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1.
The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy
Miklós Papp Zoltán Csernátony Sándor Kazai Zoltán Károlyi László Róde 《Knee surgery, sports traumatology, arthroscopy》2007,15(6):769-780
High tibial osteotomy changes the patella and tibial condyle position, which makes the subsequent total knee replacement technically
demanding. From 1 January 1993 to 31 December 2000, combined osteotomy [After the first osteotomy made 2 cm distally to the
joint line, a bone wedge is removed based laterally. Its tip ends at the center of the tibial condyle (half bone wedge). The
distal part of the tibia is placed into the valgus position and the half bone wedge is placed into the gap opened medially.]
was performed on 103 knees and closing wedge osteotomy was performed on 47 consecutive knees. Eighty combined (group A) and
41 closing wedge (group B) osteotomy were studied. All knees were assessed radiologically before surgery, in the 10th postoperative
week, in the 12th postoperative month and at the time of the final follow-up (in group A—66.15 months, in group B—66.61 months).
We examined the change of the femorotibial angle, of the patellar height according to the method of Insall and Salvati, of
the tibial slope angle according to the method of Bonnin, of the tibial condylar offset according to the method of Yoshida
and of the distance between the lateral tibial plateau and the top of the fibular head. In group A and B, the recurrence of
the varus deformity was not noted and valgus alignment did not increase in any case. In group-A, the Insall–Salvati ratio
remained unchanged in 65% of knees. The tibial slope angle decreased in both groups. There was correlation between the change
of the tibial condylar offset and the angle of the correction in both groups. There was correlation between the change of
the distance between the lateral tibial plateau and the top of the fibular head. After combined osteotomy, the transposition
of the tibial condyle and the decrease of the distance between the lateral tibial plateau and the top of the fibular head
was less than after closing wedge osteotomy, although the average angle of correction was more after combined osteotomy (11.835°),
than after closing wedge osteotomy (9.465°). Theoretically, the recurrence of the varus deformity, the increase of the valgus
alignment and (in majority of cases) the shortening of the patellar tendon do not compromise the likelihood of successful
conversion to the subsequent total knee replacement, either after combined or after closing wedge osteotomy. The combined
osteotomy does not lead to considerable transposition of the tibial condyle and to considerable lateral tibial bone loss;
therefore, theoretically, the combined osteotomy does not impair the subsequent total knee replacement. 相似文献
2.
The incidence over 10% of premature delivery in Hungary was studied. The cause which motivated this work was the fact that despite of several preventive and therapeutic measures the incidence e.g. in BAZ county surpassed even the average of the country. Professors of clinics in different countries of Europe as well as medical societies dealing with this question have been consulted about the matter of whether it was sufficient to consider a neonate a premature infant and the delivery a premature one solely on the basis of birth weight (under 2.500 g). Data of BAZ county proved that this determination was misleading and proposals are made concerning the modification on the basis of the examinations of the authors. 相似文献
3.
4.
L Papp A Kollár F Rényi-Vámos T Gy?ngy F Horkay L V Hermes E Moravcsik E Bodor Z Szabolcs Z Szabó 《Orvosi hetilap》1992,133(15):901-908
In Hungary valve replacement is still a major indication for heart surgery in adults. In the Cardiovascular Surgical Clinic of Semmelweis Medical University of Budapest from 1976 to 1990 2435 patients were operated for valve disease. Majority of the cases had single (aortic n = 856, mitral n = 912) or double (aortic + mitral n = 513) valve replacement. Over this 15 years period there have been many alterations in patients characteristics and surgical technique as well. In spite of the increasing mean age of patients the operative mortality has decreased (in the last 5 years period it was 2.7%, 5.5% and 7.9% in the three groups respectively). At the same time the number of patients requiring valve re-replacement or combined valve + coronary procedure has increased. The use of bioprosthetic valves has fallen below 10 percent from the 60--80 percent observed between 1976--1980. The analysis showes excellent surgical results in the field of valve replacement in Hungary. 相似文献
5.
Erzsébet Lizanecz Eniko T Pásztor Attila Mohácsi Zoltán Papp István Edes Attila Tóth 《Hypertension research》2006,29(3):197-201
Conflicting results are to be found in the literature on the relationship between the M235T polymorphism of the angiotensinogen (AGT) gene and hypertension. The controversy may be due to insufficient numbers of subjects, the variability of the inclusion criteria and the different genotype analysis methods used. We have experienced that the most frequently used, original polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method involves significant uncertainties when the TT genotype is determined, independently of the restriction digestion. To make the determination more accurate, we improved the PCR by designing a new antisense primer containing only one mismatch instead of the two in the original protocol and also by adding DMSO to the PCR reaction mixture. The original and our improved methods were compared by using DNA from 123 patients: parallel determinations resulted in values of 33 MM, 90 MT and 0 TT with the original method and of 33 MM, 56 MT and 34 TT with the improved RFLP protocol. In summary, a plausible explanation for some of the conflicting data published on AGT M235T polymorphism may be that inaccuracies arose during the determination of the genotype. 相似文献
6.
7.
After giving a short account on the possible ways of male contraception, the authors outline the administration of surgical sterilization and its professional follow-up based on their own experience. Their suggestions concerning legal regulations aim, on the one hand, at the extension of the topic, on the other hand at supporting the specialists interested in surgical contraception. 相似文献
8.
9.
The pharmacological profile of the two 5-HT(3) (5-hydroxytryptamine) receptor antagonists, the putative anxiolytics ICS 205-930 and GR38032F was compared with that of diazepam in four standard behavioural tests in rats. All the investigated drugs induced an anxiolytic effect in the passive avoidance test, having reduced the latency to re-enter the chamber previously associated with an inescapable footshock, and increased the time spent in that chamber. On the basis of the lowest effective dose, both ICS 205-930 and GR38032F were about 20 times more potent than diazepam, though the anxiolytic activity of either 5- HT(3) receptor antagonist was confined to a narrow dose range (ICS 205-930: 93.7-187.5 μg/ kg, GR38032F: 125-375 μg/kg), their higher doses having been ineffective. The anxiolytic effect of diazepam, but not of ICS 205-930, was abolished by flumazenil. In contrast to diazepam, neither ICS 205-930 nor GR38032F-both given in doses up to 20 mg/kg-showed any activity in the pentylenetetrazol-induced seizures, open field, and rota-rod tests. These results suggest that the 5-HT(3) receptor antagonists may represent a new class of anxiolytic drugs devoid of anticonvulsant, sedative or muscle-relaxant properties, and that their anxi olytic activity is not mediated by benzodiazepine receptors. 相似文献
10.
In the symptomatic treatment of mild to moderately severe dementia associated with Alzheimer's disease, donepezil (E2020) has been introduced for the inhibition of acetylcholinesterase activity in the human brain. However, there is no morphological evidence as to how this chemical agent affects the acetylcholinesterase-positive structures in the various areas of the human and the rat CNS. This study demonstrates by histochemical means that donepezil exerts a dose-dependent inhibitory effect in vitro on acetylcholinesterase activity. The most sensitive areas were the cortex and the hippocampal formation. Within the different layers of the cortex, the cholinoceptive acetylcholinesterase-positive postsynaptic pyramidal cell bodies were more sensitive than the presynaptic cholinergic axonal processes. In the cortex, the cell body staining was already abolished by even 2 x 10(-8)M donepezil, whereas the axonal staining could be eliminated only by at least 5 x 10(-8)M donepezil. In the hippocampus, the axonal acetylcholinesterase reaction end-product was eliminated by 5 x 10(-7)M donepezil. The most resistant region was the putamen, where the staining intensity was moderately reduced by 1 x 10(-6)M donepezil. In the rat brain, the postsynaptic cholinoceptive and presynaptic cholinergic structures were inhibited by nearly the same dose of donepezil as in the human brain. These histochemical results provide the first morphological evidence that, under in vitro circumstances, donepezil is not a general acetylcholinesterase inhibitor in the CNS, but rather selectively affects the different brain areas and, within these, the cholinoceptive and cholinergic structures. The acetylcholinesterase staining in the nerve fibers (innervating the intracerebral blood vessels of the human brain and the extracerebral blood vessels of the rat brain) and at the neuromuscular junction in the diaphragm and gastrocnemius muscle of rat, was also inhibited dose dependently by donepezil.It is concluded that donepezil may be a valuable tool with which to influence both the pre- and the postsynaptic acetylcholinesterase-positive structures in the human and rat central and peripheral nervous systems. 相似文献