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- StatPearls: Kohler Disease [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Kohler disease was first described by Alban Kohler in 1908 and refers to avascular necrosis of the navicular bone of the foot. Kohler disease is a disease only seen in pediatric patients. Although th…
Kohler disease was first described by Alban Kohler in 1908 and refers to avascular necrosis of the navicular bone of the foot. Kohler disease is a disease only seen in pediatric patients. Although the etiology is not fully understood, it is thought to be caused by the compression of the navicular bone prior to ossification. This leads to blood flow abnormalities resulting in avascular necrosis. Kohler disease is most commonly seen in males ages 4 to 7 years old. Kohler disease is typically unilateral, although one report in the literature found that 25% of Kohler disease is bilateral. Patients typically present with medial-sided foot pain, swelling of the medial foot, and/or a limp. On plain films, the navicular will have standard characteristics of avascular necrosis including sclerosis, fragmentation, and flattening. Kohler disease is a self-limiting condition with an excellent prognosis. There have been no reported cases of Kohler disease developing long-term clinical or radiologic abnormalities.
- [Alban Köhler (1874-1947): Inventor of grid therapy]. [Historical Article]
- ZMZ Med Phys 2012; 22(2):90-9
- Grid (or sieve) therapy ("Gitter-" oder "Siebtherapie"), spatially fractionated kilo- and megavolt X-ray therapy, was invented in 1909 by Alban Köhler, a radiologist in Wiesbaden, Germany. He tested …
Grid (or sieve) therapy ("Gitter-" oder "Siebtherapie"), spatially fractionated kilo- and megavolt X-ray therapy, was invented in 1909 by Alban Köhler, a radiologist in Wiesbaden, Germany. He tested it on several patients before 1913 using approximately 60-70kV Hittorf-Crookes tubes. Köhler pushed the X-ray tube's lead-shielded housing against a stiff grid of 1 mm-square iron wires woven 3.0-3.5mm on center, taped tightly to the skin over a thin chamois. Numerous islets unshielded by iron in the pressure-blanched skin were irradiated with up to about 6 erythema doses (ED). The skin was then thoroughly cleansed, disinfected, and bandaged; delayed punctate necrosis healed in several weeks. Although grid therapy was disparaged or ignored until the 1930s, it has been used successfully since then to shrink bulky malignancies. Also, advanced cancers in rats and mice have been mitigated or ablated using Köhler's concept since the early 1990s by unidirectional or stereotactic exposure to an array of nearly parallel microplanar (25-75μm-wide) beams of very intense, moderately hard (median energy approximately 100 keV) synchrotron-generated X rays spaced 0.1-0.4mm on center. Such beams maintain sharp edges at high doses well beneath the skin yet confer little toxicity. They could palliate some otherwise intractable malignancies, perhaps in young children too, with tolerable sequelae. There are plans for such studies in larger animals.
- [Alban Köhler (1874-1947). Assessment of a clinical radiology pioneer from the present-day viewpoint]. [Historical Article]
- ROFORofo 1995; 163(6):463-8