Screening times with image intensifier in orthopaedic trauma surgery

Primary lymphoma of the bladder is rare. Of the very few cases reported, most appear to be of low grade with a generally good prognosis. Since the concept of low grade lymphoma of mucosa associated lymphoid tissue (also known as marginal zone lymphoma in the REAL classification) was introduced, only six examples of this entity have been recorded at this site. We present a further case and describe its phenotypic characterization.     

Clinical experience with the copper-7 intrauterine contraceptive device. A preliminary report

There have been 203 copper-7 IUD insertions performed in 199 women. The data from 2,230 woman-months of use have been analyzed and compared with other published reports. The copper-7 IUD was an acceptable contraceptive method in regard to effectiveness, continuation, and lack of serious complications.     

The use of cryosurgery in the treatment of low and medium grade chondrosarcoma. A preliminary report

Eighteen chondrosarcoma (Grade I and Grade II) have been treated with cryosurgery. One patient subsequently developed a metastasis; three later had to have an en bloc resection (in two of these there was no tumor in the specimen) and three underwent amputation (one of these had tumor in the specimen). In general, cryosurgery for low grade chondrosarcoma is encouraging as long as the limb is protected postoperatively from fracture -- using various orthopedic appliances to allow bone regeneration (i.e. ischial weight bearing brace). Other complications such as nerve paralysis have been transient. One air embolis death occurred (in another disease) where the exit of nitrogen gas was blocked. This is preventable by allowing free exit of gas from the bone. Approximately 500 cases of primary bone have been treated with cryosurgery as of this date; long term follow-up results will be reported later.     

A preliminary report of small incision cataract surgery by phacoemulsification

The results of 34 cases with cataract extracted by phacoemulsification were preliminarily reported. Postoperatively, they achieved corrected visual acuities > 1.0 in 24 eyes (70.59%) in one week and in 25 eyes (73.53%) after 3 months. The post-operative astigmatism showed a tendency of change from with-the-rule shifting to against-the-rule. The rate of the corneal endothelial cell loss was 13.28%. No severe intra- and post-operative complications were found. It is concluded that the small incision, slight post-operative reaction and fast visual rehabilitation inherent in phacoemulsification procedures are more beneficial to patients than the conventional extracapsular cataract extraction.     

Antibiotic prophylaxis in colorectal surgery. doxycycline compared to a combination of benzylpenicillin and streptomycin. A preliminary report

The aim of the study was to evaluate the effect of two different regimens of antibiotic prophylaxis in colorectal surgery. The study comprises 57 consecutive cases. The mechanical preoperative preparation was essentially the same in all cases and the operative technique was standardized as far as possible. Antibiotic prophylaxis was started immediately before surgery and continued for three days postoperatively. Thirty-six patients received doxycycline 200 mg i.v. per day and 21 patients were given benzylpenicillin 10 million I.U. 4 times a day and streptomycin 500 mg twice a day. No major infectious complications (e.g. septicaemia, abscessess) were seen in either group. There were three wound infections in the doxycycline group and four in the penicillin-streptomycin group.     

Diagnosis of early pregnancy with A-mode ultrasound. A preliminary report

An A-mode ultrasonic analyzer was used to detect pregnancy and to determine gestational age in 102 patients, 77 of whom were pregnant and 25 of whom were not pregnant. All pregnant patients were in the first trimester. Polaroid photographs were taken of the echo pattern display and diagnosis was compared with that of the clinical examination. Results indicate, using only the Polaroid photograph of the patient's A-scope echo pattern, it is possible to (1) diagnose pregnancy with an accuracy rate of 87.2% and (2) estimate the week of gestation, within a tolerance of 21 days of the clinical examination, with an accuracy rate of 84.5%.     

The use of the MMPI for cross-cultural personality study: A preliminary report on the German translation.

Structured personality tests have seldom been used in intercultural comparisons, but present certain advantages over other techniques. The first study using a German translation of the MMPI has been reported. German men and women attending a summer course at the University of Marburg in 1948 showed profiles significantly higher on most scales than American students. Since there is a mixture of factors which might have effects, interpretation of the results is not clear, but the method seems to merit serious attention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunotherapy of cancer with "immune" RNA. A preliminary report

A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross disease and eight had minimum residual disease. RNA was administered weekly, intradermally, at doses up to 9 mg/week without any significant local or systemic toxicity. Four patients improved, thirteen achieved stability of disease or possible improvement, seven were treatment failures, and two are indeterminate. Lymphocyte-mediated cytotoxicity to allogeneic tumor target cells of the same histologic type were monitored in eleven patients. In seven patients, cytotoxicity increased after "Immune" RNA therapy; no change was observed in three patients; a decrease was noted in one patient. There appeared to be a possible correlation between cytotoxicity assessed in vitro and clinical response. There is some evidence that these responses may be specific for the particular tumor used to immunize the RNA donor.     

Development of a fluorescein operative microscope for use during malignant glioma surgery: a technical note and preliminary report

BACKGROUND: Fluorescein has been used in the field of neurosurgery; however, fluorescein enhancement or contrast proved to be inadequate because of a lack of appropriate light sources or filters. A new operative microscope system, in which the microscope itself is equipped with excitation and barrier filters, and the application of this system to surgery for malignant glioma are reported. METHODS: BP 450-490, a glass interference filter used as the excitation filter for the light source optical system, and a Kodak Wratten No. 12 filter used as the barrier filter for the microscope optical system, were incorporated in the operative microscope. A switching apparatus was devised so that filters could be inserted instantly when fluorescence was to be observed. Ten cases in which the location of malignant glioma was enhanced by computed tomography (CT) or magnetic resonance imaging (MRI) were selected for this study. After incision of the dura mater, 8 mg/Kg body weight of fluorescein Na was injected intravenously. Tumor removal was begun some 20 min after the injection with the aid of this newly developed fluorescein operative microscope system. RESULTS: Fluorescence enhancement and contrast were remarkable when this system was used. It enabled surgical maneuvering while viewing the fluorescent image of objects. The boundaries between the tumor areas enhanced by CT or MRI and the surrounding brain could be clearly distinguished in the fluorescent image; the tumor was totally removed, except for deep lesions, without any neurological deterioration. When the tumor was relatively hard, the area surrounding the tumor was aspirated with a cavitron ultrasonic surgical aspirator; as a result, the tumor could be removed en bloc; otherwise, the fluorescent tumor was removed piece by piece. CONCLUSIONS: This system provides adequate fluorescent enhancement and contrast and is useful for observing intravenously injected fluorescein during an operation. Though long-term follow-up of such cases is needed, the conditions of our patients immediately after surgery for malignant glioma were satisfactory. These results suggest that our fluorescein operative microscope system is highly effective in surgery for malignant glioma.     

Rescue thrombolysis with repeated doses of streptokinase in acute myocardial infarct. A preliminary report

A study was made on various methodological aspects of fluorescence image cytometry (FICM) for measurement of nuclear DNA content by using CCD cameras attached to an epifluorescence microscope. Cell nuclei of paraffin-embedded specimens from mouse tissues and human prostate carcinomas were isolated and stained with 4'-6-diamidino-2-phenylindole (DAPI). We found that fluorescence fading, lamp stability, and the homogeneity of the illumination can easily be controlled. A camera with a signal-to-noise ratio of 53 dB gave a slightly more precise measurement than did a 46-dB camera. The linearity of the analysis results was very good. The coefficient of variation of mouse kidney standard cells in the DNA histograms was about 5% and 7.4% in histograms of prostate carcinoma biopsies. Stained cell nuclei can be stored for long periods at -20 degrees C without impairment of quality. Comparative measurements of ploidy by FICM and flow cytometry confirmed the accuracy of the FICM analyses. Thus, FICM appears to be an easy method for quantifying the DNA content of visually inspected cell nuclei in surgical pathology.     

Toxic shock syndrome complicating orthopaedic manipulation of bone. A report of two cases

We studied prospectively 81 consecutive patients undergoing hip surgery using the Hardinge (1982) approach. The abductor muscles of the hip in these patients were assessed electrophysiologically and clinically by the modified Trendelenburg test. Power was measured using a force plate. We performed assessment at two weeks, and at three and nine months after operation. At two weeks we found that 19 patients (23%) showed evidence of damage to the superior gluteal nerve. By three months, five of these had recovered. The nine patients with complete denervation at three months showed no signs of recovery when reassessed at nine months. Persistent damage to the nerve was associated with a positive Trendelenburg test.     

Minimally invasive surgery with the Port-Access method. Preliminary experience

METHODS: Data from the initial experience of 40 patients operated on with the Port-Access technique are reported. Indication to surgery was mitral disease in 24 patients and coronary stenosis in 16 patients. Mean age was 52 years (range 32-75). Operations performed were: 8 mitral valvuloplasties, 16 valve replacements, 9 single CABG (associated with an MVR in one case), 1 double CABG, 6 triple CABG and one quadruple CABG. Coronary endarterectomy was performed in 5 patients and left atrial isolation was associated with MV surgery in 5 cases. RESULTS: There were no operative deaths and every patient was discharged after a mean postoperative stay of 5.5 days (range 3-30). Postoperative course was complicated in 7 patients: surgical revision was necessary in 4 patients due to bleeding (through the mini-thoracotomy incision in 3 cases), 1 pacemaker was implanted for A-V block, one retained pulmonary catheter was removed through the mini-thoracotomy without the aid of cardiopulmonary bypass and in one case, there was an emergency conversion to median sternotomy due to a ventricular fibrillation unresponsive to usual resuscitative maneuvers a few hours after surgery. Some of these complications can be ascribed to the learning phase of this new technique and should disappear as experience is increased. CONCLUSIONS: Port-Access surgery is a new minimally invasive technique that utilizes a cardiopulmonary bypass with femoral access and a specialized catheter system that provides endoaortic clamping, pulmonary artery venting and myocardial preservation with infusion of cardioplegic solution in the aortic bulb or in the coronary sinus. Major contraindications to this technique are iliac-femoral disease or severe dilatation of ascending aorta. The aim of the Port-Access technique is to combine the aesthetic and functional advantages of the minimally invasive surgery with the wide range of surgical options that cardiopulmonary bypass can afford (to operate on atrioventricular valves and perform all the CABG that the patient need), without the limitations characteristic of the classic minimally invasive direct coronary artery bypass (MIDCAB) technique.     

The use of the Synthes 7.3-mm. cannulated screw in rearfoot and ankle surgery: a preliminary prospective study

The authors present a preliminary prospective study of the Synthes 7.3 mm. cannulated screw used in 31 rearfoot and ankle surgeries on 29 patients. The patients had a variety of rearfoot and ankle procedures performed, in which a total of 75 screws were placed across 47 arthrodesis or osteotomy sites. The percentage of union or healing was 95.74% for the joints or sites involved. The average healing time was 2.71 months. The techniques for placement of the screw are described.     

Antimicrobial prophylaxis in orthopaedic surgery: the role of teicoplanin

Associational responses from 128 schizophrenic people and 120 healthy ones were collected. Four words with aggressive emotional shade were given as the stimuli. Semantic analysis of stimulus words was made, which made it possible to obtain a range of content categories. The collected material was analysed then according to them. Significant differences in five content categories were discovered. Basing on these differences we can infer that associational meaning at schizophrenic people is in some way varied. It was also possible to draw some conclusions concerning emotional life of the examined people.     

Intrapartum amnioinfusion in twin gestation. A preliminary report of three cases

Amnioinfusion is an intrapartum technique that is not usually attempted in twin gestations. This report describes infusion of normal saline into the amniotic sacs of three twin gestations with oligohydramnios. All the twins were safely delivered vaginally. No untoward effects were noted. Ultrasound is advised following amnioinfusion to assess the increase in the amniotic fluid volume.