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Biomedical subjects

W Noack

Publications and source records attributed to W Noack.

At least 19 recordsLinked to original sources
PubMed1997

Pathoanatomic findings in radiohumeral epicondylopathy. A combined anatomic and electromyographic study.

Several authors believe that a compression syndrome of the radial nerve or its muscle branches is responsible for the clinical picture of radiohumeral epicondylopathy. Various structural and functional stenoses have been discussed as possible causes. We performed systematic electromyographies (EMGs) on the extensors subdividing from the radial epicondyle and found significant changes (P < 0.05) in 27/51 patients regarding latency, velocity of nerve conduction and rate of polyphasic potentials. Especially affected were the extensor carpi radialis brevis and the extensor digitorum muscle. In order to clarify causal anatomic correlations, we performed a longitudinal and cross-sectional study on a total of 40 arms from cadavers. We found constant variations from the topographic anatomy published in the standard literature which corresponded to the EMG results in the area between the epicondyle and place of entry into the supinator muscle. In addition, we observed a regularly occurring ulnar deviation from the distal part of the extensor carpi radials brevis origin which protrudes over the plane of insertion of the joint extensor tendon aponeurosis and forms in most cases the arcade of Frohse. Because the deep radial branch and its parallel muscular branches cross this part at an obtuse angle, we think that dynamic pressure on a nerve without structural influences is the pathoanatomic result of this heterogeneously interpreted clinical picture.

Cadaver↗
PubMed1997

Diagnostic and therapeutic strategies for the operative treatment of radiohumeral epicondylopathy.

We examined the extent and effect of an assumed neuromuscular transmission disorder by performing a prospective clinical study on 75 patients with therapy-resistant radiohumeral epicondylopathy. Before operating, we diagnosed with electromyography an increased rate of polyphasic potentials of the long wrist extensors as well as a prolonged motor latency of the respective muscles. Disordered neuromuscular recruitment combined with a reduced maximum strength and elasticity corresponding to the suspected damage to the distal part of the motor neuron could be proven. Both effects were significantly reversible (P < 0.001) through operative intervention. We found a significant correlation (> 0.90) between the normalization of the motor latency and increased strength. Subgroups were formed according to different preoperative diagnostic efforts and differing radicality regarding the type of soft-tissue operation performed; thus, the clinical validity of the findings diagnosed in the anatomical/ electrophysiological part of the study was additionally examined. The failure rate varied between 10% and 30%, depending on the radicality of the tenotomy, which could be interpreted as a general indication for a complete extensor carpi radialis brevis tendon release. In this connection it is remarkable that the clinical result of electromyographically localized damage in the area between the epicondyle and arcade of Frohse could not be improved through open neurolysis. Dealing with strictures located on the proximal side of the epicondyle on the other hand, this technique seems to play an important role in the recurrence prophylaxis.

Activities of Daily Living↗
PubMed1995

[Immobilization damage].

Prolonged immobilization can threaten the surgical result. The reduction of the muscle diameter is reported to be between 10 and 60% after four weeks of immobilization depending on the different muscle groups. Particularly the oxidative type-1 fibers, the "slow twitch fibers" are concerned. However, the sequelae of immobilization of muscle are reversible, which is in contrast to the detrimental effects immobilization has on the bone. Inactivity osteoporosis is occurring in three stages with bone loss as much as five to twenty times that of other calcipenic disorders. The physiological coupling of bone resorption and bone remodeling is lost. Immobilization leads to arthrosis changing the cartilage matrix composition quantitatively and qualitatively as well as cartilage morphology histologically and electron-microscopically. The result of immobilization is shortening of all fibrous tissues. The loss of the ligament-specific orientation of fibrils leads to significant reduction in tensile strength. The sequelae of immobilization emphasize the importance of early functional therapy. Continuous passive motion speeds up wound healing, and the tissue-structure is improved.

Animals↗
PubMed1991

The complex between a tissue inhibitor of metalloproteinases (TIMP-2) and 72-kDa progelatinase is a metalloproteinase inhibitor.

Human rheumatoid synovial cells in culture secrete both 72-kDa progelatinase and a complex consisting of 72-kDa progelatinase and a 24-kDa inhibitor of metalloproteinases, TIMP-2. In addition, the culture medium contains TIMP-1, the classical inhibitor of metalloproteinases, with a molecular mass of 30 kDa. TIMP-1 does not form a complex with free 72-kDa progelatinase. Free progelatinase and progelatinase complexed with TIMP-2 can be activated with the organomercury compound p-aminophenylmercury acetate. The activated complex shows less than 10% the enzyme activity of activated free gelatinase. The progelatinase-TIMP-2 complex could be shown to be an inhibitor for other metalloproteinases, such as gelatinase and collagenase secreted by human rheumatoid synovia fibroblasts, as well as for the corresponding enzymes from human neutrophils.

Arthritis, Rheumatoid↗
PubMed1991

[Isokinetic measurements in adolescent runners].

The aim of the investigation was to study the course of the isokinetic parameters--peak torque, time range of tension development and fatigue index--in an age range from 13 to 19 years and to compare the results with those of competitive athletes of the same age specifically trained in running. For this purpose measurements of the flexors and extensors in the upper ankle joint, knee and hip were taken. The average for the six muscle groups correlated significantly in all three parameters not only with the age development but also with the degree of training. The individual muscle groups, however, differed widely. An increased frequency of injuries by certain ratios of peak torques between flexors and extensors was not found. Instead already in the physiological age development occurred relations that were connected with an increased frequency of injuries. Prospectively this suggests that the time range of tension development has additional influence here.

Adolescent↗
PubMed1990

[Indirect humerus fracture in sports].

The humeral spiral fracture as a result of violent muscle activity is not uncommon in throwing sports. Two cases of this injury (in a javelin thrower and in a handball player) are described. The complex mechanical reasons are discussed.

Adult↗
PubMed1988

Semiarthroscopic synovectomy of the hip.

A new surgical procedure, semiarthroscopic synovectomy of the hip is described. The operation enables a radical synovectomy to be performed without the risk of necrosis of the femoral head from temporary luxation. The early results have been encouraging and the method appears to offer a low-risk alternative to conventional radical synovectomy.

Acetabulum↗
PubMed1988

[Treatment of unreduced anterior shoulder dislocation].

We evaluated the results of treatment in six patients with unreduced chronic anterior dislocations of the shoulder. In three patients the dislocations had not been recognized by the initial treating physician. In the remaining three patients the dislocations initially had been diagnosed but reduction had failed and the dislocations had remained unreduced. In one of the six shoulders the dislocation was left unreduced. The dislocation existed for 3.5 years and there was absence of disabling functional impairment, pain or neurovascular disturbance. In five of six shoulders the function was severely impaired. One of five shoulders with an anterior dislocation of three weeks duration could be reduced by closed manipulation. Four shoulders underwent open reduction. In all patients the humeral head could be preserved. Associated osseous lesions of the glenoid or the humeral head (Hill-Sachs lesions, fractures) were treated by rotation osteotomies according to Weber and the Eden-Lange-Hybinette procedure. Preoperatively all shoulders were graded as poor. Postoperatively the results in one was graded as excellent, in three as good and in one (algodystrophy of the left arm) as fair.

Adolescent↗
PubMed1987

[Current status of the therapy of anterior cruciate ligament injuries].

This review presents the current concepts in the treatment of anterior cruciate ligament (ACL) injuries. Conservative treatment emphasising strengthening of the muscles to stabilise an unstable knee is discussed. The agonistic and antagonistic functions of the hamstrings and the quadriceps muscle in relation to the ACL are described. The possible mechanisms of muscular stabilisation of the knee are discussed on a neurophysiological basis. The existence of joint specific receptors is pointed out and their reflex and perceptive functions are demonstrated. Taking this into account one can deduce a two-step mechanism of joint protection: 1) via the mechanical strength of the joint capsule and ligaments and 2) via reflex muscle contractions. It follows therefrom that in an unstable knee with a lax capsule and disturbed reflex mechanisms, strengthening of muscles alone is insufficient and cannot protect the joint from progressive deterioration. Therefore, surgical treatment is necessary for an ACL deficient knee. Our indications for ACL reconstruction are described. In addition, the existing methods of surgical replacement of the ACL are critically elucidated. In our opinion, an extraarticular repair tendon transfer as the only surgical procedure to regain stability is of only historical interest. However, extraarticular repair of the medial or lateral capsule is often a necessary additional step to restore stability of the knee. The replacement of the ACL is the crucial step. Using autogenous grafts one must consider the doubtful outcome of biological response leading to necrosis and revascularization in the transplant.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1987

[The importance of isokinetic measurement of force in sports and rehabilitation].

The musculature serves as motor of the human body and hence promotes our movement within our environment. Its organ-specific performance is the translation of force into movement. This force can be described by means of different qualities - maximal force, speed and endurance. These properties are essential for sports activities and also set limits for the achievement of athletic records. Muscular force can be evaluated by different means. Measurement of force via isokinetic systems enables quantitative measurement of effective muscular forces in various body positions which are frequently comparable under conditions specific to different types of sports. The relevance of these measurements in sports and rehabilitation is documented in this article. Two different groups of subjects (72 sportsmen and 73 patients after capsular ligament reconstruction in the knee joint) were examined. The measurement values: dynamic maximal force, energy of acceleration, average performance and the hamstring/quadriceps ratios (H/Q quotient) are measured at different speeds. The maximal force shows intraindividual differences depending on the speed. These differences are due to different conditions of training and different distribution of muscle fibre types. The acceleration energy enables assessment of differences in the ability to exercise force. Likewise, the different muscle performances can be described by means of the appropriate individual performance maximums. In rehabilitation, muscle atrophy caused by immobilization can be measured and described. Measurement of force by means of isokinetic systems enables the analysis of muscular forces with their different properties, and hence to give advice in training matters and to supervise and control popular recreational sports and competitive sports activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Injuries of the distal epiphysis of the humerus in the period of growth].

From 1978 to 1983 in the Orthopedic University Clinic (Oskar-Helene-Heim, Berlin) 75 children with fractures of the distal humerus received medical treatment. The results of 25 intra-articular fractures of the distal humerus in children (ten fractures of the radial condyles, eight fractures of the ulnar epicondyles, three Y-fractures of the condyles, two luxations with additional flake fractures, one fracture of the ulnar condyle) will be reported. The frequency of remaining complications like valgus and varus deformities, pseudarthroses, posttraumatic osteochondroses and "fish tail" deformities are described. The possible mechanism of such developing deformities is discussed. The resulting consequences for the surgical treatment in the future are also discussed.

Adolescent↗
PubMed1982

Multicomponent analysis of meat products by infrared spectrophotometry: collaborative study.

A new method for rapid multicomponent analysis of meat products based on infrared transmission was tested in a collaborative study with 4 laboratories. A series consisting of 31 samples of different meats, cooked sausage, liver sausage, and fermented sausage was distributed and analyzed at all laboratories for protein, fat, and water by the present method and by well established reference methods. There was no significant difference between the infrared method and reference methods at the 95% confidence level for determination of protein, fat, and water in meat products.

Animals↗
PubMed1979

[Ultrastructural investigations of the palmarfascia in M. Dupuytren (author's transl)].

The palmarfascia of 30 patients with Dupuytrens disease was investigated light- and electron microscopically. As typical changes there exist an increase in cells which form noduli. Many cells contain contractile filaments in their cytoplasma are therefore described as myofibroblasts. Beside these cells active fibroblasts could be observed. Close to their cell membranes there occur filaments with a diameter of 100--300 A. In a greater distance fibrils and fibers with a diameter of 400--600 A were observed. The regular order of the connective tissue is disturbed, one often can observe "vortex" like structures. The lumina of many capillaries are collapsed. The pericytes are increased. The nerve fibers are morphologically unchanged - they are often closely surrounded by collagen fibers. Respecting the morphological findings the pathogenesis of Dupuytrens disease is discussed.

Connective Tissue↗
PubMed1976

[Causes and treatment of delayed callusformation and pseudarthrosis following fractures of the shaft of the humerus (author's transl)].

In the OHH, during the years 1969 to 1974, 28 patients were operatively treated because of delayed callusformation or pseud-arthrosis, following a fracture of the shaft of the humerus. It was possible to inquire about and to re-examine 20 patients. The operative treatment had, when possible been achieved by osteosynthesis through plates (25 cases). Each of the so treated cases lead to healing of the bone, additional nerve lesion did not in one case occur because of the operation. Objectively seen, there existed in 7 patients a slight, final restriction of movements, for the abduction and outside rotation in the shoulder joint. 6 patients complained of being sensitive to weather changes. The different treatment method of the fracture of the humerus and pseudarthrosis was discussed.

Aged↗