[The trend sport snowblading and its risks]. / Der Trendsport Snowblading und seine Risiken.

The study analysed the results of an examination of 3557 skiing, snowboarding and snowblading injuries treated at the Department of Trauma Surgery at the Klinikum Garmisch-Partenkirchen in winter seasons 99/00 through 02/03. In this study group, a total of 70 injuries occurred while snowblading. These injuries are compared to the remaining injuries resulting from skiing, carving or snowboarding accidents. This study intends to contribute to the tracking and recording of injuries occurring during snowblading, a sport that is popular but not yet well-addressed in medical literature. The results show that snowblading injuries are similar to those of skiing, but different from those attributable to snowboarding, particularly with regard to the affected parts of the body and injury patterns. Acrobatic jumps increase significantly the risk of fractures of the lower extremities. However, ruptures of ligaments, especially of the ACL, are seen more rarely in snowblading than in carving or conventional skiing. Distorsions, on the other hand, are observed significantly more often among snowbladers when compared with carvers and snowboarders. Release bindings for snowblades could reduce the risk of injuries.

[Dangers in skiing]. / Gefahren beim Carvingskifahren.

The current study deals with the results of the examination of 685 patients, who were treated in the department of traumatology in the KKH Garmisch-Partenkirchen during the winter season 99/00 and 00/01. The study included 259 injured carvers (120 female, 139 male) with an average age of 33.9 years and 426 injured conventional skiers (212 female, 214 male) with an average age of 33.2 years. The aim of the investigation was to compare both ski groups concerning injuries, the pathomechanism and the skiing experience. The results of the investigation showed that the knee injuries of carvers were more severe than in the conventional skiers. The difference was significant (p < 0.05).

[Outcome of surgically treated lateral clavicle fractures]. / Ergebnisse operativ behandelter lateraler Klavikulafrakturen.

This retrospective study presents the results of 41 patients with a lateral clavicle fracture eight years after the treatment at the Staatliche Orthopädische Klinik of the LMU München in the time between 31.10.1979 and 31.10.1994. It could be shown that the lateral clavicle fractures, due to their variety, hold a special position among the clavicle fractures and thus need a differentiated therapeutic procedure. Among the operation methods the K-wire stabilisation with cerclage was the most often chosen operation technique i.e. in 24 cases. The K-wire without cerclage was used in two cases. Twelve fractures were treated with AO-plate-osteosynthesis. Three fractures had to be treated by resection, as they produced two pseudarthrosis and one serious AC-arthrosis during the conservative therapy. 92.7% of the subjective results of the 41 checked up patients were good and very good. The clinical follow-up of 36 and the radiological follow-up of 33 patients revealed in 97% a good and very good outcome in the Boenisch-Score.

Increased state of activation of CD4 positive T cells and elevated interferon gamma production in pouchitis.

BACKGROUND: Immunoregulatory abnormalities of T cells might be of importance in the pathogenesis of pouchitis after ileoanal pouch anastomosis (IAP). AIMS: To characterise T cell subsets, their state of activation, and production of cytokines in inflamed and non-inflamed pouches in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The influence of T cell activation on mucosal transformation was also studied. PATIENTS: Mucosal biopsy specimens were taken from 42 patients with IAP (33 with UC and nine with FAP). METHODS: Mononuclear cells were isolated by standard techniques and characterised by three colour flow cytometry. Interferon gamma (IFN-gamma) production was studied using the ELISPOT technique. RESULTS: In patients with UC with pouchitis there was a significant increase in the CD4:CD8 ratio, expression of activation markers on CD3+ cells, and number of IFNgamma producing mononuclear cells compared with patients with UC without pouchitis (CD4:CD8 ratio 1.3 (range 0.7-2.7) versus 0.6 (0. 1-1.0), p=0.012). In addition, a positive correlation between increased crypt depth and the number of CD4+ cells (r=0.57) was shown. CONCLUSION: The observed increase in activated mucosal CD4+ T cells and IFN-gamma production might lead to mucosal destruction and crypt hyperplasia as seen in pouchitis.

Special features of the intestinal lymphocytic system.

The gastrointestinal lymphocytic system can be divided in two functional compartments, the organized lymphoid tissue, for example, the Peyer's patches, and the lymphocytes located diffusely in the mucosa, the lamina propria lymphocytes (LPL), and the intra-epithelial lymphocytes (IEL). Antigens enter the Peyer's patches as the afferent part of the GALT via specialized epithelial cells called M cells. After the initiation of the immune response by antigen processing and presentation to B and T cells in Peyer's patches, primed lymphocytes leave the mucosa via the thoracic duct. Finally they migrate back to the mucosa where they exert effector functions. Adhesion molecules, including integrins, especially alpha 4 beta 7 and alpha E beta 7 (HML-1) are involved in these homing and adhesion processes. LPL and LEL differ from peripheral blood lymphocytes in their expression of adhesion molecules and other surface and activation markers. Additionally, they exhibit functional features different from those of other lymphocyte compartments. In the mucosal immune system, plasma cells mainly secrete IgA, which is part of the specialized humoral defence in the gut.

[Recurrent Crohn disease--definition and diagnosis]. / Rezidiv des Morbus Crohn--Definition und Diagnostik.

Recurrence in Crohn's disease is a frequently encountered problem in the history of this chronic incurable disease. A number of studies have shown different recurrence and reoperation rates, which is partly due to different definitions and diagnostic strategies. 'Surgical relapse' as defined as reappearance of disease activity in operated patients, 'clinical relapse' after conservatively induced remission or 'endoscopical recurrence' with new pathological changes in the operated gut may be differentiated. The different definitions of recurrence are discussed and diagnostic procedures like endoscopical, laboratory or radiological methods are explained.