[A correlative retrospective study of the histological findings and arthrograms in degenerative disease of the meniscus (author's transl)]. / Die korrelation histologischer Befunde bei degenerativen Meniskusveränderungen zum Arthrogramm-Eine vergleichende retrospektive Studie.

The ability to diagnose degenerative changes of the menisci by means of arthrograms was studied retrospectively by correlating the histological and operative findings and arthrographic appearances in 45 cases. It was shown that degenerative changes, as indicated histologically, could be diagnosed by arthrography, but that the arthrogram gave no certain indication of its severity. On the other hand, it appears that fairly severe changes must be present before they become radiologically visible. In negative cases the presence of degenerative changes in bone and cartilage may indicate meniscus degeneration. Problems in the diagnosis of cartilage abnormalities in the arthrogram are discussed.

Correlation between ketoprofen plasma levels and analgesic effect in acute lumbar pain and radicular pain.

Fourteen patients with acute lumbar pain and cervico-brachial radicular pain were treated with a single oral dose of 100 mg ketoprofen. The analgesic effect of the substance was investigated, using an analog pain scale, in correlation with drug plasma levels. Blood samples were taken at zero, one-half, one, two, three, four, five, six, eight, and ten hours after oral administration of ketoprofen. On an average, pain was at its lowest two hours after the plasma level of ketoprofen was at its highest. Within the ten hour observation period, the maximum reduction in pain increased as the maximum plasma level rose. Five patients with a maximum plasma level greater than 9 microliter/ml experienced pain reduction of at least 50%.

Triletide in a cimetidine-controlled clinical evaluation in duodenal ulcer patients.

A controlled study was carried out in 20 out-patients with endoscopically confirmed active duodenal ulcer to compare the effectiveness and tolerance of a new cytoprotective agent, triletide, with an established antisecretory agent, cimetidine. Patients were allocated at random to receive 8-weeks' treatment with either 1.5 g triletide per day or 1.2 g cimetidine per day. The results showed that all patients experienced improvement of the ulcer condition by the end of treatment, the vast majority being found endoscopically healed. There was no statistically significant difference between the groups. At the same time, the intensity of heartburn and epigastric pain, as well as the mean antacid intake, decreased significantly with both drugs, almost to the same extent. A significant relief of symptoms was already apparent by the end of 2 weeks of treatment, except for heartburn in the cimetidine group which did not show improvement until the fourth week. There were no complaints of possible side-effects with either treatment and no evidence of any significant changes in blood pressure, heart rate or routine haematology and haematochemistry investigations.

[Ski injuries during growth]. / Skiverletzungen im Wachstumsalter

Ski injuries during the period of growth are important as they are relatively frequent and may cause severe late complications (injuries of the epiphyseal cartilage). It is of utmost importance to develop safer skiing-equipment for children. Regarding therapeutic measures ski injuries in childhood and adolescence cause special problems, they must be treated with greatest care and exactness, if necessary surgically. In all cases of ski injuries in childhood and adolescence long term radiological checkup is necessary during the growing period in order to recognise and treat late complications as early as possible.

Pharmacokinetics of indomethacin i.m. in blood, synovial fluid, synovial membrane, muscle, fat, bone, and spinal fluid.

Nonsteroidal anti-inflammatory drugs are an important part of the therapy of rheumatoid arthritis. For optimal dosage it would be necessary to know the levels of such compounds in inflamed tissue and not only in blood because the drugs inhibit prostaglandin synthesis in all cells of the body. In the present study, the levels of indomethacin in blood, synovial fluid, synovial membrane, muscle, fat, bone and spinal fluid of patients with rheumatoid arthritis have been measured at 1, 3, 6, and 12 hours after administration of 50 mg indomethacin (Amuno, Merck Sharp & Dohme). At 3, 6, 9 and 12 hours after administration levels in synovial fluid and tissue were higher than in blood but the differences were not significant. Levels in the other tissues investigated did not differ much from blood. In experiments with carrageenan-induced inflammation in rabbits, levels of indomethacin in blood and exudate have been measured after administration of 7.5 mg/kg i.v. Between 3 and 8 hours after administration levels in exudate were significantly higher than in blood. From the time course of indomethacin in blood compared to synovial fluid or exudate and from the comparison of the elimination half lives it can be concluded, that the transport of indomethacin into the inflamed area is mainly a process of diffusion.

[Syndrome of the painful external tibial bone]. / Das Syndrom des schmerzhaften Os tibiale externum.

The tuberosity ossis naviculare rises from a separate apophyseal nucleus normally fusing with the os naviculare. In 10% of the cases it remains autonomous during life as os tibiale external. This variance of evolution is dominantly inherited. By statically false position of the foot, but also by traumata the loosening of the synchondrosis may cause sharp pain of the os tibiale external. As to X-rays the accessory tarsal bone may be mistaken for fractures. Normally conservative treatment is successful; if not the operative removal is advisable.