The effect of computer navigation on blood loss and transfusion rate in TKA.

The blood loss that accompanies total knee arthroplasty (TKA) can be substantial. Many patients need perioperative blood transfusions. To avoid anemia and transfusion-related complications, the amount of blood loss and need for blood transfusions must be reduced.

How much tibial resection is required in total knee arthroplasty?

The purpose of our study was to calculate the optimal tibial resection depth in total knee arthroplasty. The data from 464 navigated total knee arthroplasties were analysed. An implant with a minimum insert thickness of 8 mm was used.

[Spinal surgery in the elderly: does age have an influence on the complication rate?].

In accordance with the demographic trend, the number of elderly patients with spinal diseases which require surgery will increase continuously. Up to now, age has often been regarded as a contraindication for an elective operation. However, a review of the existing literature, the results of the European spine register "Spine Tango" and our own results show that the rate of complications after minimally invasive spinal surgery is as low in the elderly as it is in the younger population.

Continuous monitoring of post mortem temperature changes in the human brain.

Recent developments in neurochemistry research on the post mortem human brain require a detailed understanding of the post mortem changes in the human brain, including the correlation between time related temperature changes and alterations in biochemical parameters. As an initial step towards our deeper insight into the intricate relationships between post mortem time, temperature and neurochemical processes, in the present study we set out to monitor continuously temperature changes in the post mortem human brain in eight cadavers for a period of up to 24 h after death under 'standard' clinical conditions at a neurosurgery clinic. A main objective of the study was to find a simple and reliable mathematical formula, requiring only time and an easily obtainable body temperature measurement parameter, with the help of which the superficial and deep brain temperatures can be obtained without invasive interactions.

Quantitative determination of hyaluronan content in cerebral aneurysms by digital densitometry.

Object: Hyaluronan (HA) is a highly hydrated macromolecule; it is one of the essential components of the extracellular matrix (ECM) of the arteries and plays an important role in maintaining the biomechanical features of blood vessels. Although the potential contribution of HA in aneurysms of different vessels has been studied intensively, no data are available about the alteration of the HA content in the extracellular matrix of intracranial aneurysms. The aim of the study was to determine the hyaluronan content in the wall of human cerebral arteries.

Spinal extradural arachnoid cyst causing cord compression in a 15-year-old girl: a case report.

The authors describe the case of a fifteen-year-old girl with progressive paraparesis of the lower limbs that was caused by an intraspinal extradural dorsal arachnoid cyst at the level of Th 3-6. Diagnosis was established with MRI and MRI myelography. The latter revealed the CSF-like content of the cyst.

Cefazolin prophylaxis in neurosurgery monitored by capillary electrophoresis.

Prophylactic use of antibiotics to prevent postoperative infections is a routine method in neurosurgery. Little is known about the period of effectiveness of antibiotics applied only for the purposes of operation. The actual concentration of cefazolin was determined in the serum, in the contents of wound drains, and in the cerebrospinal fluid in a 24-hour postoperative period after the administration of 1 g of cefazolin just prior to skin incision in 8 patients undergoing lumbar discectomy and 11 patients undergoing craniectomy.

Epidural involvement in Hodgkin's disease.

Epidural involvement is analyzed retrospectively in 512 patients with primary treatment and follow up for Hodgkin's disease (HD) between 1970 and 1999. In one case (0.2%) epidural manifestation was the first symptom and in six cases (1.

Assessment of cerebrovascular reserve capacity in asymptomatic and symptomatic hemodynamically significant carotid stenoses and occlusions.

Background: Cerebrovascular reactivity measurements are believed to be a helpful tool for selecting patients who are at higher risk for hemodynamic strokes. The aim of this study was to compare cerebral vasoreactivity among patients suffering from internal carotid artery stenosis of different severity (asymptomatic stenosis, asymptomatic occlusion, symptomatic stenosis, symptomatic occlusion).

Methods: Sixty-two patients with asymptomatic and symptomatic internal carotid artery stenoses and occlusions underwent transcranial Doppler-acetazolamide tests.

[The PET scan in neuro-oncology--indications, differential diagnosis and clinical application].

Results of 157 PET (positron emission tomography) studies in 102 patients with known or presumed intracranial (ic.) tumors are reviewed. In 106 studies [18F]-2-fluoro-2-deoxy-D-glucose (FDG) and in 51 cases [11C]-methionine (MET) was used as the PET tracer.

Examination of nasopharyngeal and tracheal somatosensory evoked potential recordings in dogs.

Objective: To investigate the value of nasopharyngeal and tracheal recordings of somatosensory evoked potentials (SSEP) in anesthetized dogs.

Animals: 10 healthy mixed-breed dogs (5 males and 5 females).

Procedure: Square-ware electrical stimuli (50 microseconds duration, 4Hz) were delivered through bipolar surface electrodes to the median nerve of the right forelimb with 7 to 12 mA constant current.

Anteposition of the internal carotid artery for surgical treatment of kinking.

Background: Kinking of the extracranial portion of the internal carotid artery (ICA) requires surgical reconstruction when it causes neurological symptoms. We suggest a simple surgical reconstruction without arteriotomy.

Method: Anteposition of the ICA ventral to the digastric muscle has been performed in three patients.

Multiple binding sites for melatonin on Kv1.3.

Melatonin is a small amino acid derivative hormone of the pineal gland. Melatonin quickly and reversibly blocked Kv1.3 channels, the predominant voltage-gated potassium channel in human T-lymphocytes, acting from the extracellular side.

Posterior interbody fusion using laminectomy bone and transpedicular screw fixation in the treatment of lumbar spondylolisthesis.

Background: Laminectomy bone is used widely in posterolateral lumbar fusion, but not interbody fusion. No prospective evaluation of interbody fusion using bone grafts from the posterior neural arch in spondylolisthesis has been found in the literature. We prospectively studied series of patients operated on for lumbar spondylolisthesis to evaluate clinical improvement and bony fusion.

Transtracheal electrical stimulation of the spinal cord for intraoperative monitoring of the motor pathway.

Because of the suppressant effects of anesthetic drugs and muscle relaxants on motor responses elicited by either magnetic or electrical transcranial stimulation, intraoperative monitoring of the motor system, and especially monitoring of lower limb function, presents many difficulties. The upper part of the spinal cord was stimulated in 14 anesthetized and relaxed dogs with a cathode attached to the intratracheal tube and an anode fixed above the upper cervical spinous processes. Action potentials evoked by single and serial stimuli were recorded from the exposed right femoral nerve and quadriceps muscle Averaging was necessary for serial stimulations.

Somatosensory and motor evoked potentials in patients with tumours in the spinal canal.

Motor and sensory evoked potentials were recorded in 27 patients with expanding spinal tumour. The patients were divided into 2 groups: I. tumours at the level of the spinal cord and II.

Motor and somatosensory conduction time between the cortex and the Erb point in patients suffering from cervical spinal stenosis and tumour.

Motor and sensory conduction time between the cortex and the Erb point were examined in patients with cervical cord compression. Patients were divided into two groups: the compression was caused either by cervical extramedullary tumour (9 cases), or by cervical spondylosis or herniated disc (16 cases). In response to median nerve stimulation, pathological somatosensory evoked potentials were recorded in 66% of the patients suffering from tumour and in 60% of the patients suffering from spondylosis.

Intraoperative monitoring of the motor pathway using transtracheal stimulation of the cervical spine in dogs.

Although SEP monitoring of the spinal cord has been a well established method recently, not an ultimate, perfectly developed technique for monitoring of the motor system is known so far, particularly, because of the disturbing effect of narcotic drugs and relaxants on the motor evoked potentials. In this study the upper part of the spinal cord was stimulated in 14 anesthetized and relaxed dogs with a cathode attached to the intratracheal tube and an anode fixed to the cervical spinous processes. Single and serial stimuli were applied.

Posterior lumbar interbody fusion (PLIF) using the bony elements of the dorsal spinal segment.

Many different types of surgical technics for treating unstable degenerative spondylolisthesis of the lumbar spine has been reported. The most important part of the different procedures is to achieve a solid bony fusion between the two vertebrae. Authors report a new simple method of posterior lumbar interbody fusion in spondylolisthesis.

Multimodal electrophysiological examinations in patients suffering from various tumors of the pineal region.

Multimodal electrophysiological examinations: blink-, glabella- and masseter-reflexes, as well as brain stem acoustic, somatosensory and visual evoked potentials were examined in thirteen patients with clear consciousness suffering from extra-axial, chronic, expanding processes in the tectal region. According to the data, the authors came to the conclusion that several modalities were often required to make a correct diagnosis or to the localization of the space occupying processes. Functional disturbances of the whole of the lower brain stem, but especially of the mesencephalon and of the lower pons were found in cases of expanding processes surrounding the tectum.

Fibrin deposition in primary and metastatic human brain tumours.

Extravascular, intratumoral fibrin deposition is frequently observed within and around neoplastic tissue and has been implicated in various aspects of tumour growth. This is the first report on the presence and distribution of fibrinogen/fibrin in primary (14 glioblastomas) and metastatic (nine samples of lung cancer origin) human brain tumours detected by immunofluorescent techniques. All tissue samples showed specific staining for fibrinogen/fibrin.