Anterior cruciate ligament reconstruction: endoscopic versus two-incision technique.

The purpose of this study was to compare the single-incision, "endoscopic" (ENDO) anterior cruciate ligament (ACL) reconstruction technique with the two-incision, "rear-entry" technique (RE). Sixty patients were entered into a prospective study. Thirty patients underwent ACL reconstruction by the RE technique, followed by 30 consecutive patients using the ENDO procedure.

Hypotension induced by haemorrhage impairs lower oesophageal sphincter function.

The effect of haemorrhage-induced hypotension on lower oesophageal sphincter (LOS) tone was studied in 11 adult mongrel dogs. Mean(s.e.

Bradykinin, coronary artery disease and gastro-oesophageal reflux.

Gastro-oesophageal reflux and coronary artery disease frequently coexist. Stimulation of myocardial vagal receptors impairs lower oesophageal sphincter (LOS) function and may explain this link. This study examined the role of bradykinin, produced in increased quantities by the ischaemic myocardium, in activating this reflex.

Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results.

Over a 3-year period nine of 585 patients undergoing shoulder surgery were found to have a superior labral detachment anterior and posterior (SLAP) lesion. Seven patients also had an associated Bankart lesion and underwent arthroscopic repair of the entire anterior-inferior-superior-posterior labral detachment using the Suretac (Acufex Microsurgical Inc., Mansfield, MA) fixation device.

Adhesions after laparoscopic inguinal hernia repair. A comparison of extra versus intra peritoneal placement of a polypropylene mesh in an animal model.

Prosthetic mesh for laparoscopic inguinal hernia repair has become popular but the method of its placement is controversial. Mesh placed within the peritoneum may cause adhesion formation and further complications. The aim of this study was to examine the laparoscopic placement of a mesh, comparing intraperitoneal vs extraperitoneal insertion.

Undiagnosed epidermoid cyst presenting as trigeminal neuralgia: a need for MRI.

A case of an epidermoid cyst in the cerebello-pontine angle presenting with facial pain is reported. The tumour was discovered during neurovascular decompression of the fifth nerve. A pre-operative CT scan was normal.

Propofol--contrasting effects in movement disorders.

We report two patients presenting for thalamotomy in whom tremor was abolished for 8 h after propofol anaesthesia. Propofol has two contrasting actions. It may have an anti-Parkinsonion effect, abolishing abnormal limb movements.

Basilar invagination and mid-line skeletal abnormalities due to in utero exposure to phenytoin.

A case of basilar invagination which is thought to have arisen from the patient's intrauterine exposure to phenytoin is presented. The patient was treated surgically by foramen magnum decompression and occipito-cervical fusion, and by transoral resection of the clivus. His symptoms of brain stem compression were alleviated and the role of phenytoin in the production of his craniocervical abnormality is discussed.

Oxytocin antagonist blocks the vasodepressor but not the vasopressor effect of neurohypophysial peptides in chickens.

Cockerels with permanent cannulas in the brachial artery and vein were put into isolated slings. Arterial pressure and heart rate were continuously recorded. Following habituation, tests were initiated.

Differential modulation of protein kinase C isoforms in erythroleukemia during induced differentiation.

Induction of erythroid differentiation of murine erythroleukemia cells (MELC) by exposure to hexamethylene bisacetamide (HMBA) involves the modulation of protein kinase C (PKC) activity. Using immuno- and Northern blot techniques, we have demonstrated that MELC express a pattern of PKC isoforms which includes PKC alpha, PKC delta, PKC epsilon, PKC zeta, and PKC eta. We show that MELC resistant to induction by HMBA express significantly less of the nPKC isoform, PKC delta, and slightly less PKC epsilon.

[Reconstruction of the cruciate ligaments with allogeneic transplants. Techniques, results and perspectives].

The authors have used allografts for reconstruction of the cruciate ligaments in over 600 cases since 1985. Advantages are the reduced operative trauma and the unlimited availability of high-quality grafts even in multiple ligament reconstructions. Arthroscopic techniques are available for reconstruction of the anterior and the posterior cruciate ligament, which makes arthrotomies and large skin incisions unnecessary.

The anterior cruciate ligament in the multiple ligament-injured knee.

The ACL may be associated with concomitant injury to the posterior cruciate ligament, collateral structures, bone or cartilage. An approach to the multiligament injured knee is discussed including evaluation, treatment, graft selection, operative techniques, graft placement, tensioning, fixation, impingement, postoperative care, and complications.

Reconstruction of the antero-superior shoulder capsule with the subscapularis tendon: A case report.

A 14-year-old boy presented with recurrent, anteroinferior, and multidirectional instability of his dominant shoulder. Examination with the patient under anesthesia demonstrated marked anterior and inferior translation when drawer testing was performed in adduction; however, abduction of the shoulder reduced the magnitude of humeral head translation in both these directions. Arthroscopy and open surgical dissection revealed the absence of any capsuloligamentous structures above the anterior band of the inferior glenohumeral ligament complex.

Hexamethylenebisacetamide-induced erythroleukemia cell differentiation involves modulation of events required for cell cycle progression through G1.

Hexamethylenebisacetamide (HMBA), a potent inducer of differentiation of transformed cells such as murine erythroleukemia cells, causes a prolongation of the G1 phase of the cell cycle during which commitment to terminal differentiation is first detected. Removal of HMBA prior to the G1 phase aborts commitment. To further define the relationship between the G1 phase and commitment to differentiation, we used two inhibitors of cell cycle progression: aphidicolin, which blocks cells at the G1/S interphase, and deferoxamine, which blocks cells at an earlier stage during G1.

At low dose, arginine vasotocin has vasopressor rather than vasodepressor effect in chickens.

It is widely accepted that both arginine vasopressin (AVP), and its avian analogue, arginine vasotocin (AVT) are vasopressor (VP) in mammals, but vasodepressor (VDP) in birds. The rat VP and chicken VDP assays were used to characterize neurohypophysial peptides and their analogues. However, these assays use pharmacological doses.

Endothelium derived relaxing factor is absent in experimental in situ vein grafts.

Endothelium derived relaxing factor (EDRF) is a local modulator of vasomotor tone in most blood vessels. Reversed vein grafts in several animal models do not produce EDRF when stimulated, and have been shown to have altered responses to several vasoconstrictors. The preservation of EDRF production and vasomotor function in in situ vein grafts was examined in this study.

A community nursery nurse working with families with multiple births.

The introduction of skill mix into the health visiting services is causing debate and some concern among health visitors. Patricia Marks describes a three year project in Brighton health authority in which a community nursery nurse was introduced to work in the home with families with multiple births. The role of the community nursery nurse is different from that of the health visitor but this extra input to these families has relieved pressure on health visitors' time, as well as being of tremendous help to the families.

Management of complications of surgery for anterior shoulder instability.

Both operative and nonoperative management of the unstable shoulder requires a thorough understanding of the natural history of instability, as well as the normal anatomy and biomechanics of the shoulder joint. Failure of management may occur at any time during the course of treatment, and may be a result of either physician or patient error, or a combination of both. The correct diagnosis allows for selection of the most appropriate treatment, and the success of surgical treatment depends on proper recognition of the pattern of instability and technically adequate anatomic capsulolabral reconstruction.

Racial differences between Maori and European New Zealanders in aneurysmal subarachnoid haemorrhage.

Racial differences in the incidence and rate of rupture of intracranial aneurysms are well recognized. A retrospective study of racial differences between Maori and European New Zealanders presenting to the Auckland Regional Neurosurgical Unit between 1985 and 1990 was conducted. It was found that the incidence per 100,000 of the population for all aneurysms was 14.

Ossified lipoma of the interpeduncular fossa: a case report and review of the literature.

The case of a 65-year-old woman with a calcified lipoma of the interpeduncular fossa presenting with a monoparesis is reported. This was excised, resulting in an improvement of her symptoms. The literature is reviewed.

Stereotactic surgery for post-traumatic cerebellar syndrome: an analysis of seven cases.

A variety of post-traumatic movement disorders may follow severe head injury. Generally, the movement disorder is a moderate to severe intention tremor, and this is often the major source of disability for the patient. The clinical features of 7 patients whose predominant problem was a post-traumatic cerebellar syndrome, who were treated by stereotactic ablation of the ventralis intermedius thalamic nucleus, are reported.