Publications by authors named "Kenn R"

It has been suggested that the distribution of the subchondral bone density may be regarded as the expression of the long-term effective stress in a joint, and previous results indicate the regularity of the distribution of subchondral bone density as a function of the passing demands made upon a joint. Computed tomography-osteoabsorptiometry has been developed to visualize the area distribution of subchondral mineralization in the major joints in vivo. The purpose of this study was to display the distribution of subchondral bone density in the acetabular cup of patients of different ages.

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To get information on the stresses acting on the shoulder joint, the distribution of subchondral mineralisation was examined by means of CT-Osteo-absorptiometry in the glenoid cavity in healthy people, athletes and patients. In young persons two density maxima are found ventrally and dorsally older persons, however, show a centrally located maximum which suggests a different joint mechanics in different ages depending on the decreasing physiological incongruence. In gymnasts the overall mineralisation is significantly higher, maxima are found centrally or shifted dorsally.

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Since the work of Pauwels and his successors, it has been possible to use the distribution of subchondral bone density within a joint surface as a metric parameter that can reflect the principal long-term stress acting upon a joint. However, the x-ray densitometry method he employed cannot be applied to living people. A procedure was therefore developed whereby CT osteoabsorptiometry (CT OAM), based on the use of computed tomography, allows the distribution pattern of the density to be demonstrated in living subjects.

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There is an increasing demand for accurate preoperative and intraoperative staging of bronchial carcinoma with respect to neoadjuvant therapy protocols and parenchyma-sparing operations. This study prospectively evaluated accuracy of computed tomographic scan and surgical assessment for staging of bronchial carcinoma in 108 consecutive patients. The stage of the primary tumor (T stage) was correctly determined in 85% of the patients, and surgical evaluation correctly determined the T stage in 92%.

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Whether conservative or operative management is selected for intra-articular fractures of the os calcis depends on subjective factors and on the surgeon's experience. There is no classification available that allows ranking of such fractures according to the extent of destruction and the degree of dislocation at the same time. CT scans of 44 calcaneal fractures have been used to elaborate a new classification system for calcaneal surfaces.

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Thorough examination of the injured foot is the basis of a complete diagnosis and the foundation for successful therapy. Anatomical and biomechanical knowledge is a necessity to achieve this goal. The radiological diagnostic procedures include plain film, digital subtraction angiography, US, CT and MRI.

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[Therapeutic concept in incidentaloma of the adrenal gland].

Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir

March 1992

The operative approach to adrenal incidentalomas depends on the subclinical hormoneactivity and the risk of malignancy. In our 18 patients there were two pheochromocytomas (3 and 5 diameter), one with subclinical hormoneactivity and three malignancies, an adrenocortical carcinoma, a metastasis without primary and a lymphoma. The malignant tumors were larger than 5 cm.

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The nonabsorbable cuff used for nonsuture anastomosis can cause residual vessel stenosis as well as regional wall rigidity. Resulting disturbances in laminar flow promote the development of irregularities in the intimal endothelial vessel lining distal to the anastomosis. Using absorbable cuffs, the degree of stenosis can be appreciably reduced, thereby diminishing thrombogenic flow turbulence.

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11 years after patch aortoplasty due to coarctation of the aorta a 33 year-old patient experienced two spontaneous haemoptyses. A centralvenous digital subtraction angiography demonstrated a large aneurysm of the proximal descending aorta penetrating the left upper lobe of the lung. The successful emergency surgical treatment consisted of implantation of a dacron-prosthesis.

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