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Biomedical subjects

G Pap

Publications and source records attributed to G Pap.

At least 55 records · Page 3Linked to original sources
PubMed1983

Intrauterine growth retardation: ultrasonic diagnosis.

In 3258 pregnant mothers with ascertained gestational length, 3736 biparietal and transverse thoracic diameters were measured by a rapid screen ultrasound device. The data were processed by computer and the possibilities of detection and typing of intrauterine fetal retardation were examined. Serial measurements performed during pregnancy satisfactorily detected type I or the proportional type. The asymmetrical form, type II, can be distinguished by the Neyman-Pearson method. The decision curves applicable for each gestational week have been computed and are described. They can also be used for determination of the degree of intrauterine wasting.

Computers↗
PubMed1980

[Use of high-speed ultrasonography for differential diagnosis of gestational haemorrhage, following formation of placenta (author's transl)].

The "Vidoson 635-S" high-speed ultrasonographic unit was used by the authors to examine 465 women pregnant in the second and third trimenons for the occurrence of bleeding. The following findings were obtained: NAD (no abnormality discovered), Placenta praevia totalis, Placenta praevia partialis lateralis, Placenta praevia partialis marginalis, deep adherence of placenta, early detachment of placenta, and uterus rupture. - Placental displacement was observed by repeated checking in 57 of 196 placentas with pathological findings. Placental prolapse observed between the twelfth and 20th weeks of pregnancy was defined as "early" Placenta praevia, and the birth canal was left in about 50 per cent of those cases. The authors' view about such phenomenon was that while the point of placental adherence was unchanged, some change was undergone by the uterus wall of which that part changed position to which the placenta adhered, the latter dislocation being caused by enlargement of the upper third of the passive uterus region and its part in the formation of the uterus cavity.

Diagnosis, Differential↗
PubMed1979

Ultrasonic estimation of gestational age and fetal weight.

Ultrasonic fast-scanning analysis was carried out during the 2nd and 3rd trimesters of pregnancy. In 1690 cases biparietal diameter, in 784 chest transverse diameter measurements were done and suitable growth charts constructed for the estimation of gestational time. Both the biparietal and chest transverse diameter values were taken into consideration in 582 cases and the results analysed by mathematical methods. A method has been worked out for the estimation of fetal weight with an absolute standard error of 261 g. On the basis of comparative studies it is suggested that obstetrical teams working with ultrasonic devices should establish their own set of parameters and methods.

Birth Weight↗
PubMedDate not supplied

[Revisions after arthroscopic interventions in the subacromial space].

PROBLEM: In the present study, we evaluated the failure and revisions rates after arthroscopic subacromial decompression (SAD). METHOD: We examined 83 patients who were treated with arthroscopic subacromial decompression for primary shoulder impingement (stage II and stage III according to Neer) at an average follow-up time of 30 months. Hereby, special attention was paid to the revision operations resulting from our treatment. RESULTS: In patients with impingement stage II, the mean follow-up Constant-score was 84.7 (SD +/- 16.7) while in patients with impingement stage III it was 78.0 (SD +/- 21.8). In ten patients (12%) revision operation had to be performed, nine of them with initial stage II impingement and one with initial stage III impingement. Reasons for revisions were persisting or increasing pain as well as functional dissatisfaction. At the follow up examination, six of these revised patients (60%) were satisfied with the result. The mean follow up Constant-score in the revised patients was 77.3 (SD +/- 17.4). In 60% of the revised patients the necessity for the revision operation was directly related to the technical problems at the primary operation, in 40% we found reasons not related to the primary SAD. CONCLUSIONS: Technical falls are the most common cause for the need of revision operations after SAD. This demonstrates how demanding this kind of operation procedure is. In case of revision operations individual strategies should be developed in which the decision whether to perform arthroscopic or open revision procedures is of special importance.

Acromion↗
PubMedDate not supplied

[3-dimensional image analysis of the shoulder joint--a new method for characterizing parameters of shoulder joint function].

OBJECTIVE: An exact assessment of shoulder movement is of special importance both in the diagnosis of and in the therapy for different shoulder diseases. Therefore, we developed a feasible method for the analysis of shoulder movement. METHODS: On the basis of an ELITE system and 6 skin markers (marker positions. acromion, humerus, olecranon, proc. styloideus ulnae, cervical and thoracic spine), movement analysis was performed during continuous abduction of the arm over 15 s. With the help of a purpose made software we determined the exact angle of abduction and, in addition, the acceleration (+aAC) and the deceleration (-aAC) of the acromion. We evaluated 12 normal subjects (10 male, 2 female, average age 29 yrs) without shoulder conditions and 8 patients (6 male, 2 female, average age 46 yrs.) with unilateral impingement syndrome stage II according to Neer. RESULTS: In addition to a significantly diminished abduction ability in patients with impingement syndrome, our results also revealed significantly decreased acceleration values for the acromion in impingement patients. In contrast, deceleration values for the acromion were not altered in patients with impingement syndrome. CONCLUSION: The presented method allows exact measurements of shoulder movement. In addition, measurements of acromion acceleration and deceleration seem to offer two parameters for the assessment of shoulder function in pathological conditions. Further investigations are required to prove the advantages and limitations of this method.

Adult↗
PubMedDate not supplied

[Is unicondylar knee prosthesis a current possibility in primary management of varus gonarthrosis?--A prospective matched-pair study].

AIM: In the present study, we performed a follow-up investigation comparing middle-term results after unicompartmental and bicompartmental knee arthroplasties. MATERIAL AND METHODS: We used matched pairs with 18 patients in each group. The first group was treated with the unicompartmental slegde prosthesis (Type Wessinghage), the second with the cementless nonconstrained bicondylar prosthesis (Type Natural knee). The mean time of follow-up was 4.5 years. (SD +/- 0.6). The average age of the patients in both groups was 59 years (SD +/- 3). Both groups included 12 female and 8 male patients. All patients suffered from primary medial osteoarthritis of the knee. In all cases, the contralateral knee also had signs of manifest osteoarthritis. The determination and evaluation of the results of the investigation were made according to the score of the American Knee Society. We also reviewed the radiological findings concerning placement of the prosthesis, radiolucent lines, and patella position in the femoral shield. RESULTS: At follow-up examination, there were no significant differences in the knee score between the patients undergoing unicompartmental or total knee replacement. However, patients with the Wessinghage sledge tended to show better results. The mean knee score was 94.3 +/- 4.9 in the Wessinghage group and 91.9 +/- 8.3 in the Natural knee group. Evaluation of the radiographs revealed radiolucent lines in the group with total replacement. In contrast, in 7 of 18 patients with the unicompartmental prostheses we found radiolucent lines at the tibial component of 1 mm or more, which, however, did not cause clinical symptoms. CONCLUSION: Our results show, that the unicompartmental arthroplasty is still an effective method for the treatment of the osteoarthritis, especially concerning the conditions for possibly needed revisions.

Aged↗
PubMedDate not supplied

[Long-term results with the cementless CLS stem in hip replacement].

OBJECTIVE: The present work aims at evaluating the clinical and radiological long-term results of the cementless CLS stem in hip replacement. METHOD: Sixty-six consecutively operated patients were examined clinically and radiologically at an average follow-up time of 10.7 (7.6 - 13.8) years. The clinical evaluation was done with the Merle d'Aubigné and the Harris hip scores. The radiological evaluation included the evaluation of radiolucencies as well as the occurrence of heterotopic ossifications. RESULTS: A total of four stems had to be revised (two infections, two periprosthetic fractures). No stem revision had to be done because of aseptic loosening. This results in a survival rate of 94.5% according to Kaplan-Meier. The mean Merle d'Aubigné scores increased from 9.0 preoperatively to 16.0 points at follow-up. The mean follow-up Harris hip score was 87.3 points. Periprothetic osteolytic zones were observed in 45% of the cases, particularly in the Gruen zones 1 and 7. These osteolytic zones were mainly found in connection with cementless polyethylene cups. CONCLUSION: The results of this study confirm the positive short and medium-term results with the CLS stem in a long-term process. The formerly described phenomenon of the residual thigh pain with cementless stems was clearly minimized.

Adult↗
PubMedDate not supplied

[Long-term results with the Harris-Galante press-fit-cup].

AIM: The present work aims at evaluating the clinical and radiological long-term results of the Harris-Galante press-fit cup. METHOD: At an average follow-up time of 9.5 years (min. 9, max. 10.3) 123 patients with 138 Harris-Galante press-fit cups (HGP) were examined clinically and radiology. The clinical evaluation was done with the Harris hip score. Together with the HGP, which was inserted in all cases, five different femoral stems were implanted. A lateral approach, according to the technique of Watson-Jones, was used in all cases. RESULTS: The mean follow-up Harris hip score was 89 of 100 points and is assessed as a good result. 7 cups (5%) were classed as being radiological loose, but only one case had also clinical symptoms. A total of 10 cups (6.8%) had to be revised. 3 cups (2 %) had to be revised because of aseptic loosening. This result represents a survival rate of 93.2% according to Kaplan-Meier. CONCLUSION: The long-term clinical and radiological results of the Harris-Galante press-fit cup and there fixation method can assessed as good.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

[Medium-term results of the cementless femoral neck prosthesis CUT].

AIM: The present work aims at evaluating the clinical and radiological midterm results of the femoral neck prosthesis CUT. METHOD: 67 femoral neck prostheses of the type CUT were implanted in 63 patients between 4/1999 and 5/2003 (average age 56 years). At an average follow-up time of 5.1 years (min.: 2.9; max.: 6.9) 53 patients with 57 CUT prostheses were examined clinically with the Harris hip score and radiologically. All together we determined the state of 64 CUT prostheses (96%). RESULTS: The mean Harris hip score improved from 55 points preoperatively to 90.4 points at the last follow-up and is assessed as a good result. A total of 7 CUT prostheses (11%) had been revised. 3 CUT prostheses (4.7%) had been revised because of aseptic loosening, 2 (3.1%) because of persisting postoperative thigh pain, 1 (1.6%) because of vertical migration of an unsuitable CUT prostheses a few days after the operation and 1 (1.6%) because of septic loosening. The survival rate according to Kaplan-Meier was 89.1% at 5.1 years. If the femoral neck was resected too widely there was an increased rate of horizontal migration with aseptic loosening of the CUT prostheses. CONCLUSION: In the midterm follow-up the CUT prosthesis shows a higher loosening rate as compared with cementless standard stems.

Cementation↗
PubMedDate not supplied

[Correlation of pathological clinical hip symptoms in the sonographic study of infant hips].

The relevance of clinical signs of infant hip dysplasia and the importance of a sonographic newborn-hip screening are often discussed. Between 1984 and 1990 at our department 6532 infant hips were examined both clinically and sonographically. Sonographic hip findings were pathological in 71.7% of the hips with positive clinical Roser-Ortolani sign and in 100% of the hips with positive Hilgenreiner sign. In contrast, pathological hip types according to Graf were seen only in 18% of the hips with limitations of the abductions of the hip joint. Examining other clinical signs for infant hip dysplasia within this study, as well we can conclude, that only the Roser-Ortolani sign and that of Hilgenreiner showed a high specificity for infant hip dysplasia, while most of the clinical signs e.g. limitation of abduction in the hip joint are rather unspecific.

Diagnostic Errors↗
PubMedDate not supplied

[Arthroscopic repair of the glenoid labrum using the 3-point knot technique. Early results with consideration to different postoperative immobilization time periods].

There are different opinions on the duration of post-operative shoulder immobilisation following arthroscopic repair of labrum tears. Between 1993 and 1994 at our department arthroscopic repairs of the glenoid labrum as described by Habermeyer (15, 16) have been performed in 38 patients. In 20 of these patients postoperative treatment included immobilisation of the operated shoulder in a Gilchrist-bandage for 3 weeks, while in the remaining 18 patients this postoperative immobilisation period was decreased to only 1 or 2 weeks. Physiotherapy started the day after the operation, using a device for passive-motion exercises. The mean follow-up time of our examinations was 15.4 month. The mean score by Rowe rose significantly from 20.0 preoperatively to 82.6 at the follow-up examination. Results were excellent or good in 89.4% of all cases, new shoulder dislocations did not occur in any case. Patients having their shoulders immobilised for 3 weeks reached significantly higher Rowe-scores at our follow-up than those patients, whose shoulders were immobilised for only 1 or 2 weeks. Therefore, postoperative management following arthroscopic repair of labrum tears should include immobilisation of the operate shoulder for 3 weeks and an early start of passive-motion exercises.

Adolescent↗
PubMedDate not supplied

[Results of mobilization under anesthesia in adhesive capsulitis in relation to stage of the disease].

PROBLEM: Mobilisation under anaesthesia is a well approved method for the treatment of idiopathic adhesive capsulitis, the best time to perform the mobilisation, however, is difficult to define. MATERIAL AND METHODS: Thirty-nine patients who had been treated with mobilisation under anaesthesia for idiopathic adhesive capsulitis stage II or III were examined at an average follow-up time of 3.4 years. RESULTS: This therapy failed in 10.3% of the patients. There were no differences in the follow-up results between both groups of patients, limitations in the range of motion remained in 20% of all patients. At follow up the average CONSTANT Score of the stage II patients was 86.8, that of the stage III patients was 89.9 points. However, manipulation under anaesthesia showed a significantly better influence on the course of the disease in patients with stage III than in patients with stage II adhesive capsulitis. CONCLUSION: Mobilisation under anaesthesia is a successful therapy in adhesive capsulitis stage III, but should be performed in adhesive capsulitis stage II only in cases of decreasing pain in which the limitation in the range of motion is the main symptom.

Adult↗
PubMedDate not supplied

[Comparison of functional outcome in implantation of Natural Knee knee prostheses with and without patellar resurfacing].

PROBLEM: Despite the great progress in knee arthroplasty made within the previous decade the problem of patellar resurfacing is still unsolved. MATERIAL AND METHODS: In a retrospective matched-pairs study in 62 patients with Natural Knee endoprostheses including one group with and another without patella resurfacing were compared. Results were assessed according to the American Knee Society Score and the patients subjective assessments. RESULTS: At an average follow-up time 2 years there were no differences in the clinical findings and the patients subjective opinions between both patient groups. However, patients with rheumatoid arthritis and patella resurfacing showed significantly better results in both categories than those rheumatoid patients without patella resurfacing. CONCLUSION: Summing our results up we cannot give a general advise towards the use of patella resurfacing in knee replacements. In patients with severe arthrosis of the femoro-patellar joint and in patients with rheumatoid arthritis, however, the patella replacement is considered to be the therapy of choice at our department.

Aged↗