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Biomedical subjects

R Gaulke

Publications and source records attributed to R Gaulke.

14 recordsLinked to original sources
PubMed2004

Solitary enchondroma at the hand. Long-term follow-up study after operative treatment.

Twenty-one patients (17 women and four men) who underwent operative treatment for a solitary enchondroma of the hand were examined at a follow-up of between 2 and 18 years (mean, 9 years). Radiographs showed normal cancellous bone at the site of surgery in 11 cases, three had recurrent enchondroma and seven had bone defects so that recurrence could not be excluded. Two of the three recurrences underwent reoperation. Previous studies have regarded persistent bony defects as evidence of complete excision without recurrence. However, in view of the slow asymptomatic growth of this tumour this opinion is incorrect. As shown in this study, recurrences may occur in these defects many years after excision surgery and go undetected until they cause widening or cortical erosion. We recommend periodical radiological re-examination for asymptomatic recurrences before weakness of bone leads to pathological fracture.

Adult↗
PubMed2003

[Solitary tumorous muscular sarcoidosis (granulomatous myopathy) of the forearm extensors].

INTRODUCTION: Besides the lung and hilar lymph nodes, sarcoidosis may affect almost every other organ. Under the aspect of histology, non-caseating granulomas are normally found in sarcoidosis but also appear in connection with other diseases. Therefore some authors prefer the definition "granulomatous myopathy" in the case of solitary muscular affection as long as sarcoidosis is not found in at least two other organs. Others, however, speak of "solitary muscular sarcoidosis", if any other origin can be excluded. CASE REPORT: A 20-year old man mentioned a painless swelling in his left forearm. During a 6-year follow-up, intermittent growth with long intervals of inactivity could be ascertained. The diagnosis was supported by two biopsies within three years. Under oral therapy with prednisone the tumor decreased evidently. REVIEW OF LITERATURE: Out of 61 cases of tumorous sarcoid myopathy described in literature, only 9 lesions appeared in just one location. Three of these 9 showed no evidence of disease in other organs and referred to lower limbs of Japanese. As far as we know a unilocular solitary tumorous sarcoid myopathy of the upper limb has not yet been described. CONCLUSION: The tumorous sarcoid myopathy is mainly located between the muscle fibers. Therefore paralysis, atrophy and contracture is rarely discovered in this kind of sarcoid myopathy. It shows a slow "stop-and-go" progress and may spontaneously go in remission. The expected success of therapy is therefore to be carefully considered in every incidence in view of side-effects. Oral prednisone with an initial dose of 1mg per kg body weight per day seems to be the most effective therapy. A moderate dose reduction prevents recurrence.

Adult↗
PubMed2003

[Phlegmon of the forearm due to therapy with Anakinra (interleukin-1 receptor-antagonist)].

INTRODUCTION: Biological modifiers (BM) are very effective in a high percentage of patients with rheumatoid arthritis being resistant to disease modifying antirheumatic drugs (DMARD). In the beginning, the therapy with the BMs was thought to be of low risk. However, due to the increase of application, a few lethal septical complications have been reported. CASE REPORT: A 38 year old male with rheumatoid arthritis and insulin deficiency diabetes mellitus achieved remission under the therapy with Anakinra within three days. Due to a spontaneous disrupture of the finger extensor tendons operative revision was performed. A phlegmon from the dorsum of the hand to the cubita was found five months after resection of a septical cubital bursa. CONCLUSION: The very effective suppression of the immune system by the BMs should not lead to noncritical therapy in patients with history of infections of bone, joints and soft tissue, because inactive organism may start growing and lead to undetected lethal sepsis.

Arthritis, Rheumatoid↗
PubMed2003

[Sauvé-Kapandji procedure in destructive monarthritis of the distal radioulnar joint].

INTRODUCTION: Detructive monarthritis of the distal radioulnar joint (DRUJ) is rare. PATIENTS AND METHODS: Three patients with destructive monarthritis of the DRUJ were treated by arthrodesis in the technique described by L. Sauvé and M. Kapandji, modified by I. A. Kapandji. Prospective evaluation with a mean follow-up of 12 months was performed. RESULTS: After cast immobilization for 3 weeks and mobilization, bone healing was uneventful. All patients were completely free of pain. Even a painless "snap" at the end of the ulna was mentioned in all, if rotating the forearm with powerful grasp. Rotation of the forearm improved completely. Wrist motion also improved after arthrodesis of DRUJ but did not reach the range of motion of the unaffected hand. Irritation of the ramus dorsalis nervi ulnaris was found in one patient 9.5 months after arthrodesis and disappeared after removal of the screws. CONCLUSION: Arthrodesis of the DRUJ with distal segmental resection of the ulna seams to be an effective therapy for destructive monarthritis of the DRUJ after failed non-operative and joint-preserving operative treatment.

Arthritis, Rheumatoid↗
PubMed2002

The distribution of solitary enchondromata at the hand.

The location of 327 solitary enchondromata of the hand reported in the English and German medical literature and 30 solitary enchondromata treated at our hospital was studied. Four were located in the carpus, 70 in the metacarpals and 283 in the phalanges. There were highly significant preferences for involvement of the proximal phalanges and the little finger ray. The proximal phalanx of the little finger was the most commonly involved bone.

Bone Neoplasms↗
PubMed2001

[The Extensor Pollicis et Indicis: An Accessory or Rudimentary Deep Extensor Tendon to the Thumb? Variants - Frequency - Clinical Relevance].

PURPOSE/BACKGROUND: Are the supernumerary deep extensor tendons to the thumb in man of accessory or rudimentary origin? METHOD AND CLINICAL MATERIAL: Two findings of extensor pollicis et indicis (EPI) were classified referring to the literature of comparative anatomy. RESULTS: Extensor pollicis longus (EPL) and extensor indicis (EI) developed phylogenetically from EPI. A common origin and proximal muscle belly of EPL and EI is a frequent manifestation of incomplete rudimentary EPI. A complete rudimentary EPI with absent EPL and EI has not yet been found in man. The accessory EPI coexisting with EPL and EI occurs in about 2 % of humans. CONCLUSION: During the EI-tendon transposition to EPL, the tendons must be identified very carefully because of the numerous variants of the deep extensors. Transposition of extensor digitorum communis of the index or just one tendon of a double-tendoned EI to EPL by mistake, will make separate extension of the thumb impossible postoperatively.

Arthritis, Rheumatoid↗
PubMed1998

[Considerations of biomechanics after clavicular resection. Case report of rower with Ewing sarcoma].

Because of poorly compartmentalized paraclavicular soft tissues, total extraperiostal claviculectomy in cases of malignoma with cortical destruction is always marginal. Due to different muscular compensation in the patients examined, literature disagrees on the biomechanical consequences of claviculectomy for the shoulder girdle. We present a case of total clavicula resection including chemotherapy and radiation in an 18-year-old rower with Ewing's sarcoma. Sixteen-month postoperative radiological and clinical examination revealed an excellent result. Thirty-six months postoperatively the patients is able to row symptom-free without any evidence of the disease. Biomechanical reflections on the significance of the trapezius muscle in compensating thoracoscapular instability provide information for rehabilitation.

Adolescent↗
PubMed1997

["Secondary" chondrosarcoma of the hand. Case report and review of the literature].

Rapid growth of a painful and often recurrent bone tumor of the hand, is suspicious of low malignant chondrosarcoma, even despite previous histological identification as an enchondroma. The difficulty of differential diagnosis of enchondroma and chondrosarcoma is demonstrated in two cases and discussed in a review of the literature.

Adult↗
PubMed1995

Serum protein and erythrocyte enzyme polymorphisms in twelve population groups of Hungary.

The distribution of the serum proteins C3, TF, HP, GC, BF, AMY2, PLG, GM, and KM and the erythrocyte enzyme polymorphisms GLO, GPT, ESD, ACP, 6-PGD, ADA, AK, PGM1 and PGP amongst twelve population groups in Hungary was investigated. Gene frequencies and genetic distances are discussed in relation to the present geographical locations of these groups and their probable history of migration.

Alleles↗
PubMed1994

[Follow-up and gait study in patients with plastic-surgery-treated foot sole defects].

A long-term follow-up study on 20 patients with soft-tissue coverage of sole defects analysing "sensitivity", "stability" and "function" is presented. The dynamic motion of walking was recorded using an EMED sensor plate. Patients with free flap coverage of the sole only walk over the remaining original plantar skin if at all possible. Patients with transposition flaps, however, were found to have normal gait motion. In spite of these results, the better stability of free flaps than split-thickness skin grafts and the high acceptance by the patients makes the free neurovascular forearm flap a good donor for larger sole defects not suitable for transposition flaps. A new scoring system for free flaps on the sole of the foot is proposed.

Adult↗
PubMedDate not supplied

[Bursitis tendinis calcanei in extensive calcaneus erosion].

INTRODUCTION: Mechanical and static stress as well as rheumatic diseases may cause retrocalcanear bursitis. Anatomic variants of the calcaneus predispose to this bursitis. CASE: A 51-year-old woman being afraid of operation waited 2 years before undergoing bursectomy al her right heel. For this reason the increase of calcanear bone loss and its stabilisation by sclerosis is well documented in X-rays and MR images. A secondary synovialitis of the peroneal tendons decided completely after bursectomy. No signs of rheumatic disease were found. CONCLUSION: The radiological, clinical and hisiological findings in long-persisting bursitis are often simular to those found in patients with rheumatic disease. Normal laboratory findings do not preclude an early stadium of rheumatic disease. For this reason, these patients had to be instructed to return if they develop further synovialitis to verify the diagnosis and to avoid delayed therapy.

Bursitis↗
PubMedDate not supplied

[Spontaneous bilateral fractures of the femoral neck. Etiology-frequency-diagnosis-therapy].

INTRODUCTION: Medial and pertrochanteric fractures of the femoral neck occur commonly in patients with bone weakness due to osteoporosis or osteomalacia. Combined bilateral hip injury is much rarer. PATIENTS AND METHODS: The case of a Turkish woman with bilateral fractures of the femoral neck due to secondary hyperparathyroidism caused by nutritional vitamin-D 3 deficiency is described and compared to 80 cases of bilateral hip fractures mentioned in English and German literature. RESULTS: Until the late 1950's the most common reason for simultaneous bilateral femoral neck fractures was convulsive therapy of psychosis by drug or electroshock without use of relaxants, followed by seizures of other origin. Primary and secondary bone diseases are the most common reason for two-fold spontaneous bilateral fractures of the femoral neck. CONCLUSION: At the time of first pain radiological findings are often normal. In this situation MRI, isotope bone scanning or additional chemical diagnostics have proved to be useful. The medical regulation of the bone disease is of highest priority. On account of the pain, bone stability and deformation, conservative and operative therapy such as osteosynthesis or THR has to be performed.

Adult↗