Initial experiences with a total knee prosthesis implanted without bone cement

Prosthetic loosening and stem fractures have been the most frequently encountered complications of knee arthroplasties using the Guepar Hinged prothesis. The insufficient intramedullary fixation of the stem and the use of cement in the femur and tibia are primarily responsible for these complications. In our clinic, we have used an altered Guepar Hinged prothesis since 1975. The femoral and tibial stems are lengthened with medullary nails, resulting in stems with high bending and torsional stress capacities. The fixation strength of these special long stems in the medullary cavities is such that we no longer use cement for this prosthesis. The initial results of our cementless implantation of these special long-stem knee prostheses, and the advantages of this method are reported.

Human pancreatic amylase polymorphism: formal genetics and population genetics

The genetically determined polymorphism of human pancreatic amylase (E.C. 3.2.1.1), AMY2, is demonstrated in serum specimens by agarose gel electrophoresis. We investigated 325 mother-child pairs and 2594 unrelated individuals from southwestern Germany. This study confirms the formal hypothesis of two common alleles AMY1/2, AMY2/2 and possibly two rare alleles AMY3/2, AMY4/2 at an autosomal locus AMY2. The frequency of the AMY1/2 allele was calculated as 0.951; AMY3/2 and AMY4/2 seem to have a frequency of 0.001 in this sample.

[Isotope methods in the radiological diagnosis of venous disease. II. Indications and accuracy (author's transl)]

Radiological diagnostic methods for the diagnosis of abnormalities of veins were discussed in the light of 1,683 contrast venograms and isotope examinations in 650 patients with acute and chronic diseases of veins. For patients with increased thrombotic risks, the 125 I-fibrinogen test is recommended as a sensitive and simple method. Where there are symptoms of venous thrombosis, radionuclide venography, together with other noninvasive methods, may be used for establishing whether there are indications for contrast venography. These may also provide evidence of previous pulmonary emboli. These methods should also be used where there is clinical suspicion of previous pulmonary emboli. Non-invasive isotope methods have proved to be sensitive techniques for preliminary examinations and for follow-up. Contrast venography is necessary if definitive treatment is planned.

[Isotope methods in the diagnosis of venous disease. II. Results of radionuclide venography (author's transl)]

The frequency of scintigraphic findings in the presence of thromboses, post-thrombotic changes and in normal veins, was determined in 150 patients. The results of radionuclide venography and contrast venography in these patients have been compared. Abnormalities in veins can be detected by radionuclide venography with a high degree of accuracy. Differentiation between acute and chronic thrombosis and post-thrombotic changes can only be made by invasive contrast venography.

[Isotope methods in the diagnosis of venous disease. I. Methods of radionuclide venography (author's transl)]

The method of radionuclide venography is best determined by the localisation and type of suspected venous abnormality. The authors describe four methods using 99mTc microspheres and 99mTc-pertechnetate. Correlation of the isotope and angiographic findings in 150 patients indicated an accuracy of 90% for the isotope methods. The risks of radionuclide venography are discussed. Isotope venography is recommended as a simple, non-invasive technique.

Crassulacean acid metabolism (CAM) in leaves of Aloe arborescens mill : Comparative studies of the carbon metabolism of chlorenchym and central hydrenchym

In the succulent leaves of Aloe arborescens Mill diurnal oscillations of the malic acid content, being indicative of Crassulacean Acid Metabolism (CAM), were exhibited only by the green mesophyll. In contrast, the malic acid level of the central chloroplast-free water-storing tissue remained constant throughout the day-night cycle. Apart from malate, the green tissue contained high amounts of isocitrat which was lacking in the water tissue. There was no significant transfer from the green mesophyll to the water tissue of (14)C fixed originally via dark (14)CO2 fixation in the mesophyll. Both isolated mesophyll and water tissue were capable of dark CO2 fixation yielding mainly malate as the first stable product. Both tissues have phosphoenolpyruvate carboxylase. However, the enzymes derived from the both sources could be distinguished by their molecular weights and by their kinetic properties, suggesting different phosphoenolpyruvate carboxylase proteins. The conclusion drawn from the experiments is that in a. arborescens the CAM cycle proceeds exclusively in the green mesophyll and that the water tissue, though capable of malate synthesis via β-carboxylation of phosphoenolpyruvate, behaves as an independent metabolic system where CAM is lacking. This view is supported by the finding that the cell walls bordering the green mesophyll from the water tissue lack plasmodesmata, hence conveniant pathways of metabolite transport.

Genetic variation of aldehyde dehydrogenase in primates

Genetic variation of aldehyde dehydrogenase has been demonstrated in catarrhine primates. The results are in accordance with the formal genetic interpretation: three alleles, AldDH1, AldDH2, AldDH3, at the gene locus AldDH. Obviously, the allele AldDH1 has undergone fixation in Homo and Hylobates, the allele AldDH2 in Macaca and Papio, and the allele AldDH3 in Cercopithecus.

PGM1 subtyping by means of acid starch gel electrophoresis

'PGM1 subtyping' can be clearly demonstrated by horizontal electrophoresis in acid starch gel. Because of the different cathodal mobilities of PGM1-gene products, the allelic superscripts for PGM1 were designated as 1F, 1S, and 2F, 2S, respectively. Gene frequencies of a population sample from Southwestern Germany are presented. They fit in well with other, previously published data on this matter.

[Arteriovenous malformations in the region of the external carotid artery]

This article reports two cases of extracranial angiomatous vascular malformation, with blood being conveyed thereto by the external carotid artery. Visible and palpable clusters of dilated and pulsating vessels in the scalp or jugular region as well as vascular murmur are of major importance for clinical diagnosis. Conditions of flow may be objectified with the use of angiography. Therefore, the radiography of vessels should always be used to reliably determine the absence of combined extra- and intracranial vascular malformations.

Mitosis in Barbulanympha. I. Spindle structure, formation, and kinetochore engagement

Successful culture of the obligatorily anaerobic symbionts residing in the hindgut of the wood-eating cockroach Cryptocercus punctulatus now permits continuous observation of mitosis in individual Barbulanympha cells. In Part I of this two-part paper, we report methods for culture of the protozoa, preparation of microscope slide cultures in which Barbulanympha survived and divided for up to 3 days, and an optical arrangement which permits observation and through-focus photographic recording of dividing cells, sequentially in differential interference contrast and rectified polarized light microscopy. We describe the following prophase events and structures: development of the astral rays and large extranuclear central spindle from the tips of the elongate-centrioles; the fine structure of spindle fibers and astral rays which were deduced in vivo from polarized light microscopy and seen as a particular array of microtubules in thin-section electron micrographs; formation of chromosomal spindle fibers by dynamic engagement of astral rays to the kinetochores embedded in the persistent nuclear envelope; and repetitive shortening of chromosomal spindle fibers which appear to hoist the nucleus to the spindle surface, cyclically jostle the kinetochores within the nuclear envelope, and churn the prophase chromosomes. The observations described here and in Part II have implications both for the evolution of mitosis and for understanding the mitotic process generally.

Mitosis in Barbulanympha. II. Dynamics of a two-stage anaphase, nuclear morphogenesis, and cytokinesis

Anaphase in Barbulanympha proceeds in two discrete steps. In anaphase-A, chromosomal spindle fibers shorten and chromosomes move to the stationary centrosomes. In anaphase-B, the central spindle elongates and ("telophasic") bouquets of chromosomes, with kinetochores still connected by the shortened chromosomal fibers to the centrosomes, are moved far apart. The length, width, and birefringence of the central spindle remain unchanged throughout anaphase-A. In anaphase-B, the central spindle elongates up to fivefold. During elongation, the peripheral fibers of the central spindle splay, first anteriorly and then laterally. The remaining central spindle progressively becomes thinner and the retardation decreases; however, the coefficient of birefringence stays approximately constant. The nuclear envelope persists throughout mitosis in Barbulanympha and the nucleus undergoes an intricate morphological change. In prophase, the nucleus engulfs the spindle; in early anaphase-A, the nuclear envelope forms a seam anterior to the spindle, the nucleus thus transforms into a complete sleeve surrounding the central spindle. In late anaphase-A, the middle of the seam opens up in a cleft as the lips part; in anaphase-B, the cleft expands posteriorly, progressively exposing the central spindle. Finally, the cleft partitions the nucleus into two. The nuclear envelope shows an apparent elasticity and two-dimensional fluidity. Localized, transient deformations of the nuclear envelope indicate poleward and counter-poleward forces acting on the kinetochores embedded in the envelope. These forces appear responsible for nuclear morphogenesis as well as anaphase chromosome movement. At the end of anaphase-B, the two rostrate Barbulanympha may swim apart of be poked apart into two daughter cells by another organism cohabiting the host's hindgut.

[Significance of the embolization of the arteria renalis for the treatment of kidney tumours (author's transl)]

In 24 patients with malignant kidney tumours percutaneous embolizations of the arteria renalis were performed in about 1 year. The material for embolization was gelatine-sponge-particles. The embolization was done pre-operatively, usually in connection with the arteriographic examination of kidney tumours (hypernephroid carcinoma). In 2 patients without operation it was done as a palliative measure. Our favourable results to improve the operability of tumours agree with reports in the literature. According to our opinion the pre-operative embolization of the arteria renalis with kidney tumours offers the possibility of a blood-sparing operation and a reduction of tumour-cell outwashings.

[Invasive myocardial perfusion scan with (131)I-MAA and (99m)Tc-Microspheres (author's transl)]

Hemodynamic evaluation of coronary artery stenosis is indicated in patients with ischemic heart disease. For this purpose myocardial perfusion scans are performed. In our study myocardial scans were performed by selective injection of 60 to 80 muCi of (131)I-MAA in the right coronary artery and of 3 mCi of (99m)Tc-microspheres in the left coronary artery. Four views (RAO, LAO, AP, LLAT) were taken with an Anger-Camera and a computer-control-led color-coded display system (Picker Dyna-Came-ra 3C/12 and Kruppe Atlas Elektronik EPR 1100, medium energy collimator). Right and left coronary artery perfusion images were stored and two-colour image produced. Following computer processing (smoothing, normalization) the images were added and photographed in color. In comparision with scans and left-ventricular and coronary angiography the sensitivity of the nuclear medicine method was shown in cases with reduced perfusion. Therefore the perfusion scans seem to be useful in combination with angiography for the determination of therapy.

[Embolisation techniques for renal tumors (author's transl)]

We have performed ten embolisations in nine patients with vascular renal tumours, eight of these pre-operatively. One patient had an inoperable hypernephroma which was embolised twice. We have used gelatine sponge particles (Gelaspon). In every patient it was possible to occlude the arterial supply. There were no complications.

[Gastroduodenal ulcers in patients of a geriatric hospital (author's transl)]

Among 3646 patients of a geriatric hospital we we found 7,82% = 285 patients who suffered once in their life from a gastroduodenal ulcer. We noted: 1. gastroduodenal scars in 3,3% = 121 cases, 2. anamnestic proved gastroduodenal ulcer disease in 1,5% = 57 cases, 3. clinical and/or pathological proved gastroduodenal ulcers in 3% = 107 cases. Additional findings were put down as there are aortal arteriosclerosis, pulmonary heart and complications like perforation, penetration, bleeding and death.

[Plethysmographic investigation of the post-thrombotic syndrome]

In 49 patients with a phlebographically ascertained postthrombotic syndrome, who were above all subdivided into morphologically defined degrees of severity, after May and Nissl, a plethysmographic investigation was carried out with the deep positioning test and the venous drainage test. The results were contrasted with a group of 53 patients with a primary varicosis and the measuring results of 102 test persons with healthy veins. A very good correlation between the morphological changes and the haemodynamic findings establishable by means of the phlebembraxis plethysmography could be proved. A clear evidence was possible by means of the venous drainage test, whereas in the deep positioning test a certain demarcation was possible only in stage III of the postthrombotic syndrome.