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Biomedical subjects

E Sudmann

Publications and source records attributed to E Sudmann.

At least 19 recordsLinked to original sources
PubMed2002

Piriformis muscle syndrome in 19 patients treated by tenotomy--a 1- to 16-year follow-up study.

We treated 19 patients with piriformis muscle syndrome. All patients complained of pain in the buttocks and the posterior thigh. Clinically the buttock was tender and passive stretching increased the pain. In ten patients skin sensation was reduced and three had a limp. All patients were treated with tenotomy. At follow-up after an average of 8 (1-16) years, eight patients had pain relief. Two-thirds of the patients evaluated their clinical state as being better.

Adult↗
PubMed2000

Biocompatibility and effect on osteogenesis of poly(ortho ester) compared to poly(DL-lactic acid).

Implantation of demineralized bone induces new bone formation by the action of contained growth factors, of which bone morphogenetic proteins are of prime importance. A biodegradable polymer may be used as a carrier for demineralized bone particles or recombinant bone growth factors to prevent displacement of the implant, preserve its volume and shape, and assure sustained release of the incorporated active components. A polymer for this use should be biocompatible and completely absorbed without interfering with the osteogenesis. We investigated the host-tissue response and effect on demineralized bone-induced bone formation by two biodegradable polymers, a poly(ortho ester) and an amorphous low-molecular poly(DL-lactic acid). Both polymers had a plastic consistency, could easily be molded, and adhered well to the demineralized bone particles. Demineralized bone particles were implanted alone and in combination with each of the polymers in the abdominal muscles of 45 male Wistar rats. Four weeks after the operation the implants were recovered and subjected to (85)Sr uptake analysis to quantify bone formation and histologic examination. The poly(ortho ester) provoked little inflammation; it was largely absorbed by 4 weeks, and no qualitative or quantitative effect on bone formation was found. The poly(DL-lactic acid) provoked a chronic inflammation with multinuclear giant cells, macrophages with engulfed material, and proliferating fibroblasts; part of the material was still present, and the bone formation was inhibited.

Animals↗
PubMed1996

[Lumbar intervertebral disk prolapse in adolescents].

We investigated the incidence, history, clinical findings and results of treatment of lumbar intervertebral disc herniation in adolescents. During the period January 1992 to medio March 1995 we operated on 20 adolescents aged 15 to 19 years (3.4% of all cases of lumbar disc herniation). In the case of five patients there was a delay of more than a year before the correct diagnosis was made. Ten women and ten men were operated on. Median time from start of symptoms to operation was 1 year (1 month-5 years). The dominant symptom was back pain with radiating pain (17/ 20). The straight leg raising test was positive in 19/20. Seven of the patients had scoliosis. The levels of herniation were ten in the 4th lumbar disc and nine in the 5th lumbar disc. The results were excellent or good in all patients, except in one patient in whom no disc herniation had been found. Lumbar disc herniation in adolescents should be considered in the case of back pain and radiating pain to one or both legs. Investigation and treatment should follow the same guidelines as for adults. The short-term results of surgical treatment are good.

Adolescent↗
PubMed1996

Cost-effectiveness of ultrasonographic screening for congenital hip dysplasia in new-borns.

OBJECTIVE: Screening for congenital dysplasia of the hips (CDH) of new-borns, mostly by Ortolani's of Barlow's tests, is widely performed, but nevertheless dysplasias are still discovered late. Ultrasonographic screening has been reported to reduce the number of these cases. The present investigation is intended to evaluate the cost-effectiveness of such as screening programme. MATERIALS AND METHODS: The cost of performing ultrasound investigations at Haukeland Hospital and the treatment costs of late-discovered CDH were calculated on the basis of 26 cases of late-discovered CDH at Hagavik Orthopaedic Hospital. Figures for sensitivity and specificity were taken from the literature. RESULTS: General ultrasonographic screening programmes for CDH will not be cost-effective because the population screened will be too large and the demands upon sensitivity too high. However, investigating babies at risk is probably cost-effective. CONCLUSION: A CDH screening programme requires high sensitivity and one should preferably aim at screening babies at risk. In Norway a centralisation to larger hospitals may therefore be necessary.

Cost-Benefit Analysis↗
PubMed1995

Local delivery of indomethacin by a polyorthoester inhibits reossification of experimental bone defects.

Inhibition of orthotopic reossification after surgical removal of bone is sometimes indicated and may be accomplished by implantation of interpositional materials or by systemic administration of indomethacin. However, implantation of nonresorbable foreign material may induce a chronic inflammation and predispose to infections; and systemic administration of indomethacin may induce systemic adverse effects. We studied the effect of local delivery of indomethacin by a bioerodible polyorthoester on the reossification of segmental defects of the radius in rats. We divided 45 Wistar rats into three groups, A-C. A 3.5 mm-long middiaphyseal osteoperiosteal resection of the right radius was made in each rat. The defect was filled with 15 mg of polyorthoester with 5% indomethacin in group A and 15 mg of polyorthoester without drug in group B. No material was implanted in the defects in the group C rats. The rats were killed 50 days postoperatively. The mean area of the residual defects were greater in the defects with the polyorthoester with 5% indomethacin compared with defects with polyorthoester without drug or without implant as judged by computer-assisted area measurements on radiographs. By light microscopy, no inflammation was seen and only traces of the polyorthoester could be detected in the defects filled with the polyorthoester with or without indomethacin. The results of this study suggest that the polyorthoester may be used as a bioerodible system for local delivery of indomethacin to inhibit reossification of skeletal defects without tissue reaction, unabsorbed carrier, or systemic effects.

Animals↗
PubMed1995

Ethylene oxide gas sterilization does not reduce the osteoinductive potential of demineralized bone in rats.

It has been shown that different sterilization procedures of demineralized bone may influence its osteoinductive properties. The aim of this study was to evaluate the effect of ethylene oxide sterilization for 1, 3, and 6 hours on the osteoinductive potential of allogeneic demineralized bone implanted heterotopically in rats. Sixty male Wistar rats were randomly assigned to one of four groups, A through D, and four demineralized bone chips (2.8 mg) were implanted in a pouch created between the right oblique abdominal muscles in each animal. In Group A, the demineralized bone was implanted without prior sterilization of the material, whereas the demineralized bone implanted in Groups B, C, and D had been sterilized in ethylene oxide gas for 1, 3, or 6 hours, respectively, and aerated for 48 hours. At 4 weeks postoperatively, bone formation was evaluated quantitatively by strontium 85 uptake and qualitatively by light microscopy of histological sections. One-way analyses of variance at the 0.05 level revealed no significant difference in strontium 85 uptake of the different groups, and no qualitative differences in osteoinduction could be detected by light microscopy. Ossicles consisting of bone and bone marrow were seen in the recovered implants of all groups.

Analysis of Variance↗
PubMed1995

Cost-effectiveness of alternative screening strategies for developmental dysplasia of the hip.

OBJECTIVE: To compare the cost-effectiveness of adding either a general or a selective ultrasound screening program to the routine clinical examination for developmental dysplasia of the hip (DDH) with use of the data from a large, randomized study of 11,925 newborns. METHODS: Our previous study comparing the clinical outcomes of three strategies for screening infants for DDH suggested (but results were not statistically significant) that general ultrasound screening resulted in fewer children requiring hospitalization and surgery for DDH than did a strategy based on ultrasound screening of the 11.8% of infants considered to be at increased risk of DDH or one with no ultrasound screening. General ultrasound screening led to early splinting of 3.4% of the newborns compared with 2.0% for the selectively screened group and 1.8% for the group not receiving ultrasound screening. Using these data, we decided on sequences and intervals of diagnostic and therapeutic actions considered to be sufficient for each regimen. We applied estimates of the costs of screening, treatment of DDH discovered early and late, and follow-up examinations to arrive at total program costs for each strategy. RESULTS: Total program costs were similar for each of the three screening strategies (costs varied by < 5%). However, treatment of late cases accounted for only 22% of total costs in the group undergoing general screening vs 65% in the two latter groups. The cost estimates were sensitive to several variables. Application of the data to a hypothetical ultrasound program in which all girls and only boys at increased risk for DDH underwent an ultrasound examination showed substantially reduced total program costs. CONCLUSIONS: Application of costs from other centers to our data regarding frequency of clinical outcomes may yield different comparative program costs. If the findings of our clinical study can be generalized to other centers, a strategy of screening all girls and boys with risk factors for DDH may be the most cost-effective approach.

Cost-Benefit Analysis↗
PubMed1994

Systemic and local silver accumulation after total hip replacement using silver-impregnated bone cement.

In a patient, at revisional Christiansen total hip arthroplasty, silver-impregnated bone cement was used as prophylaxis against deep infection. Five years later the patient developed serious neurological deficits, and the prosthesis was loose. The loose Christiansen prosthesis and the silver-impregnated bone cement were removed and a Charnley prosthesis inserted. Intra-operatively the concentration of silver in fluid drawn from the hip joint was assessed to be about 1000 times the normal serum reference value, and tissue samples from the acetabulum were densely impregnated with silver. During the following 2 years the serum concentration of silver decreased from more than 60 times to 20 times the normal; simultaneously the patient partially recovered from her grave muscle paralysis.

Aged↗
PubMed1993

Assessment in rats of a new bioerodible bone-wax-like polymer.

Holes drilled in rats' skull, iliac crest, and tibia were filled with beeswax or with a new, wax-like, bioerodible polyorthoester (Alzamer). Empty drill-holes served as controls. In addition, beeswax and polyorthoester were deposited between the left and the right oblique abdominal muscles, respectively. In muscle, both the beeswax and polyorthoester elicited a transient foreign body reaction. The beeswax was not resorbed in bone or muscle, whereas the polyorthoester was. Bone healing was inhibited in the iliac crest and the tibiae filled with beeswax, whereas holes filled with polyorthoester healed readily.

Abdominal Muscles↗
PubMed1992

[Congenital short Achilles tendon. A survey of habitual toe-walking in children].

Congenital short tendo calcaneus is seen in children as partial or complete walking on the toes, and may represent a major disturbance for normal motor development and coordination. This clinical finding may indicate a more serious, underlying disease (cerebral paresis, childhood psychosis or a neuromuscular disorder). If the patient, apart from walking on the toes exhibits normal clinical findings, the diagnosis of congenital short tendo calcaneus may be justified. The disease may be inherited. The diagnosis should be made by an orthopaedist, and the treatment is either conservative with aggressive physical therapy, or surgery. The prognosis is good after early diagnosis and special treatment. A review of the literature, with emphasis on diagnosis and treatment, is presented, together with a brief review of five patients operated by the authors.

Achilles Tendon↗
PubMed1992

[Salter's pelvic osteotomy. A therapeutic possibility for young patients with incipient degenerative hip disease].

Innominate osteotomy was performed in thirteen young adults (median age 23 (13-44) years) suffering from residual congenital subluxation or congenital dysplasia of the hip. At follow-up, median 41 months (range 11-60 months) later, the parameters pain, limp and walking distance had improved significantly. Furthermore, innominate osteotomy led to a significant reduction in the Acetabular Index, and a significant increase in the Center Edge Angle of Wiberg, indicating a more normal anatomic position of the dysplastic acetabulum.

Adolescent↗
PubMed1992

Effect of local hemostatics on bone induction in rats: a comparative study of bone wax, fibrin-collagen paste, and bioerodible polyorthoester with and without gentamicin.

Local hemostatics for osseous tissue should preferably be absorbable and biocompatible and should not inhibit osteogenesis. The tissue response and effect on demineralized bone-induced heterotopic osteogenesis in the abdominal muscle of 120 male Wistar rats by different local hemostatics were evaluated by light microscopy and 85Sr uptake analyses. Non-absorbable bone wax of 88% beeswax and absorbable bovine fibrin-collagen paste both significantly inhibited osteoinduction, whereas a bioerodible polyorthoester drug delivery system with or without 4% gentamicin did not. Bone wax was not absorbed and induced a chronic foreign body reaction. Fibrin-collagen paste induced less inflammation with numerous monocytes and macrophages with engulfed material. Bioerodible polyorthoester caused a very moderate tissue reaction and was mostly resorbed at week 4.

Absorption↗
PubMed1992

Bone induction by composites of bioresorbable carriers and demineralized bone in rats: a comparative study of fibrin-collagen paste, fibrin sealant, and polyorthoester with gentamicin.

Host tissue response and heterotopic osteoinduction by composites of demineralized bone matrix and three different substances used as bioresorbable carriers implanted in the abdominal muscles were evaluated by strontium 85 uptake and histology 4 weeks postoperatively in 60 male Wistar rats. Both fibrin-collagen paste and fibrin sealant inhibited bone induction and produced a chronic inflammation; part of the fibrin-collagen paste was still present at 4 weeks. Polyorthoester with gentamicin was almost completely absorbed, induced minimal tissue reaction, and did not inhibit osteoinduction.

Absorption↗
PubMed1992

Fracture healing in rats inhibited by locally administered indomethacin.

We studied the inhibitory effect of indomethacin on fracture healing in 135 young, male rats after oral administration compared with local application into the fracture. A closed mid-diaphyseal fracture of the left femur was performed in all the rats. The fractures were not immobilized. In one experiment, half of the animals received indomethacin via a stomach tube (2 mg/kg/day) for 10 days; the controls received only the vehicle. In another experiment, 0.5 mg of indomethacin, contained in a bioerodible polyorthoester gel, was injected into the fracture area in half the rats; in the controls, only the gel was injected. In both experiments, random animals were killed on Days 0, 5, 10, and 20. As assessed by radiographs and manual testing, the same inhibition of fracture healing was found regardless of whether indomethacin was given orally or locally. However, the amount of indomethacin that was applied locally was only one fourth of the total dose given orally; no indomethacin was detected in the serum.

Administration, Oral↗
PubMed1992

Comparison of histomorphometry and 85Sr uptake in induced heterotopic bone in rats.

Heterotopic bone formation in the abdominal muscle of 45 male 8-week-old Wistar rats induced by implantation of 5, 10, or 15 mg demineralized bone (DBM) powder was evaluated at 4 weeks by 85Sr uptake of the implants and area histomorphometry of the induced bone. Two indices of 85Sr uptake were calculated: the osteogenic index [(counts/min/mg implant)/(counts/min/mg os ilium)] and an index that we have called the osteoquantum index in which the weight of the implant is disregarded [(counts/min implant)/(counts/min/mg os ilium)]. The osteoquantum index showed a linear relationship to the area of the induced bone with a correlation coefficient (r) of 0.90. Only weak linear relationships were found between the osteogenic index and the area of the bone (r = 0.32) and between the osteogenic index and the osteoquantum index (r = 0.33). The osteoquantum index and the area of the induced bone both increased with increasing mass of implanted DBM, whereas the osteogenic index did not change.

Analysis of Variance↗
PubMed1992

Regeneration of calvarial defects by a composite of bioerodible polyorthoester and demineralized bone in rats.

A study was performed to evaluate regeneration of defects in rat calvaria either unfilled or filled with a bioerodible polyorthoester only, demineralized bone only, or a composite of both. At 4 weeks, histological and radiographic studies showed that defects filled with a composite of bioerodible polyorthoester and demineralized bone or demineralized bone alone were bridged by bone. Unfilled defects or defects filled with polyorthoester only did not heal. The polyorthoester caused slight inflammation that subsided by 3 weeks, and only traces of the filler could be detected at 4 weeks. The polyorthoester provided local hemostasis when used either alone or in composites with demineralized bone. The composite implant was moldable, easily contoured, and technically easier to use than demineralized bone alone.

Animals↗