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Biomedical subjects

S Dekel

Publications and source records attributed to S Dekel.

At least 37 records · Page 2Linked to original sources
PubMed1993

SAPHO syndrome.

Four women with pustulosis palmoplantaris (PPP) and associated sternocostoclavicular hyperostosis are described. The connection between the two diseases is not coincidental: it is encountered in 9.4% of PPP patients, and was reported in the French literature as part of the SAPHO (synovitis acne pustulosis hyperostosis osteomyelitis) syndrome. This syndrome is linked to the spondyloarthropathies, having an increased prevalence of HLA B27 and occurrence of sacroiliitis. None of our patients had HLA B27, but HLA A26 was found in the 3 patients examined. No conclusion can be drawn from this finding, however, since this antigen is found in 21.7% of Ashkenazi Jews. Recognition of this syndrome by dermatologists will improve diagnosis and treatment.

Acne Vulgaris↗
PubMed1993

The bone-cement interface: histological observations on the interface of cemented arthroplasties within the immediate and late phases.

Undecalcified specimens of cemented arthroplasties obtained during the early and late phases were studied. On the tenth postoperative day, there was excellent interlocking of the cement with the soft and hard tissues of the bone: there was no necrosis of the bed of the implant: a neutrophilic and macrophagic inflammatory response, where present, was mild and focal. Samples of the bone-cement interface of well fixed components obtained (at autopsy or by biopsy) many years after implantation revealed a thin and quiescent fibrous interfacial membrane alternating with bone and osteoid (that is, segmental osseointegration) or a cartilaginous layer abutting on the cement. It is concluded that, firstly, modern cementation techniques are not associated with extensive necrosis of the underlying bone in the immediate postoperative period; secondly, monomeric and polymeric methylmethacrylate as such is not toxic to the tissues; and, thirdly, acrylic cement is osseointegrated when motion at the interface is at its minimum.

Aged↗
PubMed1993

Levator scapulae syndrome: an anatomic-clinical study.

Twenty-two patients, all young females, presenting with a common clinical picture of pain over the upper medial angle of the scapula were studied. The dominant shoulder was the most commonly involved (82%). Pain radiated to the neck and shoulder, but rarely to the arm. Movements that stretched the levator scapulae on the affected side aggravated symptoms. Radiographs and bone scans of the shoulders and cervical spine were negative. Increased heat emission from the upper medial angle of the affected shoulder was found on thermography in more than 60% of the patients. Anatomic dissections of 30 cadaveric shoulders showed great variability in the insertion of the levator. A bursa was found between the scapula, the serratus, and the levator in more than 50% of the shoulders. This study suggests that this syndrome, leading to bursitis and pain, may be caused by anatomic variations of the insertion of the levator scapulae and origin of the serratus anterior. This may explain the constant trigger point and crepitation as well as the increased heat emission found on thermography. Local steroid injections relieved symptoms partially in 75% of those patients who underwent treatment.

Adult↗
PubMed1993

The release of cytotoxic drugs from acrylic bone cement.

The ability of cis-platinum, 5-fluorouracil, and methotrexate to leach out from various types of bone cements was examined in three different experimental systems: (1) in vitro release in physiological solution; (2) in vitro release in the presence of mouse fibrosarcoma cells; and (3) in vivo release in rabbits. The amount of drugs released was measured either spectrophotometrically by atomic absorption or by using tritium-labeled drugs. In vitro cement pellets were found to release these drugs slowly for up to six months; release was greater in the first few days, rapidly declining with time. Up to 6% of the methotrexate implanted leached out during the entire experiment. The figures for cis-platinum and 5-fluorouracil were much less: 3.3% and 3.4%, respectively. Palacos bone cement had the best leaching properties. The drugs leached out were also effective in reducing the numbers of viable mouse fibrosarcoma cells in tissue culture. In vivo, high levels of the drugs were recovered from blood drained from the operative wound of the rabbits, while very low levels of these drugs were found in the serum. Anticancer drug-loaded cement may be used effectively in the treatment of pathologic fractures and tumor surgery. This delivery method may reduce the side effects that result from systemic administration of such drugs.

Animals↗
PubMed1992

Radiological assessment of a modified anterior drawer test of the ankle.

Chronic ankle instability is a common complication of ankle sprain. The clinical assessment of ankle instability is usually incomplete and difficult to interpret. Recently, more attention has been paid to the value of the anterior drawer test of the ankle. We assessed the accuracy of a modification of the anterior drawer test, comparing it with radiological stress view of the ankle in 25 patients with recurrent ankle sprain. The radiological examinations were performed by a TELOS instrument and included lateral and anteroposterior stress views. We found that the modified anterior drawer test correlated with the posterior opening of the tibiotalar joint and with the lateral tilt of the talus. We conclude that a slightly positive modified anterior drawer test may indicate injury to the anterior talofibular ligament. A significant movement of the ankle elicited by the modified anterior drawer test may indicate combined injury to anterior talofibular and calcaneofibular ligaments.

Adult↗
PubMed1992

Carpal canal stenosis in men with idiopathic carpal tunnel syndrome.

The carpal canal and carpal bones of 14 male patients with idiopathic carpal tunnel syndrome and 26 normal male controls were examined by computed tomography. When compared with the controls, there was significant stenosis of the proximal part but not of the distal part of the carpal canal. Carpal canal stenosis is an important etiologic factor in the development of idiopathic carpal tunnel syndrome in males.

Adult↗
PubMed1991

Prostaglandin release by normal and osteomyelitic human bones.

The release of prostaglandin E (PGE) and prostacyclin (as 6-keto PGF1 alpha) by human osteomyelitic bone, compared with normal (control) bone, incubated in vitro was evaluated. Prostacyclin was the main arachidonic acid metabolite released by normal human bone, and similar quantities were released by osteomyelitic bone. However, PGE production was 5-30-fold higher in osteomyelitic bone, compared with control, thus becoming the major prostanoid in this disease. It is concluded that PGE production is probably involved in the inflammatory and/or bone resorption processes that occur in osteomyelitis.

6-Ketoprostaglandin F1 alpha↗
PubMed1991

Quadriparesis in the Laurence-Moon-Biedl-Bardet syndrome: case report.

A 36 year old patient known to suffer from the Laurence-Moon-Biedl-Bardet syndrome (LMBBS) developed spastic quadriparesis. The typical features of the syndrome, presented by this patient were polydactyly, obesity, hypogonadism, retinitis pigmentosa and relative mental retardation. Severe spinal cervical and lumbar canal stenosis imaged by plain X-rays and computerised tomography was found. Magnetic resonance imaging showed significant atrophy of the spinal cord, indicating that the cause of the quadriparesis was cervical myelopathy. The patient underwent laminoplasty with some improvement.

Adult↗
PubMed1990

Natural history of impacted subcapital femoral fractures and its relevance to treatment options.

A study of 123 patients with impacted, subcapital femoral fractures was undertaken to determine the natural history of this injury. It was found that the angle of the fracture, the degree of valgus and the degree of retroversion were without significant effect on the incidence of subsequent disimpaction. Age was important, with a 20 per cent incidence of disimpaction in patients over the age of 68 years. In patients younger than this the incidence was only 2 per cent. These results indicate that conservative treatment may be appropriate for some younger patients, but the advantages of this approach must be compared with the medical, social and economic benefits of early mobilization that the relatively simple operative procedure permits.

Age Factors↗
PubMed1990

Biochemical and biomechanical properties of avian callus after local administration of dihydroxylated vitamin D metabolites.

In vitamin D-fed chicks 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3 were implanted into experimentally-produced fractures of the mid-tibia. The mechanical and biochemical properties of the tibia were evaluated for two weeks, including torsion tests, measurement of alkaline phosphatase activity, 45Ca incorporation, and Ca2+ content. Both dihydroxylated metabolites of vitamin D3 had a direct effect on endochondral bone formation. 24,25(OH)2D3 strengthened the callus, and raised alkaline phosphate activity in the first seven days after fracture. 1,25(OH)2D3 decreased the strength of the callus concomitant with a reduction in 45Ca incorporation. It is suggested that local application of 24,25(OH)2D3 into fractures may accelerate healing and prevent non-union.

24,25-Dihydroxyvitamin D 3↗
PubMed1989

Fractures of the body of the tarsal navicular bone: case reports and literature review.

Four patients sustaining tarsal navicular body fractures are presented. Analysis based on these cases and on 36 patients suffering from identical fractures reported in the literature led to a new mechanical assumption: the axial compression on the foot, as a result of falling from height, causes impaction of the talus into the body of the navicular bone. The clinical followup results reported are usually disappointing. Favorable results are obtained in a vertical two-part fracture, by an open reduction and internal fixation of the tarsal navicular body fracture. In highly comminuted fractures, talo-navicular-cuneiform arthrodesis can be carried out.

Adolescent↗
PubMed1989

Ankle extensor tendon synovitis due to a date palm thorn.

Palm thorn injury to tendons and joints is characterized in most patients by an acute inflammatory stage followed by a relatively asymptomatic period and finally by chronic synovitis or tenosynovitis. Once the inflammatory process has begun, detection and localization of the thorn can be very difficult. We present an unusual case of palm thorn tenosynovitis of the ankle extensor tendon which was detected and localized preoperatively by ultrasound. Removal of the thorn and synovectomy were curative.

Adult↗
PubMed1989

Serum and bone vitamin D metabolites in elective patients and patients after fracture.

Vitamin D metabolite levels were measured in serum and bone samples obtained from 27 patients undergoing elective bony procedures and from 28 patients operated on after a fracture. Serum 25 hydroxyvitamin D3 (25-OH-D3) and 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) did not differ significantly between the elective and fracture patients, but serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) was significantly reduced in the fracture patients. Very little 25-OH-D3 was found in bone, although it was the major vitamin D metabolite in serum (90%). In elective patients bone levels of 24,25(OH)2D3 and 1,25(OH)2D3 were similar to those in serum; however, in bone from around pertrochanteric fractures, but not from subcapital or patellar fractures, the concentrations of these compounds were considerably increased. These findings may shed light on the mechanism of callus formation and on the role of vitamin D metabolites in bone healing.

24,25-Dihydroxyvitamin D 3↗