Long-term results after operation for funnel chest

Summary The cases of 36 out of 62 patients who underwent surgical correction of funnel chest deformity between 1978 and 1988 with an average follow-up of 7.6 years were reviewed. The mean age at which the Hegemann operation was performed was 14.1 years. Preoperative cardiorespiratory disorders were reported by 76% of patients, while 71% showed electrocardiographic and pulmonary alterations. Postoperatively, cardiorespiratory disorders were significantly reduced, but the electrocardiographic changes were not. The pre- and post-operative radiological and functional measurements of the chest deformity which allow an objective evaluation of the surgical result are described. Surgical treatment is indicated in most cases of funnel chest deformity, for cosmetic or psychological reasons. The long-term results were good or fair in 90% or more of our cases. We suggested that disfiguring scars with keloid formation cause less psychological distress than persistent congenital malformation of the chest.     

Digital subtraction angiography system evaluation with phantoms

Advances in digital subtraction angiography imaging demonstrate the need for critical evaluation of the performance of digital subtraction equipment. The design of a phantom set for noninvasive assessment of the imaging quality of digital subtraction equipment is described; components include a remotely controlled transport system and individual patterns to evaluate the contrast and detail properties of the image intensifier, low-contrast sensitivity and resolution of the system, geometric distortion of image, linearity, mechanical and electronic stability of equipment, and effects of bone and bowel gas on iodine perception. The performance of an add-on digital radiographic system is presented, along with radiation exposure levels at the image intensifier for a range of radiographic techniques.     

A founder mutation in the gamma-sarcoglycan gene of gypsies possibly predating their migration out of India

We investigated the molecular basis of a severe form of early onset autosomal recessive muscular dystrophy with sarcoglycan (SG) deficiency in seven large Gypsy families living in different parts of Western Europe and apparently not closely related. They were linked to the LGMD2C locus (13q12) suggesting a primary defect in the gamma-SG gene coding for the 35 kDa dystrophin-associated glycoprotein. All of the 18 investigated patients were homozygous for the same G-->A transition in codon 283 producing the replacement of a conserved cysteine of the extra-cellular domain of the protein by a tyrosine. All affected chromosomes in homozygous and heterozygous relatives carried the same allele 5 of the intragenic marker D13S232. Flanking markers were studied to delineate a common ancestral haplotype, the size of which was used to compute the date of the founding mutation. We found evidence that the mutation occurred between 60 and 200 generations ago, therefore possibly predating the commonly accepted date of migration of the Gypsy ancestors out of India.      

HPLC测定睾酮乳膏中睾酮的含量

采用ＨＰＬＣ测定睾酮乳膏中睾酮的含量，以甲醇－水（７０：３０）为流动相，波长２４０ｎｍ，在４０－３６０μｇ／ｍｌ范围内线性关系良好ｒ＝０．９９９９，本法操作简便，回收率高。     

Meniscectomy--total, partial, open or closed operation?

The importance of the menisci for stability of the knee joint is pointed out. Because of its mechanical importance in the knee a more conservative behaviour for treatment is recommended. Even the degenerated meniscus can play his role sufficiently. For each type of lesion individual surgery is applied, especially if there is locking impingement linked with mechanically induced arthritis. Out of the clinical results follows that arthroscopic partial meniscectomy is superior to conventional open meniscectomy, especially in the early postoperative period.     

Significance of the splitting of the lateral patellar retinaculum and the mediopatellar synovial fold in the surgical therapy of patellar chondromalacia

Using strain gauges we investigated proximal-distal and lateral-medial strain of the dorsum patellae before and after cutting of the lateral retinaculum and the plica mediopatellaris under flexion. Lateral-medial strain was abolished by the lateral release for the larger part and by cutting of the plica for a smaller part. Proximal-distal strain was not changed in any case. Therefore we conclude that the operation will only lead to a medial positioning, but not to a loosening of the extension apparat of the knee.     

Significance of imaging techniques (roentgen, scintigraphy, MRI) in the diagnosis and therapy planning of Perthes disease]

The value of MRT, bone scintigraphy and conventional radiographs were studied for early stage diagnosis of Perthes' disease. Our experience in a series of 28 patients showed MRI to have a 100% sensitivity and specificity compared with bone scintigraphy (68.1% and 66.7%) and normal radiographs (58.3% and 100%). MRT often demonstrates changes while the conventional radiographs or bone scans appear normal. This might reflect the ability of MRT to detect the histopathologic changes before a measurable bone mineral change occurs.     

Morphologische Untersuchung über die Polymerisation von Knochenzement

Zusammenfassung Die Beeinflußbarkeit der Polymerisation des Methylmethacrylates durch Kühlung, unterschiedliches Mischungsverhältnis Monomeres zu Polymerem und Luftsauerstoffeinwirkung wurde mit dem Rasterelektronenmikroskop untersucht. Es konnte gezeigt werden, daß Abweichungen vom vorgeschriebenen Mischungsverhältnis ebenso eine Störung der Polymerisation bedingen wie Kühlung während der Polymerisation und die Einwirkung von Luftsauerstoff.Die damit verbundene klinisch bedeutsame Gefahr eines erhöhten Restmonomerengehaltes im Polymerisatblock wird im Hinblick auf die Toxicität der monomeren Form des Methylmethacrylates betont. Auf die verstärkte Schrumpfung des Knochenzementes bei vermehrter Zugabe von Monomeren wird hingewiesen. Die sich aus den Untersuchungen ergebenden Möglichkeiten, den Gehalt an Restmonomeren gering zu halten, werden aufgezeigt.

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Summary The influence of cooling, different proportions of monomers to polymers, and the admittance of air-oxygen upon the polymerization of methyl-methacrylate were studied with the scanning electron microscope. It was shown, that all three factors interfere with the process of polymerization.This results in an increased amount of free monomers within the polymerized block an the inherent clinical danger is stressed in view of the toxicity of the monomeric form of methyl-methacrylate. It is pointed out, that an increased amount of monomers results in an increased shrinkage of the bone cement. The possibilities to reduce the amount of free monomers, deduced from this observations, are shown.

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Résumé Nous avons étudié l'effet de réfrigération, de mélanges différents monomèrespolymériques et de l'oxygénisation sur la polymérisation de methylmethacrylate (PMMA). On a mis en évidence la disturbation de la polymérisation à cause de changement dans les rélations de la mélange, de la réfrigération et par l'oxygénisation. On a discuté le danger de l'augmentation de la partie monomérique dans un bloc de la PMMA causant en plus un retrécissement du ciment.

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Für die freundliche Beratung auf dem Gebiet der Monomeren-Chemie danken wir den Herren Dr. Quis und Götz der Firma Röhm & Haas, Darmstadt.