Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia

Bony avulsion fractures of the posterior cruciate ligament of the tibia have commonly been treated by open reduction and internal fixation using the posterior approach. However, this approach, using the prone position, makes it difficult to investigate and treat other combined injuries of the knee joint. We report a case of posterior cruciate ligament avulsion of the tibia that was arthroscopically reduced and firmly fixed with two cannulated screws. The posterior sag was absent after the operation and the result was excellent. By arthroscopy, we got rigid fixation of the avulsed fragment for early rehabilitation, and detection of a concomitant injury was also possible.     

Thoracic electric impedance and fluid balance during aortic surgery

Indices of fluid balance were evaluated during and after aortic surgery in 16 consecutive patients. Thoracic electrical impedance (TI), heart rate (HR), central venous (CVP), pulmonary artery mean (PAMP), pulmonary wedge (PWP) and mean arterial (MAP) pressures as well as fourteen arterial and venous blood gas variables were followed. Consistent with a reduction of TI during the operation, fluid balance was in excess, and it remained elevated on the first postoperative morning. The HR, MAP and PWP remained stable, while CVP and PAMP decreased. Of the determined variables only TI revealed a meaningful correlation to fluid balance (rho = -0.41; p < 0.01). The results indicate that while central venous and pulmonary artery mean pressures gave the impression of a volume deficit, the positive fluid balance was mirrored by thoracic electrical impedance.     

IV-Controlling in einem Systemhaus

This paper analyses the characteristics of software houses as service providers. The tasks of internal IT-services are determined from these characteristics and a reporting system for the IT-controlling is outlined. The concept results from the analysis of one of the 25 largest German software houses. The paper concludes with a case study of the fiscal year 2000 IT-controlling report of the above-mentioned firm.     

Schwingfestigkeit von Schraube‐Mutter‐Verbindungen

High cycle fatigue of bolted connections Extensive tests regarding the influences on the fatigue of bolt‐nut‐connections of preloading with torsion, of preloading with yielding, of loading with superimposed bending and of the tested lot are processed. These influences are not yet known according to VDI 2230. New testing devices were designed for these tests, which allow a far less expensive operation and may easily be used for bolts of diameters up to M100 and testing frequencies up to 1000 Hz. The validity of fatigue resistance according to VDI 2230 is specified with respect to the test results. The determined influence of the tested lots is unexpectedly high. The manufacturing process of bolts should be improved to minimize this influence.     

Fibrinolytic variables and cardiovascular prognosis in patients with stable angina pectoris treated with verapamil or metoprolol. Results from the Angina Prognosis study in Stockholm

BACKGROUND: Disturbed fibrinolytic function may influence the progression of coronary atherosclerosis and contribute to thrombotic cardiovascular (CV) events. METHODS AND RESULTS: In the Angina Prognosis Study in Stockholm (APSIS), patients with stable angina pectoris were studied prospectively during double-blind treatment with metoprolol or verapamil. Various measures of fibrinolytic function were studied in 631 (of 809) patients. During a median follow-up time of 3.2 years (2132 patient-years), 32 patients suffered a CV death, 21 had a nonfatal myocardial infarction (MI), and 77 underwent revascularization. Plasma levels of tissue plasminogen activator (TPA) activity and antigen (ag), plasminogen activator inhibitor (PAI-1) activity at test, and TPA responses to exercise were determined at baseline and after 1 month's treatment and were related to subsequent fatal and nonfatal CV events. Univariate Cox regression analysis revealed that elevated levels of TPA-ag at rest (P < .05), high PAI-1 activity (P < .05), and low TPA-ag responses to exercise (P < .05) were associated with increased risk of subsequent CV death. After adjustment for baseline risk factors, TPA-ag independently predicted CV death or MI. In addition, PAI-1 activity independently predicted CV death or MI in male patients. Verapamil treatment was associated with a 10% decrease of TPA-ag levels and metoprolol treatment with a 2% increase (P < .001 for treatment difference). CONCLUSIONS: Plasma TPA-ag levels at rest, and among male patients PAI-1 activity as well, independently predict subsequent CV death or MI in patients with stable angina pectoris.     

Biaxiale Ermüdung reibrührgeschweißter Strukturelemente

Biaxial fatigue of friction stir welded stiffened panels Within the framework of the European WelAir project, cruciform specimens made from stiffening FSW overlap joints were fatigued in the DLR biaxial test rig. To resemble the loading situation of pressurized fuselage structures, proportional loading without any phase shift, but with different load ratios λ between the loading components in both directions was applied.Natural crack initiation and subsequent crack growth were governed by the stiffness gradient caused by introducing the stringer. Cracks initiated and propagated at run‐in and run‐out locations in a direction perpendicular to the weld seam. The shortest fatigue life was observed for uniaxial loading in welding direction (λ = 0). An additional stress component perpendicular to the joint line (λ > 0) resulted in a higher number of cycles to failure. Similar to single stringer panels, increasing the load ratio also increased the number of cycles to failure for FSW clip‐stringer structural members, but additionally gives a different location of the fatal crack.