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Biomedical subjects

C Gerber

Publications and source records attributed to C Gerber.

At least 127 records · Page 7Linked to original sources
PubMed1987

The subcoracoid space. An anatomic study.

Soft tissue impingement under the coracoid process has recently been identified as a cause of painful shoulder disability. In this study the normal space between the humeral head and the coracoid process in two functional positions of the arm was measured in an attempt to delineate anatomic risk factors predisposing to subcoracoid impingement. Forty-seven normal shoulders were studied by computerized tomography (CT) in adduction, 20 additionally in forward flexion/internal rotation, which is the position most frequently causing subcoracoid impingement. The distance between the humeral head and the coracoid tip averaged 8.7 mm for the adducted arm and 6.8 mm for the flexed arm. Modifications of the coracohumeral relationship were found to affect the subcoracoid clearance roughly 1.5 times more in flexion than with arm at the side. Subcoracoid impingement appeared particularly likely during forward flexion of a shoulder with a coracoid tip close to the scapular neck and projecting far laterally.

Adult↗
PubMed1987

Glenoplasty for recurrent posterior shoulder instability. An anatomic reappraisal.

Posterior glenoplasty, as performed for the treatment of recurrent posterior shoulder instability, was shown to thrust the humeral head forward and was able to cause symptomatic impingement of the anterior cuff between the coracoid process and the humeral head. Such subcoracoid impingement is relieved by resection of the inferolateral part of the coracoid tip and of the coracoacromial ligament.

Adult↗
PubMed1986

Altered skeletal muscle ultrastructure in renal transplant patients on prednisone.

Treatment with glucocorticoids causes wasting of proximal skeletal muscles. The purpose of the present investigation was to quantify in the thigh muscle the areas of the different fiber types determined by histochemical methods, and the muscle ultrastructure by means of electron microscopy, in normal subjects (N = 41) and in renal transplant patients treated with prednisone (N = 12). The cross-sectional area of all three fiber types was reduced in renal transplant patients treated with prednisone (10.6 +/- 4.3 mg/day), the fast glycolytic fibers being most affected (slow oxidative fibers: 2642 +/- 625 vs. 3677 +/- 970 micron2, P less than 0.001; fast oxidative fibers: 3275 +/- 735 vs. 4443 +/- 1343 micron2, P less than 0.01; fast glycolytic fibers: 2305 +/- 802 vs. 3920 +/- 1522 micron2, P less than 0.001). This was mostly due to a decrease in the volume of myofibrils per unit volume of muscle fiber (-30%). The intracellular lipid content and the volume density of subsarcolemmal mitochondria were increased by more than 70% in prednisone treated patients. In conclusion, the decreased myofibril areas might account for the muscle weakness in renal transplant patients treated with prednisone, and the decrease in myofibrils is in part functionally compensated by an increase in subsarcolemmal mitochondria and intracellular lipid content.

Adult↗
PubMed1986

Specificity of leg power changes to velocities used in bicycle endurance training.

Increases in leg power production resulting from 8 wk of bicycle endurance training (30 min/day, 5 times/wk) were studied using an isokinetic dynamometer. In addition, biopsies of vastus lateralis were analyzed to characterize muscle ultrastructural changes. Performance increased on the dynamometer specifically near the estimated average knee angular velocity used during the bicycle training (200 degrees/s). Power measurements were made during the first 5 contractions (maximal power: Pmax) and last 5 contractions (final power: Pend) of 25 and 50 consecutive contractions (at 60 and 240 degrees/s, respectively). Pmax and Pend increased only at 240 degrees/s but not at 60 degrees/s. These increases in Pmax (86 W) and Pend (78 W) resulted primarily from longer torque maintenance but also from increased peak torque during each contraction and were close to the increase in mechanical power output maintained on the bicycle (Pb; 78 W) during the training sessions. The specificity of these changes to the angular velocities used in the bicycle training indicates a neural basis to these adaptations. We suggest that these neural adaptations, coupled with the observed enhancement of muscle mitochondrial and capillary density (+41 and +15%, respectively) underlie the increased ability to maintain power production on a bicycle after endurance training.

Adult↗
PubMed1985

The role of the coracoid process in the chronic impingement syndrome.

Symptomatic impingement of the rotator cuff between the humeral head and the coracoid process has been studied and three varieties recognised: idiopathic, iatrogenic and traumatic. In all three the clinical findings consisted of pain in front of the shoulder, referred to the upper arm and forearm, and especially felt during forward flexion and medial rotation; the pain could be reproduced by medial rotation with the arm in 90 degrees of abduction, or by adduction with the shoulder flexed to 90 degrees. Patients were relieved of their symptoms by restoring adequate subcoracoid clearance.

Adult↗
PubMed1985

The lower-extremity musculature in chronic symptomatic instability of the anterior cruciate ligament.

We studied the musculature of the lower extremity in forty-one patients with chronic symptomatic instability of the anterior cruciate ligament. Computed tomographic and clinical measurements of the limb were taken at levels fifteen and twenty-five centimeters proximal to the medial joint line and ten centimeters distal to it. Biopsy specimens from the vastus lateralis of both lower extremities were analyzed by histochemistry and electron microscopy. Computed tomography revealed a decrease in the muscle square area of the affected thigh of 8 per cent as compared with the control lower extremity. There was quadriceps atrophy of 10 per cent and hamstrings atrophy of only 4 per cent. The atrophy of the vastus medialis was significantly greater than that of the entire quadriceps. Histochemistry revealed a similar decrease in fiber size for all fiber types, and hence no shift in fiber type. Electron microscopy showed an increase in intracellular fat but no change in mitochondrial volume density or capillarization.

Adolescent↗
PubMed1984

Evaluation of the levels of free and total amitriptyline and metabolites in the plasma and brain of the rat after long-term administration of doses used in receptor studies.

This study was conducted in order to investigate the level of amitriptyline (AT) and its metabolites. Three separate experiments were carried out. In two of these experiments, rats were treated over 7 days with IP doses of AT (10 mg/kg in experiment A and 2 X 20 mg/kg in experiment C). The rats were sacrificed either 2 (experiment C) or 12 h (experiments A and C) after the last dose. In experiment B, rats were sacrificed 2 or 12 h after a single dose of 20 mg/kg AT. The results of these experiments showed the following: in experiment A only AT was measurable in the brain and in the plasma, in contrast to experiments B and C, where NT and the hydroxylated metabolites AT-OH and NT-OH reached significant levels in the plasma and in the brain. The concentrations of AT-OH, NT-OH, and NT (12-h values) that were found in the brain are probably not pharmacologically relevant. The 12-h plasma values of all compounds tested were, even with the highest dose, lower than those expected to be clinically effective in man. Our results suggest that AT, at higher doses, may induce its own metabolism. The free plasma levels of this drug and its metabolites are higher in man than in the rat. The possible implications of these results in the use of antidepressants in the treatment of depression are discussed.

Amitriptyline↗
PubMed1983

Observations concerning the limited mobilisation cast after anterior cruciate ligament surgery.

A limited mobilisation cast (LMC) with hinges locked at 20 and 60 degrees has been advocated for the care after anterior cruciate ligament (ACL) surgery. The brace presumably limits motion to 20 and 60 degrees and prevents straining of the ACL. Extension of more than 20 degrees as well as anterior drawer forces are known to strain the ACL. We have therefore tested whether the LMC reliably limits the desired range of motion: Extension of more than 20 degrees was found in 11 of 12 patients and averaged 12 degrees. The long leg cast reduced a 30 degree anterior drawer in unstable knees by 70%, a Lenox-Hill-Derotation Brace by 53% and the LMC by only 14%. It was concluded that a modified Lenox-Hill Brace locked at 30 and 60 degrees of flexion provides better stress-protection of the ACL than a LMC and that the safety of the conventional long leg cast should be remembered in legs with unfavourable soft tissue configurations. If a LMC is used, it should be fixed to the trunk with a waist- or shoulder-strap and the hinges must be freely adjustable.

Adolescent↗
PubMed1983

Biomechanical analysis of the knee after rupture of the anterior cruciate ligament and its primary repair. An instant-centre analysis of function.

Sixty-five knees were subjected to a kinematic analysis using the instant-centre technique in order to determine the effect of deficiency of the anterior cruciate ligament on the biomechanics of active movement in the knee. The instant-centre pathway in acute ruptures of the anterior cruciate ligament was found to have a specific abnormality. This corresponded with a positive pivot-shift sign, but was present even when that sign was not clinically detectable. Primary repair using a transosseous wire suture did not usually abolish the biomechanical abnormality. The data provide a possible explanation for the doubtful prognosis of primary repair of this ligament and encourage clinical and biomechanical evaluation of alternative procedures such as primary augmented repair.

Adult↗