[Total hip arthroplasty with the cementless spiron femoral neck prosthesis]. / Hüftgelenkersatz mit der zementfreien Spiron-Schenkelhalsprothese.

OBJECTIVE: Cementless total hip arthroplasty with preservation of femoral neck and natural load transmission. Restoration of joint function and alleviation of pain. INDICATIONS: Osteoarthritis of the hip or femoral head necrosis in younger patients. CONTRAINDICATIONS: Patients biologically > 65 years. Destructed or discontinued femoral neck. Pathologic hip formation: short femoral neck, severe enhanced or reduced CCD angle. Body mass index (BMI) > 30 (relative contraindication). Manifest osteoporosis. Necessity of immediate full weight bearing. Heavy smoking (relative contraindication). Ongoing chemotherapy. SURGICAL TECHNIQUE: Anterolateral approach to the hip joint. Exposition of the femoral neck and resection of the femoral head at its lateral margin. Preparation of the acetabulum and insertion of a common acetabular component. Positioning of the center pin into the femoral neck. Face milling of the femoral neck butt. Preparation of the femoral neck with the Spiron drill bit. Insertion of the Spiron prosthesis. Trial reduction with a trial head. Substitution by the definitive head (cone 12/14 mm). Wound closure. POSTOPERATIVE MANAGEMENT: Low centred X-ray of the pelvis and cross table view of the hip joint. Physiotherapy and partial weight bearing for 6 weeks. Prevention of deep vein thrombosis until achievement of full weight bearing. RESULTS: A total of 28 Spiron prosthesis were implanted in 26 patients (15 men, 11 women, mean age 51 years [range 34-64 years], mean BMI 28 kg/m(2) [range 21-39 kg/m(2)]) from August 2009 to January 2012. Diagnoses: 13 cases of primary osteoarthritis, 8 cases of secondary osteoarthritis, 5 cases of femoral head necrosis, and 2 cases of posttraumatic osteoarthritis. The mean surgery length was 93 min (range 70-121 min), the mean hospital stay was 9 days (range 6-16 days). Blood transfusion was not necessary in any of the cases. There were no immediate complications such as deep vein thrombosis, surgery requiring secondary bleeding, wound infection, nerve palsy, or dislocation of the hip. Postoperative radiologic examinations showed an average leg lengthening of 3 mm (range -10-19 mm). No varus deviation of the prosthesis was observed. The Harris Hip Score improved from 55.4 points (range 33.5-76.9 points) preoperative to 90.5 points (range 75.7-99.9 points) 3 months postoperative. In 1 case with aseptic loosening, replacement surgery was performed without complications.

[Unusual chordoma of the neck region simulating salivary gland pleomorphic adenoma]. / Ungewöhnliches, ein pleomorphes Speicheldrüsenadenom imitierendes Chordom der Halsregion.

We report a 34-year-old woman with a cervical chordoma consisting of an intraspinal and extraspinal portion. The extraspinal component of the tumor invaded the deeper structures of the left side of the neck, and was subjected to repeated partial removal. It was misinterpreted as pleomorphic adenoma of salivary gland origin, whereas the intraspinal portion was a neurilemmoma with unusual mucous degeneration.

[A case of stromatosis uteri]. / Ein Fall von Stromatosis uteri.

A report given about a case of stromatosis uteri. The age of the patient was 42 years. This illness can be interpreted as a favourable form of sarcoma uteri. An intensive follow up is necessary following operative therapy.

[Polyarteritis nodosa under the clinical picture of terminal kidney insufficiency]. / Panarteriitis nodosa unter dem klinischen Bild der terminalen Niereninsuffizienz.

In a 24-year-old patient the diagnosis panarteritis nodosa intra vitam was made. A terminal renal insufficiency was the dominating symptom. In addition to this besides fever in the patient were clinical symptoms on the side of the lung, the musculature and the skin. The diagnosis was confirmed by means of skin-muscle-biopsy from the clinically affected area. As was shown by biopsy in the patient who died after a stay in hospital of 9 days, the case in question was a multiple affection of the organs by panarteritis. A success in therapy could not be achieved. In the discussion clinic and diagnosis of this relatively rare disease are briefly explained.

[The frequency of cellular infiltration in fetal membranes and the umbilical cord and its dependence on the time of membrane rupture, transmission and EPH-gestosis]. / Häufigkeit der zelligen Infiltration in Eihäuten und Nabelschnur sowie deren Abhängigkeit vom Zeitpunkt des Blasensprungs, von der Ubertragung und EPH-Gestose

The determination of the frequency of the histological severity of cellular, predominantly leukocytic infiltration in the fetal membranes and umbilical cord and its dependence upon the time of rupture of the membranes, the transmission, and the EPH gestosis yielded the following results: (1) Cellular infiltration of the decidua, the severity of which ranged from low to high, was observed in almost 90 percent of the placentae included in this investigation, with infiltration being not detected in only about 10 percent. (2) There was observed a continuous decrease in the frequency of low- and high-severity infiltration in the fetal membrane layers toward the choriodecidual space, so that high-severity infiltration of the amnion could be detected in about 3 percent only. (3) The percentages of infiltrates detected were roughly 13 percent in the umbilical vein wall and only 8 percent in the umbilical arterial walls. (4) Cellular infiltration of the umbilical vein may be observed significantly more frequently in those cases in which the time from the rupture of the membranes to the delivery of placenta is longer than three hours than in cases where this time is shorter than three hours. (5) In the case of transmission the frequency of cellular infiltration of the amnion and umbilical vein wall is significantly higher than in the cases of normal gestations. (6) High-severity forms of cellular infiltration of the umbilical vein and arteries are significantly more frequent in the case of EPH gestosis than low-severity forms. (7) The differences in frequency of cellular infiltration in fetal membrane layers and umbilical vessel walls not mentioned under (4) through (6) above are not significant for different times between the rupture of the membranes and the delivery of placenta, transmission, and EPH gestosis. (8) Hypoxidosis and chemotaxis due to acidification of the amniotic fluid rather than bacterial infection are considered to be the causes of cellular infiltration in the majority of cases of increases in time between the rupture of the membranes and the delivery of placenta, transmission, and EPH gestosis.

[Relations hip between placental weight and age, family characteristics, parity and activity of the mother as well as the weight or maturity and sex of the newborn infant]?1?H.

An investigation of the correlation of the placental weights of 500 unselected live-born babies delivered after a gestation period of 33 weeks at the minimum and 42 weeks at the maximum, respectively, with age, family status parity, and mother's occupation, as well as with the weight, maturity, and sex of the neonates yielded the following results: 1. Between primiparae, secundiparae, and multiparae, working and housewife mothers, workers, farmerettes, women doing other jobs, and academically trained women, eutrophic mature and hypertrophic mature neonates, and newly born male and female babies there was observed a roughly similar frequency of the generally accepted "normal weight of placenta" of 400 g to 600 g and no significance of minor differences in frequency, respectively. 2. The high incidence of mothers aged 20 and less in the "normal placental weight group" of 400 g to 600 g compared to 21- to 30-year-old and 31- to 35-year-old mothers was not found to be significant. 3. The high incidence of unmarried mothers in the "normal placental weight group" of 400 g to 600 g compared to married mothers is not significant, the higher incidence of premature labor in unmarried women being due possibly, not to the weight of placenta, but rather primiparity, age under 20, and social class. 4. The higher frequency in the placental weight group up to and including 400 g of married compared to unmarried mothers, primiparae compared to secundiparae, primiparae and secundiparae compared to multiparae, working mothers compared to housewife mothers, and workers and farmerettes compared to both women doing other types of jobs and academically trained women was not found to be significant.

[Large chorangioma]. / Grosses Chorangiom

The clinical picture with its fetomaternal complications and the pathological and anatomical condition of a chorioangioma connected with the placental tectorial membrance and measuring 5 cm by 10 cm by 2,5 cm are described. Data in the literature on chorioangiomata are compared with the case described in this paper and discussed in detail.