Beeinflussung humaner Osteoblasten durch verschiedene Analgetika

In der Behandlung von Frakturen spielt die Analgesie eine wesentliche Rolle. Es stellt sich daher die Frage, ob in der Klinik h?ufig eingesetzte Analgetika wie Tramadol oder Diclofenac negative Wirkungen auf die Knochenbruchheilung haben.     

Adverse reactions following pulsed tunable dye laser treatmentof port wine stains in 701 patients

The pulsed tunable dye laser (PTDL) is generally considered to have a very low incidence of adverse effects, allowing it to become the treatment of choice for the majority of port wine stains (PWS). The low incidence of adverse effects has led to difficulties in determining the true incidence and type of adverse effect seen with this laser. We therefore undertook a retrospective study of 701 patients with PWS, who received 3877 full treatments to determine the incidence and type of adverse effects seen following treatment with the PTDL. Blistering and crusting were seen in 5·9% and 0·7% of patients, respectively, but were transient events which usually healed without permanent sequelae. Hyperpigmentation was the most frequently observed adverse effect seen in 9·1% of patients but generally showed gradual resolution over 6–12 months. Hypopigmentation was infrequent, seen in 1.4% of patients. The most significant adverse effects were atrophic and hypertrophic scarring seen in 4·3% and 0·7% of patients, respectively. Our observations show that there is a small but definite risk of atrophic scarring with a predisposition for younger patients. Hypertrophic scarring can occur albeit rarely and there may be a predisposition towards the neck. In most cases test areas were not predictive of scarring. This underlines the need for a full discussion of scarring risk in patients with PWS undergoing treatment with the PTDL.     

MRI in hemiballismus due to subthalamic nucleus hemorrhage: An unusual complication of liver transplantation

A 60-year-old man developed hemiballismus due to an intracranial hemorrhage involving the subthalamic nucleus 8 weeks after orthotopic liver transplantation. The hemorrhage was thought to be due to alterations in cerebral blood flow following a period of hypotensive shock due to sepsis, in the presence of anticoagulant therapy and thrombocytopenia. This represents a rare neurologic complication of liver transplantation.     

Anomalies of the position of the spleen in the child Case report and review of the literature from 1896 to 1990

We report on the case of a 6-year-old girl admitted as an emergency with an acute abdomen with the diagnosis of peritonitis; clinical examination under anesthesia revealed the presence of an abdomino-pelvic mass. Laparotomy confirmed the diagnosis of torsion of an ectopic spleen. Splenectomy was required because the spleen was gangrenous. A review of the literature from 1896 to 1990 revealed reports of 74 cases. Epidemiology, etiology, pathophysiology, the diagnostic and therapeutic problems are discussed.

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Ektopische Milz beim Kind: Fallbericht und Literaturübersicht 1896–1990

Zusammenfassung Anhand eines Fallberichtes und einer Literaturübersicht über 74 Fälle werden Epidemiologie, Ätiologie, Pathophysiologie, Diagnostik und Therapie der im Kindesalter sehr seltenen ektopen Milz besprochen. Die klinischen Zeichen reichen von unspezifischen abdominellen Beschwerden bis hin zum Vollbild eines akuten Abdomen (50%). Die praeoperative Diagnostik richtet sich nach Klinik, Abdomenleeraufnahme und Sonographie, evtl. Computertomographie. Aufgrund der hohen Torsionsraten besteht generell eine Operationsindikation, wobei die Entscheidung über Splenopexie oder Splenektomie sich an dem Lokalbefund orientieren sollte. Zur Splenopexie wurden mehrere Techniken mit gleich guten Resultaten angegeben.