Intraoperative electroneurodiagnostics to detect a second granuloma in the cubital area of median nerves affected by leprosy: a new approach to prevent incomplete surgery.

A recent work reports on the necessity to localize the most proximal site of leprous ulnar neuritis with intraoperative electroneurodiagnostics. In the present study we wanted to verify the applicability of this method on leprous median nerves. In six patients, seven median nerves were exposed at the wrist, all showing a typical leprous granuloma there.

The radial sensory nerve entrapped between the two slips of a split brachioradialis tendon: a rare aspect of Wartenberg's syndrome.

A retrospective study was designed to verify how often an anatomic variation caused the radial sensory nerve entrapment at the forearm (Wartenberg's syndrome). This variation, in which the superficial branch of the radial nerve emerges from under the fascia between two slips of a split brachioradialis tendon, was mentioned once in a clinical textbook as a basis for nerve entrapment but was found to occur in 5 of 150 dissected arms in 4 of 75 cadavers (3.3% of the investigated arms) in a recent anatomic study.

Intraoperative spinal root stimulation to detect most proximal site of leprous ulnar neuritis.

In 10 patients with leprous ulnar neuritis, we investigated the most proximal site of lesion in the affected nerves. Spinal roots C8 and T1 were stimulated intraoperatively to evoke efferent mixed compound nerve action potentials which were recorded from the exposed ulnar nerves. The site at which amplitudes reached a maximum was considered the most proximal site of lesion.

Superficial branch of the radial nerve emerging between two slips of a split brachioradialis muscle tendon: a variation of possible clinical relevance.

One hundred and fifty upper extremities of 75 nonrandomized human cadavers were dissected to study the topographical relationship between the brachioradialis muscle tendon (BRMT) and the superficial branch of the radial nerve (SBRN). A split BRMT was found in nine arms, while in five of those nine arms the SBRN emerged from under the brachioradialis muscle between the two slips of a divided BRMT to become superficial. This topographical relationship is mentioned sparsely in very old literature, yet its frequency has not been studied before.

Sensory recovery in myocutaneous, noninnervated free flaps: a morphologic, immunohistochemical, and electron microscopic study.

The aim of this study was to clarify the following questions: (1) Do newly sprouting axons use the empty neurilemmal sheaths of a flap as conduits? (2) To what extent can sensibility recover? (3) Does sensory recovery occur at the margins of the flap or at its center? (4) Does chemotaxis influence the regeneration process? In 16 free myocutaneous flaps (12 latissimus dorsi, 4 rectus abdominis) we investigated pain (pinprick), constant touch, temperature, 30- and 256-Hz vibration, and static and moving two-point discrimination between 1 1/2 and 8 years after surgery. Four flaps were anesthetic, eight recovered partly, and four had six or more modalities present all over the flap; six of ten flaps with poor recovery showed better sensitivity close to the anastomosis. Nine patients agreed to have two punch biopsies (6 mm) taken from their flaps (seven from areas with different degrees of sensory recovery and two from the center and the periphery when recovery was homogeneous).

The comparative efficacy of carbamazepine low and high serum level and lithium carbonate in the prophylaxis of affective disorders.

The prophylactic efficacy of carbamazepine slow release (CBZ) at ke different blood levels and lithium carbonate slow release (LI) was compared in a retrospective/prospective, randomized, 2-year open trial. 84 patients with a DSM-III-R diagnosis of recurrent affective disorder who had no prophylactic medication in the 2 years preceding the trial (no LI nonresponders), were randomly allocated to three treatment groups: CBZ low (15-25 mumol/l), CBZ high (28-40 mumol/l) and LI (0.6-0.

Hereditary protein C-deficiency: laboratory values in transmitters and guidelines for the diagnostic procedure. Report on a study of the SSC Subcommittee on Protein C and Protein S. Protein C Transmitter Study Group.

A multicenter study on protein C-antigen and -activity values was carried out in transmitter patients with hereditary protein C deficiency (diagnosis established by pedigree analysis) and in normal controls in order to (1) establish the range of protein C levels in genetically determined heterozygotes and (2) to evaluate the usefulness of statistical procedures to discriminate between protein C deficient patients and controls. In transmitters absolute protein C activity values ranged from 19 to 82% and antigen values from 22 to 88.5%.

Artifact processing in topographic mapping of electroencephalographic activity in neuropsychopharmacology.

Mapping of the electroencephalogram (EEG) has been found to be a valuable method in clinical neuropsychopharmacology. It is evident that careful treatment of artifacts is of utmost importance for EEG data processing, as artifacts that contaminate the EEG data can lead to spurious results. The artifact-processing method described in this article splits signal analysis into a preprocessing step, yielding individual electro-oculographic (EOG) regression factors for EOG minimization, and into a processing step, yielding target variables.

Cortical DC potential shifts accompanying auditory and visual short-term memory.

Negative DC potential shifts appeared over the scalp during the performance of verbal and non-verbal short-term memory tasks. Three items were successively presented (presentation of memory items) and then had to be retained in memory for 3 sec (memory retention) before being compared to a probe which was either a member (in set) or not a member (out of set) of the memory set. Verbal items (the digits "1" through "9") were tested in the auditory and visual modality and non-verbal items (musical notes) were tested in the auditory modality.

Polygonal triple osteotomy of the pelvis. A correction for dysplastic hip joints.

A new triple osteotomy, polygonal pelvic osteotomy (PPO), is described for use in dysplastic hips. The hip joint must be congruous with a centre-edge (CE) angle between +20 degrees and -10 degrees. Templates are used before and during operation which allow precise correction of the position of the acetabulum.

Chiari osteotomy for congenital dislocation and subluxation of the hip. Results after 20 to 34 years follow-up.

We reviewed 236 of the 388 Chiari pelvic osteotomies performed between 1953 and 1967 at the Orthopaedic University Clinic of Vienna for the treatment of congenital dislocation and subluxation of the hip. Over 90% of the operations were performed by Chiari himself. Twenty-one hips had needed reoperation after an average of 15.

The management of IIB osteosarcoma. Experience from 1976 to 1985.

From 1976 to 1985, 75 IIB osteosarcomas have been treated out of a total of 98 osteosarcomas at the authors' institution. Because of the effective chemotherapy including high-dose methotrexate administered during this time period, the surgical management changed, and only ten patients out of the 75 IIB osteosarcomas required an amputation. The overall result of 76.

On brain protection of co-dergocrine mesylate (Hydergine) against hypoxic hypoxidosis of different severity: double-blind placebo-controlled quantitative EEG and psychometric studies.

Utilizing quantitative EEG and psychometric methods we investigated in two subsequent double-blind, placebo-controlled trials the following questions: 1) Does co-dergocrine mesylate (CDM) protect against cerebral hypoxic hypoxidosis as objectivated by neurophysiological and behavioral measures in man? 2) Does CDM offer protection equally both against moderate and marked hypoxia induced experimentally by inhalation of a gas mixture of 9.8% and 8.6% O2 (equivalent to 6000 m and 7000 m altitude, respectively)? 3) Are brain-protective effects of CDM improving by drug administration over a longer period of time (2 weeks)? In the first study, hypoxic hypoxidosis was induced by a fixed gas combination of 9.

Acute blocking of naloxone-precipitated opiate withdrawal symptoms by methohexitone.

In a double-blind placebo-controlled trial of 18 patients, methohexitone blocked objective signs of opiate withdrawal caused by a bolus injection of naloxone. Furthermore, in continuing the naloxone therapy for 48 hours, no withdrawal signs appeared. Levels of withdrawal distress returned to normal levels within six days.

Topographic brain mapping of EEG after acute application of ergotalkaloids in the elderly.

In a double-blind, placebo-controlled, crossover study the encephalotropic and nootropic effects of single doses of two ergotalkaloids (30 and 60 mg nicergoline and 5 mg co-dergocrine mesylate (CDM)) were investigated in 12 elderly subjects (mean age 67 years), utilizing topographic brain mapping of the EEG. Evaluation of EEG, memory, pulse and blood pressure were carried out at 0, 2, 4, 6 and 8 h. Topographic brain maps demonstrated an augmentation of total power, an acceleration of the centroid of the total activity, a decrease of delta/theta and an increase of beta activity (mostly in the alpha-adjacent frequency bands), as well as an acceleration of the centroid of the delta/theta and a slowing of the beta centroid.

Brain protection of nicergoline against hypoxia: EEG brain mapping and psychometry.

In a double-blind, placebo-controlled trial human brain function and mental performance as well as the antihypoxidotic properties of nicergoline were studied utilizing blood gas analysis, EEG brain mapping and psychometry. Hypoxic hypoxidosis was experimentally induced by a fixed gas combination of 9.8% oxygen (O2) and 90.

On the central effects of a new partial benzodiazepine agonist Ro 16-6028 in man: pharmaco-EEG and psychometric studies.

In a double-blind placebo-controlled study, the encephalotropic and psychotropic properties of a new partial benzodiazepine agonist Ro 16-6028 were investigated as compared to a pure agonist diazepam utilizing quantitative EEG and psychometric analysis as well as clinical observations. Ten normal volunteers received randomized (latin square design) and at weekly intervals, single oral doses of placebo, 0.05 mg, 0.

Enhancement of human dental cyst PGI2 formation by platelet derived growth factor and its role in cyst growth and bone resorption.

Various prostaglandins, particularly PGE2 and PGI2, appear to play a major role in osteolytic processes. Radiochromatographic studies have demonstrated that 6-oxo-PGF1-alpha is a major product of exogenously added arachidonic acid in human dental cysts. As platelets may also act as inflammatory cells, platelet-derived growth factor might also have a PGI2-stimulating influence in such cysts.

Day to day reproducibility of Doppler sonographic measurements in patients with valvular aortic stenosis.

High reproducibility of Doppler gradient measurements is necessary for both the reliable noninvasive assessment of the severity of aortic stenosis and for repeated follow-up examinations in individual patients. We therefore studied day to day reproducibility of Doppler sonographically measured peak pressure drops in 46 patients with valvular aortic stenosis. Clinically stable patients were examined twice within 29 +/- 18.

Biologic fixation of a press-fit titanium hip joint endoprosthesis.

The rectangular cross section of a straight-stem prosthesis makes a primary stable, rotation-safe fixation possible that is independent of the individual form of the femur. Due to the curvature of the femur, a three-dimensional large-area anchorage is achieved along the entire prosthesis length in the corticalis as well as in the spongiosa. The titanium-aluminum-niobium alloy is extremely biocompatible and enables the fast ongrowth of newly formed osseous tissue to act as secondary stabilization.

Drug profiling by computed electroencephalography and brain maps, with special consideration of sertraline and its psychometric effects.

The five main psychopharmacological drug groups are reviewed in respect of their effects on the pharmaco-electroencephalogram (pharmaco-EEG), with special consideration given to drug profiling by topographic brain mapping. In addition, the CNS effects of sertraline (100, 200, and 400 mg), zimelidine (100 mg), and placebo were studied. The pharmaco-EEG profiles of both sertraline (100 mg) and zimelidine were indicative of vigilance-enhancement seen after desipramine-type antidepressants; with higher sertraline dosages there was a change toward the sedation associated with imipramine-type antidepressants.

Double-blind, placebo-controlled quantitative EEG and psychometric studies in elderlies on vigilance-promoting effects of an almitrine/raubasine combination (Duxil).

In a double-blind, placebo-controlled study the encephalotropic and psychotropic properties of an acutely and 3-weeks subacutely administered novel drug Duxil (consisting of 30 mg of the antihypoxic almitrine which increases the oxygenation of the arterial blood by specific action on the pulmonary exchange system and of 10 mg raubasine, which potentiates this effect via increase in peripheral circulation), were investigated in 12 elderly subjects in their 70s. Each subject had a treatment of 3 weeks with Duxil and placebo (1 tablet b.i.

Computation of derived diagnostic quantities during intermittent coronary sinus occlusion in dogs.

The haemodynamic responses to pressure controlled intermittent coronary sinus occlusion (PICSO) were recorded intraoperatively in dogs. After analogue-digital conversion the data for coronary sinus pressure were submitted to numerical analysis for detection of systolic and diastolic envelopes and their subsequent fitting by a non-linear model. From the model variables derived quantities, such as plateau and rise times, were constructed so as to resemble the most important features of coronary sinus pressure rise during each occlusion-release cycle.