The hemostatic system function of patients with severe forms of diphtheria

Hemostasis of 100 patients with severe diphtheria infection was studied throughout the disease. The patients were found to have marked procoagulant, anticoagulant and fibrinolytic disorders. Antithrombogenic activity of the vascular wall was also abnormal. The above impairments correlated with the symptoms severity and are interpreted as DIC syndrome which ran subclinically or as hemorrhagic syndrome. The majority of the patients underwent a hyperhypocoagulant phase of DIC syndrome.     

Video-assisted thoracoscopic surgery (VATS). Endoscopic thoracoplasty technique

STUDY DESIGN: The study of two patients whose rib deformity was treated using a new endoscopic thoracoplasty technique is reported. OBJECTIVES: To report a new endoscopic thoracoplasty technique for the treatment of rib deformities associated with idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Thoracoplasty has traditionally been performed as an open procedure, often necessitating additional incisions and/or tissue dissection. METHODS: Two children with significant rib humps associated with idiopathic scoliosis were treated with a new endoscopic thoracoplasty technique. RESULTS: Both children showed dramatic cosmetic improvement of their rib deformity. CONCLUSIONS: The indications for the use of video-assisted thoracoscopic surgery in the treatment of pediatric spinal deformity are expanding. We have extended our video-assisted thoracoscopic surgery repertoire to include endoscopic thoracoplasty for treatment of rib deformities associated with idiopathic scoliosis. The technique for endoscopic thoracoplasty is discussed, and illustrative cases are presented.     

Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation

OBJECTIVE: To study the utility and functional benefits of an implanted functional electrical stimulation (FES) system for hand grasp and release in adolescents with tetraplegia secondary to spinal cord injuries. DESIGN: Intervention study with before-after trial measurement with each subject as his or her own control. SETTING: Nonprofit pediatric orthopedic rehabilitation facility specializing in spinal cord injury. PARTICIPANTS: A convenience sample of five adolescents between 16 and 18 years of age with C5 or C6 level tetraplegia at least 1 year after traumatic spinal cord injury. Key muscles for palmar and lateral grasp and release were excitable by electrical stimulation. INTERVENTIONS: A multichannel stimulator/receiver and eight electrodes were surgically implanted to provide stimulated palmar and lateral grasp and release. In conjunction with implantation of the FES hand system, surgical reconstruction in the form of tendon transfers, tendon lengthenings and releases, and joint arthrodeses was performed to augment stimulated hand function. Rehabilitation of the tendon transfers and training in the use of the FES hand system were provided. MAIN OUTCOME MEASURES: Measurements of pinch and grasp force, the Grasp and Release Test (GRT), and an assessment of six activities of daily living (ADL) were administered before implantation of the FES hand system and at regular follow-up intervals. Results of the stimulated response of individual muscles and surgical reconstruction were evaluated using standard and stimulated muscle testing techniques and standard assessment of joint range of motion. All subjects completed followup testing. RESULTS: Lateral and palmar forces were significantly greater than baseline forces (p = .043). Heavy objects on the GRT could only be manipulated with FES, and FES increased the level of independence in 25 of 30 ADL comparisons (5 subjects, 6 activities) as compared to baseline. After training, FES was preferred in 21 of 30 comparisons over the typical means of task completion. Of the 40 electrodes implanted, 37 continue to provide excellent stimulated responses and all of the implanted stimulators have functioned without problems. The surgical reconstruction procedures greatly enhanced FES hand function by either expanding the workspace in which to utilize FES (deltoid to triceps transfer), stabilizing the wrist (brachioradialis to wrist extensor transfer), or stabilizing joints (intrinsic tenodesis transfer, FPL split transfer). CONCLUSION: For five adolescents with tetraplegia, the combination of FES and surgical reconstruction provided active palmar and lateral grasp and release. Laboratory-based assessments demonstrated that the FES system increased pinch force, improved the manipulation of objects, and typically increased independence in six standard ADL as compared to pre-FES hand function. The study also showed that the five adolescents generally preferred FES for most of the ADL tested. Data on the benefits of the implanted FES hand system outside of the laboratory are needed to understand the full potential of FES.     

Magnetic Relaxation of Solid and Liquid 3He Confined Inside a Silver Sinter

We present T ₁ measurements performed in liquid and solid ³ He confined in sintered silver. In the liquid case, we find a close to linear relationship between T ₁ and the applied magnetic field, similar to other (non metallic) systems, and up to higher frequencies (corresponding to 11 T) than previously reported. In the solid, the relaxation rate is found to increase spectacularly at large polarizations, which may indicate a polarization dependence of the exchange motion. Now atNow at     

Enzymes of the gamma-glutamyl cycle are programmed in utero by maternal nutrition

Regenerative axon growth in peripheral neurons is accompanied by increased expression of the growth-associated protein GAP-43. We examined the increase of GAP-43 immunoreactivity in DRG neurons following lesions at different distances along the sciatic nerve, using immunocytochemistry. To control for the variable involvement of DRG axons following injury at different sites, injured neurons were identified by retrograde labeling with Fluoro-Gold. GAP-43 labeling was similar for proximal, distal, and far-distal injuries when only injured neurons are considered. Our results stand in contrast to studies which show that GAP-43 upregulation in neurons of the central nervous system occurs only when lesions are made close to the cell body. This suggests that the mechanisms which control GAP-43 expression following injury differ between central and peripheral neurons.     

Percutaneous nephrostolithotomy. What is its role in 1997?

A fully automated isocratic high-performance liquid chromatographic method for the determination of 9-cis-retinoic acid, 13-cis-retinoic acid, all-trans-retinoic acid, 4-oxo-13-cis-retinoic acid and 4-oxo-all-trans-retinoic acid, has been developed using on-line solid-phase extraction and a column switching technique allowing clean-up and pre-concentration in a single step. A 500-microliter sample of serum was diluted with 750 microliters of a solution containing 20% acetonitrile and the internal standard 9,10-dimethylanthracene. About 1000 microliters of this mixture was injected on a 20 x 4.6 mm I.D. poly ether ether ketone (PEEK) pre-column with titanium frits packed with Bondapak C18, 37-53 microns, 300 A particles. Proteins and very polar compounds were washed out to waste, from the pre-column, with 0.05% trifluoroacetic acid (TFA)-acetonitrile (8.5:1.5, v/v). More than 200 aliquots of diluted serum could be injected on this pre-column before elevated back-pressure enforces replacement. Components retained on the pre-column were backflushed to the analytical column for separation and detection at 360 nm. Baseline separation was achieved using a single 250 x 4.6 mm I.D. Suplex pKb-100 column and a mobile phase containing 69:10:2:16:3 (v/v) of acetonitrile-methanol-n-butanol-2% ammonium acetate-glacial acetic acid. A total time of analysis of less than 30 min, including sample preparation, was achieved. Recoveries were in the range of 79-86%. The limit of detection was 1-7 ng/ml serum and the precision, in the concentration range 20-1000 ng/ml, was between 1.3 and 4.5% for all five compounds. The method was applied for the analysis of human serum after oral administration of 60 mg Roaccutan. The method is well suited for pharmacological studies, while the endogenous levels of some retinoic acid isomers are below the limit of quantitation.