients the Dwyer compression spondylodesis (DCS) was completed with the Harrington instrumentation. 2 of 3 scoliosis were idiopathic, the residual cases were mainly neuromuscular. The primary curve (preoperative mean: 69.9 degrees) was initially corrected by 62.8% and sustained a loss of correction of 7.6 degrees resp. 10.9% during long-term follow-up. The long-term loss of correction was maximal after DCS showing 10.4 degrees (14.4%), on the average, and minimal after combined VDS and Harrington spondylodesis showing 6.9 degrees (9.3%). After simple VDS the long-term progression of the curve was 7.0 degrees (12.9%). In this group the initial correction was above-average high showing 76.4%. The main loss of correction occurred during the first 2 years after surgery. The long-term correction stability did not show significant differences between simple VDS and combined antero-posterior instrumentation. After anterior instrumentation of the primary curve the secondary cranial nerve spontaneously straightened up by 30%, on the average, and remained stable in the long-term. The anterior instrumentation of the spine lead to a mean loss of lordosis of 13.6 degrees which in the long-term additionally increased by 6.4 degrees due to the anterior epiphyseodesis effect. In 17 patients (42.5%) 24 fractures of the 3 mm-threaded VDS-compression rod occurred. In case of single rod fractures no higher loss of correction or differences in incidence of pain were observed in comparison to intact implants.

Adolescent↗
PubMedDate not supplied

[Congenital round talus].

The collective consists of 11 patients with a "ball and socket"-anomaly of the talus with a mean age of 13.7 years. All patients demonstrated typical symptoms of the FFU-syndrome with a leg length discrepancy of 4.3 cm (2-20). In 6 patients a close follow-up was done in the early development of the talus form. In the metacarpal region also synostosis of some bones were seen at a mean age of 4.8 years (3.2-5.9). No clinical complaints but a slight reduction of hind foot mobility could been registered. Ball and socket deformity can not been seen as congenital, but as a subsequent deformity after congenital fusions in the metatarsal bones.

Adolescent↗
PubMedDate not supplied

[Joint destruction and infection in advanced age].

Because of degenerative joint diseases and the reduced resistance in older patients the correct diagnoses of joint-empyema is difficult. In 29 pat (> 60 y) the mean delay of diagnoses was 5.1 months. First location of the infection have been: urinary tract 12, pneumonia 6, skin infection 10, and decubitus 3. Risk factors have been diabetes 4, polyarthritis 3, gout 3 and tuberculosis 3. The species were: s. aureus 12, s. albus 2, streptococcus 2, diphtheroid 2, e.coli 2, pseudomonas 2, proteus 4, enterobacter 3 and salmonella 1. 8 patients demonstrated mixed infections. The high mortality (3 pat.) and the frequent general sepsis (5 pat.) underline the importance of a missed joint-empyema in the elderly.

Aged↗
PubMedDate not supplied

[Prostaglandins in bone and cartilage metabolism].

Prostaglandins induce very probably the local intercellular communication and regulate the metabolism of bone and cartilage. They are supposed to be local mediators of mechanical stress, electric phenomena as well as of hormonal control mechanisms in cytobiologic and cytochemical reactions within the skeletal system. In-vitro prostaglandins act as potent bone and cartilage resorbing agents. In-vivo they also promote the synthesis of bone in a way that is not known as yet. Experimental investigations proved their influence on inflammatory processes, and, above all on the bone destruction in the pathogenesis of rheumatoid arthritis and osteomyelitis. It is the aim of the following review to elucidate the function and metabolism of prostaglandins with regard to their clinical importance and, particularly, to orthopaedic diseases.

Animals↗
PubMedDate not supplied

[Significance of arterial circulation disorders for the planning of hip prosthesis interventions].

Between 1980 and 1990 a total of 17 patients who had undergone or had been selected for total hip replacement were treated in the Department of Surgery at Münster University. Angiographic studies performed because of persistent symptoms revealed circulatory disorders of the pelvic floor. Vascular surgery was necessary to eliminate symptoms in these patients. Postoperative complications in 3 patients following total hip replacement were also only eliminated by vascular surgery. In the present authors' view, failure to recognize preoperatively existing arterial circulation disorders can lead to misdiagnosis and severe postoperative complications. Every hip replacement operation should be preceded by a thorough clinical and--if doubt persists--an angiological examination. Documented arterial circulation disorders should be eliminated by vascular surgery prior to hip surgery.

Aortography↗
PubMedDate not supplied

[Morphological, morphometric and stereological aspects of Blount's unilateral stapling of the growth plate in animal experiments].

Medial stapling of the proximal tibial growth plate in ten-week-old pigs effects in the first instance a local reaction of the growth plate being first limited to the region between the staple branches. From the 4th-5th postoperative day on, there is a significant decrease of the growth rate, the surface area of cells in the zone of opening cells, and of the surface density of the adjacent metaphyseal spongiosa. From the 10th-11th day after stapling a significant decrease in the height of the metaphyseal columns and the growth plate occurs in the medial compartment as well as a trabecular broadening of the metaphyseal spongiosa in the stapled area. Subsequently, the surface density of the metaphyseal spongiosa is significantly lower, the volume density significantly higher than the control values. With advancing postoperative interval the stapling effects involve the whole growth plate. However, the central and the lateral compartments show always less distinct findings. Unilateral stapling of the growth plate brings about a significant diminution of the radiologically determined length of the epiphysis, metaphysis and the total tibia as well as an evident broadening of the growth plate.

Animals↗
PubMedDate not supplied

[Diagnosis and long-term outcome after surgical therapy of tarsal tunnel syndrome].

In differential diagnosis of foot pain the tarsal tunnel syndrome has to be considered. Only few publications concerning clinical signs, diagnostic means, especially electrophysiological methods and postoperative long term results can be found in literature. In this study 21 of 32 patients who had a decompression operation of the posterior tibial nerve between 1972 and 1995 were reexamined at an average follow-up time of 12 years. Electrodiagnostic evaluation and clinical results by time of follow-up were compared to preoperative findings. Using the criteria described by Kaplan 10 postoperative results were rated as very good, 6 as good and 5 as poor. Sensible neurography has proven the most sensitive electrodiagnostic method. In the majority of cases the tarsal tunnel syndrome is still a clinical diagnosis.

Adult↗
PubMedDate not supplied

Congenital ball-and-socket anomaly of the ankle.

We present the clinical and radiographic appearance of 11 patients with a ball-and-socket ankle joint with an average follow-up of 13.7 years. Ten patients demonstrated parallel symptoms of the femur-fibula-ulna syndrome (FFU) associated with a mean leg-length discrepancy of 4.3 cm (range, 2-20). In six patients, an annual follow-up of talar development was possible. Radiographically the patients showed an additional tarsal coalition at a mean age of 4.8 years (range, 3.2-5.9). This earlier fusion could be detected by an arthrographic examination. All patients had no clinical complaints except a slight reduction of hindfoot mobility. The ball-and-socket ankle joint is presumably not congenital itself but secondary to congenital conditions in the peritalar region.

Ankle Joint↗