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Biomedical subjects

G Dahmen

Publications and source records attributed to G Dahmen.

At least 19 recordsLinked to original sources

Cephalic stimulation of gastrointestinal secretory and motor responses in humans.

The present study was designed (a) to investigate the cephalic phase of gastropancreatic secretion, antroduodenal motility, and regulatory peptide release in six healthy young men and (b) to assess its regulation by the cholinergic system and endogenous cholecystokinin. Sham feeding performed for 15 minutes induced a concurrent stimulation of gastropancreatic secretion, antroduodenal motility, and pancreatic polypeptide release that lasted for 30 minutes. Reappearance of interdigestive phases III was retarded in the post-sham-fed state. Atropine abolished secretory, motor, and pancreatic polypeptide responses to sham feeding and enhanced gastrin release. The cholecystokinin receptor antagonist loxiglumide did not attenuate pancreatic enzyme response but diminished antral motor response by 72% (P less than 0.05) and release of pancreatic polypeptide by 91% (P less than 0.05); it enhanced gastrin release and abolished retardation of reappearance of phase III with sham feeding. It is concluded that (a) there is a distinct cephalic phase of gastropancreatic secretion, antroduodenal motility, and pancreatic polypeptide release in humans that is primarily under cholinergic control and that (b) endogenous cholecystokinin is involved in antral motor, gastrin, and pancreatic polypeptide responses to sham feeding.

Adult

[The "positioned image" of the talo-calcaneus joint in instability of the posterior distal ankle joint].

With regard to the very common disease of sprained ankles the combined tear with ruptures of ligaments of the subtalar joint are possible. Even an isolated instability is known as the reason of long lasting post-traumatic complaints. Using the apparatus of Scheuba, well-known in diagnosing instabilities of the knee and ankle joint, a new standardized method controlling instabilities of the subtalar talo-calcanear joint is introduced. In an experimental investigation this radiological technique has been tested out in cadaveric ankle joints (nine joints) with artificial ligamentous lesions. The results show that in all cases an instability is recognizable radiologically using this technique. For clinical use the bilateral examination is recommended failing standardized values for unilateral use.

Humans

[Comparative study of the stabilizing effect of conservative-functional measures of the unstable upper ankle joint].

In a comparative study the value of castless immobilisation methods for stabilising the lateral ankle instability was examined. For this the dimension of the lateral talar tilt as a sign for chronic lateral ankle instability in 32 sportsmen with chronic ankle instability was checked initially. Afterwards the reduction of this instability due to the application of the tape-bandage and the "ankle-brace" was tested under the same standardised conditions. In regard to the reduction of the lateral talar tilt a reduction of this instability of the ankle joint is possible significantly. But compared to the normal talar tilt showing a stable ankle joint, it is not possible to reach this in all cases of ankle instability. So for treatment of the lateral ligament rupture it is necessary to use the usual cast for stabilising the joint after ligament suture before reduction of the time of immobilisation is possible. The use in cases of chronic instability or as a precaution method is not restricted when a sufficient active stabilisation is possible.

Ankle Injuries

[Involvement of the inner malleolus and deltoid ligament in supination trauma of the ankle joint].

Additional ligament ruptures or fractures of the medial side of the ankle joint accompanying the lateral ligament rupture are rare. These injuries are more often in traumas with pronation-eversion movements of the foot. In cases of lateral ligaments ruptures we only found in 2.8% and in 5.9% additional medial injuries. This is confirmed by different biomechanical experiments. Experimentally the delta ligament rupture could mostly be caused by pronation-eversion movements or by forced plantar flexion of the foot. The diagnosis of bony lesions of the medial malleolus might be easy by X-ray, but ligament lesions of the medial ankle joint can be diagnosed easily too be using the stress X-ray controlling the medial talar tilt as a sign of medial instability. Because the necessity of surgical treatment is less important than of the lateral ligaments we recommend this procedure in cases of bilateral instability or if dislocation is obvious.

Ankle Injuries

The gluteal approach to the ischium.

This paper describes a gluteal approach to the ischium which facilitates a good exposure of the whole region from the lower part of the ischium to the pubic ramus and allows extensive resections and partial hip reconstruction if necessary. The approach is demonstrated as used in two cases - one benign (desmoplastic fibroma) and one malignant tumor (chondrosarcoma).

Buttocks

[Delayed complications after dislocations and fractures in the pelvic region (author's transl)].

In the case of surgically dressed necroses of the hip condyle and coxarthroses a condition was found after fracture of the pelvis or after dislocation of the hip joint in 7.2% of the cases. In 13.2% of the cases a trauma was found anamnestically. It was subdivided into fractures of the acetabulum, fractures of the pelvic girdle, dislocations, and fractures of the pelvic brim on the basis of the system of Judet and Engler as well as Feldkamp. Fractures of the pelvic brim through muscular traction, traction of the ligament, and direct trauma were discussed. The most frequent delayed consequences arising after dislocations of the hip joint and fractures of the acetabulum are: necroses of the head of the femur, coxarthroses, pseudarthroses, and myositis ossificans. The pathogenesis of the delayed injuries resulted from: capsular and vascular lesions, damage to cartilage with fractures in the spongiosa region, incongruence of the surface of the joint, insufficiency of the static structure of the pelvic ring, deposit of calcium salt outside the bone. In some cases the progress of the necrosis could be arrested by means of osteotomy and spongiosa filling. The rate of necrosis increases in proportion to the period between the time of occurrence of the accident and reposition (limit of 6 h). Even though about half the pelvic girdle fractures show good results with conservative treatment, in the case of fractures of the acetabulum a reconstruction as far as possible continuous and without stages is to be aimed at. In many cases the development of a myositis ossificans cannot be prevented.

Adolescent

[Comments on the lateral load capacity of the phalangeal joints (author's transl)].

The article compares the load capacity of the collateral ligaments of the metacarpo-phalangeal and interphalangeal joints exposed to a laterally applied force. The tests were performed in vivo with 50 each female and male volunteers. It was found that the average load capacity of the metacarpo-phalangeal and interphalangeal joints in women was 5.8 kp and in men 12.3 kp. Furthermore, the bones of the long fingers with the preserved joint capsules and collateral ligaments of ten corpses were also examined, and the collateral ligaments exposed to a load which was increased to the point of their destruction. The average values found in this manner were 26.5 kp for the metacarpo-phalangeal collateral ligaments and 15.4 kp for the interphalangeal collateral ligaments. This means that the pain threshold is usually below the destruction limit, so that generally there will be no spontaneous overloading. It is important for the construction of endoprostheses that their stability level should always be above that of the pain threshold and should attain at least the values of the tear tests, since otherwise these endoprotheses will not function properly. These basic prerequisites enable a comparative study of endoprostheses, the results of which will be presented at a later date.

Adult

[Fatigue fractures in the anterior part of the pelvis following replacements of the hip-joints (author's transl)].

In a woman aged 74 fatigue fractures occurred in the anterior part of the pelvic ring following bilateral replacement of the hipjoints with Müller-Charnley prostheses. After increasing pain in the inguinal region radiographs disclosed fractures through the public and ischial bones on the side of the last replacement. There was no concomitant disease. The possible dynamic causes of fatigue fractures after well-placed hip-prostheses are discussed.

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