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Skopje, Macedonia

Ui M.,Orthopedic Clinic | Ogawa K.,Eiju General Hospital
Orthopedics | Year: 2010

Lipoma is the most frequently occurring benign soft tissue tumor in the shoulder and the axillary region in middle-aged and older persons, yet few such lipoma cases have been associated with clinical symptoms. A 38-year-old right-handed man presented with an enlarged feeling and a painful back-and-forth popping in his left shoulder. Although moderate tenderness of the subacromial bursa and bicipital groove existed, an obvious impingement sign was absent. Also not evidenced were signs of neurological deficits, limited range of motion, or any physical findings suggestive of instability. Magnetic resonance imaging showed a homogenous tumor in the subdeltoid that was isointense relative to the subcutaneous fat and fluid collection in the hypertrophic subacromial bursa. As the tumor was considered from the clinical and imaging findings to be attributable to all clinical symptoms, it was resected en bloc with a satisfactory result. Histopathologically, the tumor showed typical features of a simple lipoma. To our knowledge, the present case is the first of a subdeltoid intermuscular lipoma of which mechanism developing symptoms was preoperatively surmised from imaging. The symptommimicking shoulder instability was assumed to be produced by the back-and-forth snapping of the lipoma beneath the deltoid muscle. The mechanism for developing the subacromial impingement-like symptom was surmised to derive from the middle deltoid fibers pressuring the lipoma to push up into the subacromial space. This case is presented to emphasize the careful reading of imaging in considering the pathomechanism of the attributing symptoms. Source


Lange J.,University of Greifswald | Barz T.,Asklepios Clinic Uckermark | Ekkernkamp A.,University of Greifswald | Wilke B.,University of Greifswald | And 2 more authors.
PLoS ONE | Year: 2012

Background: Because inbred rat strains are widely used as laboratory models, knowledge of phenotypic and genetic variations between strains will be useful to obtain insight into the relationship between different strains. Methods and Results: We studied phenotypic traits: of each strain - BN/K, DA/K and WOKW -10 male rats were studied for body weight and serum constituents at an age of 10 and 30 weeks. In addition, a total of 95 rats were studied for life expectancy. At an age of 30 weeks, these male rats were killed by an overdose of anesthetic (Sevofluran, Abbott), and the subcutaneous and visceral adipose tissue as well as bone tissue were removed to study the expression of 20 genes. There were significant differences in body weight, serum lipids and leptin at an age of 30 weeks between strains. Regarding life expectancy, BN rats lived longest (1072±228d). The highest gene expression was found in bone of BN rats. In adipose tissues, Nfkb1 is only expressed in subcutaneous adipocytes, and 5 genes, Col2a1, Mmp9, Tnfa, Ins1 and Cyp24a1, are not expressed in adipocytes. The ranking BN = DA>WOKW was observed in only one gene in subcutaneous (Fto) and visceral adipocytes (Col6a1). There were no significant differences in gene expression of one gene in subcutaneous adipocytes and of 3 genes in visceral adipocytes. Comparing the gene expression in visceral and subcutaneous adipocytes, only one gene showed a comparable behavior (Bmp1). Conclusion: From these results, it can be concluded that obvious phenotypic differences are caused by genetic differences between three rat strains, BN, DA and WOKW, as supported by gene expression studies in bone and adipose tissues. Especially BN rats can be used to study the genetic basis of long life. © 2012 Lange et al. Source


Mann V.,Justus Liebig University | Spitzner T.,Justus Liebig University | Schwandner T.,Justus Liebig University | Mann S.T.W.,Orthopedic Clinic | And 4 more authors.
Anaesthesia | Year: 2012

Summary For personnel inexperienced in airway management, supraglottic airway devices may be the first choice in an emergency. Changing head position is known to reduce the seal pressure of a laryngeal mask airway. The aim of this study was to investigate whether the use of a cervical collar improves the stability of airways secured with the LMA Supreme™ (The Laryngeal Mask Company Limited, Mahé, Seychelles). In this crossover trial, the primary endpoint was the difference in the seal pressure of the LMA Supreme in anaesthetised patients in maximum passive extension of the neck, with and without a cervical collar. The median (IQR [range]) seal pressure was 18 (13.8-22.1 [0-30]) cmH2O in maximum passive extension without a cervical collar. With a cervical collar in place, the seal pressure increased to 28 (22.8-30 [17-30]) cmH2O (p < 0.001). In the neutral head position, the seal pressure was 22 (17.6-24.5 [12-30]) cmH2O without and 27 (22-30 [12-30]) cmH2O with a cervical collar in place (p < 0.001). We found that a cervical collar stabilises the airway with an LMA Supreme in place and we recommend this combination for (pre-hospital) emergency cases. © Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland. Source


Strobel U.,Universitatsspital Zurich | Tami I.,Orthopedic Clinic | Andreisek G.,Universitatsspital Zurich | Giovanoli P.,Universitatsspital Zurich | Calcagni M.,Universitatsspital Zurich
Handchirurgie Mikrochirurgie Plastische Chirurgie | Year: 2014

Purpose: The aim of this study was to review the outcome of transscaphoid perilunate fracture dislocations by MRI to use the advantages of MRI to show the post-traumatic degenerative changes, the examination of cartilage, the integrity of the ligaments and the vascularisation of the carpal bones. A second aim of this study is to interpret the findings in correlation to the functional results and the individual perception of hand functionality (PRWE). Patients and Methods: In this retrospective study, 20 patients (1 woman and 19 men), who were treated with open reduction and internal fixation at our institution, were reviewed at a mean of 67 (25-145) months postoperative. The mean age was 30 (12-73) years. The functional results were measured by range of motion (ROM), grip and pinch strength. The Mayo and Krimmer wrist scores were calculated and the SF-36 and the patient-rated wrist evaluation (PRWE) questionnaires were performed. Radiological findings included consolidation of the fracture and the radiological measures (revised carpal height, SL gap, SL and RL angle). An MRI, performed without a contrasting agent, was used to assess the degenerative changes of the joints, the vascularisation of the carpalia and the integrity of the SL ligament. Statistical data was calculated with SPSS. Results: Range of motion and strength were reduced by 10-20% compared to the uninjured opposite side. Although the majority of the patients (85%) achieved good to very good results in the Mayo and Krimmer wrist scores, the MRI showed osteoarthritis in 95% of the cases in at least in 1 out of 5 patients evaluated intracarpal joints. MRI showed signs of complete SL ligament tears in 5 patients and a partial tear in 2 patients. The same group also showed the strongest degenerative changes. However, there was no correlation between patient satisfaction and imaging results. Conclusion: MRI findings, as well as X-ray findings, do not correlate with the subjective and objective functional outcomes after surgical treatment of transscaphoid perilunate fracture dislocations. It can be assumed that SL ligament lesions seen in MRI play a major role over the long term course. © 2014 Georg Thieme Verlag KG Stuttgart, New York. Source


Lange J.,University of Greifswald | Barz T.,Asklepios Klinikum Uckermark | Ekkernkamp A.,University of Greifswald | Kloting I.,University of Greifswald | Follak N.,Orthopedic Clinic
Genes and Nutrition | Year: 2013

A high-fat diet (HFD) has been recognized as a risk factor for diseases such as dyslipidemia, atherosclerosis, obesity, and osteoporosis. However, studies analyzing gene expression after HFD in bone are rare. That prompted us to analyze the expression of selected genes in bone of 4-week-old diabetes-prone B(io)B(reeding) rats. Two breeding pairs were fed a HFD (+10 % tallow) or were fed a normal diet (ND; Ssniff R-Z) before mating and afterward during pregnancy. After the birth of progeny, parents continued to be given HFD or ND until the progeny was weaned (3 weeks). Thereafter, offspring were weaned and were fed the same food as their parents up to an age of 4 weeks. Body weight was measured at an age of 4 weeks, and subsequently 13 HFD rats and 13 ND rats were killed and the tibial bone was harvested to analyze the expression of 53 genes in bone. All rats fed HFD were significantly heavier than rats fed ND after 3 and 4 weeks. The diet also influenced the expression of genes in bone. There were significant differences in 20 out of 53 genes studied between rats fed HFD compared with rats fed ND. Four out of 20 had a lower and 17 out of 20 genes a higher expression in HFD rats, but differences in gene expression showed obvious differences between males and females. There were only two genes that were similarly different between males and females: Bmp4 and Atf4. Two genes, Foxg1 and Npy, were inversely expressed in males and females. It seems that the gene expression is differently regulated by diet during pregnancy and later in life between males and females. Nevertheless, it cannot be excluded that HFD also acts as an epigenetic factor in the development of offspring in utero. © 2012 Springer-Verlag. Source

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