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The article discusses an experiment investigating the role of tissue mast cells in inflammation and regeneration functions. Mast cells may release reactions due to histamine liberator compounds, antibodies or surface active agents. In the experiment, rats were treated with compound 48/80, a chemical histamine liberator compound, and examined in various circumstances such as pleuritis induced through injection of silver nitrate, injection of bolus alba to cause edema, inflammation induced by mustard oil and peritonitis due to infection by Staphylococcus aureus and Cryptococcus neoformans. Rats treated with 48/80 had decreased histamine in tissues and low numbers of mast cells except in intestinal tissue.

Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities disaster control staffs are set up by the administration. During disaster relief operations a operational command is on site. Most of the counties and district free cities, medical executives, rescue staff executives along with fire executive officers are responsible for the medical rescue organisation. All emergency physicians and medical executives have attended special training or a 520 hours-training-course (Paramedics). All volunteers of the medical service in the disaster relief organisations are trained in separate special courses (90 hours). Over the last years, civil protection, disaster relief and rescue services in the FRG have been reorganised. In 1997, the civil protection was reformed by a new federal act. Disaster relief of the "Lander" is supported by Federal Government with about 9000 vehicles and a budget for training. Emergency physicians have to take part in a (80) eighty hours lasting course on emergency medicine from an interdisciplinary point of view; they are only allowed to do rescue missions after having proved basic experience in emergency medicine as well as having completed a (18) eighteen-months-postgraduate training period at least. Senior emergency physicians receive and additional (40) forty-hours-lasting theoretical and practical training-after three years practice in rescue services as a minimum. There are special training courses offered for Medical and Non-Medical Personal to cope with disaster situation by different institutions and organisations.

From 1992 to 1995 126 patients were treated with percutaneous wire pinning. Sixty-one patients were treated by Kapandji's technique and 65 patients were treated conventionally. Forty-nine patients were examined by 3 different scores (Cooney, Castaing, Stewart). The analysis of the scores showed no differences between the Kapandji technique and the conventional method. Functional and radiological results showed no correlation. Furthermore we found out that the results depend on the score. We conclude that the Kapandji technique shows no benefit in comparison to the conventional method. Functional and radiological results are not divisible: a conclusion from X-ray to function and vice versa is not allowed. A comparison of results is senseless if someone does not use the same score.

This is a report of a rare case of an isolated fracture of the trapezium. Origin, diagnosis, differential diagnosis, treatment and complications are evaluated and described.

30 years after two-fold marrow nailing of the tibia due to the formation of a pseudarthrosis and timely removal of the implants in a miner who was 17 years of age at that time, we found a chronic irritation that required surgical therapy. After excision of a two inch long sequester and escape of a small and cheesy core without identification of germs the patient is symptom-free since one and a half year. A foreign-body reaction to corrosion products of the implant or a late infection with low-virulent germs of the bradytrophic medullary callus appears to be the underlying cause.

Cell coating with human embryonal fibroblasts was examined on solid (Plathurane UM 8300) and microporous (Tecoflex 80 A) polyurethane. Using measurements of cellular growth kinetics and adhesion strength it was found that the onset of cellular growth on the microporous material was delayed but that the vitality and adhesion strength of the cells were better than for the solid material.

Hybrid vascular prostheses are coated with vascular endothelial cells (EC) in an attempt to reduce thrombogenicity through the metabolic activities of living cells. The present studies were planned to develop a standardized method of isolating bovine aortic EC with high yield for studies of endothelial coating of vascular prostheses. The best results were achieved using a combination of incubation with collagenase and mechanically scraping the mobilised cells from the donor vessel. Isolated adult male bovine endothelial cells were identified by the typical "cobble stone" morphology in culture and characterized by factor VIII related antigen immunofluorescence microscopy. The cells were seeded successfully on PTFE vascular prostheses.

Proctocolectomy with conventional ileostomy cures patients with severe ulcerative colitis but ileostomy appliances must be worn for the rest of their lives. The continent ileostomy, as devised by Kock, provides the patient with an intraabdominal ileal reservoir and a valve constructed by invaginating the efferent ileal segment into the reservoir. The patient empties his reservoir 2-3 times a day by inserting a catheter through the valve. Our experience with 14 patients is reported. The continent ileostomy was in most cases constructed as a second procedure after proctocolectomy. Minor postoperative complications, such as abscess, fistula or partial luxation of the valve were easily corrected. One patient who underwent proctocolectomy and simultaneous construction of a continent ileostomy died in acute liver failure due to a severe preexisting cirrhosis. All the other patients are continent for feces and gas and do not need external appliances. The construction of a continent ileostomy as a secondary procedure can be recommended in patients with proctocolectomy. It offers patients a life situation with differs only insignificantly from that of normal persons.

The transfer of a free ventral and dorsal rib graft by microvascular anastomoses enables the plastic surgeon to effect bony reconstruction if the recipient site is defective. However, since this is a technically complicated procedure and associated with only partial recovery, this type of bone graft can be employed only in selected problem cases.

Hepatocyte cultivation in bioreactors for hybrid liver support systems is possible under two conditions: attached to a substrate like membranes or microcarriers or in suspension culture. To compare the ammonia metabolism of hepatocytes cultivated under these two conditions, cultures of primary seeded rat hepatocytes were cultivated either attached to collagen coated tissue culture plastic or as a suspension culture. During the time course of culture, the ability of hepatocytes to reduce the ammonia content of the medium decreased in both adhesion and suspension cultures, though to different extents. In suspension cultures, ammonia content was reduced from 350 microM to about 100 microM (day 4) and to about 180 microM (day 6). No significant reduction was seen on day 8 of culture. In contrast, hepatocytes attached to collagen coated dishes remained viable and functional for at least 8 days after plating, reducing ammonia content from 350 microM to 70 microM (day 4), 90 microM (day 6) and 180 microM (day 8). The period of useful metabolism of hepatocytes in bioreactors for hybrid liver support systems appears to depend on the culture conditions.