Die Behandlung und Ergebnisse der Malleolarfrakturen

The authors compared the therapy results of 100 conservatively treated malleolar fractures and 100 malleolar fractures operated upon with the therapy results of the malleolar fractures registered at the documentation centre of the A. O. (working association for osteosynthesis) in Bern. The comparison shows that after surgical treatment, the therapy periods are scarcely shorter than after conservative treatment, the therapy results, however, are significantly better. There is a smaller rate of complications and subjective troubles after surgical treatment. The results of clinical and X-ray check-up examinations were essentially betterafter surgical treatment than after conservative treatment. The ability of patients concerning their professional and private activities was less disturbed after surgical treatment.     

Die freie Fibulatransplantation

Five cases of free transplantation of the fibula are reported. This method is indicated as ultima ratio to save an extremity in cases of large defects of a long bone. A transplantation should be considered only if all other attempts of treatment have failed and if a bound-osteosynthesis is not possible. The primary implantation of a free fibula should not be done in open and infected fractures, in infected pseudarthrosis and if the soft tissues are contaminated. The method of osteosynthesis is the Fixateur externe, which is the treatment of choice in compound fractures grade 2 and 3, especially if there is a bone-defect, in infected pseudarthroses and in large pseudarthroses with loss of bone. Special emphasis should be laid upon a stable mounting of the Fixateur externe, to achieve a sufficient immobilization.     

Reimplantation von Milzgewebe nach geburtstraumatischer Milzruptur

Zusammenfassung Kleinkinder sind nach Splenektomie bei Pneumokokkeninfektionen vital gefährdet. Zur Erhaltung der Milzfunktion wurde bei einem Neugeborenen nach geburtstraumatischer Milzruptur homogenisiertes Milzgewebe in Peritonealtaschen und in die Bauchdecke reimplantiert. Das Fehlen von Jolly-Körperchen und der Wiederanstieg von IgM beweisen funtionstüchtiges Milzgewebe. Die sonst obligatorische Penicillinprophylaxe über mindestens 2 Jahre konnte nach 5 Monaten ohne Folgen abgesetzt werden.

---

Reimplantation of splenic tissue after neonatal abdominal trauma

Summary Loss of the spleen in children frequently results in overwhelming infection caused by pneumococci. In order to preserve splenic function the reimplantation of splenic tissue into the abdominal wall and the greater omentum was performed in a newborn child and six other children up to the age of thirteen. Postoperatively the complete absence of Jolly's bodies could be observed, while a continuous increase of IgM was noted. The otherwise mandatory antibiotic prophylaxis over 2 years could be reduced to 5 months in the newborn.

     

High‐Molecular‐Weight Polyketones from Higher α‐Olefins: A General Method

Summary: A method to optimize the polymerization conditions in order to favor chain propagation is described for the synthesis of polymers containing low reactive, long, linear 1‐olefins and carbon monoxide (CO). It consists of the use of the olefin monomer as the polymerization solvent, together with the emulsification of a carefully chosen immiscible activator. This is given as a general method applicable to different families of catalyst able to produce 1,4‐polyketones. When the catalyst precursor is [dpppPd(NCCH₃)₂](BF₄)₂, which has been extensively studied, the polymerization degrees are the highest published (up to 2.4 × 10⁵ g · mol^?1). The influence of parameters like temperature, CO pressure, volume of activator, and catalyst counter ion or ligand substitutions are reported. Some chemical and physical properties of the polymers, such as glass transition temperature, melting processes, and mechanical behavior, are examined and compared with the linear 1‐olefin homologues from C3 to C10. These properties are shown in some cases to be unprecedented.

DSC profiles from the 1st scan for α‐olefin/CO copolymers.     

Differential in vitro effects of the platelet glycoprotein IIb/IIIa inhibitors abixicimab or SR121566A on platelet aggregation, fibrinogen binding and platelet secretory parameters

The aim of this study was to compare fibrinogen binding, inhibition of platelet aggregation and secretory potential of the MAb abciximab (0.5-5 microg/mL) and the peptidomimetic compound SR121566A (15-250 ng/mL) in vitro in whole blood. Fibrinogen binding was followed by flow cytometry; platelet function was evaluated by light transmittance and by impedance aggregometry. Secretory functions of platelets were evaluated using ATP as marker for early secretion by dense granulae and P-selectin (CD62) for alpha-granular secretion as well as CD63 for lysosomal degranulation. Results showed that fibrinogen binding induced by 5 microM TRAP was maximally inhibited greater than 80% at 3 microg/mL abciximab or at 250 ng/mL SR121566A. At these concentrations of antagonists, platelet aggregation induced by 5 microM ADP or 2 microg/mL collagen was inhibited completely. Expression of CD62 was reduced 34% with abciximab or 15% with SR121566A; CD63 expression was reduced 22% with both agents. With both agents, the EC50 for inhibition of CD62 and CD63 expressions was in similar magnitudes than the EC50 for fibrinogen binding inhibition. With 3 microg/mL abciximab, ATP secretion was maximally reduced to 50% of the control, whereas SR121566A at 250 ng/mL had no inhibitory effect on this parameter. A slight increase in ATP secretion was seen with 0.5 microg/mL abciximab and with SR121566A in concentrations of less than 45 ng/mL. The data suggest a discoupling between the anti-aggregatory and the antisecretory effects of IIb/IIIa antagonists. Because it is not established to what extend CD62 or CD63 expression can be reduced by any means, the reduction by 20-30% obtained by 3 microg/mL abciximab or 250 ng/mL SR121566A might already be the maximum possible inhibition by these agents.     

Characterization of drug-drug interactions in patients whose substance intake was objectively identified by detection in urine

Background: Identification of drug-drug interactions (DDIs) typically relies on patient medication lists which are prone to inaccuracies. This study describes use of a mass spectrometry test to detect recently ingested substances in urine with subsequent identification of DDIs.

Research design and methods: This was a retrospective analysis of the prevalence of DDIs identified in patients with chronic pain, addiction and/or behavioral health conditions in the U.S. Relationships between patient demographics, polypharmacy and the occurrence of DDIs were also described.

Results: Of 15,004 patients, 2964 (20%) had a DDI identified. There was a positive association between the number of substances detected in urine and the number of interactions identified (r = 0.5033, p-value = 0.0001). Of patients with polypharmacy, 15.6% had contraindicated or severe interactions identified compared to only 3.2% of those without polypharmacy. For polypharmacy patients, the youngest population studied had a much higher likelihood of having one or more DDIs identified compared to the other age groups (p-value = 0.0002).

Conclusions: By utilizing a mass spectrometry test to objectively detect recently ingested substances followed by identification of DDIs, healthcare providers may be able to better characterize the true incidence of DDIs. Study findings may not be generalizable to healthcare populations outside of pain management, addiction treatment, and behavioral health.     

Platelet storage in PAS-2 or autologous plasma: impact on functional parameters

Currently, several platelet additive solutions for long-term platelet storage have been introduced. The aim of this study was to compare the deterioration of functional status of platelets stored for up to 5 days in autologous plasma (AP) only, with platelet stored in PAS-2, a salt solution containing acetate, citrate and sodium chloride. Change in platelet adhesion, aggregation and activation was measured by flow cytometric technique. In addition, beta-Thromboglobulin (beta-TG), lactate and glucose were determined. After 5 days of storage, the expression of P-Selectin was significantly higher, the production of lactate and the consumption of glucose were significantly lower, in platelets stored in PAS-2 than in autologous plasma. No significant differences were detected on day 5 between the two groups with regard to fibrinogen, von Willebrand factor binding capacity, or to beta-TG release. It can be concluded that neither storage medium was consistently better for the parameters tested. However, it must be emphasized that platelets stored in autologous plasma exhibited less lesion, in terms of P-Selectin expression compared with platelets stored in PAS-2.     

Experimenteller Beweis für die Entstehung der sog. Hypophysenhinterlappenwirkstoffe im Hypothalamus

Zusammenfassung Es wurde experimentell bewiesen, daß die Wirkstoffe Vasopressin, Adiuretin und Oxytocin von den neurosekretorisch tätigen Ganglienzellen der Nuclei supraoptici und paraventriculares im vorderen Hypothalamus und nicht im Hypophysenhinterlappen gebildet werden. Der Hypophysenhinterlappen ist nur Speicherungs- und Ausscheidungsort für diese Hormone. Wassermangel erzeugt tiefgreifende morphologische und funktionelle Veränderungen des Zwischenhirn-Neurohypophysensystems, die jedoch voll reversibel sind. Nach unseren quantitativen Ergebnissen sind Vasopressin, Adiuretin und Oxytocin 3 selbständige Hormone, die jedoch eine einheitliche Trägersubstanz besitzen, nämlich das im histologischen Schnitt elektiv darstellbare Neurosekret.Mit 11 Textabbildungen.Diese Untersuchung wurde durch die Unterstützung der Deutschen Forschungsgemeinschaft ermöglicht.     

Gentle vs. aversive handling of pregnant ewes: I. Maternal cortisol and behavior

The aim of the experiment was to study the effects of aversive vs. gentle handling in late pregnancy on maternal behavior of ewes. Sixteen Norwegian Dala ewes bearing twins were subjected to 10 min of either gentle (GEN — soft talking and calm behavior) or aversive (AVS — swift movements and shouting) handling twice a day during the last 5 weeks of pregnancy. Salivary cortisol was recorded before and after treatments. The following behaviors were recorded post-partum in the ewes: grooming duration, number of vocalizations and in the lambs: number of vocalizations, latency and duration of standing, latency and duration in udder-directed position. The ability of the ewe to follow her lamb carried away by a human was scored on day 1 and 7. After the treatment sessions, cortisol levels tended to increase in AVS ewes but not GEN ewes. At parturition, AVS ewes groomed their offspring for a longer duration than GEN ewes. AVS lambs tended to be heavier than GEN lambs at 24 h of age. Follow Scores from GEN ewes were higher than for the AVS ewes at day one, but no difference between treatment groups was detected after one week. These results show that aversively treated ewes increased their grooming behavior towards their offspring, but that fear of humans disrupted their ability to follow their lambs closely when carried away by a human. We conclude that the type of handling of ewes during pregnancy may have some impact on important maternal behaviors.