Traumatic dislocation of the knee

Summary Sixteen patients with traumatic dislocation of the knee were treated during the period 1977–1995. The average period of follow up was 7 years. The mean age was 39.07 years for men and 45.6 years for women. One patient sustained a rupture of the popliteal artery and peroneal nerve at the same time, while two others sustained peroneal nerve neurapraxia. Fourteen out of 16 patients underwent surgical treatment for various combinations of ligamentous injuries, and the following techniques were used: suturing, pullout, reconstruction by using the semitendinosus tendon or the iliotibial band or the patellar tendon, and finally reattachment. Simple peripheral menisceal tears were sutured, while partial meniscectomy was performed only in extensive tears of the posterior horn of the meniscus. Postoperatively all the patients had a long backslab applied for 3 weeks and from the first postoperative day commenced isometric quadricep exercises and mobilised on elbow crutches non weight bearing on the injured side. After the backslab was removed, all started active knee exercises. The postoperative results were satisfactory regarding the knee stability, the pain and the patient's level of activity despite the seriousness of the injury.     

Effect of postoperative wound infection on the course of stage II melanoma.

Microbial infections reportedly have a favorable effect on the course of certain malignant diseases. Intralesional inoculation of micro-organisms can bring about tumor regression in certain clinical and experimental situations. In order to evaluate the influence of immediate postoperative wound infection on the course of Stage II melanomas, a retrospective study was undertaken of 211 patients who had undergone axillary or groin dissection. None had any antibiotic, steroid, chemoimmunotherapy, or cryosurgery and there was no history of a second primary neoplasm, pregnancy, immunodeficiency, or administration of immunosuppressive drugs. Forty of these patients developed significant postoperative wound infections. Although their representation according to sex, tumor location, number of nodes involved, and other parameters was comparable to that of the remaining 171 patients who did not develop wound infections, the incidence of local recurrence in the group with infections was significantly lower (p less than 0.01). Patient survival and disease-free interval following node dissection were not influenced by infection. Postoperative infections in the groin or axilla offered only local protection from tumor recurrence; the ultimate course of the disease was not affected.     

A simple method of pancreatic transplantation in the dog

Canine pancreatic organ transplantation can be performed without resection of adjacent structures or transection of major blood vessels. The graft consists of the entire gland except the distal tail and is based on the superior pancreaticoduodenal vessels. Devascularization of the duodenal loop does not result in ischemic necrosis. The duct-ligated graft is placed in the groin.     

DGAI-certified seminar series: anaesthesia focussed echocardiography: module 4 cardiosonography

The use of ultrasonography in perioperative medicine has developed rapidly within the last decade. Today ultrasonic techniques are established methods for peripheral and central venous access as well as for regional anaesthesia. However, transthoracic ultrasonography by non-cardiologists has not yet been routinely established perioperatively, in intensive care medicine or in emergency medicine. With the current module 4: Cardiosonography of the DGAI-certified seminar series in Anaesthesia Focussed Sonography (AFS) it is intended to provide a basis for a quality assured training and implementation of transthoracic sonography in anaesthesia, intensive care medicine and emergency medicine.     

Permeability dependence study of the focused ultrasound‐induced blood–brain barrier opening at distinct pressures and microbubble diameters using DCE‐MRI

Blood–brain barrier opening using focused ultrasound and microbubbles has been experimentally established as a noninvasive and localized brain drug delivery technique. In this study, the permeability of the opening is assessed in the murine hippocampus after the application of focused ultrasound at three different acoustic pressures and microbubble sizes. Using dynamic contrast‐enhanced MRI, the transfer rates were estimated, yielding permeability maps and quantitative K_trans values for a predefined region of interest. The volume of blood–brain barrier opening according to the K_trans maps was proportional to both the pressure and the microbubble diameter. A K_trans plateau of ～0.05 min^?1 was reached at higher pressures (0.45 and 0.60 MPa) for the larger sized bubbles (4–5 and 6–8 μm), which was on the same order as the K_trans of the epicranial muscle (no barrier). Smaller bubbles (1–2 μm) yielded significantly lower permeability values. A small percentage (7.5%) of mice showed signs of damage under histological examination, but no correlation with permeability was established. The assessment of the blood–brain barrier permeability properties and their dependence on both the pressure and the microbubble diameter suggests that K_trans maps may constitute an in vivo tool for the quantification of the efficacy of the focused ultrasound‐induced blood–brain barrier opening. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

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