ABSTRACT
OBJECTIVE: To specify in detail the clinical phenotype in 2 Finnish families demonstrating linkage between the type II procollagen gene (COL2A1) and osteoarthritis (OA). We also reevaluated the linkage and screened the exon sequences of the COL2A1 gene for mutations. METHODS: We used single-stranded conformation polymorphism and denaturing gradient-gel electrophoresis techniques for the analyses. RESULTS: The patients' phenotype represented typical, but early-onset, OA. There was no clinical or radiographic evidence of chondrodysplasia. No mutation in the protein-coding regions of the COL2A1 gene could be identified. However, the linkage analysis with a new multiallelic marker resulted in a statistically more significant logarithm of odds (LOD) score than has been reported. CONCLUSION: Familial OA with classic clinical and radiographic findings is tightly linked to the COL2A1 gene. Systematic screening of the 54 exons did not, however, reveal any mutations; this suggests that the mutation may lie in the promoter region or within the introns of this 35-kb gene.
Subject(s)
Genetic Linkage/genetics , Osteoarthritis/genetics , Procollagen/genetics , Adolescent , Adult , Base Sequence , DNA Mutational Analysis , Electrophoresis, Polyacrylamide Gel , Exons/genetics , Female , Humans , Lod Score , Male , Middle Aged , Molecular Sequence Data , Oligonucleotide Probes , Osteoarthritis/diagnostic imaging , Pedigree , Phenotype , Polymerase Chain Reaction , Polymorphism, Genetic , RadiographyABSTRACT
12 patients were followed up who had been splenectomised between 1978 and 1985 after traumatic injury of the spleen. Analysis of late morbidity after loss of the spleen was performed besides physical examination and a study of clinical pathology findings, the analysis being based on the individual anamnesis and history of previous diseases of each patient. It was not possible to establish a clear rise in general an infection-conditioned morbidity. We believe that the simple method of comparing preoperative and postoperative disease periods on the basis of the individual list of previous diseases represents a new objective parameter for assessing the late sequelae following splenectomy.
Subject(s)
Bacterial Infections/etiology , Postoperative Complications/etiology , Splenectomy , Splenic Rupture/surgery , Adolescent , Adult , Child , Female , Follow-Up Studies , Humans , Leukocytosis/etiology , Male , Middle Aged , Respiratory Tract Infections/etiologyABSTRACT
45 patients were followed up who had undergone surgery because of acromioclavicular separation of the types TOSSY II and TOSSY III during 1983 to 1985. In 44 cases a fresh acromioclavicular separation had been treated via transcutaneous Kirschner wire fixation and in one case a chronic acromioclavicular separation had been treated according to the technique described by Bunnell. the anatomy of the acromioclavicular joint, the pattern of injury as well as the method of surgery with subsequent aftercare measures are described. The good functional final results make transcutaneous Kirschner wire fixation the method of choice as a brief and low-stress procedure, as far as our clinic is concerned.
Subject(s)
Acromioclavicular Joint/injuries , Bone Wires , Joint Dislocations/surgery , Orthopedic Fixation Devices , Acromioclavicular Joint/surgery , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Ligaments, Articular/injuries , Male , Middle Aged , Postoperative Complications/etiology , RuptureABSTRACT
A sufficiently stable osteosynthesis is demanded on the basis of the conditions formulated for the healing of bone fractures. This demand applies to fractures in general. For intramedullary nailing in particular, it is a major postulate that sufficient stability can only be attained if the medullar cavity is drilled open. Such drilling aims at establishing an extended contact between the cortical substance of the bone and the nail while exercising at the same time a clamping force that is elastic in transverse direction. In our accident emergency hospital (Ludwigshafen) the medullar cavity is not drilled open. This entails the use of frequently very thin intramedullary nails so that the nail can pass through the hourglass-like narrow pathway in the centre. Although this kind of osteosyntheses is insufficient in respect of stability and ensuring rotation, the healing of bone fractures does not present any problems. As a matter of fact, 450 femurs have been treated at our hospital during the pase 14 years with intramedullary Küntscher nailing without drilling. It is demonstrated that this kind of stabilising the fracture is associated with an extremely low incidence of pseudarthroses and infections. Further complications are stated.
Subject(s)
Femoral Fractures/surgery , Fracture Fixation, Intramedullary/methods , Adult , Humans , Male , Postoperative Complications/etiology , Wound HealingABSTRACT
Conservative treatment of a fracture is governed by generally accepted principles, in the first place absolute rest in the fractured region by inactivating the injured limb and adjacent joints. Hence, delayed healing of a fracture and formation of pseudarthroses are attributed to shear forces, insufficient retention and generally to lack of rest in the fractured area. On the other hand, the nonsurgical functional fracture treatment developed by Sarmiento in Los Angeles, U.S.A., considers unrest in the fractured area as an essential stimulant to osteogenesis of the fractured limb. This led to a new type of fracture treatment which largely does away with placing the limb at rest; on the contrary, the injured extremity may be subjected to stress quite early in fact, permitting minor movements in the fractured area and even aiming at such movements. The authors treated 32 fractures of the lower leg in this manner. Compared with fracture treatment of the conventional kind, such as via Küntscher nailing, osseous consolidation - as measured by the time the patient was able to resume his work - occurred more rapidly. There was an absence of other features such as muscular atrophy and limitation of movement; if at all present, they were only slight.
Subject(s)
Braces , Fractures, Bone/therapy , Humans , Tibial Fractures/therapyABSTRACT
Applicability, effect and toleration of dibekacin (Orbicin) were tested in pharmacokinetic, clinical and bacteriological studies treating 29 patients with severe surgical illnesses and 10 healthy volunteers as control group. The pharmacokinetic test results and the efficacy with severe infections showed dibekacin to be equivalent to the new aminoglycoside antibiotics gentamycin, sisomicin and tobramycin. Resistance was sporadic and severe side effects did not occur. Dibekacin proved itself to be a new alternative when aminoglycoside antibiotics are indicated
Subject(s)
Dibekacin/therapeutic use , Kanamycin/analogs & derivatives , Surgical Wound Infection/drug therapy , Bacterial Infections/drug therapy , Female , Humans , Male , Microbial Sensitivity Tests , Middle AgedABSTRACT
Comparative pressure measurements of ready-made elasticated stockings of compression classes I-IV were carried out on 28 patients. Considerable differences in pressure sometimes occur, stockings with a high compression cannot be put on without help. Not all of them can be boiled, the properties sometimes alter after washing. Elasticated stockings are not indicated in lymphedemas etc. Only stockings of compression class I are suitable for the prophylaxis of thrombosis in bedridden patients.
Subject(s)
Occlusive Dressings , Protective Clothing , Thrombosis/prevention & control , Varicose Veins/therapy , Edema/therapy , Evaluation Studies as Topic , Humans , PressureABSTRACT
Animal experiments with 110 female guinea pigs proved an external ovum passage in 14 per cent of cases. These results ask for the conversative character of operations on the adnexes in sexually mature females. Literature reports on several cases of external ovum passage postoperatively. We presume, however, that the phenomenon of external ovum passage also results with an anatomically and physiologically normal sexual system more often than books in out discipline normally report. The basis of this study, which has the aim to prove in an experimental investigation with guinea pigs the phenomenon of external ovum passage, represented the delivery of a patient in the department of Obstetrics and Gynecology at the University of Göttingen, in whom precended operations of contralateral tube and ovary exstirpation.
