[Traumatic and degenerative tendon lesions of the hand]. / Traumatische und degenerative Läsionen der Sehnen an der Hand.

Tendon lesions are the second most common injury in the hand and therefore an important factor in orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons; nevertheless, also less frequent injuries such as damage to the functional system of tendon sheath and pulley or dull avulsions need to be considered. Besides the clinical examination, ultrasound and MRI have proven to be important diagnostic tools. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger "intrinsic" tendon healing to guarantee a good outcome.

[Pulley injuries in sport climbers]. / Verletzungen des Ringbandapparates bei Sportkletterern.

The closed traumatic rupture of finger flexor tendon pulleys in rock-climbers represents a new complex finger trauma first observed in the mid 1980s. While initially the diagnostic and therapeutic approaches varied, nowadays a standard proceeding is being applied. After clinical suspicion and eliminating the possibility of a fracture by normal radiographs, pulley strains as well as singular or multiple pulley ruptures can be diagnosed using ultrasound. If the ultrasound fails to give a definitive diagnosis, an MRI should be performed. In the case of a singular rupture, a conservative treatment with initial immobilisation and early functional therapy is indicated. In the case of a multiple pulley rupture, a surgical reconstruction is mandatory. We favour the "loop and a half" technique of Widstrom and colleagues 1989 and, alternatively, the Weilby repair 1978. Post-operative initial immobilisation and early functional treatment under external pulley protection should be performed.

[Therapy of injuries of the pulley system in sport climbers]. / Zur Therapie von Ringbandverletzungen bei Sportkletterern.

OBJECTIVE: Closed traumatic ruptures of finger flexor tendon pulleys are frequent in rock climbing. The objectives of this study were to characterise this injury and to formulate diagnostic and therapeutic guidelines. An algorithm and a grading system are analysed for validation. METHODS: 122 pulley injuries were prospectively evaluated. After standard radiographs, a dynamic ultrasound examination was performed in all climbers. In ten cases an additional MRI was necessary. All patients were classified according to the pulley injury score. Grade I-III injuries received conservative and grade IV injuries received operative therapy. 88 patients were re-evaluated, including all grade IV patients. RESULTS: 48 climbers had pulley strains, and 74 had ruptures (a single rupture in 90.5 % of the cases and multiple ruptures in 9.5 %). According to the pulley-injury-score, 39 % were grade I, 25 % were grade II, 30 % were grade III and 6 % were grade IV injuries. 115 patients underwent conservative therapy, of which 81 were re-evaluated. 8/81 complained three months after the injury about consistent pain, mostly caused by tendinitis. All grade IV injuries underwent surgical reconstruction, in two cases through Weilby's repair, in three cases through the "loop and a half" technique and in two further cases with a combination of the two. According to the Buck-Gramcko Score we had four excellent, two good and one fair result. The functional result was excellent in one, good in five and fair in one case. CONCLUSIONS: The use of the diagnostic-therapeutic algorithm as well as the grading system proved to be highly suitable. The good results achieved with the conservative treatment in grade I - III injuries justify this approach.

[Accident statistics at "indoor climbing walls"]. / Unfallstatistik an "Indoor-Kletteranlagen".

During a period of 6 month the risk of significant injuries on indoor climbing walls was survived. A total of 25,163 visitors were registrated at the 10 walls. Overall only 4 significant injuries were found, the injury-risk per visit was 0.016%.

[Normal variants of tibial arteries--anastomotic problems in microvascular tissue transfer]. / Normvariante der Unterschenkelarterien--Anschlussprobleme bei mikrovaskulärem Gewebetransfer.

A rare variation in the branching of the popliteal artery is presented. The importance of preoperative angiography for microvascular reconstruction is shown.

[Embolization of cerebral arteriovenous malformations--methods and clinical results]. / Zur Embolisation von zerebralen arteriovenösen Malformationen--Methodik und klinische Ergebnisse.

Interventional treatment by neuroradiological embolisation of cerebral arteriovenous angiomas has become an alternative to surgical exstirpation especially in problematic localisations and large-size malformations. Clinical results showing a marked reduction in attacks and recurrent haemorrhages, evident from a three-year report on 17 patients, confirm the value of the method even in case of only subtotal occlusion of the malformation.

Problems in the balloon occlusion of aneurysms.

From 1987-1991 we performed 20 balloon occlusions in 15 patients with intracranial aneurysms. In 9 patients procedures were technically successful however long term complications included three deaths. In spite of the advancements in the balloon catheter technology fatalities occur restricting the use of percutaneous balloon occlusion to patients with unclippable aneurysms.

[Conservative or surgical treatment for foreign body injuries of the brain]. / Konservative oder operative Behandlung von Fremdkörperverletzungen des Gehirns.

Presenting our patients with cerebral foreign body injuries since 1954 we find that surgical management is not absolutely indispensable. Criteria for conservative management are presented with illustrative cases.

[Carbon disulfide excretion in urine--a biological exposure test for the workplace and environmental concentration ranges]. / Schwefelkohlenstoffausscheidung im Urin--ein biologischer Expositionstest für den Arbeitsplatz- und Umweltkonzentrationsbereich.

The biological control procedure for carbon disulphide (CS2), the determination of free and bound CS2 in urine--a procedure already applied to hygienic surveillance--were modified by using gas chromatography and sulphide selective detection (FPD). The results obtained by the changed biological monitoring test in workplace and environmental surveillance are present and discussed. For CS2 concentrations at workplaces in the range of 8-54 mg/m3 a correlation coefficient of r = 0.56 (n = 11, p less than 0.07) was calculated for the mathematical connection of CS2 shift exposure and CS2 content in urine. For environmental exposures in the range of the CS2 immision short term threshold value (MIKK) of 0.03 mg/m3 the procedure may discriminate significantly exposure load from naturally occurring CS2 background.

Stigmata of atopic constitution in patients with atopic eczema or atopic respiratory disease.

In the diagnosis of atopic eczema, minor physical markers (stigmata) frequently provide valuable clues. The prevalence of nine stigmata (dry skin, hyperlinearity of the palms or soles, infraorbital fold, white dermographism, facial pallor, orbital darkening, Hertoghe's sign, low hairline) was evaluated in 34 atopic eczema patients without atopic respiratory disease, in 16 patients with allergic rhinitis and/or asthma without atopic eczema, and in 23 controls without atopic respiratory or eczematous disease, and with negative results at prick testing with three common aeroallergens. Compared with controls, all features except Hertoghe's sign were significantly (p less than 0.01) more frequent in atopic eczema, and, except for Hertoghe's sign, dry skin and white dermographism, they were significantly (low hairline, p less than 0.05; others, p less than 0.01) more frequent also in respiratory disease. The prevalence of most stigmata did not differ significantly (p greater than 0.05) in cutaneous vs. respiratory atopic disease, only dry skin being more frequent in atopic eczema (p less than 0.05). Although not specific, most stigmata are characteristic markers not only of atopic eczema, but of atopy as such.

[Development and application of an environment dosimeter for carbon disulfide]. / Entwicklung und Anwendung eines Umweltdosimeters für Schwefelkohlenstoff.

Construction, function, and quality of parameters of a newly developed passive dosimeter for carbon disulphide are described. CS2 adsorbed on chromosorb 101 is thermically desorbed and then dosed to a gas chromatograph via a gas sampling valve and finally determined by flame photometric detection (FPD). The dosimeter allows 24-hr immission and indoor measurements, respectively, and is also suitable as a personal dosimeter for the environmental concentration range. First practical measurement results are discussed.

[Serum proteins levels of school children in areas with variable air pollution, especially by carbon disulfide (CS2)]. / Serumproteinspiegel von Schulkindern in Gebieten unterschiedlicher Luftbelastung, speziell unter Schwefelkohlenstoff (CS2)-Belastung.

Within an epidemiological transversal study concerning the effect of CS2 immissions on the health state of school children during 1987/1988, 340 9 to 10 years old children (198 exposed, 142 non-exposed) have been investigated. From a venous blood sample 12 serum proteins have been determined, among other determinations. From these 12 immunological parameters, relating the mean concentrations of them in connection to the two different areas 7 were significantly different, 2 probably different, and 3 had no differences (T-test). These results are discussed in connection with other data from the literature.

[Exposure analysis of the effect of air pollution by carbon disulfide]. / Expositionsanalyse zur Wirkung von Luftverunreinigungen für Schwefelkohlenstoff.

In the framework of an epidemiological cross sectional study on the medical effects of environmental carbon disulphide loads a specific exposure analysis has been developed concerning this harmful substance. The main point of this analysis is the determination of the individual exposure by personal sampling and biological monitoring, respectively, in addition to emission and in-door measurements. The non-metabolised and acid labile CS2 in urine is determined as the specific biological marker. For characterizing the additional exposure the drinking water, soil, and settlement structure were investigated. Since 1987 this expensive analysis is performed parallel to a specific medical examination programme.

[A program of medical examination of the effect of air pollution by carbon disulfide]. / Medizinisches Untersuchungsprogramm zur Wirkung von Luftverunreinigungen für Schwefelkohlenstoff.

For investigating the effect of emissions of the cellulose and rayon silk production on the health state of selected groups of the population as part of an epidemiological cross sectional study on 9-year old school children a medical examination programme with emphasis to the following 5 points--psychological examination, clinical-chemical investigations, lung function analysis, actual state, anamnestic inquiry--has been developed. The programme has been successfully tested in 660 specifically exposed and non-exposed children, respectively. Hitherto performed part evaluations of the mentioned 5 points confirm the correctness of the broadly constructed study.

[Development of a city planning hygiene analysis and its application in the framework of an environmental-epidemiological study]. / Entwicklung einer "Städtebauhygienischen Analyse" und ihre Anwendung im Rahmen einer umweltepidemiologischen Untersuchung.

A "town-planning hygienic analysis" is presented which has been developed within an environmental epidemiological study. This analysis contains 7 marks (maximum sound pressure level Lmax, equivalent pressure level Leq, housing conditions/sanitary, size of flat, brightness/day-light ratio, environment, building order) whose quality is scored into 3 categories (very good/good, sufficient, insufficient). The evaluation is performed by relating the frequency of the proportional quality as well as the score for the general quality, which is constructed by the mean of the proportional qualities. First results are discussed with a comparative study on 297 flats.

[Evaluating guidelines for "selection and training of staff for odor analysis"--a 7-year longitudinal study]. / Uberprüfung der Richtlinie zur "Auswahl und Schulung von Personen für die Geruchsanalyse"--eine 7 Jahres-Längsschnittuntersuchung.

During a 7 years longitudinal study on a representative group the guideline "selection and schooling of personal for odour analysis" was reexamined. It could be shown that the selection in two steps is well suited to recognize anosmia and hyposmia, respectively and that normal osmia is well to be characterized by smell scores of 30-42. A statistical significant training effect could be shown with the qualitative test for training of the odour memory as well as the articulation in describing of smell impressions. The result of the rank order test demonstrate the practicable subdivision of the odour intensity into 5 degrees.

[Teratogen-modified palatogenesis in the Uje: WIST rat. 4. Scanning electron microscopic morphology of the epithelium during the formation of the secondary palate]. / Die teratogen beeinflusste Palatogenese bei der Uje: WIST-Ratte. 4. Mitteilung: Rasterelektronemikroskopische Morphologie des Epithels während der Bildung des sekundären Gaumens.

In normal morphogenesis age-dependent and regional differences in the surface structure of epithelial cells appear, whereas in teratogenesis no qualitative changes can be observed. During the horizontal adjustment of the palatal shelves the pronounced marking of the cellular borders with microvilli has disappeared. The reduced number of microvilli in the subsequent phase of adhesion might affect the cell-cell identification and thus disturb the further cell differentiation.