A study about 3rd degree perinatal rupture (author's transl)

29 cases of 3rd degree perineal rupture occured from 1962 to 1975 at the St?dtische Frauenklinik and Hebammenlehranstalt Braunschweig and have been analysed retrospectively. Most of these were observed in the last five years. The increase is undoubtlessly related to the shorter expulsion peried by ocytocin infusion. Investigations for avoidable courses and how to reduce them to a minimum were made in this analysis. Not at least this study was motivated by the lack of informations about obstetrical complications and the eventual consequences in literature. The only prophylaxis is the adequate support of the perineum and the sufficient episiotomy at the right moment. According to the operative and post operative treatment mentioned there could be achieved a good functional result in all cases. The stationary treatment has been reduced by these measures from 19,0 to 10,5 days.     

Air contrast colon examination in patients with colostomies

A readily feasible technique for producing an excellent air contrast examination of the colon in patients with colostomies is described. The technique employes no special equipment and is easily tolerated by patients. Indications for the examination include a symptomatic patient with a negative conventional enema or suspicious single column examination. The surprisingly high incidence of both benign and malignant coexisting colonic neoplasms is reviewed.     

Writing in aphasia rehabilitation: cursive vs manuscript

An analysis of 100 patients sustaining multiple injury and pancreatic trauma was completed. Sixteen patients with penetrating injury died within the first 24 hours, 14 of whom died intraoperatively from major hepatic and/or retroperitoneal venous injury. Eighty-four patients survived long enough to permit evaluation of treatment. There was no statistically significant relationship between mode (p = 0.3) or anatomic area (p = 0.5) of injury and death. However, death was more common in the presence of duct injury (p less than 0.0001). Thirty-nine patients were determined to have duct injury and 45 did not. These two groups were equivalent, with the exception of a higher incidence of concomitant bowel injury (p less than 0.05) in those with duct violation. Combined sump and Penrose drainage was found to be adequate treatment of both proximal and distal nonductal injury with no significant difference in mortality or morbidity rates (p = 0.5). Resection of distal ductal injuries as opposed to drainage alone resulted in significantly lower morbidity and mortality rates (p less than 0.05), comparable to those of drained nonductal injuries. No conclusions could be made relevant to proximal duct injuries, except that drainage alone is inadequate. Seventeen (20 percent) of the 84 patients evaluated died. Pancreatic related mortality rate was 17 percent (14 patients). Two of 23 patients with blunt injury (9 percent) and 12 of 61 patients with penetrating injury (20 percent died). Gram-negative sepsis (82 percent) was the most common cause of death (p less than 0.01), and sepsis was correlated with the presence of pancreatic duct (p less than 0.0001) and bowel (p less than 0.001) injury.     

Mitogen-activated protein kinase is involved in the degradation of p53 protein in the bryostatin-1-induced differentiation of the acute promyelocytic leukemia NB4 cell line

Overexpression of mutant p53 has been reported to promote tumorigenicity in several cancers. However, despite its potential importance, the signals regulating mutant p53 protein expression are not known. Here we show that a form of p53 that is incapable of binding DNA is overexpressed in the acute promyelocytic leukemia NB4 cell line. Our results demonstrate that treatment of NB4 cells with bryostatin-1, which induces differentiation in this cell line, leads to hyperphosphorylation of this DNA binding-impaired form of p53 via mitogen-activated protein kinase. After this phosphorylation, the p53 protein is degraded by the ubiquitin/proteasome pathway. Furthermore, we show that inhibition of p53 hyperphosphorylation blocks p53 protein degradation and cell differentiation. In addition, inhibition of the ubiquitin/proteasome pathway also blocks p53 protein degradation and cell differentiation. These findings suggest a role for mitogen-activated protein kinase in the degradation of the DNA binding-impaired form of p53 protein and in the bryostatin-induced differentiation observed in this cell line. The implications of these results with respect to the functional significance of p53 phosphorylation and degradation in cell differentiation are discussed.     

Beneficial effect of treatment with a monoclonal anti-tumor necrosis factor-alpha antibody on markers of coagulation and fibrinolysis in patients with active Crohn's disease

Crohn's disease has frequently been associated with coagulation abnormalities, causing intravascular deposition of fibrin and local infarction which can subsequently compromise the gut mucosa. Also, arterial and venous thromboembolic complications of larger vessels appear to be associated with Crohn's disease. Coagulation activation in patients with Crohn's disease could be a result of increased serum and tissue levels of cytokines, as reported. We prospectively studied parameters of coagulation and fibrinolysis in 10 patients with active Crohn's disease, who were subsequently treated with a monoclonal anti-tumor necrosis factor-alpha (TNF) antibody. Ten consecutive patients with active Crohn's disease (CDAI > 150), not responding to a daily dose of at least 20 mg prednisolone, received a single infusion of human/mouse chimeric anti-TNF antibody cA2. All evaluable patients attained complete clinical and endoscopic     

The effect of the mismatch between the core diameter of self-threading dentine pins and the pinhole diameter

The results of STT-fusion for treatment of advanced Kienb?ck's disease were investigated in a retrospective study. The follow-up included 25 of 28 patients, the average follow-up time was 39 months. Pain relief, range of motion, grip strength and X-ray findings were the most important criteria for rating the results. On the one hand, there was a decrease of range of motion, but on the other hand, grip strength improved markedly. Of course, one part of the decrease of pain is caused by the performed partial denervation of the wrist. However, the decrease of pain was impressive.