[Haptic perception and language development assessment in kindergarten and pre-school children]. / Haptische Wahrnehmungs- und Sprachentwicklungsleistungen bei Kindergarten- und Vorschulkindern.

In a study with 101 children aged 3 to 5 years expressive vocabulary, morpho-syntactical language skills, and tactile-kinesthetic/haptic perception (stereognosis of object properties, object stereognosis) were assessed. Substantial correlations were found between tactile-kinesthetic/haptic perception and the selected language facets. Age differences in expressive language skills remained significant even when tactile-kinesthetic/haptic perception was partialized out. On the contrary, age differences in tactile-kinesthetic/haptic perception were partially eliminated when language skills were controlled for. The results are discussed with regard to the role of the tactile-kinesthetic/haptic senses in language development.

Upper and lower limb fractures with concomitant arterial injury.

We describe a management strategy for upper- and lower-limb fractures with associated arterial injury and report the results in 113 cases treated over a period of 18 years. Primary amputation was performed in 23 patients and of those who underwent primary vascular repair, 27 needed secondary amputation, two-thirds of them within a week of the injury. Of those requiring secondary amputation, 51.8% had ischaemia exceeding six hours, 81.4% had severe soft-tissue injury and 85.2% had type III open fractures. The patients whose limbs had been salvaged were followed up for an average of 5.6 years. The eventual outcome depended on the severity of the fracture, the degree of soft-tissue damage, the length of the ischaemic period, the severity of neurological involvement, and the presence of associated major injuries. There was a 30% incidence of long-term disability in the salvaged limbs, largely due to poor recovery of neurological function. Prompt recognition of such combined injuries is vital and requires a high index of suspicion in patients with multiple injuries and with certain fracture patterns. We recommend a multidisciplinary approach, liberal use of pre-operative angiography in upper-limb injuries and selective use of intra-operative angiography in lower-limb injuries. Stable external or internal fixation of the fractures and re-establishment of limb perfusion are urgent surgical priorities to reduce the period of ischaemia which is critical for successful limb salvage.

Phagocytic functions and tumor necrosis factor secretion of human monocytes exposed to natural porcine surfactant (Curosurf).

In this study we have analyzed various phagocytic functions and tumor necrosis factor (TNF) secretion of human monocytes exposed to either a biochemically well-defined porcine surfactant or a purified phospholipid preparation. Adherence, random migration, and chemotactic response to zymosan activated serum and formyl-methionyl-leucyl-phenylalanine were normal in surfactant-treated monocytes; surfactant was not a chemotactic stimulus. In contrast, phagocytosis of Staphylococcus aureus by monocytes exposed to surfactant (100 micrograms/mL) or phospholipids (100 micrograms/mL) was slightly impaired [surfactant: at 30 min (t30) 48.5 +/- 11%, t60 73.3 +/- 10.1%; phospholipids; t30 47.3 +/- 2.5%, t60 68.0 +/- 6.6%; controls: t30 66.6 +/- 9.9%, t60 81.0 +/- 6.6%, p less than 0.05 at t30 for both, p less than 0.05 at t60 for phospholipids]. Due to the smaller number of S. aureus ingested, bactericidal activity of surfactant- or phospholipid-treated monocytes was slightly reduced when compared with controls. Surfactant or phospholipids had no bactericidal activity. Uptake of Candida albicans was identical in surfactant- or phospholipid-treated monocytes and untreated controls; the same was true for the number of Candida organisms ingested per cell. Phagocytosis-associated chemiluminescence and production of superoxide anion by monocytes of either source in response to phorbol myristate acetate and opsonized zymosan were also unaffected.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of natural porcine surfactant (Curosurf) on the function of neutrophilic granulocytes]. / Einfluss von natürlichem porcinen Surfactant (Curosurf) auf die Funktion neutrophiler Granulozyten.

In this study we have analyzed various phagocytic functions of human neutrophils exposed to either biochemically well defined porcine surfactant (Curosurf) or a phospholipid preparation. Adherence, random migration and chemotactic response to zymosan activated serum and formyl-methionyl-leucyl-phenylalanine were normal in surfactant treated neutrophils; surfactant was not a chemotactic stimulus. In contrast, phagocytosis of S. aureus by neutrophils exposed to surfactant (100 micrograms/ml) or phospholipids (100 micrograms/ml) was impaired (surfactant: t30 49.5 +/- 9.0%, t60 65.0 +/- 8.0%; phospholipids: t30 66.3 +/- 12.6%, t60 78.0 +/- 7.8%; controls: t30 78.1 +/- 8.9%, t60 90.1 +/- 6.2%; p less than 0.001 at t30, t60 for surfactant, p less than 0.05 at t60 for phospholipids). Due to the smaller number of S. aureus ingested, bactericidal activity of surfactant or phospholipid treated neutrophils was slightly reduced when compared to controls (surfactant t30 p less than 0.05, surfactant t60 p less than 0.001, phospholipids t60 p less than 0.05). Surfactant or phospholipids had no bactericidal activity. Uptake of candida was identical in surfactant or phospholipid treated neutrophils with untreated controls; the same was true with the number of candida per cell ingested. Phagocytosis-associated chemiluminescence and production of superoxide anion by neutrophils of either source in response to phorbol myristate acetate and opsonized zymosan was also identical.

[Fractures accompanied by injuries of the great vessels in sport and leisure accidents. Diagnosis and management concept]. / Frakturen mit begleitenden Verletzungen grosser Gefässe bei Sport- und Freizeitunfällen. Diagnostik und Behandlunskonzept.

Extremity fractures with concomitant vascular injuries are surgical emergencies. Especially injuries of the upper extremities require a preoperative angiographic examination for the localization of the vascular lesion. In vascular lesions of the lower extremities a primary angiography is not necessary, if there is an opportunity for an intraoperative radiologic evaluation. In our traumatological department 104 patients were treated over the last 15 years with that combined injury. The concept of immediate stabilization of the fracture with simultaneous or postponed arterial repair has been proved to be appropriate. The fasciotomy as prophylactic procedure of a postischemic compartment syndrome is also a part of our concept during the last years. The late results in our mostly young patients depended on the degree of soft tissue damage and the time of ischemia. The often untreatable nerve lesions contributed to a loss of use of about 30% in the late courses.