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Biomedical subjects

R Lampe

Publications and source records attributed to R Lampe.

15 recordsLinked to original sources
PubMed2005

[Chronic radiculopathy. Use of minimally invasive percutaneous epidural neurolysis according to Racz].

Treatment of chronic low back pain exhibiting radicular symptoms poses a clinical problem that has not yet been solved. The technique of percutaneous minimally invasive neurolysis described by Racz is being performed increasingly to treat chronic radiculopathy. A total of 61 patients with corresponding symptomatology after screening for inclusion and exclusion criteria in the region of the lumbar spinal nerve were treated with the Racz catheter technique. Distinct clinical improvement was observed at the 3- and 6-month follow-ups after percutaneous minimally invasive epidural neurolysis. Subjective pain perception, quantified by the McNab score, clearly improved after 3 as well as 6 months. With the exception of partial catheter shearing in two cases and one occurrence of infection, no relevant side effects were noted. The Racz catheter technique for treatment of chronic radiculopathy following disk surgery is suitable with minimal side effects.

Analgesics↗
PubMed2003

[Leading symptom elbow pain. Differential diagnosis].

Pain affecting the elbow joint may be caused by a number of different pathologies. In principle, these can be grouped by causality criteria into degenerative causes, inflammatory causes, tumor disease, congenital disease and the sequelae of trauma. The majority of these latter are associated with typical clinical symptoms that can be established with the aid of a systematic clinical examination, history-taking, inspection, palpation, an examination of joint mobility, and finally radiography. In this way, the diagnosis can rapidly be established.

Arthritis↗
PubMed2003

[Congenital clubfoot].

Owing to the relatively high incidence of this condition (2 in 1,000 neonates) and the poor functional outcome of inadequate treatment, clubfoot represents a major clinical problem. Although its etiology is not fully known, modern three-dimensional analyses have led to a better understanding of the pathomorphology and provide a new basis for a differentiated therapeutic strategy. Of central importance is early diagnosis and immediate postpartum initiation of primarily conservative treatment taking the form of intensive redressment measures. Depending on the residual deformity, an appropriate surgical procedure aimed at achieving complete correction should be done between the age of 4 to 6 months. To ensure a lasting positive outcome, rigorous follow-up physiotherapeutic treatment and close surveillance are essential.

Age Factors↗
PubMed2003

[Minimally invasive percutaneous epidural neurolysis in chronic radiculopathy. A prospective controlled pilot study to prove effectiveness].

The treatment of chronic back pain with sciatica is still an unsolved therapeutic challenge. Percutaneous minimally invasive neurolysis according to the Racz technique is increasingly applied and discussed controversially. So far there is no prospective randomized controlled study for evaluation of a possible treatment effect. In a prospective pilot study, 25 patients with monosegmental radiculopathy of the lumbar spine were treated with minimally invasive percutaneous epidural neurolysis according to Racz's technique. They all suffered from chronic disc herniations or failed back syndromes after surgery, all with radiculopathy. The average age of the patients was 51+/-16 years, the average duration of the symptoms was 28 months. Twelve weeks after the procedure patients had significant clinical improvement. The Oswestry score increased from 64+/-17 to 22+/-12 points. Subjective pain sensation according to the McNab score showed improvement too. None of the patients had worsening of the situation compared to preoperative findings. No clinically relevant complications were observed. The results are being used to design a clinical trial in accordance with good clinical practice guidelines to analyze the therapeutic efficacy of the procedure. The described technique is still a clinically experimental procedure. However, due to a low probability of side effects and due to the good results reported so far by most authors, the Racz catheter technique may be applied in certain patients with chronic radiculopathy refractory to conservative treatment.

Anesthesia, Epidural↗
PubMed2000

Reestablishing Naturally Functioning Dunes on Developed Coasts.

/ The potential for reestablishing dune habitat is investigated in municipalities in New Jersey, USA, where natural coastal landforms and biota have been eliminated or reduced in extent. Dunes are classified using width, relationship to natural and cultural features, and changes through time, and they are assessed for their value as naturally functioning landforms in developed municipalities. The relationship between size and longevity that exists under natural conditions is altered by human activity. Small dunes on privately owned lots can survive as long as larger dunes in natural areas that are located farther inland, and foredunes repaired using sand fences and earth-moving equipment can survive where they could not under natural conditions.Common beach management practices reduce the ecological values of coastal dunes. Mechanical beach cleaning eliminates incipient dunes, habitat for nesting birds, seed sources for pioneer dune colonizers and food for fauna, and artificially small, stabilized foredunes reduce the variability in microenvironments necessary for biodiversity. Recent initiatives for reducing coastal hazards, protecting nesting birds, and encouraging nature-based tourism provide incentive for the development of a restoration program for beaches and dunes that is compatible with human use. Suggested changes in management practice include restricting or rerouting pedestrian traffic, altering beach-cleaning procedures, using symbolic fences to allow for aeolian transport while preventing trampling of dunes, and eliminating or severely restricting exotic species. Landforms will be more natural in function and appearance but will be more dynamic, smaller and in a different position from those in natural areas. Research needs are specified for ecological, geomorphological, and attitudinal studies to support and inform restoration planning.

Journal Article↗
PubMed1991

The pediatric program director. An analysis of the role and its problems.

A questionnaire designed to elicit information about the work environment, knowledge, and stresses of pediatric residency program directors was mailed to the 235 member programs of the Association of Pediatric Program Directors (APPD). At the time that the 187 respondents (80% return rate) assumed responsibility for their training programs, many rated their knowledge of various aspects of residency program administration as "poor." The respondents indicated that a lack of time, the pressures of too many other academic responsibilities, and a fear of not "filling" all positions in the National Intern Matching Program created much personal stress. Most program directors felt that educational conferences designed to teach educational methods, and administrative skills, and provide technical information knowledge necessary for residency program supervision would be beneficial.

Adult↗
PubMed1986

Cortical projections originating from the cat's insular area and remarks on claustrocortical connections.

The cortical projections originating in the cat's insular cortex and claustrum were investigated with the aid of the horseradish peroxidase retrograde tracing technique. Twenty small injections of horseradish peroxidase were distributed along lateral and medial regions of the hemisphere. Labeling in the insular cortex occurred following all injections except those six situated along the lateral gyrus--that is, within the visual cortex. In the claustrum labeled neurons were found following all injections, except following the injection situated in the posterior temporal area. Claustral labeling was frequently more intense than insular labeling. The injections into the occipital cortex that revealed no insular innervation nevertheless received a considerable number of claustral projections. As the insular cortex itself receives at most a minor projection from the claustrum the differing cortical projection patterns of insula and claustrum have to be considered unrelated. Our findings confirm the view that the claustrum projects to most regions of the cerebral cortex; these projections are at least in part topographically organized. A topographical pattern can also be constructed for the insular cortex, though it is less stringent than for the claustrocortical connections. Both the afferent and efferent connections of the insula show similarities to those of the prefrontal cortex. Nevertheless, the insula differs in that it receives strong input from the sensory associative nuclei of the thalamus. Consequently, and in line with behavioral observations following its ablation, we consider the insula as involved in the temporal structuring of perceived patterns.

Animals↗
PubMedDate not supplied

[Calculation of hallux bending moments from plantar pressure distribution measurement].

PURPOSE: The following study aims to demonstrate the bending stress on a hallux valgus during normal gait. The bending axis was related to the position of an open wedge osteotomy. The moments were calculated from plantar pressure measurements. METHOD: In the gait analysis laboratory plantar pressure distribution measurement was done with healthy adult volunteers during barefoot gait. From the plantar pressure distribution the vertical forces were derived just for the region hallux metatarsal I. The following calculation of the bending stress regarding to the hypothetic region of the osteotomy was done by integrating the pressure distribution multiplicated with the distance to the osteotomy. The measurements are compared with theoretical values derived from the anatomy of the foot under some plausible assumptions. RESULTS: The results of the mean values of the bending stress were 15.8 +/- 4.8 Nm for the female subjects and 21.6 +/- 5.6 Nm for the male subjects. The amount of the bending moments depended with low significance on the weight. More important is the individual type of gait. CONCLUSION: The measurements show the size of bending stress the plate stabilizing the osteosynthesis has to resist under unfavorable circumstances (for example if the plantar foot muscles are not adequately activated) and if no external stabilization (for example, cast) is used.

Adolescent↗
PubMedDate not supplied

[Using the gait laboratory for the investigation of orthopaedic clinical problems in children].

AIM OF THE STUDY: We point out multiple applications of a gait laboratory in solving different problems in the children's orthopaedic field. With typical examples we show how biometrical data of the gait laboratory can be helpful to solve problems in orthopaedic examinations. MATERIAL AND METHOD: The range of questions to be solved in the gait laboratory differs from individual diagnostic examinations of a patient up to the control of devices in the functional use at the patient. As a typical example for the individual examination we show the gait analysis in a 14-year-old girl with idiopathic chondrolysis of the hip joint. The functional use of orthopaedic devices will be shown in youths with neuroorthopaedic diseases. As a very special question to the gait lab we describe the supply of children and youths with optimal sport shoes for running. RESULTS: The biometrical measurement techniques generate exact data to solve individual diagnostic and therapeutic questions. Orthopaedic devices can be tested in their functional efficiency and quality. Special questions can be answered very flexible. CONCLUSION: Diagnosis and therapy in orthopaedics and children's orthopaedics rely on exact data. However, details of the dynamics during movement are neither visible to the most experienced orthopaedic surgeon nor can they be documented by conventional diagnostic imaging procedures. The present technical potential of biometric assessment methods allow to precise and correct some empirical knowledge, they open a wide field of new applications in diagnostic and therapeutic examinations.

Adolescent↗
PubMedDate not supplied

[Plantar pressure measurement in children and youths during sports activities].

The aim of this study was to consider whether changes occur in the foot area while under repeated physical stress and if they are age related. In addition it interests what consequences this might have in regard to proper shoe wear. The subjects for this study consisted of 15 children and youths aged between 4 and 16 years. The plantar pressure distribution and vertical ground reaction forces were measured before and after physical exercise. The subjects first ran a given distance wearing sport shoes, had a rest and then ran the same distance barefoot. The results showed marked age related differences after exercise. The pressure values were increased in all of the youths in the middle foot region. In comparison young children always exhibited an unbound gait pattern without any dynamic foot roll during heel strike or toe-off. The forefoot had ground contact from the beginning of the stance phase. To compensate for the lack of dynamic foot roll it is recommended that children wear a shoe with a soft sole and with sufficient space for toe movement. The sports shoe for youths should grip the heel and support the longitudinal arch to prevent an incorrect weight distribution.

Adolescent↗
PubMedDate not supplied

[Calculation of functional kinetic parameters from the plantar pressure distribution measurement].

PURPOSE: The aim of this study was the development of a simple procedure to calculate functional kinetic parameters from the plantar pressure distribution measurement which is used in many orthopaedic practices and clinics as a standard measurement device. The special purpose is the comparison of functional parameters between datasets taken before and after a surgical operation, for example the correction of a hallux valgus. METHOD: In the gait laboratory, pressure distribution measurements were recorded from healthy test subjects and patients with different foot diseases. The test subjects walked barefoot over the measurement plate which is integrated in a gangway. The device records a "movie" of the pressure distribution in the unrolling of the foot. It takes 72 pressure distribution pictures per second. By integrating the pressure over all segmental areas, i. e., pressure distribution picture for pressure distribution picture, the temporal progress of the total ground force can be calculated. By integration of the pressure only over a certain part of the foot, the ground force on that certain anatomic structure can be calculated, for example, the ground reaction force upon then hallux. By integration of the pressure over the same segmental areas considering their lever distance to the axes of the ankle joint, the external joint moment can be calculated. For this, the musculature of the lower leg must generate an internal moment, which exactly compensates the external moment. RESULTS: In the case of a correction of a hallux valgus, the percentage of the total external moment with regard to the upper ankle joint can be measured which is taken on by the hallux and metatarsal I. This allows us to verify a functional improvement through the operative treatment. With patients after one-sided injuries of the foot and ankle joints, the functional success of a treatment can be quantified by means of a comparison of sides, for example, after a fracture of the calcaneus. CONCLUSION: The determination of muscular ankle joint moments from the pressure distribution measurement improves the objectivity when reviewing the functional success of a therapy in different orthopaedic or surgical interventions at the foot and ankle joint.

Algorithms↗
PubMedDate not supplied

[Treatment of congenital tibial pseudarthrosis using a free vascularized fibula transfer and plate osteosynthesis. Case report].

Congenital pseudarthrosis of the tibia is a rare disorder of unknown etiology. The free vascularized fibula-pro-tibia-transplant permits correction of the defect and the leg length-discrepancy during one surgical procedure. A 5 year old girl with congenital pseudarthrosis underwent a free vascularized fibular-pro-tibia-transplant. At a follow-up examination 5 years post surgery she had no subjective complaints, she walked without external orthopaedic support, there was no leg length-discrepancy. As stated in the literature the rates of bony unions are much higher than after conventional methods.

Bone Plates↗
PubMedDate not supplied

[Recurrent Perthes disease in a 6-year-old boy].

Two episodes of avascular necrosis in the same femoral capital epiphysis have been reported in Gaucher's disease and in six cases of Legg-Calvé-Perthes disease. The present case report is an additional example of a recurrent avascular necrosis in a six years old boy two years after complete healing of the first occurrence had been documented clinically and radiologically.

Bone Wires↗
PubMedDate not supplied

[Protrusion of a calcified cervical intervertebral disk in a 5-year-old boy].

Herniation of the calcified nucleus pulposus is a complication of intervertebral disc calcification. The herniated nucleus pulposus may assume an intraspinal location which may lead to cord compression and produce alarming neurological symptoms and radiographic images. Surgical intervention is, however, rarely necessary as complete resorption of the calcified disc material will generally occur. We report the case of a five years old boy with the symptoms of an acute tortcollis, radiographs of the cervical spine revealed calcification of C5/C6 intervertebral disc and MRI narrowing of the spinal canal. With conservative treatment his symptoms resolved within three weeks, three months later X-rays and MRI showed complete resolution of the calcification and herniation.

Calcinosis↗