Surgery of True Recurring Median Carpal Tunnel Syndrome with Synovial Flap by Wulle Plus Integument Enlargement Leads to a High Patient's Satisfaction and Improved Functionality.

This prospective study was conducted to investigate electrophysiological qualities and patient's satisfaction of a synovial gliding tissue flap in treating true recurring carpal tunnel syndrome. In 14 patients (11 women, three men), 15 median nerves were included in this retrospective study. For all 15 nerves, motor and sensory nerve conduction velocity, compound muscle action potential, a Visual Analogue Scale-score (VAS-score) questionnaire and an adapted Levine-Test were evaluated pre- and postoperatively.

Urethroplasty performed with an autologous urothelium-vegetated collagen fleece to treat urethral stricture in the minipig model.

Introduction And Objective: Tissue-engineered materials in urethral reconstructive surgeries are a promising field for innovative therapy. Collagen matrices increase stability of cell-based implants and can promote viability and proliferation of urothelial cells. In this study, a collagen type I-based cell carrier (CCC) with stratified multi-layer autologous urothelium was used for urethroplasty after induction of urethral stricture in eight minipigs.

Prevalence of undernutrition during hospitalisation in a children's hospital: what happens during admission?

Background/objective: The aim of the study was to compare the prevalence of undernutrition in children on presentation to hospital and on discharge.

Methods: On a screening week, 141 children aged from birth to 17 years who were hospitalised for ⩾72 h were reviewed on presentation and discharge or after 3 months (if still in hospital) by auditing hospital records. Weight for age standard deviation (s.

Motor evoked potentials enable differentiation between motor and sensory branches of peripheral nerves in animal experiments.

Differentiation between motor and sensory fascicles is frequently necessary in reconstructive peripheral nerve surgery. The goal of this experimental study was to verify if centrally motor evoked potentials (MEP) could be implemented to differentiate sensory from motor fascicles, despite the well-known intermingling between nerve fascicles along their course to their distant periphery. This new procedure would enable surgeons to use MEP for placing nerve grafts at corresponding fascicles in the proximal and distal stumps without the need to use time-consuming staining.

Histologically verified lung metastases in benign giant cell tumours--14 cases from a single institution.

From 1975 to 1997, 649 cases of benign giant cell tumours of the bone were treated at the Istituto Rizzoli. Fourteen patients (2.1%) experienced lung metastases after a mean of 35.

Do high serum levels of anti-Saccharomyces cerevisiae antibodies result from a leakiness of the gut barrier in Crohn's disease?

Objectives: To examine the relationship between serum levels of anti-Saccharomyces cerevisiae antibodies (ASCAs) and intestinal permeability at a given time (hypothesis 1) and the probability of increased ASCA serum levels with increased intestinal permeability (hypothesis 2) in patients with Crohn's disease.

Methods: Each hypothesis was tested retrospectively with its own study population: group A for hypothesis 1 and group B for hypothesis 2. Intestinal permeability was measured by lactulose/mannitol test and ASCAs were quantified by using ELISA.

Large interarcuate spaces in the cervical vertebral column of the tyrolean mountain sheep.

Large interarcual spaces have been described between the arcus vertebrae C5/C6 and C6/C7 in the cervical vertebral column of Nubian goats. This aperture enables direct access to spinal cord and rootlets without the need to perform a hemilaminectomy. The present study was performed in order to determine whether these large interarcual spaces can also be found in the vertebral column of the Tyrolean mountain sheep, as this small ruminant, which is anatomically very similar to the Nubian goat, is frequently used for experimental purposes at the Surgical University Clinic in Austria.

Directional coronary atherectomy: the Vienna experience.

Background: Several multicenter trials have shown excellent results for directional coronary atherectomy (DCA) in a selected patient cohort. To prove the applicability of this method in daily clinical routine and a nonselected patient cohort, we analyzed 46 consecutive cases performed at our catheterization lab.

Methods: DCA was performed as a routine procedure in 45 suitable patients.

A clinical study of a fibrinogen-based collagen fleece for dural repair in neurosurgery.

Background: There is frequently a need for dural grafts to cover defects resulting from retraction, shrinkage, or excision following neurosurgical procedures. Many substances have been tried as possible dural substitution, and different tissues and materials have been evaluated for use in dural repair.

Method: The authors performed a retrospective review of 288 consecutive neurosurgical procedures using a fibrinogen based collagen fleece (TachoComb), a resorbable mesh of collagen from horse tendons, coated with human fibrinogen, bovine thrombin, bovine aprotinin and riboflavin (for marking the coated side), for dural substitution.

Magnetic resonance imaging contrast enhancement of brain tumors at 3 tesla versus 1.5 tesla.

Rationale And Objectives: To compare the diagnostic efficacy of a standard dose of MRI contrast agent in the evaluation of primary brain tumors and metastases using a high-field 3 tesla MR unit versus a 1.5 tesla MR unit.

Methods: Sixteen patients with brain tumors were examined at both field strengths using identical axial T1-SE protocols pre- and postcontrast (0.

Growth prediction in extendable tumor prostheses in children.

Limb salvage procedures for malignant bone tumors of the lower limb in children usualy involve resection of at least one growing physis. To achieve equal leg length, reconstruction relies on accurate prediction of the remaining growth potential of the child. The current authors present the results of predicted growth versus actual prosthetic elongation observed in a group of 15 children fitted with extendable tumor endoprostheses of the lower limb who subsequently have reached skeletal maturity.

Treatment of focal hyperhidrosis with botulinum toxin type A: long-term follow-up in 61 patients.

Background: The blocking action of botulinum toxin type A (BTX-A) on cholinergically innervated sweat glands has been used successfully to treat patients with focal hyperhidrosis.

Objectives: To investigate the long-term efficacy and safety of intradermal injections of BTX-A.

Methods: We performed an open-label study in 61 patients treated over a period of 3 years for axillary or palmar hyperhidrosis.

Effects of milrinone on pulmonary gas exchange in catecholamine-dependent heart failure.

Hemodynamic benefits of milrinone administration are accompanied by adverse effects on arterial oxygenation in mechanically ventilated patients with end-stage heart failure. Particular attention should be focused on pulmonary gas exchange variables after initiation of milrinone treatment in the critically ill patient.

Long-term functional effects of aneurysmal subarachnoid haemorrhage with special emphasis on the patient's view.

Although physical and emotional dysfunction appears to be quite frequent even among independent survivors of aneurysmal subarachnoid haemorrhage (SAH), these symptoms may easily be missed on routine follow-up examinations. To assess the long-term functional effects of SAH and to outline possible treatment approaches, a cross-sectional study using multidimensional measures of relevant areas of function was performed on 40 independent survivors. After an average follow-up period of 22 months, patients were selected and enrolled following a pre-designed protocol.

Pulsatility does not change cerebral oxygenation during cardiopulmonary bypass.

Background: To determine the effect of pulsatility during cardiopulmonary bypass (CPB) on cerebral oxygenation, we measured oxyhaemoglobin (HbO2), deoxyhaemoglobin (Hb) and oxidised cytochrome aa3 (CtO2) with near-infrared spectroscopy (NIRS) in 14 patients electively scheduled for cardiac surgery.

Methods: Cerebral oxygenation was measured during steady state CPB at a core temperature of 32 degrees C. Non-pulsatile flow and pulsatile flow were performed for 10 min each.

Milrinone therapy in catecholamine-dependent critically ill patients with heart failure.

Background: Treatment with the PDE-III inhibitor milrinone improves hemodynamics in patients with heart failure. We examined whether therapy with milrinone is safe and effective in critically ill patients with catecholamine-dependent heart failure and whether treatment with milrinone facilitates weaning from prolonged catecholamine therapy.

Methods: Twenty adult patients with reduced left ventricular function and prolonged (7+/-4 days) catecholamine therapy in whom attempts at catecholamine weaning had failed were examined.

Lack of renoprotective effects of dopamine and furosemide during cardiac surgery.

Because development of acute renal failure is one of the most potent predictors of outcome in cardiac surgery patients, the prevention of renal dysfunction is of utmost importance in perioperative care. In a double-blind randomized controlled trial, the effectiveness of dopamine or furosemide in prevention of renal impairment after cardiac surgery was evaluated. A total of 126 patients with preoperatively normal renal function undergoing elective cardiac surgery received a continuous infusion of either "renal-dose" dopamine (2 microg/kg per min) (group D), furosemide (0.

Cerebral oxygenation during cardiopulmonary bypass measured by near-infrared spectroscopy: effects of hemodilution, temperature, and flow.

Objective: To determine the effects of hemodilution, PaCO2, PaO2, arterial pressure, and temperature on cerebral oxygenation during mild hypothermic cardiopulmonary bypass (CPB).

Participants: Fourteen patients electively scheduled for cardiac surgery.

Interventions: Oxyhemoglobin (HbO2), deoxyhemoglobin (Hb), hemoglobin differential (Hb-diff = HbO2-Hb), and oxidized cytochrome aa3 (CtO2) were measured with near-infrared spectroscopy (NIRS) during CPB.

A comparison of the monitors INVOS 3100 and NIRO 500 in detecting changes in cerebral oxygenation.

Background: Measurements of cerebral haemoglobin oxygenation of 2 near-infrared spectroscopy devices (INVOS 3100 and NIRO 500) were compared during and after hypocapnia.

Methods: Fifteen awake, healthy volunteers, who hyperventilated to obtain end-tidal CO2 (EtCO2) values of approximately 20 mmHg, were studied. During hyperventilation and 8 min thereafter, EtCO2, INVOS 3100 (RSO2 = regional cerebral oxygenation) and NIRO 500 recordings (HbO2 = oxyhaemoglobin, Hb = deoxyhaemoglobin, Hb-diff = HbO2-Hb, CtO2 = oxidised cytochrome oxidase aa3) were analysed.

Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies.

Objectives: To evaluate and compare outcomes and complications in patients having undergone gastrostomy by surgical (SG), percutaneous endoscopic (PEG), or percutaneous radiological (PRG) procedure.

Design: Retrospective analysis.

Setting: University-based tertiary care center.

Leprosy affects facial nerves at the main trunk: neurolysis can possibly avoid transfer procedures.

The predilective sites of lesions in leprous peripheral nerves are well established, and their surgical decompression is common practice when sensorimotor disorders persist after medication. By contrast, the precise localization of leprous facial neuropathy still remains unclear, and musculofascial transfers have been the only type of surgical treatment. The goal of this study was to clarify where leprosy affects facial nerves and to determine whether neurolysis might suffice to restore facial function.

Intraoperative electroneurodiagnostics (transcranial electrical motor evoked potentials) to evaluate the functional status of anterior spinal roots and spinal nerves during brachial plexus surgery.

Intradural spinal root lesions cannot be recognized by dissecting the brachial plexus and lead to ineffective surgery if they remain undetected. Therefore, patients need to undergo a diagnostic procedure to assess the intradural status of the spinal roots. Although motor recovery is the main goal of brachial plexus surgery, the techniques currently applied do not permit adequate evaluation of the anterior root.

Double-blind trial of botulinum A toxin for the treatment of focal hyperhidrosis of the palms.

We performed a randomized double-blind study within-group comparison in 11 patients to study the effect of subcutaneous injections of botulinum A toxin in focal hyperhidrosis of the palms. A total dose of 120 mU (mouse units) of botulinum A toxin (Dysport) was injected into six different sites on one palm, whereas the other was injected with sterile saline. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets.

The contribution of extracranial blood oxygenation on near-infrared spectroscopy during carotid thrombendarterectomy.

To determine the contribution of extracranial oxygenation on regional cerebral oxygenation measured by an Invos 3100 near-infrared spectrometer, we measured oxygenation in blood drawn from both the facial vein (draining substantially blood from forehead areas) and the jugular venous bulb. There was no correlation between regional cerebral oxygenation and facial vein oxygenation (p = 0.35) but there was a significant correlation between regional cerebral oxygenation and jugular venous bulb oxygenation (p = 0.