Use of ultrasound to assess healing of a mandibular distraction wound.

PURPOSE: A standardized, noninvasive technique to assess healing of the mandibular distraction wound is not available. Current methods include clinical examination, plain radiography, and computed tomography. These imaging techniques are expensive and obligate the patient to serial radiation exposure. In addition, anatomic overlap and metal artifacts may obscure the distraction gap. In contrast, ultrasound has been shown to be a noninvasive, efficient, and inexpensive way to evaluate bone healing. The purpose of this study was to test the feasibility of ultrasound to evaluate an experimental mandibular distraction osteogenesis wound. MATERIALS AND METHODS: Distraction devices were placed via a submandibular incision into 24 minipigs. The protocol consisted of 0-day latency and distraction rates of 1, 2, or 4 mm/d for a 12-mm gap. The wounds were assessed in vivo after 0, 8, 16, and 24 days of neutral fixation. Ex vivo radiographs were used to estimate bone fill using a semiquantitative score. A semiquantitative ultrasound score was assigned, and the beam penetration depth was measured in millimeters. RESULTS: In all groups, clinical stability of the distraction wound increased with the duration of fixation. Plain radiographs, taken during neutral fixation, showed that the desired distraction gap was achieved and maintained. The ultrasound score increased with fixation time, whereas beam penetration depth decreased as expected. Ex vivo radiographs showed increasing bone fill score with time and paralleled the ultrasound score. CONCLUSIONS: The results of this feasibility study indicate that ultrasound is potentially useful for the assessment of bone formation in distraction osteogenesis wounds.     

Rohmilch als Ursache lebensmittelbedingter Campylobacter-Infektionen Erneuter Ausbruch nach Rohmilch-Verzehr in Sachsen-Anhalt Erneuter Ausbruch nach Rohmilch-Verzehr in Sachsen-Anhalt

Campylobacter (C.)-Infektionen des Menschen, vorwiegend durch C. jejuni und C. coli, nehmen gegenw?rtig – mit steigendem Anteil – nach den Salmonellen den 2. Platz unter den bakteriell bedingten Durchfallerkrankungen in Deutschland ein. Insbesondere bei Gruppenerkrankungen durch C. jejuni wird in zunehmendem Ma?e der Verzehr kontaminierter Rohmilch als Ursache ermittelt. Im April 2000 erkrankten in Sachsen-Anhalt erneut 28 Kinder und drei Betreuer bei einem Erlebnisausflug auf einen Bauernhof nach dem Verzehr von Rohmilch an Campylobacteriose. Der durch Befragung der Erkrankten in “klassischer” Weise ermittelte epidemiologische Zusammenhang zwischen den Erkrankungen und dem Rohmilch-Verzehr konnte durch mikrobiologische und molekularbiologische Untersuchungen best?tigt werden. Anhand der klonalen Identit?t der von den Milchkühen, aus der Rohmilch und von den Durchfallpatienten isolierten C. jejuni-St?mme, lie? sich die Infektkette verifizieren. Die Untersuchungsergebnisse unterstreichen den hohen Aussagewert laborgestützter infektionsepidemiologischer Untersuchungen. Sie zeigen aber auch die Notwendigkeit gezielter epidemiologischer überwachung der Campylobacteriosen, weiterer Ursachenforschung zu deren Pr?vention und verst?rkter Aufkl?rung über die gesundheitlichen Risiken des Rohmilchverzehrs. Letzteres betrifft Campylobacter- und EHEC-Infektionen gleicherma?en.     

Failure of vasoldilator infusion to alter pulmonary diffusing capacity in systemic sclerosis.

PURPOSE: Patients with systemic sclerosis (SSc) do not exhibit a normal increase in the diffusing capacity for carbon monoxide (DLCO) on assuming the supine position. We sought to determine whether a potent prostacyclin derivative and vasodilator, iloprost, would reverse this defect. PATIENTS AND METHODS: Fourteen patients with SSc were enrolled in a randomized, double-blind, placebo-controlled study of iloprost. Patients were tested before and during 3 days of iloprost or placebo infusion with both upright and supine pulmonary function studies. RESULTS: The results of baseline pulmonary function studies including DLCO were not significantly altered by iloprost. Furthermore, iloprost did not alter the abnormal postural DLCO response. CONCLUSION: These results suggest that the pulmonary vascular defects seen in this group of patients are not a consequence of reversible pulmonary vasospasm.     

Genetic diversity and clonal relationships of Acinetobacter baumannii strains isolated in a neonatal ward: epidemiological investigations by allozyme, whole-cell protein and antibiotic resistance analysis.

Sixty-five strains of Acinetobacter baumannii which had been isolated from patients and the indoor environment of a neonatal intensive care unit and, for comparative purposes, isolates from three other wards, were examined by means of electrotyping and analysis of whole-cell protein and antibiotic resistance patterns. Fourteen different electrotypes were determined. The predominant type, a multiply resistant acinetobacter clone, persisted in the neonatal ward over several months. The results underline the usefulness of electrophoretic subtyping, in particular by means of allozyme pattern and as a supplement to whole-cell protein pattern analysis, in epidemiological investigations into the routes of transmission of nosocomial A. baumannii infections.     

High frequency radial movements of the reticular lamina induced by outer hair cell motility

Recently, it was shown in cochlear explants from the guinea pig cochlea that electrokinetic motile responses of outer hair cells can induce radial and transverse motion of the reticular lamina. Here we demonstrate, that the radial component of these motions can be measured up to high frequencies (15 kHz). Cochlear explants were taken from guinea pig inner ears and exposed to a sinusoidal electric field. A double photodiode was used as a linear position detector with high spatial and temporatl resolution to detect radial movements in the plane of the reticular lamina. The organ of Corti of the second, third and fourth cochlear turns was stimulated with frequencies of the electrical field between 0.5 Hz and 20 kHz. Sinusoidal movements of up to 15 kHz were recorded. At higher frequencies the signal-to-noise ratio became too small. The largest responses were measured at the three rows of outer hair cells. If the strength of the electrical field was 2 kV/m, into which the cochlear explants were placed, the amplitudes of outer hair cell movements were around 1 μm at 1 Hz and 10 nm at 10 kH. Uncoupling of the outer hair cells from the tunnel of Corti and from the inner hair cells decreased the oscillations of inner hair cells but did not affect outer hair cells. The movements showed frequency dependent amplitudes like a complex low-pass filter but no best frequency was observed.