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Biomedical subjects

J R Döhler

Publications and source records attributed to J R Döhler.

At least 19 recordsLinked to original sources
PubMed2002

[Supracondylar corrective osteotomy in post-traumatic cubitus varus. 3 cases in 2 patients].

Supracondylar fractures of the humerus in childhood frequently result in cubitus varus deformity. Pain, functional impairment and cosmetic problems can request surgical correction. This is a report on an adult and on a mature child with such deformities. The boy had sustained three injuries with following bilateral cubitus varus and lengthening of one lower leg. Planning, surgical technique and outcome of the osteotomies are described. We should recommend the resection of a full wedge with two oblique osteotomies and internal fixation with two plates on either side of the humerus.

Adolescent↗
PubMed2001

Treatment of enterogenic endotoxinemia with lactoferrin in rats.

Enterogenic endotoxinemia was induced in 28 Wistar rats by means of intraperitoneal injection of 80 mg/kg carrageenan and intraduodenal administration of 5 x 10(10)/kg Escherichia coli bacteria and 10 mg/kg nebacetin. The control group A received 600 mg/kg albumin in addition via the duodenal probe, and the groups B, C and D received 20, 40 and 80 mg/kg lactoferrin, respectively. The therapeutic effect was investigated by determining the endotoxin activity in the plasma every hour. In addition, the bacterial contamination of peritoneal lavages and mesenteric lymph nodes was checked by incubation for 48 h at 37 degrees C. The period of observation was 5 h. There was a dose-dependent improvement of the endotoxin activity in plasma and the bacterial contamination of the peritoneum cavity and mesenteric lymph nodes after lactoferrin administration. The maximum plasma endotoxin activity could be reduced by 89% with 80 mg/kg lactoferrin.

Albumins↗
PubMed1999

[Chondrosarcomas of the proximal femur and large toe. 2 case reports].

This is a report on two patients in their eighth decade suffering from a chondrosarcoma in the proximal femur and in the big toe. The resection of 22 cm of the proximal femur and the replacement with a modular tumour prosthesis proved successful. The other patient had a tumour in the proximal phalanx of the big toe and wide resection of the first ray was performed. No patient gave evidence of local recurrence or distant metastasis.

Aged↗
PubMed1997

[Vascularization of the humerus].

The proximal third of the humerus is fed by the anterior and posterior circumflex arteries of the axillary artery. They construct a fine anastomoses network at the humeral head as well as longitudinal anastomoses to the diaphysis. The middle third of the humerus is maintained by the rami musculoperiostales originating in both the brachial artery and the deep brachial artery. These periosteal vessels are formed both horizontally and vertically. The distal third of the humerus is mainly supplied by the horizontal anastomoses of the collateral arteries. The inner part of the bone is normally penetrated by just one nutrient artery entering the nutrient canal below the middle of the humerus.

Adult↗
PubMed1997

[Morphologic effect of adrenaline and insulin on bone capillaries after receptor blockade. Functional transmission electron microscopy analysis].

In three groups of six mice each, the alpha- and beta-receptors were blocked by phentolamine and propranolol. The mice in the three groups then received an intravenous bolus injection of saline solution, epinephrine, and insulin, respectively. Cortical bone capillaries from the tibia diaphysis were submitted to transmission electron microscopy (TEM). The lumen and endothelium were measured and the results compared. Significant changes were only noted in the endothelium after the administration of insulin. These findings suggest that there are also insulin receptors in bone. Furthermore, they support previous findings in similar studies with epinephrine.

Adrenergic alpha-Antagonists↗
PubMed1995

[Reactivity of cortical bone capillaries. Functional TEM analysis with adrenaline, ATP and insulin].

In order to study any morphological effects that vasoactive drugs might exert on cortical bone capillaries, Swiss mice received one intravenous bolus injection each of epinephrine, ATP and insulin. In one control group saline solution was injected and another was not treated. All animals were handled in the same way. A piece of the tibia diaphysis was resected and prepared for transmission electron microscopy (TEM). The lumina and the endothelia of capillaries were submitted to computerized morphometry. Some significant changes were noted: epinephrine increases both the width of the lumen and the endothelium. ATP decreases the endothelium. Insulin (hypoglycaemia?) thickens the endothelium. These finding suggest some physiological hypotheses: the epinephrine-induced widening of the lumen and the thickening of the endothelium might reflect a decreased extravasal space and oedema of cortical bone that might cause the diffusion of minerals to take longer. Intracortical perfusion pressure would then decrease and the bone perfusion rate increase. ATP might reduce the transcapillary diffusion time and increase the extravasal space in cortical bone. Apparently there are specific insulin receptors in cortical bone capillaries.

Adenosine Triphosphate↗
PubMed1993

[Plasma cell and sclerosing osteomyelitis. A follow-up of 21 patients].

Plasma cellular osteomyelitis was seen in the metaphysis while sclerosing osteomyelitis affected the diaphysis of long bones. In only about 20% of both forms local bacteria were noted. The onset of symptoms was inconspicuous and both clinical and radiological signs were nonspecific. Curettment or resection usually cured the disease. In some cases, however, aggressive surgery was necessary. As to surgery and outcome sclerosing osteomyelitis appeared less riskful than plasma cellular osteomyelitis. Both forms apparently represent the same basic pathological condition.

Adolescent↗
PubMed1992

Nickel-, chrom- and cobalt-concentrations in human tissue and body fluids of hip prosthesis patients.

The world-wide experience with millions of metallic implantations suggests the biocompatibility of modern alloys, commonly made of cobalt, chromium and nickel. There is, however, little information available on the internal metal exposure resulting from implants. In this study we assessed the metal concentrations in body fluids and tissue samples (muscle, bone) of patients who had undergone total hip replacement. Our patients were divided up into two groups. One group had firmly fixed implants two years after surgery. The other group had loose implants of the same Co-Cr-Mo alloy. Urine analyses revealed an increased renal elimination of nickel, chromium and cobalt. Cobalt and nickel exceeded the upper normal value. In serum the concentrations of nickel and chromium were normal or slightly elevated, the cobalt concentrations were significantly elevated. In some cases tissues adjacent to the implant showed extremely high concentrations of chromium and cobalt. This finding was also obtained in tissues that had no direct contact with the arthroplasty. The findings suggest that alloys of prostheses can undergo corrosion and release metal ions.

Aged↗
PubMed1988

Delta formation in foot polydactyly.

Congenital triangular deformity of the foot bones may occur in phalanges and metatarsals. As it resembles the Greek letter delta it is called "delta phalanx" and "delta metatarsal". We report on 19 delta formations in ten patients with foot polydactyly. Our long-term follow-up of these patients indicates four stages in the ossification process: no ossification of the epiphysis; appearance of single or multiple ossification centers; unification of the ossification centers with nonosseous tissue between the diaphysis and the epiphysis; and, finally, complete ossification. Pathogenetically, the delta formation may represent an intermediate stage in the bifurcation process of a polydactylic ray. Splitting longitudinally in a direction from distal to proximal, it is the root of the bifurcated toe ray.

Epiphyses↗
PubMed1987

[Ankylosing hyperostosis of the sternoclavicular joint].

The rarely occurring ankylosing hyperostosis of the sternoclavicular joints can be taken as a paradigm of chronic seronegative inflammation of tendinous insertion involving the capsular apparatus of the sternoclavicular joints. Etiologically uncertain erosions of the insertion lead to reparative ossifications. There are few symptoms but the course is protracted. If the condition cannot be arrested by anti-inflammatory drugs in its initial stages, there develops a progressive loss of sternoclavicular joint function. The case is described of a 66-year-old woman who has had the condition for 33 years. At wide intervals she has had severe pain. Electromyography a few years after biopsy gave an indication of mild irritation of the roots C 7 and C 8. Resulting from loss of function of the sternoclavicular joint the acromioclavicular joint was dislocated. No specific drug or surgical treatment has so far been necessary.

Aged↗
PubMed1987

Lateral mass fusion for lower back pain.

Forty patients who underwent Wiltse's lateral mass fusion by two different surgeons for spondylolisthesis or degenerative disc disease have been independently reviewed. It was found at follow-up (mean 22 months +/- S.D. 14 months) that factors that affected the final result were the age of the patient, the presence of preoperative nerve root symptoms, previous disc surgery, and incomplete fusion. The duration of symptoms, length of follow-up, preoperative spondylolysis, and the extent of the fusion did not appear to affect the result. This series confirms the previous reports that Wiltse's mass fusion is a good technique for relieving pain in the majority of patients.

Adolescent↗
PubMed1986

Fibrous dysplasia of bone and the Weil-Albright syndrome. A study of thirteen cases with special reference to the orthopaedic treatment.

Four patients with monostotic and nine with polyostotic fibrous dysplasia of bone, including one with the classical Weil-Albright syndrome and a male child who may have had this syndrome, are presented. While monostotic forms affect adults and are amenable to curative surgery, polyostotic involvement may become evident in childhood and early infancy, and represent a difficult therapeutic problem. Screening of the skeleton is essential for proper diagnosis and treatment, and should be achieved by total body scan in preference to a complete radiological survey. Biopsy is of particular importance in monostotic cases. The course of polyostotic fibrous dysplasia of bone is not predictable and depends partly upon the unassessable osteogenic potential of the bone, and also on surgery. The Weil-Albright syndrome and its variants are no worse than polyostotic fibrous dysplasia. Orthopaedic treatment deals with pathological fractures and with the prevention and correction of deformities, particularly of coxa vara. Sufficient stability of diaphyseal and metaphyseal lesions of the femur and tibia can usually be provided by intramedullary fixation, which needs to be left, or exchanged, at least until the end of adolescence. Extensive lesions of the proximal femur make aggressive surgery necessary. Pelvic involvement and destruction of the hip joint preclude surgery and require the use of calipers.

Adolescent↗
PubMed1986

The effect of sympathomimetic drugs on bone capillaries.

Mineral transport to bone is dependent on an adequate blood supply. Thus, the role of vasoactive agents merits orthopaedic interest. This paper outlines the morphology of osteons and capillaries in cortical bone and discusses the possible morphological effects of systemic phenylephrine on mice tibiae. The frequency of dilated capillaries on histological serial sections did not significantly change. Hence, a postcapillary mechanism is likely to explain previous EM findings: i.e., an adrenaline-induced increase of the lumen diameter and perivascular cell edema.

Animals↗
PubMed1986

Idiopathic hyperphosphatasia with dermal pigmentation. A twenty-year follow-up.

Hyperphosphatasia, or hereditary bone dysplasia with hyperphosphatasaemia, is a rare genetic disorder which is characterised by failure to transform woven into lamellar bone. Clinical, radiological and histological features establish the diagnosis, fractures, deformities, diffuse sclerosis on radiographs and high serum alkaline phosphatase being characteristic. We report the case of a 27-year-old man with follow-up at the same hospital for 20 years. Attempts at treatment with calcitonin and disocium etidronate (EHDP) failed, but stapling of the growth plates at the knee was successfully performed. Transverse "brittle" fractures of the humerus, lower leg and ribs healed normally, but internal fixation and late bone grafting were required for a subtrochanteric stress fracture of the femur at the age of 24 years. At present the patient has no clinical problems and leads a normal life.

Adult↗
PubMed1985

Instability of the cervical spine after anterior interbody fusion. A study on its incidence and clinical significance in 21 patients.

Twenty-one patients suffering from cervical spondylosis and peripheral symptoms underwent uncomplicated anterior interbody fusion of the cervical spine and were re-examined clinically and radiologically at 27 +/- 15 months (mean +/- SD) after the operation. Translatory displacement of the segment adjacent to the fusion level was noted in 14 patients. Its incidence could not be related to the age and sex of the patient, to extent of the fusion, or to postoperative time. Anterior slippage did not correlate with persistent or recurring pain.

Adult↗