1,227 research outputs found
Intraosseous foreign body granuloma in rotator cuff repair with bioabsorbable suture anchor
No full textBiodegradable implants lead to problems such as cyst formation, soft-tissue inflammation, loose implant fragments or local osteolysis. This report represents the first published case of an intraosseous foreign body granuloma in the humeral head after arthroscopic rotator cuff tear fixation with a poly-l-lactide (PLLA) suture anchor. A 48-year-old female patient presented with pain in her right shoulder. A refixation of her right supraspinatus tendon with a biodegradable suture anchor was performed 11 months ago at an external hospital. Laboratory tests showed normal values for C-reactive protein, leukocytes and the erythrocyte sedimentation rate. No signs of infection or instability were noted. The visual analogue scale (VAS) was 8, the simple shoulder test (SST) was 4 and the American shoulder and elbow surgeons score (ASES) was 44. Plain radiographs showed high lucency in the area of the tuberculum majus. MRI showed an intra- and extraosseous mass surrounded by fluid in this area. Surgical care involved arthroscopic debridement and removal of the suture anchor. Histological examination revealed a foreign body granuloma. At the 18-month follow-up the patient was nearly pain-free. The VAS was 2, SST was 10 and ASES was 88. Foreign body granulomas are a well known but rarely described complication that arises after the use of biodegradable suture anchors in shoulder surgery. Every patient presenting with shoulder pain after usage of a biodegradable fixation material should be evaluated closely. Orthopaedic surgeons should be aware of the possibility of delayed foreign body reactions, especially after using PLLA anchors
Surgical management of sternoclavicular septic arthritis
No full textSeptic arthritis of the sternoclavicular joint (SCJ) is a rare condition and has many diagnostic and therapeutic standards. The purpose of this study was to evaluate our experience with surgical and diagnostic management to provide a surgical pathway to help surgeons treat this disease. We retrospectively reviewed five patients who were managed surgically between 1999 and 2007. All patients underwent structured diagnostic and treatment protocols. The functional outcome was evaluated using the Constant Score. The patients had the following underlying medical conditions: laryngeal cancer, port-explantation linked to a rectum carcinoma, spondylodiscitis, and brain stem infarct with reduced general condition; one patient had no underlying medical problems. Three patients underwent a simple incision, debridement and drainage, and two patients underwent an extended intervention with partial resection of the sternoclavicular joint. The mean duration of follow-up was 29 months (range 24-36 months). All patients had well-healed wounds without signs of reinfection. The Constant Score for the functional outcome at the time of the last follow-up was 76 points (range 67-93 points). All patients recovered completely from SCJ disease. Our recommendations for the management of septic arthritis of the sternoclavicular joint include standard treatment steps and assessments. The early stages of infection can be managed by simple incision, debridement and drainage. In advanced stages of infection, a more radical intervention is preferable
Septic arthritis of the shoulder joint : An analysis of management and outcome
No full textWe retrospectively reviewed the records of 21 patients (23 shoulders) who underwent surgical treatment for septic arthritis of the shoulder joint, between 2000 and 2007. Patients were on average 63.7 (41-85) years old; they were treated either by arthroscopic debridement (12 shoulders) or by combined arthroscopic and open procedures (11 shoulders). The mean duration of symptoms prior to surgery was 16 (5-76) days. The mean Constant score recorded at the last follow-up - on average 35.3 months (25-43) after surgery - was 73 (46-82) points. Patients with symptoms for two weeks or less prior to surgery had better results and a lower re-operation rate than those with symptoms longer than two weeks. Early infection can be managed arthroscopically, and satisfactory results can be expected. In advanced infection, a more radical approach is more appropriate
Septic arthritis of the shoulder joint : An analysis of management and outcome
No full textWe retrospectively reviewed the records of 21 patients (23 shoulders) who underwent surgical treatment for septic arthritis of the shoulder joint, between 2000 and 2007. Patients were on average 63.7 (41-85) years old; they were treated either by arthroscopic debridement (12 shoulders) or by combined arthroscopic and open procedures (11 shoulders). The mean duration of symptoms prior to surgery was 16 (5-76) days. The mean Constant score recorded at the last follow-up - on average 35.3 months (25-43) after surgery - was 73 (46-82) points. Patients with symptoms for two weeks or less prior to surgery had better results and a lower re-operation rate than those with symptoms longer than two weeks. Early infection can be managed arthroscopically, and satisfactory results can be expected. In advanced infection, a more radical approach is more appropriate
Sven Lidman: Silfverstååhl i den judiska finansvärlden
No full textSven Lidman was a Swedish author who had a great interest in the industrialization and financial growth in Sweden. In his novel Köpmän och krigare (1911) the noble family Silfverstååhl encounter what Lidman calls “the Jewish finance world”. The response to his work was of mixed character, including response of anti-Semitic character
Fresh fish and amazing trees
No full textMeet John Kilaka, author and illustrator of children’s books and Tingatinga artist in a conversation with Sven Hallonsten.</p
Phylogenetic diversity and the structure of host-epiphyte interactions
No full textThis repository contains code, and data used in the paper "Phylogenetic diversity and the structure of host-epiphyte interactions!", by Marcio R. Pie, Fernanda S. Caron, Sven P. Batke, Johan Reyes-Chávez, Thom Dallimore et al. Use the following link: https://github.com/fernandacaron/epi_evo
All dödlighets sång och skrian : Studier i Sven Rosendahls naturprosa
No full textPär-Yngve Andersson,”All dödlighets sång och skrian”: Studier i Sven Rosendahls naturprosa (The song and scream of all mortality: Studies in the nature writing of Sven Rosendahl)Sven Rosendahl (1913-1990) was an author of novels as well as of various books about landscape and animals. However, his nature writing has not been devoted much attention by critics or literary scholars. Rosendahl himself expressed at many times his dissatisfaction with this. This study is exclusively devoted to his nature writing, and the aim is thereby to fill a disturbing lacuna in Swedish literary research. Several of his most important books are analysed carefully, from Räven från Krackberget (1941) to Från himmelens fåglar… (1968). Major importance is attached to analyses of style and narrative technique, and issues concerning genres and borders between fact and fiction in this kind of nature writing are discussed. I also refer to researchers in environmental literature and philosophers interested in experiences of nature. Detailed lyrical description is regarded as a kind of basis in Rosendahl’s artful language, but his nature writings are at the same time existential literature. Man is clearly seen as a part of nature, but seems to be the only specie conscious of its own mortality. The author is considering man’s place in this world, among all the other species. Confidence in nature’s reiteration is played off against the mortality of the individual. In later parts of the authorship, his awareness about environmental pollution is clearly evident. It even threats the genre of nature writing itself.</p
The role of Sven Ekman, Adolf Remane, Carl Schlieper and Sven G. Segerstråle in Baltic biology
No full textSven EKMAN (1876-1964), zoogeographer and limnologist in Uppsala, wrote significant articles on marine glacial relicts, drew up a proposal of the natural history division of the Baltic Sea and wrote the textbook "Tiergeographie des Meeres", first of its kind and later published in English as "Zoogeography of the Sea". - Adolf REMANE (1898-1976), zoosystematician and ecologist in Kiel, was one of the first to analyse the faunal composition and communities of the Baltic in "Die Tierwelt der Nord-und Ostsee". A pioneering textbook by him and C. SCHLIEPER "Biologie des Brackwassers" appeared also in English. REMANE found the interstitial habitat. He described numerous new Gastrotrichs, Rotifers and Archiannelids. - Carl SCHLIEPER (*1903), zoophysiologist in Kiel, is the founder of the "School of Baltic physiologists". Studies by him and his many students on salt water tolerance and osmoregulation, ionic and temperature adaptation and high pressure tolerance of aquatic animals are known world wide. He is the co-author of four textbooks. Sven G. SEGERSTRÅLE (*1899), zooecologist in Helsinki, initiated the yearly monitoring of the bottom fauna in coastal waters of Finland. He studied the systematics and ecology of amphipods, especially the genus Gammarus and Pontoporeia and biology of the mussel Macoma balthica. His descriptive articles on the Baltic Sea and studies on marine glacial relicts are well known
Osteochondral autografting in articular cartilage defects of the knee
No full textZiel war die Ermittlung des klinischen Therapieeffektes der Knorpel-Knochen Transplantation. Mit der Hypothese, dass durchschnittlich 7 Jahre postoperativ eine signifikante Verbesserung von (1) Lebensqualität, (2) Gelenkfunktion und (3) Knorpelstruktur vorliegt (p<0,05), wurde der Einfluss von Alter, BMI, Defektgröße sowie Zeit zwischen Trauma und Operation untersucht. 31 Patienten wurden nachuntersucht (21 Männer und 10 Frauen). Das Durchschnittsalter lag bei 35 Jahren (17-53 Jahre). Der mittlere BMI betrug 25 kg/m2 (19-32 kg/m2). Im Mittel lagen 53 Tage (7-140 Tage) zwischen Trauma und Operation. Behandelt wurden monofokale Knorpelschäden im Stadium III (n=11) oder IV (n=20) nach Outerbridge. Die mittlere Defektgröße betrug 3 cm2 (1-4,8 cm2). Zur Therapie wurde die Knochen-Knorpel-Transplantation angewandt (Smith & Nephew MOSAICPLASTY® System). Sämtliche Eingriffe wurden durch einen Operateur durchgeführt. Das mittlere Follow-Up betrug 7 Jahre (4,4-9,3 Jahre). Die Auswertung erfolgte anhand des ICRS-Beurteilungspaketes. Zur statistischen Analyse wurde SPSS (Volume 13) benutzt. Die Daten zeigen eine Schmerzreduktion, eine Verbesserung des subjektiven Gesundheitsgefühles sowie des Vitalitätsempfindens (Reduktion der somatischen Beschwerden). Der SF-36-Score zeigt signifikante Verbesserungen in den Subskalen Körperliche Schmerzen (p<0,001), Allgemeine Gesundheitswahrnehmung (p<0,001), der Vitalität (p=0,008) sowie der Körperlichen Summenskala (p<0,001). Im Vergleich mit den altersgruppenspezifischen Normwerten der deutschen Bevölkerung zeigt sich eine Annäherung der Werte an die Norm. Es besteht ein signifikanter Zusammenhang zwischen BMI und der Körperliche Funktionsfähigkeit (p=0,013) sowie der Emotionale Rollenfunktion (p=0,01). Mit zunehmendem BMI nimmt die Körperlichen Funktionsfähigkeit linear ab und die Emotionalen Rollenfunktion verschlechtert sich (p=0,01). Des Weiteren zeigt sich ein signifikanter Zusammenhang zwischen Defektgröße und dem Psychischen Wohlbefinden . Mit zunehmender Defektgröße nimmt das Psychische Wohlbefinden linear ab (p=0,036). Der allgemeine Gesundheitszustand wird verbessert. Der IKDC-Score zeigt signifikante Verbesserungen in 26 Fällen (p<0,001). BMI und der IKDC-Werte weisen einen linearen Zusammenhang auf. Mit zunehmendem BMI verschlechtert sich der IKDC-Wert (p=0,025). Bei Patienten mit einem BMI unter 25 kg/m2 besteht eine Verbesserung der Skalenwerte. Defektgröße, Zeit zwischen Trauma und Operation sowie das Alter zeigen keine signifikante Zusammenhang mit dem IKDC-Wert. Der ICRS-Score (anhand MRT) zeigt eine Verbesserung in 26 von 28 Fällen (normaler (n=12), fast normaler Befund (n=14). Die Knorpel-Knochen-Transplantation ist eine etablierte Methode zur Therapie von Knorpelschäden im Stadium III und IV. Diese Studie belegt einen Gewinn an Lebensqualität und Gelenkfunktion sowie eine Verbesserung der Knorpelstruktur (MRT) nach Knorpel-Kochen-Transplantation am Kniegelenk. Patientenselektion (unter Beachtung der patienteneigenen Ressourcen wie Compliance und BMI) sowie die korrekte Indikationsstellung (Defektgröße und Alter) sind entscheidende Faktoren in Hinblick auf ein gutes klinisches Ergebnis. Je größer der BMI oder die Defektgröße, desto schlechter ist das klinische Ergebnis. Der Zeitraum zwischen Trauma und Operation scheint keinen Einfluss auf das klinische Ergebnis auszuüben. Zur Erlangung valider und vergleichbarer Ergebnisse bedarf es jedoch weiterer Studien mit größeren Patientenkollektiven unter Nutzung einheitlicher Beurteilungsskalen (wie zum Beispiel das ICRS-Beurteilungspaket).The aim of the study was to evaluate the clinical benefit of the autologous osteochondral transplantation according to quality of life and joint function at a mean Follow-Up of 7 years. We hypothesized that the osteochondral autografting presents a significant improvement in (1) quality of life, (2) joint function and (3) cartilage structure (p<0.05). Moreover, the influence of age, BMI, defect size as well as the time between suffering trauma and surgery was measured. Thirty-one of thirty-eight patients were examined (21 men, 10 women). The average age was 35 years (17-53 years), the middle BMI was 25 kg/m² (19-32 kg/m²). The average period between trauma and surgery was 53 days (7-140 days). Monofocal osteochondral lesions III° (n=11) or IV° (n=20) were treated (Outerbridge classification). The average defect size was 3 cm2 (1-4.8 cm2). For transplantation the Smith & Nephew MOSAICPLASTY® system was used. All surgeries were executed by one surgeon. The mean Follow-Up was 7 years (4.4-9.3 years). For evaluation the ICRS-Evaluation-Package was used. Data analysis was performed by SPSS, Volume 13. We observed a pain reduction, improvement of the subjective health feeling as well as an improvement of the vitality feeling (reduction of the somatic discomfort). Significant differences of the SF-36-Values ( physical pain (p <0.001), general health perception (p <0.001), vitality (p=0.008) and physical sum scale (p <0.001) were noticed. In comparison to the standard values of the German population nearly normal values were reached. There was a significant correlation between the SF-36-Values and the BMI ( physical effectiveness (p=0.013) as well as the emotional role function (p=0.01)). With increasing BMI the values of the physical functioning and the values of the emotional role function (p=0.01) decreased. The defect size has a significant influence on the change of the psychic health feeling . As bigger the defect size was as worse was the psychic health feeling (p=0.036). The general state of health was improved. The IKDC-Values showed a significant improvement in 26 cases (p<0.001). BMI and IKDC-Values showed a linear correlation. With increasing BMI the IKDC-Values decreases (p=0.025). As bigger the BMI is as more slightly is the improvement of the scale values. Only the patients with a BMI lower than 25 kg/m² showed positive scale values. Defect size, the time between suffering the trauma and the surgery as well as the age showed no significant correlation according to the IKDC-Values. The ICRS-Score (MRI) was improved in 26 of 28 cases (n=12: normal, n=14: almost normal). The autologous osteochondral transplantation is an established method to treat articular cartilage defects in stage III or IV. This study shows a better quality of life, joint function and cartilage structure after autologous osteochondral transplantation of the knee. Patient selections with respect to the individual resources (compliance, BMI) as well as the correct indication (defect size, age) are determining factors in order to get good clinical results. As higher the BMI or the defect size is, as worse are the clinical results. The time interval between suffering the trauma and the surgery seems to have no influence on the results. Nevertheless, studies with bigger patient groups and the use of standardized scores (ICRS- Cartilage Repair Evaluation Package) are needed to get a valid and comparable statement
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