Endocrine and metabolic response in the human newborn to first feed of breast milk

The hormonal and metabolic response to the first feed of breast milk was studied in 12 infants at 4-6 hours of age. After the feed there was an increase in blood glucose concentration but no changes in the concentrations of lactate, pyruvate, alanine, or ketone bodies. The feed was followed by an increase in the concentrations of plasma insulin, growth hormone, gastrin, and enteroglucagon, but no change in levels of plasma glucagon or gastric inhibitory peptide. Several hormone systems are functionally active at birth and are stimulated by the first feed of milk.     

Experiences with centralized care for pregnant diabetic women--results of the 1976 treatment period

73 diabetic pregnant were controled and treated in our clinic 1976, there was a perinatale mortality of 2,7%. The great part of EPH--gestosis and infections of the urinary system and more operative deliveries show of a higher risk already in the stage of latent diabetes. By screening methodes for diabetics during pregnancy and by intensive control in the first trimester it will be possible to obtain better results in the future.     

Diamine oxidase in the diagnosis of ruptured fetal membranes

Diamine oxidase activity is present in amniotic fluid but absent from vaginal secretions, providing a method for diagnosing rupture of membranes. Vaginal secretions were absorbed onto sterile paper strips, eluted, and assayed for diamine oxidase activity. Interfering substances included maternal serum, iodine antiseptics, and large amounts of meconium. Two of 109 prenatal clinic (negative control) specimens displayed measurable diamine oxidase activity; one of 144 postamniotomy (positive control) specimens had no diamine oxidase activity. Of 75 test specimens obtained by speculum examination and 488 test specimens obtained without the aid of a speculum, 18 and 62, respectively, displayed a diamine oxidase test result different from results of conventional tests (nitrazine paper, ferning, fetal cell stains). These discrepancies are discussed in view of the utility of the diamine oxidase test as an adjunct to conventional methods for diagnosing rupture of membranes. The diamine oxidase test appears to be objective, sensitive, quantitative, and capable of detecting amniotic fluid leaks more than 25 hours after rupture of membranes. It can be performed in 1 hour and requires a scintillation counter.     

Tissues at the surface of the new composite material titanium/glass-ceramic for replacement of bone and teeth

A new composite implant material titanium/glass-ceramic was tested in rabbits using light microscopy, histomorphometry, and biomechanical testing methods. Two rabbit implant models were used. The first premolar tooth was replaced and cylinders inserted into the trabecular bone of the distal femur below the patella sliding plane. There was bone bonding to the glass-ceramic component and additional mechanical interlocking, due to bone ingrowth between the titanium matrix into secondary pores. This was proved by measuring the tensile strength at the interface of the new composite material which was in the same range as compared to pure glass-ceramic implants. In tooth replacement there was a tight attachment of gingival epithelium and stroma to composite titanium/glass-ceramic. These results are of particular clinical interest: physicochemical bone bonding and additional mechanical interlocking result in a resistance of the implant material against shear and tensile loads at the interface. Therefore this new composite material should be suitable for further load-bearing applications.     

Autologe Chondrozytentransplantation am oberen Sprunggelenk

Ankle sprains are one the most common injuries of the lower limb. Fractures, ligamentous lesions, and cartilaginous damage are often associated. Nevertheless the injury is often misjudged and concomitant chondral lesions are assessed late. In the case of a symptomatic osteocartilaginous lesion of the talus, which can be illustrated by MRI or X-ray, operative intervention is indicated. Methods such as microfracturing, mosaicplasty, and autologous chondrocyte transplantation (ACT) are in clinical use. The latter is well known and being established as the treatment of choice for large cartilage defects in the knee. Due to the good results in the knee and the technological improvements (three-dimensional tissue constructs seeded with autologous chondrocytes) this method is being increasingly applied for cartilage lesions of the talus. In contrast to the mosaicplasty donor site morbidity is low and the size of the defect is not a limiting factor. The current studies about ACT of the talus show a stable repair of the defect with mostly hyaline-like cartilage and high patient satisfaction. Therefore, the procedure can be recommended for lesions >1 cm². Concomitant treatment of posttraumatic deformities (malalignment), ligamentous instabilities, and especially the reconstruction of bony defects are compulsory.     

Operative therapy in tumor involvement of the spine]

We report on 56 patients, who underwent operative treatment of tumorous lesions of the spine. We indicated dorsal instrumentation in 14 cases, ventral tumorectomy in 11 cases and a combined dorsal and ventral instrumentation in 31 cases. The median survival time was 14.8 months. Reduction of pain and the improvement of the preexisting neurological symptoms were the most important postoperative factors. According to our follow-up study, the combined dorsal and ventral instrumentation seems to be the best method for an operative treatment of tumorous spine lesions.