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Biomedical subjects

I Kempf

Publications and source records attributed to I Kempf.

At least 55 records · Page 3Linked to original sources
PubMed1992

Efficacy of danofloxacin in the therapy of experimental mycoplasmosis in chicks.

Specific pathogen free day-old chicks were inoculated with a virulent strain of Mycoplasma gallisepticum. Birds received either danofloxacin (50 ppm), tylosin (500 ppm) or no medication in the drinking water from 24 hours after infection for three days. The effects of medication on mortality, weight gain, serology, lesions and reisolation of M gallisepticum 21 days following infection were studied. Treatment with danofloxacin and tylosin significantly decreased mortality and increased weight gain compared with infected unmedicated birds. Twenty-one days after infection, M gallisepticum was isolated from 96 per cent of unmedicated birds compared with only 6 per cent of danofloxacin-treated and 40 per cent of tylosin-treated birds, and the percentage showing positive serological tests was reduced from 100 per cent of unmedicated birds to 0 per cent of danofloxacin-treated and 29 per cent of tylosin-treated birds. In both cases, the proportion of positive birds from the danofloxacin-treated group was significantly lower than that from the tylosin-treated group. The occurrence of air sac lesions was also significantly lower in danofloxacin-treated than in tylosin-treated birds.

Animals↗
PubMed1991

[Total prosthesis after ankylosis of the hip joint. Report of 22 cases].

Between 1968 and 1987 we carried out a total replacement arthroplasty on 22 hips which were either ankylosed or had previously undergone arthrodesis. The hips were revised because of pain due to pseudoarthrosis or malposition, pain in the other joints such as the lumbar spine, the ipsilateral knee or the contralateral hip, fractures about the hip, or professional disability. Significant functional and subjective improvement was obtained. The revised hips were painfree, stable and had an average range of flexion of 70 degrees. Pain in other joints was improved if their degenerative changes were moderate, but many required further procedures. Revision of a hip arthrodesis to a replacement arthroplasty is a worthwhile procedure in suitable cases.

Adult↗
PubMed1991

[Interlocking central medullary nailing of recent femoral and tibial fractures. Statistical study apropos of 835 cases].

Kuntscher's conventional closed intra-medullary nailing represents a good procedure in the treatment of diaphyseal fractures of the femur and the tibia but had a very restricted area (the midshaft) of indications. Thanks to the interlocking technic which consists in the fixation of the nail to the bone by means of transfixing screws either in a static or in a dynamic procedure, the method can be extended to fractures localised between both epiphysis of the long bones. After a first period between 1974 and 1983 of development of the method summarized in a first statistic, a second study was performed between 1984 and 1989 in the Center of Traumatology of Strasbourg with 837 cases of fresh fractures of the femur (385) and the tibia (397) treated by locked intra-medullary nailing. In two third of the cases the procedure was static and in one third it was dynamic. Full weight bearing was allowed in a mean period of 60 days. On the femur (371 closed and 65 open fractures), we had noted 8 infections out of which 2 deep infections (0.45%), 5 non unions, 25 moderate malunions in varus and 18 in valgus. On the tibia (267 closed and 132 open fractures) we had observed 15 deep infections (3.7%) out of which 9 (2.2%) after open fractures, 15 non unions (3.7%), 22 compartment syndroms, 6 mal unions in varus and 54 malunions in valgus greater than 5 degrees out of which 15 greater than 10 degrees.

Adult↗
PubMed1991

[Comparison of mechanical qualities of cortical bone preserved by various freezing methods].

The purpose of this study was to compare the mechanical properties of the human cortical bone following three deep-freezing techniques: addition of D.M.S.O. (di-methyl-sulfoxide) and staged decrease of temperature with immersion into liquid nitrogen, immersion into nitrogen without cryoprotection, deep freezing in an electric device, down to -80 degrees C. Axial loading tests performed on two femurs (88 samples) allowed to determine the strain of failure fmax and the Young's modulus E. Torsion tests were undertaken on four femur (66 samples) to obtain the strain failure tmax and the Young's modulus G. We have taken several samples from the cortex, that we randomly divided into four groups, three of them being deep-frozen with one of the methods studied, the fourth being tested "fresh", after standard sample manufacturing. The results obtained at the fresh state were comparable with those published in the literature (fmax = 158 MPa, E = 9000 MPa, tmax = 60 MPa, G = 4000 MPa). The results obtained after deep freezing both in axial loading and in torsion, demonstrated significant differences, ever though of low value. The surgeon may use one of either freezing method, without fearing any deterioration of the mechanical properties that could threaten the primary stability of the graft. However, only liquid nitrogen permits a long lasting storage, and only the use of cryoprotection can give the hope of preservation of the chondrocytes in case of diaphyseal-epiphyseal grafts.

Bone Transplantation↗
PubMed1991

[Screw fixation of fractures of the odontoid process].

In the year 1981, J. Böhler completed for the first time a screw fixation for unstable fractures of the odontoid process of the axis. This surgical technique preserves the anatomy and the physiology of the articulation between the atlas and the axis, as a guarantee for a good functional recovery. It is not a very difficult technique when performed by a trained surgeon with a very good X-ray image intensification for the per-operative control. We have treated 32 unstable fractures of the odontoid process without any neurological complication per- or post-operatively. We had a follow-up on only 29 cases. In 19 cases the fracture healed in leading to a good bone union, complete mobility and no residual pain. Seven patients complained of residual pain or a limitation in cervical movement, because of the association with other cervical fractures, an age superior of 70 years, or a major initial instability. In 2 cases the authors noted a non-union and a secondary displacement because of technical faults at the beginning of their experience. These good results determined the authors to prefer the direct screw fixation for the unstable fractures of the odontoid process, to the posterior arthrodesis which leads to functional limitations.

Adolescent↗
PubMed1991

[A study of primary mooring and deformation of the peri-acetabular area under static load].

We propose a method to study the primary stability and the periacetabular deformation under static load, with and without cemented and cement-free acetabular implants, using a biomechanical model that stimulates the balance mechanism described by Pauwels. The biomechanical model uses whole pelvises of recently frozen corpses. We have imitated the gluteus medius and minimus muscles on the pelvis with cables and pulleys. The loading device comprises a metallic frame, on which a hydraulic press is set up for static testing, and a prototype femoral prosthesis made of two main parts: one on which the gluteal muscles are inserted, and another one on which the femoral head is attached. The pelvis is fixed to the metallic frame by a plate attached to the sacrum and allowing movements in all planes of space. The measurement method utilizes: for primary stability, four transducers, including three three-directional ones, in the three planes of space outside the pelvis, only one being located inside the pelvis with a 16 degrees orientation relative to the vertical; for deformation, a transducer located in three different places in the periacetabular region. We have used ten freshly frozen pelvises with six different implants (two with and four without cement) and eighteen implantations.

Acetabulum↗
PubMed1990

Massive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball.

The purpose of this case study of severe metallosis is to draw the attention of orthopedic surgeons to extremely serious results of this kind in the event of the fracture of the ceramic ball in a total hip prosthesis. Eleven months after implantation of a KJF hip prosthesis with an aluminum oxide ceramic ball in combination with a polyethylene acetabular cup, fracture of the ceramic ball was observed. After examining the polyethylene cup during the revision operation, the operating orthopedic surgeon merely replaced the fractured ceramic ball with a metal ball head made of stainless steel. Twenty-five months after this procedure, radiography revealed massive wear of the steel ball head with resulting severe metallosis of the surrounding tissues. All prosthetic components therefore had to be removed. Careful examination of the removed prosthetic components clearly showed that sharp-edged ceramic particles originating from the fractured ceramic ball had become embedded in the bearing surface of the polyethylene cup. These tiny ceramic fragments, ranging from 0.05 to 2 mm, were too small to be seen by the operating surgeon's unaided eye. It is these extremely hard ceramic fragments that were responsible for the massive wear of the steel ball head, the hardness of which is approximately ten times less than that of aluminum oxide ceramic. The fracture of the ceramic ball further resulted in damage to the metal taper of the stemmed femoral component. In cases of this kind it is consequently absolutely essential to remove both the polyethylene cup and the ball head, and--if necessary--the femoral component as well.

Acetabulum↗
PubMed1990

[Admission and organization of emergency care for multiple injured patients. The experience of the Strasbourg Center of traumatology and orthopedics].

The admission of patients with severe multiple trauma and the organization of treatment must follow a few basic principles: 1) continuous, uninterrupted management by the various links of the medical chain, 2) single location: the various persons ensuring the treatment must go to the patient's side, and not the opposite, 3) pluridisciplinary, polyvalent care, and lastly, 4) single command: for us, the orthopedist-traumatologist must direct and coordinate care to the severely injured persons, and the so-called general surgeons is in charge of the others. Three structures of admission currently coexist in France: the department of admission, the emergency department and, rarely, the center of traumatology. Carefully planned routes, adapted facilities, plenty of material and staff are essential. The initial management of patients with multiple trauma in both diagnostic and therapeutic at the same time: first aid in case of vital emergency, resuscitation, clinical, radiological and biological assessment, aimed at drawing a complete census of the lesions and establishing their hierarchy. Considering this hierarchy, the treatment must urgently, completely and definitively deal with: In the first place, and in extreme emergency, vital lesions: visceral rupture, internal and external hemorrhages as well as orthopedic priorities: neuromedullary compression, fracture with vascular lesion, open fracture. All the lesions must be treated definitively if this is possible. However, not all fractures must be operated immediately. Only the severe lesions that are a factor of shock (eg. fracture of both femurs) must be reduced and fixed in emergency. The temporary treatment of the other lesions with plaster casts or continuous extension must not be neglected.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergency Medical Services↗
PubMed1990

[Correction osteotomy and stabilization with the interlocking nail].

Compression and angle plates fitted after corrective osteotomies for congenital or post-traumatic bony malalignment entail the disadvantage that a longer period of non-weight-bearing is needed before consolidation. This is in contrast to the advantages of medullary nailing with interlocking nails in dynamic and static applications, which allow early weight-bearing. The interlocking nail can be used after osteotomies to correct derotation and axial malalignment, but also after lengthening and shortening osteotomies, which we perform both as open procedures and as closed procedures with the aid of the Küntscher saw.

Adolescent↗
PubMed1989

An intramolecular hydrogen bond with large proton polarizability within the head group of phosphatidylserine. An infrared investigation.

Films of O-phospho-L-serine-P-ethylester (PSE) were studied by infrared spectroscopy. PSE films were studied pure and as 1:1 mixture with LiOH, NaOH, KOH, and Ca(OH)2 as a function of the degree of hydration. The same investigations were performed if (L-glu)n was added to the system (ratio 1:1, PSE/glu residue). In the PSE molecules an intramolecular (I) COOH...-OP in equilibrium with COO-...HOP (II) hydrogen bond is present. In this bond a double minimum proton potential occurs and it shows large proton polarizability. This hydrogen bond is relatively stable as shown by the neutralization experiments. At low degree of hydration the cations are present at the phosphate groups. The Li ions polarize the intramolecular hydrogen bonds much more than the other cations, i.e., the weight of the proton-limiting structure COOH...-OP is increased by Li ions. Regarding these results one has to assume that such a hydrogen bond is also present in the phosphatidylserine head groups. It is discussed that such hydrogen bonds could be part of a lateral charge-conducting system in the polar surfaces of biological membranes. Such systems could connect proton-creating and proton-consuming centers at the membrane surface and conduct positive charge at an extremely high rate.

Hydrogen Bonding↗
PubMed1989

[Efficacy of spiramycin and tylosin in preventing mycoplasmosis in chicks experimentally infected with mycoplasma gallisepticum].

In order to evaluate the activity of two drugs (spiramycin and tylosin), one-day-old chicks are inoculated with a virulent strain of Mycoplasma gallisepticum (MG) and given spiramycin (3 different doses) or tylosin (1 dose) for two or three days. Effectiveness is assessed on different criteria: mortality, symptoms, weight gains, gross lesions, MG tracheal recovery and serology. Results show that spiramycin and tylosin have the potential of reducing mortality, symptoms and lesions. Weight gains of treated birds are greater than those of infected untreated birds. However, MG was recovered from tracheas of all treated birds.

Ammonium Chloride↗
PubMed1988

[Role of intrafocal pinning in the treatment of wrist fractures].

We have treated 350 displaced Colles fractures by percutaneous fixation with K wires arranged in a 'basket' formation, as described by Kapandji. This technique enables satisfactory stabilisation of the fragments and early mobilisation and rehabilitation, usually without the use of a plaster cast or brace. We describe our indications for use of the method, the technique followed and analyse our results.

Adolescent↗
PubMed1986

[Value of the assay of C-reactive protein in osteoarticular infection].

The C-reactive protein is specifically increased in the acute phase of inflammation. Its level in the serum is measured by the use of immunonephelometry and is obtainable after 2.5 hours. It normally ranges between 3 and 22 mg/litre. The authors have measured the C-reactive protein after 50 surgical procedures in septic cases. They have compared its levels with other biological tests such as the sedimentation rate and the leucocyte count. The variations in C-reactive protein occurred very early and were very extensive, the increase ranging between 200 and 1500 per cent after the surgical procedure. In cases without septic complications the level returned to normal within seven days, while the sedimentation rate only became normal after three months. In cases with septic complications, the rise of C-reactive protein appeared before clinical signs. Therefore, such an increase should lead to a search for a persistent infective focus or the presence of an osteitis. However, this biological test cannot differentiate between an acute infective and a severe inflammatory process.

Arthritis, Infectious↗
PubMed1986

The treatment of noninfected pseudarthrosis of the femur and tibia with locked intramedullary nailing.

Sixty-six cases of noninfected nonunions (27 femoral and 39 tibial) were treated with an interlocking nail. In these cases, 92.6% of the femurs and 94.8% of the tibias healed after the first operation in a mean time of 15.4 and 13.0 weeks, respectively. Deep infection complicated five nailings (7.5%, two femur and three tibia), which included three patients with reactivation of latent osteomyelitis. All cases healed after debridement and use of gentamicin PMMA beads. In one case the nail had to be removed and replaced by an external fixator. Residual angulation between 5 degrees and 10 degrees occurred in three femurs and seven tibias. Shortening occurred in all patients and averaged 0.9 cm in the femur and 0.5 cm in the tibia. Of the patients treated for femoral nonunion, 92.5% achieved full hip flexion and 77.8% full knee flexion on final follow-up examination. In patients with tibial nonunions treated with a locked nail, 92.3% had normal knee flexion and 84.6% obtained normal ankle function. Interlocking nailing offers unique advantages to patients with femoral or tibial shaft pseudarthrosis. The technique allows early weight-bearing, range of motion of adjacent joints, and reliable rates of consolidation of the nonunions.

Adolescent↗
PubMed1986

Locked intramedullary nailing. Its application to femoral and tibial axial, rotational, lengthening, and shortening osteotomies.

Interlocking nailing is an alternative method of internal fixation following corrective osteotomies for malunions or after correction of leg length inequality. Of 13 osteotomies (six femoral, seven tibial) for angular or rotational malunion, all healed following dynamic locked nailing. Eleven were considered anatomic and two had mild residual deformity. One-stage femoral lengthening was performed in 17 patients. The preferred operative technique includes a long Z-shaped osteotomy, static interlocking nailing, primary cancellous bone grafts, and one or two supplemental screws at the osteotomy site to prevent shortening following dynamization. Thirteen complications developed following one-stage lengthening of the femur, which included significant loss of length in five patients, femoral nerve palsies in four patients, three deep infections, and one nonunion. Lengthening should not exceed 4.0 cm in the femur. The recommended technique of shortening osteotomy consists of resection of a cylindric segment of bone from the distal diaphyseal metaphyseal area. Shortening should not exceed 4.5 cm in the femur or 3.0 cm in the tibia. In ten patients who were shortened, all healed, but radiologic signs of union appeared very slowly in most cases.

Adolescent↗
PubMed1985

Closed locked intramedullary nailing. Its application to comminuted fractures of the femur.

For many fractures of the femoral shaft, closed intramedullary nailing will not control rotation or telescoping of the fragments. Locked intramedullary nailing combines closed nailing with the percutaneous insertion of screws that interlock the bone and nail. This method permits static locking that controls rotation and telescoping and subsequently conversion to dynamic locking when weight-bearing is started after approximately twelve weeks. By providing greater stability, this method extends the indications for intramedullary nailing to severely comminuted, oblique, and spiral fractures as well as to fractures complicated by loss of bone and fractures in the proximal and distal ends of the femoral shaft. Of fifty-two patients with forty-nine severely comminuted fractures of the femoral shaft and three fractures that were complicated by loss of bone, forty-seven patients had uneventful consolidation of the fracture, with a mean time of 4.5 months for the severely comminuted fractures and seven months for the fractures that had a loss of bone. At follow-up, all forty-seven patients had normal motion of the hip, and forty-five had normal motion of the knee. Of the remaining five patients, four had a non-union that eventually healed (three after a second locked nailing and one after a third) and one had a septic non-union that eventually healed after removal of the nail and screws, débridement, and immobilization with an external fixator. Based on this experience, we concluded that this form of treatment has many advantages. The risk of infection and non-union is low, the incidence and severity of malunion are reduced, the hospital stay is short, and early mobilization of the patient is possible.

Adult↗
PubMed1985

[Chiari's osteotomy in the treatment of coxarthrosis in adults. Apropos of 39 cases].

The authors have reviewed 39 Chiari pelvic osteotomies for hip arthrosis in adults. The surgical technique was found to be difficult and several modifications have been made during the last ten years. The complication rate was high initially but improved later thanks to technical improvements. However, the overall results were very satisfactory as regards both function and radiological appearances. Improved coverage of the femoral head was usually obtained when the operation was performed correctly and pain was diminished in two-thirds of the patients. The results were less satisfactory as regards gait, hip movement and the radiological joint space. In 13 cases a femoral osteotomy was made in association with Chiari pelvic osteotomy without any special complications.

Adolescent↗