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Isolated avulsion fracture of the lesser tuberosity represents an extremely rare injury that occurs mainly in younger patients. This report outlines the case of a 35-year-old healthy man who sustained a bony avulsion of the subscapularis tendon during an abduction external rotation trauma to his left shoulder. The injury was diagnosed by physical examination, standard radiographs, and magnetic resonance imaging. An arthroscopic reconstruction including closed reduction and internal fixation using suture anchors was performed. After a follow-up of 6 months, the patient's Constant Score increased from 62.4 points preoperatively to 91.3 points. At the latest follow-up, the patient was completely pain free, had regained a full work activity level, and returned to overhead sports. On postoperative standard radiographs and magnetic resonance images, the bony fragment was shown to be consolidated in an anatomic position. In cases of displaced isolated fractures of the lesser tuberosity without significant subluxation or dislocation of the long head of the biceps arthroscopic reconstruction using suture anchors can lead to a good clinical and radiological result.

The purpose of this randomized, prospective study was to compare accuracy in tunnel placement as performed with a traditional arthroscopic anterior cruciate ligament (ACL) reconstruction technique and with KneeNav™ ACL, a computer-assisted surgical navigation technique. Two surgeons experienced in ACL reconstruction, but inexperienced in computer-assisted surgical navigation technique, each randomly used traditional arthroscopic guides or KneeNav™ ACL to drill a tunnel in twenty identical foam knees. Placement of the resulting tibial and femoral tunnels was measured with a computer-assisted digitizing method and compared to traditional biplanar radiographs. Statistical analysis with Student's t-test was used to compare the distance from the ideal tunnel placement to the femoral and tibial tunnels. Accuracy of tunnel placement with KneeNav™ ACL was significantly better than that obtained with the traditional arthroscopic technique. Distances from the ideal tunnel placement to the femoral and tibial tunnels were 4.2 ± 1.8 mm (mean ± SD) and 4.9 ± 2.3 mm, respectively, for the traditional arthroscopic technique, and 2.7 ± 1.9 mm (femur) and 3.4 ± 2.3 mm (tibia) for KneeNav™ ACL. These differences were statistically different. Tunnel placement for ACL reconstruction with KneeNav™ ACL, an image-based, computer-assisted surgical navigation device with a simple and intuitive interface, was more accurate than with the traditional arthroscopic technique. Comp Aid Surg 6:279–289 (2001). © 2002 Wiley-Liss, Inc.

The purpose of this randomized, prospective study was to compare accuracy in runnel placement as performed with a traditional arthroscopic anterior cruciate ligament (ACL) reconstruction technique and with KneeNav™ ACL, a computer-assisted surgical navigation technique. Two surgeons experienced in ACL reconstruction, but inexperienced in computer-assisted surgical navigation technique, each randomly used traditional arthroscopic guides or KneeNav™ ACL to drill a tunnel in twenty identical foam knees. Placement of the resulting tibial and femoral tunnels was measured with a computer-assisted digitizing method and compared to traditional biplanar radiographs. Statistical analysis with Student's t-test was used to compare the distance from the ideal tunnel placement to the femoral and tibial tunnels. Accuracy of tunnel placement with KneeNav™ ACL was significantly better than that obtained with the traditional arthroscopic technique. Distances from the ideal tunnel placement to the femoral and tibial tunnels were 4.2 ± 1.8 mm (mean ± SD) and 4.9 ± 2.3 mm, respectively, for the traditional arthroscopic technique, and 2.7 ± 1.9 mm (femur) and 3.4 ± 2.3 mm (tibia) for KneeNav™ ACL. These differences were statistically different. Tunnel placement for ACL reconstruction with KneeNav™ ACL, an image-based, computer-assisted surgical navigation device with a simple and intuitive interface, was more accurate than with the traditional arthroscopic technique.

We studied the natural history, and therefore prognosis, of patients with chronic pyelonephritis presenting to adult nephrologists with a plasma or serum creatinine <90 mmol/l. From the Newcastle chronic pyelonephritis database, 255 patients with radiologically-proven disease were reviewed. Median follow‐up was 95 months (95%CI 82.3–109.3). Plasma creatinine was 90 μmol/l (PCr90 group) at presentation in 138. At presentation, hypertension, bilateral disease and proteinuria were less frequent in the PCr90 group (hypertension 19% vs. 32%, p<0.05; bilateral disease 25% vs. 70%, p<0.001; proteinuria 18% vs. 60%, p<0.001). With the exception of two patients, the renal prognosis of this group was excellent. Patients over the age of 18 years presenting to adult nephrologists with a diagnosis of chronic pyelonephritis and a creatinine 90 μmol/l can be reassured that the chances of developing end‐stage renal failure in the future are very small. Most could be referred back to their general practitioner for long‐term follow‐up.

Summary: We report a case of an osteolytic tibial enlargement in association with a pretibial cyst formation 8 months after successful anterior cruciate ligament reconstruction with autologous bone-patellar tendon-bone graft and tibial graft fixation with a bioabsorbable interference screw. No joint inflammatory reaction or graft insufficiency was detected. The patient underwent cyst excision and curettage of the tibial tunnel with full recovery and return to preinjury level of activity 2 months after the revision surgery. To our knowledge, the reported complication is the first obvious adverse reaction to a poly-D,L-lactide interference screw in anterior cruciate ligament surgery. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 15, No 3 (April), 1999: pp 317-320

The presence of synthetic auxins (2,4-D at a concentration as low as of 0.5 to 5.0 mg I-1, NAA at least at 5 mg I-1) in the cultivation medium was essential for the induction of callogenesis in anther cultures ofZea maysL. The application of IAA was ineffective. Kinetin induced bursting, darkening and a rapid anther necrosis, but at an appropriate concentration ratio with 2,4-D it stimulated pollen maturation at the same time.

Objective: A transient but severe systemic leukopenia regularly occurs after the antagonization of heparin by protamine in patients and in animals. The aim of the present study was to investigate the site and mechanisms of white blood cell retention during this transient leukopenia by studying the leukocyte-endothelial cell interaction in skeletal muscle venules. Methods: Syrian golden hamsters were equipped with a dorsal skinfold chamber for intravital fluorescence microscopy and arterial and venous catheters for drug infusion, blood pressure measurement, and blood sampling. Microhemodynamic parameters and leukocyte-endothelial cell interactions were observed in one single collecting venule per animal after intravenous infusion of saline solution (control, n = 10), of protamine (n = 9), and after infusion of heparin followed by either intravenous protamine (n = 9) or intraarterial protamine (n = 9). Results: All parameters remained unchanged in the control group. Whereas venular diameters remained unchanged, protamine transiently increased arterial blood pressure and venular erythrocyte velocity in all groups. Systemic leukocyte counts and the venular leukocyte discharge concentration decreased concurrently after protamine administration by about 60% to 70% at 2 minutes while the fraction of rolling leukocytes and the number of adherent leukocytes remained unchanged. Two and one-half minutes later, systemic leukocyte counts and venular discharge concentrations normalized while the fraction of leukocytes rolling slowly along or adhering firmly to the venular endothelial wall increased considerably and similarly in all groups receiving protamine. Myeloperoxidase (an indicator of polymorphonuclear leukocytes) determination in 20 separate hamsters 2 minutes after protamine infusion revealed increased myeloperoxidase activity exclusively in the lungs. Conclusion: The response of leukocytes to protamine infusion with or without prior heparinization is biphasic: initial retention of leukocytes in the lungs is followed by enhanced leukocyte-endothelial cell interaction in the systemic circulation. (J Thorac Cardiovasc Surg 1997;113:784-91)

Summary: Present development of forestry entomology in the CcaronSSRThis article gives an outline on the occurrence of the more important harmful forest insects in the CcaronSSR in the year 1950–1962 and on the results of their study. The Norway spruce suffered from the year 1954 notably byIps typographus L. The control was based on insecticides, studies included optimal density of natural regeneration at the mass propagation etc. It was found, for instance, that typical density borings in bark (151–300 borings per 1 sq.m. of bark) shows variation in the shortest distance between borings from 54–70 mm. Relation between density of borings and their distance indicates function y = a.x–b, (constant a = 476,9 and constant b= 0,38). It was further found thatIps typographus L. shows even sister generations twice in a year (about 60%, eventually even 30% females of the preceding population). Sister laying is conditioned mainly climatically, i.e. also by the forest stand elevation above sea level. A secure control of further harmful species of Norway spruce,Trypodendron lineatum (Ol.) was carried out by extirpation of wintering beetles in soil, eventually by treating of round wood by emulsions on the HCH + DDT basis.Cephaleia abietis L. shows two diapause periods in a larval stage. For this reason, the development of this species lasts prevailingly two years (90% population). Swarming imagines are controlled by chemical aerosols (10% DDT in the dosis 4–8 kg/ha). On obtained from eggsTrichogramma cephalciae Hochm. et Mart. which cannot be grown on eggs of butterflies. Investigations found that the clean eating ofZeiraphera diniana Guen. begins at the density of 300 caterpillars per one meter of long branch. Chemical control (aerosol 10 l/ha) is recommended when feeding is repeated for three years. The mass propagation ofBupalus piniarinus L. appeared on the Scotch pine. The critical number amounts 400 caterpillars per one kg of needles.Hylobius abletis L. is controlled by insecticides in trap barks and by underground traps for concentration of egg laying. Oak was injuried mostly by the rollerTortrix viridana. The critical number is one caterpillar per one bud. Other, in the CcaronSSR new harmful insect of oakArchips crataegana (Hb.) showed the critical number 100 egg heaps on the stem to the height of 2 m. The eggs of the above mentioned species showedTrichogramma embryophagum cacoeciae March., which can easily be grown on butterfly eggs. Oak 60–200 years old was attacked byApethymus biaccatus (Gmel.) andA. abdominalis (Lep.). Silver fir was harmed mainly by the rollerChoristoneura murinana (Hb.). Also the critical number was found. Egg rearing gaveTrichogramma minutum Ril. Ash indicates new type of bark injuries caused probably by a representative of the genusLestes (Fig. 1.). Poplars are damaged by the species of the familyCerambycidae, further byCryptorrhynchus lapathi L. and by the species of the familyAegeridae. Saperda carcharias L. has in the Czechoslovak conditions a generation of three years. Eggs overwinter.Cryptorrhynchus lapathi L. has in the southern Moravia mostly (70% population) one year generation, the rest shows a generation of two years. Beech and hornbeaum were harmfully attacked byErannis aurantiaria Hb.) andColotois pennaria (L.). It is obvious that in the year 1950–1962 several species (Alchips crataegana (Hb.),Apethymus braccatus (Gmel.),A. abdominalis (Lep.) on oak,Erannis aurantiaria (Hb.) andColotois pennaria (L.) on. hornbeam and oak,Pachynematus scutellatus Htg. on Norway spruce etc.) previously not known as important forest injurious insect, appeared as calamity species. Further it is obvious that some harmful insects probably under the influence of changed structure and also forest stand microclimate are retreating whereas other species show mass outbreak. For this reason it is necessary to study the lawfulness of the propagation of the individual species.

We studied the natural history, and therefore prognosis, of patients with chronic pyelonephritis presenting to adult nephrologists with a plasma or serum creatinine <90 mmol/l. From the Newcastle chronic pyelonephritis database, 255 patients with radiologically-proven disease were reviewed. Median follow‐up was 95 months (95%CI 82.3–109.3). Plasma creatinine was 90 μmol/l (PCr90 group) at presentation in 138. At presentation, hypertension, bilateral disease and proteinuria were less frequent in the PCr90 group (hypertension 19% vs. 32%, p<0.05; bilateral disease 25% vs. 70%, p<0.001; proteinuria 18% vs. 60%, p<0.001). With the exception of two patients, the renal prognosis of this group was excellent. Patients over the age of 18 years presenting to adult nephrologists with a diagnosis of chronic pyelonephritis and a creatinine 90 μmol/l can be reassured that the chances of developing end‐stage renal failure in the future are very small. Most could be referred back to their general practitioner for long‐term follow‐up.