Experience with thoracoscopic pleurodesis in the treatment of idiopathic spontaneous pneumothorax

Between January 1987 and December 1988 thoracoscopic pleurodesis has been used as a standard treatment for idiopathic spontaneous pneumothorax. Bullae were electrocoagulated, and visceral and parietal pleurae were cauterized. Chemical pleurodesis with 50% glucose-solution was added. 34 procedures were performed on 32 patients. The average hospital stay was 8 +/- 2 days. One patient suffered from postoperative Horner-syndrome. No other complications occurred. Patients were re-evaluated 11 +/- 8 months after the operation. Recurrence was found in four patients within 30 days. These patients underwent pleurectomy. Another patient had recurrence after two months. He was again and successfully treated by thoracoscopic pleurodesis. Our data show improvement of the results as compared with simple chemical pleurodesis.     

Rehabilitation problems in traumatic spinal cord injuries following spinal stabilization using Harrington's fixation device

Authors describe their experiences in medical rehabilitation of 18 patients with traumatic injuries of the medulla after spinal stabilisation with Harrington instrument. The Harrington method is a classical method for spinal stabilization used in the whole world. Besides its doubtless advantages experiences are gathered on its numerous disadvantages: It is not suitable for direct reduction, its stability is insufficient against flexion and extension forces, its biomechanical characteristics are not the most favourable in respect of consolidation, it is too long and includes healthy sections of the spine in immobilization, finally external fixation is needed. For all this, the claims of modern rehabilitation cannot be fulfilled. In possession of newer, more modern methods (fixateur interne, groove plate) the use of it is not at all recommended.     

Direct opto-electronic analysis of the interaction of head and eye movements

To study interactions of head and eye during various motor tasks in a clinical environment, a recording system is needed which should be characterized by high precision and reliability. A computer-assisted optoelectronic method based on the SELSPOT system is described. All the equipment was specially designed for neuro-ophthalmologic purposes and fulfills the requirements. A range of programs was developed using several types of signal processing algorithms, allowing simultaneous one-dimensional and two-dimensional representation of motor acts of the head and eye, including separate analysis of slow and rapid movements. Thus, the method is suitable for analyzing physiologic and pathologic mechanisms of complex interactions. The quality of this novel SELSPOT application is demonstrated by recordings made during induced circular movements.     

Influence of bile on the severity of acute experimental pancreatitis induced by closed duodenal loop in rat.

The study was performed to assess the ethiological role of bile in acute pancreatitis provoked by closed duodenal loop in rat. In group I a closed duodenal loop was created by method of Nevalainen. A similar operation was performed in group II, but the common pancreatico-biliary duct was ligated just under the liver. In the control group (group C) only the mobilization of duodenum was performed. After 24 hours the mortality rate was 20% in group I, but 0% in group II and C. The amount of ascitic fluid showed significant elevation in group I versus II and group C, and in group II as compared to group C, too. The serum amylase was significantly higher in group I than group II and group C, and in group II was also higher as compared to group C. Serum total protein differed significantly between all groups, while albumin and total calcium were significantly lower in group I than group II, but group II was only slightly reduced versus group C. Histology showed no differences between groups I and II, but both differed significantly from group C. In conclusion bile seems to be an aggressive factor in pathogenesis of acute pancreatitis induced by closed duodenal loop in rat, but other factors may play more important roles.     

The relationship between anti-human eye muscle antibodies and thyroid function, anti-TSH receptor antibodies and eye symptoms in Graves' ophthalmopathy.

Circulating IgG, IgA, and IgM antibodies to human eye muscle cytosol antigens were studied in 60 patients with Graves' ophthalmopathy using the indirect ELISA method. There was a significant difference in the levels of both IgG and IgA antibodies between the patients with Graves' ophthalmopathy and a control group (p < 0.001). IgA antibodies to eye muscle cytosol antigens were raised in 20 out of 29 patients with proptosis (class 3 ophthalmopathy), in comparison with 31 patients out of the total group of 60 with Graves' ophthalmopathy (p < 0.02). Anti-TSH receptor antibodies (TRAK) were not present in over half of the 31 patients with raised IgA antibodies to eye muscle antigens. However, a significant difference was found between the levels of IgG and IgA antibodies in the TRAK-negative patients (p < 0.05). These findings suggests that both IgG and IgA antibodies to eye muscle antigens might be important in the development of ophthalmopathy.     

Generation of nitric oxide from organic nitrovasodilators during passage through the coronary vascular bed and its role in coronary vasodilation and nitrate tolerance

This study investigated the release of nitric oxide (NO) from glyceryl trinitrate (GTN) and SIN-1 in Langendorff rabbit hearts. Infusion of either GTN (10-40 microM) or SIN-1 (0.45-4.5 microM) into the coronary inflow tract resulted in a decrease in coronary perfusion pressure and NO release (oxyhemoglobin technique) into the coronary effluent. NO release from SIN-1 occurred spontaneously whereas passage through the coronary circulation, i.e. active metabolism, was required for NO release from GTN. Removal of the coronary endothelium and blockade of endothelial NO formation did not affect NO release from GTN and SIN-1. In GTN-tolerant hearts, there was a considerable inhibition of GTN- but not SIN-1-induced NO formation and coronary vasodilation. These data suggest (1) that metabolic NO release from GTN occurs during passage of the coronary circulation and is independent of the presence of endothelium, and (2) reduced NO release is a major cause of nitrate tolerance.     

Power and weakness of spontaneous reporting: a probabilistic approach.

It has been clearly demonstrated that spontaneous reporting remains one of the best ways for picking up new adverse drug reactions (ADRs) once a drug is on the market. The probability of revealing a new ADR by spontaneous reporting was studied as a function of reporting rate, strength of drug-event association (relative risk), background incidence of the event and number of patients treated. The model included determination of (i) the probability of reporting at least one drug-event association case and (ii) the overall probability of concluding that the drug-event association is not coincidental. Both probabilities were generally low. The results suggest that the identification of a new risk by spontaneous reporting implies a strong association between the drug treatment and the occurrence of the event.     

A tactile maze test in unilateral spatial neglect: the influence of vision and recording technique

Summary Right brain-damaged patients with left spatial neglect were examined on a tactile maze task. They started to explore the right side of the maze and their search times were longer on the left side. Their performance was the same whether blindfolded or not, which contrasts with the results of other studies and probably reflects differences in task demand. The present results do not support a previous observation that visual neglect can be compensated through the tactile modality. Our patients had markedly longer search times than normal controls in the right as well as the left hemifield, and search times in both hemifields were positively correlated. The outcome of the maze test in this context may therefore depend to a large extent on impaired topo graphical processing.     

Possibilities of surgical management of fractures of the scapular corpus]

Authors report on the possibilities of the operative treatment of the corpus scapulae. In chosen cases--young patients, isolated occurrence, great dislocation--they have performed the plate osteosynthesis of the corpus fractures. The frequency of the occurrence, the classification of fractures, the possibilities of the operative technique, the indication of the operations, the postoperative therapy are mentioned and their cases are described.