[Exchanging intervertebral disks. The concept and clinical experience using a cement-free intervertebral disk endoprosthesis of the "Charité Modular SB" type].
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Biomedical subjects
Publications and source records attributed to K Büttner.
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A trial of the routine use of two test procedures for the evaluation of free L-triiodothyronine (FT3) was carried out (1070 patients). The normal values given by the manufacturers are not correct with respect to our patient group. In order to avoid false hyperthyroid (FT3-Amerlex) or false hypothyroid (FT3-DPC) values, the normal spectrum was redetermined for each. Under these conditions, both tests could show a definite difference between normal and overfunctioning of the thyroid. In substitution therapy with L-thyroxine, the quality of adjustment may be assessed according to the FT3 value. An extension of the normal spectrum, as for FT4, is not necessary. Since any additional assessment of the carrier protein concentration becomes irrelevant, the FT3 test is advisable also for economic reasons.
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Two patients with polycythemia vera received intravenously an accidental tenfold overdosage of radiophosphorus therapy (60 and 50 mCi 32P, respectively). In both patients, the occurrence of hemorrhagic complications 3 wk after the 32P medication led to detection of the error and referral to our hospital. Upon admission they showed an agranulocytosis, severe thrombocytopenia, and bone marrow aplasia. In both cases, spontaneous recovery of the hematopoiesis was observed from day 40 posttreatment onward. In one patient, a slow but ultimately complete normalization of blood counts and marrow morphology took place, whereas in the other, a mild thrombocytopenia persists. Nearly 5 yr after the accidental overdosage, both patients are clinically well. Symptoms of polycythemia vera have not reappeared up to now. Attempts were made to evaluate the radiation dose absorbed by the bone marrow. In the first patient, the daily 32P excretion was determined from day 22 to day 60, whereas in the other patient a whole body count was performed on day 78 after administration. From these results, an approximate cumulative bone marrow dose of 10 Sv (1000 rem) could be calculated.
Analgesic drugs, physiotherapy and corticosteroids are concurrently used in the conservative treatment of lumbar pain. In 100 patients a double-blind study with dexamethasonephosphate versus placebo was performed. Lumbar pain and no findings with myelography were the basic requirements for inclusion into the study. There was no significant difference between the treatment group and the placebo group concerning the clinical investigation before and after treatment. The positive effect of dexamethasonephosphate, which was seen in a pilot study, was not confirmed in the double-blind study. Because corticosteroids are also psychotropic drugs there is a mild antidepressive effect. Considering the fact that cortisone has no effect on the symptoms of lumbar pain, it should not be used furthermore in the conservative treatment of lumbar pain.
Inbred rats have been studied to determine under what circumstances sensitization will or will not induce uveitis. After 50 days of biomicroscopic follow-up and histologic evaluation of 119 eyes the following was found in black hooded CAP-rats (RtH-1c) presensitized to eye, liver or kidney (guinea pig): 1. Alterations only following additional damage to their own tissue by lens discission plus iridotomy 2. As the case of lens-induced uveitis in humans, alterations after the disappearance of traumatization reaction in the form of protein-rich exudate clinically and an accumulation of round cells in the anterior uvea, surrounding the lens and retinal vessels histologically 3. Dependence of these alterations on sensitization by xenogenic tissue 4. Dependence of the alterations on the animal strain, i.e. absence in albino LEW (RtH-1(1)).
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Extracorporeal blood-circuit devices can be sterilized by ethylene oxide (EtO), irradiation, or steam. The majority of these devices are sterilized by the first two processes, and the use of steam sterilization seems to be limited. This article compares the different processes, discusses their advantages and disadvantages, and makes a case for sterilizing these products by steam.
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