No abstract

Forty-one patients were analyzed after surgical treatment of Achilles tendon ruptures. The following parameters served as the outcome measure: (1) duration of wearing cast, (2) length of hospital stay, (3) outpatient treatment, (4) time of absence from work, (5) complications, (6) re-rupture rate, (7) subjective evaluation by patients, (8) scar condition, (9) ability to stand on tiptoes, (10) Thompson test, (11) movement of talocrural joint, (12) circumference data of lower extremity, (13) radiographs, (14) power measurement of the ankle (in kg), (15) ultrasound examination, (16) blood cholesterol levels, (17) scoring by Trillat's score. Surgical treatment achieved an excellent or good outcome in 91% of patients as evidenced by the Trillat score. Furthermore, cholesterol levels were found to be elevated in 83% of patients. Given the good results, surgical treatment of Achilles tendon ruptures is recommended, but patients of status post-Achilles tendon rupture should be checked for high cholesterol levels. In the future, controlled, prospective trials need to prove a correlation between Achilles tendon rupture and a pathological blood lipid status.

No abstract

The eect of acetyl ± tyrosyl-valyl-alanyl-aspartyl ± chloromethylketone (ac-YVAD-cmk), an irreversible caspase-1 (IL-1b converting enzyme, ICE) inhibitor on mortality, leukocyte and platelet counts and cytokine levels was investigated in a double-blind rat model of endotoxaemia. Intravenous (i.v.) bolus administration of lipopolysaccharide (LPS) (25 ± 75 mg kg 71 , n=12 per group) to anaesthetized rats induced a dose dependent increase in mortality over 8 h (LD 50 =48 mg kg 71 ). During this period, animals became leukopenic and thrombocytopenic. Serum levels of IL-b, IL-6, and TNF-a were highly elevated. Pretreatment of rats with ac-YVAD-cmk at a dose of 12.5 mmol kg 71 signi®cantly reduced mortality from 83 to 33% using Log Rank analysis. However, ac-YVAD-cmk did not modify blood cell counts or cytokine pro®les as compared with the LPS-drug vehicle group. These data lay credence to the potential importance of caspase-1-inhibition in modifying the in¯ammatory response to endotoxin. Further investigations are warranted in understanding the relationship between caspase-1 inhibition, cytokine production and animal survival in dierent experimental paradigms of sepsis.

This rodent model of antibiotic-treated, intra-abdominal infection features key characteristics of clinical sepsis. Although the hyperdynamic response observed in septic patients undergoing resuscitation was not clearly elicited, this paradigm better mimics clinical sepsis compared with the commonly used endotoxin model. Thus, utilization of this paradigm may provide additional opportunities to explore mechanisms of sepsis and to examine novel therapeutics.

No abstract

The direct costs of harvesting cancellous bone graft and the use of bone replacement material are comparable. Due to the high complication rate at the donor site the total-cost-of-illness might be higher when using autologous bone graft.

Background:Today, humerus nails have become the surgical method of choice in the treatment of humerus shaft fractures. Whether or not the radial nerve should be intraoperatively examined by default in case of primary paresis is currently under discussion.Patients and Methods:Clinical findings from 38 patients with humeral shaft fractures surgically treated with unreamed humerus nail (UHN) at the Department of Accident Surgery, University Clinics Bonn, Germany, between 2000 and 2003 were retrospectively assessed. Constant Score was applied for evaluation of functional results.Results:In 40% of patients, primary radial nerve paresis was present. This was especially common after high energy trauma (e.g. traffic accident) and significantly increased in fractures of the middle third. In 93% of cases, spontaneous remission of motor and sensory loss was observed. No iatrogenic radial nerve impairment occurred.Conclusion:Due to the high rates of spontaneous remissions of radial nerve palsy after treatment with UHN in humerus shaft fractures, primar exploration of the radial nerve does not appear to be necessary.