A serum-free medium formulation supporting growth of human umbilical cord vein endothelial cells in long-term cultivation.

A serum-free medium formulation - TUD-1 - was developed supporting growth of HUVEC in tissue culture. Special features of the basal medium formulation are highly elevated levels of glutamine and serine as well as the inclusion of N-acetylcysteine and phosphoascorbic acid. The cellular mitogenic needs are satisfied by bFGF, VEGF, EGF and liver growth factor. Further hormone supplementation consists of insulin and hydrocortisone. A protocoll for serum-free passage of HUVEC was established for serum-free long-term cultivation of freshly isolated HUVEC for up to 20 cumulative population doublings without significant differences in final cell density compared to controls cultivated with serum.

[Proper and improper tension band fixation exemplified by patellar fracture]. / Zuggurtungen-Richtiges und Falsches am Beispiel der Patellafraktur.

The tension band, performed with rigid cerclage wire, is known worldwide as a standard operation technique for the patella fracture as well as for all fractures gaping under strong muscular tensile forces. Eccentricity of power input and transformation of tension into pressure forces are its theoretical rationale. This is a contradiction to the knowledge of engineers. Its disadvantages are: tilting and rolling-out, steps and gaps in the cartilage surface and distraction. Rigid cerclage wire is not a tensile instrument. Corresponding to this, the results are only mediocre. Here we describe a static tension band principle, consisting of axial power input by 2 lateral cables. The very good and good X-ray and functional results amount to 78%, far exceeding the rate with the conventional wire tension band.

[From "bone suture" to modern osteosynthesis--a chronology]. / Von der "Knochennaht" zu zeitgenössischen Osteosynthesen--eine Chronologie.

The five extremely well-known principals of osteosyntheses have been developed since the mid 19th century. Anaesthesia and antisepsis as absolute conditions blossomed into the heyday of surgery. Wire was the earliest material for osteosyntheses, successfully applied for the first time in 1827 by Rodgers in New York, systematically by Lister in Glasgow since about 1870, and later used in form of various 'bone sutures' and cerclages. In 1963 Weber (St. Gallen) developed the excentric wire tension band which for the first time provided technical knowledge in the treatment of fractures. In 1978 Labitzke introduced cables instead of the rigid cerclage wire. His lateral cable tension band which compresses the entire fracture area by itself, clearly improves the functional results. 1843 after the wire came the external fixation clamp from Wutzer (Bonn), 1886 the plate osteosynthesis from Hansmann (Hamburg), 1909 the K-wire from Kirschner (Greifswald) and 1939 the intramedullary nail from Küntscher (Kiel). Time has changed and modernised all principals. At the moment intramedullary stabilizing systems are at the centre of intensive research.

Cloning and DNA sequence analysis of a polygalacturonase cDNA from Aspergillus niger RH5344.

A 1319 bp long cDNA encoding for a polygalacturonase (EC 3.2.1.15) from Aspergillus niger RH5344 comprises a single open reading frame of 1089 bp which includes the mature protein of 362 amino acids and an NH2-terminal signal peptide of 27 amino acids. The directly determined peptides of the mature polygalacturonase confirmed the sequence information deduced from the cDNA.

"Sleeve-rope closure" of the median sternotomy after open heart operations.

A new method of sternal osteosynthesis following median sternotomy using the "sleeve-rope" principle is introduced. This method has been successfully applied in 20 patients.

Indication for thoracotomy and chest wall stabilization.

In multiply injured patients with major blunt thoracic injuries, the continued high mortality is mainly caused by the additive effect of the unstable flail chest associated with pleural and lung injuries upon the pulmonary gas exchange disturbance caused by haemorrhagic shock. A more active approach with early thoracotomy and chest wall stabilization is recommended. Three groups of injuries provide the appropriate indication: 1. Penetrating injuries, ruptures of organs and great vessels, when associated with serial rib fractures, which should be stabilized 'on retreat'. 2. Anterior or lateral wall instability due to double serial rib fractures with concomitant pleural and lung injuries. 3. Flail chest injuries with severe respiratory insufficiency. In all cases the thoracotomy should be performed after resuscitation of the patient on the day of the accident or within 3 days. Screwless elastic self-clasping rib plates were used in 15 multiply injured patients and in 5 isolated thoracic cases with good results and a low complication rate. The mortality was reduced from 64 per cent to 36 per cent in the patients with multiple injuries.

[Biomechanic examination of rib plates (author's transl)]. / Zur Frage der biomechanischen Prüfung von Metallimplantaten für die Thoraxwandstabilisierung.

The aim of a rib osteosynthesis is entirely the physiological restoration of the chest wall compound. Elastic rib clamps are very suitable for this purpose; rigid plates hinder the breathing movement of the ribs and often work loose. An examination meant to evaluate the best form of osteosynthesis has to consider these aspects. Crush tests of rib osteosyntheses, however, are not representative for the respiratory physiology of a stabilized thorax.

[Early thoracotomy and chest wall stabilization with elastic rib clamps (author's transl)]. / Die Bedeutung der Thorakotomie and Brustwandstabilisierung mit Rippenklammern im Behandlungskonzept des Thoraxtraumas.

In patients with chest injuries, serial rib fractures and intrathoracic lacerations the indication for primary thoracotomy is usually limited to life-threatening organ ruptures. In our own experience with 18 patients primary thoracotomy offers the chance of immediate closure of lung lacerations, suture of pleural and pericardial tears, ligature of torn intercostal vessels and stabilization of the chest wall by elastic rib clamps "Essener Model". Postoperative respiration, freedom of pain, is restored immediately and therefore complications and duration of high-risk respirator treatment can be reduced.

[Indications for thoracotomy and rib stabilization in thoracic trauma in the aged]. / Indikation zur Thoracotomie und Rippenstabilisierung beim Thoraxtrauma im hohen Lebensalter.

In trauma patients with chest injuries, serial rib fractures and intrathoracic lacerations, the indication for primary thoracotomy is usually limited to life-threatening organ ruptures. In our own experience with 13 patients, primary thoracotomy offers the chance of immediate closure of lung lacerations, suture of pleural and pericardial tears, ligature of torn intercostal vessels, and stabilization of the chest wall by rib plating. Postoperative, respiration, free of pain, is restored immediately. Complications and duration of respirator treatment can be reduced. This will reduce the high lethality rates of chest injuries significantly.

[Concerning the double-side traumatic hip dislocation (author's transl)]. / Zur doppelseitigen traumatischen Hüftluxation.

The double-side posttraumatic dislocation of the hip of a 17 year old moped rider is in order to discuss our concept of treatment of hip-dislocation without fracture. The result of the 2-years check-up is reported.

[Stabilization of the thoracic wall (author's transl)]. / Operative Thoraxwandstabilisierung.

The improvement of mechanical respiration by surgical stabilization of the chest wall is an important measure to reduce disadvantages and complications of long time respiratory treatment. Indications are: (1) Chest wall instability with indication for emergency thoracotomy; (2) Respiratory insufficiency mainly caused by chest wall instability; (3) Respiratory insufficiency due to severe laceration of intrathoracical organs with additional chest wall instability as an obstacle for sufficient respirator treatment.