A Treatment Algorithm for Free Vascularized Bone Reconstruction in Rare Large Osseous Defects Involving the Wrist.

Large bone defects of the distal radius and/or carpus following tumor resection, trauma, or infection are extremely rare. There are few case reports and series in the literature on the reconstruction approaches required in such cases. Therefore, large studies cannot be used to guide the therapeutic decisions of reconstructive plastic and hand surgeons.

Antibiotics in patients with severe burn injury-A modifiable variable in hypernatremia etiology.

Introduction: Hypernatremia is a common problem among patients with severe burn injuries and seems to be associated with an unfavorable clinical outcome. The current study was designed to evaluate the impact of antibiotics with a high proportion of sodium on this phenomenon.

Methods: All admissions to our burn center from 01/2017 till 06/2023 were retrospectively screened.

Severe Burn Injuries - The Day the Sodium Starts Rising.

Background/aim: The current study was designed to evaluate the etiologies of hypernatremic episodes in patients with severe burn injuries in comparison to critically ill non-burn patients.

Patients And Methods: The retrospective data acquisition was limited to the first 14 days and to patients with at least 20% total body surface area (TBSA) 2 degree burn injuries or more than 10% TBSA when including areas of 3 degree burn injuries. The results were compared to the results of a previously published study that analyzed the risk factors for hypernatremia in 390 non-burn intensive care unit patients.

Occurrence of discal and non-discal changes after sequestrectomy alone versus sequestrectomy and implantation of an anulus closure device.

Sequestrectomy alone represents a procedure for the treatment of lumbar disc herniation. For selected cases, an anulus closure device (ACD) can be implanted which may result in lower reoperation rates. However, comparative magnetic resonance imaging (MRI) changes and their clinical relevance of both procedures are unclear and have not been reported so far.

The neglected need for psychological intervention in patients suffering from incidentally discovered intracranial aneurysms.

Objectives: Previous studies demonstrated a conspicuously elevated rate of psychiatric disorders in patients with incidental intracranial aneurysms. This study was designed to analyze the impact of this observation on the post-interventional rates of PTSD, depressions and anxiety disorders in this collective.

Methods: Physically unaffected iA patients with an unremarkable medical history were included in this two center study.

Sonographic examination of the median nerve in dialysis patients and after renal transplantation.

Objective: Patients with renal insufficiency are predisposed to develop CTS (carpal tunnel syndrome). In particular, long-term dialysis seems to contribute to changes in median nerve texture which lead to an increased risk for CTS. The current study was designed to evaluate if these structural changes can be detected by HRS (high-resolution sonography).

Impairment of Dynamic Pressure Autoregulation Precedes Clinical Deterioration after Aneurysmal Subarachnoid Hemorrhage.

Background: This study was designed to evaluate the potential of the dynamic autoregulation index (ARI) to serve as an early warning system for an imminent clinical deterioration after subarachnoid hemorrhage (SAH).

Methods: All patients received a baseline digital subtraction angiography and a computed tomography (CT) prior to treatment. The clinical status, the ARI, and the transcranial Doppler (TCD) values were evaluated daily until discharge from the intensive care unit (ICU).

The Preinterventional Psychiatric History as a Major Predictor for a Reduced Quality of Life After Treatment of Unruptured Intracranial Aneurysms.

Background: A significantly increased rate of positive preinterventional psychiatric histories in the unruptured aneurysm collective was demonstrated previously. The current study was designed to analyze the influence of the preinterventional psychiatric status on the outcome after treatment of unruptured intracranial aneurysms.

Methods: Patients treated due to meningioma World Health Organization °I and unruptured intracranial aneurysms in 2 German neurosurgical centers between 2007 and 2013 were screened for exclusion criteria including malignant/chronic diseases, recurrence of the tumor/aneurysm, and neurologic deficits among others.

The spontaneous arterial blood pressure rise after aneurysmal subarachnoid hemorrhage - a biphasic phenomenon.

Objectives: A spontaneous blood pressure (BP) rise is frequently observed after aneurysmal subarachnoid hemorrhage (aSAH). The current study was designed to characterize the time course of this BP rise and its relation to clinical and radiological parameters.

Methods: The diastolic (DBP), mean (MAP), and systolic (SBP) BP values were determined in 61 aSAH patients from day 0 to 9.

Dynamic Autoregulatory Response After Aneurysmal Subarachnoid Hemorrhage and Its Relation to Angiographic Vasospasm and Clinical Outcome.

Background: Impaired cerebral autoregulation (CA) is increasingly recognized to contribute to sequelae after aneurysmal subarachnoid hemorrhage (SAH). The current study characterizes the course of the dynamic autoregulation index (ARI) during the first 8 days after SAH and its coherence with angiographic vasospasm (VS) and clinical outcome.

Methods: Fifty-one patients with SAH were prospectively included within 48 h after the ictus.

Missing relationship of moyamoya and persistent primitive artery in Europeans. Another distinctive feature or artifact?

Purpose: Previous studies found higher incidence of persistent primitive arteries in Asian moyamoya (MM) patients than in the general population, which was thought to be a characteristic trait of the MM entity in general. We analyzed incidence of persistent primitive arteries and demographics of patients with European MM treated in one single center. First, we compared our large dataset to existing literature and second, we raised the question whether European MM demonstrates similar high prevalence of persistent primitive arteries as it was previously presented within Asian MM.

N-octanoyl dopamine treatment of endothelial cells induces the unfolded protein response and results in hypometabolism and tolerance to hypothermia.

Aim: N-acyl dopamines (NADD) are gaining attention in the field of inflammatory and neurological disorders. Due to their hydrophobicity, NADD may have access to the endoplasmic reticulum (ER). We therefore investigated if NADD induce the unfolded protein response (UPR) and if this in turn influences cell behaviour.

Imbalanced protein expression patterns of anabolic, catabolic, anti-catabolic and inflammatory cytokines in degenerative cervical disc cells: new indications for gene therapeutic treatments of cervical disc diseases.

Degenerative disc disease (DDD) of the cervical spine is common after middle age and can cause loss of disc height with painful nerve impingement, bone and joint inflammation. Despite the clinical importance of these problems, in current publications the pathology of cervical disc degeneration has been studied merely from a morphologic view point using magnetic resonance imaging (MRI), without addressing the issue of biological treatment approaches. So far a wide range of endogenously expressed bioactive factors in degenerative cervical disc cells has not yet been investigated, despite its importance for gene therapeutic approaches.

Smart trepanation system: preclinical analysis of safety, efficiency, and user satisfaction.

Background/objective: To reduce the risk of dural tears during craniotomies and the associated complications, we developed the Smart Trepanation System (STS) that provides an image- and sensor-based automatic control of the cutting depth of a manually guided soft tissue preserving saw. This article presents the results of an initial user-centered evaluation.

Methods: Interactive usability tests with six neurosurgeons were conducted.

A combinatorial relative mass value evaluation of endogenous bioactive proteins in three-dimensional cultured nucleus pulposus cells of herniated intervertebral discs: identification of potential target proteins for gene therapeutic approaches.

Painful degenerative disc diseases have been targeted by different biological treatment approaches. Nucleus pulposus (NP) cells play a central role in intervertebral disc (IVD) maintenance by orchestrating catabolic, anabolic and inflammatory factors that affect the extracellular matrix. IVD degeneration is associated with imbalances of these factors, resulting in a catabolic inflammatory metabolism.

Vagal stimulation in brain dead donor rats decreases chronic allograft nephropathy in recipients.

Background: Although it has been shown that a vagus nerve stimulation of brain dead (BD) donors leads to an improvement of renal function in recipients in an acute allograft rejection model, its influence on chronic allograft nephropathy is still unknown. In the present study, we assessed the influence of donor vagus nerve stimulation on survival, renal function and histology in a chronic allograft model.

Methods: Brain death was induced in Fisher rats, and electro-stimulation of the vagus nerve was applied in one group (BD + vagus) during the whole course of BD (6 h).

Surgical management of basilar artery laceration caused by transorbital penetrating injury: case report.

Transorbital penetrating injuries are rare and present with a heterogeneity of intracranial injury patterns that require individualized therapeutic procedures. In this report, we describe the case of a distal basilar artery laceration in a 16-month-old boy caused by accidental transorbital penetration with a pencil. Surgical removal of the pencil was performed, but hemostasis could only be achieved by clipping the impaired vessel.

UW is superior compared with HTK after prolonged preservation of renal grafts.

Background: In recent clinical studies, the efficacy of histidine-tryptophan-ketoglutarate (HTK) in kidney transplantation was questioned. This study compares the efficacy of University of Wisconsin (UW) and HTK solutions on transplantation outcome.

Materials And Methods: Rat kidneys were preserved for different periods of cold ischemia (CIT).

The additional detrimental effects of cold preservation on transplantation-associated injury in kidneys from living and brain-dead donor rats.

Background: Brain death and cold preservation are major alloantigen-independent risk factors for transplantation outcome. The present study was conducted to assess the influence of these factors on transplantation-associated injury independently or in combination.

Methods: Brain death was induced in F344 rats.