Extracorporeal membrane oxygenation for unprotected left main stenting in a patient with totally occluded right coronary artery and severe left ventricular dysfunction

We report a case of unprotected left main stenting in an elderly female with severe left ventricular dysfunction and a totally occluded right coronary artery using hemodynamic support with the Extracorporeal Membrane Oxygenator (ECMO). There were no procedural complications and at 6-month follow-up, the patient was doing well with no cardiovascular events. Stenting of unprotected left main and the use of ECMO in high-risk coronary intervention are reviewed.     

Functional diversity of synaptic AMPA/KA receptors from rat as revealed by subtype‐specific antagonists

Subtype-specific pharmacological compounds represent important tools to identify the molecular components of synaptically activated glutamate receptors in central neurones. Here, we utilized a collection of subtype-specific antagonists and modulators to investigate the functional profile of glutamate receptors in identified synapses in thin slices of the cerebellum, hippocampus and brain stem. During whole-cell patch-clamp recordings α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate/kainate (AMPA/KA) receptor-mediated synaptic currents (EPSCs) in cerebellar Purkinje cells were (i) prolonged by 100 μm cyclothiazide, (ii) not significantly changed after preincubation in 10 μm concanavalin A, (iii) not affected by 1 μm Evans Blue or polyamine toxin analogue N-(4-hydroxyphenylpropanolyl)-spermine (NHPPS), but (iv) significantly reduced by high (≥ 100 μm ) concentrations of Evans Blue. These pharmacological properties were distinct from those observed in hippocampal granule cells and brain stem interneurones and markedly different from those of recombinant glutamate receptor channels GluR1–GluR6 previously investigated in heterologous expression systems.     

Spätergebnisse von 103 operativ behandelten Hüftpfannenbrüchen

This paper describes a long-term follow-up study of 103 operatively treated acetabular fractures. The interval between accident and follow-up examination ranged from 18 months to 12 years, with a mean interval of 4.0 years. The frequency of post-traumatic complications caused by avascular necrosis of the femoral head, coxarthrosis and periarticular calcification is reported. The evaluation of the overall results for each patient was determined using a specially designed evaluation scheme. The long-term results seen in this study demonstrate that operative methods are superior to conservative treatment in severely displaced acetabular fractures. This study emphasizes clearly three demands for the treatment of acetabular fractures: 1. the immediate reduction of the femoral head; this is mandatory in posterior dislocations, 2. a skilled, standardized operative technic and 3. the reduction of the interval between accident and operation to a period of less than two weeks for all transacetabular fractures.     

Die operative Versorgung von Hüftpfannenbrüchen mit standardisiertem Verfahren nach anatomischen und biomechanischen Gesichtspunkten

The conservative treatment of displaced acetabular fractures, with splintering of large fragments out of the main weight bearing zone, generally results in incongruence arthrosis. Better results can only be achieved surgically, through an anatomically and functionally stable reconstruction of the hip socket. As with all osteosyntheses, good results on a large scale are only obtainable when indications for operation and surgical technics both have been largely standardized. This article describes our procedure, used by us for years and now standardized for the various types of fractures. Our experience has shown that the dorsal osteosynthesis, using the narrow dynamic compression plate, in nearly all cases meets the anatomic and biomechanical standards which have been established for treating articular fractures.