A comparison of conservative treatment and silicone replacement arthroplasty in Kienböck's disease.

Two forms of treatment of Kienböck's disease were compared in a total of thirty-seven wrists. Sixteen had been treated conservatively and were followed-up for an average of twenty years. Twenty-one had undergone silicone replacement arthroplasty an average of five years prior to review.

The proximal interphalangeal joint in Dupuytren's disease.

In one hundred patients with Dupuytren's disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42 degrees and the average percentage improvement in proximal interphalangeal joint extension at post-operative review was 41%. Fourteen amputations were performed (9.

Incorporation of 35sulfate into the glomerular basement membrane in puromycin aminonucleoside nephrosis.

The in vitro incorporation of 35sulfate into the glomerular basement membrane (GBM) of rats with puromycin aminonucleoside was compared with that of normal rats. 35Sulfate incorporation into the GBM of glomeruli from nephrotic rats did not differ significantly from that observed in normal rats. These data suggest that 35sulfate anionic charges in the GBM play no important role in the pathogenesis of the proteinuria in this experimental model.

Reduction potential of iron in transferrin.

The reduction potential of Fe3+ in transferrin was measured spectrophotometrically by equilibration with methyl viologen in the presence of sodium dithionite. For an ionic strength near 0.1 M at 25 degrees C and pH 7.

Factors affecting the outcome of Colles' fracture: an anatomical and functional study.

A prospective radiological and functional assessment has been performed on 235 consecutively treated displaced Colles' fractures. The age and sex of the patients, as well as the initial displacement, involvement of articular surface and the adequacy of reduction of the fracture, were all analysed. Because of their greater potential for collapse, the better reduced fractures tended to lose more position during treatment.

The hand complications of Colles' fractures.

Two hundred and thirty-five patients with displaced Colles' fractures were followed to union, and 209 patients to six months, specifically searching for hand pathology. The incidence of carpal tunnel syndrome was seventeen per cent at three months and twelve per cent at six months. The patients with the syndrome were significantly older and their fractures showed significantly greater residual dorsal angulation.

Total and renal sympathetic nervous system activity in alcoholic cirrhosis.

Basal sympathetic nervous system activity was assessed in 8 unmedicated patients with alcoholic cirrhosis using a previously developed radiotracer method for measuring total and renal noradrenaline release to, and clearance from, plasma. Compared to the control group total noradrenaline clearance was significantly increased in the patients with advanced alcoholic cirrhosis (Pugh grade C) [1.89 +/- 0.

Estimation of 'total' renal, cardiac and splanchnic sympathetic nervous tone in essential hypertension from measurements of noradrenaline release.

The overall rate of release of noradrenaline to plasma was increased in 31 patients with essential hypertension; the median value was 32% (526 pmol/min) higher than in 22 subjects with normal blood pressure. To ascertain the pattern of sympathetic nervous system activation underlying this abnormality, regional sympathetic nervous activity was estimated, from radiotracer-derived estimates of organ-specific noradrenaline release to plasma, in the kidneys, heart and hepatomesenteric circulation. Renal sympathetic nervous tone was preferentially increased in essential hypertension, especially in young patients with hypersecretion of renin.

Functional cast-bracing for Colles' fractures. A comparison between cast-bracing and conventional plaster casts.

The use of Orthoplast cast-bracing to allow early hand function in the treatment of displaced Colles' fractures was investigated in 243 patients. They were randomly allocated into three groups: in the first a conventional Colles' type plaster was used; in the second an above-elbow cast-brace with the forearm in supination; and in the third a below-elbow cast-brace. Radiographic measurements were made at each stage of treatment, and the final anatomical result was scored using Sarmiento's (1975) criteria.

Vibration disease of the capitate.

There are four previous cases of isolated avascular necrosis of the capitate in the literature. This report describes a fifth, and the first to be associated with vibration. A paint sprayer presented with wrist pain, tenderness over the capitate and radiological changes of avascular necrosis of the capitate.

Dupuytren's contracture: a comparative study of fasciectomy and dermofasciectomy in one hundred patients.

This study reviews one hundred patients with Dupuytren's disease treated surgically by the Derby Hand Unit between January 1975 and September 1981. One hundred and twenty-eight operations were assessed with a follow-up period from nine months to ninety months, average thirty-eight months. In thirty-five patients the overlying skin was excised and replaced by a full-thickness skin graft (dermofasciectomy).

Total, and organ-specific, noradrenaline plasma kinetics in essential hypertension.

We have developed radiotracer techniques, based on measurement of the rate of spillover of noradrenaline to plasma, to simultaneously estimate total, and organ-specific, sympathetic nervous activity in humans. In 27 unmedicated subjects without renal or liver disease, or cardiac failure, regional noradrenaline spillover rates were as follows: lungs 33% of total noradrenaline release to plasma, kidneys 22%, skeletal muscle 20%, hepatomesenteric 9%, skin 5%, and heart 3%. These findings have relevance to numerous previous studies on the importance of the sympathetic nervous system in the pathogenesis of human essential hypertension.

Contribution of individual organs to total noradrenaline release in humans.

Plasma noradrenaline measurements are a fallible guide to sympathetic nervous tone, being dependent on noradrenaline plasma clearance. We have developed radiotracer techniques, based on measurement of the rate of spillover of noradrenaline to plasma, to simultaneously estimate total, and organ-specific, sympathetic nervous activity in humans. In 27 unmedicated subjects without renal or liver disease, or cardiac failure, regional noradrenaline spillover rates were as follows: lungs 138 +/- 36 ng/min (mean +/- SE) (33% of total noradrenaline spillover), kidneys 77 +/- 10 ng/min (22% of total), skeletal muscle 64 +/- 11 ng/min (20%), hepatomesenteric 29 +/- 9 ng/min (9%), skin 18 +/- 4 ng/min (5%), and heart 11 +/- 4 ng/min (3%).

A prospective controlled trial of valgus osteotomy in the fixation of unstable pertrochanteric fractures of the femur.

A total of 62 patients with unstable pertrochanteric fractures of the neck of the femur was subjected to either nail plating with 130 degrees neck-shaft angle or valgus osteotomy using a neck-shaft angle of at least 140 degrees. The patients were assessed in terms of ability to walk and stability of fracture fixation. A clear superiority of valgus osteotomy over the controls was demonstrated in terms of fracture fixation, but the difference in terms of ability to walk was less remarkable.

Clinodactyly. A review of a series of cases.

A review of 50 patients with clinodactyly is presented in which six patients required surgery for a combination of functional and cosmetic problems. It is suggested that patients with a delta phalanx at the proximal phalangeal level should have a reversed wedge osteotomy early, while those with brachymesophalangism requiring surgery have a closing wedge osteotomy performed late. Delta phalanges in the triphalangeal thumb should be excised early and the joint reconstructed.

The effect of irradiation on developing teeth.

Although the consequences of ionizing irradiation on adult teeth have been adequately described in the literature, there have been few reports concerning the adverse effects on the developing dentition. A case is presented in which the jaws were irradiated at an early age and it was possible to examine some of the abnormal teeth in detail by using clinical, radiographic, and histologic techniques.