The infiltration of the AC joint performed by one specialist: ultrasound versus palpation a prospective randomized pilot study.

Introduction: The acromio-clavicular (AC) joint is very susceptible to degenerative processes that result in pain and functional impairment. One common modality of treatment has been local infiltration of the joint space. Although this procedure has produced notable positive results, needle misplacement occurs frequently.

Breech presentation: a retrospective analysis of 12-years' experience at a single center.

Objective: To investigate neonatal outcome after breech presentation in term pregnancies.

Study Design: Data from 1345 term breech deliveries over a 12-year study period were retrospectively reviewed. Neonatal morbidity and mortality were compared by route of delivery.

Failure of short-term psoralen and ultraviolet A light maintenance treatment to prevent early relapse in patients with chronic recurring plaque-type psoriasis.

Background: Photochemotherapy using psoralen and ultraviolet A light (PUVA) is a highly effective treatment option for patients with severe psoriasis. Maintenance treatment has been advocated to provide for sustained remission. However, only a few studies have been conducted to assess the efficacy of maintenance treatment and these have provided inconsistent results.

Moderate risk-adapted dose escalation with three-dimensional conformal radiotherapy of localized prostate cancer from 70 to 74 Gy. First report on 5-year morbidity and biochemical control from a prospective Austrian-German multicenter phase II trial.

Purpose: Evaluation of late side effects and biochemical control (bNED) 5 years after three-dimensional radiotherapy with moderate, risk-adapted dose escalation.

Patients And Methods: From 03/1999 to 07/2002, 486 patients have been registered in the prospective Austrian-German multicenter phase II trial (AUGE). 399 (82%) localized prostate cancer patients (T1-3 Nx/N0 M0) were evaluated.

Accidents and injuries in competitive Enduro motorcyclists: a prospective analysis.

The Erzberg Rodeo Motor Enduro race, was analyzed over three consecutive years to analyze the risk of sustaining an accident, to determine the kind and site of injured body regions and to correlate the incidence of accidents with the site on the race track suspiring that most accidents happen at the first- and the last-third. In this prospective, field study questionnaires were used recoding fallen riders. Demographic data, the third of the race track on which the accident happened and details of the accident itself like its mechanism were noted.

Angular stable fixation of proximal humeral fractures.

Background: Proximal humeral fractures requiring surgical stabilization remain a therapeutic challenge. High rates of treatment-related complications have been reported to be associated, particularly in elderly patients with unstable fracture types and diminished bone quality. In recent years, angular stable implants have been introduced to improve the patients' outcome.

Supra-aortic transposition for combined vascular and endovascular repair of aortic arch pathology.

Background: Supra-aortic transpositions in various extents followed by endovascular stent graft placement are now an established tool in the treatment of various pathologies affecting the aortic arch. Results remain to be determined.

Methods: From 1996 through 2007, 73 patients (median age, 71 years) presented with aortic arch pathology (atherosclerotic aneurysms, n = 42; type B dissections, n = 9; penetrating ulcers, n = 17; traumatic lesions, n = 2; aneurysms based on prior surgery for aortic coarctation, n = 3).

Primary uterine leiomyosarcoma and primary atypical meningioma diagnosed during pregnancy.

Objective: Uterine leiomyosarcoma during pregnancy is an extremely rare event. The incidence of meningioma during pregnancy is comparable with that in nonpregnant women of the same age group. We report a case of both--a primary uterine leiomyosarcoma and additionally an atypical meningioma of the brain both diagnosed during pregnancy.

Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta.

Background: The purpose of this study was to address a previously not described mechanism underlying intramural hematoma (IMH) of the entire thoracic aorta and to test the hypothesis whether endovascular stent graft placement in this particular mechanism could be beneficial.

Methods: Within a 5-year period, we treated 8 patients with IMH affecting the entire thoracic aorta. The presumed site of initial plaque rupture was chosen as target for endovascular stent graft placement.

Mechanical aortic valve prostheses in the small aortic root: Top Hat versus standard CarboMedics aortic valve.

Background: The purpose of this study was to evaluate outcome in patients with a small aortic root receiving either a standard CarboMedics mechanical aortic valve or a Top Hat CarboMedics valve (CarboMedics, Austin, TX), specifically designed for the small aortic root.

Methods: Between 1986 and 2006, 316 consecutive patients underwent 19- or 21-mm mechanical aortic valve replacement, receiving either a CarboMedics Top Hat bileaflet valve (n = 56; mean age, 66 +/- 14 years) or a standard CarboMedics aortic valve replacement (n = 260; mean age, 60 +/- 13 years) at our institution based on institutional indications for the choice of type of valve prostheses. Median follow-up time was 83.

Posterior capsulorhexis combined with optic buttonholing: an alternative to standard in-the-bag implantation of sharp-edged intraocular lenses? A critical analysis of 1000 consecutive cases.

Background: Current after-cataract prevention relies on optimizing the natural barrier effect of the optic rim against lens epithelial cell (LEC) migration. However, deficiencies in circumferential capsular bag closure caused by the intraocular lens (IOL) haptic or delayed secondary re-division of the fused capsules by Soemmering s ring formation lead to primary or secondary barrier failure. Consequently, surprisingly high posterior laser capsulotomy rates have been reported long-term, even with optimal capsular surgery and the most widespread hydrophobic acrylic IOLs, considered to be the most advanced.

Femoral shortening after surgical treatment of trochanteric fractures in nongeriatric patients.

Background: Femoral shortening is a well-known clinical finding after surgical treatment of per- and intertrochanteric fractures. Particularly, in geriatric patients with poor bone quality and unstable fracture types, secondary compression of these fractures often leads to length inequality of the lower limbs. In younger patients with good bone quality and mobilization with delayed weight bearing, limb length shortening is expected to be a rare complication.

Biomechanical analysis of fracture healing in guinea-pigs.

To validate the hypothesis that healing of fractures can be accelerated by oral administered L-arginine a guinea-pig model was chosen. A diaphyseal defect fracture was established in the right femur of each of the 32 small animals and stabilized. According to randomization groups the oral administration was realized (2 or 4 weeks medication / solvent).

Displaced fractures of the greater tuberosity: a comparison of operative and nonoperative treatment.

Background: Displaced two-part fractures of the greater tuberosity requiring surgical intervention are rare and the literature gives only few data of functional results after operative treatment. The purpose of this study was to analyze functional and radiographic long-term results in patients who had undergone surgical treatment of displaced greater tuberosity fractures and to compare those results with the results of patients who had been treated nonoperatively.

Material: From a prospectively gathered database, we retrospectively analyzed functional and radiographic results of 52 patients with operative treatment of displaced greater tuberosity fractures at an average time of 5.

Mid-term results after endovascular stent-graft placement due to penetrating atherosclerotic ulcers of the thoracic aorta.

Background: To determine mid-term durability of endovascular stent-graft placement in patients with penetrating atherosclerotic ulcers (PAU) involving the thoracic aorta and to identify risk factors for death as well as early and late cardiovascular events.

Methods: From 1997 to 2006, 27 patients (mean age 66 yrs) presented with PAU (rupture n=7). Mean numeric EuroScore was 11 and mean logistic EuroScore was 35.

Endorectal advancement flaps in the treatment of high anal fistula of cryptoglandular origin: full-thickness vs. mucosal-rectum flaps.

Purpose: The treatment of high anal fistula using endorectal advancement flaps represents an important technique to attain cure of fistulation and preserve anal continence. The creation of the advancement flap may comprise the rectal mucosa only or involve the full transection of the rectal wall. A comparison between full-thickness flaps and mucosal (partial-thickness) flaps was made to analyze the defining elements of successful fistula treatment: recurrence rates and anal continence.

Subclavian to carotid artery transposition: medial versus lateral approach.

Introduction: Subclavian to carotid transposition (SCT) is gaining importance as an adjunct for thoracic endovascular aortic repair (TEVAR). Two different anatomical approaches are described. We reviewed our experience with both approaches to evaluate the occurrence of complications and long-term outcome.

The Enduro motorcyclist's wrist and other overuse injuries in competitive Enduro motorcyclists: a prospective study.

According to public opinion, Enduro motorcycling is a dangerous sport. Little is known about overuse injuries in connection with this sport. The study consisted of two phases.

Redo pedal bypass surgery after pedal graft failure: gain or gadget?

Pedal bypass failure is not always associated with limb loss. Management of critical limb ischemia after failure is controversial. The aim of this study is to evaluate the results of redo bypass procedures to foot arteries in the absence of alternative tibial outflow arteries.

Characteristics of polytrauma patients between 1992 and 2002: what is changing?

Objective: To analyse the characteristics of polytrauma patients and the quality and progress of treatment regimens by an evaluation of a trauma population.

Methods: The study included all polytrauma patients treated between 1992 and 2002 at a level 1 trauma centre. Data of 501 cases were collected prospectively and analysed retrospectively.

Breast cancer diagnosed during pregnancy.

Cancer is rare during pregnancy, but breast cancer is the second most common cancer in pregnant women. Pregnancy-associated breast cancer (PABC) is defined as breast cancer that occurs during pregnancy or within one year of delivery. Five cases of PABC occurring during the second and third trimester of pregnancy managed at the University Hospital of Vienna during the year 2005/2006 are reported.

Salvage surgery for recurrent carcinoma of the hypopharynx and reconstruction using jejunal free tissue transfer and pectoralis major muscle pedicled flap.

Objective: To evaluate patients undergoing salvage surgery after recurrent squamous cell carcinoma of the hypopharynx.

Design: Retrospective analysis.

Setting: All patients underwent surgery and follow-up evaluations at the Medical University of Vienna.

Endovascular stent-graft placement of aneurysms involving the descending aorta originating from chronic type B dissections.

Background: The performance of endovascular stent-graft placement in patients suffering from aneurysms involving the descending aorta originating from chronic type B dissections is unclear.

Methods: Within a 2-year period, we treated 6 patients with this pathology. Four patients required extension of the proximal landing zone (autologous double transposition, n = 2; subclavian-to-carotid artery transposition, n = 2) before stent-graft placement.

A comparison of two different treatments with navigated extracorporeal shock-wave therapy for calcifying tendinitis - a randomized controlled trial.

Background: Extracorporeal shock-wave therapy is recommended for calcifying tendinitis, and navigated low-energy therapy has given better results than biofeedback localization. This investigation was planned to analyze whether the outcome of navigated low-energy shock-wave therapy can be improved by raising energy flux density to middle-energy levels. The clinical and radiological differences in outcome between three sessions of low-energy navigated shock-wave therapy and two sessions of middle-energy therapy were therefore compared.