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At least 595 records · Page 33Linked to original sources
PubMed1981

Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds.

The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase.

Bacterial Infections↗
PubMed1983

Thigh muscle strength in below-knee amputees.

The aim of this investigation has been to study the magnitude of the reduction of thigh muscle strength of below-knee amputees and to correlate the strength to the degree of atrophy and to the clinical function. Thirty-two below-knee amputees participated in examinations of the isometric and isokinetic knee extension and flexion strength using an isokinetic dynamometer (Cybex II). The atrophy was evaluated by measuring the mean muscle fibre area on muscle biopsies of the vastus lateralis and the cross-sectional area of the quadriceps and hamstring muscles measured with computed tomography. The isometric and isokinetic knee extension and flexion strength in the amputated leg with and without prosthesis was significantly lower than the strength in the non-amputated leg (p less than 0.01). Knee extension strength was significantly correlated to the mean muscle fibre area of the vastus lateralis. There was no correlation between strength and the cross-sectional area of the quadriceps muscles. There was, however, a significant correlation between the side differences (amputated leg versus non-amputated leg) in isometric knee extension and flexion strength and the side differences in cross-sectional areas. The reduction in isometric and isokinetic knee extension and flexion strength in the amputated leg both with and without prosthesis compared with the non-amputated leg was larger than the reduction in cross-sectional areas of the quadriceps and hamstring muscles and in muscle fibre areas of the vastus lateralis. This indicates that besides muscle atrophy changes in motor unit recruitment pattern may be of importance for the reduction in muscle strength. Isometric and isokinetic knee extension and flexion strength values in the amputated leg with prosthesis were significantly correlated to step length, maximal walking speed and circumference of the thigh. These results indicate that below-knee amputees with a better preserved thigh muscle strength have a good walking capacity.

Adult↗
PubMed1981

Multiple-organism bacteremia in the surgical intensive care unit: a sign of intraperitoneal sepsis.

Multiple-organism bacteremia (MOB), as defined by the growth of two or more organisms in the same blood culture, was studied in the surgical intensive care unit at the Royal Victoria Hospital. Over the 2 years encompassing 1977 and 1978, there were 125 bacteremic episodes in 83 patients; of this total, 32 episodes of MOB were present in 27 patients. The mortality rate associated with MOB was 48% compared to 25% in those patients with a single organism in their blood (P less than 0.025). Three patients had two episodes of MOB, and one had three episodes; all died. The etiology in two patients was, surprisingly, intravascular devices. Two patients with four episodes of MOB had severe burns, whereas aspiration pneumonia and an infected amputation stump accounted for two more episodes. In the remaining 21 patients (78%) with 24 episodes of MOB (75%), all had intraperitoneal pathologic findings. Of these cases, 19 (59%) episodes were clearly related to intraperitoneal sepsis. The remaining five appeared related to intraperitoneal causes but were without confirmation. There was no difference in the incidence of Bacteroides and Staphylococcus epidermidis. The incidences of enterococci and Escherichia coli were significantly higher (P less than 0.005 for both) and dominant in multiple- versus single-organism bacteremia. Multiple-organism bacteremia is associated with an increased mortality rate, with origins characteristic of polymicrobial infections. The most important source is intraperitoneal and the occurrence of MOB should alert the surgeon to the likelihood of intraperitoneal sepsis.

Adult↗
PubMed1982

[Current reconstructive measures for the covering of defects in the extremities].

Large defects of soft tissue and bone in the lower extremity are still a great surgical problem with regard to morbidity and preservation of the leg. Conventional operative procedures such as cross leg or pedical flap are frequently not sufficient to guarantee successful treatment. Local muscle flap, myocutaneous flap and free-tissue transfer with microvascular anastomoses are excellent surgical supplements for better and quicker treatment, as they can generally be performed in one operative step. Strict indication and a specially trained operating team are essential for successful treatment in these more risky procedures. The new techniques and applications are demonstrated on various cases.

Adult↗
PubMed1995

[Transcranial magnetic stimulation of the accesory nerve--investigation of the site and mechanism of excitation in the cat].

The site where transcranial magnetic stimulation excites the accessory nerve was studied in 5 cats. Transcranial magnetic stimulation of the accessory nerve was recorded from the right trapezius. The accessory nerve was stimulated electrically at the C1 level, jugular tubercle and jugular foramen. The latencies of the compound muscle action potentials (CMAPs) for each portion were measured and compared with the magnetic response, which was coincidental with that of the jugular tubercle. The accessory nerve was then transected in steps distally from the C1 level, and CMAPs following magnetic stimulation were recorded at each step. The CMAPs disappeared following the nerve transection at the jugular tubercle. The results of both approaches in this study conclude that transcranial magnetic stimulation excites the accessory nerve at jugular tubercle. This stimulation site was anatomically coincidental with that of the facial nerve and trigeminal nerve in being right before the point where the nerve bends. Following the accessory nerve transection at the C1 level, the amputation stump was moved cranially, and CMAPs disappeared. CMAPs recorded after the accessory nerve was returned to its original position. These examinations suggested that sudden alteration of the traveling lie of the nerve participates in the mechanism of transcranial magnetic stimulation.

Accessory Nerve↗
PubMed1994

[Reconstruction of grip function in bilateral complex explosion injury].

Evaluation, therapeutical possibilities, and surgical planning for the restoration of bilateral grip function are described, based upon the case of a blind patient presenting after severe bilateral explosion injuries of the hand with grade 3-4 loss of thumbs and fingers. Finally, the given level of amputation and remaining components of the hand together with toe transplantation permitted restoring of power grip on one side and fine grip on the other side in combination with bone and soft-tissue procedures.

Adult↗
PubMed1994

[Classification of limited hyperkeratoses].

A classification of limited hyperkeratoses (LH) was developed for practical use in out-patient surgical practice on the basis of literature data and personal studies and observations over 630 patients. Hyperkeratoses are classified according to the etiological sign (mechanical damage to the skin, diseases and deformities of the locomotor apparatus-neurotrophic, genetic, miscellaneous), clinical course (acute LH-soft corn, uncomplicated and infected and chronic LH-dry corn or callus, uncomplicated and complicated with suppuration, formation of fistula, malignization), according to shape (spherical, ellipsoid, cone-shaped), according to localization (hand and foot, unilateral, bilateral, combined, palm, finger, toe, interdigital), according to size (small, moderate, large), and according to number (solitary, multiple). The cause of the disease in 452 patients was the mechanical effect of poorly fitting shoes and trauma caused by various objects. In 19 patients LH occurred as the result of a pathological condition of the locomotor apparatus (exostosis, flexion contracture of the toes, amputation stump, etc.). In 70 cases LH was a consequence of diseases of the peripheral nervous system. There were rare causes in the remaining patients. Various methods of treatment are suggested, including the use of a laser scalpel, depending on the classification signs of the disease. Removal of the etiological factors is a very significant measure in the treatment and prevention of LH.

Foot Dermatoses↗
PubMed1993

Vascularized megaflaps.

In the early 1980s Japanese surgeons introduced very long free flaps based on two vascular pedicles from the thoracodorsal and groin territories. Such flaps, vascularized through two pedicles, may be called megaflaps. One or both bundles may be anastomosed as necessary to vascularize the flap. Anatomical studies and clinical experience point to new donor sites for such megaflaps.

Adult↗