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Biomedical subjects

D Kohn

Publications and source records attributed to D Kohn.

At least 145 records · Page 8Linked to original sources
PubMed1991

The function of the Thomas splint. An experimental study.

A Thomas splint of traditional design was fitted with measuring devices and examined for its hip-relieving effect during varying activities. It was shown that there is no complete weight relief of the hip joint with this orthosis. In the most favourable case, 50% of the weight can be conducted via the ischial tuberosity and therefore transferred to the ground surface bypassing the hip joint. In regard to the hip joint, the Thomas splint is a device that reduces weight but does not entirely remove it. The results proved to be practically independent of the fitting of the orthosis and of the kind of activity.

Biomechanical Phenomena↗
PubMed1991

Long-term follow-up of patients aged 75 years and older admitted to an acute care hospital in Israel.

Certain biomedical and psychosocial factors may be important in predicting short-term and long-term outcomes in elderly inpatients in an acute care hospital. We prospectively studied all patients aged 75 years and older who were admitted to an acute inpatient geriatrics unit between June, 1984 and May, 1985, and we followed them for 5 years. Patients were followed by phone and/or the outpatient ambulatory service; follow-up visits occurred at 4 to 6 weeks following discharge and annually thereafter. After 5 years, 21% of the patients were alive. Apparently, age and gender were the major parameters associated with prognosis. Functional status and nutritional state (body weight, serum albumin) were also important prognostic factors. Of the geriatric syndromes, urinary incontinence seemed to be most strongly associated with a poor outcome, followed by falls and confusion. Iatrogenic conditions apparently had no such association. These findings suggest that certain demographic and clinical factors may be useful prognosticators for elderly hospitalized patients.

Aged↗
PubMed1991

[Routine ultrasound diagnosis of the shoulder. A simplified examination procedure].

With increasing use of ultrasonography at the shoulder, a confusing number of transducer positions have been recommended. At the shoulder, however, dynamic examination yields more information than fixed transducer orientations. In our examination routine, the transducer is guided across the shoulder following the shape of a triangle. Orientation is secured by palpable, bony structures. The clinically relevant parts of the rotator cuff and the long biceps tendon are investigated, first medially and laterally in a transverse projection and then longitudinally. Dynamic examination is provided by moving the transducer as well as the shoulder joint. In a time-saving examination routine, all important soft tissue structures of the shoulder are visualized.

Humans↗
PubMed1991

[The significance of the activity score in evaluating knee ligament reconstructions].

In a follow-up study of 156 patients after knee ligament reconstruction for chronic instability, the results of subjective Lysholm score grading and of Tegner activity grading were compared. The postoperative Lysholm score averaged 85 +/- 13.2 points, the activity scores 6.9 +/- 0.9 points prior to instability, 1.7 +/- 0.9 points preoperatively and 5.9 +/- 1.2 points postoperatively. 89 patients reached their preinjury activity level, the average improvement through surgery was 4.2 +/- 1.6 points. Non-active patients regularly returned to their original activity-level, competitive athletes were less likely to regain their previous activity. The subjective results of athletes and non-athletes showed no significant differences. The postoperative activity level clearly correlated to subjective grading by the patient. For scoring results after knee ligament surgery, we use the subjective Lysholm score and an activity score based on average German sports activities.

Activities of Daily Living↗
PubMed1991

Optical technology demonstrates benefits.

This article explores four applications of optical technology in the healthcare industry. The author has approached several end users of existing optical-technology-based systems to learn their reasons for choosing these systems and what benefits they have realized.

Cost-Benefit Analysis↗
PubMed1991

Refined imaging technologies spark urgent interest.

On assignment for Computers in Healthcare, imaging technology consultant Deborah Kohn scoured the exhibit hall at the huge Association for Information and Image Management (AIIM) annual conference--this year boasting 33,500 attendees--where she discovered that a five-year hesitancy about image management is definitely over. Across all industries, and particularly in healthcare, image management technologies are booming.

Diagnostic Imaging↗
PubMed1991

Hepatic veno-occlusive disease post-bone marrow transplantation in children conditioned with busulfan and cyclophosphamide: incidence, risk factors, and clinical outcome.

We performed a retrospective analysis of the incidence, risk factors, and clinical outcome of hepatic veno-occlusive disease (VOD) in 50 children prepared for bone marrow transplantation with busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg). The overall incidence of VOD was 28% (14/50). The incidence of VOD among patients transplanted for leukemia was 36% (14/39). In contrast, no patient transplanted for a genetic disease developed VOD. Neither patient age, sex, remission status, type of graft (i.e. allogeneic or autologous), past history of liver disease nor pretransplant liver function tests were associated with an increased risk of VOD. In addition, 23 of 50 patients had pretransplant samples available for antihepatitis C virus (HCV) testing; 3/23 were reactive (two of nine patients with VOD and one of 14 patients without VOD were positive for anti-HCV). We found a high incidence of pleural effusion in patients with VOD (7/14), an association that has previously not been described. VOD was manageable and resolved in all patients.

Adolescent↗
PubMed1990

[Intravenous iron-dextran in the elderly].

127 of 1000 patients treated during the first 2 years of this department's operation were found to be anemic. In 69 of them iron deficiency was diagnosed and 54 of them were treated with intravenous iron-dextran (Imferon). It had to be stopped because of adverse effects in 11 of them; 1 of them had a nonfatal anaphylactoid reaction, 4 women, 75-84 years old, are presented to demonstrate the indications for intravenous iron therapy. Oral administration is the treatment of choice in ambulatory patients. However, when as in the cases presented it fails, because of failure-to-thrive, intolerance to the oral preparation or noncompliance, intravenous iron is indicated.

Administration, Oral↗
PubMed1990

[Meniscus replacement using Hoffa's infrapatellar fat bodies--initial clinical results].

Between December 1986 and July 1988 a replacement of the absent medial meniscus was taken by means of the infrapatellar adipose body in seven patients. A replacement of the anterior cruciate ligament by means of the middle one third of the patellofemoral ligament was taken too. This operation was done for reconstruction of the synergism between the anterior cruciate ligament and the posterior horn of the medial meniscus. All patients are controlled in our special knee outpatient service. There were no complication postoperatively and on all seven patients a control arthroscopy was performed twelve months postoperatively. The subjective results are very satisfying because of the restoration of knee stability. The arthroscopic controls of the meniscal replacements, however, showed a reduction in size of the transplants after one year, the tissue was weak and not identical to that of a normal meniscus. Autologous strong tissue, e.g. quadriceps tendon, may have better presuppositions for meniscal replacement.

Adipose Tissue↗
PubMed1990

[Meniscus transplantation and anterior cruciate ligament replacement--results 2-4 years postoperative].

23 transplantations of meniscus combined with replacement of the anterior cruciate ligament were performed from May 1984 to December 1986 at the Department of Orthopaedics of the University of Munich ('Klinikum Grosshadern'). Clinical follow-ups were coupled with arthroscopic follow-ups on the average 10 months postoperatively in 19 patients with transplantation of the medial meniscus of the knee joint. In 17 cases a lyophilised meniscus was transplanted and in 6 cases a deep-freeze allogenous meniscus. There were no operation-specific complications in either group. Both the lyophilised meniscus transplants and the deep-frozen ones underwent a reduction in size during the observation period. Whereas good to excellent results were generally obtained with the deep-frozen transplants, the results seen in the lyophilised transplants were less satisfactory due to reduction in size partly down to regenerate size. The treatment results were of course positively influenced due to the contributory effect of the regained stability; in the patients with meniscus transplants the preoperative Lysholm score was 72 +/- 14 points, on the average 36 weeks postoperatively 82 +/- 15 points. However, clinical and arthroscopic findings showed that no clinically, immunologically and morphologically satisfactory meniscus replacement has become available to date.

Adult↗
PubMed1990

Mycobacterium avium-intracellulare infections after allogeneic bone marrow transplantation in children.

Serious infections caused by the Mycobacterium avium-intracellulare (MAI) complex have been increasingly recognized in patients with acquired immunodeficiency syndrome (AIDS). Allogeneic bone marrow transplant recipients are prone to infections caused by a wide spectrum of organisms. However, infection with MAI has been reported only once in an allogeneic bone marrow transplant setting. We describe two allogeneic bone marrow transplant recipients with severe combined immunodeficiency syndrome (SCID) in whom MAI infections occurred. Thus, MAI must be added to the list of infectious pathogens that can infect allogeneic bone marrow transplantation (BMT) recipients. Aggressive multidrug antituberculosis therapy may be of benefit in such patients.

Bone Marrow Transplantation↗
PubMed1990

Epidermal Langerhans' cells in elderly patients with decubital ulcers.

Langerhans' cells in the sacral epidermis 8-10 cm from the lesion of elderly patients (mean age 74 years) with decubital ulcers were studied ultrastructurally and compared with the patients' own normal epidermis from the upper leg, with age-matched normal controls, and with young normal controls (mean age 43 years). High percentages of Langerhans' cells (ranging between 30 and 50%) without dendrites were found in patient epidermis from the sacral region near the lesion and similar percentages in normal skin from the patients' upper leg. In both elderly and young controls, Langerhans' cells without dendrites found in the epidermis of the upper leg were fewer, ranging between 13 and 33%. The density of Langerhans' cells in adjacent sites of the same epidermis was non-homogeneous, being in the range of 0.56-1.19% in patient sacral epidermis, 0.69-1.31% in patient normal leg epidermis, 0.63-4.17% in leg epidermis of the elderly controls, and 0.63-3.94% in leg epidermis of the young controls. The majority of the Langerhans' cells in both patients and controls were located near the basal cell layer and in the mid-epidermis. The percentage of Langerhans' cells found in patient sacral epidermis (0.84 +/- 0.08%) and in their leg epidermis (0.87 +/- 0.15%) was significantly lower than in the elderly controls (1.91 +/- 0.30%) and young controls (1.84 +/- 0.24%). The low percentage of Langerhans' cells in the epidermis of patients with decubital ulcers may affect the healing process of the lesions.

Adult↗