Biomedical subjects
Publications and source records attributed to L Meiss.
To date, only one patient with spinal affection of Gaucher's disease requiring surgery for spinal compression has been reported. We present an additional case with extensive affection of three consecutive vertebral bodies, and present a review of the literature relating to the management of therapy and follow-up of this disease.
In a 49-year-old woman with dysphagia diagnostic endoscopy revealed a mass directly dorsal to the esophagus. CT showed an aberrant right subclavian artery being the cause of her swallowing problem: dysphagia lusoria.
The language spoken by orthopaedic surgeons is filled with eponyms. In orthopaedics, perhaps more than any other medical specialty, we speak cryptically to one another using code words and other secret language. Certain hyphenated eponyms are of particular interest because they pique one's curiosity as to how these people came to be partners in orthopaedic history. In this paper, we offer some bits of orthopaedic hyphenated-history, outlining the pertinent work of Theodor Kocher and Bernhard von Langenbeck, as well as associated background information. These two surgeons are linked through a common hyphenated eponym in orthopaedic surgery: the Kocher-Langenbeck surgical approach, a well-known posterior approach to the proximal femur and acetabulum.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Ehlers-Danlos Syndrome Type VI (EDS VI) is a rare autosomal recessively inherited connective tissue disorder, which poses several problems of diagnosis and management. We report on a patient who developed severe kyphoscoliosis long before the diagnosis was reached. We conclude that early biochemical diagnosis and a timely operative procedure by extensive posterior instrumentation is the basis for successful management of this disorder.
Atherosclerosis is common in the adductor hiatus region. The aim of this study was to evaluate atherosclerosis in relation to themorphological structure of the femoropopliteal region. Two anatomic features are thought to play an important role in the origin of these lesions: (1) curvature of the vessel, which may lead to unfavorable local hemodynamic factors that change during leg flexion; and (2) abrupt changes in stiffness of surrounding tissues of the vessel. The distal part of 23 postmortem femoral arteries were investigated. Cross sections were obtained every 1 mm over a length of 100 mm. For each cross section, lesion thickness was measured at 12 points along the circumference of the vessel. No apparent relation was found between surrounding structures of the femoral artery and location of atherosclerotic lesions. Three-dimensional reconstructions showed that atherosclerotic lesions were spiraling through the artery in 18 of 23 cases. Spiraling atherosclerotic lesions may be consistent with expected flow patterns in this part of the femoral artery.
We report the cases of 28 patients with bacterial infections of the shoulder treated between 1979 and 1991. There were ten cases of septic arthritis, ten cases of simple osteomyelitis of the proximal humerus, four cases of septic arthritis and concomitant osteomyelitis of the proximal humerus and four cases of periarticular soft-tissue infection. The infections, except for the cases of osteomyelitis, were staged by a "Classification of Exogenic Bacterial Infections" (CEBI). In septic arthritis and in periarticular soft-tissue infection, the time between the initial symptoms of infection and diagnosis was about 20 days. In the cases with osteomyelitis, there was an average delay of 9 months, which was partly due to the slow evolution of plasmacellular osteomyelitis. Treatment was based on operative debridement and arthrotomy, the insertion of drains, the implantation of gentamicin-polymethylmethacrylate beads and the application of high-dose parenteral antibiotics. In the postoperative period physiotherapy with early active and/or passive range-of-motion exercises favoured the draining of secretions and therefore gave better results than complete immobilisation. Treatment was evaluated using a modification of the shoulder score of Wülker et al. [17]. This study demonstrated that favourable results could only be obtained if the diagnosis was made early. This is particularly true for infections with Staphylococcus aureus (found in 19 patients). The overall result of the treatment of osteomyelitis and periarticular soft-tissue infection was good or satisfactory, while unsatisfactory results were noted for the patients with septic arthritis, particularly those with both septic arthritis and osteomyelitis.
Explore the source record for details and available documents.
PURPOSE: Evaluation of imaging quality and safety of iobitridol 300 compared to iohexol 300 in urography. MATERIALS AND METHODS: 180 patients were included in an urography multicenter study (3 centers, 60 patients in each). RESULTS: There was no significant difference in either the imaging quality or the clinical safety between the 2 contrast media groups. CONCLUSION: Iobitridol is a safe and efficient contrast agent in urography.
We report on a rare disease called to Anquin's disease or spinous engagement or impingement syndrome. Low-back pain in this specific syndrome probably combined with sciatica is caused by a hypertrophic spinous process along with a spina bifida occulta of the underlying vertebra. Mostly, the enlarged spinous process is seen at L5 and the spina bifida occulta at S1. Conservative therapy consists of physiotherapy with postural exercises including improvement of lumbar flexion. If conservative treatment is unsuccessful, surgical treatment is indicated. Surgical therapy should include resection of the hypertrophic spinous process, probably combined with revision of the nerve roots and division of adhesions. Between 1981 and 1993 six patients were treated surgically after long-lasting periods of conservative therapy. All patients were re-examined clinically and radiologically after a mean follow-up period of 2.9 years. In all but one patient a distinct release from lumbar back pain and/or sciatica was observed. Regarding this, the most important fact in de Anquin's disease is to be aware of this specific syndrome. If low-back pain can be traced to a hypertrophic spinous process the first choice of therapy should be conservative. In unsuccessful cases simple surgical resection probably combined with division of the adhesion can lead to significant release from pain and is recommended.
RATIONALE AND OBJECTIVES: The application of various high-resolution (< 100 microns) imaging techniques for in vitro bone mineral analysis is explored. METHODS: The techniques of contact microradiography and microtomography, using the x-ray spectrum filtered out of synchrotron radiation (SR) and conventional staining techniques, are compared to each other by presenting a variety of different samples. The relationship between radiation exposure and spatial resolution micro-computed tomography (CT) images of a finger bone is explored. The relevant properties of SR are explained. RESULTS: In CT images, a spatial resolution of 100 microns was obtained. New bone mineral induced by mechanical periosteal irritation in a rabbit tibia was quantified. In one case a microradiogram and a microtomogram of the same slice were taken for comparison. Histologic sections and microradiograms taken from a specimen of a human femur for comparison are presented. CONCLUSIONS: Microradiography and staining techniques require rather sophisticated sample preparation; quantitative image analysis is more difficult as the resulting image must be digitized. The CT technique requires almost no sample preparation and allows for accurate bone mineral quantification. However, CT images with a resolution of several microns limit the sample size to a few mm. Micro-CT and microradiography can be performed with conventional x-ray sources, but the use of SR is of particular interest in high resolution imaging, because its white spectrum allows for optimum x-ray energy selection and its high intensity for short scan times.
Colony breeding records were analyzed in order to obtain information on pre- and neonatal survival in chimpanzees. Biweekly urinary chorionic gonadotrophin testing appeared suitable for determining pregnancy age. The probability of pregnancy termination was low (0.008 per 10 days) to a pregnancy age of 180 days. Between the ages of 180-210 days it was 0.080 per 10 days, and it steadily increased to one per 10 days after 240 days of age. There were no livebirths before 190 days of pregnancy age. Thereafter, the probability of a delivery to be a livebirth rapidly increased to about 0.90 after 210 days of pregnancy age. Infant mortality was less than 0.026 during the first two years of life.
By repeated measurements in each of ten normal subjects and ten patients with mild intermittent claudication, the performance of three transcutaneous oxygen tension (PtcO2) test in the diagnosis of obliterative peripheral arterial disease was studied. PtcO2 resting value, PtcO2 response to oxygen breathing and PtcO2 reperfusion response after tourniquet obstruction were all measured on the dorsum of the foot. We found that PtcO2 resting values were not different between patients and controls, while responses to 100% oxygen breathing and reperfusion responses differed significantly between the two groups. The most prominent difference between the two groups was observed in the latency of PtcO2 rise after reperfusion. Therefore the reperfusion response test may have a place in the assessment of claudication by PtcO2 measurement.
Besides the known cardiovascular effects of hemorrhagic shock, regular metabolic consequences can be demonstrated in the rabbit: 1. The rise in blood sugar in hemorrhagic shock increases with the amount of blood withdrawn per unit of time. 2. The characteristic rise in blood sugar lasts longer than the phase of the partial exsanguination. 3. In traumatic shock, the rise in blood sugar indicates the degree of severity of the injury earlier than the fall in blood pressure does. The rise in blood sugar is attributable to a reflex increase in glycogenolysis due to catecholamine secretion elicited via baroreceptors in hemorrhagic shock. For the pronounced rise in blood sugar in traumatic shock, an additional receptor is postulated. Supplementary investigation of the blood sugar may possibly enable the extent of the injury to be diagnosed earlier in traumatic shock, and the negative sequelae may be reduced by timely, adequate therapy.
A modified surgeon's knot is proposed. Tying is based on twisting the throws instead of laying them down flat. The second (granny) throw is snugged against the first in a locking manner. The knot is tied rapidly by needleholder and is particularly useful for skin sutures with monofilament thread.
Explore the source record for details and available documents.