Effects of cast-bracing of the knee on physical performance in healthy subjects.

Effects of application of a hinged cast-brace on thigh muscle strength and physical performance tests were studied in eight healthy volunteers. The cast-brace was applied to one leg for four weeks. The subjects were free to move around.

Functional and morphological adaptations following four weeks of knee immobilization.

Immobilization of the knee as part of the treatment in bone or joint lesions leads to atrophy and consequently loss of functionally. In patients this atrophy and loss of functionality is difficult to quantify because of interfering symptoms and missing baseline data. In the present study structural and functional changes in thigh muscles were examined in eight healthy volunteers of whom one leg was immobilized in a cast for four weeks.

c-erbB-2 positive breast tumours behave more aggressively in the first years after diagnosis.

In a retrospective study the expression of the c-erbB-2 oncogene was determined immunohistochemically in 276 breast cancer samples from 253 patients with the antibody 21N. The follow-up period was between 7 and 12 years. This study showed a trend for an inverse relationship between c-erbB-2 positive tumours and estrogen receptors (ER).

Methods of decision analysis: protocols, decision trees, and algorithms in medicine.

Algorithms, decision trees, and protocols are defined and explained since they constitute an accepted part of clinical decision analysis and application to clinical care. Algorithms are particularly useful for common clinical problems where uncertainties are unlikely. Decision trees are helpful when--as usually occurs in difficult clinical decisions--there are problems in probability.

Gallstone obstruction of the intestine: an analysis of ten patients and a review of the literature.

Ten patients with gallstone ileus were studied to evaluate diagnostic and therapeutic procedures. The preoperative diagnosis was correct in four patients. All patients underwent laparotomy.

The high thoracic sympathetic nerve system--its anatomic variability.

Upon studying microscopically and macroscopically 18 resection preparations of upper thoracic sympathectomies it is clear that the variability in the anatomy of the sympathetic nervous system in connection with the spinal nervous system is higher than has always been described. A fine network of smaller and larger nerve bundles was found which connect the sympathetic and spinal nerve systems. Light microscopical perikarya were identified in many nerve bundles.

Strain gauge plethsymography in ischemic handsyndromes.

In sixteen patients with ischemic handsyndromes, strain gauge plethysmography was used as a noninvasive diagnostic test. Contrast-arteriography was available for comparison. These patients demonstrate the role for a noninvasive test in selecting patients with Raynaud's phenomenon or asphyxia for arteriography.

24-hour systemic antimicrobial prophylaxis with gentamicin and metronidazole, or metronidazole alone, in elective colorectal surgery after mechanical bowel preparation with mannitol and whole gut irrigation.

In a prospective randomized trial, systemic antimicrobial prophylaxis with metronidazole and gentamicin was compared to the administration of metronidazole alone in elective colorectal surgery. In both groups, an identical mechanical large-bowel preparation was performed. In order to reduce the duration of the whole-gut irrigation, a 10% mannitol solution was administered before the irrigation procedure.

Assessment of aortoiliac disease using hemodynamic measures.

To study the role of accurate hemodynamic assessment of aortoiliac disease, intra-arterial pressure measurements of 100 aortoiliac segments were compared with Doppler velocity waveform analysis and contrast arteriography. By applying the statistic kappa, we assessed the degree of agreement among the three methods corrected for chance. The agreement between pressure measurements and contrast arteriography provided a kappa of 0.

Dome fracture of the talus.

Three cases of transchondral fracture of the dome of the talus are reported. Two were treated surgically, one conservatively. A review of the literature is presented and the relative values of surgical intervention and conservative therapy are discussed.

The clinical value of preoperative indirect systolic ankle pressure measurements in wound healing after amputation of the lower extremity.

With the intention towards more distal amputation of the lower extremity for peripheral vascular disease, failure of amputation wound healing remains a common clinical problem. Because calf blood flow correlates well with the indirect systolic ankle pressure, this pressure could be a prognostic guide to the outcome of amputation wound healing. To evaluate the clinical role of systolic ankle pressure measurements for selecting the most appropriate level of amputation, data of 93 patients undergoing 100 amputations were studied retrospectively.

Clinical and rheological studies in patients with intermittent claudication.

While the resistance to flow offered by means of arterial narrowing and the collateral arteries are the major determinants affecting peripheral flow, there may be a contribution by those elements which affect the viscosity of the blood. To evaluate these factors, haematocrit, red blood cell aggregation and plasma viscosity were measured in 100 patients with occlusive arterial disease of the lower extremities. Disturbances in these parameters were noted and appeared to be related to the severity and extent of the occlusive disease.

The value of objective measurements to select patients who are malnourished.

Several studies have attempted to define nutritional parameters that can be used to select malnourished hospitalised patients for nutritional support. A combination of objective nutritional parameters was evaluated in a group of 50 patients selected for total parenteral nutrition on clinical grounds only and compared with a control group. This control group consisted of 38 patients who were admitted for elective minor surgical procedures such as varicectomy and hernia repair.

Chylothorax after gastric resection.

Traumatic chylothorax has been described as an uncommon complication of various thoracic and cervical surgical procedures. No previous reports have been made of chylothorax following gastric resection for malignancy. Two cases of chylothorax following damage to the thoracic duct during gastric resection for malignancy are presented and the literature is reviewed.

Prospective study on the incidence of complications of right heart catheterization.

Indications for hemodynamic assessment by right heart catheterization include shock, pulmonary edema, severe trauma and sepsis. The introduction of the catheter and the location of the tip in the pulmonary artery, however, can cause severe complications. In the present study the incidence of complications was observed in 93 consecutive right heart catheterizations in critically ill patients with no evidence of recent myocardial infarction.

A palliative percutaneous drainage procedure for proximal bile duct carcinoma.

Proximal bile duct carcinoma is surgically irresectable in most patients and some form of palliative drainage is necessary. Percutaneous transhepatic drainage for this condition has been performed in eight patients through internal and external drainage. Five patients had an adequate drainage with a mean palliative drainage period of 11 months, the longest period being 21 months.

Clinical diagnosis, arthrography, stress examination and surgical findings after inversion trauma of the ankle.

In a series of 921 patients with acute inversion trauma of the ankle joint, the diagnostic features of lateral ligamentous ruptures were evaluated. Patients with proven lateral ligamentous rupture (150 patients in this series) were submitted to a prospective trial to compare three methods of treatment. In the 50 patients operated upon, the results of clinical diagnosis, stress radiography, and ankle arthrography were compared with surgical findings.