Experiences with computer navigated total knee arthroplasty.

The successful outcome of total knee arthroplasty (TKA) is very much dependent on precise positioning of the components. Inaccuracy may result in complaints as well as in early mechanical failure. Between March 2003 and September 2005, 69 TKA procedures were performed by the computer navigated technique.

[Total knee arthroplasty in hemophilic arthropathy].

The case of a bilateral total knee arthroplasty in a hemophiliac patient is presented below. Postoperative blood loss, required factor substitution, complications after surgery were observed. Functional results were evaluated using the Hospital for Special Surgery Score.

Genetic variants of angiotensin converting enzyme and methylenetetrahydrofolate reductase may act in combination to increase migraine susceptibility.

Migraine, with and without aura (MA and MO), is a prevalent and complex neurovascular disorder that is likely to be influenced by multiple genes some of which may be capable of causing vascular changes leading to disease onset. This study was conducted to determine whether the ACE I/D gene variant is involved in migraine risk and whether this variant might act in combination with the previously implicated MTHFR C677T genetic variant in 270 migraine cases and 270 matched controls. Statistical analysis of the ACE I/D variant indicated no significant difference in allele or genotype frequencies (P > 0.

Correlations between mood scores, LH, adrenocortical steroids, and urine volumes in a patient with a history of postpartum depression and monthly psychotic episodes.

A simple semantic differential test was administered twice daily and urinary hormones measured as described previously . The subjects included the patient and two controls, one of whom experienced premenstrual physical, but not mental, discomfort. The test scores of the two controls, administered for five weeks, did not differ significantly from one another but greatly differed from those of the patient.

A controlled study of light therapy for bulimia nervosa.

Objective: Winter worsening of mood and eating symptoms, similar to that of seasonal affective disorder, has recently been reported in patients with bulimia nervosa. To assess the effectiveness of light therapy for treatment of bulimia nervosa, the authors conducted a study of light therapy during winter comparing an active (bright white light) condition to a control (dim red light) condition in bulimic patients who were not selected for a seasonal pattern of bulimia.

Method: After a 2-week baseline assessment, 17 female patients with a DSM-III-R diagnosis of bulimia nervosa underwent early morning light treatment with 2 weeks of bright white light exposure (10,000 lux for 30 min/day) and 2 weeks of dim red light exposure (500 lux for 30 min/day) in a counterbalanced, crossover design.

[Reoperation of hip endoprostheses].

Experiences gained in 106 reoperations of 88 patients following 1968 total and 18 Wagner arthroplasties, performed in the Department of the authors between 30. 05. 1969.

Experience with cementless Protetim 'M' total hip endoprosthesis (A preliminary report).

A cementless Protetim 'M' endoprosthesis is used as an alternative to the cemented endoprosthesis. In the period from May 1992 to August 1992, 17 Protetim 'M' endoprostheses were implanted in 17 hips in 17 patients in our department. Of these 16 were without complaints after an average follow-up of 6.

Fluoxetine treatment of obsessive-compulsive disorder.

Two patients suffering from severe obsessive-compulsive disorder which had proven refractory to clomipramine and/or phenelzine treatment were successfully treated with fluoxetine, a new drug with a strong serotonin uptake inhibiting action. Outcome of treatment was measured on psychometric tests including the Leyton Obsessive Inventory, Hopkins Symptom Checklist-90, Beck Depression Inventory, and daily self-reports of the duration and degree of discomfort of their most severe obsessions. The delay in responding to fluoxetine, the continuing improvement even after one year on the drug, and the prompt relapse with abrupt withdrawal of treatment were noted.

Seasonal mood symptoms in bulimia nervosa and seasonal affective disorder.

Mood and appetite disturbances are commonly found in bulimia nervosa and seasonal affective disorder (SAD). To investigate seasonality of mood symptoms, we administered the Seasonal Pattern Assessment Questionnaire (SPAQ) to 38 consecutive bulimic patients, 38 age- and sex-matched SAD patients, and 25 age- and sex-matched normal controls. The SPAQ is a reliable, retrospective, self-rated questionnaire that assesses seasonal changes in mood, sleep, weight, and social activity.

The structure of phobias in panic disorder.

Fear and avoidance of individual phobic situations were measured in 1168 patients with panic disorder suffering current attacks. Correlation and principal-components analyses give components of agoraphobia, illness phobia, and social phobia in panic disorder. Agoraphobia does not stand out so clearly as illness phobia and social phobia as a separate factor; 'fear of open spaces' shows some separation from other agoraphobic situations.

Fluoxetine in panic disorder.

This paper presents the cases of two patients who suffered from panic disorder with agoraphobia and depression. One had been refractory to alprazolam and tricyclics and to behaviour therapy; she had responded to phenelzine, but due to a weight gain of 50 lbs, had discontinued treatment and she relapsed. The second patient, who also suffered from post-traumatic stress disorder, did not respond to alprazolam, imipramine or to phenelzine, but gained weight (33 lbs) on phenelzine.

A case of obsessive-compulsive disorder related to AIDS: psychopharmacologic treatment.

It is well known that delusions, obsessions and phobic reactions may centre on items which are of current topical interest. We report a case of obsessive-compulsive disorder manifested primarily by intrusive thoughts about AIDS. The patient eventually responded to an unusual combination of medications.

An unusual case of pica.

This paper presents the case of a 29 year old woman who compulsively ate rocks and pebbles, a habit developed in childhood. Extensive psychometric testing did not demonstrate phobias, obsessions, tendency to increased anxiety, depression or anorexic or bulimic disorder. The development of pica is partially explained by a childhood eating disorder, obsessive personality traits, cultural factors and specific (personality induced) stresses.

The fluoxetine treatment of low-weight, chronic bulimia nervosa.

Ten low-weight (mean, 87.8% of ideal), chronic bulimic patients, seven of whom were previously unsuccessfully treated with antidepressant drugs, received fluoxetine 80 mg/day for 3 months. Endpoint analysis showed a significant decrease in bulimic episodes (p = 0.

Successful fluvoxamine treatment of a case of refractory obsessive-compulsive disorder.

Fluvoxamine, a potent and selective serotonin uptake inhibitor, effectively reduced compulsive handwashing and other rituals in a patient previously refractory to behaviour therapy, clomipramine, MAO inhibitors and other pharmacotherapy. Treatment effect was delayed but broadly patholytic, reducing anxiety and depression scores as well as ratings of obsessiveness.

A treatment program for functional paraplegia/Munchausen syndrome.

Two patients, referred following lengthy, extensive and frequent medical evaluations, were diagnosed as suffering from chronic factitious disorder with physical symptoms (DSM III). A treatment plan to eliminate the positive reinforcements apparently operating in the hospital and home environment, while preventing "loss of face" of the patient, was formulated and successfully carried out. Two detailed case histories to provide evidence for the diagnosis, the "faradic massage" treatment, patient response, and follow-up are documented.

Trazodone treatment of bulimia nervosa.

Thirteen consecutive referrals of bulimic patients who met DSM-III criteria for bulimia were treated in an open-label, flexible-dose study with trazodone. Three of the 13 dropped out before the fourth week of treatment, the minimum duration of treatment for evaluable subjects, and hence were not included in the analyses. For the 10 evaluable patients, the mean duration of treatment was 6.

[Experience with total hip prosthesis].

Authors report on their material of total hip endoprosthesis, performed 30 May 1969--31 August 1988 on the Department of Orthopaedics of the Semmelweis University of Medical Science. In this period 1480 operations were made. The formerly and recently used operative technique and the types of the prostheses are described.

Delineating social phobia.

The natural history--including psychiatric symptoms, precipitating factors, onset and course of illness, and personality characteristics--of 47 social phobics, 80 agoraphobics, and 72 simple phobics was examined. The social phobia group differed from the agoraphobia group by having a lower mean age, fewer females and married members, and a higher educational and occupational status. They were less fearful generally, less obsessive, and less likely to follow a fluctuating or phasic course.