This paper reviews the mechanisms of brachial plexus injury which includes the traumatic: stretch/contusions with or without avulsion, gunshot wounds(GSWs) and lacerations and the nontraumatic from tumors and the various etiologies of thoracic outlet syndrome(TOS). Another type of brachial plexus injury is that of obstetrical birth injury. The paper also reviews the anatomy of the brachial plexus and operative approaches with the anterior approach used in the majority of cases. The posterior subscapular approach with resection of the first rib is occasionally used for tumor resection, GSWs of the lower roots and trunk and the majority of patients with TOS. Surgical techniques and their indications in brachial plexus surgery are presented including nerve action potential(NAP) recording, neurolysis, end-to-end suture anastomosis repair and graft repair including split-repair. The mechanisms of brachial plexus injury are individually reviewed and results for each type of repair of same from the Louisiana State University Health Sciences Center(LSUHSC) experience with 1, 019 patients between 1968-1998 are summarized. There were 509 (49%) stretch/contusion injuries, which was the majority lesion followed in number by brachial plexus GSWs (12%) and lacerations (7%). Nontraumatic brachial plexus injuries included tumors (16%) and TOS (16%). Obstetrical brachial plexus injury though not included with the 1, 019 patients presented in a paper by Kim and Kline et al (J Neurosurg 98: 1005-1016, 2003) are presented and the LSUHSC experience with these are included as well.
Birth Injuries ; Brachial Plexus* ; Humans ; Lacerations ; Louisiana ; Ribs ; Sutures ; Transplants

Before the development of dapsone the standard remedy for Hansen's disease was the chaulmoogra oil. The oil was first introduced to western physicians in the 1850's by Dr. Fredric J. Mouat, the British physician, in India. Around 1900, leprosaria in the Hawaiian Islands and at Carville, Louisiana, adopted the chaulmoogra oil as their main treatment. But the oil has been traditionally treated as a drug for Hansen's disease in India and China since 2000 years before. Although the mechanism of action is not known, the lipolysis hypothesis or chemotatic theory resulted from counter irritation was suggested. Since the development of sulfone in 1947, the oil has not been used anymore as antileprosy medication. However, recent reports about the effect of the oil on wound healing in Hansen's disease and diabetes provided us with the possibility of the reappraisal of the chaulmoogra oil. We performed this study to determine the effect of the chaulmoogra oil on wound healing in Hansen's disease patients still having neuropathic foot ulcers and ulcerations of paraffinoma as sequelae.
China ; Dapsone ; Foot Ulcer ; Humans ; India ; Islands ; Leprosy ; Lipolysis ; Louisiana ; Ulcer ; Wound Healing

This study is about the Sisters of Charity of St. Joseph in New Orleans' Charity Hospital during the years between 1834 and 1860. The Sisters of Charity of St. Joseph was founded in 1809 by Saint Elizabeth Ann Bailey Seton (first native-born North American canonized in 1975) in Emmitsburg, Maryland. Seton's Sisters of Charity was the first community for religious women to be established in the United States and was later incorporated with the French Daughters of Charity of St. Vincent de Paul in 1850. A call to work in New Orleans' Charity Hospital in the 1830s meant a significant achievement for the Sisters of Charity, since it was the second oldest continuously operating public hospitals in the United States until 2005, bearing the same name over the decades. In 1834, Sister Regina Smith and other sisters were officially called to Charity Hospital, in order to supersede the existing "nurses, attendants, and servants," and take a complete charge of the internal management of the Charity Hospital. The existing scholarship on the history of hospitals and Catholic nursing has not integrated the concrete stories of the Sisters of Charity into the broader histories of institutionalized medicine, gender, and religion. Along with a variety of primary sources, this study primarily relies on the Charity Hospital History Folder stored at the Daughters of Charity West Center Province Archives. Located in the "Queen city of the South," Charity Hospital was the center of the southern medical profession and the world's fair of people and diseases. Charity Hospital provided the sisters with a unique situation that religion and medicine became intertwined. The Sisters, as nurses, constructed a new atmosphere of caring for patients and even their families inside and outside the hospital, and built their own separate space within the hospital walls. As hospital managers, the Sisters of Charity were put in complete charge of the hospital, which was never seen in other hospitals. By wearing a distinctive religious garment, they eschewed female dependence and sexuality. As medical and religious attendants at the sick wards, the sisters played a vital role in preparing the patients for a "good death" as well as spiritual wellness. By waging their own war on the Protestant influences, the sisters did their best to build their own sacred place in caring for sick bodies and saving souls. Through the research on the Sisters of Charity at Charity Hospital, this study ultimately sheds light on the ways in which a nineteenth-century southern hospital functioned as a unique environment for the recovery of wellness of the body and soul, shaped and envisioned by the Catholic sister-nurses' gender and religious identities.
*Catholicism ; Charities/*history ; History, 19th Century ; Hospitals, Religious/*history ; Hospitals, Urban/*history ; New Orleans