Mercaptoacetate induces feeding through central opioid-mediated mechanisms in rats.

The endogenous opioid system has been implicated in the mediation of food intake elicited by such regulatory challenges as glucoprivation induced by 2-deoxy-D-glucose (2DG) or food deprivation in rodents. Administration of the free fatty acid oxidation inhibitor, mercaptoacetate (MA), produces a potent short-term increase in feeding in rats, the mechanisms of which have been dissociated from that elicited by 2DG. The present study evaluated whether MA-induced feeding in rats was mediated by the endogenous opioid system through systemic administration of the general opioid antagonist, naltrexone, through central administration of either general, mu, mu(1), kappa(1) or delta opioid antagonists, and through central administration of antisense oligodeoxynucleotide (AS ODN) probes directed against specific exons of either the mu (MOR-1), kappa (KOR-1), kappa(3) (KOR-3/ORL-1) or delta (DOR-1) opioid receptor clones. MA-induced feeding was significantly and dose-dependently reduced by systemic naltrexone (0.005-5 mg/kg); these ingestive effects were quite selective since neither total, ambulatory nor stereotypic activity was affected by either MA itself or MA paired with naltrexone. MA-induced feeding was significantly reduced by central pretreatment with either naltrexone (0.1-20 microgram) or mu-selective (beta-funaltrexamine, 0.1-20 microgram), mu(1)-selective (naloxonazine, 1-20 microgram), kappa(1)-selective (nor-binaltorphamine, 0.1-20 microgram), or delta-selective (naltrindole, 1-20 microgram) opioid receptor antagonists. MA-induced feeding was significantly reduced by AS ODN probes directed against either exons 1, 2 or 3, but not exon 4 of the MOR-1 clone, exon 3, but not exons 1 or 2 of the KOR-1 clone, exons 1 or 2, but not exon 3 of the KOR-3/ORL-1 clone, and exon 1, but not exons 2 or 3 of the DOR-1 clone. These data are discussed in terms of opioid mediation of ingestive responses related to fat, and in terms of potential central sites of action at which lipoprivic ingestive responses might act.

[Traumatic diaphragmatic ruptures in an accident surgery patient sample]. / Traumatische Zwerchfellrupturen im unfallchirurgischen Krankengut.

The problems of the direct and indirect diaphragm lesions are discussed based on the own collective of patients. The most common trauma pattern was the direct immediate rupture of the left half (Strug). All ruptures were combined with additional trauma including lesions to the abdomen, pelvis, thorax and cranium. Diagnosis could usually be made by conventional X-ray techniques. The high rate of lethality is explained by the extensive additional trauma that is seen with rupture of the diaphragm.

[The post-burn process--a determinant in local surgical treatment of deep burns]. / Der Nachbrennvorgang--eine Determinante in der chirurgischen Lokalbehandlung tiefer Verbrennungen.

Afterburning has been studied in the animal experiment by use of intravital dye indicators and by measuring partial oxygen pressure. After third degree burn the oxygen conduction of the damaged skin increased. The afterburning was seen to be finished on the 5th day after the burn trauma. The histological changes in the depth of the afterburn area reaches to the subcutis. The extend of the afterburn area was not related to the applied temperature or the duration of the experimental burn injury.

[Post-traumatic expert assessment of the shoulder joint in pre-existing os acromiale]. / Zur posttraumatischen Begutachtung des Schultergelenkes bei vorbestehendem Os acromiale.

It often is difficult to assess a posttraumatic status if there is a skeleton anomaly in the region involved. A rare case of contusion of a shoulder joint with an os acromiale is presented. The os acromiale itself is unimportant in respect of the posttraumatic evolution. Posttraumatic damage can only be accepted if it can be verified objectively.

[Gunshot injuries--their incidence and surgical problems]. / Schussverletzungen--ihre Inzidenz und chirurgische Problematik.

Since the time when firearms became readily available, surgeons have had to deal with the gunshot wounds which have presented for treatment. In middle europe, in peace time, gunshot wounds account for only a small percentage of the total number of trauma cases seen. This is reflected in our patient census in which a mere 0.065% of cases were associated with such injuries. It would seem that a relevant knowledge of the technical and physical attributes of firearms is important. With this understanding, the formulation of an according treatment plan is made easier. Gunshot wounds are frequently not confined to the extremities. The trauma surgeon, who largely deals with limb injuries, is now confronted with an increasing number of chest and trunk wounds and their particular therapeutic consequences.

[Experimental determination of the time-dependent extent of after-burning with reference to possibilities of the plastic surgery reconstruction of 3d degree burns]. / Experimentelle Feststellung des zeitabhängigen Ausmasses des Nachbrennens im Hinblick auf die Möglichkeit der plastischen Deckung drittgradiger Verbrennungen.

The present experiments try to answer the question as to the time-dependent extent of the after-burning process after full-thickness burn (third degree). For an early plastic surgical treatment it was of interest to determine the most early time of escharotomy. The time-dependent spreading of the after-burning area reached its maximum five days after the burn injury. The after-burning area was marked by intravenous injections of Patentblau which caused distinct intravital colouring. Subsequently no further progress could be observed. In the present experiments we suggest this time as the earliest time for plastic covering in case it would be dependent upon the end of the after-burning process.

[The value of Ender nailing in hip para-articular femoral fractures in gerontologic traumatology. Ender nailing--hip para-articular femoral fractures--gerontologic traumatology]. / Der Stellenwert der Endernagelung hüftgelenksnaher Femurfrakturen in der Gerontotraumatologie. Endernagelung--hüftgelenksnahe Femurfrakturen--Gerontotraumatologie.

Nailing according to Ender is one of several competing methods of osteosynthesis for treating per- and subtrochanteric fractures of the femur in geronto-traumatology. Within 5 years we have treated 62 geriatric patients by this procedure. The average-age of our patients was about 76 years. Only 20 of them were able to be examined after a time of ca. 37 months post operationem. Intraoperative complications were backing out of the femur corticalis at the entry hole, followed by perforations of the head or neck of the femur. In one case we saw a supracondylar fracture. In the postoperative period we mostly found dislocations of the nails to cranial or caudal. Moreover there were one wound infect and one pseudarthrosis. The mortality rate came to 6.5% and was never caused by the method. When leaving the hospital the majority of the elderly patients was mobilized and able to walk. In spite of reduction of function of hip and knee and external rotation deformity and shortened legs the patients declared to be content with the result of the operation. Important geronto-traumatological aspects of the Endernailing-method could be seen in the simple procedure, the short operating time, a minimal surgical trauma and a diminishing of the risk of the mostly multi-morbid patients. Regarding the great number of specific complications competing methods are going on to be preferred. Meanwhile the application of Endernails is an exception in geronto-traumatology.

[Seat-belt syndrome. Is "securing" children in back seats of cars exclusively with a lap belt defensible?]. / Das Seat-Belt-Syndrom. Ist die "Sicherung" von Kindern auf Pkw-Rücksitzen mit einem ausschliesslichen Beckengurt vertretbar?

In automobile accidents the "seat belt syndrome" describes a combination of injuries involving the thoraco-lumbar vertebrae and intraabdominal organs. This may result from wearing of only a pelvic seatbelt. Children are often involved. Analysis of two separate cases showed the "assurance" of children as passengers on the backseat with a pelvic belt to be dangerous and not longer justifiable. Anatomical proportions and posture in childhood necessitate backseats especially designed for children. They should include the possibility of installing a three point safety belt system.

[Polytrauma in automobile drivers--on the coincidence of adolescents and the elderly]. / Polytraumen motorisierter Strassenverkehrsteilnehmer--zur Koinzidenz mit Jugend- und Seniorenalter.

In traffic severe accidents accompanied by polytraumata reach more and more importance to traumatology. We explored our own patients with regard to the coincidence of such accidents with juvenile and senior age and found out a very high risk in the age groups between 16 and 25 years. The causes could be little experience, readiness for risks and overrating their own talent. Elder persons driving motor vehicles are also very often involved in traffic accidents. In this group polytraumata however are not so frequent compared to many accidents without severe consequences. Polytraumatisized patients are very important as to the costs in the health and social system. In any case they cause a considerable economical loss.

[Is there a noticeable temporary protective function of homologous skin grafts of variable thickness in deep burns against the effect of atmospheric oxygen?]. / Gibt es eine unterschiedliche temporäre Schutzfunktion verschieden dicker homologer Hauttransplantate auf tiefen Verbrennungswunden gegen die Einwirkung atmosphärischen Sauerstoffes?

The injurious influence of atmospheric oxygen upon healing of large wound areas for instance of burn wounds is well known, in differently thick skin grafts different protective functions can be demonstrated. Experiments show the isolation functions of the full-thickness on the one and split skin grafts on the other hand in burn wounds by measuring the subcutaneous pO2: under temporary full-thickness grafts there are with regard to the atmospheric oxygen clearly lower oxygen partial pressures than under split skin grafts.

Normative apparent diffusion coefficient values in the developing fetal brain.

BACKGROUND AND PURPOSE: Previous studies of diffusion-weighted imaging (DWI) in fetuses are limited. Because of the need for normative data for comparison with young fetuses and preterm neonates with suspected brain abnormalities, we studied apparent diffusion coefficient (ADC) values in a population of singleton, nonsedated, healthy fetuses. MATERIALS AND METHODS: DWI was performed in 28 singleton nonsedated fetuses with normal or questionably abnormal results on sonography and normal fetal MR imaging results; 10 fetuses also had a second fetal MR imaging, which included DWI. ADC values in the periatrial white matter (WM), frontal WM, thalamus, basal ganglia, cerebellum, and pons were plotted against gestational age and analyzed with linear regression. We compared mean ADC in different regions using the Tukey Honestly Significant Difference test. We also compared rates of decline in ADC with increasing gestational age across different areas by using the t test with multiple comparisons correction. Neurodevelopmental outcome was assessed. RESULTS: Median gestational age was 24.28 weeks (range, 21-33.43 weeks). Results of all fetal MR imaging examinations were normal, including 1 fetus with a normal variant of a cavum velum interpositum. ADC values were highest in the frontal and periatrial WM and lowest in the thalamus and pons. ADC declined with increasing gestational age in periatrial WM (P = .0003), thalamus (P < .0001), basal ganglia (P = .0035), cerebellum (P < .0001), and pons (P = .024). Frontal WM ADC did not significantly change with gestational age. ADC declined fastest in the cerebellum, followed by the thalamus. CONCLUSIONS: Regional differences in nonsedated fetal ADC values and their evolution with gestational age likely reflect differences in brain maturation and are similar to published data in premature neonates.

[Mortality and morbidity following surgical therapy of perforated gastroduodenal ulcers]. / Letalität und Morbidität nach chirurgischer Therapie perforierter Gastroduodenalulzera.

A retrospective study was conducted into 136 patients who had received surgical treatment for perforated gastroduodenal ulcers, with the view to establishing postoperative lethality and morbidity (comparing simple suturing with definitive ulcer surgery). Factors of relevance to prognosis were taken into consideration, including age of patients, number of concomitant diseases, time from perforation to surgery, presence of peritonitis, ulcer location, and length of ulcer history.

[Significance of duodenogastric reflux in the pathogenesis of primary stomach cancer]. / Zur Bedeutung des duodenogastralen Refluxes in der Pathogenese des primären Magenkarzinoms.

Duodenogastric reflux has often been discussed as a causative factor in the pathogenesis of gastric carcinoma. The author's clinical examinations of 135 patients with primary cancer of the stomach revealed slight increase in duodenogastric reflux. Yet, apart from these findings, no correlations were found to exist between reflux incidence and tumour localisation nor between histological tumour type and tumour size.

[Peritoneal lavage in the diagnosis of blunt injuries of hollow intra-abdominal organs]. / Die Peritoneallavage in der Diagnostik stumpfer Verletzungen intraabdomineller Hohlorgane.

In some cases of blunt abdominal trauma lesions of gastrointestinal tract are occasionally found. The difficulty with these injuries lies in establishing the diagnosis. Clinical examination alone does not reliable evidence, particularly if the patient is unconscious and therefore unable to respond subjectively. Although abdominal sonography ist becoming increasingly important in the diagnosis of blunt abdominal trauma lesions of the gastrointestinal tract frequently remain undetected or are diagnosed to late where this method of examination is used exclusively. In the retrospective analysis of our patients we have encountered serious complications such as peritonitis and even cases resulting in death. On the other hand when peritoneal lavage was employed, no false negative results occurred. Consequently the value of this method in the diagnosis of blunt abdominal trauma and possible lesions of the gastrointestinal tract is indisputable.

[Use of the dynamic condylar screw in fractures of the coxal end of the femur--are there advantages in gerontologic traumatology?]. / Die Anwendung der dynamischen Condylenschraube bei Frakturen am coxalen Femurende--Bringt sie Vorteile in der Gerontotraumatologie?

Till now instable fractures of the upper end of the femur were treated by using the 95 degrees fixed angle blade in gerontotraumatology, too. As an alternative treatment within 16 month we used the dynamic condylar screw (DCS) in 87 cases of patients elder than 65 years. The results were compared to 81 patients, who had been treated by implantation of 95 degrees fixed angle blades. As to gerontotraumatology it was interesting, that there were no DCS-specific complications, which demanded operative revision. Advantages of the DCS are easy insertion, firm fixation, increased strength and resistance to stress failure, short times of operation and hospitalisation. The most important disadvantage--as to gerontotraumatology--however is the not existing primarily load capacity.