Biomedical subjects

H U Sons

Publications and source records attributed to H U Sons.

At least 19 recordsLinked to original sources

PubMed1990

[Possibilities of sonography in patellar apex syndrome].

23 Patients suffering from jumper's knee were examined by sonography. Using ultrasound imaging, we demonstrated pathologic changes in the tendon. Reproducible documentation of the patella tendon was proved by using three specimens. In a control group of 110 normal objects normative values for the size and structure of the tendon were documented. We present a classification using ultrasound patterns. With this classification the diagnosis becomes objective and reproducible. The physician can decide which conservative therapy is appropriate to this state of the disease, the surgeon gets information for the operation, and the success of the therapy can be documented.

Adolescent↗

PubMed1990

[Secondary impingement syndrome in athletes].

Dysfunction of the shoulder joint is based not only on anatomic conditions. The consideration of the special kinesiology of the shoulder helps to understand the shoulder pathology. This mainly applies to young "overhead athletes" like swimmers, handball-, basketball-, volleyball-, and racketplayers. These disciplines cause stress on the anterior joint structures (capsule, ligaments, labrum, subscapularis tendon) and lead to anterior instability. This includes anterior subluxation or even dislocation. Finally, an impingement syndrome with the typical symptoms can frequently result from these conditions. The impingement-syndrome of the elderly must be considered as a primary disease, whereas the young overhead athlete suffers from the impingement syndrome as a secondary disease and does not take the first place in therapy. The first step in therapy should to be treat the muscular imbalance of the shoulder. To gain a regular pattern of motion the rotator cuff must be strengthened. This regimen is likely to be successful in 80-90% of the cases. If the conservative therapy fails the surgical treatment may come into consideration. Arthroscopic surgery has the advantage not to affect the proprioceptivity. To retain the previous level of performance an adequate rehabilitation programme is essential for the athlete.

Adolescent↗

PubMed1990

[Orthopedic aspects of Crohn disease. Examples of extra-intestinal organ manifestations].

Articular changes in Chron's disease represent extraintestinal organic manifestations which generally take the form of so-called enteropathic synovitis. Articular alterations - diagnosed as non-specific arthritis in the great majority of cases--may precede the intestinal disease. In very rare cases it can be shown that the joints display histological changes typical of Morbus Crohn. The etiology and pathophysiological mechanisms of the articular changes are not clear. Probable factors are: autoimmune disease, stimulation of the immunological system by exogenous antigens, induction of a self-sustaining inflammatory process, and demonstrable circulation of antigen-antibody complexes. Genetic factors seem to play a role (familial disposition). A pure "colonic Crohn" (= colitis granulomatosa) leads to a higher degree of articular alteration than a pure "small-intestine Crohn" (= ileitis terminalis). The joints preferentially affected are in the region of the lower extremities (knee and ankle joints). Concomitant Bekhterev's disease (spondylitiis ankylopoietica) is found in 7-10% of cases. Osteomyelitis represents a rare and serious complication: it can appear in the course of chronic Chron's disease (mainly with intestinal fistulas), especially in the region of the pelvic bones. Further aspects of interest from an orthopedic viewpoint are hypertrophic osteoarthropathy with periossal neoformation, granulomatous changes in the bone itself, and aseptic osteonecrosis.

Arthritis↗

PubMed1990

[The disease picture of melorheostosis].

The rare syndrome of Lér's melorheostosis is described on the basis of a case encountered in one of our own patients, a 29 year old male patient. Particular attention is given to the symptoms, the specific results of clinical examination, and the differential diagnosis.

Adult↗

PubMed1989

Pulmonary embolism and cancer: predisposition to venous thrombosis and embolism as a paraneoplastic syndrome.

In patients with a malignant primary disease the risk of thromboembolic complication is demonstrably increased. This is undoubtedly attributable to a whole range of factors (multifactorial etiology) which are highlighted in the present synoptic study. In addition to local influences from the tumor, a particular role appears to be played by an increased aggregation of thrombocytes, various tumor cell products, polyglobulism, hypercalcemia, increased release of thrombocinase, microthrombotic embolization, and a decrease in antithrombin III.

Humans↗

PubMed1989

Palliative and curative surgical therapy of malignant stenoses of the esophagus and cardia.

Between January 1967 and July 1986, 171 patients with malignant stenosis of the esophagus and cardia were subjected to curative or palliative surgical treatment. Specifically, there were 84 primary esophageal carcinomas, 5 cases of malignant esophageal stenosis caused by an extra-esophageal malignant tumor (inter alia bronchial carcinoma), and 82 primary carcinomas of the cardia. The average age of the patients as a whole was 63.7 years, and the sex ratio (male:female) was 4.0:1. In 18 esophageal carcinoma patients and 21 patients with carcinoma of the cardia curative resection was possible, but in 132 patients merely palliative surgery was performed, most frequently esophageal intubation and gastrostomy. The specific operations with a curative objective performed upon the esophageal carcinoma patients were abdominothoracic esophageal resection with upward displacement of the stomach (n = 16) or interposition of a colonic segment (n = 2), whereas in the patients with carcinoma of the cardia, proximal resection was performed in 13 cases, either subtotally or as a cardiofundectomy, and total gastrectomy in 8 cases. For the subsequent reconstruction of the passage the interposition of a jejunal segment was most frequently used. The clinical mortality for the curative resections was 33% for the 18 esophageal carcinoma patients and 9.5% for the 20 patients with carcinoma of the cardia. The long-term survival rates are depressing: of the patients who underwent curative resection 47.6% were still alive after one year, 28.6% after 2 years and 14.3% after 5 years. Of the patients treated only palliatively on account of an already advanced stage of the tumor, 91.5% died within the first year; only 4.9% of patients from this group were still alive after 2 years.

Adult↗

PubMed1989

[The value of sonography in assessing intracompartmental pressure in the anterior tibial compartment].

Fifty recreational athletes were subjected to a defined exercise programme (running on a treadmill, 8 km/h). The pressure in the middle third of the anterolateral compartment was measured. We also assessed the geometry and the echogenicity in the transversal and the longitudinal plane by sonographic means. The increase of the intracompartmental pressure increased as the ap-diameter of the compartment in the transverse plane increased (distance = superficial fascia - interosseous membrane). We found a correlation factor of 0.79. The echogenicity increased as the intracompartmental pressure increased. The changing ultrasound reflex pattern is considered non-reproducible because there are too many artifacts, nor is the increase in the ap-diameter due to the low correlation.

Adolescent↗

PubMed1989

[Ultrasound determination of the humerus retrotorsion angle. An experimental and clinical study].

We examined the value of ultrasound to determine the retroversion of the humerus in an experimental and clinical study. In twenty human upper arms of corpses the retroversion angle was measured by ultrasound and by direct means using a paralellograph. The angle was also evaluated by sonography and CAT scan in 7 patients, and in 6 patients by sonography and x-ray. There was a poor correlation between sonographic measurement and direct measurement, CAT scan, or x-ray. Hence, we do not recommend sonography as a useful tool in preoperative planning. For this purpose, CAT scan or x-ray should be preferred. However, sonography may be useful for screening.

Chronic Disease↗

PubMed1989

[The value of sonography in injuries of the knee joint].

In an experimental study we examined three knee specimens with regard to the value of ultrasound for imaging soft tissue structures. Subsequently we documented artificial lesions at the menisci and ligaments. With this experience we started a prospective study comparing the preoperative ultrasound investigation with the results of arthroscopy in 101 patients. For ultrasound evaluation we used a 5 MHz linear and a 7.5 MHz sector scanner. In the experimental as well as in the clinical study the menisci were well visualised. For medial meniscus lesions the accuracy and the predictive value was 81%. For the lateral meniscus the predictive value was 80%, although there was only an accuracy of 7% because of a large number of false positive results. We were not able to reliably detect cruciate ligament ruptures. However, ultrasound was useful to visualise Baker's cysts, bursitis, and jumper's knee.

Arthroscopy↗

PubMed1989

[Possibilities for using sonography in sports injuries of the shoulder joint].

Sonography is a useful tool for the examination of the shoulder joint. Concomitant cartilaginous and soft tissue lesions (Hill-Sachs, effusion, cuff-tears) can be visualized. Subacromial pathology can be differentiated. The type of instability in the unstable shoulder can be documented. The ultrasound investigation is of diagnostic value for the unstable shoulder as well as for the impingement shoulder in athletes. Therefore it may be helpful for planning the adequate treatment and also for the follow up of the patients.

Athletic Injuries↗

PubMed1989

[Intracompartmental pressure in the anterior tibial compartment. Demonstration of the course of pressure in the gait cycle].

During walking the anterior tibial compartment pressure was measured continuously using a new technique. The test subjects were made to walk on a treadmill at the standardised walking spees fo 3, 6, and 8 km/h. Documentation of intrafascial pressure was obtained continously, while gait-analysis and pressure changes were simultaneously documented on video-tape. Readily reproductible pressure curves were obtained. The increase in walking speed correlated to increase in intracompartmental pressure, and the varying pressure was accurately correlated to gait phases. Minimum pressure was recorded in the phase immediately prior to initial heel contact (IC). During "mid-stand" (MST) the pressure remained constant. "Terminal-stand" (TSZ) and pre-swing (PS) are associated with peak pressure. The method described is suitable for continuous and reproducible measurement during walking.

Adolescent↗

PubMed1989

[Etiology of sub-acromial impingement syndrome--a biomechanical study].

Eight fresh shoulder specimen were dissected and the functional relationship of the rotator cuff tendons to the acromion was demonstrated through various arcs of shoulder motion. The scapula was fixed and the arm was elevated, rotated, and abducted by pulling the muscle tendon according to EMG activities. Using FUJI compression films the subacromial compression of the rotator cuff was measured. Different forms of acromion were tested. While moving the shoulder with normal relationship of deltoid to rotator cuff, there is no -or at least less than 0.1 mPa compression of the rotator cuff in the subacromial space. Weakness of the rotator cuff results in a moderate compression of 0.6 mPa. In type III acromion there was significant increase up to 1.0 mPa between the acromion and the rotator cuff. This study suggests, that a mechanical subacromial compression only occurs in shoulder joints with a Bigliani acromion type III and/or in joints with a imbalance of the deltoid/rotator cuff relation. Thus an acromioplasty should be primarily undertaken only if the pathology affects the acromion. If there is a muscle imbalance, we recommend a special rehabilitation program in order to strengthen the cuff-muscles the first place.

Acromion↗

PubMed1989

[Results of surgical treatment of chronic pancreatitis].

On the basis of a group of 67 patients studied by the authors, the various techniques for the surgical treatment of chronic pancreatitis are discussed. The average age of the patients covered by this study was 45.7 years, and the male:female ratio was 2.9:1. In more than 82% of the cases a history of chronic alcohol abuse was definitely established. For the drainage operations performed the preferred operative techniques were the pancreaticojejunal anastomosis and, where pancreatic pseudocysts were present, the cystojejunostomy. Resection of the pancreas was performed in a total of 18 patients, the clinical mortality here being 5.6%. In our study also the long-term prognosis for patients with chronic pancreatitis depended, on the whole, less upon the operative technique chosen than upon the subsequent degree of alcoholism.

Adult↗

PubMed1987

Carcinoma of the extrahepatic bile ducts: a postmortem study of 65 cases and review of the literature.

From 1950 to 1982, 65 patients with carcinoma of the extrahepatic bile ducts were autopsied in the Institute of Pathology of the University of Düsseldorf. The average age of men was 64.5 years and that of women was 70 years. The ratio of men to women was 1 to 1.71. The greatest number of tumors was found in the common bile duct (40.1%), followed by the hepatic ducts (29.2%) and the confluence of the common hepatic duct with the cystic duct (27.7%). Adenocarcinomas of various differentiation were found in 96.7% of the cases and anaplastic carcinoma in 3.3%. Metastases were present in 49 cases (75.4%). Cholelithiasis was found in 51% of the cases. The results of the present postmortem study are compared with the literature.

Adenocarcinoma↗

PubMed1987

Effect of N-ethyl-N-butyl-nitrosamine on the esophageal mucosa of the rat. Histometric investigation of early tumor stages.

80 male Wistar rats received an oral ad libitum application of N-ethyl-N-butyl-nitrosamine in a concentration of 0.18 g per litre of drinking water. The changes induced in the esophageal mucosa and determined at three intervals (up to 48 days, up to 91 days, and up to 112 days after commencement of carcinogen exposure) were compared by microscopy with the results from a control group of 10 male Wistar rats of the same age. Several histomorphometric parameters were investigated with the aid of a Leitz ocular micrometer. The earliest localized changes found were an increase in the thickness of the epithelium and the horny layer, and an elongation of the papillary bodies and a widening of the parabasal cellular layer. Later--with a substantial increase in the rate of mitosis in all layers of the epithelium, there was a significant thickening of the non-papillomatous and papillomatous epithelium, an enlargement of the nuclei, especially in the middle and upper layers of the epithelium and a thickening of the horny layer, parts of the latter being parakeratotic. The papillomatous changes corresponded in some cases to moderate epithelial dysplasias. As expected, no fully-developed invasive carcinomas occurred in the early period investigated. The histometric data permit the conclusion to be drawn that the lesions described are demonstrable not only at the exophytic-papillomatous epithelium but also in multifocally localized form at the flat, non-papillomatous mucosa, and that they can definitely be regarded as the expression of an incipient field cancerification.

Animals↗

PubMed1987

Etiologic and epidemiologic factors of carcinoma of the esophagus.

Carcinoma of the esophagus is one of the most interesting tumors due to the great diversity with regard to its regional incidence worldwide. The areas of especially high incidence include the Caspian provinces of Iran and certain regions of the People's Republic of China, South America and Africa. The precise cause of these major regional differences with regard to the incidence of carcinoma of the esophagus are still not fully clarified. The results of the present study explain conceptions with regard to the etiopathogenesis and shows that the factors with a promotive role in various individual regions differ, in some instances, considerably from one another.

Adenocarcinoma↗

PubMed1987

[Gallbladder cancer as unexpected histologic diagnosis following cholecystectomy for cholelithiasis and cholecystitis].

Uncharacteristic symptoms, inadequate early diagnosis, and high malignancy are the major reasons why most of the patients with carcinoma of gallbladder are not admitted for clinical examination until metastasation had begun to involve the liver. So, the majority of authors who have made contributions to the literature are in agreement to the effect that the prognosis is extremely poor for patients with gallbladder carcinoma and that curative therapy is possible only in rare cases. There are only few reports on cases on whom operations could be performed in good time. Curable gallbladder carcinoma is more often than not an absolutely accidental finding obtained in the course of surgical treatment for cholelithiasis. Reported in this paper are four cases in which malignant lesions to mucosa were accidentally discovered by pathologists in histological examination of specimens obtained from cholecystectomy for cholecystolithiasis and cholecystitis. Problems involved in therapeutic action are discussed.

Adenocarcinoma↗

PubMed1987

[Results following the surgical treatment of pancreatic cancer].

A retrospective study was conducted into clinical data recorded from 152 patients who had been operated on for carcinoma of the pancreas, between 1967 and July 1986. Tumours could be removed only in 25 cases (16.5 per cent). Non-removing, purely palliative operations had to be performed on 127 patients (83.5 per cent), because of too advanced tumour stages. In most of these cases, surgical action was taken with the view to eliminating obstructive jaundice or pyloric stenosis. The surgical approaches to 22 cases (14.5 per cent) even had to be completed as exploratory laparotomy. Cumulative survival rates revealed extremely unfavourable long-term prognosis of pancreas carcinoma. Five-year survival has proved to be achievable only through radical removal of the carcinoma but was found to be restricted to few cases.

Adenocarcinoma↗