Development and clinical application of titanium minipins for fixation of nonresorbable barrier membranes.

Clinical applications of the principle of guided bone regeneration in oral and maxillofacial surgery include preimplant reconstruction of atrophied bone defects and coverage of endosseous implants that were incompletely covered by bone through primary intention. Nonresorbable polytetrafluoroethylene membranes are used. Over the past several years, the use of periosteal sutures to fix membranes has been supplemental or replaced by the use of metallic fixation systems. Five-year clinical results with a membrane pin set developed for fixation of such membranes are reported. Application of the titanium pin limits the relative movement between the membrane and surrounding bone and/or between and surrounding soft tissue flaps. Moreover, the titanium pin expands the range of applications for such membranes, particularly to topographically complicated bone defects at sites where clinically secure and biologically functioning placement of the membrane is not always easy.

A call center primer.

Call centers are strategically and tactically important to many industries, including the healthcare industry. Call centers play a key role in acquiring and retaining customers. The ability to deliver high-quality and timely customer service without much expense is the basis for the proliferation and expansion of call centers. Call centers are unique blends of people and technology, where performance indicates combining appropriate technology tools with sound management practices built on key operational data. While the technology is fascinating, the people working in call centers and the skill of the management team ultimately make a difference to their companies.

[Malignant non-Hodgkin's lymphoma of the joint. Report of two cases, review of the literature and problems of classification]. / Das maligne Non-Hodgkin-Lymphom des Gelenks. Bericht über 2 Fälle, Literaturübersicht und Problematik einer Einteilung.

This paper gives a survey of malignant Non-Hodgkin lymphomas (NHL) of joints. Primary and secondary malignant lymphomas of joints are rare. Our analysis of 6 years', new entries in the lymph node register in Kiel, covering 37.367 cases of malignant lymphomas, revealed only 20 cases (0.05%) with infiltration of joints. Slightly more men than women (1.18:1) are actually affected by articular lymphomas. In addition to 34 articular lymphomas of joints described in the literature between 1974 and 1992, we analyse 2 cases seen in our own institute and the 20 cases taken from the Kiel lymph node register. The peak incidence is between 40 and 60 years of age. One of our own cases, a woman of 92, is the oldest person ever affected. The most frequent localizations of NHLs are the knee, hip, and shoulder joints, with low-grade lymphomas predominating. Osteolytic lesions on radiographs are of decisive clinical and diagnostic significance for malignant articular lymphomas with affected bones. Lymphomas of joints are treated almost exclusively by radiation and chemotherapy, and sometimes a combination of both. Decisive prognostic significance attaches to the grade of malignancy and the fact of primary or secondary infiltration of the synovium and of the bone. The average survival time for patients with low-grade NHLs is 19 months with infiltration of the synovium and 27 months with infiltration of joint forming bones only, whereas the average survival time for patients high-grade lymphomas is 8 months with infiltration of the synovium and 11 months with infiltration only of joint-forming bones.(ABSTRACT TRUNCATED AT 250 WORDS)

A dual-frequency circularly polarizing whole-body MR antenna for 69/170 MHz.

The design concept of a dual-frequency whole-body MR antenna for circular polarization is presented. First, the principle of the capacitively shortened transmission line antenna, which is the basis of the design, is discussed. Emphasis is given to the antenna design at high frequencies. Two variants of possible antenna constructions are described and the RF efficiency is calculated for both frequencies. The antenna performance is discussed for the example of 69 and 170 MHz, the nuclear magnetic resonance frequencies of the nuclei 31P and 1H at 4 T. For 31P experiments, a whole-body antenna is useful only for transmitting and, thus, the antenna performance can be optimized for 1H. The design principle is not limited to two frequencies; however, the RF efficiency decreases with an increasing number of resonance frequencies. Results of a laboratory version and 1H images at 4 T are presented.

[Sudeck's disease after radius fracture]. / Morbus Sudeck nach Radiusfraktur.

Clinical and radiological features of Sudeck's dystrophy following radius fracture are described. Peripheral and endogenous factors are pointed out. Therapy consists in preventing and alleviating pain by primary immobilisation combined with gentle physical therapy of the non-involved parts of both upper extremities. Calcitonin, non-steroid antirheumatic and anxiolytic drugs should be administered simultaneously. The physician's care and tolerance of the mentally upset and labile patient are essential. Physiotherapy plays a major role in the long-standing rehabilitation process.

[Acute management of spinal injuries. The thoracic and lumbar spine, conservative and functional therapy]. / Akutversorgung von Wirbelsäulenverletzungen. Brust- und Lendenwirbelsäule, konservative und funktionelle Therapie.

Fractures of the thoracic spine are commonly treated functionally. In the thoracolumbar and lumbar region compression fractures with angulation can be treated by closed reduction and casting according to the Boehler method. Yet, stable fractures with minor deformities may be treated with advantage by early weight bearing. Primarily unstable thoracic and lumbar vertebra fractures gradually become stable with increasing fracture healing and may also be treated functionally but with prolonged bed rest of 6-12 weeks. Thus open reduction and internal fixation achieve better anatomical alignment and also allow early mobilisation and ambulation. They are therefore recently favoured.

[The fibula-pro-tibia operation in infected defect pseudarthroses of the lower leg]. / Die Fibula-pro-Tibia-Operation bei infizierten Defektpseudarthrosen am Unterschenkel.

Surgery to effect synostosis between fibula and tibia is to be considered if it is not possible to bridge a relatively large gap at the tibia directly at the site of the defect by autologous (cortico)-spongiosaplasty because of inflammatory complications. Various modifications of the procedure are possible--they are described in the article--but the authors are of the opinion that preference should be given to synostosis which leaves the fibula at its physiological site. Technical details are given and the pros and cons discussed. This article is based on the experience collected during the treatment of eight patients.

Post-clinical follow-up of spinal patients through domestic check-ups. (Koblenz model).

One hundred spine-injured patients have been visited at their homes, examined and questioned about their medical and social situation. The medical conditions have improved, compared with a former similar check-up. But the tendency to work has decreased and is lagging behind other countries. Possible reasons are pointed out.