Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial

European Journal of Orthopaedic Surgery & Traumatology - The goals of this study were to compare patient satisfaction and wound-related complications in patients receiving 2-octyl cyanoacrylate...     

The ventral rib cage muscles in the dog: contractile properties and operating lengths

To have some insight into the mechanical interplay between the parasternal intercostal and triangularis sterni muscles during breathing, we have examined the isometric contractile properties of these two muscles in the dog. Using piezoelectric crystals, we have also measured the respiratory changes in muscle length in eight spontaneously breathing animals in the supine posture, and we have compared the in situ relaxation length (Lr) of these two muscles to their respective in vitro optimal force-producing length (Lo). The triangularis sterni and parasternal intercostals had similar isometric twitch, force-frequency, and length-tension characteristics. These two muscles, therefore, are intrinsically similar. In supine dogs, however, they operate on quite distinct segments of their length-tension curve. Whereas Lr for the parasternals corresponded to 117% Lo, Lr for the triangularis sterni was only 75% Lo. This suggests that the triangularis sterni in supine dogs operates on a poorly advantageous portion of its length-tension curve. However, shortening of the parasternals during inspiration causes considerable passive distension of the muscle. As a result, the triangularis sterni is much closer to its optimal length when it starts contracting in early expiration.     

Siebenj?hrige erfahrungen mit der ?dintraoperativen maschinellen autotransfusion? und ?pr?operativen plasmapherese? bei chirurgischorthop?dischen eingriffen

Zusammenfassung Bericht über ?dintraoperative maschinelle autotransfusion?, kombiniert mit ?pr?operativer plasmapherese?. Mit maschineller autotransfusion kann intraoperativer blutverlust durch rückführung eigener erythrozyten halbiert werden. In kombination mit pr?operativer plasmapherese werden weitere fremdblutkonserven eingespart. übertragung von infektionskrankheiten und erzeugung irregul?rer antikōrper kōnnen verhindert werden. Bei der derzeitigen AIDS-situation wird das infektionsrisiko auf null reduziert.      

Tumor necrosis factor production in septic conditions following pancreatitis (preliminary report)]

Detectable TNF levels in sera 33% of patients with sepsis following pancreatitis have been found. No correlation was observed between serum TNF concentration and the severity of illness. However, monocytes and granulocytes of septic patients exerted higher TNF-mediated cytotoxicity than leukocytes of normal blood donors. The in vitro TNF-producing capacity was also higher in the patients in the study group, and it decreased only before fatal outcoming of sepsis. Our results suggest that determination of the TNF-producing capacity of leukocytes might be more informative than measurement of the serum TNF level in the evaluation of the severity or prognosis of sepsis.     

Sympathetic reinnervation after heart transplantation, assessed by iodine-123 metaiodobenzylguanidine imaging, and heart rate variability.

OBJECTIVE: Complete allograft denervation occurs during heart transplantation. Partial ventricular sympathetic reinnervation may develop one year or later after transplantation and can be measured with iodine-123-meta-iodobenziylguanidine (MIBG) uptake. Aim of this study was to assess sinus node sympathetic reinnervation measured with heart rate variability and ventricular sympathetic reinnervation evaluated with MIBG. METHODS: Twelve patients and 14 healthy controls were included. In patients, MIBG scintigraphy with early and late imaging was performed. Heart to mediastinum ratio (HMR) was calculated and patients were divided in groups with (HMR>1.3) and without left ventricular reinnervation (HMR<1.3). Bipolar ECG with high sampling rate and resolution was recorded over 8.5 min in supine position and in upright position after 10 min interval. R-R intervals in time domain and heart rate variability in frequency domain through spectral power analysis of R-R intervals were analysed to evaluate sinus node reinnervation. Spectral power in low frequency range (0.04-0.15 Hz) above 4.5 ms(2) was considered as sinus node sympathetic reinnervation. RESULTS: Six (50%) patients had evidence of left ventricular sympathetic reinnervation on scintigraphy. Sinus node sympathetic reinnervation based on heart rate variability was detected in 6 (50%) patients in supine, and in 4 (33%) patients in upright body position. Four patients groups were discerned: (1) with ventricular and sinus node sympathetic reinnervation, (2) with sinus node sympathetic reinnervation, (3) with ventricular sympathetic reinnervation and (4) without atrial or ventricular sympathetic reinnervation. Ventricular reinnervation process was time dependent and sinus node reinnervation was not. CONCLUSIONS: Simultaneous ventricular sympathetic reinnervation assessed by MIBG and sinus node sympathetic reinnervation assessed by heart rate variability in supine as in upright position were detected only in two patients (17%). The results of our study show that eventual sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation do not occur simultaneously.     

Clinicopharmacological examination of Anteovin

The effectiveness, side effects and serum FSH, LH, prolactin, estradiol and progesterone levels were monitored in 79 women taking Anteovin for a total of 506 cycles (mean 6.4 cycles). Anteovin is a biphasic oral contraceptive with 11 tablets containing 0.05 mg levonorgestrel and 0.05 mg ethinyl estradiol, and 10 tablets containing 0.125 mg levonorgestrel and 0.05 mg ethinyl estradiol. There were no pregnancies. 11 women dropped out because of hepatomegaly (1), bleeding disorder (3), gastric pain and nausea (1), breast pain (1), nausea and vomiting (1), and personal reasons (4). 10.3% of those continuing reported minor side effects. Menses occurred every 28 days for 3-5 days, with 2 cases of breakthrough bleeding but no oversuppression. Progesterone ranged from 1.5-2.0 nmol/1, estradiol varied between 68-93 pmol/1, LH stayed constant at 6.3-11 U/1, FSH remained at 5.8-6.8 U-1 without a peak, and prolactin levels were lower than those seen in control cycles. These hormone levels all resemble those observed in anovulatory cycles. This pill is especially suitable for teens and nulliparas.     

Neuroplastic effects of neonatal capsaicin on barrel cortex of adult rat. An electrophysiological and autoradiographic study

Capsaicin (50 mg/kg s.c./25 μl) was administered to rats on the 2nd and 5th days after birth. The animals were raised, and from the age of 3 months the properties of the evoked activity were tested in the contralateral barrelfield. This neonatal capsaicin treatment was found to induce profound changes in the responsiveness of the barrel cortex in the adult rats: (1) the receptive field of the neurons in the Cl barrel was expanded; units within a particular barrel were driven by a significantly larger number of vibrissae than in the controls. (2) The rate of discharge evoked by the related vibrissa deflection was enhanced, while (3) the angular sensitivity of the neurons was decreased. (4) The most prominent change in cortical activity was observed by autoradiography: capsaicin-treated rats exhibited an enhanced labelling of different types of neurons throughout the hemisphere (surpassing the cortical representation of stimulated vibrissae). The present observations indicate that neonatal capsaicin affects the functional activity of the rat somatosensory cortex. It is suggested that unmyelinated sensory afferents play a role in the development of the rat somatosensory system.     

An HLA-DRB α-helix motif shared by DR11 and DR8 alleles is implicated in the pluriallelic restriction of peptide-specific T-cell lines

The T-cell recognition of HLA-DR-peptide complexes is generally restricted by the polymorphism of the DRB molecules but pluriallelic restriction has been described. The molecular basis of restriction and promiscuity of such peptide-specific responses is poorly understood. We isolated a panel of T-cell lines specific for the tetanus toxin peptide p2 (TT830-843) exhibiting pluriallelic restriction by DR11 and DR8 alleles. Fine restriction specificity of the T-cell lines was examined in functional assays against DR oligotyped APCs expressing different variants of DR11 and DR8 alleles. Our results show that (a) polymorphisms between serologically related alleles are relevant in terms of restriction of the peptide-specific T-cell response; in some instances, a single amino acid substitution can determine the restriction of a T-cell line; (b) different patterns of restriction are not the result of specific differences in DR-p2 binding as p2 peptide binds to all DR11 and DR8 alleles tested (DRB1^* 1101, -1102, -1103, -1104, 110X, -0801, -0802, -0803, and -0806); and (c) pluriallelic restriction of the peptide-specific T-cell responses correlates with the presence of a DRB1 α-helix motif (67-71-86) shared by some DR11 and DR8 alleles. Possible implications of pluriallelic restriction of peptide-specific T-cell response in autoimmune disorders associated with DR11 and DR8 are discussed.