[Treatment of hip dysplasia in young adults]. / Behandlung der Hüftgelenkdysplasie beim jungen Erwachsenen.

Developmental dysplasia of the hip (DDH) is one of the most common disorders of hips in children. The deformity can remain asymptomatic into adolescence and adulthood; however, it is considered to be a form of prearthritis and is the main cause of premature osteoarthritis of the hip. The deformity affects the acetabulum but can also be accompanied by changes in the shape of the proximal femur. If conservative treatment for mild DDH is insufficient, or in cases of moderate to severe DDH, operative treatment should be carried out, for example by corrective osteotomy of the pelvis and/or the proximal femur and hip arthroscopy may be considered adjunctively in order to resolve the prearthritis and prevent premature osteoarthritis of the hip. This manuscript elucidates the deformity, the diagnostic measures required to make the diagnosis and the treatment options available for prevention of arthritis.

Focusing on functional knee parameter determination to develop a better clinical gait analysis protocol.

BACKGROUND: Attempts to improve protocol standards of marker-based clinical gait analysis (CGA) have been one of the main focuses of research to enhance robustness and reliability outcomes since the 1990s. Determining joint centres and axes constitutes an important aspect of those protocols. Although the hip joint is more prominent in such studies, knee joint center (KJC) and axis (KJA) directly affect all outcomes. RESEARCH QUESTION: What recommendations arise from the study of the scientific literature for determining knee joint parameters (KJP) for protocols of CGA? METHODS: A systematic, electronic search was conducted on November 2018 using three databases with the keyword combination ("functional approach" OR "functional method" OR "functional calibration") AND ("hip joint" OR "knee joint" OR "ankle joint") and analyzed by four reviewers. Given the existence of a recent review about the hip joint and the lack of material about the ankle joint, only papers about the knee joint were kept. The references cited in the selected papers were also screened in the final round of the search for these publications. The quality of the selected papers was assessed and aspects regarding accuracy, repeatability, and feasibility were thoroughly considered to allow for a comparison between studies. Technical aspects, such as marker set choice, KJP determination techniques, demographics, and functional movements, were also included. RESULTS: Thirty-one papers were included and on average received a rating of about 75 % according to the quality scale used. The results showed that functional methods are superior or equivalent to predictive methods to estimate the KJA, while a regression method was slightly better for KJC prediction. SIGNIFICANCE: Calibration methods should be applied to CGA whenever feasibility is reached. No study to date has focused on evaluating the in vivo RoM required to obtain reliable and repeatable results and future work should aim in this direction.

[Torticollis in children]. / Der Schiefhals beim Kind.

BACKGROUND: Torticollis is a common neck deformity in both newborn and older children. The various causes of the abnormal posturing of the head differ in severity, long-term consequences and their treatment. METHODS: This article gives an overview of the differential diagnoses of torticollis in children and current literature, and provides insight into our diagnostic and therapeutic algorithm. RESULTS: A distinction is drawn between congenital and acquired deformities and whether or not they are painful. Most commonly, children present with a congenital muscular torticollis, which has an estimated incidence of 0.3 to 1.9%. The main differential diagnosis of congenital muscular torticollis is Klippel-Feil syndrome. Acquired torticollis often has more severe causes and always needs a thorough diagnostic clarification. CONCLUSION: The knowledge of possible causes and their treatment is essential to provide adequate care for affected children and their families and to prevent long-term consequences.

[How many potential organ donors are there really? : Retrospective analysis of why determination of irreversible loss of brain function was not performed in deceased patients with relevant brain damage]. / Wie viele potenzielle Organspender gibt es wirklich? : Retrospektive Analyse zu nichterfolgter Diagnostik des irreversiblen Hirnfunktionsausfalls bei verstorbenen Patienten mit relevanter Hirnschädigung.

BACKGROUND: No systematic study has previously been undertaken in Germany to ascertain why irreversible brain death determination (BDD) has not been carried out. OBJECTIVE: A comprehensive analysis of reasons for unperformed BDD in deceased patients with acute, severe brain damage could improve the identification of potential organ donors. METHOD: Using the Transplantcheck program of the German Organ Transplantation Foundation (DSO) an analysis of the data from 2016 was undertaken in participating hospitals in Saxony, Saxony-Anhalt and Thuringia (Region East of the DSO), regarding why a BDD was not initiated in deceased patients with primary or secondary brain damage. RESULTS: In 128 of the 144 Region East hospitals, 7889 deceased patients with primary or secondary brain damage were detected. In 7389 patients a BDD was out of the question for a variety of reasons. In 232 patients organ donation was not considered due to an advance directive. In 195 cases treatment was limited based on the patient's infaust neurological prognosis without the possibility of organ donation being discussed with relatives. In 73 cases initiation of BDD was indicated but not performed. CONCLUSION: The number of potential organ donors in Region East of the DSO could be significantly increased by identifying patients where BDD is indicated. By consistent evaluation of patients' wills in terms of organ donation before treatment is withdrawn in patients with poor neurological prognosis, additional potential organ donors could be identified. Furthermore, involving neurointensive care physicians in the care of all patients with brain damage could improve the prognostic assessment.

Vertical adaptation of the center of mass in human running on uneven ground.

In running we are frequently confronted with different kinds of disturbances. Some require quick reactions and adaptations while others, like moderate changes in ground level, can be compensated passively. Monitoring the kinematics of the runner's center of mass (CoM) in such situations can reveal what global locomotion control strategies humans use and can help to distinguish between active and passive compensation methods. In this study single and permanent upward steps of 10 cm as well as drops of the same height were used as mechanical disturbances and the adaptations in the vertical oscillation of the runners CoM were analyzed. We found that runners visually perceiving uneven ground ahead substantially adapted their CoM in preparation by lifting it about 50% of step height or lowering it by about 40% of drop height, respectively. After contact on the changed ground level different adaptations depending on the situation occur. For persisting changes the adaptation to the elevated ground is completed after the first step on the new level. For single steps part of the adaptation takes place while returning to the ground. The consistent adaptations for the different situations support the idea that controlling the CoM by adapting leg parameters is a general control principle in running.

[Effect of thrombus endarterectomy (TEA) on the regional cerebral bloodflow (rCBF) in patients with unilateral internal carotid artery stenosis]. / Einfluss der Thrombendarteriektomie (TEA) auf die regionale Hirnperfusion (rCBF) bei Patienten mit unilateraler Karotis-interna-Stenose.

AIM: In a study of patients with unilateral and symptomatic stenosis of the internal carotid artery (ICA), the effect of endarterectomy (EA) on the regional cerebral blood flow (rCBF) was tested over a postoperative interval of 12 months. METHOD: Xenon-133-rCBF was assessed in 74 patients pre- and post-surgery (one week, six weeks, three months and 12 months after EA). This was done at rest and after stimulation with acetazolamide in order to test the perfusion reserve. RESULTS: Before surgery all 74 patients showed a diminished perfusion ipsilaterally-at rest and/or after stimulation. 38/74 (51%) patients had a significant (> 5%) and 36/74 (49%) patients a non-significant (< 5%) interhemispheric perfusion asymmetry. Twelve months after EA, there were only 23/74 (31%) patients with significant interhemispheric perfusion asymmetry. By stimulation, this decreasing effect became more evident: Before surgery 44/74 (60%) patients had a significant interhemispheric perfusion asymmetry, 12 months after surgery there were only 14/74 (19%) patients. CONCLUSION: In regard to the brain hemisphere distal to the ICA stenosis, our study revealed a significant improvement of brain perfusion after EA. Brain perfusion was stable over an interval of 12 months post-surgery. By EA, especially the perfusion reserve increased, as shown by a normal acetazolamide test. Hence, Xenon-133-rCBF could be shown to be an important method in the evaluation of the indication for surgery and of the result of it. In the intra-individual follow-up after EA, rCBF was able to identify hypoperfusion and may help decide, whether re-angiography is necessary or not.

Bone mineral density in patients receiving suppressive doses of thyroxine for differentiated thyroid carcinoma.

To determine bone mineral density in patients with differentiated thyroid carcinoma receiving thyroxine replacement therapy in suppressive doses, we studied 65 patients (47 women and 18 men; age 25-83 years, mean+/-SD 52.5+/-15.4 years). Patients were free of thyroid cancer in clinical and laboratory examinations at the time of the study. Bone mineral density of the lumbar spine and both hips was measured by dual-energy X-ray absorptiometry. There was no decrease in bone density in either 32 postmenopausal or 15 premenopausal women compared with an age- and sex-matched control group, nor was any decrease in bone density found in men. Our data suggest that thyroxine treatment in suppressive doses in patients with differentiated thyroid carcinoma is not a risk factor for the development of osteoporosis.

HIV-enteropathy and bile acid malabsorption: response to cholestyramine.

Chronic diarrhea and weight loss are common in patients with AIDS. We report on an AIDS patient with chronic diarrhea, steatorrhea, and marked weight loss. A 75SeHCAT test demonstrated that the diarrhea was mainly due to bile acid malabsorption. Therapy with cholestyramine dramatically reduced bowel movements and led to significant reversal of weight loss.

[The inhibition of meiosis of bovine oocytes using biologic of synthetic inhibitors]. / Untersuchungen zur Hemmung der Meiose von Rinderoozyten mittels biologischer oder synthetischer Inhibitoren.

About 1,200 cumulus oocyte complexes were used in an attempt to investigate the influence in vitro of various biological or synthetic inhibitors on meiosis of bovine oocytes. The biological inhibitor used was a low-molecular protein fraction (OMI) of bovine follicle fluid. N6, O2-dibutyryl-cAMP (0.3-1 mol/l), hypoxanthine (4.0 mol/l), adenosine (0.75 mol/l), and nicotinamide (20.0 mol/l) were the synthetic inhibitors. The OMI-active lyophilisate caused inhibition by 34 percent after 24 hours of culturing. Meiosis was inhibited by 15-28 percent by the synthetic inhibitors. Eight transferable embryos have so far resulted from in vitro fertilisation of oocytes of extracorporal non-ovulatory maturation. Pregnancy was achieved in heifer recipients by tubal transfer.

[Results of endocrinologic studies in culture media after coculture of bovine oocytes with granulosa cells]. / Ergebnisse endokrinologischer Untersuchungen in Kulturmedien nach der Kokultur von Rinderoozyten mit Granulosazellen.

The steroid hormones progesterone (P.), and testosterone (T.) were radio-immunologically determined in 108 medium samples, following co-culturing of bovine oocytes with granulosa cells. P. and T. values recorded from a control group were lower with significance than those recorded from co-culturing groups, that is 72 +/- 21 ng/ml and 264 +/- 84 pg/ml as compared to 208 +/- 138 ng/ml and 2,168 +/- 1,595 pg/ml in the oocyte plus fresh granulosa cell co-culturing group as well as 364 +/- 215 ng/ml and 825 +/- 233 pg/ml in the oocyte plus pre-incubated granulosa cell co-culturing group. These rises were accompanied by decline in maturation rate, increase in oocyte degeneration, and rises in the rates of fertilisation and segmentation.

[The release of immobilized substances from Symplex capsules]. / Untersuchungen zur Freigabe immobilisierter Substanzen aus Symplexkapseln.

A new procedure of microencapsulation was studied with regard to substance release and quantification of diffusion processes on the capsule membrane. The permeability behaviour on the capsule membrane was especially studied in metabolites, which are essential for immobilized biological objects (i.g. preimplantative mammal embryos). Peptide and proteohormones, cyanmethemoglobin and proteins were enclosed in simple and multiple Symplex Capsules. All substances examined are able to pass the Symplex membrane. The speed of release is influenced by the size of the capsule, the ion force, temperature, concentration of immobilized substances as well as their linear and globular structur. Compared with simple capsules the release of substances from multiple capsules was delayed. Corresponding to the results found under the experimental design described the Symplex membrane can be considered as coating for the compartmentation of cells, that allows the passage of essential substances for the immobilized objects. The method of microencapsulation used and described has various ways of application.

[Surgical intervention in cases of gastro-duodenal ulcer bleeding (author's transl)]. / Chirurgische Intervention bei Blutungen aus gastroduodenalen Ulzera.

Results in the treatment of the bleeding gastro-duodenal ulcer during a period of 21 years are analysed. The results refer to an early surgery intervention. A bleeding-stop must be tried, particularly in the elderly patient. If possible a causal therapy should be performed.

[Use of copper for the support of physiological reproductive processes. 1. Copper level in the serum of castrated male swine after various applications of copper and copper compounds]. / Uber den Kupfereinsatz zur Unterstützung fortpflanzungsphysiologischer Prozesse. 1. Mitteilung: Uber die Höhe des Kupferspiegels im Serum kastrierter männlicher Schweine nach unterschiedlicher Kupfergabe und bei Applikation verschiedener Kupferverbindungen.

Various copper compounds (CuSO4, Cu-glycinate, Cu-lactate, Cu-citrate) were applied subcutaneously, intramuscularly, and intravenously to 17 barrows, doses being up to 50 mg Cu, while doses between 0.5 g and 1.0 g CuSO4 were orally administered. Curves of copper levels in the serum then were checked at different times. In response to intravenous application, copper levels reached maximum values as early as after two minutes and dropped to the normal about 90 minutes from application. Subcutaneous and intramuscular applications had but little effect on serum copper levels, while oral administration actually had none at all.

[Effects of biotechnical management procedures on blood parameters in gilts. 3. Lipids]. / Uber die Auswirkung biotechnischer Behandlungsverfahren auf Blutparameter bei Jungsauen. 3. Mitteilung: Lipide.

Suisynchron treatment was applied to platform-kept gilts over 20 days. The dosage was 100 mg per animal and die. This was followed by 1,000 I.U. PMS and 250 I.U. HCG. Artificial insemination was applied five days after the first hormone administration and followed by one Gravigonan injection after another twelve to 15 days. Blood samples were drawn from those animals as well as from 20 gilts synchronised in the above way and another 20 untreated gilts from a production unit during the various phases of treatment and cycle. Those samples were used for assessment of cholesterol, lipoid-P, free fatty acids, triglyceride, and beta-lipoproteids. The levels of free and total cholesterol went up along with Suisynchron feeding, whereas lipoid-P and beta-lipoproteids declined. Free fatty acid levels went down with significance (P less than 0.01), and triglycerides increased (P less than 0.05). Cholesterol levels were not altered by PMS/HCG administration. The levels of lipoid-P, free fatty acids, and beta-lipoproteids rose to their magnitudes prior to Suisynchron treatment. Tirglycerides rose by 50 per cent. At the time of full oestrus triglyceride levels doubled (P less than 0.01). Unimportant rises were recorded also for cholesterol, beta-lipoproteids, free fatty acids, and lipoid-P. In animals with spontaneous oestrus all lipid parameters were ligher than in sows with full oestrus after synchronisation.

[Effect of anticoagulants on the change of blood parameters in diestric gilts]. / Einfluss von Gerinnungshemmern auf die Veränderung von Blutparametern bei diöstrischen Jungsauen.

The above problem was studied by furnishing four groups of six gilts each with ear catheters for the following intravenous catheter treatment: 2,500 IU heparin per die over ten days, supported by two daily oral applications of 1 g Falithrom, or 2,500 IU heparin plus two daily applications of 1 g Falithrom, all intravenously. The last group remained untreated for control. One day of the dioestrus was chosen for catheter bleeding of all animals at 6 a.m., 8 a.m., noon, and 4 p.m. and subsequent determination from the plasma of free fatty acids, copper, inorganic phosphorus, total protein, albumin, globulin, chloride, urea, cholesterol, alkaline phosphatase, blood sugar, and beta-lipoproteides. Significant differences regarding these parameters between the various groups were not even established, if alpha = 0.25. The anticoagulants used in the study may be used without any reservation for catheter rinsing and clearing and will not cause any significant change in the levels of the blood parameters.