[Traumatic lesions of the brachial plexus : Clinical symptoms, diagnostics and treatment]. / Traumatische Läsionen des Plexus brachialis : Klinische Symptome, Diagnostik und Therapie.

Brachial plexus lesions mostly occur in young patients as a result of high-speed accidents. They are often diagnosed and treated after a delay. This has been shown to worsen the prognosis of surgical reconstructions evidently. In 70-80% of traumatic lesions functional reinnervation can be achieved by various surgical procedures. An early sufficient diagnosis and the subsequent referral of the patient to an appropriate competence center for consultation and, if necessary, surgery are therefore essential.

A patient-controlled functional electrical stimulation system for arm weight relief.

A patient-driven control strategy for Functional Electrical Stimulation (FES), which amplifies volitionally-initiated shoulder abductions, is proposed to improve stroke patients' rehabilitation. Based on the measured abduction angle, a FES-induced muscle recruitment is generated that yields a pre-specified percentage of this angle - yielding arm weight relief. To guarantee the correct recruitment also under fatigue and uncertain muscle activation we employ feedback control of the recruitment level determined by filtering the FES-evoked electromyogram. Filter parameters are user-optimized to obtain a linear relation between filter output and angle with a good signal-to-noise ratio. The auto-tuned recruitment controller (RC) was tested on five healthy subjects and compared to direct stimulation (DS) while muscle fatigue progressively occurred. Results showed a more linear relation between recruitment level and angle than between non-controlled stimulation intensity and angle (R2=0.93 vs. R2=0.79, angular range of 54°). After 6 min of stimulation, abduction decreased by 42% ± 14 for DS and by 0% ± 12 for RC, showing an effective compensation of fatigue. RC yielded significant smaller errors than DS in generating desired angles (0.23% ± 5.9 vs. 14.6% ± 9.7). When FES-induced arm weight support was provided, a mean reduction of the volitional effort (determined by Electromyography) of 78% was achieved compared to angular tracking without FES. First experiments with one acute stroke patient are also reported.

Shear bond strength of different types of adhesive systems to dentin and enamel of deciduous teeth in vitro.

OBJECTIVES: The present study aimed to evaluate the suitability of self-etch adhesives for restoration of deciduous teeth compared with etch and rinse approaches. MATERIALS AND METHODS: One hundred twenty primary teeth were divided into five groups, each being assigned to an adhesive system. Self-etch adhesives XenoV (XV) and Clearfil S(3) Bond (CB), Prime&Bond NT with (PBE)/without preliminary etching (PBN), and Optibond FL (OBFL) as an etch and rinse system were included. Enamel and dentin specimens were prepared (n = 36/group), adhesives applied, and compomer cylinders polymerized. After 24-h storage in 37 °C distilled water and thermo-cycling (1440 cycles, 5/55 °C, 27 s), shear bond tests and fracture mode classification based on SEM investigation were performed. Statistical analysis involved ANOVA and Scheffé procedure with Bonferroni-Holm correction (p ≤ 0.005). RESULTS: High shear bond strengths to primary enamel were determined for PBE (mean [M] = 22.48 ± 7.7 MPa) > OBFL (M = 19.06 ± 5.62 MPa) > CB (M = 17.6 ± 6.55 MPa), and XV (M = 16.85 ± 5.38 MPa) and PBN (M = 8.26 ± 4.46 MPa) formed significantly less reliable enamel-resin interfaces (p ≤ 0.005). PBE generated the highest bond strength on primary dentin (M = 21.97 ± 8.02 MPa); significantly lower values were measured for XV (M = 13.44 ± 5.43 MPa) and OBFL (M = 12.92 ± 4.31 MPa) (p ≤ 0.005). CONCLUSIONS: Adhesives requiring preliminary etching ensure optimal bond strength to primary enamel. If separate etching is to be avoided, selected self-etch adhesives obtain acceptable shear bond values on primary enamel and dentin. CLINICAL RELEVANCE: The treatment of pediatric patients presents a great challenge in dental practice, and optimization of treatment processes is important.