[Long-term results of arthroscopic meniscectomy]. / Langzeitergebnisse nach arthroskopischer Meniskektomie.

The long-term results after partial arthroscopic meniscectomy were evaluated in follow-up examinations on 77 patients performed according to identical criteria after post-operative periods of two (6-36 months) and seven years (66-96 months). The subjective results after up to more than seven years showed a stable course and were unrelated to the radiological signs of osteoarthritis. The objective clinical results, assessed in the Lysholm score, showed a significant deterioration as compared to the two-year follow-up (p < 0.0002). In particular, an obvious increase of pain and an increased tendency for swelling were observed, while the results in the Lachman test showed a significant reduction of anterior instability (p < 0.0015) as an obvious result of a marked improvement of muscle strength. These results also correlated with a significant increase of sporting and exercise capacity as compared to the results obtained in the two-year follow-up. While osteoarthritis rates seen in the first follow-up were similar to the preoperative findings, a massive increase of osteoarthritis could be seen at the second follow-up after a further five years with only 22 of 77 patients (28.6%) showing no radiographic signs of osteoarthritis. In 31 patients (40.25%) with negative preoperative findings slight to moderate signs of osteoarthritis were seen in the seven-year follow-up. Regardless of the type of meniscal tear the osteoarthritic changes seen were related to the age of the patient and the stability of the joint and were significantly different from those in the non-operated, contralateral joint.(ABSTRACT TRUNCATED AT 250 WORDS)

[Left ventricular function in young type I diabetic patients. A Doppler echocardiography study]. / Die Linksventrikelfunktion bei jungen Typ I-Diabetikern. Eine Doppler-echokardiographische Studie.

Systolic and diastolic left ventricular function was assessed by M-mode and pulsed Doppler echocardiography in 10 young type I diabetic patients without late complications and maximal diabetes duration of 5 years and in 10 healthy persons. Fractional shortening, a measure of systolic ventricular function, was significantly lower in diabetics than in controls (33.9 +/- 2.9 vs. 37.9 +/- 4.9; p less than 0.05). Fractional shortening decreased significantly with advancing diabetes duration (R = -0.819; p less than 0.01). Indexes of diastolic ventricular function (isovolumetric relaxation period and transmitral flow velocity pattern) were not significantly different in the two groups, but 3 patients had 1 parameter (3x isovolumetric relaxation period) and another patient had 2 parameters (isovolumetric relaxation period and early diastolic peak velocity E-E') outside the normal range. Follow-up studies should define the clinical significance of these alterations of systolic and diastolic left ventricular function.

Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in young alcoholics.

M-mode echo recordings of the left ventricle and left ventricular inflow Doppler velocimetry were performed in 34 male alcoholics below age 45 and in 25 nonalcoholic male controls. Groups were well matched for age, body surface area and heart rate. Systolic arterial pressure was slightly higher in alcoholics and none of the subjects studied had cardiorespiratory symptoms. Data from imaging echocardiography (M-mode echo) were comparable in both groups, and fractional shortening, reflecting left ventricular systolic performance, was identical. Left ventricular inflow Doppler velocimetry showed quite different results in alcoholics and control subjects for the early diastolic flow velocity peak (0.52 +/- 0.12 versus 0.61 +/- 0.11 m/s; p less than 0.01) and in peak flow velocities in the atrial contraction phase (0.32 +/- 0.11 versus 0.27 +/- 0.06 m/s; p less than 0.05). The lower ratio of both velocities in patients (1.88 +/- 0.95 versus 2.34 +/- 0.60 m/s; p less than 0.05) suggests that left ventricular distensibility is altered in alcoholics. In addition, isovolumetric relaxation period, reflecting an early diastolic event, was slightly but significantly prolonged in alcoholic subjects (68 +/- 14 versus 56 +/- 10 ms; p less than 0.001). It is concluded that diastolic performance is altered in young alcoholics without cardiorespiratory symptoms showing normal systolic performance, and that these alterations may be an early marker of alcoholic cardiomyopathy.