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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Physica C: Superconductivity and its applications 162-164 (1989), S. 811-812 
    ISSN: 0921-4534
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 449-450 
    ISSN: 1279-8517
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1279-8517
    Keywords: Patella ; Cartilage degeneration ; Subchondral mineralisation ; Chondromalacia patellae ; Femoropatellar arthrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Selon la littérature, l'os sous-chondral joue un rôle important dans la transmission des forces à travers les articulations et dans la pathogénie de l'arthrose. C'est pourquoi la dégénérescence du cartilage articulaire a été étudiée sur les patellas de 30 sujets anatomiques et de 20 patients venant de subir une arthroscopie et dont la minéralisation sous-chondrale de l'os sous-jacent avait été appréciée au même moment par absorptiométrie osseuse par scanner. Les lésions cartilagineuses latérales étaient situées sur de l'os sous-chondral fortement minéralisé ; elles paraissent êtres dues à des contraintes à long terme. Elles furent principalement trouvées sur les spécimens âgés et montraient un fort taux de progression en fonction du vieillisement. A l'opposé, les lésions cartilagineuses médiales étaient situées dans une région de transition entre des minéralisations modérée et faible ; elles pourraient être dues à des pics de contrainte intermittents et à des contraintes en cisaillement sur le cartilage articulaire, la partie la plus médiale de l'articulation étant privée de stimulations mécaniques la plupart du temps. Ces lésions furent trouvées essentiellement sur les sujets les plus jeunes et montraient peu de progression avec le vieillissement. Les patients présentant une dégénérescence cartilagineuse latérale avaient une minéralisation supérieure à la normale, les patients présentant une chondromalacie médiale avaient une minéralisation plus faible que la normale. La distribution de la densité indique donc un mécanisme pathogénique différent pour les lésions cartilagineuses sur les facettes latérale et médiale. L'absorptiométrie osseuse par scanner permettrait donc d'apprécier la situation mécanique individuelle de chaque articulation fémoropatellaire. Cette situation est fortement corrélée à la pathogénie de la dégénérescence du cartilage patellaire.
    Notes: Summary According to the literature subchondral bone plays a significant role in the transmission of load through joints and in the pathogenesis of osteoarthrosis. Therefore the degeneration of the articular cartilage was investigated in the patellae from 30 dissecting-room specimens and of 20 patients, previously submitted to arthroscopy, and subchondral mineralisation of their underlying bone was at the same time assessed by means of CT osteoabsorptiometry. Lateral cartilage lesions were localised over highly mineralised subchondral bone; these appear to be due to long-term stress. They were mainly found in the older specimens and showed a high rate of progression with increasing age. Medially localised cartilage lesions, on the other hand, were situated in a transitional region between moderate and slight subchondral mineralisation; they may be caused by infrequent stress peaks and by shear stress in the articular cartilage, the very medial part of the joint being deprived of mechanical stimulation for much of the time. These lesions were to be found predominantly in the younger specimens and showed little progress with advancing age. Patients with lateral cartilage degeneration exhibited higher, patients with medial chondromalacia patellae lower mineralisation than normals. Their density patterns therefore indicate a different mechanical pathogenesis of the cartilage lesions in the lateral and medial facet. It could be shown that CT osteoabsorptiometry allows an assessment of the mechanical situation, present in individual femoro-patellar joints, and that this situation is highly relevant for the pathogenesis of patellar cartilage degeneration.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 429-438 
    ISSN: 1279-8517
    Keywords: Articular cartilage ; Magnetic resonance imaging ; Cartilage thickness ; Patella ; Knee joint
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'évaluation quantitative de l'épaisseur et du volume du cartilage de patellas humaines, fixées dans un mélange d'alcool et de formol, a été réalisée en imagerie par résonance magnétique (IRM) car on ne sait encore avec exactitude si l'aspect morphologique du cartilage normal ou lésé peut être parfaitement démontré par cette technique. L'IRM a été réalisée sur un appareil 1.0 T (épaisseur de coupe : 2 mm, résolution : 0,39–0,58 mm) avec les séquences suivantes : 1) séquence en spin écho pondéré T1, 2) 3D-MRAGE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Après la réalisation de l'IRM, la patella était sectionnée tous les 2 mm, perpendiculairement à sa surface articulaire, à l'aide d'une scie à ruban. Le volume de son cartilage était déterminé sur les coupes anatomiques et les images IRM grâce à un système d'analyse d'images Vidas IPS 10 (Kontron). Les mesures étaient réalisées avec et sans la couche en hyposignal correspondant à la zone transitionnelle située entre le cartilage articulaire et l'os sous-chondral. Lorsque cette couche en hyposignal était prise en compte, le volume était surestimé par l'IRM de 16 à 19%. Lorsque cette couche en hyposignal n'était pas prise en compte, les volumes étaient inférieurs à ceux déterminés par les coupes anatomiques : T1-SE : −18,2%, MPRAGE : −22,6%, FISP : − 17,1%, MTC-FISP : − 9,5%, DESS : − 9,3% et FLASH : −6,1%. La séquence FLASH permettait l'appréciation la plus correcte et la plus reproductible de la morphologie du cartilage. La différence persistante par rapport au volume réel du cartilage peut être due au fait que la zone calcifiée du cartilage n'est pas délimitée par l'IRM.
    Notes: Summary Quantitative assessment of cartilage volume and thickness in a formalin-alcohol fixed specimen of a human patella was conducted with magnetic resonance imaging (MRI), as it is still unclear whether the morphology of normal and damaged cartilage can be accurately demonstrated with this technique. MR imaging was carried out at 1.0 T (section thickness 2 mm, in-plane-resolution 0.39 – 0.58 mm) with the following pulse sequences: 1) T1-weighted spin-echo, 2) 3D-MPRA-GE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Following imaging, the patella was sectioned perpendicular to the articular surface at intervals of 2 mm with a diamond band-saw. The volume of its cartilage was determined from the anatomical sections and the MR images, using a Vidas IPS 10 image analysing system (Kontron). Measurements were carried out with and without the low-signal layer in the transitional zone between the articular cartilage and the subchondral bone. If the low-signal layer was included, the volume was overestimated with MRI by 16 to 19 %. Without the low-signal layer the volumes were less than those determined from the anatomical sections: T1-SE −18,2 %, MPRAGE −22.6 %, FISP −17.1 %, MTC-FISP −9.5 %, DESS −9,3% and FLASH −6.1 %. The coefficient of variation for a 6-fold determination of the volume amounted to between 6.2 % (T1-SE) and 2.6 % (FLASH). The FLASH sequence allowed the most valid and reproducible assessment of the cartilage morphology. The remaining difference from the real volume of the cartilage may be due to the fact that the calcified zone of the cartilage is not delineated by MRI.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1433-2965
    Keywords: Key words:Bone mineral density – DXA – Femoral failure loads – Hip fracture – Osteoporosis – Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The objective of this study was to determine experimentally the sex-specific correlation of femoral and lumbar DXA and calcaneal ultrasound, measured in situ, with the in vitro failure loads of the proximal femur. Fifty-eight cadavers with intact skin and soft tissues (34 male, aged 81.2 ± 8.7 years; 24 female, aged 83.7 ± 10.6 years) were examined. The bone mass of the proximal femur and the lumbar spine were determined using dual-energy X-ray absorptiometry and the ultrasonic properties of the calcaneus with quantitative ultrasound. Afterwards, the right femora were excised 18 cm distal to the minor trochanter, and their load to failure determined with a material testing machine. Femoral fracture loads were significantly higher in males than in females, both before and after correcting for body height and weight. Femoral neck bone mineral density (BMD) was significantly correlated with femoral failure loads (r= 0.65 all specimens, 0.57 males (0.64 after excluding trochanteric fractures) and 0.77 females; p 〈0.001). The correlations with the ultrasonic Stiffness Index of the calcaneus were in a similar range (r= 0.67 all specimens, 0.48 males (0.64 after excluding trochanteric fractures) and 0.65 females; p 〈0.001). The correlations between femoral failure loads and the spinal BMD were lower (r= 0.40, p 〈0.01), particularly in males (r= 0.30, not significant). In contrast to previous experimental investigations on excised bones, our results are consistent with clinical studies that have reported that ultrasound and femoral DXA have a similar ability to predict the risk of hip fracture.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Der Orthopäde 27 (1998), S. 675-680 
    ISSN: 1433-0431
    Keywords: Key words Labrum acetabulare • Limbus acetabularis • Lig. transversum acetabuli ; Schlüsselwörter Labrum acetabulare • Limbus acetabularis • Lig. transversum acetabuli
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Labrum acetabulare stellt ein streng ringförmig angeordnetes Bündel kollagener Fasern dar. Es begleitet den Limbus tangential, setzt sich aber bis auf eine kleine kraniodorsale Zone von der Knorpelbedeckung der Facies lunata durch einen scharfen Spalt ab. Mit dem Lig. transversum acetabuli ist es fest verbunden. Eine zirkulär verlaufende äußere Anastomose, die vornehmlich von Ästen der A. glutea superior, der A. obturatoria und einem aszendierenden Ast der A. circumflexa femoris medialis gespeist wird, gewährleistet die arterielle Versorgung. Die Innervation erfolgt über den Muskelast zum M. quadratus femoris sowie über den N. obturatorius. Im Labrum finden sich alle Typen von Mechanorezeptoren. Das Labrum acetabulare stellt eine feste Zuggurtung des Randes der Hüftpfanne dar, deren wichtige Rolle sich von der physiologischen, lastabhängigen Inkongruenz der Gelenkkörper ableitet.
    Notes: Summary The acetabular labrum appears as a bundle of distinctly circular lined up collagenous fibers. It surrounds the limbus tangentially and is separated from the cartilagenous covered facies lunata through a thin gap (fissure) except of a small zone in the craniocaudal part. The labrum is strongly fixed with the transverse acetabular ligament. A vascular anastomotic ring surrounds the capsular attachement. It derives its blood supply especially from the superior gluteal vessels, the obturator artery and one ascending branch of the medial femoral circumflex artery. The innervation of the acetabular labrum is coming from a branch of the nerve to the quadratus femoris muscle and from the obturator nerve. There are all types of mechanoreceptors in the labrum. The acetabular labrum is able to exert a high tensional force on the rim of the acetabulum. This plays a very important role in view of the physiological, load depending incongruity of the articulating parts of the hip-joint.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1433-044X
    Keywords: Key words Hip joint • Contact stress • Incongruity • Gait • Joint loading ; Schlüsselwörter Hüftgelenk • Druckverteilung • Inkongruenz • Gang • Gelenkbelastung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Ziel der Untersuchung war die experimentelle Bestimmung der Druckverteilung im Hüftgelenk für charakteristische Phasen des Ganges. Die von Bergmann et al. (1993) mittels telemetrischer Endoprothesen in vivo bestimmten Gelenkkräfte wurden auf Basis kinematischer Ganganalysen in ein beckenbezogenes Koordinatensystem transformiert. An 8 Hüftgelenkpräparaten (Alter 18–75 Jahre) wurden dann während 4 Gangphasen (Fersenkontakt, 1. Kraftmaximum, Ferse vom Boden, Abrollen der Zehen) die Gelenkkräfte eingeleitet und die Druckverteilung mittels FUJI-Druckmeßfolie bestimmt. Wir fanden Maxima von 10 MPa während der mittleren Standbeinphase, die Zonen höchster Druckbelastung waren im ventrosuperioren Anteil des Azetabulums (vorderes Pfannendach) und dorsoinferior (Hinterhorn der Facies lunata) lokalisiert. Die Druckverteilung war während der 4 Phasen relativ konstant, die Größe der Maxima variierte nicht proportional zu den eingeleiteten Kräften. Die normale Druckverteilung im Hüftgelenk wird offensichtlich von der physiologischen Inkongruenz der Gelenkflächen sowie der inhomogenen knöchernen Unterstützung des Azetabulums bestimmt. Bei operativen Maßnahmen im Bereich des Hüftgelenks sollte diese physiologische Druckübertragung möglichst exakt wiederhergestellt werden.
    Notes: Summary The objective of this investigation was the experimental determination of the contact pressures in the hip joint for characteristic phases of the gait cycle. The joint forces determined in vivo with telemetric endoprosthesis by Bergmann et al. (1993) were converted into a pelvic reference system, based on kinematic gait analysis. In eight cadaveric hip joints (age 18–75 yrs.) the reaction forces were applied corresponding to four phases of the gait cycle (heel strike, mid-stance, heel off, toe off) and the pressure distribution determined with FUJI pressure sensitive film. We found maxima of 10 MPa during mid stance. The areas of highest pressure were located in the ventro-superior aspect of the acetabulum (anterior part of the acetabular roof) and in the dorso-inferior aspect of the lunate surface. The pressure distribution was relatively constant during the four phases and the maxima did not vary proportional to the applied load. The normal pressure distribution in the hip appears to be determined by the physiological incongruity of the articular surfaces and the inhomogeneous bony support of the acetabulum. During operative interventions this normal load transfer should be restored as accurately as possible.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Der Orthopäde 28 (1999), S. 424-431 
    ISSN: 1433-0431
    Keywords: Key words Motion segment • Gear system • Ligamentous apparatus • Fascia thoracolumbalis ; Schlüsselwörter Bewegungssegment • Getriebe • ; Bandapparat • Fascia thoracolumbalis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wirbelkörper und Wirbelbögen weisen eine jeweils charakteristische Verteilung von Compacta und Spongiosa auf. Die Pediculi sind einer uniplanaren Biegebeanspruchung ausgesetzt, was sich in der Anordnung der Corticalis widerspiegelt. Der Bandapparat besteht aus longitudinalen und – bis auf das Lig. longitudinale anterius – quer bis schräg ausgerichteten vorwiegend segmentalen Faserbündeln. Zusammen mit dem Anulus fibrosus funktioniert der Bandapparat als eine Art Getriebe, das den Bewegungsablauf benachbarter Wirbel exakt steuert und vor allem die Endphasen der maximalen Bewegungsausschläge kontrolliert. Die Leistung der Bandscheibe besteht neben der Aufgabe der möglichst gleichmäßigen Druckverteilung auf die angrenzenden Wirbelkörper in der Erhaltung einer notwendigen Vorspannung. Die Wirbelgelenke sind entscheidende Faktoren für die Führung der Bewegungen, indem sie deren Ausmaß in bestimmten Ebenen und Richtungen einschränken. Sie sind aufgrund ihrer Ausrichtung in der Lage, vor allem nach ventral gerichtete Scherkräfte aufzunehmen. Entscheidend für die Gewährleistung einer protektiven Funktion der autochthonen Rückenmuskulatur ist die Integrität der Fascia thoracolumbalis.
    Notes: Summary The vertebral bodies and vertebral arches show a characteristic distribution of cortical and cancellous bone. The pedicles are loaded by uniplanar bending that is reflected by the arrangement of the Corticalis. The ligaments of the vertebral column consist of longitudinal and (with exception of the lig. longitudinale anterius) horizontal/oblique segmental ligament bundles. In combination with the anulus fibrosus, the ligaments work as a kind of gear system. They regulate the process of movements of adjactent vertebral bodies in a very precise manner and control the final phase of motion. Besides maintaining the necessary amount of pretension the intervertebral disc distributes the loads uniformly onto the adjacent vertebral bodies. The intervertebral joints are important for guided motion, by restricting the extent in specific planes and directions. Because of their position, they are able to take up the shear forces and to simultaneously restrict them in different planes. The integrity of the fascia thoracolumbalis warrants the protective function of the autochthonuos muscles.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Der Orthopäde 28 (1999), S. 822-832 
    ISSN: 1433-0431
    Keywords: Key words Carpus • Mineralisation • Ligamentous ; apparatus • Stability • Mobility ; Schlüsselwörter Carpus • Bandapparat • Mineralisierung • Stabilität • Mobilität
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Stabilität des Carpus wird vom exakten Zusammenspiel seiner knöchernen und ligamentären Elemente bestimmt. Als hauptsächliche und damit für die Gewebeanpassung verantwortliche Beanspruchung ist eine longitudinale Kompression anzusehen, wie sie durch den Zug der Unterarmmuskeln bei nahezu jeder stärkeren Aktivität entsteht. Durch die keilförmige Anordnung der Knochen der distalen Reihe wird die proximale Reihe einer Querdehnung ausgesetzt, die durch schräge radio- und ulnokarpale Bänder aufgenommen wird. Auch die Retinacula sind als zirkuläre Sicherung aufzufassen. Der Bandapparat wird hier aufgrund des Verlaufes der einzelnen Faserbündel in 3 Gruppen eingeteilt, wobei besonders auf die interossären Bänder Bezug genommen wird. Der zur Aufnahme der beträchtlichen statischen und dynamischen Kräfte notwendige Materialaufwand wird dadurch minimiert, daßüber die schräg zu den Bewegungsebenen eingestellten Faserbündel des komplexen Bandapparats der gesamte Carpus jeweils in den Kraftfluß einbezogen wird. Dies ist die Voraussetzung der weitgehenden Beweglichkeit der Handwurzel. Die strenge funktionelle Interaktion des differenzierten Bandapparats mit den knöchernen Elementen des Carpus bedingt allerdings, daß schon die Schädigung eines einzigen Elements schwerwiegende Folgen für die Stabilität des Gesamtkomplexes hat.
    Notes: Summary The stability of the carpus is determined by a precise interaction of the osseous and ligamentous elements. The main load of the carpus responsible for the adaptation of concerned tissues is a longitudinal compression caused by the force of the muscles of the forearm with their insertions to the metacarpus and fingers. As a consequence, the proximal row is distracted due to the wedge-shaped form of the hamatum together with the capitatum. It is the function of the mainly oblique orientated ligaments to take these transverse tensional forces, supported by the circular arrangement of the retinacula. Here, the ligaments are described in respect of their precise course into three groups. The distribution of material which is needed for bearing the enormous static and dynamic forces is minimised by the integration in a system of oblique fibre bundles which guaranties that all elements, osseous as well as ligamentous, are involved in the force distribution. This is the prerequisition for the minimalisation of osseous material. On the other hand, damage of only one element can cause severe consequences to the stability of the whole system.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0568
    Keywords: Subchondral bone ; Cartilage thickness ; Functional adaptation ; Morphometry ; Methyl methacrylate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The regional thickness distributions of the subchondral plate and the unmineralized part of the articular cartilage were morphometrically determined in normal human patellae, and the correlation coefficient for each specimen calculated from the paired measurements. For this purpose the patellae were embedded in methyl methacrylate and cut as serial sections, which were assessed with a Vidas image-analyzing system (Kontron). The values obtained were used to reconstruct the individual and average thickness distributions and to calculate the correlation coefficients for each subject. Both the thickness of the subchondral plate and that of the cartilage revealed regular distributions which, however, followed different patterns. Central regions with maximum values from which the thickness decreased concentrically towards the periphery were found in both. However, the distribution patterns of the unmineralized cartilage and the subchondral plate could be clearly distinguished, both by the position of the maxima and by the arrangement of the isocrassids (contour lines of equal thickness). The thicknesses of the two tissues showed a correlation between 0.38 and 0.82 (mean 0.6). We attribute this to their different reactions to the type of stress acting upon them. It appears that the thickness of the subchondral plate is principally determined by stresses acting over a longer period of time with low frequency, whereas the thickness of the articular cartilage seems to be a response to intermittent dynamic stresses of a higher frequency.
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