PubMed Health⌕ Search

Biomedical subjects

D Kohn

Publications and source records attributed to D Kohn.

At least 91 records · Page 5Linked to original sources
PubMed1997

The subjective shoulder rating system.

We developed a subjective shoulder rating system (SSRS) and tested its reliability against a recognized system (Constant-Murley Score) and a four-point verbal rating scale in 200 patients (mean age 43 years, range 18-71 years; 83 women and 117 men; 48 anterior shoulder reconstructions, 123 subacromial decompressions, 29 manipulations under anesthesia). Within the study period of 1 year, patients completed the SSRS preoperatively and at 1 and 2 weeks, also at 3, 6, and 12 months. The examination according to the Constant-Murley Score was performed preoperatively and at 3 and 12 months. Linear regression showed a highly significant correlation between the SSRS and the Constant-Murley Score (r = 0.83, n = 592, P < 0.001). Ninety-seven percent of the SSRS forms were completed and returned. The average time to complete the SSRS form was 55 s (range 20-310 s) as compared with an experienced examiner requiring an average of 410 s (range 190-720 s) to complete the Constant-Murley Score. The time difference was highly significant (P < 0.001).

Adolescent↗
PubMed1997

[Shoulder arthrodesis in deltoid paralysis].

After loss of active glenohumeral motion the arm cannot be positioned in space and function is impaired. Fusion of the glenohumeral joint creates a new platform for the movement of elbow, hand and fingers and leads to an improvement of function. The use of the reconstructive plate makes the operation easier. Shoulder fusion is especially suited if the function of elbow and hand is well preserved and if the patient is physically active. But fusion is definite and the options of muscle transfer operations and above elbow amputation have to be considered.

Adolescent↗
PubMed1997

Medial meniscus replacement by a fat pad autograft. An experimental study in sheep.

The medial meniscus in 15 sheep was replaced by a pediculated infrapatellar fat pad graft and resulted in the development of a macroscopically meniscus-like structure within 6 months. Five additional sheep with a meniscectomy were controls. Degenerative changes in the fat pad autograft were visible after one year. Osteoarthritis of the weightbearing medial compartment was detected after 6 months. A temporary protective effect on the cartilage could be attributed to the autograft, but the long term results indicated that this was not permanent. Fat is not suitable as a meniscal substitute.

Adipose Tissue↗
PubMed1997

[Injuries during handball. A comparative, retrospective study between regional and upper league teams].

To evaluate the injuries in Team Handball 186 male players out of 16 teams were questioned retrospectively at the end of a season. An important difference between practice and competition injuries could be found with an injury rate of 0.8 injuries per 1000 training hours and 13.5 injuries per 1000 playing hours. Injuries were predominant at the lower extremities with ankle injuries being the most frequent injury type. 2/3 of the playing injuries occurred in offense. 1/3 of these offense injuries could be attributed to a counter-attack. These injuries were generally more severe which lead us to a proposition of changing the rules of the game in foul plays in this situation. Elbow injuries in goalkeepers and shoulder injuries in throwers were specific for these types of players. Prophylactic braces were used by nearly 2/3 of the players.

Adult↗
PubMed1997

The expression cassette determines the functional activity of ribozymes in mammalian cells by controlling their intracellular localization.

In order to better understand the influence of RNA transcript context on RNA localization and catalytic RNA efficacy in vivo, we have constructed and characterized several expression cassettes useful for transcribing short RNAs with well defined 5' and 3' appended flanking sequences. These cassettes contain promoter sequences from the human U1 snRNA, U6 snRNA, or tRNA Meti genes, fused to various processing/stabilizing sequences. The levels of expression and the sub-cellular localization of the resulting RNAs were determined and compared with those obtained from Pol II promoters normally linked to mRNA production, which include a cap and polyadenylation signal. The tRNA, Ul, and U6 transcripts were nuclear in localization and expressed at the highest levels, while the standard Pol II promoted transcripts were cytoplasmic and present at lower levels. The ability of these cassettes to confer ribozyme activity in vivo was tested with two assays. First, an SIV-growth hormone reporter gene was transiently transfected into human embryonic kidney cells expressing an anti-SIV ribozyme. Second, cultured T lymphocytes expressing an anti-HIV ribozyme were challenged with HIV. In both cases, we found that the ribozymes were effective only when expressed as capped, polyadenylated RNAs transcribed from Pol II cassettes that generate a cytoplasmically localized ribozyme that facilitates co-localization with its target. We also show that the inability of the other cassettes to support ribozyme-mediated inhibitory activity against their cytoplasmic target is very likely due to the resulting nuclear localization of these ribozymes. These studies demonstrate that the ribozyme expression cassette determines its intracellular localization and, hence, its corresponding functional activity.

Animals↗
PubMed1996

Retroviral mediated transfer of the cDNA for human glucocerebrosidase into hematopoietic stem cells of patients with Gaucher disease. A phase I study.

Patients with Gaucher disease suffer from a lack of functional glucocerebrosidase enzyme (Gc). Disease symptoms are a result of macrophage engorgement secondary to this enzyme deficiency. This study is designed to determine if cDNA encoding normal Gc can be introduced into macrophage precursors using a retroviral vector. CD34+ cells obtained from G-CSF mobilized peripheral blood stem cells or from bone marrow will be transduced ex vivo using one of the following three methods of transduction: 1) GlGc retroviral supernatant in the presence of autologous stroma over a period of 72 hours, 2) GlGc retroviral supernatant in the presence of interleukin-3, interleukin-6, stem cell factor and autologous stroma over a 72 hour period, 3) G1Gc retroviral supernatant in the presence of interleukin-3, interleukin-6, and stem cell factor over a 72 hour period. These transduced cells will be reinfused into the patient and the patient monitored for toxicities as well as evidence of successful gene transfer and expression. A total of twenty-four patients will be enrolled on the protocol. Patients will be assigned in equal numbers to each of six groups. The two sites participating are the National Institutes of Health and Childrens Hospital of Los Angeles.

Clinical Protocols↗
PubMed1996

Revision anterior cruciate ligament surgery: experience from Germany.

From 1976 to 1992, reconstruction after failed anterior cruciate ligament repair or reconstruction was done for 87 patients (8%) compared with 1064 primary operations at the authors' institution. Fifty-seven patients had 1 previous reconstruction, 27 patients had 2, and 3 patients had 3 or more previous reconstructions. Fifty-two patients (60%) were satisfied with their results after a mean followup time of 8 years (range, 2-18 years). Lysholm scores after revisions (68 +/- 12) were significantly inferior compared with scores after primary anterior cruciate ligament surgery (83 +/- 14). The authors favor the use of the patellar tendon or quadriceps tendon autograft in revision surgery. Medial meniscus reconstruction is done whenever possible, or the medial meniscus is replaced by autograft tissue. Open or arthroscopic techniques are used, depending on the individual case.

Adolescent↗
PubMed1996

[Arthrodesis following revision of a knee endoprosthesis. Literature review 1984-1994].

Two percent of primary and 8% of revision total knee replacements are followed by arthrodesis. Today knee arthrodesis is the most important salvage procedure after failed total knee arthroplasty, resection arthroplasty and above-the-knee amputation being the only alternatives. Analysis of the literature between 1984 and 1994 revealed 533 cases treated with arthrodesis of the knee; 403 were done after failed total knee arthroplasty. The fusion rate was 74%. External fixation, intramedullary nail, plates and combinations of these are currently used for fixation. The literature and an analysis of our own patients from 1988 to 1994 showed that arthrodesis after failed arthroplasty is a difficult procedure, and complications often occur. Bone loss of the distal femur and proximal tibia is the one most important prognostic factor. A new classification system for bone loss is presented.

Aged↗
PubMed1996

[Arthrodesis].

Explore the source record for details and available documents.

Arthrodesis↗
PubMed1995

[Critical age as the main parameter of deterioration of health in the elderly].

The concept of critical age (CA) relates to accelerated development of illness in the elderly and defines the decade in which there is the greatest increase in a specific pathological condition. Clinically, increased rates for pathological medical, biological, psychological and social conditions occur in defined populations. 78 parameters with linear increase in rate were excluded. 693 parameters were computed and classified according to both decade of life and to physiological and multisystem problems (such as diabetes). The most dangerous age is 70-79 years, when calamities of various degrees of severity "bomb" a subject approximately twice a month. CA was similar for some systems (immune, endocrine, and cardiovascular), and for diabetes and hypercholesterolemia. Among 351 CA distributions relating to 27 systemic and multisystemic problems, there were 103 statistically different CAs. We conclude that the rate of deterioration in health is largely system-oriented. Following the most dangerous decade, rates of increase in CA slow or CA even decreases, so that health is relatively stabilized. Such stabilization is related in part to improvement in risk factors. Improved health at age 80 seems to be related to selection by the death of the sick, but the concept of true functional improvement at this age is being seriously discussed. Physical, psychological and social bilateral adaptation of both old people and of western society, play important roles, because better medical and social protection improves living conditions. Our data confirm the identification of 2 subpopulations of the elderly, the young-old and the old-old. Study of frailty according to both age and physiological systems gives additional useful information.

Age Factors↗
PubMed1995

Arterial blood supply of the infrapatellar fat pad. Anatomy and clinical consequences.

The arterial blood supply to the infrapatellar fat pad (Hoffa's fat pad) was investigated in 12 knee joints of human cadavers. The infrapatellar fat pad is supplied by an anastomotic network which displays some striking topographic features. Its vascular blood supply protects it against necrosis, when either reconstructive operations are carried out or extensive surgical exposures of the knee are done. The blood supply to the center of the fat pad is limited. This is of practical importance for the choice of arthroscopic portals. In addition, arthroscopically verified sources of bleeding are described in 57 patients with hemarthrosis without clinically detectable instability. Rupture of the infrapatellar synovial fold can be a cause of posttraumatic hemarthrosis in rare cases. Arteries irregularly found within the fold contribute to the blood supply of the anterior aspect of the synovial membrane covering the cruciate ligaments.

Adipose Tissue↗
PubMed1995

Meniscus insertion anatomy as a basis for meniscus replacement: a morphological cadaveric study.

A morphological cadaveric study was carried out to gain exact data concerning location, shape, and size of the meniscal insertions to bone. Ninety-two knee joints were dissected (46 donors; age 18 to 58 years). Peripheral length of the menisci, including their insertion ligaments, was measured. The peripheral length was 111 +/- 14 mm for the medial and 111 +/- 10 for the lateral meniscus. The tibial insertion ligaments for the medial meniscus were fixed in areas that could be defined by bony landmarks. The posterior insertion area measured 80 +/- 10 mm2, the anterior insertion area measured 139 +/- 43 mm2. Bony tibial insertions of the lateral meniscus were less well defined. The posterior meniscofemoral ligament (Wrisberg) was found in 76% of the knees; the anterior meniscofemoral ligament (Humphry) was found in 50% of the specimens. The meniscofemoral ligaments in the right knee and the left knee of the same individual were frequently different. The anterior transverse ligament was found in 64% of the specimens. We concluded that an anatomical attachment of a medial meniscus substitute should be possible but to restore the lateral meniscus anatomically would be far more complicated.

Adult↗