[Pretherapeutic diagnosis of fibrous dysplasia]. / Prätherapeutische Diagnostik der fibrösen Dysplasie.

A safe differentiation of fibrodysplastic lesions from "real" bone tumours is of high importance because a fibrous dysplasia often requires no further therapy. While polyostotic involvement of fibrous dysplasia can be safely diagnosed before therapy, in monostotic disease differential diagnostic problems may occur. In the present investigation only in 6 of 14 mon- and biostotic lesions caused by fibrous dysplasia a correct diagnosis could be established by radiologic methods. However, in all cases of fibrous dysplasia malignancy could be excluded by radiology and the false diagnosis had no therapeutic consequences.

[An acute septic course of melioidosis after a stay in Thailand]. / Akute septische Verlaufsform einer Melioidose nach Thailandaufenthalt.

HISTORY AND CLINICAL FINDINGS: Two weeks after returning from a trip to Thailand a 79-year-old man developed a higher fever, pain in the right flank and progressive clouding of consciousness. She had meningism on admission. INVESTIGATIONS: There was a marked leukocytosis (WBC count 17,700/microliter) and raised C-reactive protein (6.5 mg/dl). Cerebrospinal fluid was clear, containing 119 cells/mm3 and elevated protein (90 mg/dl). Abdominal sonography demonstrated segmental pyelonephritis, and blood culture grew Pseudomonas pseudomallei. TREATMENT AND COURSE: On the basis of sensitivity tests imipenem was chosen as the antibiotic and was given for 6 weeks. Because of an inadequate response and a right renal abscess a right nephrectomy was performed. After marked improvement the septicaemia recurred one week after antibiotic treatment had been discontinued, and the patient died. CONCLUSION: Efficacious treatment of melioidosis (a glanders-like disease) presupposes diagnosis of the causative microorganism and testing of its antibiotic sensitivity. As Pseud. pseudomallei may encapsulate and persist intracellularly, the selection of antibiotic and the duration of treatment are crucial.

[Short-term results (2-5 years) of type Furlong hydroxyapatite-coated hip endoprosthesis]. / Kurzfristige Ergebnisse (2 bis 5 Jahre) der Hydroxylapatit-beschichteten Hüftendoprothesen vom Typ Furlong.

The short term clinical and radiological results of a hydroxyapatite-coated hip prosthesis with bonding osteogenesis on the hydroxyapatite ceramic and bony tissue reaction had to be studied. 233 patients who had hip replacement were followed up for two to five years and assessed radiologically and by the Merle D'Aubigné rating. Primary total hip arthroplasty as well as revision arthroplasty show sufficient clinical results. Tight pain and aseptic loosening of the stem did not occur. Hydroxyapatite-coating and contour for the Furlong hip prosthesis show a reliable short term anchorage.