Comparison of femoral and carotid blood pressure during laparoscopy in piglets.

PURPOSE: The impact of a capnoperitoneum on the known blood pressure (BP) difference of the upper and lower limb was studied in piglets. METHODS: Eleven German Landrace piglets (body weight, 4.3-7.4 kg; mean body weight, 6.2 kg) were studied. Arterial lines were placed in the right carotid and right femoral artery for pressure monitoring. Intraabdominal pressure levels were increased in steps of 6 mm Hg up to 24 mm Hg. RESULTS: We found that elevated intraabdominal pressures up to 24 mm Hg did not change the preexisting systolic BP difference between the carotid and femoral arteries. Systolic femoral artery pressure constantly remained 5% higher than its carotid counterpart. In addition, mean and diastolic values were not affected. CONCLUSIONS: Arterial BP measurements recorded at the legs of piglets when abdominal pressure is increased by up to 24 mm Hg can be used for intraoperative assessment of systemic arterial BP.

[Capitate fracture in an 11-year-old boy]. / Fraktur des Os capitatum bei einem 11-jährigen Jungen.

We report the case of an isolated non-displaced fracture of the capitate in an 11-year-old boy. On the basis of the relevant literature we present a survey of the diagnostic and treatment options. To the best of our knowledge this is the first description of a paediatric capitate fracture in the German-speaking area.

Locking plates for corrective osteotomy of malunited dorsally tilted distal radial fractures: a biomechanical study.

The purpose of the study was to compare the biomechanical properties of five different palmar fixation plate designs in a distal radius osteotomy cadaver model. A 1cm metaphyseal osteotomy gap was made to simulate a corrective osteotomy and the osteotomy plated. Axial load was applied to the distal end of each construct by a material testing machine under control of a motion analysis video system. The specimens were arranged into five implant groups of eight specimens each. No test group developed deformity and movement of the fracture gap greater than 2mm with a load of 100N. Increasing the load to 250N revealed statistically significant differences in stiffness and failure load between the different plates. Axial failure strength and stiffness were greater for the radial correction plates than for the other implants. The former may provide enough stability for corrective osteotomy of dorsally angulated distal radial malunions, even when the osteotomy gap is only filled with cancellous bone graft instead of cortical bone graft.

["Progressive" hypothenar hammer syndrome Indication for operative treatment]. / Das "progrediente" Hypothenar-Hammer-Syndrom Indikation zur operativen Versorgung.

Hypothenar hammer syndrome (HHS) is ischemia of the distal ulnar artery caused by injury to the ulnar part of the palmar arch. This disease often involves workers who frequently use the hypothenar part of the hand as a hammer. The aneurysmatic form of HHS represents an indication for operative treatment; the thrombotic form is treated mainly conservatively. In our opinion, the symptomatic thrombotic form represents an indication for operation if symptoms persist during conservative therapy, particularly if symptoms progress. In fresh embolic occlusions, regional thrombolysis is usually successful. We present here the symptomatic treatment and course in two patients with complaints increasing during conservative therapy. The patients reported progressive Raynaud's phenomenon of the fingers. Angiography confirmed corkscrew-like aneurysmatic configuration of the distal ulnar artery and subsequent embolization of digital arteries. In both cases, we removed the source of the embolism with resection of the involved arterial segment and anastomosis with autologous vein grafts.

[MRT-induced burns in tattooed patients. Case report of an traumatic surgery patient]. / MRT-induzierte Verbrennung bei Tätowierungen Fallbericht eines unfallchirurgischen Patienten.

Skin burns to patients with tattoos during MRI procedures are reported but rare complications. MRI scans are being used more often also as diagnostic procedures in trauma patients. In this article we present the case of a patient after trauma of the vertebral column who experienced burning pain at the site of a tattoo on the distal femur during the MRI examination, necessitating cessation of this procedure. Based on this example we discuss possible pathomechanisms of MRI-induced skin burns to patients with tattoos. It becomes clear that patients have to be asked about possible tattoos before MRI scans and should be informed about possible pain development.

[Indications for islet cell transplantation after total duodenopancreatectomy in chronic pancreatitis]. / Zur Indikation der Inseltransplantation nach totaler Duodenopankreatektomie bei chronischer Pankreatitis.

The clinical course of a 37-year old female patient with chronic pancreatitis undergoing total duodenopancreatectomy and subsequent autotransplantation of purified pancreatic islets into the portal vein is described. The indication, technical aspects and the metabolic outcome of the procedure are discussed along with the current literature.

Successful cryopreservation of fetal porcine proislets.

This study reports the cryopreservation of purified fetal pig proislets (FPP) which were isolated by a culture technique. The FPP were equilibrated with 2 M dimethyl sulfoxide (Me2SO), cooled at a rate of 0.25 degrees C/min to -40 degrees C, transferred to liquid nitrogen (-196 degrees C), stored for 2 h to 2 months at -196 degrees C, and thawed in a 37 degrees C water bath. The morphology of frozen-thawed FPP was similar to that of noncryopreserved FPP. One hundred percent recovery of response capacity was achieved when tested with 16.7 mM glucose plus 10 mM theophylline. We have recently shown that streptozotocin is not toxic to FPP. Accordingly, we transplanted a standardized dose (10-15 mg/mouse) of either cultured of frozen-thawed FPP beneath the renal capsule of nude mice. Three to four weeks later the recipients of the FPP were rendered diabetic by iv streptozotocin. All of the mice transplanted with cultured FPP and seven of eight mice receiving cryopreserved FPP achieved normoglycemia, 74.8 +/- 32.9 and 54.7 +/- 8.1 days (P > 0.05) after transplantation. An intraperitoneal glucose tolerance test in the mice of both groups showed a flatter response to glucose compared to those of normal controls. Grafts removed from the mice with normoglycemia for > 3 weeks, in both groups, had the capacity to secrete insulin in response to 16.7 mM glucose alone and 16.7 mM glucose plus 10 mM theophylline during in vitro perifusion. Histological examination revealed that the extent of differentiation and development, in vivo of cryopreserved FPP was comparable with that of cultured FPP. These data indicate that cryopreservation, with the protocol used here, is successful in maintaining functional viability of frozen-thawed FPP. This study is valuable for clinical islet transplantation research.

Impact of culture and cryopreservation on MHC class II antigen expression in canine and porcine islets.

Canine and porcine islets were either cultured for 10 days at 37 degrees C or cryopreserved. The effect of these treatments on MHC class II antigen expression was examined by indirect immunofluorescence test using the class II monoclonal antibody 2MC3. Within untreated canine islets exclusively round shaped cells as leukocytes and monocyte/macrophage like cells with dendritic branches were positive with 2MC3. Porcine islets additionally exhibited strong immunofluorescence of the vascular endothelium. Tissue culture significantly reduced the class II antigen expression in both species. The majority of the untreated canine islets had between 5 and 19 2MC3 positive cells. Cell culture reduced the number of class II positive cells to a maximum of 3 and even 84.9% of the islets were completely negative for class II antigens. Porcine islets showed a total class II antigen loss of the vascular endothelium, whereas leukocytes and monocytes/macrophages remained class II antigen positive. Cryopreservation did not have clear-cut effects on the MHC expression in both species.