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  • 1
    ISSN: 1432-0932
    Keywords: Low-back pain ; Sciatica ; Spinous hypertrophy ; Spina bifida occulta ; Spinous impingement syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report on a rare disease called to Anquin's disease or spinous engagement or impingement syndrome. Low-back pain in this specific syndrome probably combined with sciatica is caused by a hypertrophic spinous process along with a spina bifida occulta of the underlying vertebra. Mostly, the enlarged spinous process is seen at L5 and the spina bifida occulta at S I. Conservative therapy consists of physiotherapy with postural exercises including improvement of lumbar flexion. If conservative treatment is unsuccessful, surgical treatment is indicated. Surgical therapy should include resection of the hypertrophic spinous process, probably combined with revision of the nerve roots and division of adhesions. Between 1981 and 1993 six patients were treated surgically after long-lasting periods of conservative therapy. All patients were re-examined clinically and radiologically after a mean follow-up period of 2.9 years. In all but one patient a distinct release from lumbar back pain and/or sciatica was observed. Regarding this, the most important fact in de Anquin's disease is to be aware of this specific syndrome. If low-back pain can be traced to a hypertrophic spinous process the first choice of therapy should be conservative. In unsuccessful cases simple surgical resection probably combined with division of the adhesion can lead to significant release from pain and is recommended.
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  • 2
    ISSN: 1432-2307
    Keywords: Perichondrium ; Cartilage defects ; Tissue culture ; Fibrin glue ; Collagen sponge
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effectiveness of autologous rib perichondrium for repair of full-thickness hyaline cartilage defects has been shown experimentally and clinically in various reports. The purpose of this study was to examine the behaviour of sheep rib perichondrial tissue under in vitro conditions and the influence of different culture matrices in order to evaluate possible stimulating effects. Rib perichondrium was obtained from sheep used for an experimental in vivo trial. After removal of adjacent cartilage remnants the tissue was devided and specimens cultured for 14 days in different ways. Explants cultured on collagen sponges (group A), fibrin glue (group B) and cellulose acetate filter (group C) were examined histologically, histochemically, histomorphometrically and autoradiographically. Clear differentiation of perichondrial cells towards a chondrocyte-like cell shape, particularly in the proliferation zone, was noticed on all matrices. These cells synthesized new matrix substances comparable to the ground substance normally present in hyaline cartilage. Morphometric comparison of tissue differentiation on different culture matrices revealed no significant differences in proliferation rates.
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  • 3
    ISSN: 1432-2307
    Keywords: Perichondrium ; Cartilage defects ; Cartilage transplantation ; Fibrin glue ; Collagen sponge
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of the present study was to examine the fate of autologous perichondrial grafts after transplantation into cartilage lesions in weight-bearing joints. Osteochondral lesions were made in the articular surface of knee joints in 36 sheep. The defects were filled with autologous rib perichondrial grafts which were secured by either collagen sponges (12 animals) or fibrin glue (12 animals). Defects without perichondrial grafts served as controls (12 animals). Following 1 week of immobilization of the operated leg, the plaster was removed and the animals were allowed to move freely. Animals were sacrificed after 4, 8, 12 and 16 weeks. The grafts were removed and investigated histologically. In contrast to weight-bearing areas and control defects, hyaline-like cartilage formation was seen in non-weightbearing areas after 4 weeks. This newly formed cartilage revealed strong metachromasia following staining with acidic toluidine blue and reacted positively with periodic acid-Schiff, indicating de novo synthesis of proteoglycans and glycoproteins. Scanning electron microscopy and examinations with polarized light confirmed a hyaline cartilage-like architecture for the surface area as well as for the fibre orientation of the whole graft. Enzyme histochemistry for alkaline and acid phosphatase activity showed positive reactivity only at the base of the transplants.
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  • 4
    ISSN: 1433-7347
    Keywords: Knee joint ; Arthroscopy ; Osteochondritis dissecans
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract We report a case of bilateral osteochondritis dissecans of the medial trochlea femoris. Arthroscopic removement of loose bodies in the symptomatic left knee led to an excellent result; the untreated right knee showed effusion and locking one year later. This condition should be considered in the diagnosis of patellofemoral pain.
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  • 5
    ISSN: 1433-7347
    Keywords: Synovial hemangioma ; Knee joint ; Synovectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Description / Table of Contents: Zusammenfassung Anhand von 4 Kasuistiken wird über mögliche Symptome, Befunde und präoperativ durchgeführte diagnostische Verfahren beichtet, die mit der Erkennung und Therapie des seltenen, gutartigen synovialen Hämangioms verbunden sein können. Danach gibt es keine präoperative Maßnahme, die in jedem Fall die sichere Diagnosestellung ermöglicht. Daraus ist zu folgern, daß bei mehrdeutigen klinischen und bildgebenden Befunden frühzeitig an das Vorliegen eines synovialen Hämangioms gedacht werden muß. Als Therapie der Wahl ist die möglichst frühzeitige und vollständige Tumorresektion, verbunden (je nach Befund) mit einer partiellen oder totalen Synovektomie, zu empfehlen. Langfristiges Abwarten oder Verzicht auf eine Tumorentfernung haben sekundärarthrotische Veränderungen zur Folge.
    Notes: Abstract We report our clinical experiences in the diagnosis and treatment of four patients with synovial hemangiomata. Synovial hemangiomata are rare causes of recurrent, nonspecific joint complaints and occur most often at the knee joint. Nontraumatic joint swelling combined with recurrent, possibly hemorrhagic joint effusions must be considered signs of a synovial hemangioma. Although no preoperative diagnostic tool enables confirmation of the diagnosis, and MRI seems to be the diagnostic procedure of first choice, it is most important fact for the clinician to be aware of the existence of this disease. Early surgical treatment with the excstence of this disease. Early surgical treatment with excision of the tumor within wide margins of noninvolved normal synovial tissue as partial or total synovectomy is the therapy of choice and avoids degenerative changes as demonstrated with the four cases reported here.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Biomechanical factors influencing the patterns of pressure distribution at the articular surface and the subchondral bone are suggested to be most important in the pathogenesis of osteoarthritis and ostechondritis dissecans at the knee joint. Besides this, chronic joint instability is another important factor under discussion in the etiology of osteoarthritis of the knee. The patterns of pressure distribution on the femoral condyles of weight-bearing knee joints were investigated in a biostatic cadaver model. The pressure on the femoral condyles was evaluated using pressure-sensitive films with the knee in different physiological joint positions (extension, 15° and 30° flexion) with and without division of either the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the MCL and the anterior cruciate ligament (ACL), or the LCL and the ACL. Results showed that the location of the contact area and peak pressure depended on the joint position and stage of ligament division. Without ligament division the maximum peak pressure was always observed on the medial condyle. Only after MCL and combined MCL + ACL division did the lateral condyle show in extension a higher peak pressure than the medial condyle. Division of the LCL and LCL + ACL resulted in an increase in peak pressure on the medial condyle, particularly in flexion. The highest peak pressure of all was measured in the 30° flexion position on the medial condyle after division of the LCL. The lowest at all was found on the lateral condyle in 15° flexion after LCL division. Additional ACL division resulted in only minor further changes. These results are important for the interpretation of clinically observed factors discussed in the etiology of secondary osteoarthritis of the knee and contribute to the theory of mechanical induction of osteoarthritis and osteochondritis dissecans.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Clinical results in two groups of patients treated for osteochondrosis dissecans tali were examined in a follow-up examination: adolescents up to age 16 years versus adults. Thirteen patients were reexamined in each group. Clinical comparison revealed distinct differences between the groups. In adolescents there were eight excellent and three good results, only one fair, and one poor result. In contrast, adults demonstrated excellent results in only two and good results in five patients; five patients showed fair results and one a poor outcome. No signs of osteoarthrosis were detected in adolescents whereas in four adult patients slight radiological signs of osteoarthritis were visible. In both groups clinical and radiological results were better when the cartilage layer at the talar dome was found to be intact at the time of surgical intervention. Detectable cartilage damage at the time of operation was accompanied by a worse result at the time of follow-up examination. In conclusion, adolescents without any signs of joint locking or loose body formation should first be treated conservatively. The older the patient the shorter the period of nonsurgical treatment should be. In cases of increasing stages, joint locking, or formation of loose bodies surgical intervention is recommended.
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  • 8
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Traumata or repetitive microtraumata, malalignment with varus or valgus deviation, or chronic joint instability are discussed in the aetiology of osteoarthritis and osteochondritis dissecans of the knee. Biomechanical factors influencing the patterns of pressure distribution at the articular surface and the subchondral bone are suggested to be most important in the pathogenesis. Consequently, the patterns of pressure distribution at the femoral condyles of weight-bearing knee joints were investigated in a cadaveric biostatic model. The pressure in the articular joint space was evaluated with pressure-sensitive films of the knee in different joint positions in the coronal plane (10° varus, 10° valgus, and neutral position) without and with medial collateral ligament (MCL), lateral CL (LCL), MCL + anterior cruciate ligament (ACL) or LCL + ACL ligament division. Results demonstrated that the location of the contact area and the peak pressure depended on the joint position and stage of ligamentous division. Without ligament division, a maximum peak pressure was observed at the medial condyle in the neutral and varus positions. Only in the valgus position did the lateral condyle show a higher peak of pressure than the medial condyle. Ligament division of the LCL and LCL + ACL resulted in an increase of peak pressure at the medial condyle, particularly in the varus position. Division of the MCL and MCL + ACL ligament complex reduced the differences between the medial and lateral condyle. In the valgus position, the peak pressure was significantly higher at the lateral condyle. The absolute maximum peak pressure was measured in the varus position at the medial condyle after division of the LCL and ACL. The absolute minimum was found in the valgus position at the medial condyle after division of the MCL and ACL. No significant change of the location of the centre of peak pressure area was observed due to the different joint positions.
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  • 9
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Pigmented villonodular synovitis (PVS) is a rare disease of the synovial layer in joints, seen particularly in children. Early diagnosis allows treatment with resection of the affected synovial tissue, avoiding secondary osteoarthritic lesions of the normally unaffected joint structures. In this article, symptoms, clinical findings, and the diagnosis procedure are reported in a rare case of diffuse PVS in an 11-year-old girl. Diagnostic procedures are of differing value, and it seems that the most important factor is suspicion of this disease even in children. Since preoperative verification of the histological diagnosis is impossible, early invasive investigation such as arthroscopy are recommended to confirm the histological character of the lesion. Arthrotomy or arthroscopy followed by total synovectomy is recommended as the surgical treatment of first choice. Our patient was treated by total synovectomy via an arthrotomy of the affected knee joint after histological diagnosis has been confirmed by arthroscopic excision and histological analysis. Follow-up examinations 4 and 6 months postoperatively revealed no signs of recurrence.
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  • 10
    Electronic Resource
    Electronic Resource
    Woodbury, NY : American Institute of Physics (AIP)
    Applied Physics Letters 64 (1994), S. 2700-2702 
    ISSN: 1077-3118
    Source: AIP Digital Archive
    Topics: Physics
    Notes: The influence of He+ implantation on the properties of crystalline silicon solar cells has been investigated. The implantation of 550 keV He+ ions into the masked surface of solar cells was used to form a two-dimensional defect layer inside the cell space-charge region. For suitable implantation doses it is possible to increase the photocurrent without degenerating the values for open circuit voltage thus resulting in an improved efficiency of the cells.
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