The management of acute fractures involving the distal radio-ulnar joint and distal ulna

The acute management of fractures involving the distal radio-ulnar joint and distal ulna is controversial. The primary goal is recognition and differentiation between stable and unstable fracture patterns. Although an operative approach is adopted in the treatment of these injuries, the optimal management protocol awaits good prospective randomized studies.     

Needle arthroscopy in rheumatology--its role in diagnosis and therapy

Needle arthroscopy is a new technique in rheumatology. The procedure is only marginally more invasive than a normal joint puncture, because small instruments are available. The method allows repeated interventions, e.g. synovial biopsy under visual inspection during the course of a disease. The procedure is demonstrated in detail, and the possibilities in the management of rheumatic diseases offered by needle arthroscopy are discussed.     

The role of arthroscopy in the treatment of wrist injuries in the athlete

Wrist arthroscopy provides an ideal means of evaluating intraarticular soft-tissue injuries of the wrist. Many lesions such as tears of the triangular fibrocartilage complex can be treated by arthroscopic means as well. Reduction of articular fractures of the distal radius and pin fixation, reduction of scaphoid fractures and intramedullary fixation, and arthroscopic reduction and transcutaneous pin stabilization of acute carpal dissociation patterns can all be accomplished with minimally invasive techniques under arthroscopic control. These measures often provide the athlete with shorter periods of immobilization and earlier return to athletic competition. Wrist arthroscopy provides a very useful adjunct to the treatment armamentarium of all sports medicine physicians.     

Ulnar buttress arthroplasty for reconstruction after resection of the distal ulna for giant cell tumour

A giant cell tumour of the distal end of the ulna was treated by en bloc resection. The resected distal end of the ulna was replaced by an iliac bone graft, preserving the triangular fibrocartilage complex. The wrist was pain-free and had a full range of motion 6 months postoperatively.     

Stress osteotomy of the distal radius- and ulna metaphysis (Illarramendi procedure): an alternative treatment method in lunate necrosis

Using conventional in vitro extracellular field potential recordings we have investigated both short- and long-term synaptic plasticity in the hippocampal CA1 area of mice infected with ME7 scrapie. In agreement with earlier studies, no changes were seen in the properties of the Sch?ffer collateralevoked field excitatory postsynaptic potential during the early stages of the disease (up to 160 days, post inoculation, d.p.i) after which time the recorded potentials were seen to attenuate. Also, up to this time no changes were seen in either paired-pulse facilitation or post-tetanic potentiation, which are short-term phenomena associated with brief elevations in presynaptic calcium levels. However, there was a significant shift from the ability of slices to maintain long-term potentiation (LTP) from 100 d.p.i. onwards. In all of these experiments short-term potentiation (STP) was preserved, suggesting that from the time that abnormal PrP becomes detectable, or perhaps even earlier, the mechanisms responsible for stabilizing the maintenance phase of LTP are impaired. This result is discussed in terms of the relationship between STP and LTP and how this might be compromised by the conversion of cellular prion protein (PrPC) to the scrapie, protease resistant form of PrP (PrPSc).     

The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes

BACKGROUND: Diagnostic laparoscopy plays a significant role in the evaluation of acute and chronic abdominal pain in the era of therapeutic laparoscopic surgery. METHODS: We referred to our personal series of laparoscopy for both acute and chronic abdominal pain. This is a retrospective review of data accumulated prospectively between 1979 and the present. RESULTS: In our series, 387 consecutive patients underwent laparoscopy because of abdominal pain. In a group of 121 patients with acute abdominal pain, a definitive diagnosis was made in 119 cases (98%). Two patients needed laparotomy to confirm the diagnosis; both had a disease process that did not require laparotomy to treat. A definitive therapeutic laparoscopic procedure was performed in 53 cases 944%). In 45 patients (38%), a diagnosis was made that did not require therapeutic laparoscopy or laparotomy to treat. In the remaining 21 patients (17.5%), exploratory laparotomy was needed to treat the condition. In a chronic abdominal pain group of 265 patients, the etiology was established laparoscopically in 201 cases (76%). A definitive therapeutic laparoscopic procedure was performed in 128 patients (48%). There was a normal laparoscopic examination in 64 patients (24%). There was one false negative laparoscopy that required laparotomy to treat 1 month later. CONCLUSIONS: Laparoscopy is an accurate modality for the diagnosis of both acute and chronic abdominal pain syndromes. These data support the use of laparoscopy as the primary invasive intervention in patients with acute and chronic abdominal pain.     

The role of dynamic contrast magnetic resonance tomography in the complex radiation diagnosis of focal hepatic lesions

The results of complex radiation study of 269 patients with various focal hepatic diseases were analyzed. Present day methods of radiation study were used. Dynamic contrast magnetic resonance imaging (DCMRI) was made in 62 patients. It is concluded that DCMRI is higher sensitive in detecting focal hepatic diseases than other techniques. The time course of changes in signal intensity in different abnormalities greatly differs in quantitative and qualitative parameters, which differentiates the nosological nature of the revealed changes to a high accuracy.     

The surgical treatment of distal hypospadias

Distal hypospadias is one of the most common conditions encountered by the pediatric urologist. For many years it was considered to be a non-surgical pathology, since attempts to correct this condition was cosmetically unsatisfactory and more problems were caused rather than resolved. Over the last 15 years, early in the 80's, John Duckett rekindled the interest in this pathology whose treatment had advanced very little since the era of Mathieu. This article is a posthumous tribute to my mentor, John W. Duckett, who contributed considerably to the advancement of surgical treatment of hypospadias.     

Differential treatment selection: The role of diagnosis in psychotherapy.

Outlines a 4-step model of disposition-based diagnosis in psychotherapy in which the role of diagnosis is only one of many patient, context, relationship, and technique variables that can be applied sequentially to select specific treatments. Certain nondiagnostic dimensions may allow clinicians to apply the best parts of different psychotherapeutic models and formats to maximize prediction from clinical assignments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The current potentials and the role of echocardiography in the diagnosis and surgical treatment of infectious endocarditis

The authors have analyzed results of examination of 107 patients with infective endocarditis (IE) of the natural (IENV) and artificial valves (IEAV) of the heart. It was found that the revealed ultrasonic symptoms of IE were specific in 97.7% of patients with IENV and in 100% of patients with IEAV. The sensitivity of transthoracal echocardiography was 89.6% in patients with IENV and 65% in patients with IEAV. The intracardiac morphological alterations were found to coincide with the findings of echocardiography in 78.2% of patients with IENV and in 55%--with IEAV. The authors have elaborated an algorithm of the complex diagnostic examination of patients.     

The indications for and techniques and outcomes of ablative procedures of the distal ulna. The Darrach resection, hemiresection, matched resection, and Sauvé-Kapandji procedure

Several ablative procedures exist for the treatment of distal radio-ulnar joint arthritis. This article describes the indications, techniques, pitfalls, and outcomes for the four most popular procedures: Darrach, hemiresection-interposition, Sauvé-Kapandji, and matched ulnar resection. The authors explain their personal algorithm for treatment selection, emphasizing patient requirements versus the physiologic characteristics of each procedure.     

The topical treatment of distal ulcerative colitis

Two patients with the acquired immunodeficiency syndrome (AIDS) developed psoriasis, one of them presenting the more severe form and the other one the milder form of the disease, were treated with zidovudine per oral via, 200mg 3 times a day. In the first case the therapeutical response was complete. No lesion was verified in the patient after 9 months under maintenance schedule. In the second case, despite the response being clear, after 6 months of treatment, the patient still presented furfuraceous scalings at limbs ever under the medication schedule.     

The role of childhood sexual trauma in the etiology of borderline personality disorder: Considerations for diagnosis and treatment.

Highlights recent research findings that demonstrate a connection between severity and type of sexual abuse and presentation of borderline-like symptoms. Similarities are drawn between the type of symptoms that make up a posttraumatic stress disorder (PTSD) diagnosis, and those that compose borderline personality disorder (BPD). Neither the PTSD nor BPD diagnoses are completely adequate to address the conditions of psychiatric patients with sexual abuse histories. In PTSD, characterological dysfunction in response to severe abuse experiences is not represented in the diagnosis, while BPD attributes symptoms solely to characterological dysfunction without recognizing their adaptive nature in the face of childhood trauma. A more accurate and less stigmatizing diagnostic category for survivors of sexual abuse has a significant role in expanding the possibilities for successful treatment of these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The diagnosis and treatment of the gummy smile

The diagnosis and treatment of the "gummy smile" (altered passive eruption, excessive gingival display) help the periodontist to provide the most beautiful smiles possible for patients. This article describes diagnosis, surgical planning, and case reports that show the benefits of treatment of this common clinical problem for the patient and restorative dentist who can now provide ideal cosmetic results for their patients.