Pathomorphological changes in infectious mastitis in sheep

Having used the method of electrostimulation of the fracture site with direct current of 10--50 mA in patients with crural fractures, the authors noted a more rapid callus formation. The latter is supported by clinical data and roentgenograms. The method results in shortening of the terms of recovery in patients treated conservatively and surgically. It is believed that this method may be recommended for a wider clinical use in crural fractures.     

Cervical electrostimulation in some vestibular diseases

Vestibular disorders may be treated by means of drugs, surgical tools or rehabilitation. Cervical electrostimulation may be regarded as physical therapy and its activity is connected to neural pathways between cervical receptors and vestibular nuclei. In present study electrodes were placed lateral to cervical column on the opposite side of vestibular deficit as pointed by electronystagmography; stimulus duration was 18 msec and frequency 100 Hz. Every stimulation lasts for 30 minutes and were repeated twice a week for a total number of 10. The ability to adjust vestibulo-ocular reflex was evaluated by means of a Compensatory Index. The following materials were enrolled in the study: 20 normal subjects were observed before and after a cycle of stimulations: 24 patients suffering from acute labyrinthitis or neuritis, 48 cervical vertigo, 8 cervical traumatic injures and 3 patients operated for acoustical neuroma. All these groups were coupled with control groups composed of the same pathology and the same number of subjects. Statistical treatment of reports was evaluated by t-student test before therapy after one month and after 3 months. Results point out good effects of electrostimulation on vestibulo-ocular reflex compensation, especially in cervical vertigo and labyrinthitis or neuritis with respect to control groups. No important results were obtained in neuroma group and in normal subjects. Electrostimulation may act on vestibular nuclei by direct spino-vestibular pathway but also by repeated decompensations mainly mediated via the cerebellum or spino-reticular connections.     

An unusual CT and MR appearance of a posterior fossa dermoid

A study was made of the effect of transcutaneous diaphragmatic electrostimulation (2 mA, 0.3 ms, 20-30 V) on the external respiratory function in 12 asthmatic patients with respiratory insufficiency. The course comprised 7 daily sessions for 20 min. The improvement in respiratory function parameters was observed in the majority of the patients. The effect of electrostimulation was related to the quantity of the procedures.     

Fast-to-slow muscle conversion by chronic electrostimulation: effects on mitochondrial respiratory chain function with possible implications for the gracilis neosphincter procedure

The effects of chronic, around the clock, low-frequency electrostimulation on the respiratory chain activity and cytochrome content of freshly isolated mitochondria were evaluated in rabbit skeletal muscle before and after 30 days of continuous or cyclical electrostimulation using a totally implantable system and a training programme now used in humans. The respiratory activity measured in state III increased strongly after electrostimulation. The efficiency of the respiratory chain increased significantly after electrostimulation but the activity of complex [(reduced nicotinamide adenine dinucleotide dehydrogenase) did not increase. The amount of cytochromes a and a3, b562, and c and c1 increased clearly after electrostimulation. The respiratory activity rate of mitochondria obtained after continuous electrostimulation was apparently higher than after cyclical electrostimulation. Chronic uninterrupted low-frequency electrostimulation, using a clinical training programme, induces an increase in mitochondrial respiratory chain activity in purified mitochondria of skeletal muscle. These changes are the basis of induced resistance to fatigue in fast-to-slow muscle conversion by chronic electrostimulation.     

The effectiveness of vibratory stimulation in anejaculatory men with spinal cord injury. Review article

Most spinal cord injury (SCI) men have fertility problems caused by anejaculation and a decreased fertility of the ejaculate. There are several methods to induce ejaculation, such as vibratory stimulation and transrectal electrostimulation. In order to investigate the current state of knowledge about the effectiveness of vibratory stimulation and to prepare a controlled clinical trial we reviewed the available literature. Ten articles met our inclusion criteria. Articles were found by various strategies, such as computer searches and screening of relevant journals. We used a structured approach to evaluate these articles. In total 428 patients had been treated with vibration. Sixty percent (257) of the patients responded to treatment, ie produced ejaculate. Because of methodological shortcomings in most studies it remains unclear whether there is a relationship between injury type, such as level and completeness of the injury, and the response rate. Semen analyses showed a large intersubject variation. From the data available, it could be concluded that the semen volume is usually normal, whereas sperm motility and morphology of spermatozoa were in most cases far from normal. Side effects of vibratory stimulation were reported in 6% of the patients. Semen could be used for various (assisted) reproductive technologies, eg artificial insemination, in vitro fertilisation and microinsemination. Therefore, it is very important to know which stimulation method is most effective in treating anejaculatory SCI men. This review of the literature shows that the effectiveness of vibratory stimulation remains unclear. New, well designed clinical trials as well as basic research activities might clarify the effectiveness of vibratory stimulation and transrectal electrostimulation.     

The effect of an extract of Baikal skullcap (Scutelleria baicalensis) on succinic acid oxidation by the brain mitochondria in rats with hypoxia

Rehabilitation of 39 patients with osteoarthrosis deformans (OD) consisted of transcranial electrostimulation (TCES) which was performed by means of Transair unit generating impulse current (77 Hz, frontal-retroauricular electrodes position). There was a positive trend in clinical indices, pain intensity, skin temperature. TCES mechanism of action involves stimulation of endorphine brain structures which elevates blood levels of beta-endorphines.     

基于pH值的超强永磁场处理工业循环水阻垢效果评估与预测

磁场处理工业循环水具有一定的阻垢效果。在实验室利用研制的超强永磁场模拟处理工业循环水装置,研究磁场处理后循环水pH值与磁场强度、循环水速度、循环水温度、磁场处理时间、钙离子浓度等的关系,建立基于pH值的超强永磁场循环水处理阻垢效果评价模型,为研制磁场处理循环水的质量控制模型提供参考,为超强永磁场应用于工业生产实践提供必要理论基础。     

基于pH值的超强永磁场处理工业循环水阻垢效果评估与预测

磁场处理工业循环水具有一定的阻垢效果。在实验室利用研制的超强永磁场模拟处理工业循环水装置，研究磁场处理后循环水pH值与磁场强度、循环水速度、循环水温度、磁场处理时间、钙离子浓度等的关系，建立基于pH值的超强永磁场循环水处理阻垢效果评价模型，为研制磁场处理循环水的质量控制模型提供参考，为超强永磁场应用于工业生产实践提供必要理论基础。     

Implementation of groups for creative expression on a psychiatric inpatient unit

Intracranial identification by electrostimulation and monitoring of the status of the facial nerve was intraoperatively used in 21 patients with cerebellopontine angle tumors of varying histological structure. Monopolar and bipolar electrostimulation, as well as electromyography and mechanography for recording the function of the facial nerve were compared. During removal of cerebellopontine angle tumors, identification and monitoring of the function of the facial nerve provide anatomic retention of this nerve when the tumor is radically eliminated. This is of essential significance for acoustic neurinomas. A combination of monopolar and bipolar stimulation for identification of the facial nerve simplifies removal of these tumors. As compared with electromyography, mechanography of facial nerve function during these operations is a more convenient technique due to the simplicity and absence of false operation for electric interferences. The study provided the optimum procedure for intracranial stimulation to identify the facial nerve within the cerebellopontine angle.     

After ship''s accident--physician on duty made wrong decision about ambulance

In 56 patients in an early terms after cholecystectomy excision the complex rehabilitational treatment was conducted using medical physical training, electrostimulation and acupuncture.     

Sympathetic activity and blood pressure in normotensive and hypertensive patients undergoing ophthalmic surgery under electrostimulation anaesthesia (author's transl)

Plasma adrenaline, noradrenaline, blood pressure and heart rate were determined in 10 normotensive and 10 hypertensive patients undergoing ophthalmic surgery under electrostimulation anaesthesia. Venous blood samples for the determination of the catecholamines by a spectrofluorometric method were taken 30 min after premedication and 45 min after surgical incision. The catecholamine concentrations showed no significant differences neither by comparing the normotensive patients with the hypertensive patients nor by comparing the values during operation with them after premedication in each group. However, in the hypertensive patients blood pressure showed a higher increase during operation than in the normotensive patients.     

Transrectal electrostimulation therapy for neuropathic bowel dysfunction in children with myelomeningocele

PURPOSE: We attempted to evaluate the efficacy of transrectal bowel stimulation for neurogenic bowel dysfunction in children with myelodysplasia. MATERIALS AND METHODS: Daily sessions of transrectal electrostimulation were performed on an outpatient basis for 2 to 3 weeks on children with myelodysplasia and stool incontinence. If benefits were noted, 5 to 10 additional daily sessions were performed. Complete success was defined as improvement in all parameters of interest, including decrease in the frequency of daily bowel movements, increased sensation, increased ability to hold stool and a significant subjective change in bowel habits. Moderate success implied improvement in 1 to 3 parameters and treatment failure was defined as lack of improvement in any parameter. RESULTS: A total of 55 children 2 to 14 years old (mean age 6.7) completed a mean of 18 daily sessions per patient of bowel electrostimulation. Followup ranged from 1 to 6 years. Diapers are no longer required due to defecation problems in 14 children older than 3 years. Complete success was achieved in 20 cases (36.3%) and moderate success in an additional 30 (54.5%, overall success rate 90.8%). Specifically, 89% of the patients reported elimination of stooling accidents, 82% reported increased sensation and 71% were able to hold the bowel movement. Overall 68% of the patients noticed significantly improved bowel function. Complete/moderate success of transrectal electro-stimulation was statistically significant for all 4 parameters (p < 0.05), and complete success was significant for increased sensation, ability to hold and episodes of accidents. Therapy failed in 5 children (9%). There were no untoward effects. CONCLUSIONS: Transrectal electrostimulation is a well tolerated and minimally invasive modality that provides sustainable improvement in stool continence in children with myelomeningocele and neuropathic bowel dysfunction.     

The management of chronic hysteria: a review and double-blind trial of electrosleep and other relaxation methods

The effectiveness and mode of action of electrosleep therapy in chronic hysteria was evaluated in a double blind trial with a 1 month follow-up. Matched groups of hysterics were treated with central electrical stimulation and relaxation, peripheral electrical stimulation and relaxation, or relaxation only. Autogenic training exercises were used initially to standarize the relaxation instructions for all the patients. Central electrical stimulation has no specific benefit for hysteria. Rhythmic peripheral stimulation does increase the effect of verbal suggestions to relax initially but has no long term advantage over relaxation alone. Regular brief periods of relaxation can improve the mood and diminish the anxiety level of psychiatric outpatients with hysteria but have no persistant benefit for sleep disturbance or hypochondriasis. The best treatment of depression in chronic hysterics was found at follow-up to be relaxation without electrostimulation. Specialized somatic and psychotherapeutic methods have no advantage over treatment with low doses of anxiolytic drugs, reassurance, suggestion, and regular periods of relaxation.     

Epidemiology of tuberculosis in Tashkent and ways of its improvement

Radioimmunoassay of beta-endorphine (RIA) in plasma was performed in patients with acute, subacute and chronic neurosensory hypoacusis. The RIA and audiological examination were made before treatment and after combined therapy consisting of pharmacopuncture and following low-frequency electrostimulation using negative polarity current. The above treatment elevated beta-endorphine levels in blood plasma. Positive results of the treatment correlated with elevated beta-endorphine levels in the end of the treatment.     

Observations on the natural history of a parotid epithelial-myoepithelial carcinoma of intercalated ducts

Five men (aged 29-43 years) with ejaculatory dysfunction and spinal cord injuries for 10-41 years and level of complete lesions from C6 to T10 underwent electrostimulation. Antegrade ejaculate was obtained in all five participants and simultaneous retrograde ejaculation in four. In general, the total number of spermatozoa was greatest in the retrograde ejaculates and highly variable between the subjects both in the antegrade (0.2-5330 mill.) and in the retrograde ejaculates (0.4-5690 mill.). The percentage of immobile and morphologically abnormal spermatozoa was increased compared with normal values. In connection with the electrostimulation procedures no cases of autonomous hyperreflexia or rectal mucosal injury were observed.     

Prognostic significance of coexistent bulky metastatic central nervous system disease in patients with leptomeningeal metastases

OBJECTIVE: To assess the clinical significance of bulky metastatic central nervous system disease in patients with leptomeningeal metastases. PATIENTS AND METHODS: Forty patients (24 women and 16 men) ranging in age from 32 to 74 years (median, 56.5 years) with cytologically documented leptomeningeal metastases were demonstrated by cranial or spinal magnetic resonance imaging to have either no bulky central nervous system metastatic disease (group A; 20 patients) or bulky central nervous system metastatic disease (group B; 20 patients). Twenty-nine patients were treated with involved-field radiotherapy, and all patients were treated with sequential intraventricular chemotherapy. RESULTS: Median survival was 7 months in group A (range, 5-12 months) as compared with 4 months in group B (range, 2-12 months) (P < .01; Mantel-Cox log rank analysis). Cause of death was similar in both patient groups. CONCLUSIONS: In patients with leptomeningeal metastases, neuroradiographic demonstration of bulky metastatic central nervous system disease independently predicts survival and is useful in determining which patients are candidates for intraventricular chemotherapy.     

Treatment of Adamantiades-Beh?et disease with systemic interferon alfa

PURPOSE: The aims of the study contained herein were to analyze the efficacy and safety of a chronically electrostimulated double-wrap graciloplasty for restoration of continence after a curative abdominoperineal resection for rectal carcinoma and to evaluate late results of a stimulation protocol that was begun early. METHODS: During the last six years, 31 consecutive patients underwent this procedure: in 24 patients, electrostimulated double-wrap graciloplasty was performed simultaneously with abdominoperineal resection for lower rectal cancer, 7 strictly selected patients underwent conversion to an abdominal stoma following previous abdominoperineal resection (mean length of time from stoma creation, 71.4 months) Anorectal reconstruction was performed following a surgical scheme already standarized since 1985 in 102 patients: after abdominoperineal resection, the distal colon was pulled through to the perineum and surrounded by both gracilis muscles following an "alfa and new-sling" configuration; using platinumiridium electrodes, both muscles were then connected to pulse generator, which was implanted subcutaneously in the abdomen. All surgical steps were performed during the same surgical session to allow early postoperative stimulation of the transposed muscles. A contemporary covering stoma was abandoned as a standard procedure; the distal colon was left closed for a few postoperative days, then it was resected and sutured to the perineum under local anesthesia. Eighteen patients underwent preoperative or postoperative radiotherapy or both, without any significant adverse outcome. To increase gracilis resistance to prolonged "tonic" contraction, patients underwent a chronic, low-frequency stimulation protocol. In the last 11 patients, a new "over-the-nerve and intramuscular" implant was adopted to optimize fiber recruitment and to reduce electrostimulation thresholds. At regular intervals, all patients were evaluated using continence scores and questionnaires, electromanometry, endoluminal ultrasound study, and defecography. RESULTS: Twenty-six of 31 patients were evaluated for continence, with a mean length of follow-up of 37.8 (range, 4-68) months; 3 patients died because of cancer recurrence, 1 underwent conversion to an abdominal stoma, and 1 is waiting for stoma closure. Continence to liquid and solid stools was achieved in 22 patients (85 percent), and electromanometry findings confirmed a good muscular contraction postoperatively and during follow-up intervals. No postoperative mortality (40 days) was observed; the postoperative complication rate was high 22-percent), but early treatment (drainage and temporary diversion in 7 patients) led to favorable outcomes (4 resolutions, 3 partial muscular impairments). Four stimulators had to be temporarily explanted because of late complications, and two stimulators had to be replaced because of battery exhaustion after three years of use with high stimulation parameters. A significant difference was observed comparing full-contracting threshold after intramuscular (14 patients) and the new over-the-nerve and intramuscular implant technique. CONCLUSIONS: The study contained herein confirms the efficacy of the surgical scheme we have adopted since 1985 to reconstruct sphincteric apparatus after abdominoperineal resection of the rectum. The "one-step" timing of surgical and electrostimulation-related procedures and the early start of stimulation did not show a significant increase in the complication rate and did not produce noticeable muscular or nerve damage. Adoption of chronic electrostimulation protocols using implantable devices increased the rate of fully continent patients; nevertheless, the overall cost for devices and medical staff duties was high, and a small increase of late morbidity was observed. Finally, the preliminary experience with our new technique of electrode implants encourages further application.     

Indication and clinical results of laminoplasty for cervical myelopathy caused by disc herniation with developmental canal stenosis

STUDY DESIGN: The outcome of a herniated disc in patients with cervical myelopathy treated by laminoplasty without discectomy and in those treated conservatively was studied by magnetic resonance imaging. OBJECTIVES: To compare the surgical results of laminoplasty with those of anterior spinal fusion in patients with myelopathy caused by to cervical disc herniation and to make a treatment strategy for cervical disc herniation depending on these results. SUMMARY OF BACKGROUND DATA: Anterior discectomy and spinal fusion have had acceptable surgical results, but many complications have been reported, especially adjacent segment degeneration and bone graft complications. METHODS: Forty-seven patients with cervical disc herniation were examined in this study. Of them, 32 patients (mean age, 56 years) underwent laminoplasty without resection of the herniated disc. Seven patients with mild cervical myelopathy and 8 patients with radiculopathy (mean age, 53 years) were treated conservatively. As a control group, 44 patients (mean age, 50.3 years) who underwent anterior spinal fusion were examined. All patients in the laminoplasty group also had congenital spinal canal stenosis in which the ventrodorsal canal diameter was less than 13 mm. The association between the outcome of a herniated disc and clinical features was investigated. The severity of myelopathy was evaluated according to the Japanese Orthopaedic Association's scoring system. Surgical outcomes were evaluated by the system of Hirabayashi for determining recovery rate. RESULTS: The recovery rate averaged 67.9% in laminoplasty and 68.8% in anterior spinal fusion. There were no significant differences between the groups. No patients underwent anterior spinal fusion after laminoplasty. Follow-up magnetic resonance imaging showed regression of the size of the herniated disc in 15 of the 20 patients in the laminoplasty group and in 12 of 15 patients treated conservatively. In the MRI studies of the natural course of disc herniation, the size of the herniated disc decreased to almost half in 1 to 2 months and almost disappeared within 3 months after surgery. CONCLUSIONS: The size of the herniated disc in cervical lesions regressed as it does in the lumbar lesions. Laminoplasty for patients with narrowed spinal canals showed favorable surgical results. Therefore, the therapeutic method for cervical disc herniation should be chosen after taking the natural history of the disc herniation into consideration.     

Experimental model of pudendal nerve innervation of a skeletal muscle neosphincter for faecal incontinence

BACKGROUND: Faecal incontinence is difficult to treat. A variety of reconstructive procedures has been described, but none is entirely satisfactory. This study evaluated the feasibility of cross-innervating a skeletal muscle neosphincter with the pudendal nerve in a canine model. METHODS: Thirty dogs were rendered surgically incontinent (the pudendal nerve was cut and the external sphincter was partially excised). A neosphincter was then created using the semitendinosus muscle. In ten dogs pudendal nerve transposition (PNT) to the nerve to the semitendinosus muscle was performed. Ten dogs were given a dynamic neosphincter by inserting a pulse generator at 6 weeks. The remaining ten dogs served as controls with passive semitendinosus wraps. Anal manometry was performed before operation and monthly for 5 months. Muscle biopsies, performed at the initial operation and at 5 months, were stained for slow- and fast-twitch fibres, and were examined histologically. RESULTS: At 1 month, mean sphincter function was 32 per cent of the preoperative value in the control animals, 34 per cent in the PNT group and 27 per cent in the electrostimulation group; all dogs were incontinent. At 5 months the mean recovery of sphincter function was 42 per cent of the preoperative value in controls, 100 per cent in dogs with PNT (P < 0.001) and 63 per cent in dogs having electrostimulation (stimulator on) (P = 0.02). Six dogs with PNT had squeeze pressures equal to or greater than preoperative levels. At 5 months the ratio of slow to fast fibres was significantly greater in all dogs (control P = 0.01, PNT P < 0.005, electrostimulation P < 0.001). CONCLUSION: Use of the pudendal nerve to innervate a canine skeletal muscle anal wrap produced a functional anal sphincter that was superior to electrically stimulated and passive wraps.     

Use of activator appliances in pediatric patients treated with costochondral grafts for temporomandibular joint ankylosis: analysis of 13 cases

PURPOSE: The long-term outcomes and clinical results of costochondral transplants used for the treatment of condylar ankylosis of the mandible in children with and without application of postoperative activator appliances are evaluated and compared. MATERIALS AND METHODS: A nonrandomized, retrospective clinical study of 13 cases of condylar ankylosis (16 joints) of the mandible surgically treated during a 9-year period from 1988 to 1997 was performed. All 13 patients were treated by condylectomy and immediate costochondral rib grafts. Nine of these patients underwent long-term postoperative therapy using removable activator appliances. Four patients did not undergo activator therapy postoperatively. Casts, radiographs, photographs, computed tomography (CT) scans, magnetic resonance imaging (MRI) and 99Tc bone scans were used postsurgically to evaluate graft take, condylar growth and function, occlusion, and facial and condylar symmetry. RESULTS:The postoperative and long-term clinical results in both groups showed costochondral growth center transplants to be effective in restoring mandibular growth of the affected side. However, symmetry, arch coordination, correction of occlusal canting, mandibular deviation, facial growth, and prevention of reankylosis were obtained and better controlled only in those cases that underwent long-term orthodontic activator therapy postoperatively and were followed closely. CONCLUSIONS: Children with long-standing condylar ankylosis of the mandible and its resultant facial asymmetry and occlusal canting (secondary to a nonfunctional joint and maxillary compensation) treated with condylectomy and immediate costochondral rib graft reconstruction of the affected joint were treated more favorably when activators were used postsurgically. The patients that failed to comply with or continue activator therapy postsurgically developed complications relating to mandibular deviation, occlusal dysharmony, asymmetry and, in one case, reankylosis of the temporomandibular joint (TMJ).