Ulnar collateral ligament (UCL) tears may be nondisplaced or displaced relative to the adductor pollicis aponeurosis. Nondisplaced tears typically heal with immobilization whereas displaced tears require surgery. Nineteen patients with UCL injuries were evaluated using MR Imaging (MRI), MR arthrography, and stress radiography (SR) to determine the efficacy of these techniques in differentiating nondisplaced from displaced UCL tears. Nineteen patients with UCL Injuries were evaluated. MRI was utilized in 5 patients, and MR arthrography in 14, with 12 of these 14 undergoing SR. They were followed until resolution of symptoms; those without relief, and those with suspected displaced UCL tears were surgically explored. Surgery and imaging was correlated. Eight patients underwent surgical repair. SR was abnormal in six patients treated surgically, but was negative in four of six conservatively treated patients with MR findings of nondisplaced tears. All patients with MR or MR arthrographic findings interpreted as being normal or as having a nondisplaced tear improved after conservative treatment. Based on surgical findings and clinical followup, MR arthrography accurately diagnosed 13 of 14 UCL injuries, with one false-positive interpretation. SR is often falsely negative. MR imaging with or without intra-articular contrast injection proved to be accurate in a small series of patients with UCL injuries.

Adult↗

PubMedDate not supplied

Intra-operative radiotherapy--5 years of experience in the palliative treatment of recurrent and advanced head and neck cancers.

Recurrent and advanced cancer in the head and neck region is usually associated with limited therapeutic concepts and a dismal prognosis. Efforts mainly focus on palliative treatment in order to improve the patient's quality of life. From May 1989 to December 1994, a total of 120 intra-operative radiotherapy (IORT) procedures with high-energy electron beams (mean energy: 7 MeV: mean dose: 20 Gy) were performed in 95 patients. Therapy was usually performed under endotracheal anaesthesia (84%). There were 91 cases (75.8%) of recurrence in the lymph nodes of the neck and 14 cases (11.7%) of local recurrence. 15 patients (12.5%) received IORT as part of the initial treatment. Considering the palliative nature of IORT in these patients, only an R2 resection (gross residual tumour) was achieved in 71.7%. Local tumour control was nonetheless possible in 17% (R2 resection) to 64% (complete R0 resection), with a mean 11-month follow-up period for survivors (mean for deceased patients: 8 months). Regarding palliative criteria, IORT proved to be feasible since patients profited from short hospitalisation (median: 10 days), a low complication rate (27 instances; e.g. tracheostomy: 11; necrosis: 8, or fistula: 3) and, in part, a substantial reduction of pain (73.8%). Most of them regained physical and psychic integrity for weeks to months and were able to take part in social life during the final stage of their disease.

Adult↗

PubMedDate not supplied

Azelastine reduces histamine-induced swelling of nasal mucosa.

In a monocentric placebo-controlled double-blind study with two-period cross-over the anti-obstructive effect of azelastine nasal spray was evaluated. Nasal provocation with histamine or specific allergen respectively was performed before the pollen season in 28 patients with a history of seasonal allergic rhinitis. Efficacy was documented by rhinomanometry, acoustic rhinometry, rhinoscopy and symptom score. Acoustic rhinometry showed a statistically significant lesser decrease in nasal cavity volume in favour of azelastine after histamine provocation (p < 0.05). Reduction in nasal flow as determined by rhinomanometry confirmed this tendency (p < 0.1) after allergen provocation. The analysis of the patients' symptom scores clearly indicated the superior efficacy of azelastine as compared to placebo, especially for nasal obstruction after provocation with both histamine (p = 0.005) and allergen (p < 0.02).

Cross-Over Studies↗