Injuries of the small and large intestine following blunt abdominal trauma

From 1979 to 1987 1428 patients with blunt abdominal trauma were treated in the Department of Surgery of the University of Freiburg; 119 patients had intestinal injuries. They were mainly young adults who had sustained a car accident. 71.3% of the small bowel injuries were overseen, 14.2% needed resection, and in 14.5% an operative procedure was not necessary. The surgical procedure for colonic injuries has to be chosen with regard to the age and general condition of the patient, to the severity of the trauma, to associated injuries and to the stage of peritonitis. Accordingly, 18% of the patients were treated with and 58% without a protective colostomy, 24% could be treated conservatively. Mortality and morbidity correlated with the severity of associated injuries. Morbidity was also dependent on the time interval between accident and operative therapy.     

Alloplastic ligament replacement. A study of the biological fixation of 5 non-resorbable materials

The long-term stability of alloplastic ligament prostheses depends on various parameters, on including the quality of the biologic fixation in the bone tissue. Biomechanical and histological tests were therefore performed to examine the stability obtained with five different alloplastic and non-resorbable ligament substitute materials following stress-free implantation into the distal femur and proximal tibia of Wistar rats. The materials were: a filament of the PTFE ligament prosthesis, PTFE suture material (Goretex), polyethylene terephthalate (Mersilene), polyethylene (Braun-Dexon) and polybutylene terephthalate (Miralene). The materials used were all of USP-1 quality. Extraction trials of the implants 32 weeks later did not show any differences between the PTFE materials, such as polyethylene and polyethylene terephthalate, whereas a significantly lower value was found for polybutylene terephthalate. The fixation involved connective tissue exclusively with all the materials tested except for PTFE. PTFE not only induced tight and direct bony contact externally, within the material itself extensive formation of new bone was also found. PTFE was found to be the most histocompatible material, while polyethylene terephthalate led to the most pronounced foreign-body-type reactions.     

The repertoire of HLA-Cw-specific NK cell receptors CD158 a/b (EB6 and GL183) in individuals with different HLA phenotypes.

Over the last few years, natural killer (NK) cells have been shown to express major histocompatibility complex (MHC) molecules recognizing receptors that are thought to function primarily as negative signalling receptors. Much attention has been focused on the NK cell receptors CD158a (EB6) and CD158b (GI 183), which recognize two alternative epitopes on the HLA-Cw locus. In order to investigate whether HLA type affects the CD158a/b repertoire, expressed as percentage positive cells for a particular receptor and mean expression on this population of NK cells, peripheral blood lymphocytes of 47 HLA-typed donors were examined. Peripheral blood samples were examined by flow cytometric analysis to investigate the expression of CD158a and CD158b receptors on the surface of NK cells. In parallel, we determined each individual's HLA phenotype. There was a great heterogeneity in CD158 expression; nevertheless all individuals had NK cells belonging either to the CD158 a+b-, a-b+ or a-b- populations. No positive or inverse correlations could be shown between either receptor expression intensity or proportion of positive cells, and presence of the appropriate ligand. Thus no association between an individual's NK receptor repertoire and HLA serotype could be demonstrated. It is concluded that CD158 is expressed on NK cells in a highly redundant fashion. Our data do not support either a positive selection mechanism or the receptor calibration model.