Buchbesprechungen

Ohne Zusammenfassung     

Experimentelle Untersuchungen über die Beziehung zwischen dem Gehalt an Immunitätseinheiten und dem schützenden und heilenden Werth der Diphtherieheilsera

Ohne Zusammenfassung     

Anaphylaxie und Blutgerinnung

Zusammenfassung 1. Das Meerschweinchen zeigt im anaphylaktischen Shock vollkommen normale Blutgerinnungszeit. 2. Dennoch zeigt im Shock entnommenes Blut einen erh?hten Serum-Antithrombinspiegel. 3. Heparin wirkt unter bestimmten Bedingungen shockverhütend.     

Die Gestalt des Paracelsus

Ohne Zusammenfassung     

Bemerkenswerte Fälle von Tötung kleiner Kinder

Ohne ZusammenfassungNach einem auf der Tagung der Deutschen Gesellschaft für gerichtliche und soziale Medizin im September 1927 in Graz gehaltenen Vortrage.     

Myopiefragen

Ohne Zusammenfassung     

Elastase-induced saccular aneurysms in rabbits: comparison of geometric features with those of human aneurysms.

BACKGROUND AND PURPOSE: The development of more effective intracranial aneurysm therapy depends on the ability to test various intravascular occlusion devices and techniques in preclinical animal models. This requires the creation of experimental aneurysms, which, ideally, should mimic the size and geometric features of human intracranial aneurysms. The purpose of this study was to characterize the morphologic features of elastase-induced saccular aneurysms in rabbits to determine whether the morphology of such aneurysms mimics that of human intracranial aneurysms. METHODS: Elastase-induced saccular aneurysms were created in 40 New Zealand white rabbits. Intravenous digital subtraction angiography was performed 14 days after surgery. Relative to an external sizing device, the following dimensions were determined: aneurysm dome (height and width), aneurysm neck diameter, and parent artery diameter. Based on maximal diameter, aneurysms were categorized as small (2.0-4.9 mm), medium-sized (5.0-9.9 mm), or large (10-16 mm), and as narrow-necked (<4.0 mm neck width) or wide-necked (>4.0 mm neck width). Mean dome-neck ratio was calculated and compared with that of human aneurysms. RESULTS: All aneurysm cavities were angiographically patent. Widths of the cavities ranged from 2.5 to 7.1 mm (mean, 4.1 +/- 1.2 mm); heights ranged from 3.0 to 15.6 mm (mean, 8.8 +/- 2.6 mm). Three (7.5%) of 40 aneurysms were small, 20 (50%) were medium-sized, and 17 (42.5%) were large. Twenty-two (55%) of 40 aneurysms were small-necked, and 18 (45%) were wide-necked. Mean dome-neck ratio was 1.13 +/- 0.54. Mean parent artery diameter was 4.3 +/- 1.4 mm. CONCLUSION: Saccular aneurysms of sizes similar to that of human intracranial aneurysms were reliably created using a simple method of vessel ligation and elastase injury. Neck sizes varied with both large and small-necked aneurysms created.     

Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment.

PURPOSE: To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the jaws. MATERIALS AND METHODS: Detailed data from 30 consecutive cases were compared with 116 cases due to intravenous aminobisphosphonates. RESULTS: Results in part noted a higher incidence related to alendronate (Fosamax; Merck, Whitehouse Station, NJ), a 94.7% predilection for the posterior mandible, and a 50% occurrence spontaneously, with the remaining 50% resulting from an oral surgical procedure, mostly tooth removals. Just over 53% of patients were taking their oral bisphosphonate for osteopenia, 33.3% for documented osteoporosis, and 13.4% for steroid-induced osteoporosis related to 4 or more years of prednisone therapy for an autoimmune condition. There was a direct exponential relationship between the size of the exposed bone and the duration of oral bisphosphonate use. There was also a direct correlation between reports of pain and clinical evidence of infection. The morning fasting serum C-terminal telopeptide (CTX) test results were observed to correlate to the duration of oral bisphosphonate use and could indicate a recovery of bone remodeling with increased values if the oral bisphosphonate was discontinued. A stratification of relative risk was seen as CTX values less than 100 pg/mL representing high risk, CTX values between 100 pg/mL and 150 pg/mL representing moderate risk, and CTX values above 150 pg/mL representing minimal risk. The CTX values were noted to increase between 25.9 pg/mL to 26.4 pg/mL for each month of a drug holiday indicating a recovery of bone remodeling and a guideline as to when oral surgical procedures can be accomplished with the least risk. In addition, drug holidays associated with CTX values rising above the 150 pg/mL threshold were observed to correlate to either spontaneous bone healing or a complete healing response after an office-based debridement procedure. CONCLUSIONS: Oral bisphosphonate-induced osteonecrosis is a rare but real entity that is less frequent, less severe, more predictable, and more responsive to treatment than intravenous bisphosphonate-induced osteonecrosis. The morning fasting serum C-terminal telopeptide bone suppression marker is a useful tool for the clinician to assess risks and guide treatment decisions.