[Arthroscopic synovectomy of the hip joint]. / Arthroskopische Synovektomie des Hüftgelenks.

OBJECTIVE: The aim of the treatment is reduction of hip pain through arthroscopic synovectomy of the hip joint, reduction in activity of the synovial disease and removal of loose bodies in chondromatosis. INDICATIONS: Synovialitis of the hip due to synovial disease, such as pigmented villonodular synovitis (PVNS) and chondromatosis, synovialitis of the hip due to a further diseases of the hip. The disease must be treatable by arthroscopy (e.g. femoroacetabular impingement and lesion of the acetabular labrum). CONTRAINDICATIONS: Suspicion of malignant synovial disease, extensive synovitis, especially in those areas of the hip which are difficult to reach or inaccessible to arthroscopy, primary disease not sufficiently treatable by arthroscopy, e.g. coxarthrosis. SURGICAL TECHNIQUE: Arthroscopy of the central compartment of the hip is carried out by lateral, anterolateral (alternatively inferior anterolateral) and posterolateral portals, using all portals both for the camera and for instruments. In the central compartment synovectomy of the acetabular fossa is performed. A shaver and/or a high frequency diathermy applicator (HF applicator) are employed for removal of the synovial membrane. For arthroscopy of the peripheral compartment lateral, anterolateral (alternatively inferior anterolateral) and superior anterolateral portals are established and all portals are used both for the camera and instruments. In the peripheral compartment, the synovial membrane of the anterior, anteromedial, anterolateral and as far as possible posterolateral areas of the hip is removed. The dorsolateral synovial plica needs to be spared. POSTOPERATIVE MANAGEMENT: Non-steroidal anti-inflammatory drugs (NSAIDs) are administered as prophylaxis of heterotopic ossification for 10 days. Contraindications for NSAIDs need to be considered. Thrombosis prophylaxis with low molecular weight heparin over 5 days. Mobilization with full weight bearing. Intensive physiotherapeutic exercises for at least 6 and possibly up to 12 postoperative weeks. Radiosynoviorthesis 6-8 weeks after surgery depending of the histopathological results. RESULTS: From June 2007 to December 2013 a total of 20 patients with specific synovial diseases were treated with hip arthroscopy of which 18 had chondromatosis and 2 had PVNS. A telephone interview was carried out after an average of 40.2 months (range 8-92 months) and revealed a recurrence rate of the synovial disease of 20 %. In two cases (10 %) a second arthroscopy was necessary due to recurrent symptoms but without return of the synovial disease.

[Arthroscopic arthrolysis of the hip]. / Arthroskopische Arthrolyse des Hüftgelenks.

OBJECTIVE: Increase of range of motion and pain reduction for pain limited movement of the hip joint by arthroscopic arthrolysis of the peripheral compartment. INDICATIONS: Painful primary or secondary restriction of movement of the hip joint with adhesive capsulitis and after previous surgery or additional arthroscopically treatable intra-articular changes. CONTRAINDICATIONS: Extensive periarticular ossification, severe arthrofibrosis and advanced arthritis of the hip. SURGICAL TECHNIQUE: Arthroscopy of the peripheral compartment of the hip, initially using a lateral portal for the arthroscope and an anterolateral portal for instruments. After expansion of the portal entry site with a shaver and/or HF applicator and removal of scar tissue between the capsule and femoral neck, the capsule is reduced from anterolateral to anteromedial. After exchange of arthroscope and working portal, the lateral and dorsolateral arthrolysis is done. POSTOPERATIVE MANAGEMENT: Administration of nonsteroidal anti-inflammatory drugs for prophylaxis of heterotopic ossifications. Thrombosis prophylaxis with heparin. Mobilization with full weight bearing. Intensive physiotherapeutic exercises for at least for 6 weeks and if needed for 12 postoperative weeks. RESULTS: After arthroscopic (n=38) or open (n=11) hip surgeries, 49 revision hip arthroscopies were performed from January 2009 to August 2013. Arthrolysis in the described technique was performed if adhesions were present. In 19 of these cases, a limitation of at least 30 % for one direction of movement was present pre-operatively. The following average values were obtained for the range of motion (preoperative/postoperative/increase): flexion 94°/128°/34 °, abduction 18°/40°/22°, internal rotation of 8°/20°/12°, external rotation 18°/38°/20°.

In vivo marking of single cells in chick embryos using photoactivation of GFP.

Selective marking of a single cell within a living embryo is often difficult due to the inaccuracy and invasiveness of standard techniques. This unit describes a minimally invasive optical protocol that uses 405-nm laser light to photoactivate a variant of green fluorescent protein (PAGFP). This method takes advantage of the accessibility of the chick embryo to inject PAGFP into a region of interest and uses electroporation to deliver the construct into cells. This unit describes in detail how single and small groups of cells (n<10) that express PAGFP can be made visually distinguishable from the host population using the photoactivation process. Included is a means to maximize the fluorescence increase due to photoactivated GFP signal and to reduce photobleaching. Briefly outlined are previously developed chick culture and time-lapse imaging techniques to allow for the subsequent monitoring of photoactivated cell migratory behaviors. The technique has the potential to be a less-invasive, accurate tool for in vivo studies that involve following cell lineage and cell migration.

A case-control study of Nocardia mastitis in Ontario dairy herds.

A case-control study was conducted to identify milking hygiene and udder therapy factors associated with a diagnosis of Nocardia mastitis in dairy herds from which milk samples are submitted to the Ontario Ministry of Agriculture and Food, Veterinary Laboratory Services, Guelph laboratory. The data were collected by telephone interview from 31 case and 31 control herds.After analytical control for confounders, blanket dry cow therapy and a dry cow antibiotic product were associated with a diagnosis of Nocardia mastitis in a herd, whereas another dry cow antibiotic product had a sparing effect.In comparison to mastitis pathogens susceptible to dry cow antibiotic therapy, Nocardia species were isolated infrequently from milk specimens submitted to the Guelph mastitis laboratory.

Value of high resolution real-time ultrasonography in secondary hyperparathyroidism.

Thirty-two patients were treated surgically for symptomatic secondary or tertiary hyperparathyroidism, and 27 of these patients had high resolution (10 mHz) real-time ultrasonography before parathyroidectomy. This preoperative localization study identified one or more enlarged hyperplastic parathyroid glands in all but one patient who had not had a previous parathyroid operation, and in five of six patients who did have previous parathyroid operations. In both of the patients in whom no parathyroid glands were identified by ultrasonography the only abnormal enlarged parathyroid glands were those situated within the superior mediastinum. When large glands are not observed by ultrasonography in patients with severe secondary hyperparathyroidism, the glands are usually situated in the superior mediastinum, behind the trachea or esophagus, or deeply within the neck. The size of the parathyroid glands correlated positively with the serum parathyroid hormone level and with the severity of the secondary hyperparathyroidism. Thus, the preoperative identification of parathyroid glands by ultrasonography not only localizes the site of most hyperplastic parathyroid glands (70 percent of patients), but also detects those patients who have enlarged parathyroid glands, elevated serum parathyroid hormone levels, and severe secondary hyperparathyroidism. These are the patients who are thus unlikely to respond to further medical therapy.

Illness associated with abdominal adhesions in a cow.

A mature Holstein cow became inappetent , dehydrated and weak, with a marked drop in milk production, 17 days after a dead calf was removed by cesarean section. Laparotomy revealed adhesions among the cecum, jejunum, colon, bladder and uterus. Transection of the adhesions resulted in recovery; however, the cow was sent to slaughter a month later because of apparent recurrence of the abdominal adhesions.