Neuropsychological impairment in auto-immune disease.

Estimations of the prevalence of central nervous system involvement in patients with systemic lupus erythematosus (SLE) vary from 25 to 75%. In order to assess possible deficits in memory, attention, and/or reaction time, a battery of neuropsychological tests was administered to 15 patients with SLE and to two matched groups of control subjects; eight patients on corticosteroids and 15 healthy controls. The test battery included the Multiple Choice Word Fluency Test (MWT-B), Benton Visual Memory Scale, Syndrome Short Test (SKT; attention and memory), Attention and Concentration Test (d2), Wechsler Adult Intelligence Scale (WAIS) subtests for Comprehension, Digit Span, Block Design, a Computer Controlled Reaction Time task (CCRT), and a Learning and Memory Test (LGT-3). Results revealed a statistically significant short-term memory deficit (for all six relevant subtests used) and a marked delayed simple reaction time in SLE patients as compared with scores in healthy subjects. An attention deficit as well as the expected difference between the estimated premorbid and actual level of intelligence could not be demonstrated. With three exceptions (SKT-9 figural recognition, Benton Visual Memory, and LGT-3 figural recognition), patients treated with corticosteroids did not differ from healthy controls. They also did not differ from SLE patients in any of the parameters tested. It therefore appears that the demonstrated deficit in short-term memory and reaction time in SLE patients may not only be due to the neuropsychiatric manifestation of SLE but possibly also result from medication side-effects.

[Experiences with the Mittelmeier ceramic screw acetabulum in exchange operations for loose endoprostheses]. / Erfahrungen mit der Keramikschraubpfanne nach Mittelmeier bei Austauschoperationen gelockerter Endoprothesen.

This is a report about our experience with the replacement of loosened acetabular endosprotheses by the self locking ceramic Endoprosthesis Mittelmeier. That's an analysis of 60 patients concerning age, sex incidence, indications, primary implant type and long term findings. The clinical findings are illustrated according to the schedule of Merle d' Aubigné. The critical evaluation shows, that the self locking ceramic cup allows the additional implantation of homologous or autologous bone chips and grafts avoiding further allogenous implants.

Cefoperazone in the treatment of osteomyelitis.

Twenty-six patients (aged 20 to 78 years) with osteomyelitis of the lower extremity (22) and infections of the spine (4) were treated with the broad-spectrum antibiotic cefoperazone. Staphylococcus aureus was the major pathogen isolated. A complete cure was obtained in 18 (69.2%) of the 26 patients treated; an additional four patients (15.4%) demonstrated a satisfactory clinical result without complete eradication of all baseline pathogens.

[Experiences and results of replacement of the fibulo-talar ligaments in relatively old ankle-joint traumas (author's transl)]. / Erfahrungen und Ergebnisse der Watson-Jones-Plastik bei älteren Aussenbandverletzungen am oberen Sprunggelenk.

This is a report about the experiences and results of replacement of the fibulo-talar-ligaments by using the peronaeus brevis tendon. The typical anatomic and biomechanic findings are shown as well as the typical traumatisms. The importance of a good primary diagnosis and a good primary treatment is shown. In case of persisting of older instabilities we have the possibility of operative reconstruction. This is a report about 18 patients operated by the technique of Watson-Jones by using the peronaeus brevis tendon. Our results can demonstrate the big values of this technique for operative treatment of chronical fibulo-talar instabilities.

[Preventing postoperative edema with Irritren. Results of a double-blind study]. / Prophylaxe postoperativer Schwellungen mit Irritren. Ergebnisse einer Dopelblind-Studie.

In order to inhibit postoperative swelling we compared the new antiphlogistic Lonazolac-Ca with Diclofenac-Na in 20 patients each undergoing knee joint surgery. Leg volume increased in a smaller extent in the Lonazolac-Ca patients and pretreatment values were achieved on the 8th day. On the first day of physiotherapy (4th postoperative day) pain on motion was significantly less marked than before surgery in the Lonazolac-Ca group. No side-effects were observed in the Lonazolac-Ca group. One patient on Diclofenac-Na had to discontinue treatment on the 2nd day because of gastric disturbance and itching. Though both treatments showed good efficiency, Lonazolac-Ca was slightly superior.

[Therapy of degenerative joint diseases of a rheumatic nature. Effectiveness of naproxen at a daily dosage of 500 mg]. / Therapie degenerativer Gelenkerkrankungen des rheumatischen Formenkreises. Zur Wirksamkeit von Naproxen bei einmal täglicher Dosierung von 500 mg.

40 patients with degenerative joint diseases were treated with a new application form of naproxen (Proxen 500 film-coated tablets). The patients received one tablet daily in the evening for a period of 4 weeks. The therapeutic efficacy was demonstrated clinically on swelling of the joints, reduction of mobility, pressure pain, muscular stiffness and by improvement of pain symptoms: pain during day and night, pain at rest, movement pain. During therapy 75% of the cases showed marked improvement of the subjective and objective symptoms. The once daily application in the evening did not only influence favourable nocturnal and rest pain, but also reduced diurnal and movement pain significantly. In accordance with these findings 23 hours after application in the evening nearly constant serum levels of naproxen were found for the whole duration of treatment. The fast release of the active substance from the film-coated tablets leads to a rapid onset of the analgesic activity.

[Spinal traction syndrome]. / Das Spinal-Traction-Syndrome.

The causes of Spinal-Traction-Syndrome are discussed in a case of marked Spinal-Traction-Syndrome, that appeared after correction of a thoracal scoliosis, instrumented according to Harrington. On account of our case we tend to support the opinion, that the cause for the Spinal-Traction-Syndrome is to be seen rather in the mechanical obstruction of the flexura duodeno-jejunalis than in the overstretching of vagus nerve.

[A report on the syndroma of narrow spinal canal at congenital chondrodystrophy (author's transl)]. / Ein Beitrag zum Syndrom des engen Spinalkanals beim chondrodystrophen Zwergwuchs.

It is reported on a case of congenital chondrodystrophy associated with a narrow spinal canal. The difficulties in diagnosis are pointed out and electromyography is marked to enlarge the diagnostic possibilities in such patients. In cases with clinical signs of spinal--or nerve nerve root compression, complete laminectomy is indicated.

[The radialis compression syndroma and the epicondylopathia radialis as differential diagnosis. Electromyographic diagnostic and findings (author's transl)]. / Das Supinator-Tunnel-Syndrom als Differentialdiagnose zur Epicondylitis radialis. Elektromyographische Diagnostik und Verlaufskontrolle.

This report will show the necessarity of the correct differential diagnostic clearing between the so called Epicondylopathia radialis and radialis compression syndroma. After anatomical introductions it's reported about technics of operative treatment. The most exact diagnosis is given by electromyographic tests of the extensor muscles. A good postoperative control of the neurolysis is possible by the electromyographic test.

[Pathology of paratenonitis achilleae in Athletes (author's transl)]. / Pathologie der Paratenonitis achillaea bei Hochleistungssportlern. II

This is a report about the histopathological findings after excision of the inflammably overhead paratenon at top sportsmen, which were operated of cause of a paratenonitis. The good clinical results are written and the histological findings are described and discussed. The development of the paratenonitis is decleared. Pathological alterations of the paratenon at the tendon itself are difficulty to merk off. At the sportsmen the etiology of the disease is often a mechanical overloading of the tissue.

[Operative treatment of paratenonitis achilleae in athletes (author's transl)]. / Operative Behandlung der Paratenonitis achillaea bei Hochleistungssportlern.I.

This is a report about indications, technics of operation, treatment after the operations and the results of the paratenonitis at the Achilles-tendon. Our 21 patients were top-sportsmen and the treatment conservative had no succes. All patients were able to continue their sportive activity after the excision of the paratenon.