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Biomedical subjects

H R Casser

Publications and source records attributed to H R Casser.

At least 19 recordsLinked to original sources
PubMed1995

Reactivation of a tuberculous coxitis due to loosening of a total hip endoprosthesis.

A 45-year-old woman who suffered from juvenile tuberculous coxitis at the age of 4 is presented. Her hip joint replacement lasted for 18 years and then needed replacing. Intraoperatively removed caseous soft tissue and an opalescent secretion histologically resembled a tuberculous focus, and bacteriological culture grew a Mycobacterium tuberculosis strain. Four months after the replacement, the patient suffered from a tuberculosis-induced septic loosening of the newly replaced hip joint endoprosthesis. The tuberculosis relapse was probably due to aseptic loosening of the first hip joint endoprosthesis.

Female↗
PubMed1993

A new holder and surface MRI coil for the examination of the newborn infant hip.

A special holder was developed for examination of the infant hip joint using MRI. This holder allows the infant hip joint to be examined both in a neutral position and in various defined functional positions. A special integrated surface coil, also developed for this purpose, provides the high spatial resolution required for assessment of the fine joint structures. Thirty infants were examined and the new device has proved useful in advanced hip dysplasia, therapy-resistant subluxation and luxation, and for operative therapy planning (reconstruction of the acetabular roof, redirectional osteotomies). Interpretation errors due to misprojection can be eliminated to a large extent since the holder allows standardized and reproducible positioning.

Child, Preschool↗
PubMed1993

[Current developments in ultrasonography of the meniscus].

Sonography of the meniscus is a new diagnostic method, the instructive value and clinical relevance of which are subject to controversy. Sonographic assessment of the meniscus requires the use of focusing that can cope with the different anatomical conditions of the individual parts of the meniscus and can largely eliminate artifacts by means of wide sound-wave propagation. The dynamic examination technique allows the identification of both longitudinal and flap tears, which are relatively easy to diagnose, and of tear formations that are harder to visualize, such as horizontal and transversal tears. A sonographic criterion of a tear is the detection of a clearly visible, strong-signal double or single-stroke reflection pattern that can be traced in several section planes. While sonographic examination allows location of the tear, definite conclusions as to the shape of the tear are not possible on the basis of the echo pattern. In the literature, the statistical results, depending on the patient group and technical equipment, vary between 76% and 100% for sensitivity and between 50% and 97% for specificity, 74% and 93% for accuracy and between 61% and 95% for the positive prediction value. Sonographic examination of the meniscus is an easily available, noninvasive imaging technique that, as a supplement to clinical findings, can be used to optimize preoperative diagnosis and to check the indication for arthroscopy. Careful consideration of the technical requirements and systematic performance of the dynamic examination should lead to further improvement in the examination results and to growing clinical significance in the future.

Humans↗
PubMed1991

MR-anatomy of infants hip: comparison to anatomical preparations.

The correlation between anatomical preparations and MRI images of the most important structures of newborn hips in coronal and axial orientation was performed in 18 post mortem babies. T1-weighted images present a good differentiation between cartilage, bone, ligaments and surrounding soft tissues. Coronal images give the best opportunity to study the clinically important structures of the roof of acetabulum including the labrum and the ground of the acetabulum. The latter is shown in a more detailed way by MRI than by sonography. Axial images allow additional examinations of the ventral and dorsal parts of the joint. By using both coronal and axial images the exact determination of the centering of the femur head in the hip joint is possible.

Acetabulum↗
PubMed1991

[Sources of error in sonographic diagnosis of the rotator cuff].

Sonography of the shoulder joint has developed into an established examination technique in the diagnosis of periarticular lesions of the shoulder. Sonographic diagnosis of the rotator cuff in particular contains a multitude of possible errors, which are gone into by this study by means of 149 clinically, radiologically and sonographically examined shoulder patients with an average age of 50.5 years. Besides errors made by wrong examination technique such of the transducer as incorrect adjustment of the equipment, insufficient contact of the transducer with the skin and unsuitable choice of the examination plane, there are sources of errors in the interpretation of the sonogram caused by lack of knowledge about physically caused artifacts and sonoanatomical qualities of the shoulder joint. Calcification inside the rotator cuff and the so-called "sonographic inhomogeneity of the rotator cuff" are numbered among the sources of error particular to the shoulder joint. Most errors in sonographic diagnosis of the rotator cuff can be avoided by careful examination of both shoulder joints with an exactly tuned ultrasound device, taking into account the sonoanatomical and ultrasonic qualities. Radiological examination of the affected shoulder joint cannot be replaced by ultrasound.

Diagnostic Errors↗
PubMed1991

[Dynamic examination technique in meniscus sonography].

The aim of this study was to introduce an improved dynamic examination technique for sonographic assessment of the menisci, a technique that takes into account the special anatomy and function of the knee joint. The dynamic examination technique was used together with a 7.5 mhz sector transducer fitted with a water or PVC pad attachment when the area around the anterior horn and the pars intermedia was being scanned. Misinterpretation as a result of confusing reflections from a tear with the Hoffa fatty pad, popliteal tendon or popliteal groove can be largely avoided owing to the better sonoanatomic imaging and orientation. Diagnosing lesions of the meniscus from echogenic torn surfaces has also become easier thanks to dynamic examination. 60 patients with, for the most part, chronic knee-joint complaints were selected. A comparison of sonographic and arthroscopic findings demonstrated that large percentages of tears in the meniscus can be detected (76.7%) or ruled out (90.0%), and that recent longitudinal tears, flap and non-luxated bucket-handle tears can be considered to be "ideal" tear shapes. Because of its high specificity, sonography of the meniscus presents itself as a suitable method when lesions have to be ruled out, especially in recent knee injuries where clinical findings are unclear. On the other hand, if there are sure indications of a tear, sonography of the meniscus makes it possible to introduce therapeutic measures immediately and thereby to avoid any possible secondary damage.

Adolescent↗
PubMed1991

[Immune competence of human tissue lymphocytes in contact with loosened hip joint prostheses. On the topic of cellular or humoral rejection reaction as the mechanism of loosening].

In several investigations rejections were accused of being a possible cause for the loosening of hip endoprostheses. Using immunocytochemical techniques we studied the number and type of lymphocytes in the tissue adjacent to loosened hip endoprostheses. Tissue samples were taken from 18 patients being reoperated for a loosened endoprostheses. Impressive lymphocyte infiltrates were found in 4 of 18 patients (22%). These infiltrates only consisted of T-cells. In the other samples only few lymphocytes were detected belonging to T- and B-lymphocyte population, respectively. In our patients T-cell mediated rejections were of minor importance for the loosening of total hip replacement. B-cell accumulations were detected in none of the samples.

Aged↗
PubMed1990

Influence of bone and soft-tissue operations on serum concentrations of growth hormone, somatomedin C and alkaline phosphatase.

After animal experiments suggested there was an interaction between growth hormone and bone healing, our aim in this paper was to ascertain whether there were any changes or possible interaction between the serum level of growth hormone, somatomedin C and alkaline phosphatase while a fractured bone was healing. To this end, the serum concentrations of growth hormone, somatomedin C, alkaline phosphatase and calcium were ascertained both pre- and post-operatively in two groups of patients--one with bone operations, the other with soft-tissue operations--and the results were compared. Comparing the groups, we found that after bone operations there was no increase in the serum level of growth hormone, nor of somatomedin C. An increase would have implied that these two hormones are directly involved in bone regeneration. There was no change in the serum level of alkaline phosphatase or calcium after either bone or soft-tissue operations.

Adolescent↗
PubMed1990

Current evaluation of sonography of the meniscus. Results of a comparative study of sonographic and arthroscopic findings.

Sonography of the knee has gained in significance in the diagnosis of the meniscus; experimental and clinical studies have demonstrated that the normal and pathological anatomy of the meniscus can be visualized on a sonogram. The aim of this comparative investigation is to evaluate sonographic lesion diagnosis in comparison with arthroscopic findings, using a standardized examination method. Two hundred and six knee joints were first scanned sonographically using a 7.5 MHz sector transducer. The examining doctor had neither anamnestic nor clinical information in advance. On the following day, the joints were examined arthroscopically, without the findings of the day before being available to the examiner. When the findings were compared, the sensitivity of sonographic diagnosis of lesions was found to be 82.2% and its specificity 87.6%. The patients were of varying ages and had varying anamneses. The results show that sonography of the meniscus is a valuable diagnostic help when the knee-joint symptoms are not clear, given that the correct technical equipment and sufficient experience with this form of examination are at hand. The advantage of sonography is that, in contrast to arthroscopy, it is noninvasive and easily available.

Adolescent↗
PubMed1990

[Ultrasound criteria of a meniscus lesion].

The tear in the meniscus interrupts the outline at which the sound-wave energy is reflected. This means that the sonogram shows an echo-rich, light reflection pattern. Degeneration also shows up as an echo-rich area, reflecting greater density of the tissue in the meniscus. This has been confirmed by experimental examination of knees of corpses, and also by clinical experience based on more than 2000 sonograms of the meniscus. A quota of more than 90% correct diagnoses can be obtained if the proper criteria are observed in case of a lesion of the meniscus, and if the technical equipment is adequate and the examiner has acquired sufficient skill.

Diagnosis, Differential↗
PubMed1989

[Treatment of infected total hip endoprostheses].

In total hip arthroplasty the most serious complication besides aseptic loosening is infection. The results observed in 42 cases of infected hip arthroplasties are presented. In contrast to early superficial infection, deep infection following total hip replacement is difficult to treat. Depending on the general condition of the patient, a well-defined, adequate treatment is required. In patients at vital risk the provocation of a permanent fistula can be recommended as an alternative method in preference to revision arthroplasty.

Aged↗
PubMed1985

[7 MHz real-time sonography of the skeletal musculature in Duchenne muscular dystrophy].

The lumbar paravertebral musculature, the M. quadriceps femoris and M. triceps surae of boys suffering from Duchenne's muscular dystrophy of different clinical progression, were examined via sonography. The sonographic incisions were made at fixed levels. The sonographic findings were compared with those of healthy boys. The sonographic findings showed - depending on the clinical stage of Duchenne's muscular dystrophy - typical reflex patterns of different intensity determined by lipomatosis and fibrosis of the skeletal musculature, correlating with the clinical stage, and hence musclesonography is an important diagnostic element in the observation of the course and in therapy planning in Duchenne's muscular dystrophy. The 7-MHz transducer has an advantage over the low-frequency transducers mostly in use, because the image quality is substantially superior.

Adolescent↗
PubMed1979

[Hypothermic storage under aerobic conditions--the effect of different flushing solutions on kidney functional recovery].

Canine kidneys (n = 17) were flushed with COLLINS (C2), SACKS II, LAMBOTTE (KMgS), ROSS (hypertonic citrate), or RINGER glucose-mannitol solution following a 30-min period of normothermic ischemia. After 24 h hypothermic preservation with retrograde oxygen persufflation (ROP) and autotransplantation, the immediate functional recovery was determined using inulin and PAH clearance methods and compared with the normal contralateral kidney. While a good functional recovery was found in the COLLINS group, significantly exceeding results from hypothermic ischemic storage preservation, in experiments using other flush solutions ROP preservation resulted in only a small immediate function. Thus the experiments indicate that COLLINS solution C2 is the optimal flush solution for ROP preservation.

Aerobiosis↗
PubMedDate not supplied

[Increased incidence of developmental hip dysplasia in hypertrophic newborn infants].

"Lack of space" in utero is considered to be a major factor in the aetiology of the congenital dislocation of the hip. This study tries to answer the question whether hypertrophy of a newborn has to be regarded as a risk factor on the basis of the principle mentioned above. The results of postnatal clinical and sonographical examination performed on 98 large-for-gestational-age (LGA-) newborn were compared to those performed on 310 newborn children during a non selective screening program. Among the LGA-newborn pathological hip joints were found more often mainly female LGA-newborn infants were affected. It seemed that the birth weight did not correlate to the extent of the retardation of the hip joint development. It was again confirmed that the restriction to only clinical diagnostic procedures in the neonatal period is not effective in the early diagnosis of the malformation. Hypertrophy of a newborn has to be considered as a risk factor behind the development of congenital dislocation of the hip. It is recommended to examine all LGA-newborn infants post partum by clinical and most importantly also by sonographical means to recognize a retardation of hip joint development.

Birth Weight↗