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Biomedical subjects

B Fink

Publications and source records attributed to B Fink.

17 recordsLinked to original sources
PubMed1992

Frequency of curettage in middle-aged women treated with sequential preparations versus untreated women.

Over a 2-month period a register was kept of all dilatation and curettage procedures performed in Frederiksborg County, Denmark, involving women aged 40-59 years. The total recorded was 284. In the same period, questionnaires were sent out to 1200 women in the county who fell within the same, randomly selected age group, to establish the number of women treated with sequential oestrogen/progestogen and those who had been hysterectomized. Based on the results and the total female population in the county, it was calculated that the frequency of the procedure in sequentially-treated women as compared with untreated women was 3.1 times higher in the 55-59 age group. In the 40-54 age group no difference in the incidence of curettage in the sequentially-treated women could be demonstrated.

Adult↗
PubMed1992

Pathophysiology of unilateral high-grade carotid artery stenosis: evaluation of intracranial haemodynamics by analysis of velocity waveforms from the middle cerebral artery.

1. Transcranial flow velocity waves were measured via Doppler sonography of the middle cerebral artery during hypo-, hyper- and normo-capnia. Applying the principle of vascular impedance, flow velocity waves were analysed in 30 young subjects, 37 elderly subjects and 18 patients with high-grade unilateral internal carotid artery disease. 2. There was evidence that the relative peak-to-peak velocity in the middle cerebral artery could serve as an index of peripheral wave reflection and cerebral resistance (CRi). The response of CRi to changes in arterial CO2 concentration (CRi reactivity) showed a clear age-dependency. However, the absolute side-to-side asymmetry of CRi reactivity (delta R) did not vary with age and could be used to define a normal range (0-4%CRi/vol.%CO2). 3. Selective angiography demonstrated no cerebral cross-flow through the anterior part of the circle of Willis in nine patients with carotid artery stenosis whose absolute delta R was above the normal range and whose CRi reactivity of the affected hemisphere was lower than that of the healthy opposite hemisphere. Conversely, another group of nine patients, whose ipsilateral CRi reactivity was higher than the contralateral CRi reactivity, demonstrated cross-flow through the anterior part of the circle of Willis. 4. delta R may be used to identify patients who have high-grade internal carotid artery stenosis and present with low cerebral vascular resistance owing to poor intracerebral collaterals.

Adult↗
PubMed1992

[Ilisarov ring fixation and its technical application].

The Ilisarov ring fixator is an extremely versatile external fixation device. There is a wide range of indications for its use, e.g. fractures, pseudarthroses and non-unions, large defects, deformities and limb shortening. The device consists of rings or half-rings, which are connected to each other by threaded rods or plates and to the bone by wires under tension. This design allows neutral fixation, compression or distraction of the bone fragments. Because of its low axial stiffness at low loads and increased stiffness at higher loads, this fixator promotes osteogenesis and reduces strain on the tissues in functional treatment. Surgical intervention for its application is minimally invasive. This is a useful addition to the orthopaedic surgeon's armamentarium, providing proper attention is paid to preoperative planning, the principle rules of frame design and wire insertion technique, and postoperative management.

Biomechanical Phenomena↗
PubMed1992

[Fracture treatment in the area of the tibia].

From May 1990 to March 1992 17 open and 6 closed fractures of tibia and fibula with second- to third-degree soft tissue injuries were treated by external fixation using the Ilisarov technique. In 14 patients this external fixation was used as the primary treatment. In nine cases it was used secondarily, mainly in patients transferred after stabilization with other internal or external devices. The mean duration of fixation for diaphyseal tibial fractures was 127 days and for metaphyseal fractures, 107 days. After removal of the fixation device, a brace was temporarily fitted for full weight-bearing. Disadvantages observed include less comfort for the patient and longer operation time compared to other external fixation systems. On the other hand, this method allows full weight-bearing soon after the operation and involves minimal damage of soft tissue. Furthermore, injured soft tissue was well protected during healing.

Adolescent↗
PubMed1992

[Treatment of post-traumatic limb shortening].

The physiological phenomenon of changes in callus formation during distraction was first described by Codivilla at the beginning of this century. Having investigated and proved the influence of tension stress on callus formation, Ilizarov used this as a method to treat limb shortening and deformities. Because of his remarkable results we introduced this method in our hospital in 1990, using the original Ilizarov ring fixator. From November 1990 to December 1991, we used this technique in 10 cases of combined post-traumatic bone shortening with deformity (the tibia was affected in six patients, the femur in three and the forearm in one). The mean shortening was 3.1 cm, the mean varus or valgus deformity 9.5 degrees, the mean anteflexion or recurvation 8.3 degrees, and the mean rotation deformity 8.5 degrees. Distraction/correction lasted between 8 and 55 days (mean: 37 days). Fixation was necessary for between 60 and 339 days. If corticotomy was performed in the diaphyseal bone, fixation lasted almost twice as long (11.33 days/mm lengthening) as in the metaphyseal area (6.55 days/mm lengthening). There were 14 complications, most of which were considered minor. The latter included pin infections (4), wire breaking (1) and restricted range of motion of the knee or ankle (5). Among the major complications were two nerve irritations, which recovered spontaneously, and two pin-induced local bone infections, which required surgical intervention. Achievement of the goals of treatment-complete correction of shortening and deformity-was not affected by these complications.

Adult↗
PubMed1992

[Treatment of chronic osteitis of the femur].

Since May 1990, we have treated seven patients with chronic osteomyelitis of the femur. The Ilisarov apparatus was used in three of these cases for fixation and in four cases for segment transport. The treatment of four patients is now complete. We have not found any problems in bone regeneration. The use of pins in the proximal and middle thirds of the femur has proved problematic due to the soft tissue damage. Instead of this, we recommend using Schanz screws, which can be fixed to the arch with the AO lock. Moreover, it is easier to shorten the 180 degrees arch to 90 degrees or 120 degrees using the Schanz screws. To prevent problems, it is better to assemble the apparatus before use and to take into consideration the anatomical and functional situation.

Adult↗
PubMed1992

[Treatment of chronic osteitis of the tibia].

Since the beginning of May 1990, we have been using the original Ilisarov apparatus in our treatment of osteomyelitis. It has been used both statically and dynamically after corticotomy for segment transport and lengthening. So far we have treated 24 patients, of whom 13 had defect osteomyelitis, 9 had unstable infections and 2 had stable osteomyelitis with deformities. On average the bone defects measured 7.6 cm, and nine patients had soft tissue defects larger than 6 cm2. The Ilisarov apparatus performed a holding function in seven cases after defect grafting using autogeneic spongiosa. It was used in four cases for gradual compression, in seven cases for segment or fragment transport, in three cases for secondary lengthening and in three cases for correction. In all cases the infections were eliminated and stability was obtained. The duration of segment transport corresponded to the defect size, with a daily lengthening of approximately 1 mm. The fixation times ranged from 112 to 483 days (mean: 240 days). Apart from one special situation, no bone regeneration problems were observed. Some of the complications we encountered must be regarded as beginners' mistakes. We observed problems with segment transport (early corticotomy healing, deformity, non-union at the docking site) and problems with equipment, which has now been improved. For closure of the soft tissue defects it was sufficient to use mesh grafting. Its versatility and advantages as a stabilizing apparatus have made the Ilisarov fixator the instrument of our choice, especially in the treatment of circular infected defects larger than 3 cm.

Adult↗
PubMed1991

Cyclic stress analysis of flexor tendon repair.

A method of evaluating flexor tendon repair techniques with the use of cyclic testing is presented. This type of evaluation complements the presently used load-to-failure tests by providing more detailed information about gap formation at the repair site. During load-to-failure testing in this study, core sutures alone demonstrated initial gap formation at 0.85 kg tensile force or more; yet on cyclic testing all techniques demonstrated gap formation of 1.9 mm or greater at 0.5 kg tensile force. Thus cyclic testing demonstrated gap formation not readily apparent on load-to-failure testing. An epitenon stitch placed circumferentially around the laceration site added strength in both load-to-failure and cyclic tests, and significantly reduced gap formation regardless of the core suture technique.

Hand↗
PubMed1990

A family history study of neuropsychiatric disorders in the adult siblings of autistic individuals.

The family history method was used to obtain developmental, social, and psychiatric histories on the 67 adult siblings of 37 autistic probands. Two of 67 siblings (3.0%) were autistic, three siblings (4.4%) had severe social dysfunction and isolation, 10 (15%) had cognitive disorders, and 10 (15%) had received treatment for affective disorder. This study is the first to investigate the frequency of disorders in the adult siblings of autistic probands. These results suggest aggregation of a variety of neuropsychiatric disorders in the siblings of autistic individuals.

Adolescent↗
PubMed1990

Screening workers exposed to 4,4'-methylenebis(2-chloroaniline) for bladder cancer by cystoscopy.

A bladder cancer incidence study was conducted among 540 workers exposed to the potential bladder carcinogen 4,4'-methylenebis(2-chloroaniline) from 1969 to 1979. Among the 385 workers who participated in a urine screening examination, none had suspicious or positive cytology. Twenty-one workers had at least one reading of atypia and 60 had either a positive dipstick for heme or greater than five red blood cells per low power field. The study protocol initially involved referral to private physicians for follow-up of any suspicious laboratory results. However, the diagnosis by cystoscopy of a bladder tumor in a nonsmoking man less than 30 years old with low-level hematuria prompted us to offer cystoscopy to all members of the cohort. A total of three tumors were identified in 200 persons who received cystoscopy. All were low-grade, papillary tumors and two occurred in men with completely normal urine screening results. These findings suggest that cystoscopy of asymptomatic persons should be considered in designing bladder cancer screening programs in high-risk cohorts.

Adult↗
PubMed1988

Bladder tumors in two young males occupationally exposed to MBOCA.

MBOCA (4,4' methylenebis (2-chloroaniline) is a structural analogue of benzidine and is carcinogenic in mice, rats, and dogs. MBOCA has not yet been demonstrated to be carcinogenic in humans and is not regulated as an occupational carcinogen in the United States. We report two noninvasive papillary tumors of the bladder identified in a screening study of 540 workers exposed to MBOCA during its production at a Michigan chemical plant from 1968 to 1979. Both tumors occurred in men under 30 years old who had never smoked. Although the prevalence of grade 1-2 tumors among asymptomatic males in this age group is unknown, the incidence of clinically apparent tumors on U.S. males aged 25-29 is only 1 per 100,000 per year. The detection of the two tumors in young, nonsmoking males is consistent with the hypothesis that MBOCA induces bladder neoplasms in humans.

Adult↗
PubMed1988

Effect of oestrogen and progestagen on gonadotrophins and sex hormones in oophorectomized women.

Five premenopausal women were followed with measurements of androgens, oestrogens, gonadotrophins and sex hormone binding globulin (SHBG) after ovariectomy for benign disease. After a period of 6 weeks without treatment the women were treated with oestradiol 4 mg daily for 8 weeks, oestradiol 4 mg plus norethisterone acetate (NETA) 2 mg daily for 8 weeks and finally oestradiol 4 mg daily for another 8 weeks. The levels of androgens did not change during the various periods. As usual during oral treatment oestrone and oestrone sulphate were elevated while oestradiol levels were in the pre-operative range during treatment, regardless of the addition of NETA. SHBG was elevated during oestrogen-only treatment, while addition of NETA normalized the concentration of SHBG. In the combined NETA period concentrations of free oestradiol and non-SHBG-bound oestradiol were significantly elevated, and gonadotrophins returned to premenopausal levels, in contrast to the high levels in the oestrogen-only periods. Using oral oestrogen therapy it may be preferable to add a progestagen rather than elevate the oestrogen dose. Progestagen will result in more free oestradiol and give greater relief of symptoms, but the potentially harmful effect of progestagens on blood lipids must be considered.

Adult↗
PubMed1987

Interaction of human thrombospondin with types I-V collagen: direct binding and electron microscopy.

Binding of thrombospondin (TSP) to types I-V collagen was examined by direct binding assays using 125I-TSP and by visualization of rotary-shadowed intermolecular complexes in the electron microscope. The binding of TSP was highest to type V collagen in the absence of Ca, while lower but significant levels of binding were observed to all other collagen types in the presence or absence of Ca. Unlike intact TSP, the trimeric collagen-binding domain of TSP composed of 70-kD chains showed no Ca dependence in its binding to type V collagen. Further evidence for binding of TSP to types I and III collagen was obtained by competition studies in which these soluble collagens effectively inhibited binding of 125I-TSP to immobilized type V collagen. The binding of TSP to type V collagen was inhibited by heparin and fucoidin, both high-affinity ligands of TSP's heparin-binding domain. mAb A6.1, which binds to the 70-kD domain of TSP, is also the best of a panel of anti-TSP mAbs at inhibiting the TSP-collagen interaction. Electron microscopy of rotary-shadowed replicas of TSP-collagen complexes revealed that all five types of collagen examined had a binding site for TSP at one end of the pepsinized, triple helical molecule. The specificity of this site was tested by examining the ability of BSA to form a complex with the end of the pepsinized collagens. Rotary-shadowed replicas revealed a low frequency of apparent BSA-collagen complexes, and histograms of these data showed no evidence for the preferential association of BSA with the end of the collagen molecules. In addition to the specific end site, type V collagen had an internal binding site for TSP located about two-thirds of the distance along the length of the collagen molecule from the end site. The internal binding site for TSP on type V collagen is apparently the site responsible for the higher affinity binding of TSP to that protein observed in direct binding assays. The trimeric 70-kD collagen-binding domain of TSP bound to the same sites on the collagens as did intact TSP.

Binding, Competitive↗
PubMed1976

The rap session.

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Adult↗
PubMedDate not supplied

Shoulder arthrodesis in pediatric patients.

Shoulder arthrodesis was performed in 17 pediatric patients. Diagnoses included birth-related brachial plexus palsy (six patients), posttraumatic palsy (three patients), and residual paralysis after poliomyelitis (eight patients). The position of fusion was not as important as the stability gained by the patient. Excessive abduction or forward flexion should be avoided, however, because this can be cosmetically displeasing to patients.

Adolescent↗