No abstract

To investigate matrix-specifity of probiotic effects and particularly of the reduction of antibiotics-associated diarrhea, a controlled, randomized, double-blind study was performed, in which 88 Helicobacter pylori-infected but otherwise healthy subjects were given for eight weeks either a) a probiotic fruit yoghurt "mild" containing Lactobacillus acidophilus LA-5 plus Bifidobacterium lactis BB-12, n = 30), b) the same product but pasteurized after fermentation (n = 29) or c) milk acidified with lactic acid (control, n = 29). During week five, a Helicobacter eradication therapy was performed. Helicobacter activity was measured via 13C-2-urea breath tests and antibiotic-associated diarrhoea and other gastrointestinal complaints were recorded by validated questionnaires. In intervention group a, b and c the mean number of days with diarrhoea was 4, 10 and 10 (P<0·05), the frequency of episodes 17%, 7% and 27% (n.s.), and the change in total symptoms score before antibiotics treatment was -1·4 ± 1·1, -1·2 ± 1·1, 2·6 ± 1·1 points/four weeks (P<0·05). All milk products decreased Helicobacter activity by 18 to 45% without significant differences between groups. The observed decrease in Hel. pylori activity seems to be not or not only due to probiotic bacteria but (rather) to components of acidified milk (most probably lactic acid). Fruit-yogurt-like fermented milk products with living probiotic bacteria significantly shorten the duration of antibiotics-associated diarrhoea and improve gastrointestinal complaints. Fruit yogurt-like fermented milk is a matrix suitable for probiotic bacteria.

Rotation-plasty was carried out on fifteen patients--10 male and 5 female patients aged between 6 and 32--with an osteosarcoma of the distal femur following resection of the tumor. In the operation the lower leg was rotated through 180 degrees after resection of the distal femur and knee joint so that the ankle joint was effectively turned into a "knee joint". The indication for this operation was initially limited to children for whom the only possible therapeutic alternative was a high above-knee amputation. The surprisingly good functional rehabilitation justifies the indication of this method as an alternative to an endoprosthesis or arthrodesis even for young adults. In spite of the cosmetically very unusual position of the foot, none of the patients has so far experienced psychological problems thanks to suitable guidance. Both from an oncological and psychological point of view, this method represents an extremely responsible operation and should therefore only be carried out by hospital departments specializing in the therapy of bone tumors.

Exact differentiation into stump and phantom pain is required when pain is reported after amputation. In a majority of cases appropriate treatment can improve the pain. Thermography is simple and gives a good indication of the circulation in the stump without operative intervention. It provides a key to the nature of the pain in stump and phantom. Although typical patterns occur for pain in the stump or phantom, in this study the thermographic image could confirm the presence of phantom pain, but it could not rule out errors or false statements.

The dorsal parts of the calcanei of rabbits were resected and replaced with similarly-shaped implants made of ash wood. In each case the Achilles tendon was reinserted into the projecting part of the implant so as to subject the latter to the dynamic loads generated by use of the limb. The implants were removed from some of the animals after 5 weeks and from the others after 14 weeks. They were evaluated by preparing undecalcified microtome sections and ground sections which were examined by light microscopy and microradiography. Some of the animals underwent vital staining so as to produce polychromatic sequential labelling of the calcaneal specimens. In the area of insertion of the Achilles tendon soft tissue grew into the larger pores of the wood and, in some cases, differentiated into cartilage. Every implant remained stably anchored in the calcaneus. In every animal the intracalcaneal part of the implant became surrounded by new bone which was in direct contact with the surface of the implant and which also formed in the pores of the wood, even all rabbits loaded the operated foot. The formation of new bone in and around the implants demonstrates the basic feasibility of using ash wood as an isoelastic implant material in bone.