Spinal Cord Injury Resulting From Injury Missed on CT Scan: The Danger of Relying on CT Alone for Collar Removal

Background  

Strict criteria have been used before removing cervical collars in patients with injuries who have midline pain or are unable to be reliably examined. This sometimes leads to prolonged immobilization in cervical collars or use of MRI to rule out injury. Several studies suggest a collar may be removed in the absence of fractures, dislocation, or pathologic subluxation on a cervical CT scan. This may avoid the morbidity of prolonged cervical immobilization or cost of advanced imaging study but risks devastating consequences from missing injuries.     

Histological ex vivo analysis of retrieved human tantalum augmentations

Purpose

The characteristics of tantalum augment osseointegration in human ex vivo specimens from re-revision procedures are unknown and limited data in this regard is available. The purpose of this study was to investigate the osseointegration pattern into porous tantalum augmentations harvested during re-revision procedures.

Methods

Between 2007 and 2010 a total of 324 hip and knee revisions with a tantalum augmentation were performed in our institution. Out of this cohort, seven patients (2.2 %) had to be re-revised. To analyse the status of trabecular ingrowth in the retrieved cases (four hips, three knees), all specimens were analysed by contact radiography, subjected to undecalcified processing, histology, thin-section analysis and backscattered electron imaging.

Results

Trabecular and vascular ingrowth could be found along the bone-augment-interface in two of seven revised specimens, respectively. The depth of bone ingrowth reached up to 2.6 mm. However, the analysis of the remaining cases revealed no bony ingrowth into trabecular metal. Rather, large parts of the implants were embedded in cement or pores were filled with autologous bone.

Conclusions

Although the cause for the missing bony ingrowth seems to be multifactorial, some fundamental conditions, such as the provision of the greatest possible interface between the tantalum implant and the host bone, should be met and thus, bone cement and autologous bone grafts should be used with caution.     

Die Reaktivität chlorhaltiger Desinfektionsmittel gegenüber verschiedenen stickstoffhaltigen Substraten unter besonderer Berücksichtigung des Azochloramids

Zusammenfassung In mehreren Versuchsreihen wird an Hand von Diagrammen die außerordentlich geringe Reaktivität eines neuen chlorhaltigen Desinfektionsmittels gegenüber verschiedenen stickstoffhaltigen Substanzen im Vergleich mit anderen gleichartig wirkenden Stoffen festgestellt.Die dem Azochloramid eigentümliche oxydierende Wirkung hält auch bei Anwesenheit größerer Mengen stickstoffhaltiger Substanzen lange Zeit an und konnte auch nach 24stündiger Einwirkung der verschiedenen Substrate nachgewiesen werden. Das Azochloramid erwies sich dabei allen übrigen zum Vergleich herangezogenen anorganischen und organischen, chlorabspaltenden Desinfektionsmitteln beträchtlich überlegen.Diese Eigenschaften lassen das Azochloramid als Wunddesinfektionsmittel ganz besonders geeignet erscheinen.Mit 11 Textabbildungen.     

Böhmiella perichitinea n. sp., ein neuer Trichostrongylide (Nematodes) des Nutria

Ohne Zusammenfassung     

Ein neuer Wiederkäuer-Peitschenwurm — Trichuris gazellae n. sp. — aus der Damagazelle

Ohne Zusammenfassung     

Pädiatrische Rhythmusstörungen

Diagnosis and therapy of cardiac dysrhythmia has become an important subspecialization in pediatric cardiology. The limited possibilities of antiarrhythmic drug therapy and antibradycardia pacing have been expanded by completely new and fascinating developments over the last 30 years. Curative treatment for the majority of tachyarrhythmias has been achieved by catheter ablation. Secondary as well as primary prevention of sudden arrhythmic death has become possible thanks to implantable defibrillators. Multiple hereditary life-threatening arrhythmia syndromes have been discovered and give a fascinating insight into the molecular genetic background of arrhythmogenesis. Cardiac resynchronization therapy has evolved into one of the few causal treatment strategies for heart failure and points toward intriguing remodeling processes at the cellular level. The following article provides practical as well as background knowledge of some of these developments.     

Entzündliche Arrosionsblutungen aus Viszeralarterien

Spontaneous or postoperative hemorrhage into the abdominal cavity due to inflammatory vessel arrosion represents an uncommon but menacing situation. According to the literature, such hemorrhage is associated with a lethality of nearly 2%. Therapeutical options include reoperation and interventional radiological techniques such as endovascular catheter techniques with stent graft implantation or the embolization of vessels. We report on the management of seven cases with hemorrhage either from the gastroduodenal artery ( n=5) following pancreatic surgery for pancreatic carcinoma, liposarcoma, and chronic pancreatitis or from the common hepatic artery ( n=1) and the superior mesenteric artery ( n=1) following chronic pancreatitis. The present article describes our experiences with stent graft implantation (hemobahn prosthesis) in four cases. Based on these experiences, we see the advantages of stent grafts in primary hemostasis without any contact to infected tissue and the preservation of regular perfusion. However, further clinical data are required focussing on indication, technical success rates, stent-related complications, and long-term outcome.