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Biomedical subjects

B Mandelbaum

Publications and source records attributed to B Mandelbaum.

17 recordsLinked to original sources
PubMed2001

Autologous chondrocyte implantation of the knee: multicenter experience and minimum 3-year follow-up.

OBJECTIVE: To determine clinical outcome and graft survivorship in patients undergoing autologous chondrocyte implantation (ACI) for the repair of chondral defects of the knee. DESIGN: Prospective cohort study. SETTING: 19 centers in the United States. PATIENTS: 50 patients (37 males, 13 females). Mean age was 36 years (range: 19-53). Defects were grade III or IV with a mean size of 4.2 cm 2. All patients had a minimum of 36 months postoperative follow-up. MAIN OUTCOME MEASUREMENTS: Clinician and patient evaluation based on the modified Cincinnati Knee Rating System. Graft failure was defined as replacement or removal of the graft due to mechanical symptoms or pain. RESULTS: Clinician and patient evaluation indicated median improvements of 4 and 5 points, respectively, at 36 months following ACI (p < 0.001). Previous treatment with marrow stimulation techniques and size of defect did not impact the results with ACI. The most common adverse events reported were adhesions and arthrofibrosis and hypertrophic changes. Three patients had graft failure and required reimplantation or treatment with alternative cartilage repair techniques. Kaplan-Meier estimated freedom from graft failure was 94% at 36 months postoperatively (95% CI = 88-100%). CONCLUSIONS: These results of this study indicate excellent graft survivorship using ACI as well as substantial improvement in functional outcome.

Adult↗
PubMed1990

[Percutaneous endoscopic gastrostomy. 174 cases].

Nutritional assistance was given by percutaneous endoscopic gastrostomy to 174 patients with neurological diseases (80 cases), tumours of the ear, nose and throat (ENT) region (70 cases) or malnutrition (24 elderly people). These patients had either deglutition disorders with inhalation or severe malnutrition, or could not tolerate a nasogastric tube. The endoscopic catheter (Bioser) was installed by the pull technique under general anaesthesia (26 percent), neuroleptanalgesia (16 percent), premedication (14 percent) or without sedation (44 percent). Installation was possible in 98 percent of the cases. Twenty-nine percent of the patients were treated in an outpatient clinic. The problems encountered (21 percent) were mainly due to blockade of the flange and rupture of the thread. Transoperative accidents, such as dyspnoea, bleeding or cardiac arrest, all without sequelae, were noted in 5 percent of the cases. The catheter remained in situ for a mean period of 3.9 +/- 0.3 months (range: 0.1 to 20 months). The following complications were observed: short-term (15 percent), hyperthermia (5), local infection (6), abscess of the abdominal wall (3), meteorism (9), pneumoperitoneum (1), subocclusion (2); long-term (25 percent), inflammatory reactions (13), leakage (19), catheter displacement (8) and catheter rupture (3). Local infections were more frequent in patients with ENT tumours than in the others. Percutaneous endoscopic gastrostomy is a fast and reliable technique preferable to surgical gastrostomy. Complications are frequent (46 percent) but usually minor (42 percent). Contra-indications must be respected, and the catheter must be introduced with the utmost care.

Administration, Cutaneous↗
PubMed1987

MR imaging of the knee. Part I. Traumatic disorders.

One hundred thirty patients with a diversity of knee joint injuries were evaluated with a high-resolution magnetic resonance (MR) imaging technique. The authors report the accuracy of this technique in the evaluation of 105 patients with suspected meniscal tears, 26 patients with suspected cruciate ligament tears, and eight patients with suspected patellar tendon injuries. Of those menisci rated as definitely or probably torn on MR imaging, 80% were found to be torn at subsequent arthroscopy. The predictive value of negative MR imaging results was 100%. MR imaging was 92% accurate in predicting the clinical outcome in patients with suspected meniscal tears who did not undergo surgery. MR permitted complete disruption of the patellar tendon to be differentiated from partial tears, ligamentous inflammation, and localized effusion of the infrapatellar bursa. Injuries to the anterior and posterior cruciate ligaments were identified on MR images, and the status of synthetic grafts of the anterior cruciate ligament was ascertained.

Humans↗
PubMed1987

MR imaging of the knee. Part II. Chronic disorders.

Sixty patients with symptoms of chronic disease of the knee joint were evaluated with high-resolution, thin-section magnetic resonance (MR) imaging. MR imaging depicted a wide variety of knee joint abnormalities including osteochondritis dissecans, medullary infarcts, epiphyseal osteonecrosis, intraarticular osteochondral fragments, synovial cysts, joint effusions, intraarticular soft-tissue tumors, synovial disease, leukemic infiltration of bone marrow, Osgood-Schlatter disease, and nonossifying fibroma. In two cases MR imaging depicted bone infarcts not seen on both radionuclide bone scans and standard radiographs. The highly detailed depiction of the articular cartilage was of particular importance in predicting arthroscopic findings in cases of osteochondritis dissecans. In two cases, a soft-tissue mass (pigmented villonodular synovitis) and a large osteochondral fragment undetected at arthroscopy were accurately localized with MR imaging. The results indicate that MR imaging is capable of providing information that might otherwise require multiple, sometimes invasive diagnostic procedures.

Chronic Disease↗
PubMed1981

Ductus arteriosus closure may result from suppression of prostacyclin synthetase by an intrinsic hydroperoxy fatty acid.

Fetal sheep ductus arteriosus readily synthesizes prostacyclin from exogenous prostaglandin endoperoxides, and in the presence of high oxygen tension, this synthesis is markedly suppressed. Fetal aorta and pulmonary artery also synthesize prostacyclin; however, this synthesis is much less suppressed by high oxygen tension. We propose that ductal closure may be regulated by the oxygen dependent synthesis of hydroperoxy fatty acid which would block the production of the vasodilatory prostacyclin and expose the direct contractile properties of intrinsic prostaglandin endoperoxide. This mechanism would result in ductal closure at birth.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

Elevated plasma hydroxyproline. A possible risk factor associated with connective tissue injuries during overuse.

Basal plasma hydroxyproline was measured in 104 male Navy Seal candidates 1 week into their intense physical training program, which lasted 7 weeks, and correlated to the incidence of connective tissue injuries incurred later in the training program. Eleven subjects (10.6%) were diagnosed as having connective tissue injuries. Those subjects with connective tissue injuries had a significantly higher (P less than 0.05) mean plasma hydroxyproline value (4.02 micrograms/ml) than subjects without injury (3.10 micrograms/ml). The majority of graduates (75%) had plasma hydroxyproline values less than 3.3 micrograms/ml. These graduates represented the strongest and most enduring injury-free subjects. Of the subject pool who incurred connective tissue injuries, only 27% had plasma hydroxyproline values less than 3.3 micrograms/ml. The majority of the injured subjects (73%) had plasma hydroxyproline values greater than or equal to 3.3 micrograms/ml. In conclusion, there is a relationship between initial training basal plasma hydroxyproline levels and connective tissue injuries later incurred in an intense physical training program. These data suggest that elevated plasma hydroxyproline levels may represent a risk factor associated with connective tissue injuries.

Adolescent↗