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Biomedical subjects

V Katz

Publications and source records attributed to V Katz.

At least 19 recordsLinked to original sources
PubMed2003

[GUEPAR radial head prosthesis for recent and old fractures: a series of 22 cases].

PURPOSE OF THE STUDY: We reviewed retrospectively outcome in 22 patients with recent or old fractures of the radial head treated with a GUEPAR radial head prosthesis. This prosthesis, derived from the GUEPAR sliding total elbow prosthesis, has a cemented mobile metal cup. MATERIAL AND METHODS: Eighteen patients underwent emergency surgery, four deferred surgery. Mean age at surgery was 41 years and mean follow-up was 18 months. The Mayo Clinic score was calculated to assess clinical outcome. Static and dynamic x-rays of the elbows and wrists were analyzed. All of the fractures were total or displaced head fractures and 72% involved elbow dislocation. The coronoid process was fixed in one patient, the olecranon in one and the medial ligaments were repaired in 5. The quality of the cartilage of the humeral condyle was checked before insertion of the prosthesis. Proper position and height of the prosthesis were carefully controlled. RESULTS: There were no complications. Outcome was good in the patients who underwent emergency surgery with a mean Mayo Clinic score of 83/100, mean force 75%, good joint motion (77 degrees pronation, 79 degrees supination), stable elbow, and no wrist problems. Outcome was not as good in patients who underwent deferred implantation, particularly for joint motion (pronation 44 degrees, supination 54 degrees ). The distal radio-ulnar ratio was not perfectly restored. Finally 4 patients required arthrolysis for limited flexion/extension, proportionally more among the deferred patients. DISCUSSION: Resection of the radial head is an alternative in case of complex fractures. There are two drawbacks. The first is an unstable elbow in valgus if the medial ligaments are damaged. The second is an ascension of the radius if the interosseous membrane is damaged. Osteosynthesis is another alternative which is difficult to achieve and does not give good results (in our experience in comparison with 20 equivalent fractures, and in the literature). The GUEPAR radial head prosthesis appears to be a good solution. It stabilizes the elbow, prevents ascension of the radius, allows early rehabilitation, and provides good subjective results, particularly after emergency surgery.

Adult↗
PubMed2001

The association of abnormal alpha-fetoprotein and adverse pregnancy outcome: does increased fetal surveillance affect pregnancy outcome?

OBJECTIVE: Our purpose was to investigate whether adverse outcomes associated with elevated maternal serum alpha-fetoprotein levels may be prevented by intensive antenatal monitoring. STUDY DESIGN: Records of patients with elevated maternal serum alpha-fetoprotein values of > or =2.0 multiples of the median between 1995 and 1999 were reviewed. Pregnancy histories were analyzed to determine whether intensive antenatal monitoring (twice-weekly nonstress tests and determinations of the amniotic fluid index) would have detected the adverse outcomes when routine obstetric care would have missed them. Women with elevations explained by multiple gestations, structural abnormalities, or a fetal death were excluded. RESULTS: The study enrolled 136 patients. Twenty-three patients were excluded because of multiple gestations, structural or chromosomal abnormalities, or fetal death or for lack of available follow-up. Seventy-eight patients had no perinatal complications, but 12 of these patients underwent heightened surveillance. One of these patients was subjected to an induction of labor. Thirty-five pregnancies had complications (21 with preterm labor, 7 with pregnancy-induced hypertension, 6 with growth restriction or oligohydramnios, 1 with abruptio placentae, and 1 with vasa previa). Of these 35 pregnancies, 22 were followed up with routine obstetric care and 13 with heightened surveillance. Heightened surveillance did not achieve earlier or improved detection in this group. These results suggest that routine pregnancy management is an adequate strategy for providing care to pregnant patients with unexplained elevated maternal serum alpha-fetoprotein levels. Adverse outcomes were detected with routine pregnancy management or were undetectable even with intensive management. CONCLUSION: Increased risks of pregnancy-induced hypertension, preterm delivery, intrauterine growth restriction, intrauterine fetal death, oligohydramnios, and abruptio placentae are associated with elevated maternal serum alpha-fetoprotein levels. However, in our study, routine pregnancy management was an acceptable method of detecting these adverse outcomes when they were detectable.

Abruptio Placentae↗
PubMed1999

Edema of pregnancy: a comparison of water aerobics and static immersion.

OBJECTIVE: To compare the edema-relieving effects of static immersion with water aerobics. METHODS: Eighteen healthy women between 20 and 33 weeks' gestation were studied standing on land, immersed to the axilla, and participating in a water aerobics class, each for 30 minutes. RESULTS: Water aerobics and the static immersion led to a similar diuresis, 187 and 180 mL, respectively. Both were significantly greater than standing 30 minutes on land, 65 mL (P < .01). The dilutional effect as measured by a decline in urine specific gravity was also similar between static immersion and water aerobics and greater than standing on land (P < .01). Standing on land led to a small increase in leg volume compared with water aerobics or static immersion (P < .01). CONCLUSION: Water aerobics had diuretic and edema-relieving effects similar to static immersion. When women develop edema of pregnancy, water aerobics classes may be used as a potential treatment.

Adult↗
PubMed1998

Sprains of the radial collateral ligament of the metacarpophalangeal joint of the thumb. A series of 14 cases.

Fourteen surgically treated radial sprains of the M.P. joint of the thumb, are reported. 8 were recent cases, 6 were longstanding. At the time of surgery, the extensor head was severed in 4 cases, the APB tendon in 6 cases, the dorsal articular capsule in 9. The radial collateral ligament was elongated 6 times, ruptured 4 times, and presented bony avulsion in 4 cases. The mean postoperative immobilization was 37 days. 13 patients were reviewed with a mean follow-up of 22 months. Only eight were satisfied. The mean loss of motion was 27 degrees. The mean laxity, assessed on specific dynamic X-rays, was 6 degrees. 3 patients presented with radiographic arthritis, all of them with chondral lesions at the time of surgery. Despite the absence of Stener's lesion, the authors recommend surgery when volar subluxation or radial laxity is observed > 10 degrees.

Adult↗
PubMed1998

[Fracture of the great trochanter treated by dynamic hip screw plate: measure of impaction according to fracture type].

INTRODUCTION: The sliding plate has appeared to be a reliable answer for trochanteric fractures. However, impaction allowed by the material may, have an adverse effect (medialisation, shortening, jutting out of the lag screw). The aim of our study was to measure the sliding of the screw in order to assess the impaction in various types of fracture, according to the Ender classification. MATERIAL AND METHODS: Hundred trochanteric fractures have been treated between 1991 and 1993. Eighty four have been analyzed with a follow-up of three months after surgery. The average age was 80.1 years with a 4.2 sex ratio (16 males). One hundred and thirty five degrees free sliding plates were employed for fracture fixation. Full weight bearing was allowed in 78.6 per cent of patients. According to Ender classification, 35 per cent of fractures were type 1, 4 or 5. This was the first group. The second group consisted of types 2 and 3 and the third group of types 6, 7 and 8. The results were assessed on AP and lateral X-rays. The ratio between screw thread length (constant) and screw outside the barrel length, was used to measure impaction on AP view. Osteoporosis was evaluated according to Singh. RESULTS: Despite two screw protrusions out of the femoral head and two failures of the plate, we have observed a healing rate of 100 per cent after three months. Sliding averaged 6.2 mm in group 1, 10.5 mm in group 2 and 16.4 mm in groupe 3. Weight bearing had a low influence on the amount of sliding. DISCUSSION: Group 1 consists of fractures (types 1, 4 and 5) which are two parts fractures considered as stable. Group 2 corresponds to types 2 and 3 considered as intermediate fractures with relative stability. In group 3 (types 6, 7 and 8) we have observed major fracture instability. Osteoporosis does not seem to be the major factor regarding screw sliding. CONCLUSION: The sliding plate is reliable. However, complex fractures healed in a wrong position which is definitely not acceptable, especially for young patients. Therefore, we advise to avoid the use of sliding plate in case of Ender type 6, 7 and 8.

Adult↗
PubMed1997

Safety, functionality and acceptability of a prototype polyurethane condom.

Male condoms made from synthetic materials offer an alternative to latex condoms that may be more acceptable to users, thereby potentially resulting in more protected acts of intercourse. A prospective, noncomparative clinical study was conducted to evaluate the safety of using certain polyurethane materials to make condoms. Fifty-one healthy, contracepting, mutually monogamous couples were recruited between June 30 and November 24, 1993 to use a prototype roll-on polyurethane condom developed by Family Health International. Couples were to use the condoms for 10 consecutive acts of vaginal intercourse over a 4-week period. Baseline and postexposure genital examinations, including colposcopy for female participants, were performed. Fifty couples completed the study requirements and 517 acts of intercourse occurred using the condoms. Two adverse events were reported: irritation of introitus in a female participant and a small irritated erythematous lesion on a male participant's penis. Neither event was considered to be serious and both were resolved without treatment. Breakage and slippage rates were similar to those reported for latex condoms. These results suggest that polyurethane condoms represent a safe, functional and acceptable alternative to latex condoms.

Adult↗
PubMed1997

Influence of age and breed on the binding of oxygen to red blood cells of bovine calves.

The influence of somatic growth and genetic selection on the whole blood oxygen equilibrium curve (OEC) was measured under standard conditions in double-muscled and dairy calves during their first 3 mo of life. Crossbreed animals were also investigated. Hemoglobin, 2,3-diphosphoglycerate (DPG), Cl, and Pi concentrations were also measured. The percentage of fetal hemoglobin (HbF) was determined. The influence of exogenous Cl, Pi, and pH on the OEC was also assessed. The PO2 at 50% hemoglobin saturation (P50) increased during somatic growth, probably because of the increase in DPG recorded in double-muscled neonates and to the progressive disappearance of HbF in both breeds. The oxygen exchange fraction (OEF%) was used to assess the combined influence of the OEC shift and OEC shape changes on blood oxygen desaturation under standard conditions, when the PO2 decreases within a physiological range. The OEF% showed an increase during the first month, then a stabilization. The effects of Cl, Pi, and pH in Friesian calves were similar as in adult cattle. Double-muscled neonates had a lower P50, OEF% values, and DPG concentrations and higher hemoglobin and Cl concentrations than Friesian neonates. The Pi concentration and the percentage of HbF were similar in both breeds. The pH and the Cl concentration had significantly less effect on the OEC in double-muscled than in Friesian calves. Crossbreed animals exhibited intermediate parameter values, between those recorded for double-muscled and Friesian calves. All differences between breeds progressively disappeared during the first month. These data show that blood function changes markedly in calves during the first month of life and that genetic selection can alter blood function.

Age Factors↗
PubMed1996

Periodontal infection as a possible risk factor for preterm low birth weight.

Peridontal diseases are gram-negative anaerobic infections that can occur in women of childbearing age (18 to 34 years). In the present investigation we sought to determine whether the prevalence of maternal periodontal infection could be associated with preterm low birth weight (PLBW), controlling for known risk factors and potential covariates. A case-control study of 124 pregnant or postpartum mothers was performed. PLBW cases were defined as a mother with a birth of less than 2,500 g and one or more of the following: gestational age < 37 weeks, preterm labor (PTL), or premature rupture of membranes (PROM). Controls were normal birth weight infants (NBW). Assessments included a broad range of known obstetric risk factors, such as tobacco use, drug use, alcohol consumption, level of prenatal care, parity, genitourinary infections, and nutrition. Each subject received a periodontal examination to determine clinical attachment level. PLBW cases and primiparous PLBW cases (n = 93) had significantly worse periodontal disease than the respective NBW controls. Multivariate logistic regression models, controlling for other risk factors and covariates, demonstrated that periodontal disease is a statistically significant risk factor for PLBW with adjusted odds ratios of 7.9 and 7.5 for all PLBW cases and primiparous PLBW cases, respectively. These data indicate that periodontal diseases represent a previously unrecognized and clinically significant risk factor for preterm low birth weight as a consequence of either PTL or preterm PROM.

Adolescent↗
PubMed1993

Restoration of brain myo-inositol levels in rats increases latency to lithium-pilocarpine seizures.

Lithium pretreatment in rats potentiates the epileptogenic effects of pilocarpine and other cholinergic agonists. In order to determine if this effect of lithium could be reversed by myo-inositol, rats were pretreated with intracerebroventricular (ICV) injections of myoinositol, artificial CSF or L-chiro-inositol. Lithium chloride, 3 meq/kg was administered intraperitoneally 20-24 h prior to the subcutaneous injection of pilocarpine, 20 or 30 mg/kg. In both experiments, myo-inositol significantly prolonged the latency to the appearance of clonic seizures and lowered the pilocarpine seizure score. myo-Inositol prevented the development of clonic seizures in 50% of the rats receiving pilocarpine, 20 mg/kg. The levels of cortical myo-inositol in rats injected with myo-inositol were approximately double those of the CSF and L-chiro-inositol groups.

Animals↗
PubMed1992

Necrotizing fasciitis of the vulva.

OBJECTIVE: We attempted to characterize the natural history of necrotizing fasciitis of the vulva. STUDY DESIGN: The records of 29 nonpregnant women with necrotizing fasciitis of the vulva were evaluated. RESULTS: These women experienced a rapidly progressing polymicrobial infection. Initially, the infections in many women were thought to be labial cellulitis, appearing mild and innocuous. Delays in recognition and aggressive surgical management were associated with increased morbidity and mortality. Of 15 women with a delay greater than 48 hours between presentation and treatment, 11 died. Twenty of 29 (69%) were diabetic, accounting for 11 of the 14 deaths. CONCLUSION: Early diagnosis and aggressive surgical debridement in spite of mild symptoms will improve outcome in this serious disease process.

Adult↗
PubMed1991

Laparoscopic colon resection: a case report.

The first case of a villous lesion of the colon removed by laparoscopic-guided surgery is reported. Injection of methylene blue into the lesion facilitated its access and exposure via the laparoscope. A very small skin incision allowed delivery onto the abdominal wall for resection and anastomoses.

Anastomosis, Surgical↗
PubMed1991

Myo-inositol attenuates two specific behavioral effects of acute lithium in rats.

Acute and chronic lithium treatment reduces levels of brain myo-inositol in rats. Several biological effects of lithium can be reversed in vitro by addition of myo-inositol. The ability of myo-inositol to reverse behavioral effects of lithium was tested using chronic inositol administration or acute intracerebroventricular (i.c.v.) injections. Chronic myoinositol elevated activity during the first 10 min in an open field, but did not reverse lithium-induced hypokinesia. Myo-inositol (i.c.v.) reversed the suppression of rearing behavior 24 hrs after an acute dose of lithium (5 mEq/kg) but did not attenuate hypokinesia 24 hrs after a high dose of lithium (10 mEq/kg). Myo-inositol, but not the inactive isomer chiro-inositol (i.c.v.), also significantly prolonged the latency to clonus in the lithium pilocarpine seizure model. These studies suggest that reduction of brain myo-inositol may be a critical mechanism for the behavioral effects of lithium.

Animals↗
PubMed1990

The beta-endorphin responses of pregnant women during aerobic exercise in the water.

To determine the effect of pregnancy on the plasma beta-endorphin response to exercise in the water, 12 women were tested during the 15th, 25th, and 35th wk of pregnancy and 10 wk post partum. Each trial consisted of 20 min of lateral supine rest on land, 20 min of immersion to the level of the xiphoid in 30 degrees C water, 20 min of exercise at 60% predicted maximal capacity, and 20 min of lateral supine recovery. Resting beta-endorphin concentrations were elevated during the 15th wk (137.4 +/- 77.4 pg.ml-1) compared to post partum levels (19.8 +/- 17.6). However, neither was different from the 25th (65.6 +/- 68.4) or 35th (48.0 +/- 54.4) wk. Immersion increased beta-endorphin during the post partum trials but resulted in no consistent change during pregnancy. Conversely, exercise had no effect on beta-endorphin post partum but significantly elevated it during pregnancy, the greatest increase occurring during the 15th wk compared to the 25th or 35th wk. Twenty minutes after exercise, beta-endorphin returned to resting levels during all trials. It was concluded that the effect of pregnancy on plasma beta-endorphin is greater than the effect of exercise. Furthermore, pregnancy seems to accentuate the exercise-induced increase in beta-endorphin.

Adult↗
PubMed1989

Survival and morbidity of extremely premature infants based on obstetric assessment of gestational age.

To provide current clinical information for obstetric decision-making and perinatal management, we present early morbidity and mortality data for extremely premature infants based on obstetric assessment of gestational age. We reviewed the records of 141 live-born infants with birth weights of 1600 g or lower born at a university hospital level III neonatal intensive care unit between January 1986 and April 1988, whose gestational ages estimated by antenatal obstetric evaluation were between 24-29 completed weeks. Neonatal survival to 30 days ranged from 20% at 24 weeks to 94% at 29 weeks. Chronic lung disease was present at 30 days in all infants born at 24 weeks' gestation, decreasing to 13% of infants born at 29 weeks' gestation. Rates of severe intraventricular hemorrhage (grade 3 or 4) ranged from 100% at 24 weeks to 7% at 29 weeks. These data represent a significant increase in survival and a decrease in early morbidity compared with those form similar populations before 1986.

Birth Weight↗
PubMed1988

Perinatal group B streptococcal infections across intact amniotic membranes.

We reviewed the perinatal mortality due to group B streptococcal infection over a three-year period at a tertiary center. In 6 of 16 perinatal deaths due to group B Streptococcus, representing a range of gestational ages, infection occurred with the membranes intact. A review of reports from the obstetric and pediatric literature revealed that 10-50% of group B streptococcal infections occur in this manner. Several investigators of both animals and humans have demonstrated the pathophysiology of an ascending transamniotic infection. The current series emphasized this mode of infection in group B streptococcal disease.

Adult↗
PubMed1987

Atenolol and short umbilical cords.

Umbilical cord length may be a function of fetal movement. Agents that cause decreased fetal movement may cause short umbilical cords. This investigation examined the effect of the beta-blocker atenolol on umbilical cord length in rabbits. Fetuses of rabbits treated with atenolol had significantly shorter cords than control animals (p less than or equal to 0.0005). Since short cords are associated with problems in labor, low Apgar scores, and abruption, we recommend careful surveillance of mothers and fetuses who are given beta-blocking agents in the first 30 weeks of pregnancy.

Animals↗
PubMed1978

Past history and degree of depression in paraplegic individuals.

The purpose of this study was to attempt to collect sufficient data to substantiate the clinical impression that the degree of depression in the paraplegic and his past history are correlated. It was hypothesised that the poorer the past history, the greater the degree of depression in paraplegic individuals. This study was conducted on ten paraplegic subjects from the Spinal Cord Clinic at Columbia Presbyterian Medical Center, Department of Rehabilitation Medicine, based on data obtained from the administration and scoring of the Depression Scale (D-scale) of the Minnesota Multiphasic Personality Inventory (MMPI) and by the clinical observation by the consulting psychiatrist with the Spinal Injury Clinic. Past history was assumed measurable as 'favourable' to 'poor' by the use of an original questionnaire. The results of this investigation suggested a relationship between a paraplegic individual's past history and the degree of depression. The study was deemed significant in presentation of an original past history questionnaire and in the prediction of future difficulties in the rehabilitation of paraplegics so that preventive measures could be instituted.

Achievement↗