Micro-fluorescence lifetime and spectral imaging of ytterbium doped laser materials.

We present the application of a confocal fluorescence microscope to the analysis of Yb-doped solid-state laser materials, with examples of Yb-doped crystals, photonic crystal fibers and fiber preforms made with different manufacturing processes. Beside the fluorescence lifetime image itself, a microscopic spectral fluorescence emission analysis is presented and spatially resolved emission cross sections are obtained. Doping concentration and its distributions and other laser optical parameters are measured, which help to analyze manufacturing steps. Further properties like photodarkening and saturation are addressed.

[Possibilities of wrist arthroscopy. Even for patients with arthritis?]. / Möglichkeiten der Handgelenkarthroskopie. Auch für den Rheumapatienten?

The wrist is the most commonly involved joint in rheumatoid arthritis (RA). Because it becomes involved early in the disease course and because this involvement rapidly progresses, early and adequate treatment is necessary to prevent disease progression. Arthroscopic synovectomy is recommended for pain relief and functional recovery in early-stage RA and is also helpful in advanced RA. The technique is complicated, and the learning curve is steep, but its efficiency is high. Arthroscopic synovectomy of the wrist reduces pain and improves function in most cases. It also improves motion, which is an advantage to the open procedure, and patient acceptance of this procedure is high. Nevertheless, arthroscopic synovectomy may delay the need for complex surgery, such as wrist arthrodesis or total wrist arthroplasty in selected cases.

[The arthroscopic "wafer procedure" in degenerative disc ulnocarpal tears with ulnocarpal compression syndrome. Techniques, indications, results]. / Die arthroskopische "wafer procedure" bei degenerativen Discus-ulnocarpalis-Rissen mit ulnokarpalem Kompressionssyndrom. Methode, Indikation, Ergebnisse.

The wafer procedure is a technique involving the partial resection of the distal ulna for the treatment of patients with symptomatic tears of the TFCC, for ulnar abutment syndrome or both. The TFCC-tears are classified as Palmer type 2. The wafer procedure can be performed as an open procedure or arthroscopically. It is an alternative to a shortening osteotomy of the ulna and decompresses the ulnocarpal joint. In ten cases with long-term follow-up, the preferability of the arthroscopic method is demonstrated: a minimally invasive technique, optimal assessment of all lesions, maximum protection of all uninjured structures in comparison to the open method, single stage procedure, and low complication rate. The long-term results are predominantly positive, so that the arthroscopic wafer procedure should be performed more often than it is today.

[Arthroscopic image of wrist joint instability]. / Das arthroskopische Erscheinungsbild ulnarer Handgelenkinstabilitäten.

In a consecutive series of 107 arthroscopies, 88 wrists showed a ligamentous lesion on the ulnar side. The TFCC was affected in 90% (79 patients), the triquetrum in 53% (47 patients), the ulnocarpal ligaments in 22% (19 patients) and the hamate in 17% (15 patients). The number of ligament injuries averaged three per wrist. Surprisingly, there were multiple lacerations noted in 22% of the TFCC and these occurred in characteristic combinations.

[The importance of arthroscopy for hand surgery today]. / Der Stellenwert der Arthroskopie für die Handchirurgie heute.

Wrist arthroscopy is a new approach to the diagnosis and treatment of chronic wrist pain and pathology, that could not be achieved by conventional diagnostic instruments. The arthroscopy allows detailed assessment to articular surfaces, chronic synovitis, triangular fibro-cartilage tears, lesions of the intercarpal and palmar ligaments, and intraarticular fractures of the radius. The technique is very demanding and should be performed only by experienced surgeons. The dorsal portals are located with relation to the six extensor compartments. Because of the limited space of the wrist joint, an arthroscope with an outermost diameter of 2.5 mm or less is necessary with a high-sensitivity, light-weight microchip video-camera and special mini-instrument. With this equipment, surgery can be performed within the radio-carpal- and midcarpal joint. Only few in Germany are experienced in wrist arthroscopy; looking to the USA, this technique has already shown its great potential.

[Burn injury of the child's hand]. / Die Brandverletzung der kindlichen Hand.

The treatment of the burnt hand of a child requires careful consideration of both the physical and psychological aspects involved in this programme; measures such as physical therapy, which play an important part in the treatment of adults, are of less significance. Nevertheless, due to a very low incidence of complications eg. joint stiffness, the final results are very good. Generally the recommended approach to the treatment programme is to use the closed method (i. e. dressings), whereas in such cases care on a special unit employing the open method and a topical bactericidal agent is considered advisable. When the general condition of the child permits, the surgical treatment of a third degree burn should be carried out as early as possible, rather than waiting for spontaneous escharatomy and formation of granulation tissue. Immobilisation of a wound grafted with split-thickness skin should be obtained using KIRSCHNER wires or a hay-rake splint. An early date should also be set for secondary surgical procedures involving improvement of function. Depending upon the surgical findings, flaps or free grafts may be used. It is essential that flexor contractures in the region of the PIP joints be dealt with primarily, in order to prevent the secondary formation of button-hole deformities. During follow-up examinations, growth disorders of the phalanges may be seen. These may arise as sequel to arthrodesis, or trauma to epiphyses as a result of electrical current. On the other hand, disorders of growth may also be observed in purely thermal injuries -- these are mainly confined to growth in the length. Deviation from the central axis of the finger resulting from scar tissue contracture, was not observed among our group of patients.