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Biomedical subjects

E Trepman

Publications and source records attributed to E Trepman.

36 records · Page 2Linked to original sources
PubMed1995

Partial rupture of the flexor hallucis longus tendon in a tennis player: a case report.

A 39-year-old woman sustained a forced dorsiflexion injury to the left great toe while pivoting to the right during tennis activity. Posteromedial ankle pain was reproduced with active plantarflexion and passive dorsiflexion of the great toe and, to a smaller extent, the lesser toes. Symptoms persisted for 9 months despite nonoperative treatment. Magnetic resonance imaging 5 months after injury revealed evidence of fluid surrounding the flexor hallucis longus (FHL) tendon. Operative findings 9 months after injury included scar tissue and tenosynovitis of the FHL and flexor digitorum longus tendon sheaths, with impingement of distal FHL muscle fibers and a longitudinal split tear (partial rupture) of the FHL tendon. Tenolysis, tenosynovectomy, excision of the distal muscle fibers, and repair of the partial tendon rupture were performed, resulting in resolution of symptoms. Partial rupture of the FHL tendon as a single-impact injury, or in activity other than ballet, has not been documented previously.

Adult↗
PubMed1995

Nonoperative treatment of metatarsophalangeal joint synovitis.

The results of nonoperative treatment of metatarsophalangeal (MP) joint synovitis in 13 patients without known rheumatologic conditions (15 joints) were reviewed. Average duration of forefoot pain was 4 +/- 3 months (range 0.5-12 months), except for one patient who had pain for 30 months. The second MP joint was involved in nine cases (60%), and the third was involved in six cases (40%). Examination revealed tenderness and palpable fullness of the MP joint in all cases; painful dorsal drawer sign was present in 10 cases (67%), adjacent interdigital tenderness in six cases (40%), and hammertoe deformity in eight cases (53%). Treatment included intra-articular corticosteroid injection and rocker-sole show modification to limit MP joint dorsiflexion. At follow-up evaluation (18 +/- 9 months, range 4-26 months), the involved MP joint was asymptomatic in nine joints (60%), improved or almost asymptomatic in five joints (33%), and operated in one (7%) joint. Two of seven (29%) joints not initially associated with hammertoe developed a mild hammertoe deformity from time of diagnosis to follow-up. In conclusion, nonoperative treatment can be effective for MP joint synovitis, and the incidence of progressive hammertoe deformity in successfully treated cases is low.

Adult↗
PubMed1994

Detection of wooden foreign bodies in muscle tissue: experimental comparison of computed tomography, magnetic resonance imaging, and ultrasonography.

An experimental study was performed to compare computed tomography (CT), magnetic resonance imaging (MRI), and real-time, high resolution ultrasonography (US) for the detection of wooden foreign bodies in muscle tissue. Wooden splinters were prepared, measured for size, soaked in saline, and placed in porcine muscle distant from and adjacent to bone. The specimens were then examined using roentgenography, CT and MRI in planes parallel and perpendicular to the splinters, and US. The largest wooden foreign bodies (minimum smallest width = 10 mm) were easily detected by CT, MRI, and US. Almost all splinters of various sizes, small and large, soaked in saline for 5 months were easily detected by MRI. Smaller splinters (minimum smallest width = 1-4 mm) soaked for only 3 days and placed distant from bone were most easily detected by US; those soaked for 5 months were most easily detected by either US or MRI. The smaller splinters soaked for only 3 days and placed near bone were not reliably detected by any of the imaging methods; CT and MRI were both more sensitive than US in this situation. MRI scanning was more sensitive perpendicular than parallel to the long axis of the splinters. Therefore, either US or MRI may be the best initial imaging modality for evaluation of a suspected wooden foreign body, depending on availability of imaging method, chronicity of symptoms, and proximity to bone.

Animals↗
PubMed1994

Expression and regulation of Ly-6 differentiation antigens by murine osteoblasts.

Osteoblasts arise from mesenchymal stem cells and differentiate to become osteoid-secreting cells. However, little is known about these cells during their stages of differentiation. One reason for this lack of information is that there is no reliable method to identify osteoblasts as they mature. One method that has been used successfully with other cell types is the identification of plasma membrane-expressed differentiation antigens. The Ly-6 multigene family encodes differentiation antigens originally detected on lymphoid cells. Primary murine osteoblasts and the osteoblast-like MC3T3 cell line were examined for expression of Ly-6 antigens by flow cytometry. Primary osteoblasts and MC3T3 cells constitutively expressed both Ly-6A and Ly-6C antigens, although Ly-6C was much less abundant. Antigen expression was markedly increased by pretreating the cells with interferon-alpha/beta or -gamma. Northern blot analysis revealed constitutively expression of Ly-6 messenger RNA that was up-regulated by interferon treatment. Pretreatment of the cells with transforming growth factor-beta 1 or 1,25-dihydroxyvitamin D3 diminished constitutive Ly-6 expression. Ly-6 was localized intracellularly to the Golgi complex. The current results demonstrate that mature osteoblasts express on their cell surface specific Ly-6 antigens in a pattern that distinguishes them from the surrounding bone marrow cells. These studies represent the first identification of osteoblast differentiation antigens that can be directly related to cells within the hematopoietic lineage. By identifying similar antigens, osteoblasts at various stages of differentiation may be identified, isolated, and characterized.

Animals↗
PubMed1994

Electromyographic analysis of standing posture and demi-plié in ballet and modern dancers.

Surface electromyography was used to analyze lower extremity muscle activity during standing posture and demi-plié in first position with lower extremities turned out, in five ballet and seven modern female professional dancers. In standing posture, increased electromyographic (EMG) activity above baseline was detected most frequently at the medial gastrocnemius (54% standing repetitions) and tibialis anterior (29%) electrodes (all dancers); in ballet dancers, increased EMG activity during standing was significantly less frequent at the medial gastrocnemius, but more frequent at the tibialis anterior, than in modern dancers. In demi-plié, the tibialis anterior had a discrete peak of EMG activity at midcycle in all dancers (97% demi-pliés). All dancers also had midcycle EMG activity in both vastus lateralis and medialis (100% demi-pliés). At the end of rising phase of demi-plié, ballet dancers had greater EMG activity than at midcycle in vastus lateralis (100% demi-pliés) and medialis (92%); in modern dancers, end-rising phase voltage was lower than at midcycle for vastus lateralis (71% demi-pliés) and medialis (83%). Genu recurvatum > or = 10 degrees was observed at the beginning and end of demi-plié in all ballet dancers, but not in modern dancers. There was marked variation of EMG activity during demi-plié in the lateral gastrocnemius, medial gastrocnemius, gluteus maximus, hamstrings, and adductors. The results support the hypothesis that ballet and modern dancers have different patterns of muscle use in standing posture and demi-plié, which in part may be a result of differences in genu recurvatum and turnout between the two groups.

Adult↗
PubMed1993

Osteochondritis dissecans of the knee in an adult with Stickler syndrome.

A 35-year-old man with hereditary progressive arthro-ophthalmopathy (Stickler syndrome) was treated for osteochondritis dissecans of the knee. As has been described in families with this autosomal-dominant connective-tissue disorder, phenotypic variation was present in his family; the patient's primary manifestations of the syndrome were ocular, but his brother had significant joint involvement. Osteochondritis dissecans of the knee may be a component of the arthrosis in this syndrome, but in the current case, the occurrence might have been coincidental. Stickler syndrome can be manifested by multiple musculoskeletal abnormalities, often early in life, and may be mistaken for several other diseases.

Adult↗
PubMed1992

Transient osteoporosis of the hip misdiagnosed as osteonecrosis on magnetic resonance imaging.

A 34-year-old man developed idiopathic, bilateral, asynchronous transient osteoporosis of the hip. The symptoms included hip pain with activity, and roentgenography revealed osteoporosis of the femoral head and neck. Radionuclide bone scans showed increased uptake of the involved femoral head. Magnetic resonance imaging (MRI) early after the onset of right-side symptoms was characterized by decreased signal intensity on T1-weighted images and patchy areas of increased and decreased signal intensity on T2-weighted images; this was initially interpreted as being consistent with osteonecrosis. Despite evaluation by multiple physicians and imaging methods, including MRI, the correct diagnosis of transient osteoporosis of the hip was delayed until after resolution of the syndrome. Transient osteoporosis of the hip should be included in the differential diagnosis of hip pain.

Adult↗
PubMed1991

Early failure of silicone radial head implants in the rheumatoid elbow. A complication of silicone radial head implant arthroplasty.

Three cases of early recurrent synovitis of the rheumatoid elbow following silicone radial head implant arthroplasty are presented. All three patients underwent synovectomy with silicone radial head implant for pain and loss of function due to rheumatoid synovitis. All three implants failed within 4-9 months after surgery. This failure was associated with radiographic medial joint space widening. At reexploration, recurrent synovitis with hemosiderin pigmentation was noted. Patterns of prosthetic failure included fracture, fraying, and compressive deformation or rotary wear ("motar and pestle") of the silicone radial head; a prosthetic stem fracture was also present. Histologic examination of the synovium revealed evidence of silicone-induced synovitis; particulate, refractile silicone debris was associated with inflammatory and foreign body giant cells. The presence of rheumatoid destruction of the joint surface may have accelerated this process and may be a relative contraindication to silicone radial head implant arthroplasty.

Adult↗
PubMed1991

Radial head replacement in capitellocondylar total elbow arthroplasty. 2- to 6-year follow-up evaluation in rheumatoid arthritis.

We reviewed six capitellocondylar metal-to-plastic total elbow replacement prostheses with radial head components, implanted in patients with rheumatoid arthritis. At an average of 4.7 +/- 1.5 years, relief of pain, improvement of function, and a functional range of motion were preserved. Five of the six elbows (83%) were clinically rated good or excellent. Radiolucent lines were seen at the bone-cement interface in 50% of the humeral component stems and in all ulnar component boats within 2 years after surgery; none had progressed at subsequent examination. Most were less than or equal to 1 mm wide, and none were associated with clinical deterioration. Only one of the humeral components was radiographically loose. No radiolucent lines were seen along the stems of the ulnar or radial components. There were no postoperative dislocations when the radial component was used, presumably because the prosthetic radial head provided increased constraint. None of these elbows have required revision. Radial head replacement in capitellocondylar arthroplasty had been discontinued because radiolucent lines were observed at early review. However, the absence of clinical failure, dislocation, or progression of radiolucency at long-term follow-up examination favor radial head replacement in primary unconstrained total elbow arthroplasty.

Arthritis, Rheumatoid↗
PubMed1983

Cell shape and phenotypic expression in chondrocytes.

The relationship between cell shape, proliferation, and phenotypic expression was studied in human chondrocytes. Shape was controlled independent of serum concentration, anchorage, and cell density by alteration of substratum adhesiveness with poly(2-hydroxyethyl methacrylate) (poly[HEMA]). Cells that were held rounded displayed features of the chondrocyte phenotype; i.e., they were round, proliferated slowly, incorporated low levels of [3H]thymidine into DNA, and incorporated large amounts of 35SO4 into glycosaminoglycans. In contrast, cells that were held flat were fibroblast-like: they exhibited flattened morphology, more rapid growth, greater incorporation of [3H]thymidine, and less incorporation of 35SO4. These studies suggest that cell shape may play an important role in phenotypic expression in chondrocytes.

Cartilage↗
PubMed1979

Fluorescence properties of o-phthaldialdehyde derivatives of amino acids.

The fluorescence properties of the products formed by reaction of o-phthaldialdehyde with amino acids and their derivatives, in the presence of thiol compounds, have been studied. The emission spectra, quantum yields, and lifetimes depend on the primary amine and thiol compound used; the observations confirm the report (Simsons, S.S., Jr. and Johnson, D.F. (1978) J. Org. Chem 43, 2886--2891) that the product incorporates molecules of all three types of compounds. The fluorescence quantum yields of o-phthaldialdehyde derivatives of the naturally occuring amino acids ranged from 0.33 to 0.47, using 2-mercaptoethanol as the thiol compound. The fluorescence lifetimes were about 18--20 ns. Lower quantum yields were obtained when mercaptoethanol was replaced by dithiothreitol or ethnethiol. Derivatives of amino acid amides and peptides had quantum yeilds as low as 0.03, due to quenching by the carboxamide group. The intramolecular quenching was relieved by the detergent, sodium dodecyl sulfate, and by dimethylsulfoxide. Monosubstituted lysine exhibited a normal fluorescence, but the di-substituted product was largely quenched, presumably due to interaction between the two isoindole fluorophors. Fluorscence stopped-flow experiments showed that the alpha- and epsilon-amino groups reacted at different rates, with the epsilon-amion group reacting 10 times faster, with a t 1/2 of about 6 s under pseudo first order conditions at pH 9.0 with 10(-3) M o-phthaldialdehyde. The amount of instability shown by the o-phthaldialdehyde derivatives depended on the thiol compound used, the primary amine involved, and the solvent. Cysteine and o-phthaldialdehyde reacted to give an unstable, weakly fluorescent product; but cysteine could be assayed normally if its sulfhydryl was blocked. The o-phthaldialdehyde reagent was discussed in relation to fluorescamine, another reagent for primary amines.

Amino Acids↗
PubMed1979

The microscopic characterization of multinucleated giant cells formed on polymeric surfaces perfused with blood.

Multinucleated, foreign body giant cells were formed by the fusion of blood monocytes on polymeric membranes perfused with blood during extended extracorporeal circulation. In the current study, heparinized blood, flowing in an arteriovenous shunt in a sheep, perfused polycarbonate, polypropylene and silicone rubber membranes of a recently developed bioartificial tissue culture system. The multinucleated giant cells were studied by light, scanning electron, and transmission electron microscopy, after membrane perfusion for periods of one to two weeks. The giant cells, which were the predominant cellular components of the blood-polymer interface layer, contained from a few to more that one hundred nuclei and varied in diameter up to 400 microns. The cellular interaction with the three membrane types was similar, although fewer mononuclear cells were observed adhering to the silicone rubber membrane. The presence or absence of micropores in the membranes had no effect on the formation of giant cells, nor did the presence of foreign tissue in culture behind the microporous membranes. High blood flow rates and chronic anticoagulation with heparin permitted observation of this foreign body reaction of blood independent of thrombosis.

Animals↗
PubMed1979

Phosphorescence evidence for the role of solvent--protein interactions in the energetics of conformational flexibility of liver alcohol dehydrogenase.

When tryptophyl side chains are hidden within relatively inflexible domains of globular proteins, the lifetime of the phosphorescence from these residues provides a measure of the local conformational flexibility. The phosphorescence decay from the tryptophan buried at the base of the nucleotide-binding domain in liver alcohol dehydrogenase (alcohol:NAD+ oxidoreductase, EC 1.1.1.1) was monitored between 1 and 40 degrees C to determine the energetics associated with the rate of local unfolding. The slow rate at which this process takes place is found to result from a high entropic barrier rather than from the disruption of strong intramolecular interactions. This observation along with the response of the system to solvent perturbations points to the significance of solvent-protein interactions in determining conformational flexibility.

Alcohol Oxidoreductases↗
PubMedDate not supplied

Uniplanar supracondylar humeral osteotomy with preset Kirschner wires for posttraumatic cubitus varus.

Between 1974 and 1989, a lateral closing wedge osteotomy was used to correct posttraumatic cubitus varus in 36 patients. In 35 (97%) of the patients, the deformity was corrected to within 5 degrees of the contralateral elbow, and the patient was satisfied with the result. There were no nerve palsies or infections. Of the nine patients treated before age six years, seven had a minimum 2-year follow-up (average 9 years), and there was no evidence of recurrent deformity. This technique allows good correction of deformity with minimal complications.

Adolescent↗