No abstract available.
Humans ; Infant, Newborn* ; Membranes* ; Mortality* ; Mothers* ; Rupture*

No abstract available.
Polyhydramnios*

The hand is an organ of both motion and sensibility. Motion is necessary for the highly adaptive functions of pinch, grasp, and hook. When a major muscle is paralyzed, the balance of the hand is disrupted. The objective of reconstructive procedure is to achieve a limited but balanced functional performance by means of redistributing assets rather than creating new motor and sensory units. Among the variable methods of treatment, the tendon transfer is a useful method in restoring the lost functions of the paralyzed hand. Authors reviewed 3 cases of paralyzed hands: the first one had an impairment of the opposition and flexion of the thumb caused by brachial plexus injury; the second one had an adducted thumb and a flexion contracture of the index and middle fingers due to a severe compression injury to forearm; the third one was a quadriplegics due to the C5-6 fracture-dislocation, but fortunately had a function of active flexion in ring and little fingers. They were treated by Omer's technique plus other reconstructive procedures for the paralysis at the Department of Orthopaedics, Catholic Medical Center from 1978 to 1981. By this procedure gratifying results such as restoration of pinching and grasping function were obtained.
Brachial Plexus ; Contracture ; Fingers ; Forearm ; Hand Strength ; Hand ; Methods ; Muscles ; Paralysis ; Tendon Transfer ; Thumb

BACKGROUND: Peripheral nerve injury may produce a syndrome consisting of spontaneous pain, allodynia and hyperpathia. Cholinesterase inhibitors are known to have an antinociceptive effect in hot plate and tail flick tests and to be mediated by spinal muscarinic system. The purpose of the current study was to determine the effect of intrathecally (i.t.) administered edrophonium and neostigmine on the touch-evoked allodynia and to identify the antagonism of antiallodynia in a rat model of neuropathic pain. METHODS: Sprague Dawley rats were prepared with tight ligation of left L5/L6 spinal nerves with 6~0 black silk and chronic lumbar intrathecal catheters. After obtaining the baseline hindpaw withdrawal scores, edrophonium (3~100ug) or neostigmine (0.3~10ug) was administered intrathecally. Tactile allodynia was measured using von Frey filaments and allodynic threshold was calculated by updown method. Motor dysfunction was assessed by observing righting/stepping reflex responses and abnormal weight bearing. To examine the reversal of antiallod ynia, muscarinic receptor antagonist atropine (10ug) or nicotinic receptor antagonist mecamylamine (10ug) was injected intrathecally 5 min. prior to injection of edrophonium or neostigmine. RESULTS: I.t. edrophonium and i.t. neostigmine produced a dose dependent antagonism of allodynic state but had moderate to severe effect on motor weakness at doses of 3 and 10 g of neostigmine. Pretreatment with i.t. atropine yielded a complete antagonism of antiallodynia in both drugs, but i.t. mecamylamine did not significantly reverse incresed allodynic threshold. CONCLUSIONS: These experiments suggest that i.t. edrophonium or i.t. neostigmine produces a dose dependent antagonism on touch-evoked allodynia at the spinal level and this antagonism is likely due to spinal muscarinic system.
Atropine ; Catheters ; Cholinesterase Inhibitors ; Edrophonium* ; Hyperalgesia ; Ligation ; Mecamylamine ; Models, Animal ; Neostigmine* ; Neuralgia* ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Receptors, Muscarinic ; Receptors, Nicotinic ; Reflex ; Silk ; Spinal Nerves ; Weight-Bearing

No abstract available
Constriction, Pathologic* ; Stents*

Despite the technical improvements in Internal flxation of neck fracture were made in recent years, complications, such as non-union of the fracture and avascular necrosis of the femoral head, are not infrequent. Various operative techniques have been proposed to secure the reduced fracture fragment till union, and to restore or improve the circulation in the femoral head. One of them is muscle-pedicle bone graft to the fracture site of neck. It is very important if one can predict the vascularity of the femoral head prior to treatment and also the healing process of the neck fracture during treatment. In the past, there have been considerable investigations to achieve these goal, but no method universally has been accepted as reliable and practical. Among them, Intra-osseous venography (I.O.V.) and sclntimetry utilizing the isotope trace techniques were widely used in recent. Authors adopted a cephalic and trochanteric I.O.V. to observe the fracture healing and to predict viabillty of the femoral head, and also tried a new technique (Indirect cepallc I.O.V.) to perform both techniques of I.O.V. at the same time. With the ald of image Intensifler, a bone marrow needle Is inserted 1 inch below the greater trochanter of femur, and when the tip of the needle is reached 0.5 to 1.0 cm near to fracture line in the marrow cavity, about 25 cc of 75% Urograffin is Injected by speed of 1 cc per second with sereial X-rays taken at 1,3,5 and 15 minutes (trochanteric I.O.V.). Then already inserted puncture needle for trochanteric I.O.V. are more advanced through the fracture line of the neck into the femoral head. About 10 cc of 75% Urograffin Is Injected by speed of 1 cc per second with serial X-rays taken (Indirect cephallc I.O.V.). The merits of this indirect cophalic l.O.V. via trochanteric route is that it is also simple and Practical and there is no significant complication: such as septic arthritis of hlp & thrombophlebitis. Difficulties of inserting the needle through the trochanter and the neck into the head and occasional unwanted hip-arthrogram are listed as the main demerits of this technique. But these demerits can be minimized by the accurate image intensifier control. A positive trochanteric venography is one in which venous drainage is established across the fracture site with opaque contrast medium being spread out diffusely into the head, and eventually draining out into the surrounding soft tissue via draining velns. While positive cephalic venography via trochanteric route is one in which contrast medium is spread out diffusely in the head and trochanteric region via crossing veins. Hereby, we performed internal fixation and an autogenous muscle-bone pedicle graft composed of the quadratus femoris muscle in 4 cases of femoral neck fracture which are confirmed that there are head viability by using of the cephalic I.O.V.. Since then, we checked the both I.O.V. every 6 wks post-operatively. The results seemed to be good in regard to bony union in all 4 cases, and we have also found that cephalic and trochanteric I.O.V. are a useful diagnostic tool in hip fracture.
Arthritis, Infectious ; Bone Marrow ; Drainage ; Femoral Neck Fractures ; Femur Neck ; Femur ; Fracture Healing ; Head ; Hip ; Methods ; Neck ; Necrosis ; Needles ; Phlebography ; Punctures ; Thrombophlebitis ; Transplants ; Veins

It is well-known that early diagnosis and treatment is still the most important aspect of congenital dislocation of the hip. However, the orthopaedist can not see the cbildren with dislocated hip before they begin to Walk, especially in the developing countries. When the children with dislocated hips are discovered lately,it is impossible to reduce the hip by simple manipulation, and also is very difficult to maintain the reduction successfully. Our method of treatment was based on the concept that the various components of the abnormal joint will develop satisfactorily into a normal hip provided acccurate congrucus and concentric reduction is obtained as early as possible to take advantage of the maximum growth potential, and is maintained throughout growth, In this study 16 children with 18 dislocated hips among the 75 children with congenitally dislocated hips were primarily treated by open reduction,followed by 3 weeks of temporary fixation of reduced hip by Kirschner wire and 6 weeks of cast immobilization from November 1973 to April 1979. They were clinically and roentgenologically analized. The end results of treatment were assessed by 3 roent- genological determinants; the medial joint space, the acetabular angle and the centeredge angle. The results obtained were as follows: 1. The pathologically widened medial joint space of hip or hips decreased rapidly during first 6 months after reduction, irrespective of the age at reduction, and satisfactory results were obtained in 83 per cent indicated by joint space distance less than 10 mm. 2. Postoperative Kirschner wire fixation of reduced hip to maintain the reduced position did not impair the physeal growth or bring the joint stiffness. 3. The acetabular angle improved rapidly during the first year after reduction in all age groups of patients and thereafter the rate of acetabular development decreased, but the acetabular angle continued to improve throughout the period of observation and satisfactorily (less than 25 degrees) developed in 83 per cent of children. 4. The center-edge angle increased rapidly during first three months after reduction and was satisfactory (more than 20 degrees) in 78 per cent. Overall success rate of treatment was 81.3 per cent. 5. Assessment of end results by medial joint space has more advantages in evaluating the result of treatment because of the aimplicity of it's measurement and leas error regardless of the change of patients position on roentgenagrams. 6. There were only few complications (11.1%) after surgical treatment; coxa magna in a case and resubluxation in another case were complicated. 7. Parameters utilized for assessing the results were faund to be the very helpful criteria to evaluate the hip development indicated by cephalocotyloid relation when used together. 8. Simultaneous open reduction followed by temporary internal fixation with K-wire was found to be recommendable method of treatment ae a first choice of treatment even in children under age of 3 if once nonsurgical reduction fails; because by this type of treatment more easily and accurately concentric reductions were obtained, and also reduction was more easily maintained without subsequeat redislocation.
Acetabulum ; Child ; Developing Countries ; Dislocations ; Early Diagnosis ; Hip ; Humans ; Immobilization ; Joints ; Methods

No abstract available.
Lithotripsy* ; Shock*

Pulmonary artery rupture with a flow-directed balloon tipped pulmonary artery catheter (Swan-Ganz catheter)is a rare complication with high mortality. This report concerns a case of this complication with hemothorax leading to fatal exsanguination. Emphasis is placed on the safety guidelines to prevent this. Also, possible causes and managements are presented. A high index of suspicion is necessary whenever a patient with the catheter has hemoptysis or unexplained hemodynamic or respiratory changes.
Arteries* ; Catheters* ; Exsanguination ; Hemodynamics ; Hemoptysis ; Hemothorax ; Humans ; Mortality ; Pulmonary Artery ; Rupture*

Pulmonary artery rupture with a flow-directed balloon tipped pulmonary artery catheter (Swan-Ganz catheter)is a rare complication with high mortality. This report concerns a case of this complication with hemothorax leading to fatal exsanguination. Emphasis is placed on the safety guidelines to prevent this. Also, possible causes and managements are presented. A high index of suspicion is necessary whenever a patient with the catheter has hemoptysis or unexplained hemodynamic or respiratory changes.
Arteries* ; Catheters* ; Exsanguination ; Hemodynamics ; Hemoptysis ; Hemothorax ; Humans ; Mortality ; Pulmonary Artery ; Rupture*