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  • 1
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract We have previously reported recurrent clonal chromosomal aberrations in synovia, osteophytes and articular cartilage from patients with osteoarthritis (OA). In particular, gain of chromosomes 5 and 7 was found to be strongly associated with OA. In order to exclude the possibility of in vitro artefacts, we studied three to four parallel, independent cultures from ten samples of synovia and three samples of osteophytes from ten women with primary OA. In all, 40 cultures were cytogenetically analysed, 39 of which had clonal chromosomal aberrations. The most common aberrations were +7 and +5 which were found in 38 and 12 cultures, respectively. There were striking karyotype similarities among the parallel cultures from each case. Out of a total of 83 clones, only 11 were unique for one culture, 7 from synovia and 4 from osteophytes. The genetic homogeneity among different cultures from the same patients excludes the possibility of in vitro artefacts and indicates a widespread distribution of the cytogenetically aberrant clones in vivo.
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  • 2
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract We examined, cytogenetically and by in situ hybridization (ISH) techniques, the synovia, osteophytes, and articular cartilage from 32 patients with pronounced osteoarthritis (OA), a prevalent form of arthropathy characterized by progressive reduction of articular cartilage, and synovial samples from 17 control patients. In short-term cultures, clonal chromosome aberrations, in particular the gain of chromosomes 7 (+7) and 5 (+5), were found to be strongly associated with OA. These aberrations were found in almost 90% of the cultures from synovia and osteophytes, whereas only 1/11 synovial samples from joints unequivocally unaffected by OA had cells with +5 or +7. The in vivo nature of trisomy 7 was demonstrated by ISH on uncultured cells, and serial passaging showed that cells with +7 had a proliferative advantage in vitro. Thus, the combined data indicate that cells with somatic mutations appear early and may be influential in the disease process leading to OA.
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  • 3
    ISSN: 1433-7347
    Keywords: Knee ; Anterior cruciate ligament ; Collateral ligament ; Memscus ; Injury mechanism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract 100 consecutive patients with a recent anterior cruciate ligament injury were examined with respect to type of sports activity that caused the injury, mechanism of injury and the occurrence of collateral ligament and meniscal lesions. There were 53 medial collateral ligament injuries, 12 medial, 35 lateral and 11 bicompartmental meniscal lesions. 59 patients were injured during contact sports, 30 in downhill skiing and 11 in other recreational activities, traffic accidents or at work. An associated medial collateral, ligament tear was more common in skiing (22/30) than during contact sports (23/59), whereas a bicompartmental meniscal lesion was found more frequently in contact sports (9/59) than in skiing (0/30). Weightbearing was reported by 56/59 of the patients with contact sports injuries and by 8/30 of those with skiing injuries. Non-weightbearing in the injury situation led to the same rate of MCL tears (18/28) as those reporting weightbearing (35/72) but significantly more intact menisci (19/28 vs 23/72). Thus, contact sports injuries were more often sustained during weightbearing, with a resultant joint compression of both femuro-tibial compartments as shown by the higher incidence of bicompartmental meniscal lesions. This might be an important prognostic factor for future joint disease and arthrosis. The classic “unhappy triad” was a rare finding (8/100) and we suggest that this entity should be replaced by the “unhappy compression injury”.
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  • 4
    ISSN: 1433-7347
    Keywords: Key words Knee ; Injury ; Proprioception
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract A disturbed proprioception has been described in patients with an anterior cruciate ligament (ACL) deficient knee. The relation to demographic data and to different commonly associated anatomical lesions, as well as to subjective knee function, was prospectively studied in 16 consecutive patients after an acute knee ligament injury. All patients had a complete rupture of the ACL, but variable associated anatomical lesions. The threshold to detect a passive motion, as a measure of their proprioceptive ability, was registered repeatedly during the first year after injury. Four of the patients had consistently severe and persistent deficits at 1, 2 and 8 months. These four individuals had more chondral lesions and a lower subjective rating of their knee function than the remaining patients. In the whole group there were significant correlations between the recorded thresholds and associated chondral lesions, meniscal lesions and the subjective rating of knee function. We found no significant relation between age, gender, activity level, grade of mechanical laxity increase or a medial collateral ligament rupture, and the proprioceptive recordings. Thus, morphological lesions other than a rupture of the ACL seem to contribute to the proprioceptive deficits after a knee ligament injury, and the patients’ ability to detect a passive motion showed a relation to subjective knee function from the time of injury onwards.
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  • 5
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une enquête prospective portant sur 145 malades chez qui a été pratiquée une arthroscopie en raison d'une suspicion clinique de lésion méniscale a permis d'étudier la justesse du diagnostic. On a eu recours à une analyse statistique multivariée pour évaluer 68 paramètres cliniques différents. L'exactitude clinique était de 61% puisqu'une déchirure du ménisque a été découverte dans 88 genoux; 78 d'entre elles s'accompagnaient d'une autre lésion intra-articulaire. Treize genoux étaient strictement normaux à l'arthroscopie. Il apparaît donc que la prédiction d'une lésion méniscale est possible dans 8 cas sur 10.
    Notes: Summary The accuracy of diagnosis was tested in a prospective study of 145 patients who were arthroscoped because a meniscal tear was suspected clinically. Multiple variate analysis was used to evaluate 68 different clinical parameters. The clinical accuracy was 61% as a tear was demonstrated in 88 knees; 73 of these tears were associated with other intraarticular abnormalities. Thirteen knees were entirely normal at arthroscopy. It was possible to predict a meniscal tear in 8 out of 10 patients.
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  • 6
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La fixation de prothèses du genou PCA Modular à tige tibiale cruciforme, cimentée ou non, a été étudiée par analyse stéréophotométrique, 6 semaines après l'intervention, chez 26 patients randomisés. Des contraintes externes physiologiques ont été appliquées en rotation externe et interne et l'accroupissement a simulé la mise en charge excentrique postérieure. Dans tous les cas un déplacement provoqué a pu être constaté. Une différence statistiquement significative, entre les deux groupes, n'a pu être mise en évidence ni pour le déplacement provoqué, ni pour la migration initiale, à l'exception de l'abaissement constaté entre les positions couché sur le ventre et debout (0,0 pour le groupe cimenté contre 0,2 mm pour le non-cimenté, p〈0.05). Dans certains cas le déplacement le plus important a été noté durant le passage de la position de repos à la position debout ou lors des contraintes en rotation interne-externe, alors que dans d'autres cas le déplacement le plus grand a été observé lors de l'accroupissement. Une différence statistiquement significative de l'abaissement de la prothèse dans cette position a été constatée, puisqu'il est nul pour les pièces cimentées et de 0,2 mm pour les non-cimentées (p〈0,05). La forme de la prothèse avec une queue cruciforme ainsi que l'utilisation d'une lame de scie à refroidissement interne peuvent expliquer que la différence ne soit que minime entre les deux groupes, cimenté et non-cimenté.
    Notes: Summary The fixation of cemented and uncemented PCA modular cruciform-stemmed tibial components was examined 6 weeks after operation using roentgenstereophotogrammetric analysis in 26 randomly selected patients. Physiological external forces were applied in external/internal rotation and eccentric posterior loading generated by squatting. All cases showed inducible displacement, but there were no statistically significant differences between the 2 groups in inducible displacement or in the initial migration, except for subsidence between the lying and standing position. In some, the greatest movement was found when changing from resting to standing, or during rotational stress; in others, the greatest movement was found during squatting. There was a statistical difference in subsidence on squatting which was greater in the uncemented group. The design of the cruciform stem and the use of an internally cooled saw may explain this small differences between the 2 groups.
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  • 7
    ISSN: 1432-2161
    Keywords: Knee ; Cruciate ligament displacement ; Radiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 16 patients with chronic, symptomatic anterior cruciate ligament-deficient knees, sagittal displacement was studied in the standing position using fluoroscopic control and a simple device to support the knee. In slight weight bearing all knees but one had normal femorotibial alignment in the lateral view. During full weight bearing sagittal displacements between 2 mm and 17 mm were recorded in 14 patients. The largest displacements were obtained at different angles of inclination of the leg and flexion of the knee joint and were independent of the point of support of the knee joint. The reproducibility of this new standing technique was within 2 mm. A high correlation with previous methods of radiographic measurements of sagittal laxity was found. By the use of the normal relationship between the tibial eminence and the femoral condyles it is possible to record and measure sagittal displacements on a single lateral radiograph of the standing knee joint.
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  • 8
    ISSN: 1460-9568
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The origin and neuropeptide content of nerve fibres in the rat circumvallate papilla was studied by retrograde tracing in combination with immunocytochemistry. An injection of the retrograde tracer True Blue into the circumvallate papilla resulted in the appearance of labelled nerve cell bodies in the superior cervical, the stellate, the thyroid, the nodose, the jugular, the petrosal, the otic, the trigeminal and the dorsal root ganglia at level C2. Most of the True Blue-labelled nerve cells in the superior cervical ganglia contained neuropeptide Y. The majority of labelled cell bodies in the thyroid ganglia contained vasoactive intestinal peptide. In the jugular and trigeminal ganglia, the majority of the labelled nerve cell bodies stored calcitonin gene-related peptide. A small number of neurons in the medial reticular formation of the central nervous system was labelled. Tracer injections deep into the tongue tissue beneath the circumvallate papilla gave rise to True Blue-labelled neurons in the hypoglossal nucleus.
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  • 9
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In three cases operated with high tibial osteotomy for medial gonarthrosis the exact method of roentgen stereophotogrammetry with tantalum balls as bone markers (Selvik 1974) was used to study angular and translational movements in three dimensions at the operation and during the healing period. Tibial osteotomy caused angular and translational movements even in planes where correction was not intended, and the stereo technique revealed that stability was not present when knee mobilisation started. Correlation between the stereo values and conventional radiographic measurements were best in the frontal plane (root mean square value of discrepancies 1.3°). Roentgen stereophotogrammetry gives superior information compared with the conventional radiographic technique, but it is concluded that the latter has sufficient accuracy for the clinical assessment of corrections in the frontal plane.
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  • 10
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective series of 52 knees selected for high tibial osteotomy because of early medial arthrosis, special care was taken to obtain a final over-correction in valgus. The operative procedure and the pre- and post-operative radiographic examinations were standardized and the follow up was 1–3 years. 49 of the 52 knees had obtained a normal or over-corrected mechanical axis. 45 of these had improved painfree walking distance, and 31 were painfree. In 45 knees the arthrotic condition had not progressed, and in 5 of these there were signs of cartilage restitution. It is concluded that precise correction of medial gonarthrosis can be achieved, and this provides a rational basis for definitive treatment of early stages of this condition; for the majority an endoprothesis operation should not be needed in the future.
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