[Complications of percutaneous tracheostomy in German otorhinolaryngological departments]. / Komplikationen der dilatativen Punktionstracheotomie in deutschen Hals-Nasen-Ohren-Abteilungen.

AIM: This study was carried out to clarify complications which need intervention from otorhinolaryngologists after percutaneous dilatational tracheostomy (PDT). METHODS: In October 1996 questionnaires were sent to all heads of otorhinolaryngological departments in Germany. The first part of this questionnaire dealt with the frequency and application of PDT. In the second questionnaire specifications were made about complications that had been observed personally by the head of the department. The questionnaire inquired not only about complications in his or her own patients, but in all patients that had been referred to the department. RESULTS: Of the departments contacted 78% returned evaluated questionnaires. The most frequently used method was the modification described by Ciaglia. This method was more often used by anesthesists and specialists in internal medicine and general surgery. PDT was in use in 10% of the ENT departments. The most frequently observed complications were bleeding during the change of the canula and tracheal stenosis. Four fatal cases were reported in connection with PDT. Almost half of the department heads responding felt PDT was not appropriate for intensive care patients. Thirty-three percent believed that PDT was suitable. Three percent thought that PDT was a more effective method than conventional tracheostomy.

[Treatment of distal radius fracture. Surgical technique: bore wire osteosynthesis]. / Behandlung der distalen Radiusfraktur. Operative Technik: Bohrdraht-Osteosynthese.

The Kirschner wire fixation is mainly indicated in unstable types of Colles' and children's fractures of the distal radius. Out of 2760 distal radius fractures (1975-1989) 626 (20.7%) were treated operatively including 326 (11.8%) with K-wires. Primary operation was performed in 53.5% immediately after trauma. Exposing the sensitive radial nerval paths, 3-4 K-wires were inserted from the radial and the dorsoulnar aspect. The K-wire ends were covered subcutaneously. The clinical evaluation of a series of 226 patients according to the score of Lidström presented 79% excellent and good, 16% fair and 5% poor results. The clinical results correlate to the radiocarpal angle and radial shortening. Because of additional injuries to the ulnar complex give worse results in reposition, the ulnar styloid should be fixed.

[Special forms of distal radius fractures]. / Spezielle Formen der distalen Radiusfraktur.

The severity of a fracture of the distal radius is not only determined by the type of the fracture but also by concomitant ligamentous and carpal injuries, which are often underestimated and imply a higher degree of instability than the bony lesion alone. Therefore classifications are valuable, which combine fracture type and associated lesions, thus permitting conclusion about the therapeutic method of choice. The article discusses indication, operative technique and special features of radial fractures in combination with carpal injuries, of radial styloid fractures as well as Barton's and Reverse-Barton's fractures, of bilateral radial fractures and of radial fractures as part of a chain fracture. It is important to perform an early fasciotomy and carpal tunnel release in cases of severe soft tissue damage and threatening compartment syndrome.

X-ray dose-effect relationship on unscheduled DNA synthesis and spontaneous unscheduled DNA synthesis in mouse brain cells studied in vivo.

X-irradiation of the head of adult mice leads to DNA repair synthesis (unscheduled DNA synthesis, UDS) in non-proliferating cells of the brain as shown autoradiographically after injection of 3H-thymidine and subsequent irradiation. The extent of UDS induced by one and the same X-ray dose varies between different cell types and also between different brain areas. Within the range of X-ray doses studied (2 to 100 Gy) a linear dose effect relationship was observed. No evidence of a saturation effect was found. The slopes of the regression lines for the dose effect relationship differ considerably for the different cell types. Two interesting correlations were found, if the present results were compared with other data in the literature: (i) There seems to be a correlation between the extent of UDS and radiosensitivity of the different cell types, the cells with low DNA repair synthetic rates being more radiosensitive. (ii) The extent of UDS of the different cell types correlates well with the extent of protein synthesis of the corresponding cell types. Apart from radiation induced UDS, spontaneous UDS was found to occur in sham-irradiated animals. The extent of spontaneous UDS also differs considerably between different cell types as well as between different brain areas. The increase of spontaneous UDS with increasing duration of immobilization of the animals during sham irradiation suggests a relationship between spontaneous UDS and stress.