Bone Replacement Materials in Hand Surgery

Abstract Background: In recent years, biomaterials are being found and frequently utilized in bone defects. They have also gained significant precedence in hand surgery. Objectives: The respective requirements for such replacement material will be cited and acknowledged in this article. The individual material groups will also be referred to in this review. An introduction to some of the customary bone replacement materials will be cited and concluded with a corresponding recommendation. Conclusion: The implantation of autologous cancellous bone is still regarded today as the “gold standard”. Nevertheless, the usage of bone replacement material can be an enormous advantage in certain indications. The original article can be found online at There was an error in the author’s affiliation and the address for correspondence was incomplete. Please note the correct institution and complete address: Department of Orthopedics and Traumatology, Hand-, Foot- and Reconstructive Surgery, Kreiskrankenhaus Gummersbach GmbH, Germany. Alexander von Friesen, MD Department of Orthopedics and Traumatology, Hand-, Foot- and Reconstructive Surgery Kreiskrankenhaus Gummersbach GmbH Wilhelm-Breckow-Allee 20 51643 Gummersbach Germany Phone (+49/2261) 171-575, Fax -449 e-mail: Friesen@kkh-gummersbach.de     

A Neuromagnetic Study of the Functional Organization of the Sensorimotor Cortex

Movement-related neuromagnetic fields from eight healthy human subjects were investigated in a Bereitschaftspotential paradigm. The three conditions studied were right-sided mouth, index finger and foot movement. The neuromagnetic field patterns corresponding to the motor field and the movement-evoked field I were analysed using a moving dipole model. For both components a somatotopic organization was found: the estimated dipole locations for the mouth were more lateral and those for the foot more medial than the estimated dipole positions for the index finger movement. With regard to possible clinical applications, e.g. non-invasive mapping of the sensorimotor cortex and studies of plasticity of the motor function, the present results suggest that the investigation of movement-evoked field I for the index finger condition is most likely to yield further results.     

Prevalence of autoimmune diseases in islet transplant candidates with severe hypoglycaemia and glycaemic lability: previously undiagnosed coeliac and autoimmune thyroid disease is identified by screening.

AIMS: Autoimmune diseases such as Addison's or coeliac disease can contribute to hypoglycaemia or malabsorption and are more common in Type 1 diabetes (T1DM). This brief report describes the prevalence of known and newly detected autoimmune disease in clinical islet transplant candidates with longstanding T1DM and severe hypoglycaemia and/or glycaemic lability who are routinely screened for coexisting autoimmune disease. METHODS: One hundred and twenty-four C-peptide negative T1DM subjects [77 (62%) female, mean age 44 +/- 9 years, diabetes duration 28 +/- 11 years, body mass index 24.9 +/- 3.5 kg/m(2)] with indications for clinical islet transplantation at the University of Alberta were screened for autoimmune disease by history and measurement of anti-transglutaminase antibodies (positive > 10 U/ml), 09.00 h cortisol (followed by adrenocorticotrophic hormone-stimulation if < 495 nmol/l) and thyroid-stimulating hormone to determine the prevalence of coeliac disease, Addison's disease and autoimmune thyroid disease, respectively. RESULTS: Forty per cent of subjects had one or more coexisting autoimmune disease. The prevalence of autoimmune disease was 35%, coeliac disease 8% and Addison's disease 1.6%. In 11 individuals (9%), one or more autoimmune disease were newly detected (seven coeliac disease and five thyroid disease). Seven of 10 cases of coeliac disease were newly detected. A gluten-free diet in individuals with newly diagnosed coeliac disease reduced gastrointestinal symptoms, but indications for clinical islet cell transplantation persisted. CONCLUSIONS: Coexisting autoimmune disease is common in candidates for clinical islet cell transplantation. Screening in this group identified a substantial number of previously unrecognized cases. Clinicians should consider the presence of autoimmune disease even in the absence of classical symptoms.     

Calciumantagonisten: Antihypertensiva der ersten Wahl

Ein 57-jähriger Bankangestellter stellt sich wegen seit Monaten bestehender Abgeschlagenheit und Müdigkeit vor. Anamnese: seit 3 Jahren dokumentierte Hypercholesterinämie (Gesamtcholesterin 350 mg/dl) und Hypertriglyzeridämie (Triglyzeride 430 mg/dl), zurzeit mit einem Statin behandelt, ferner seit einem 1/2 Jahr symptomatische Gicht (letzter Anfall vor 4 Wochen), jetzt mit 300 mg Allopurinol behandelt, sowie Claudicatio intermittens (Gehstrecke 300 m) bekannt. Seit der Jugend ist zudem ein allergisches Asthma bekannt, das mit inhalativen Steroiden und einem lang wirkenden β-Mimetikum behandelt wird. Die Frage nach Dyspnoe, Thoraxschmerzen oder einer plötzlich auftretenden Hautblässe wird verneint.Körperliche Untersuchung: Gewicht 89,2 kg, Größe 1,78 m, Blutdruck 210/90 mmHg. Die 24-h-Blutdruckmessung zeigt eine nächtliche Blutdrucksenkung von 15% systolisch und 12% diastolisch. In der Routinelaboruntersuchung keine Auffälligkeiten, insbesondere ausgeglichene Elektrolyte, normale Nierenfunktion. Im Urin-Stix keine Erythrozyt- oder Proteinurie. Verlauf: Der Patient erhält zunächst 5 mg Amlodipin und wird bezüglich nichtmedikamentöser Maßnahmen eingehend beraten. Bei einer Wiedervorstellung nach 3 Wochen hat er 1,5 kg an Gewicht abgenommen und einen Blutdruck von 170/85 mmHg.