Timm J. Filler

Guidelines for case reports of adverse events related to acupuncture

Numerous case reports of adverse events of acupuncture have been published, mostly in journals which are not related to acupuncture. The authors usually have no training in acupuncture. In principle, case reports on adverse events are of value as an aid for learning. They can only achieve this effect if useful information is provided. In the case of acupuncture related adverse events and complications, basic information about the patient and the therapist as well as the treated acupuncture points and topographical regions and the needling technique are desirable. This article offers suggestions on what details should be included in a case report on adverse events related to acupuncture.

Periprosthetic bone density changes after MiniHipTM cementless femoral short stem: one-year results of dual-energy X-ray absorptiometry study

Introduction: The purpose of the current study was to investigate the reaction of the femur to the implantation of the MiniHipTM in terms of: (1) bone density change during one year; (2) correlations between stem length, CCD (caput-collum-diaphyseal), femoral offset, T-value, and bone density; (3) other co-variables that influence the change of bone density. Patients and methods: MiniHipTM implant was performed for 62 patients. The age range of the patients who underwent treatment was 25–78 years. Periprothestic bone density was determined within two weeks postoperatively, after three, six, and twelve months utilizing the DEXA scan. Results: The highest change was observed in the first three months post-implantation, while significant decrease in density was recorded at proximal Gruen zones 1, 2, and 7, and at distal Gruen zone 4. The decrease in density reached a plateau between the third and sixth months after operation. Afterwards, bone density recovered up to the 12th postoperative month. The correlation analysis showed significant difference between Gruen zone 1 and stem size and CCD. The same significant trend was not reached for Gruen zone 7. Femoral offset showed no correlation. Covariance analysis was unable to establish connection of the results with diagnosis, pairings, or gender. Discussion: MiniHipTM densitometric results are promising and comparable to good results of the other representatives of the femoral neck partially-sustaining short stem prostheses with a lower proximal bone density reduction. Periprosthetic bone resorption is a multifactorial process where stem size, CCD angle, and patient-specific variables such as T-value have an impact on the periprosthetic bone remodeling. In particular, this applies to Gruen zone 1.

Distributed Architecture for a Peer-to-Peer-Based Virtual Microscope

Virtual microscopes are commonly used in medical education. They provide a platform for distributing whole slide images (WSI) with several GB size to exploring students. Even in courses with a few hundred students and dozens of WSI the network traffic may be high, but it will vastly increase, when the system is opened to access from the Internet. The same applies to user-generated content like interactive annotations (each student generates approx. 200 labels per term). In a collection that consists of several thousand WSI, which need to be annotated for training or quiz-based purposes, there will be millions of user contributions. In an abstract view users navigate through a universe of WSI and annotations and may meet other users watching the same or related WSI. This paper presents a distributed architecture build on PathFinder for Internet-based virtual microscopy addressing the challenges of distributing tightly connected data chunks on an overlay network consisting of random graphs.

Wirbelsäule im Sport: Aspekte der klinischen Anatomie der Wirbelsäule unter besonderer Berücksichtigung der Lendenwirbelsäule und sportlicher Belastungen

Zusammenfassung Ruckenschmerzen betreffen im Laufe eines Lebens einen Grosteil der Menschen. Im Beitrag werden die anatomisch-funktionellen Grundlagen dargestellt. Besondere Berucksichtigung finden neuere Aspekte zur Innervation der Bandscheibe und der Bezug zu sportlichen Belastungen.

Iliopsoas-Impingement nach Hüft-TEP: Ursachen, Diagnostik, Therapie

In der vorliegenden Arbeit werden Ätiologie, Diagnostik und Therapie des Iliopsoas-Impingement-Syndroms bei Patienten nach einem endoprothetischen Hüftgelenkersatz dargestellt. Anhand eigener Erfahrungen werden die Möglichkeiten und Ergebnisse der konservativen und der offenen beziehungsweise arthroskopischen invasiven Therapie zusammengefasst.

Anatomical versus functional motor points of selected upper body muscles

In this study we aimed to identify nerve entry points (NEPs) of superficial skeletal muscles obtained by dissection of 20 human cadavers and compared them with motor points (MP) obtained previously by electrical stimulation.

Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

AIM To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system. METHODS Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compared to the CoR of the prosthesis by using the MediCAD® software. Additionally, the pre- and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS Both, the Constant and DASH scores improved significantly from 11% to 75% and from 70 to 30 points, P < 0.01 respectively. There were no significant differences regarding age, etiology, cemented or metal-backed glenoids, etc. (P > 0.05). The pre- and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neck-shaft angle showed no significant changes (P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome scoring. CONCLUSION TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.

A Portable and Platform Independent File System for Large Scale Peer-to-Peer Systems and Distributed Applications

Virtual microscopy is an evolving medical application used for teaching and learning at universities. We have developed a peer-to-peer based solution called Omentum, aiming at bringing virtual microscopy to an Internet-scale community. Omentum has to manage more than 10,000 large proprietary microscopic images that are converted to easily dividable JPEG-trees, each consisting of millions of very small-scaled image parts. In this paper we propose a portable and platform independent user space file system (USPFS) for addressing the application-specific access patterns, security concerns and data integrity. USPFS is able to efficiently manage huge capacities (roughly 9 × 1018 slices with 9,000 Petabytes each) with a theoretically infinite number of storable objects while providing highly important platform independency, data integrity checks as well as an easily extendable API. The evident metadata overhead is only 0.3 % and the performance evaluation shows promising results for both read and write operations.

Omentum - A Peer-to-Peer Approach for Internet-Scale Virtual Microscopy

Virtual microscopy is increasingly used for e-learning and medical online exams at universities. Traditional client-server systems support upi¾?to a few hundred of users accessing more than 10.000 large microscopic images each several Gigabyte and each being able to make interactive annotations. We have developed the first peer-to-peer based solution bringing virtual microscopy to an Internet-scale community. We address data distribution and replication by a novel overlay called Omentum, which is based on a random-graph architecture. Omentum uses a lightweight messaging service for peer communication and supports traffic-free routing-path calculation. Based on the directed random graph the system achieves path compression by walking along inbound links during the actual routing phase. The evaluation shows the efficiency and scalability of the Omentum overlay network, its replication strategy and an administrative communication overhead for creating new replicas around