PubMed Health⌕ Search

Biomedical subjects

D Kohn

Publications and source records attributed to D Kohn.

At least 163 records · Page 9Linked to original sources
PubMed1990

Document image management systems: promise versus reality.

Do you dream of using a document image management system at your facility? This article balances the reasons why healthcare facilities are slow to invest in such technology against the benefits offered by electronic document image management systems. The author also provides a list of vendors.

Capital Expenditures↗
PubMed1990

Autologous bone marrow transplantation with 4-hydroperoxycyclophosphamide purged marrows for children with acute non-lymphoblastic leukemia in second remission.

Although autologous bone marrow transplantation (ABMT) following purging with 4-hydroperoxycyclophosphamide (4HC) has been effective for some adults with acute non-lymphoblastic leukemia (ANLL), there are few data on ABMT for children. We have performed ABMT for 13 patients (median age, 5 years) with ANLL in second remission. Bone marrow was treated ex vivo with 4HC to kill residual leukemic cells. In order to enhance the anti-leukemic effect of 4HC, exogenous red blood cells were eliminated from the marrow/4HC mixture. All patients were conditioned for transplantation with busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg), followed by infusion of the 4HC treated marrow. Eleven of 13 patients had complete hematologic reconstitution; there were no transplant-related deaths. Five patients relapsed at 2, 4, 5, 6 and 6 months post-BMT. Eight patients are disease-free survivors; the median time for survival is 24 months, with a projected disease-free survival of 61%. ABMT is a safe and efficacious treatment modality for children with ANLL in second remission. Our results suggest that the disease-free survival for pediatric patients may be superior to that seen in adults.

Actuarial Analysis↗
PubMed1990

[Value of diagnostic measures in soft tissue diseases and soft tissue lesions of the shoulder joint].

Calcifying tendinitis, acute tendinitis, frozen shoulder, rotator cuff rupture, subluxation of the gleno-humeral joint and injury of the biceps tendon are commonly classed under the blanket term "peri-arthropathy of the shoulder". It is now possible to make a precise diagnosis of these shoulder disorders by means of a clinical examination supported by X-ray examination, ultrasonography, arthrography, computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy. Calcifying tendinitis is diagnosed by consideration of the patient's history, followed by clinical examination and X-ray examination. Acute tendinitis is a clinical diagnosis, as is frozen shoulder. Ruptures of the rotator cuff can be detected by ultrasonography, which is a screening method; such ruptures can also be detected by arthrography. The localization and extent of the defect are best estimated by arthroscopy. Shoulder instability is another clinical diagnosis. Bony defects of the humeral head (Hill-Sachs lesion) or the glenoid rim are revealed by computed tomography (CT). CT arthrography reveals the presence of any Broca-Hartman lesion in the anterior inferior part of the anterior capsular mechanism. Rupture, subluxation or luxation of the biceps tendon are diagnosed either by clinical examination or by arthroscopy. Knowledge of the sensitivity, specificity and accuracy of the diagnostic procedures makes it possible to carry them out in a standardized, logical sequence. Arthroscopy allows a decidedly more accurate diagnosis than any of the other methods, but as it is an invasive procedure it should be kept until last when diagnosis of disorders of the gleno-humeral joint is required.

Arthroscopy↗
PubMed1990

Arthroscopic evaluation of anterior cruciate ligament reconstruction using a free patellar tendon autograft. A prospective, randomized study.

In a prospective study, follow-up arthroscopy was performed (with the informed consent of the patient) after anterior cruciate ligament reconstruction using a free patellar tendon autograft. Nineteen of 21 consecutive patients agreed to arthroscopy. Time between operation and arthroscopy ranged from six to 25 months (average, 15 months) and was distributed at random among the patients. In evaluating knee stability and functional performance, the arthroscopic findings were disappointing. The Lysholm score improved from 68 +/- 8 points preoperatively to 84 +/- 8 points postoperatively. KT-1000 measurement on the day before follow-up arthroscopy showed only a slightly increased anterior laxity of 6.2 mm compared to 4.7 mm on the uninjured side. When the arthroscopic results were graded from 0 (ruptured) to 3 (excellent), four patients had a Grade 3 result, ten patients had a Grade 2 (moderate) result, and five patients had a Grade 1 (poor) result. No graft was ruptured. These findings indicate that, in the majority of patients, reconstruction of the anterior cruciate ligament using a free patellar tendon autograft will not result in an arthroscopically normal substitute for the anterior cruciate ligament.

Adult↗
PubMed1989

Meniscus suture techniques: a comparative biomechanical cadaver study.

The primary stability of four common meniscus suture techniques was tested on human cadaver menisci. The test series was carried out under standard conditions (25 degrees C, 100% air humidity) using the Instron 1122 Tensometer. The tearing stress of different sutures was reproducible in different specimens dependent only on the suture technique. Knot-end techniques gave inferior results (tearing stress, 24 +/- 9 N) compared with arthroscopic techniques using a loop placed on the meniscus surface (tearing stress, 89 +/- 4 N). When an open meniscus repair is performed, a vertical stitching technique (tearing stress, 105 +/- 4 N) should be the preferred method. Horizontal sutures are weaker (tearing stress, 44 +/- 18 N).

Adult↗
PubMed1989

[Basic principles of after care following autoplastic reconstruction of the cruciate ligament].

Since 1984 we avoided immobilization after reconstruction of the anterior and/or posterior cruciate ligament. Principles of kinematics were taken in consideration during aftertreatment. Results were very satisfactory in anterior cruciate ligament reconstruction. Subjective assessment of knee function (Lysholm score), objective measurement of anterior-posterior knee stability (KT-1000 arthrometer) and clinical follow-up results were good without immobilization.--This cannot be said for the posterior cruciate ligament, because the number of patients was too small. Our current concept of rehabilitation after reconstruction of the posterior cruciate ligament may yet serve as a reasonable but still unproven approach to the problem.

Athletic Injuries↗
PubMed1988

Unsuccessful arthroscopic treatment of pyarthrosis following anterior cruciate ligament reconstruction.

Postoperative purulent infection developed in the knee of a patient who had undergone anterior cruciate ligament reconstruction. Initially, arthroscopic lavage and debridement was performed, but was unsuccessful because the infection had spread into the soft tissues of the former surgical wound. Open debridement had to be performed to control the periarticular infection. It is important to stress that the extent of the infection has to be considered when instituting a method of treatment. It should be possible to clinically diagnose this extraarticular infection.

Adult↗
PubMed1988

[Knee arthroplasty in osseous ankylosis. A case report].

We report on the successfully performed arthroplasty of a knee joint in a 19-year-old female patient in whom a bony ankylosis in malalignment had occurred following an infection. The deciding factor for performing the arthroplasty was not only the patients wish to regain mobility in the knee joint, but also the existing possibility of postoperative mobilization of the joint on a CPM-machine in combination with analgesia by means of a peridural catheter.

Adolescent↗
PubMed1988

Thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome in three siblings.

Two brothers and one sister had three variants of thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome (the 'TTP-HUS' complex). The sister had a chronic fatal variant of thrombotic thrombocytopenic purpura with severe neurological manifestation. One brother had a chronic relapsing disease but the kidneys were not affected, and the other brother had haemolytic uraemic syndrome. This occurrence in one family supports the hypothesis that haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura are actually two variants of the same disease.

Child, Preschool↗
PubMed1987

Fatigue properties of cast and heat treated Ti-6Al-4V alloy for anatomic hip prostheses.

The intricate shape of Ti-6Al-4V anatomic hip prostheses necessitates the use of casting as a fabrication method, since neither machining, nor forging or powder metallurgial processing are reasonably acceptable. Cast and hot isostatically pressed Ti-6Al-4V, however, has a relatively low ductility and reduced fatigue properties. Appropriate thermal treatments can improve these properties. Specifically, treatments comprising a beta-solutionizing and an aging step yield ductilities similar to the forged and annealed condition, and fatigue properties 11.5% above the non-treated condition. Such treatments produce small alpha-beta platelet colonies with a ragged, tortuous morphology. The reduction of scatter in fatigue strength is the result of the formation of this well controlled microstructure.

Alloys↗
PubMed1987

The clinical relevance of glenoid labrum lesions.

This study describes the microscopic and macroscopic appearance of the glenoid labrum in 106 unselected shoulder specimens. In a prospective investigation the clinical relevance of endoscopically confirmed lesions of the glenoid labrum in 46 patients is examined. Fibrillation (76%), detachment (50%), rupture (35%), and ossification (21%) of the glenoid labrum were the most frequent alterations in our autopsy material. Only 17 shoulders showed an intact limbus--despite the presence of the lesions of the labrum in 45 cases, none of the followed-up patients reported symptoms that could be related to this structure. Only in one patient, did part of the labrum have to be excised. According to the present results, we consider that most lesions of the glenoid labrum have little clinical relevance.

Adolescent↗