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Biomedical subjects

S L Weinstein

Publications and source records attributed to S L Weinstein.

At least 91 records · Page 5Linked to original sources
PubMed1984

A long-term follow-up of Legg-Calvé-Perthes disease.

In an effort to define the impairment in hips affected by Legg-Calvé-Perthes disease, we attempted to contact 112 patients whose disease had been diagnosed between 1920 and 1940. Data were available on thirty-five patients with thirty-seven affected hips. The average period of follow-up was 47.7 years. Statistically significant correlations were found between clinical outcome (as measured by the Iowa hip rating and by the incidence of arthroplasty) and Catterall head-at-risk signs, femoral head-size ratio, and age at onset of the disease. The measurements of deformity, both femoral and acetabular, and the congruity of the articular surfaces did not change significantly with time. The Catterall classification alone did not correlate well with the clinical outcome. Fifteen affected hips in fourteen patients had undergone hip arthroplasty because of pain and dysfunction. Eleven arthroplasties had been done in the fifth or sixth decade of life and four (three patients), in the third or fourth decade.

Acetabulum↗
PubMed1983

Curve progression in idiopathic scoliosis.

One hundred and thirty-three curves in 102 patients who were followed for an average of 40.5 years were evaluated to quantitate curve progression after skeletal maturity and for prognostic factors leading to curve progression. Sixty-eight per cent of the curves progressed after skeletal maturity. In general, curves that were less than 30 degrees at skeletal maturity tended not to progress regardless of curve pattern. In thoracic curves the Cobb angle, apical vertebral rotation, and the Mehta angle were important prognostic factors. In lumbar curves the degree of apical vertebral rotation, the Cobb angle, the direction of the curve, and the relationship of the fifth lumbar vertebra to the intercrest line were of prognostic value. Translatory shifts played an important role in curve progression. Curves that measured between 50 and 75 degrees at skeletal maturity, particularly thoracic curves, progressed the most.

Adolescent↗
PubMed1983

Legg-Calvé-Perthes disease. Histochemical and ultrastructural observations of the epiphyseal cartilage and physis.

UNLABELLED: Biopsy specimens of the lateral aspect of the femoral head and neck were obtained from five children with Legg-Calvé-Perthes disease and were studied using histochemistry and electron microscopy. Beneath the normal articular cartilage there was a thick zone of hyaline (epiphyseal) cartilage containing sharply demarcated areas of hypercellular and fibrillated cartilage with prominent blood vessels. The fibrillated cartilage was strongly positive to alcian blue, weakly positive to periodic acid-Schiff, and positive to aniline blue. The interterritorial matrix in the hypercellular areas was weakly positive to both alcian blue and periodic acid-Schiff. Ultrastructural examination of these areas revealed many irregularly oriented large collagen fibrils and variable amounts of proteoglycan granules. These results suggest that in the fibrillar areas there are: (1) a high proteoglycan content, (2) a decrease in structural glycoproteins, and (3) a different size of collagen fibrils from that of normal epiphyseal cartilage. The hypercellular areas had a decrease in proteoglycans, glycoproteins, and collagen. The lateral physeal margin was often irregular, with a marked reduction of collagen and proteoglycan granules, and contained numerous large lipid inclusions. CLINICAL RELEVANCE: The abnormal areas in the epiphyseal cartilage of patients with Legg-Calvé-Perthes disease have different histochemical and structural properties from normal cartilage and from fibrocartilage. This suggests that the disease could be a localized expression of a generalized, transient disorder of epiphyseal cartilage that is responsible for delayed skeletal maturation. The cartilage lesions are similar to those seen in the vertebral plates in patients with juvenile kyphosis. Whether the epiphyseal cartilage abnormalities are primary or are secondary to ischemia remains uncertain; however, it appears that the collapse and necrosis of the femoral head could result from the breakdown and disorganization of the matrix of the epiphyseal cartilage, followed by abnormal ossification.

Cartilage, Articular↗
PubMed1982

Long-term follow-up of fascia lata transfer for the paralytic hip in myelodysplasia.

We evaluated the results of fifty-eight fascia lata transfers and anterior hip releases in thirty-three myelodysplastic patients with a minimum follow-up of 10.9 years. The procedure does not appear to achieve hip stability or prevent recurrent flexion deformity. Pelvic obliquity occurs secondary to scoliosis and results in increased instability of the hip on the high side and ischial decubitus ulcers on the low side. The degree of scoliosis and pelvic obliquity is related to the level of neural involvement. Similarly, ambulatory status is dependent on neural function and is not affected by instability of the hip.

Adolescent↗
PubMed1982

The sudden infant death syndrome and apnea/obstruction during neonatal sleep and feeding.

Respiratory observations made during nutritive feeding and a complete daytime nap within the first week of life on ten newborns who subsequently were victims of sudden infant death syndrome (SIDS) were compared with normative data based on 1,301 infants of comparable ages. Measurements were obtained of all apneic pauses and/or transient respiratory obstructive events at least two seconds in duration. A statistically significant increased number of future SIDS victims were found to have an unusual amount of apnea/obstruction episodes during nutritive feeding when compared with the normative group. Future SIDS victims, as a group, also had an increased frequency of apneic pauses during sleep. Furthermore, all SIDS victims demonstrated either an unusual amount of apnea/obstruction during nutritive feeding or apneic pauses during sleep. None of the airway obstruction measures during sleep differentiated the SIDS infants from the normative group. These results are consistent with the general hypothesis that prolonged apnea or airway obstruction is part of the pathophysiologic process resulting in SIDS and those hypotheses implicating unstable respiratory activity during sleep as well as apnea and pharyngeal/laryngeal dysfunction induced by liquid stimulation of the upper airway. They are also compatible with the growing body of evidence indicating that factors that predispose an infant to SIDS originate in the perinatal period.

Humans↗
PubMed1981

Tibial agenesis.

Tibial agenesis is a congenital defect involving major anomalies of both knee and ankle joints, as well as of the adjacent musculotendinous units. A neoarthrosis at the knee joint was formed in two patients by centralizing the fibular head into the inter condylar notch. A neoarthrosis was also formed at the ankle joint by performing a talectomy and displacing the lateral malleolus over the calcaneus. This allowed independent ambulation in both patients, thus avoiding arthrodesis or amputation.

Adolescent↗
PubMed1981

Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients.

Two hundred and nineteen patients with untreated adolescent idiopathic scoliosis who were seen at the University of Iowa between 1932 and 1948 were studied, and recent information was available on 194 of the patients. The mortality rate was 15 per cent. Backache was somewhat more common in these patients than in the general population, although it was never disabling. The backache was unrelated to the presence of osteoarthritic changes on roentgenograms. Many curves continued to progress slightly in adult life, particularly thoracic curves that had reached between 50 and 80 degrees at skeletal maturity. The lumbar components of combined curves between 50 and 74 degrees also tended to progress. Pulmonary function was affected only in patients with thoracic curves.

Adult↗
PubMed1981

A radiographic study of skeletal deformities in treated clubfeet.

Thirty-two patients with treated unilateral clubfoot deformity were followed for a period of 13 to 30 years. The functional results were satisfactory in 28 feet. A comparison of the skeletal features of the normal and the clubfeet was made on roentgenographs. Many clubfeet had small, slightly flattened talar heads, decreased talocalcaneal angles, undersized or misshapen facets of the subtalar joint, and medially displaced navicular. The residual deformity of the hindfoot was compensated by the lateral displacement and lateral angulation of the cuneiforms with respect to the navicular resulting in a normal alignment of the forefoot in relation to the hindfoot. The range of ankle dorsiflexion, subtalar and midtarsal joint motion was restricted in the clubfeet.

Adolescent↗
PubMed1980

The medial approach in congenital dislocation of the hip.

From January 1970 to January 1979, 50 hips in 39 patients were operated on for congenital dislocation of the hip at the University of Iowa. Each hip was evaluated for acetabular development, aseptic necrosis and subluxation; arthrograms were correlated with intraoperative findings. Aseptic necrosis occurred in two patients (5%). Intraarticular obstacles to reduction are described. Acetabular development progressed rapidly once concentric reduction was obtained. The medial approach provided a safe, effective way to reduce dislocated hips in infancy. We advocate this procedure when a concentric reduction cannot be obtained by closed manipulation or when the reduction is considered unstable.

Acetabulum↗
PubMed1979

Pentasomy X with multiple dislocations.

We describe a pentasomy X (49,XXXXX) patient whose multiple dislocations led to a consideration of the Larsen syndrome. Review of the 11 reported cases of pentasomy X showed that elbow dislocations are known to occur in this syndrome. Our patient is the first to present hypoplasia of the glenoid process with consequent should dislocation. Clinical and radiologic findings of previously reported cases of pentasomy X are reviewed.

Abnormalities, Multiple↗
PubMed1979

Congenital dislocation of the hip.

From January 1970 to December 1976, seventeen patients with twenty-two congenital hip dislocations were treated by open reduction through a medial approach. The average follow-up was 42.2 months. The patients were evaluated for acetabular development, aseptic necrosis, and intraoperative findings. The incidence of aseptic necrosis was 10 per cent. The acetabular index improved rapidly during the first year after reduction. After the first year the rate of development was decreased, but the acetabular index continued to improve throughout the period of study. The medial approach provides a safe, effective way to reduce a dislocated hip in infancy. This procedure is advocated when closed reduction cannot be obtained by gentle manipulation or maintained by positioning once reduction is done.

Acetabulum↗
PubMed1976

Evaluation of the two-stage flexor-tendon reconstruction in severely damaged digits.

From July 1971 to July 1974, the two-stage tendon-grafting procedure of Hunter and Salisbury was performed in thirty-two severely damaged digits in twenty-five patients. Of these digits, twenty-three fingers and five thumbs could be evaluated for gain in total active flexion (expressed as per cent of preoperative passive flexion) and for gain in total active motion (expressed as per cent of total preoperative passive motion) after follow-ups ranging from six to fifty months. The results for total active flexion were 60.9 per cent good, 21.7 per cent fair, and 17.4 per cent poor, and for total active motion 21.7 per cent good, 56.5 per cent fair, and 21.7 per cent poor. Complications were frequent after both stages and included infection, migration of the rod, and adhesions within the proximal end of the newly formed sheath. Flexion contractures were a significant problem.

Adolescent↗