Pathological mutations reveal the key role of the cytosolic iRhom2 N-terminus for phosphorylation-independent 14-3-3 interaction and ADAM17 binding, stability, and activity.

The protease ADAM17 plays an important role in inflammation and cancer and is regulated by iRhom2. Mutations in the cytosolic N-terminus of human iRhom2 cause tylosis with oesophageal cancer (TOC). In mice, partial deletion of the N-terminus results in a curly hair phenotype (cub).

Mechanical activation of lung epithelial cells through the ion channel Piezo1 activates the metalloproteinases ADAM10 and ADAM17 and promotes growth factor and adhesion molecule release.

In the lung, pulmonary epithelial cells undergo mechanical stretching during ventilation. The associated cellular mechanoresponse is still poorly understood at the molecular level. Here, we demonstrate that activation of the mechanosensitive cation channel Piezo1 in a human epithelial cell line (H441) and in primary human lung epithelial cells induces the proteolytic activity of the metalloproteinases ADAM10 and ADAM17 at the plasma membrane.

A structural model of the iRhom-ADAM17 sheddase complex reveals functional insights into its trafficking and activity.

Several membrane-anchored signal mediators such as cytokines (e.g. TNFα) and growth factors are proteolytically shed from the cell surface by the metalloproteinase ADAM17, which, thus, has an essential role in inflammatory and developmental processes.

Exposure to incivility hinders clinical performance in a simulated operative crisis.

Background: Effective communication is critical for patient safety. One potential threat to communication in the operating room is incivility. Although examined in other industries, little has been done to examine how incivility impacts the ability to deliver safe care in a crisis.

One-lung ventilation for surgical repair of thoracic aortic aneurysm.

Advances in the surgical approach to thoracic aortic aneurysm repairs have led to the increasing use of one-lung ventilation. Today's practice of cardiothoracic and vascular anesthesia requires a clear understanding of the techniques available for lung separation and the technical skills necessary to employ them. In this article, we discuss and evaluate the options for one-lung ventilation in thoracic aortic aneurysm repair with regard to preoperative, intraoperative, and postoperative management.

An unexpected needlestick injury.

Needle stick injuries occur at a significant rate. According to the National Institute for Occupational Safety and Health, there are approximately 600,000 to 800,000 needlestick and other percutaneous injuries every year among healthcare workers. Not only do the needlestick injuries put workers at risk for blood borne pathogens, but they cause a significant psychological and emotional burden for those involved.

Missed steps in the preanesthetic set-up.

Background: Anesthesiologists accomplish many tasks rapidly during induction of an anesthetic. Key preparation for induction is needed to maximize patient safety. Given the intense environment of the operating room, preparatory steps may be missed either unintentionally or possibly even intentionally to save time.

Evaluation of postdischarge surveillance of surgical site infections after total hip and knee arthroplasty.

Background: Artificial joint replacement of hip (HPRO) and knee (KPRO) are 2 of about 20 categories of operative procedures of the surveillance of surgical site infection (SSI) as stated by nosocomial infections surveillance systems in the United States and in Germany. Periprosthetic SSI can manifest itself after a long period.

Methods: Seven hundred fifty-six orthopedic patients from 2 centers were evaluated after HPRO (n = 508) or KPRO (n = 248).

Results of humeral stump angulation osteotomy.

Between 1972 and 1989 angulation osteotomy was performed on 61 patients with long humeral stumps at the Orthopaedic Hospital of Heidelberg University. Marquardt's surgical technique was used to improve function in patients who had undergone above-elbow amputation and in children with a risk of terminal osseous overgrowth. Thirty-one patients with 43 angulation osteotomies were followed up.

Follow-up results 20 years after surgical treatment of habitual ventral shoulder luxation using the Eden-Lange technique.

After undergoing an operation according to the Eden-Lange technique, 56 patients with recurrent anterior shoulder luxation were re-examined clinically at an average follow-up period of 20 years. The mean age of the patients at the time of the operation was 24.9 years; the ratio of male to female patients was 2.

A computertomographic study on the congruence of the hip joint.

This study describes investigations into the appearance of intra-articular spaces of hip joints. In CT scans of cadaver hip joints in the supine position an increased intra-articular space was found dorsally, while in the prone position the same hip joint showed an increased intra-articular space ventrally. It is assumed generally that the gap between the bone ends seen on plane X-rays represents the cartilage, but this study indicates that there may in fact be a space between the cartilage surfaces in the unloaded joint.

Hip joint congruence: experimental studies.

Three-dimensional imaging of hip joint preparations was carried out by means of computed tomography (CT). On the assumption that the head of the femur and acetabulum are incongruent, a special experimental design was used to quantify the extent and direction of the gliding movement of the head and socket. A series of CT images in the supine and prone positions was made from hip preparations, and the cartilage was visualized by injecting a contrast medium.

[Wedge osteotomy of the tibial head using fractionated drilling. A complication-reducing surgical modification].

Two techniques of closed wedge osteotomy of the proximal tibia in 132 cases using external fixation device were compared retrospectively for neurological complication rate. While in group 1 (n = 89) wedge osteotomy was performed conventionally using an oscillating saw, in group 2 (n = 43) osteotomy was done with consecutive drill holes of increasing diameter followed by osteoclasis. Neurological complications in group 1 were found postoperatively 15.

[Cementless cup anchorage in hip endoprostheses. Comparative study of 3 cup systems with titanium surface].

A wealth of commercially available hip endoprotheses makes it difficult for the practitioner to choose the best implant for each individual case. In a multi-centre study, in which 22 hospitals took part, a cementless stem was used 1172 times and was combined with 3 different cementless cup components. The follow up period ranged from 1-8 years.

[Exchange of endoprosthesis using a proximal femur resection prosthesis].

Total hip arthroplasty (THA) with the use of a Mega prosthesis was performed on 24 patients with significant loss of bone stock in revision THA. A clinical and radiological examination was carried out according to the Enneking evaluation scheme on average 7 years after THA. Pain, active hip motion and strength of hip muscles, walking ability, and activities of daily living rated excellent or good and compared well with the results following conventional THA.

Macromorphological comparison of frozen sections concerning the problem of congruency of the hip joint.

We report on a comparative anatomical investigation of hip joints from animals which can walk on two legs or use their distal legs for jumping. The investigation supports the results of Bläsius [1] that the hip is not congruent. The cartilage of the load induction area is thicker.

[Clinical and radiological results with the spherical Mecring as acetabulum prosthesis in hip joint diseases].

The recent experiences which the university hospital in Heidelberg has made with the spherical Mecring must be valued positively. Clinical, radiological and subjective dates from 147 patients were worked up retrospectively. Indeed, the positive results must be considered as relative because of the short respectively medium-term period of control.

[CLS multicenter study--8-year results].

The principles of proximal fixation of cementless endoprostheses is established already. This theory was the subject of the present multi-center study of 22 clinics. Between 1984 and 1992 all 1830 patients with an uncemented CLS press-fit stem had a clinical and radiological follow-up examination and computer documentation.

[Changes in the sex life of female patients following intertrochanteric transposition osteotomy].

Female patients planned for intertrochanteric osteotomy have to be advised in postoperative sexual impairment, besides surgical risks. Our investigation shows that the sexual experience was impaired postoperatively. Release from pain has to be contrasted to postoperative sexual problems.