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Biomedical subjects

I Kempf

Publications and source records attributed to I Kempf.

At least 37 records · Page 2Linked to original sources
PubMed1997

Evaluation of polymerase chain reaction for detection of Mycoplasma meleagridis infection in turkeys.

Different methods were compared for the detection of the turkey pathogen Mycoplasma meleagridis in a turkey field flock before and after antibiotic (oxytetracycline) treatment. They included culture, serology (detection of antibodies by ELISA) and a polymerase chain reaction (PCR) based assay developed by Boyle et al. [Boyle, J.S., Good, R., Morrow, C.J., 1995. Detection of the turkey pathogens Mycoplasma meleagridis and M. iowae by amplification of genes coding for rRNA. J. Clin. Microbiol. 33, 1335-1338]. Culture and PCR assay with tracheal swab samples were much more sensitive than ELISA with serum samples. Percentages of infected birds detected by culture or PCR for samples collected prior to antibiotic treatment were almost identical but the percentage of positive samples detected after antibiotic treatment was much higher with the PCR test.

Animals↗
PubMed1997

Identification of two pathogenic avian mycoplasmas as strains of Mycoplasma pullorum.

Two mycoplasma strains were isolated from dead turkey embryos. Growth properties, biochemical and serological characteristics, and protein profiles indicated that these strains were closely related to Mycoplasma pullorum CKKT (T = type strain). This was confirmed by 16S rRNA sequence analysis, and the phylogenetic position of M. pullorum was established. Pathogenicity studies showed that the two strains, as well as M. pullorum CKKT, induced a statistically significant level of mortality after inoculation into chicken embryos.

Animals↗
PubMed1997

DNA amplification methods for diagnosis and epidemiological investigations of avian mycoplasmosis.

Rapid, sensitive and specific tests that detect nucleic acid from pathogenic mycoplasmas are very attractive for the laboratory detection of infected flocks, and methods for direct detection of the four main pathogenic mycoplasmas have been developed. Moreover, most avian mycoplasma species can be differentiated, according to their unique restriction fragment length polymorphism (RFLP) patterns generated with different restriction enzymes. However, this method is limited to the identification of pure cultures of avian mycoplasmas as other bacteria may be amplified by the set of primers chosen. Another application of PCR-RFLP is the ability to distinguish between very closely related species such as M. gallisepticum and M. imitans. In order to characterise isolates below the species level, PCR-based subtyping methods have been introduced. One of them, arbitrarily primed-PCR, results in strain-specific arrays of DNA fragments that can distinguish even closely related strains of a given species. This method was successfully used to investigate the molecular epidemiology of vaccine strains or of Mycoplasma gallisepticum conjunctivitis in songbirds. Major issues in the development of DNA amplification tests concern the selection of the appropriate target for amplification, specimen collection, DNA preparation and detection of amplification reaction inhibitors. Detection of amplified products is most commonly performed after gel electrophoresis or probe-based methods. Careful consideration to the design and work flow of the facility are necessary to avoid false-positive results.

Agglutination Tests↗
PubMed1996

Diagnostic value of C-reactive protein and transthyretin in bone infections of the lower limb.

In a prospective study, white and red blood cell counts, hematocrit, erythrocyte sedimentation rate (ESR), albumin, alpha-1 acid glycoprotein, C-reactive protein (CRP), and transthyretin (TTR) values were determined by serial measurements during 23 days in 80 patients with an open fracture of the lower limb. Postoperative reference profiles were defined in 74 patients without septic complications. In the six remaining patients, serum CRP and TTR concentrations were found efficient for the early diagnosis of postoperative infections: a CRP/TTR mass concentration ratio higher than 0.6 from the 8th day after surgery was sensitive (100%) and specific (93%). Variations of CRP and TTR concentrations often preceded the clinical diagnosis in patients with early infection. ESR was found unreliable with regard to postoperative infection because of its high dependence with respect to red blood cell count.

Adolescent↗
PubMed1996

Mycoplasmoses in poultry.

The most important mycoplasmas isolated from domestic avian species include Mycoplasma gallisepticum (MG), M. synoviae (MS), M. meleagridis (MM) and M. iowae (MI). MG causes chronic respiratory disease of chickens and infectious sinusitis in turkeys, resulting in economic losses. MS causes infectious synovitis or mild upper respiratory disease. MM infects only turkeys, causing airsacculitis and sub-optimal production and hatchability. MI is associated with reduced hatchability in turkey flocks. Transmission is either direct, from bird to bird or through the egg, or indirect. Diagnosis is based on isolation and identification of mycoplasmas, according to biochemical, serological or molecular biology tests, or serological examination of host sera by slide agglutination, haemagglutination inhibition or enzyme-linked immunosorbent assay (ELISA) tests. Antibiotics (i.e. tetracyclines, macrolides, quinolones and tiamulin) may be used for therapeutic treatment or prophylactic medication. The eradication of mycoplasma infection can be achieved through improvements in hygiene and management practices, therapeutic treatment of breeder layers and/or of hatching eggs and better monitoring procedures.

Animals↗
PubMed1995

Utility of measurement of gentamicin release from PMMA beads in wound drainage fluid after in-vivo implantation.

Acute or chronic osteomyelitis in 188 patients was treated by surgical debridement and filling of the cavity with gentamicin-PMMA beads. The gentamicin concentration was measured in the total drainage fluid of the first postoperative day. There was no correlation between this concentration and the amount of implanted beads. It is impossible to predict preoperatively the gentamicin concentration which will be obtained in situ. The measurement of gentamicin concentration in the total drainage fluid of the first postoperative day and its comparison to the minimal bactericidal concentration of responsible pathogens, allow very early assessment of the effectiveness of the local antibiotherapy and if necessary, adaptation, of systemic antibiotherapy.

Exudates and Transudates↗
PubMed1995

[Mechanical performance of non slotted small diameter nails of Gross and Kempf].

The goal of this study was to evaluate the mechanical properties of closed section small diameter Grosse-Kempf tibia nails. This type of implant has been advocated for an unreamed nailing of open tibia fractures in order to avoid further damage of bone blood supply and an increased risk for compartment syndrome. Static and dynamic tests were performed on 9 and 10 mm nonslotted Grosse-Kempf (G-K) and Russel-Taylor (R-T) nails. Results were compared with the properties of a 11 mm slotted G-K nail, considered as the reference nail. Axial loading tests were realized on nailed cadaver tibiae after resection of a midshaft bone segment. 3 points bending tests have shown a mean diminution of the elastic limit of 50 per cent, and a 25 per cent decrease of the bending rigidity for the closed section nails, as compared with the slotted reference nail. The rigidity in torsion was on the other hand 10 times higher with the nonslotted nails, which is a direct consequence of the elimination of the slot. Axial loading tests performed on isolated implants have given comparable results for all types of nails, including the reference nail. Nailed tibiae axially loaded demonstrated a stable bone-implant interface for loads up to 200 daN, with a mean displacement of 2 mm for a 50 daN load, whatever the type of the nail. Bending tests achieved on locking screws have indicated that G-K screws are twice as rigid as R-T screws.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1995

[Interlocking nail according to Seidel in recent diaphyseal fractures of the humerus. Review of 41 cases of 48 fractures].

The Seidel's humeral interlocking nail is used in our department since december 1986. We report about the 48 first cases, 41 of them have been reviewed with a mean time follow up of 14 months. The indications were humeral mid-shaft fractures with associated lesions (20 cases), failures of non operative treatment (10 cases) and compound fractures (7 cases). Primary radialis nerve lesions has to be explored before nailing. In 41 cases we used a static procedure; post-operative immobilisation average time: were 13 days. Consolidation occurred in all cases within an average time of 10.5 weeks. Post-operative complications consisted in 1 case of infection healed after removal of the nail, and 1 case of secondary displacement after dynamic nailing with secondary radio-circumflex paralysis. The results were appreciated concording to the criteria of Stewart and Hundlay. We noted 64 per cent excellent and good results for fractures of the upper third, 80 per cent for fractures of the middle third and 85 per cent for the distal third of the diaphysis. All transverse fractures had a very good result but also the transverse and spiral fractures with third fragment which represent very unstable fractures especially at the upper third. The closed interlocking nailing of the humeral fractures according to Seidel represents a reliable and stable fixation method. Consolidation occurs in all cases whatever the type or the level of fracture.

Adult↗
PubMed1995

[Risk of infection in centro-medullary locking nailing of open fractures of the femur and tibia].

Intramedullary reamed locking nail of open fractures remains controversial because of the risk of infection. 1,474 closed reamed locked nailings were performed between 1974 and 1989 for femoral (744 cases) or tibial (730 cases) fractures. 349 fractures were open: 100 femoral fractures (51 Gustilo and Anderson Grade I and 49 Grade II) and 249 tibial fractures (140 Grade I, 99 Grade II et 10 Grade III). 24 femoral (3.2%) and 46 tibial (6.3%) nails were followed by infection. This difference is significant (p < 0.01). Reoperations for infection occur more frequently for femoral than tibial fractures (p < 0.05). There is no difference between the results of infection treatment between femoral or tibial fractures. Traumatic opening of the femoral fracture site does not affect the occurrence of an infection, its severity or the results of its treatment. Traumatic opening of the tibial fracture site significantly increases the infection rate (p < 0.001), and the incidence of infection increases with the severity of the soft tissue lesions; but the severity of the infection and the results of its treatment are not modified. Acute closed reamed intramedullary locking nail is the best treatment for open femoral or tibial fractures with respect to the bone healing and infection rate for Grade I and II fractures. For Grade III fractures, nailing must be followed by a coverage flap.

Femoral Fractures↗
PubMed1994

[Ender nail with interlocking mechanism or dynamic hip screw in pertrochanteric fractures? A prospective study extending its limits].

In a prospective study on 148 patients with trochanteric fractures of the hip we compared the results of two implant-systems: the Ender-nailing modified by the dynamical interlocking method of Kempf and Bitar, and the dynamic hip screw (DHS) of the AO-ASIF. The Ender-method had the shorter operation time, earlier weight-bearing and less septic complications. Fracture consolidation was complete after three months in all cases. But in 8% reosteosynthesis because of hip joint perforations of nails was necessary. The method leads in less cases to anatomical reduction (85%), more often relevant varus (9%) and rotationary (14%) malpositions and functional deficits in hip (25%) and knee joints (9%), compared with the DHS. The DHS had less implant complications, reosteosynthesis was necessary in 4%. Technical failures were seldom. In 96% anatomical reduction could be achieved and the function of the hip was in 87% good to excellent. The Ender-nailing with dynamic interlocking is a system for internal fixation of trochanteric fractures in elder patients. The DHS-system has better functional results. Both systems need to be performed in a very careful, exact surgical procedure, to avoid complications.

Adult↗
PubMed1994

Comparison of antigenic and pathogenic properties of Mycoplasma iowae strains and development of a PCR-based detection assay.

The six reference strains of Mycoplasma iowae (I, J, K, N, Q and R) and 12 field strains, most of them isolated from turkeys, were studied with a growth-inhibition test and a dot immunobinding test with rabbit antisera to the different serovars of M iowae, 16S rDNA gene amplification by polymerase chain reaction, and pathogenicity for chicken or turkey embryos. Antigenic tests tended to be strain specific and showed that most field strains were closely related to serovars K or N. The two pairs of primers chosen in 16S rDNA guided the amplification of 332 base pairs (bp) or 892 bp fragments from all the M iowae strains tested. All the field strains tested were highly pathogenic for turkey embryos.

Animals↗
PubMed1994

Mycoplasma gallisepticum infection in drug-treated chickens: comparison of diagnosis methods including polymerase chain reaction.

Ten chickens were inoculated with Mycoplasma gallisepticum (MG) and treated with enrofloxacine. On eight different dates post-inoculation (PI), tracheal swab samples were collected for mycoplasma culture or detection by polymerase chain reaction (PCR), and blood samples were analysed by slide-agglutination test (SA) and enzyme-linked immunosorbent assay (ELISA). Results showed that culture and PCR detected MG from 14/80 or 20/80 samples, respectively. The last culture-positive sample was collected on day 26 PI, whereas PCR still gave positive results on day 54 PI. This difference may be attributed to the high sensitivity of PCR and to its ability to detect non-viable or non-culturable pathogens. Sera were SA positive as early as 5 days PI and some of them remained positive up to day 47 PI. ELISA detected 53 suspicious or positive sera.

Animals↗
PubMed1994

Infection after reamed intramedullary nailing of lower limb fractures. A review of 1,464 cases over 15 years.

We studied 1,464 consecutive immediately-reamed intramedullary locked nailings of tibial or femoral fractures. There was an increase in postoperative infection if the tibial fracture was open; the relative risk increased with the severity of the soft tissue lesion. There was a marginal increase in the postoperative infection rate for open femoral fractures. A comparison of these figures with those in other methods of treatment and the mechanical and clinical advantages of nailing leads us to propose this method of treatment for Grades I and II open fractures of the femur or tibia.

Bone Nails↗
PubMed1994

[Necrotizing fasciitis of the foot. An unknown surgical emergency. Apropos of a case].

INTRODUCTION: The purpose of this study was to review the literature concerning Necrotizing Fasciitis (N.F.) and to discuss a typical case where late diagnosis led to severe consequences. MATERIAL AND METHODS: A young male patient with no pertinent medical history, progressively developed a large swelling of his foot and severe pain 3-4 days following a simple contusion. The absence of an entry site lead to local incision without microbiological study. The patient developed blistering on the leg, then septic shock necessitating amputation. DISCUSSION: N.F. is an infectious necrosis of the sub-cutaneous tissue appearing frequently in surgical or post traumatic contexts. Streptococcal origin is classical but multibacterial anaerobic infection is more and more frequently observed. An entry site is not always found while the affected site becomes red, hot and painful. Evolution is extremely rapid with the appearance of blisters and cutaneous necrotic sites and a severe alteration in the general condition of the patient. The extent of sub-cutaneous necrosis is larger than the affected area of skin. N.F. is a surgical emergency. Treatment consists of complete debridement, sometimes very extensive and mutilating. High dose intra-venous antibiotic therapy is necessary while the benefits of hyperbaric therapy are discussed. Because of the lack of specific clinical signs, diagnosis is difficult and is often made too late. The rapidity of the evolution shows that vital and functional prognosis is better with early diagnosis and treatment even for patients without associated pathology. The rate of mortality is approximately 50 per cent. CONCLUSION: Better information of practitioners allowing a rapid clinical diagnosis could improve the prognosis which is still life-threatening in 1994.

Adult↗
PubMed1993

Aneurysmal cyst of the proximal radius: resection and free vascularized fibular bone graft.

We present the case of a 22-year-old woman with an aneurysmal cyst of the right proximal radius, treated by resection and a free bone graft (microvascular fibular transfer), without recurrence after 4 years. Over a 4 month period, there was a rapidly expanding and lytic lesion found in the radius. There were symptoms of elbow and wrist pain and early radially innervated muscle weakness. Radiological examination showed a localized tumour of the proximal radius, type 2, grade C, according to the classification of Campanacci. Biopsy led to the diagnosis of an aneurysmal bone cyst. Complete tumour resection was followed by a free vascularized fibular bone graft, resulting in good functional improvement, without local recurrence. Aneurysmal bone cysts are a rare condition, and the location in the radius has not previously been described. Vascularized bone grafts are mechanically and biologically superior in this type of case.

Adult↗
PubMed1993

Specific interactions of the allosteric effector 2,3-bisphosphoglycerate with human hemoglobin--a difference FTIR study.

The specific interactions of 2,3-bisphosphoglycerate (BPG) with human deoxy-hemoglobin (deoxy-HbA) are studied by difference FTIR spectroscopy. Due to these interaction effects the O2 affinity of the hemoglobins is regulated. In deoxy-HbA a NH+ ... -OOC hydrogen bond is formed between beta 82 Lys and the carboxylate group of BPG. The phosphate groups of BPG are completely deprotonated causing a strong electrostatic stress within the Hb molecule. The aminotermini (beta 1 Val) interact with the phosphate groups but no hydrogen bonds are formed. The interaction is limited to an electrostatic interaction between the NH3+ and the negatively charged phosphate group, i.e. only ionic bonds are built up. The histidines beta 2 and beta 143 of the two beta-chains form hydrogen bonds with the phosphates. To each phosphate two bonds are formed. These bonds polarize each other and hence only the polar structures NH+ ... -OP of the hydrogen bonds are realized. This follows since no protons are present at the BPG molecules. Thus, caused by the hydrogen bonds and the electrostatic interaction the conformation of HbA is changed by BPG in the way that the T-structure is favored and hence the affinity for oxygen is decreased.

2,3-Diphosphoglycerate↗
PubMed1993

[Gamma nail in the treatment of closed trochanteric fractures. Results and indications apropos of 121 cases].

The Gamma Nail, developed at the Centre for traumatology and orthopaedics of Strasbourg, is the latest advance in the treatment of trochanteric fractures, based on the intra-medullary principle and on the closed procedure. It was inspired both by the Y nail of Küntscher and by the interloking nail. This is the study of the results of a first series of 121 cases treated between 1988 and 1990 and followed until consolidation. The mean age was 75 years, mostly patients in poor general condition, unstable fracture types were predominant. The preoperative reduction was anatomic in 72 per cent and the quality of osteosynthesis was good in 66 per cent, acceptable in 27 per cent; 83.4 per cent of the patients resumed full weight bearing during the first week. Only one case of deep infection occurred, treated by Gentamicyn beeds without removal of the nail. The mortality rate was 12.3 per cent at three months. We note 7 malunions in varus > 10 degrees, 3 in valgus > 10 degrees, 2 in external rotation > 10 degrees and 1 internal rotation > 10 degrees. In six cases, there was a cut out of the femoral head by the screw (in two cases the screws were too short, in four cases they were in a bad position). The same criticism against all surgical methods of treatment of trochanteric fractures can be done against the Gamma Nail. Nevertheless, it keeps the advantages of a closed procedure and, in comparison to the Ender nail, the absence of knee pain and the systematic weight bearing whatever the fracture type.

Aged↗