5—羟色胺M受体和胆碱能受体阻断剂在红霉素所致小肠动力紊乱和呕吐中的作用

本实验对８条犬进行小肠肌电测定，并在记录期间分别静注胆碱能神经阻断剂，阿托品和六甲季胺，以及５－羟色胺（５－ＨＴ）Ｍ受体阻断剂，灭吐灵，以观察其对红霉素所致肠道副作用的影响。结果发现阿托品和六甲季胺不仅能明显地抑制空腹时正常传播性肌电综合波（ＭＭＣ）的发生和传播，降低红霉素促进小肠动力的作用，还能减轻红霉素所致饱腹动物的快波数增加，但对呕吐无明显影响。灭吐灵的实验结果显示红霉素的致吐作用是由５－ＨＴＭ受体介导的，与其促进小肠动力的作用无明显因果关系。     

Significance of microbial colonisation in materials for orthopaedic technology. New insights

A great problem in the treatment of diabetes are infections of diabetic feet. A likely reservoir of microorganisms are contaminated orthopaedic materials. Insoles from 70 patients were examined for potential microbial colonisation. Commonly employed materials were contaminated in vitro under standardised conditions using known microorganisms. After treating with an alcoholic skin disinfectant, the organisms were counted semiquantitatively. In addition to pathogens, the surfaces showed mainly microorganisms present in the normal skin flora. In all materials tested, disinfection reduced the number of organisms by 4-5 log orders. It could be shown that simple disinfection (wiping) reduces the microorganisms present on orthopaedic materials to an acceptable number. Further studies are needed to determine whether this also reduces the incidence of diabetic skin and soft tissue infection.     

The influence of proprioceptive insoles (Bourdiol) on the sagittal curvature and inclination of the trunk

Proprioceptive insoles rely on the concept of Réné-Jaques Bourdiol, a French neurologist. The aim is to modulate plantar surface sensibility and to influence posture and statics of patients: it is hypothesized that the effect of modified afferent sensory input through proprioceptive stimulation of terminal muscle chains will have either a relaxing or stimulating effect on the whole body, which may be realized by affecting the posture. Small pads with a thickness of typically 1-3 mm are embedded into the insole to provide a specific stimulation. In fitting the insoles selectively to the individual patient the effect of the insoles on the trunk posture is taken as a feedback. This study investigates the influence of proprioceptive insoles on the sagittal curve in 20 selected patients. The protocol used a repeated measures research design. The measures of the sagittal curve were obtained using raster stereography. The four different conditions were: (1) barefoot, (2) convenient shoes without the insoles, (3) the same shoes with a placebo insole, and (4) the same shoes with neurological insoles. Evaluation of raster stereographs provided the kyphotic angle between T4 and T12 and lordotic angle between T12 and S1. Statistical evaluation was performed with the t-test for paired measurements. No significant differences were found in the sagittal profile. Only trunk inclination in normal posture was found to yield a significant difference (0.38 degrees) between placebo and neurological insoles. However, no clear statement on the efficiency of neurological insoles can be made.     

Anxiety and depression after loss of a lower limb

A good number of psychosocial-, disease-, and disability-related variables influence the adaptation process after the loss of a lower limb. In this case psychological problems, as a result of a failed adaptation process, are common. Of the 75 patients examined who had an amputation of a lower extremity 27% showed increased depression and 25% increased anxiety scores; 18.3% showed higher than normal scores in both categories. Regression analysis showed that in addition to pain reception poor acceptance of the prosthesis is an important predictive factor for the development of psychological disorders and diseases like anxiety and depression. Therefore, measures for psychological diagnostics and care should be initiated soon after the amputation to prevent psychological abnormalities. Here interdisciplinary management and cooperation of the professions involved in the care of the patient are recommended.