[Surgical treatment of posterior shoulder dislocation: importance of arthroscopy]. / Operative Versorgung der posterioren Schulterluxation: Stellenwert der Arthroskopie.

OBJECTIVE: Posterior dislocations of the shoulder represent a rare injury with frequently occurring soft tissue and/or bony concomitant lesions such as the reverse Hill-Sachs lesion and the dorsal labrum tear. For the combination of these injuries, no evidence-based therapeutic recommendations exist. AIM OF STUDY: Reflecting on two clinical cases and the current literature data, options for the treatment of combined osseous and soft tissue injuries due to posterior dislocation of the shoulder are presented. METHODS: We report two cases of fresh traumatic first-time posterior dislocations that were each explored arthroscopically and subsequently operated using an open technique. In the first case, we performed refixation of the labrum, followed by open osteosynthesis with bone substitution. Treatment of the second case included diagnostic arthroscopy and - after a frustrating attempt to elevate the defect in an arthroscopically assisted retrograde technique - open reconstruction of the humeral head with an allograft. RESULTS: In both cases good clinical outcomes with Constant scores of 79 and 86 points at the 16- and 12-month follow-ups, respectively, were achieved. Radiologically complete integration of the used materials was found. CONCLUSION: These cases show that for the operative treatment of fresh, traumatic posterior shoulder dislocation, it is useful to explore the joint arthroscopically to identify concomitant injuries of the labrum and if necessary treat them. The bony pathology of the humeral head can subsequently be addressed in an open technique, whereby the appropriate treatment should be chosen based on the size of the defect.

[Refixation of sternoclavicular luxation with a suture anchor system]. / Refixation der sternoklavikulären Luxation mit einem Fadenankersystem.

Luxations of the sternoclavicular joint are rare injuries. We present a case of anterior dislocation which was caused by a minor fall onto the right shoulder. Diagnosis was delayed by 2 weeks which prevented treatment by closed reduction. As an alternative surgical treatment a PDS cord around the clavicle and the first rib was used to stabilize the clavicle at the vertical level. Subsequently, fixation to the medial side was achieved by a suture anchor that was placed into the manubrium. The presented case highlights this simple and safe method to treat dislocations of the sternoclavicular joint in which standard treatment cannot be performed. A detailed description for each operation step is given and our experience in terms of aftercare and outcome is reported.

Presence of negative charge on the basal planes of New York talc.

Potentiometric titration measurements as well as rheological measurements of talc aqueous suspensions indicate that the behavior of the New York talc particles is consistent with the presence of a negative charge on their basal planes. The possibility of the presence of a negative electrical charge on the basal planes of talc particles is analyzed in this paper. Samples of New York talc were studied using electron microprobe analysis and dehydration techniques and the exact chemical formula of New York talc was determined. It was found that there exists a deficiency of protons in the tetrahedral layers of talc, resulting from substitution of Si(4+) ions with Al(3+) and Ti(3+) ions. The comparison of the level of substitution of Si(4+) ions with ions of a lower valency was found to be of a similar order of magnitude as that found in other talc deposits. This strongly points to the presence of a negative charge on the talc basal planes.

[The German Cartilage Registry (KnorpelRegister DGOU) for evaluation of surgical treatment for cartilage defects: experience after six months including first demographic data]. / Das KnorpelRegister DGOU zur Erfassung von Behandlungsergebnissen nach Knorpeloperationen: Erfahrungen nach 6 Monaten und erste epidemiologische Daten.

The German Cartilage Registry (KnorpelRegister DGOU) has been introduced in October 2013 and aims on the evaluation of patients who underwent cartilage repair for symptomatic cartilage defects. It represents a nation-wide cohort study which has been introduced by the working group "Tissue Regeneration" of the Germany Society of Orthopaedic Surgery and Traumatology and is technically based upon a web-based remote data entry (RDE) system. The present article describes first experiences with the registry including patient and treatment characteristics. Between October 2013 and April 2014, a total of 230 patients who had undergone surgical cartilage repair for symptomatic full-thickness cartilage defects of the knee has been included in the German Cartilage Registry from 23 cartilage repair centres. Mean age was 37.11 years (SD 13.61) and mean defect size was 3.68 cm(2) (SD 0.23). Since the introduction of the KnorpelRegister DGOU the total number of registered patients has increased steadily up to the most recent figure of 72 patients within one month. Patients were treated mainly according to the recommended therapies. The highest percentage in therapy is represented by the bone marrow stimulation techniques (55.02 %) as well as by the autologous chondrocyte transplantation (34.92 %). Unlike the patient collective in the majority of prospective randomised controlled trials, the patient population within the registry shows a high proportion of patients with accompanying pathologies, with an age of more than 50 years at the time of treatment and with unfavourably assessed accompanying pathologies such as an affection of the opposite cartilage surface or a previously resected meniscus. In summary, the technical platform and forms of documentation of the KnorpelRegister DGOU have proved to be very promising within the first six months. Unlike data from other clinical trials, the previous analysis of the patients' data and therapies reflects successfully the actual medical care situation of patients with cartilage defects of the knee joint. This analysis also provides new information on subgroups of patients that have not yet been recorded in the scientific literature. This will be part of the first analysis of clinical treatment data. An expansion of the KnorpelRegister DGOU to patients with cartilage defects of the ankle and hip joints is already decided upon and initialised.

Effect of carboxymethyl cellulose and ionic strength on stability of mineral suspensions in potash ore flotation systems.

The adsorption of sodium carboxymethyl cellulose from aqueous solutions varying in ionic strength from that of distilled water to 50% NaCl/KCl brine (about 3.5 mol/dm(3)) onto illite and dolomite has been studied. The purpose of this work was to investigate the solvency effects in the phenomena underlying the potash flotation process that is carried out in saturated brine. Based on viscosity measurements, the adsorption results were analyzed in terms of a simple model of polymer macromolecules in solution. Suspension stability measurements carried out concomitantly with adsorption tests showed the ranges of carboxymethyl cellulose concentration over which the tested suspensions either were aggregated or were restabilized.

Mineral matter distribution on coal surface and its effect on coal wettability.

Coal is an organic sedimentary rock composed of organic macerals and mineral matter. As it is demonstrated in this paper the discrete mineralogical nature of coal largely influences the wetting of the coal surface by water. Both advancing and receding contact angles were measured using the captive-bubble technique with an automatic bubble shape analysis software. The distribution and amount of mineral inclusions on the coal surface were determined by scanning electron microscopy and examined using the image analysis system. To determine the amount and size distribution of mineral grains, the coal surface layer, on which the contact angles were measured, was separated from the larger piece used in the measurements by microslicing. The separated surface layer was subjected to a low-temperature ashing followed by particle size analysis. As expected, a significant scatter of contact angle values was obtained for the same coal samples. Increasing the amount of mineral matter on the coal surface reduced the value of both advancing and receding contact angles. Also, the scatter of contact angle values increased with the increasing mineral matter content from about 1 to 50 wt%. The results reveal that an important factor in analysis of contact angle variation on coal surfaces is the size of the hydrophilic mineral inclusions. Both the advancing and the receding contact angles decrease with increasing size of the mineral grains. Additionally, the scatter of contact angle values increase with increasing size of the mineral matter grains. Finally, the results of fractal dimension analysis of mineral matter grains distributed over the coal surface indicate that there is no significant effect from the shape of hydrophilic mineral inclusions on both advancing and receding contact angles.

Intrapleural administration of vitreous high duty ceramic fibres and heated devitrified ceramic fibres does not give rise to pleural mesothelioma in rats.

In order to determine whether they are potentially carcinogenic to the pleural mesothelium, three samples of ceramic fibre have been administered to rats by the intrapleural route. These samples were a high-duty grade refractory ceramic fibre (manufactured by Thermal Ceramics Ltd) in the as-manufactured vitreous state and two devitrified samples produced by heating the same fibre for 2 weeks at 1200 degrees C and for two weeks at 1400 degrees C. The mean lifespans of the groups of rats treated with vitrified and devitrified ceramic fibres were not significantly different from that of the control rats. In these studies none of the treated or control rats developed pleural mesothelioma, making it unlikely that ceramic fibres of this type, whether vitreous or devitrified, are potentially carcinogenic to the pleural mesothelium.

[Ovarian cancer. I. Epidemiology, symptoms, FIGO staging]. / Rak jajnika w materiale Kliniki Chirurgii Ginekologicznej Instytutu CZMP. I. Epidemiologia, objawy, stopnie zaawansowania.

OBJECTIVES: The purpose of our study was to analyse the epidemiological data, signs and symptoms, FIGO staging in patients operated for the first time for ovarian cancer. MATERIALS AND METHODS: A retrospective review of patients' charts with ovarian cancer operated at the Department of Gynaecological Surgery of Polish Mother's Memorial Hospital-Research Institute in 1990-1999 was conducted. We analysed the data of women operated for the first time for this disease. FIGO staging was performed due to operational and histologic findings. RESULTS: Between January 1990 and December 1999, 107 patients were operated for the first time for ovarian cancer. The mean patients' age was 54 years (range: 25-82); 31.8% of patients were aged from 41 to 50 years, 24.8% 51-60, 27.1% 61-70%, 7.5% above 70 years, and 9.3% were below 40 years. The main symptoms were: abdominal pain (61.7%), increasing abdominal circumference (35.5%), urination and bowel problems (14.0%), weight loss (8.4%), dyspeptic problems (7.5%), slightly elevated temperature (4.7%) and abnormal vaginal bleeding (3.7%). No symptoms were reported by 16.8% of patients (frequency similar in I/II and III/IV stage by FIGO). There were no statistical differences in the incidence of reported symptoms in I/II vs III/IV FIGO stage. FIGO staging was as follows: I--13.1%, II--14.95%, III--59.8%, IV--12.15%. CONCLUSIONS: Our data showed that ovarian cancer is very rare below the age of 40 and above 70 years. There is a great need to improve screening for ovarian cancer because the development of the disease is clinically silent or nonspecific and almost 70% of patients with ovarian cancer is diagnosed in the late stages of illness.

[Cutaneous xanthomas associated with minocycline-induced cholestatic jaundice]. / Xanthomatose der Haut bei cholestatischem Ikterus nach Minocyclin-Langzeittherapie.

Minocycline is an effective treatment of acne vulgaris, especially for inflammatory forms. Prescription rates have increased in recent years accompanied by a number of reports concerning drug-induced side effects. An otherwise healthy woman developed an erythema multiform-like rash and and toxic hepatic damage causing cholestatic jaundice following long-term minocycline use. Unusual cutaneous lipid deposition also developed. Minocycline-induced side effects are reviewed.

The effects of heating and devitrification on the structure and biological activity of aluminosilicate refractory ceramic fibres.

Three grades of ceramic fibre have been examined for their composition, structures and biological effect in several in vitro assay systems. The fibres were examined in the 'as-manufactured' state and after heating at 1200 and 1400 degrees C. Devitrification of the fibres at 1200 degrees C probably gave mullite crystals on the surface and caused the formation of the high-temperature form of cristobalite and, in zirconia grade fibres, the high-temperature, tetragonal form of zirconia as well. Further heating changed surface structure and led to zircon production in the zirconia fibres. Heating reduced the affinity of the fibres for the surface of V79-4 cells and lowered fibre toxicity toward these cells and towards macrophage-like cells. These changes in toxicity were not due to a reduction in the fibrous nature of the materials although they did become more brittle and powders prepared from them contained more isometric particles than those from as-manufactured materials. This suggests that the devitrification occurring during the use of these materials in high-temperature environments will not necessarily enhance their adverse biological activities despite the production of one phase of crystalline silica.

Job exposures as correlates of recovery in population-based rehabilitation intervention for work-related low back disorders.

PURPOSE: Evaluating the impact of population-based rehabilitation interventions for work-related low back disorders (WR-LBD) requires job exposure factors to be considered as time-varying covariates. The role of job factors in recovery has not been well-established as most studies are based upon clinic samples, not working populations. This report represents the initial exploration of variables to be included in modeling job exposures as time-varying covariates of a study of work-place based rehabilitation intervention.METHODS: The study sample consisted of 162 hourly production employees from two automotive plants with work-related low back disorder not due to external trauma. Data reported herein were collected at baseline from an on-going large randomized clinical trial of rehabilitation for WR-LBD. Low back pain as measured by the North American Spine Society Baseline Form was examined in relation to: self-reported job factors from the Job Content Questionnaire and job risk category for low back disorder determined by the Lumbar Motion Monitor (LMM), an electronic goniometer which transmits back motion signals to a computer for analysis.RESULTS: Low back pain, with and without leg pain, was not found to be associated with hours worked in the previous week, job shift, perceptions of the pace of the job, or job risk of low back disorder as measured by the LMM. Low back pain was significantly (p < 0.05) correlated with perceptions of: how hard the work was, how much physical effort was required, how hectic the job was, whether or not there was sufficient time to do the job, and how much concentration and physical effort were required for the job.CONCLUSIONS: Self-report of perceptions of job strain may be as important, if not more important, than current quantitative factors thought to influence recovery from work-related low back pain.