Presence of oxytalan fibers in human regenerated periodontal ligament

The aim of the present study was to investigate whether oxytalan fibers are formed in the regenerated human periodontal ligament. 6 patients, each of them exhibiting an advanced intrabony defect, were treated with a bioresorbable membrane according to the GTR-principle. Following a healing period of 6 months, the teeth were extracted together with their surrounding soft and hard tissues and subsequently fixed in 10% buffered formalin. Following decalcification in EDTA, the specimens were embedded in paraffin and 8-microm histological sections were cut in the mesio-distal direction, parallel to the long axes of the teeth. The sections were stained with hematoxylin and eosin, or with the oxone-aldehyde-fuchsin-Halmi staining method and examined in the light microscope. A regenerated periodontal ligament containing newly-formed oxytalan fibers was observed in all specimens. Many of them inserted into the newly formed cementum on the root surface. It is concluded that oxytalan fibers are formed de novo in human regenerated periodontal ligament tissue.     

Risk of cardiac complications in patients undergoing major vascular surgery

In patients undergoing major vascular surgery cardiac complications are the major cause of perioperative morbidity and mortality. This is related to the frequent presence of underlying coronary artery disease. The aim of the preoperative cardiac risk assessment is to evaluate the presence and degree of coronary artery disease along with other risk factors such as cerebrovascular disease, renal insufficiency, and diabetes mellitus that may influence the perioperative risk of these patients. Based on the presence and number of cardiac risk factors the individual risk profile can be determined, which may facilitate medical decision making about the perioperative and long-term management of these patients. In the present review based on data from current literature we summarized the pathology of perioperative cardiac complications, and the role of cardiac risk assessment and risk reduction strategies in patients undergoing major vascular surgery. In this review the authors summarized data from current literature and found that a limited set of risk factors and a result of a noninvasive test used for detection of coronary artery disease may help to stratify patients into low-, intermediate- and high risk for perioperative cardiac complications. If patients with intermediate- to high-risk prescribed beta-blockers the risk of cardiac complications can be reduced. Along with beta-blockers it was also found that perioperative use of statins may also help to reduce the risk of cardiac complications. In patients identified to be at very high-risk further perioperative evaluation and management should include coronary angiography with subsequent coronary revascularization if there is a clearly defined need, independent of the need for vascular surgery.     

Complication-free labor in operated-on Cushing's syndrome

By the casuistical report on a successfully carried out gravidity of a 21 years old female patient without suprarenal glands which have been removed totally because of a hyperplasia of the suprarenal cortex on both sides, the problems of gravidities and their successful carrying to the term of operated femal patients with Cushing's disease are dealt with. Under experienced substitution therapy and an intensive care a gravidity without complications is to be expected. The apprehension is unfounded that overdosage of corticoid during gravidity could induce malformations of new-born children. The substitution dosis during gravidity is discussed by literature.     

The effect on oxidative metabolism in brain, liver and heart muscle homogenates of peptide derivatives and calf blood dialysates

Three peptide preparations, derived from different proteins, and one protein free extract, produced by dialysis of calf blood, were tested. Typical effects of the individual preparations on oxidative metabolism could be shown. A comparable high stimulation of oxygen consumption of brain homogenates by 117 to 165% was measured after application of the peptide derivatives. One of them, the peptide enriched derivative, caused a high and not organ specific stimulation, increasing the oxygen consumption of brain, liver and heart muscle by 165, 203 and 202%, respectively, thus exceeding the effects of the other tested preparations. Extracts of calf blood, which showed maximal stimulation in liver homogenate (98%), led to rather small effects in brain homogenate (51%) compared with those induced by the peptide derivatives.     

Pneumatic compression with foot pumps facilitates early postoperative mobilisation in total knee arthroplasty

Deep-vein thrombosis (DVT) and pulmonary embolism (PE) represent life-threatening postoperative complications frequently responsible for in-hospital mortality following total knee arthroplasty (TKA). Mechanical prophylaxis in the form of a foot pump offers an alternative to pharmacological and physical therapy. The aim of this prospective and randomised study was to examine the clinical efficacy of the A-V Impulse (AVI) system in reduction of soft-tissue swelling of the lower limb following a TKA. A total of 80 patients undergoing cemented TKA between September 2005 and December 2006 were randomised into two groups of 40 patients (n¹ = 40, n² = 40) during the 16-month study period. All patients received a subcutaneous dose of low molecular weight heparin (LMWH) (Enoxaparin/Clexane® 40 mg) once daily beginning 24 hours prior to the operation. The mean age for the groups n¹ and n² were 68.93 and 68.15 years, respectively. The reduction of soft-tissue swelling in the n¹ group was significantly higher (p < 0.05) compared with n². Evaluation of body mass index (BMI) with regard to the average reduction of soft-tissue swelling showed no significant influence (p < 0.05). The better function of the operated knee in group AVI was a significant predictor for improved agility and mobility (p < 0.01). No complications were reported for the application of the AVI. No ultrasonographic evidence of DVT or PE was found in any of the 80 patients during the investigative time period of eight days. After three months, there was no evidence of a symptomatic DVT.     

The influence of lateral and anterior angulation of the proximal ulna on the treatment of a Monteggia fracture: an anatomical cadaver study

We have investigated the anatomy of the proximal part of the ulna to assess its influence on the use of plates in the management of fractures at this site. We examined 54 specimens from cadavers. The mean varus angulation in the proximal third was 17.5 degrees (11 degrees to 23 degrees ) and the mean anterior deviation 4.5 degrees (1 degrees to 14 degrees ). These variations must be considered when applying plates to the dorsal surface of the ulna for Monteggia-type fractures. A pre-operative radiograph of the contralateral elbow may also be of value.