Range of motion and complications after postburn heterotopic bone excision about the elbow

OBJECTIVE: To review the results of surgical management of heterotopic ossification about the elbow in burned patients. DESIGN: Retrospective analysis with long-term patient follow-up. MATERIALS AND METHODS: Eleven patients with 16 elbows requiring surgery were admitted between January 1, 1982 and December 31, 1993. A posterior approach to the elbow with release of the encased ulnar nerve +/- anterior transposition and transolecranon osteotomy to access extensive bone formation in the olecranon fossa was employed. Eight patients (11 elbows) were available for long-term follow-up conducted at mean 50 +/- 13 months after surgery. Long-term follow-up consisted of measurement of range of elbow motion, as well as clinical assessment of ulnar nerve function. MAIN RESULTS: For the 11 elbows examined postoperatively, the mean range of motion preoperatively in flexion-extension was 11 degrees +/- 5 degrees compared to 89 degrees +/- 12 degrees postoperatively (p < 0.001). Three patients with poor long-term results had ankylosis of the joint preoperatively. Of four patients with ulnar nerve paresis preoperatively, none had ulnar nerve dysfunction at follow-up. Of 16 elbows operated on, four (25%) had postoperative complications. Two suffered soft-tissue breakdown with hardware exposure requiring abdominal flap closure, one early failure of olecranon fixation, and one late infected hardware. CONCLUSIONS: Surgery for both limited range of motion as well as ulnar nerve compression is effective in cases of heterotopic ossification about the elbows of burned patients. Early operative intervention is indicated in progressive disease, particularly ulnar nerve palsy, if soft-tissue quality is adequate. Complications with 25% of elbows suggest that use of olecranon osteotomy for joint access may warrant review.     

Interferon gamma protects against hepatic tumor growth in rats by increasing Kupffer cell tumoricidal activity

An increasing number of hepatic resections are being performed as potentially curative surgery for malignant liver neoplasms. Hepatectomy and subsequent liver regeneration produce a local environment that enhances growth of microscopic residual tumor. To determine if pretreatment with murine interferon gamma (IFN-gamma) can protect against such enhanced tumor growth, Buffalo rats were randomized to receive a 3-day treatment of IFN-gamma (50,000 U/qD intraperitoneally) or saline. Groups then underwent intrasplenic injection of 10(6) Morris hepatoma cells, followed 1 hour later by sham (control) or partial hepatectomy (PH) of 70%. PH significantly enhanced tumor growth within the liver (control, 8 +/- 3 nodules per liver; PH, 73 +/- 12 nodules per liver; P < .001). This enhancement was attenuated by prior administration of IFN-gamma IFN-gamma/PH, 16 +/- 3; P < .001 vs. PH). Growth factor release and liver regeneration were not affected significantly by pretreatment with IFN-gamma. The effect of IFN-gamma on tumor growth is associated with a significant enhancement of Kupffer cell (KC)-mediated tumoricidal activity (percentage of specific lysis, 55 +/- 10% control, 78 +/- 11% IFN-gamma, P < .01) but not lymphocyte-mediated tumoricidal activity. Because microscopic residual disease may be present after hepatectomies for cancer, IFN-gamma may be useful agent in retarding growth of residual tumors.     

Canine bladder cancer: epidemiologic features

Significantly reduced immunoglobulins were found in 22 patients with phenylketonuria. Tests of cellular immune function which included delayed skin hypersensitivity, T rosettes and PHA transformation were normal. Escherichia coli antibodies and the booster response to tetanus toxoid were also normal.     

An approach to general oncology: principles and procedures

53 patients clinically suspected of having a cerebellopontine angle (CPA) lesion were examined by computer tomography (CT) with 160 X 160 matrix EMI scanner. 17 cases (32%) had tumour positive CT, of which 12 were neurinomas and 1 meningioma. 1 CT suggestive of a CPA lesion was false positive and 1 unoperated case is probably a false negative CT. Three of the eleven verified neurinomas (27%) were of the medial type originating in the angle cistern. One neurinoma protruding 1 cm into the cistern showed no contrast enhancement. 2 CT scans (3.8%) were unsatisfactory due to movements and the large size of the head. CT is valuable for the investigation of CPA pathology and the diagnostic efficiency compares favourably to other neuroradiological procedures.     

Nickel sulphide-induced rhabdomyosarcomata in rats

Fifty-nine Fischer rat tumors and eleven Hooded rat tumors induced by intramuscular injection of Ni3S2 were examined and their histopathologic and cytologic characteristics studied. Nine out of eleven Hooded rat tumors metastasized whereas 15 out of 59 Fischer rat tumors metastasized within 30 days. Histopathological characterization of the Ni3S2-induced tumors was made according to their preponderant cellular constitution. They were grouped into six types: well-differentiated rhabdomyosarcomas, poorly-differentiated rhabdomyosarcomas, embryonal rhabdomyosarcomas, mesenchymal tumors, leiomyosarcoma-like tumors and fibrosarcoma-like tumors. Forty-seven of total of 70 were rhabdomyosarcomas. Tumors with shorter latent periods in Fischer rats and tumors with fleshy and soft texture demonstrated a higher incidence of metastases.     

Functional longevity of intraperioneal drains: an experimental evaluation

Various types of drains were inserted into the peritoneal cavity of twenty-eight dogs. After one to seven days, all drains failed to show the presence of 200 cc of colored fluid injected intraperitoneally. On autopsy, all tubes were surrounded and occluded by omentum.     

Second examination in meat inspection (author's transl)

A second examination at the expense of the party adjudged to be in error is based on Section 13 of the Meat Inspection Act in the Netherlands, which has been elaborated in Sections 51 and 51a of the Meat Inspection Order. The procedure to be adopted by the second veterinary-surgeon inspector, however, has not been stipulated. The need for clear instructions is stressed. The present paper was designed to promote objectivity and uniformity in second inspections to provide legal security for the owner of the slaughtered animal as well as for the first veterinary-surgeon inspector.     

A histopathologic study of macular cysts and holes

Forty-four eyes from 39 patients with either lamellar macular holes (17 eyes), full-thickness macular holes (18 eyes), and/or macular cysts (9 eyes) were studied histopathologically. Lamellar and full-thickness holes were frequently found in eyes with a history of trauma or ocular surgery. Diabetes mellitus was the most common condition associated with macular cysts. Four lamellar holes and four full-thickness holes occurred in eyes with senile macular degeneration. Six lamellar holes, eight full-thickness holes, and one macular cyst developed on an idiopathic basis. Residual cystoid macular edema was the most prevalent accompanying pathologic feature. Cystoid macular edema was also noted in the opposite eye in seven cases of lamellar and full-thickness holes. A preretinal glial membrane, thought to be a secondary change, was found at or near the edges of the lamellar or full-thickness holes or over the macular cyst in the majority of cases. Wrinkling of the internal limiting membrane (ILM) was present in five cases. Vitreous traction, with or without an operculum, was infrequently associated with these entities.