Zur konservativen Therapie der Unterarmfraktur im Wachstumsalter mit besonderer Berücksichtigung der Korrelation von röntgenologischem Verlauf,objektivem und subjektivem Gesamtergebnis

143 out of 310 patients in the age of one to 18 years suffering from forearm-shaft-fractures could be followed up at the 2nd Department of Traumatology University of Vienna, out of a period between 1978 and 1983. A correlation between radiologic follow-ups and objective/subjective findings was achived by means of the WAMASTAT/SAS program at the Institute of Medical Computer Sciences. With the aid of computer diagrams of the angulation of fracture-dislocation awaited restrictions of movement can be anticipated. Corrective reductions performed in time can prevent disalignment and improve long-term follow-up results.     

Hüfttumorprothese-Indikation in einem unfallchirurgischen Schwerpunktkrankenhaus und Ergebnisse

This is a report about six cases of replacement of the proximal femur by a cementless special prosthesis in modular system done in the Unfallkrankenhaus Wien-Meidling. One of the patients suffered by a lymphoma, three others had fractures caused by bone metastasis. One was a pertrochanteric fracture complicated by osteoporosis, and finally one fracture of the femur preceded by an insufficient implantation of a semitotal hip replacement. The hipsocket was supplied four times by a cementfree Polyäthylensocket, in one case a CLW-ring was implanted. Investigation showed that after a little more than two months the stump of femur became porous and by an average of eleven months the prosthesis was covered by bone. The complications were in one case an incomplete fracture of the diaphysis and in another case a luxation for three times. There are several indications for a tumor prosthesis: 1. Primary and secondary malignant tumors. 2. Bone metastasis with or without fractures. 3. Comminuted fractures complicated by various factors, e. g. osteoporosis. 4. Loosening of prosthesis with poor bone conditions or failed implantation of a standard prosthesis. Although the successes seem to be quite promisingly, this method should be applied in a quite differentiated way, as any retreat is nearly impossible, once started.     

Überlegungen zum Kongreß “Medikamentöse Schmerztherapie” in Berlin

Ohne Zusammenfassung     

Cytokines and immuno-endocrine factors in recurrent miscarriage

Recurrent miscarriage remains an enigma. The main aetiologiesare endocrinological, immunological and unexplained. With thegrowth in molecular biology, it is now possible to look at theeffect of these aetiologies in more detail, allowing greaterunderstanding of the underlying pathogenesis. Keywords: cytokines/recurrent miscarriage     

Effect of wound infiltration with bupivacaine on pulmonary function after elective lower abdominal operations

Background

Subcutaneous or intrafascial wound infiltration of local anaesthetic with systemic opioids has been shown to enhance patient comfort with improved analgesia and reduced opioid requirements.

Objective

To demonstrate improved pulmonary function when postoperative analgesia was provided by combined bupivacaine wound infiltration and systemic opioid.

Methods

In a prospective, randomized, placebo-controlled study, 46 patients (23 per group) scheduled for elective gynaecological surgery under general anaesthesia had subcutaneous and intrafascial wound infiltration of 40 ml, 0.25% bupivacaine (study patients) or 40 ml 0.9% saline (control) just before the end of surgery. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) were done before surgery and at 6, 12 and 24 hours postoperatively. Student''s T and chi-square tests were used for tests of significance set at P < 0.05.Postoperative analgesia was provided with intramuscular morphine 0.15mg/kg 4hourly and 10mg/kg of intravenous paracetamol as rescue analgesia.

Results

PEFR, FVC and FEV1 were reduced in both the control and study groups but the reduction was greater in the control group.

Conclusion

Bupivacaine wound infiltration produced statistically significant elevations in pulmonary function tests results at all assessment periods.     

Lactogenic Activity of Rats Stimulated by Gunnera Perpensa L. (Gunneraceae) from South Africa

Gunnera perpensa L. (Gunneraceae) is a medicinal plant used by Zulu traditional healers to stimulate milk production. The effect of an aqueous extract of the rhizome of the plant on milk production in rats was investigated. Female lactating rats that received oral doses of the extract of G.perpensa significantly (p<0.05) produced more milk than controls. The plant extract did not however, significantly influence the levels of prolactin, growth hormone, progesterone, cortisol, ALT, AST and albumin in the blood. The mammary glands of rats treated with the extract showed lobuloalveolar development. The extract (0.8 µg/ml) was also found to stimulate the contraction of the uterus and inhibit (23%) acetylcholinesterase activity. The cytotoxicity of the extract (LC₅₀) to two human cell lines (HEK293 and HepG2) was 279.43 µg/ml and 222.33µg/ml, respectively. It is inferred that the plant extract exerts its activity on milk production and secretion by stimulating lobuloalveolar cell development and the contraction of myoepithelial cells in the alveoli. It is concluded that Gunnera perpensa contains constituents with lactogenic activity that apparently contribute to its effectiveness in folk medicine.