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E Adler

Publications and source records attributed to E Adler.

10 recordsLinked to original sources

Stability of press-fit acetabular cups.

Mechanical tests were performed to characterize the initial stability of press-fit cups as a function of cup design, surface structure, and surgical preparation. Eight cups from six manufacturers were press-fit into acetabular cavities prepared in two densities of Sawbones polyethylene foam and in bovine knee trabecular bone. Cavity sizes and cup loading forces were varied. Acetabular defects were simulated in the Sawbones model. Preparations were tested to determine axial-rotatory and tangential ("levering-out") stability. Results suggested that cup geometry and proper surgical technique--in particular, proper sizing and depth of the acetabular cavity--are important in determining initial cup stability independent of adjuvant screw or spike fixation. Stability is a function of the area of interface contact between the cup rim and the substrate. If the cavity is too small or too shallow, and the substrate too dense, the cup will not seat to the rim and stability will be compromised. If there are defects in the rim, the area of interface contact will be diminished and stability compromised. Cups with a true hemispherical design have a greater area of rim interface contact than "low-profile" cups and are therefore more stable. 1 mm undersizing of the cavity (or 2 mm undersizing in less dense substrate) appears to provide optimal stability.

Acetabulum

On the dissociation constants of BAPTA-type calcium buffers.

We have determined or redetermined the calcium dissociation constants of seven BAPTA-type buffers with KD's in the range from 0.4 microM to about 20 mM in 300 mM KCl. These include four newly synthesized ones: 5-nitro BAPTA; 5,5'-dinitro BAPTA; 5-methyl-5'-nitro BAPTA; and 5-methyl-5'-formyl BAPTA. Moreover, we tabulate dissociation constants or KD's for BAPTA and eleven BAPTA-type buffers, compare most of them with an empirical curve based upon so-called Hammett values, and predict KD's for several still unsynthesized but potentially valuable buffers.

Buffers

Naso- and oropharyngeal dimensions in children with obstructive sleep apnea.

Sixty children (3-11 years) were evaluated to determine variations in naso- and oropharyngeal dimensions associated with tonsil and adenoid hypertrophy. The subjects were grouped according to tonsil size and a clinical history of chronic upper airway obstruction. Intraoperative measurements included oropharyngeal diameter, length of the hard and soft palates, width and arch of the hard palate, nasopharyngeal volume, as well as tonsil and adenoid weights and volumes. A significantly larger oropharyngeal diameter was found in children with small, non-obstructing tonsils (P less than 0.01). Children with large, non-obstructing tonsils had a similar oropharyngeal diameter to those children with large, obstructing tonsils. However, tonsil volume, not weight, was increased in the children with large obstructing tonsils as compared to those with large non-obstructing tonsils and small non-obstructing tonsils (P less than 0.04). A shorter soft palate was associated with larger, obstructing tonsils (P less than 0.004). The length of the hard palate was similar in all patients, however, a trend towards a higher arched palate was seen in patients with larger, obstructing tonsils. The distance from the soft palate to the posterior pharyngeal wall was greater in obstructed patients with adenotonsillar hypertrophy (P less than 0.003). In patients requiring adenoidectomy, the nasopharyngeal volume prior to adenoidectomy was significantly smaller in patients with obstructive symptoms (P less than 0.001). Postadenoidectomy, no significant difference was found in the nasopharynx volume amongst all subjects. These data indicate that subtle differences in oropharyngeal dimensions exist which along with increased lymphoid tissue volume, lead to the development of obstructive symptoms. Etiologic considerations are discussed.

Adenoids

Acetaminophen hepatotoxicity in alcoholics. A therapeutic misadventure.

We have treated 6 chronic alcoholics and identified an additional 19 reported in the literature who developed severe hepatotoxicity from acetaminophen taken in apparently moderate doses. The clinical disease in these 25 patients had a characteristic pattern: mild to moderate jaundice; mild to severe coagulopathy; and strikingly abnormal aminotransferase levels, values inconsistent with either acute alcoholic hepatitis or viral hepatitis. The possible causes for the injury from ostensibly nontoxic drug levels appear to be either the induction by chronic alcohol intake of the cytochrome P-450 system responsible for converting acetaminophen to a toxic metabolite, or the effect of alcoholism and the associated malnutrition in reducing the glutathione concentration, responsible normally for preventing hepatotoxicity by conjugation with the toxic metabolite. The research data pertaining to the apparent enhanced toxicity from chronic alcoholism are reviewed. Despite the low frequency of ethanol-potentiated acetaminophen hepatotoxicity, alcoholics should be cautioned about the use of acetaminophen while they persist in heavy consumption of alcohol.

Acetaminophen

Cholestatic hepatic injury related to warfarin exposure.

Despite the widespread use of oral anticoagulants derived from 4-hydroxycoumarin, there have been only a small number of well-defined cases of hepatotoxicity. We report a well-defined case of cholestasis following exposure to warfarin sodium (Coumadin). Inadvertent rechallenge reproduced the syndrome. Cholestasis may occur in response to exposure to derivations of 4-hydroxycoumarin.

Aged

[Open combined thoracic and abdominal wounds (author's transl)].

We report 27 open wounds of the thorax and abdomen combined, which were treated during one year on the hospitalship "Helgoland" in Vietnam. The patients came from every age group. 12 of the wounded were male, 15 were female. Hemopneumothorax was the most frequent finding in the thoracic wounds. With abdominal wounds the organs of the upper abdomen were mainly involved. We found it best to begin treatment with closed chest-tube drainage in order to bring the chest wound under control, then to proceed with laparatomy. Only in a few cases was a thoracotomy necessary. 4 of the 27 wounded died.

Abdominal Injuries

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Adult