Epidemiology of fracture of the upper end of the humerus.

The age and sex specific indicence was calculated in 729 cases of fracture of the upper end of the humerus. The prevalence of other fractures and conditions in these patients was investigated. The age and sex specific incidence is as that of femoral neck fracture with a rapid increase with age, twice as fast in women as in men. Only fractures which include evulsion of the greater tuberosity deviate somewhat from that pattern. The more displaced fractures have a tendency to occur later in life. The prevalence of other fractures is about doubled in patients with fracture of the proximal end of the humerus as compared to age and sex matched controls. This is true for fracture of the distal end of the forearm and fracture of the upper end of the femur but also for other fractures. The prevalence of severe alcoholism was significantly greater than in controls. A history of gastric resection was in these patients about three times as frequent as in a control sample. We conclude that fracture of the upper end of the humerus must be assigned a prominent place in the category of bone fragility fractures.     

Dynamics of indices of the natural resistance of patients with cancer of the stomach

The complement titer, bactericidal serum activity and cation protein content of the peripheral blood granulocytes in gastric cancer, polyps and gastric ulcer disease were studied in dynamics. The most decrease in the indices listed was noted in patients with stage IV gastric cancer. The results of the tests mentioned permit to judge about the state of the non-specific resistance of the body of patients with gastric cancer, and in the complex with the other clinico-laboratory findings are of prognostic value.     

Comparative evaluation of various methods of initial hypothermic perfusion of donor kidneys

The authors discuss three various methods of initial hypothermic perfusion applied in 160 donors. The function of the donor kidneys was evaluated according to the results of clinical transplantation. The advantage of high-current perfusion in situ is shown, it allows the number of donor kidneys which are unfit for transplantation to be reduced to minimum. The method of in situ perfusion of organs in multiorganic collection ensures the most adequate antiischemic protection of all organs removed for transplantation, particularly in donors after circulatory arrest.     

网状接骨板在颈椎病治疗中应用的初步报告

目的：结合网状接骨板的设计探讨颈椎固定的新方法的特点。方法：对12例颈椎间盘脱出的病人采用前路显露颈椎,摘除椎间盘或椎体,彻底解除脊髓压迫,取髂骨植骨,将网状接骨板固定在颈椎前缘,使颈椎适度伸展达到应力的平衡。结果：所有病人均能获得良好的即刻稳定固定。术后随访6－18个月,优良率91．7％,颈椎高度恢复良好,无术后并发症,无复发。结论：网状内固定物设计合理,操作简便,能恢复颈椎高度和生理弯曲,防止并发症。设计符合植骨固定的生物力学原理,有广泛的适应证。     

Technique of scleral fixation of extraocular muscles

In this paper the subject of scleral fixation is thoroughly outlined and reviewed.The strength of the scleral fiber is stressed. The technique of scleral suturing in the region of the equator is outlined and intimately described. The three regions in which scleral suturing can be practiced, i.e.: (a) behind the equator; (b) between the equator and muscle insertion; and (c) the region anterior to the muscle insertion, are discussed in detail. The instrumentation, especially the needle to be used is described. The advantages of catgut are cited. The ligated suture used in cases of tension is stressed.     

Case of cystic metastasis of the liver

The report is about a patient clinic of Iassy from oncologic clinic. He had pain in the right, back and inferior hypocondrium, with irradiation, vomitings, pain less (7 kg in 2 months), weekness. The echography shows three years ago, hepatic cysts (the patient refused the admitted in hospital). Computed tomographic (CT) exam made in jan. 1996 shows three cystic hepatic tumors (2 in right and 1 in left lobes). The CT function revealed sterile biliohematic liquid. The laparotomy made the sharp diagnosis--cephalic pancreatic tumor with cystic metastatic hepatic tumors. The surgical treatment was partial resection of pancreatic tumor and drainage of hepatic cysts, with good postoperator evolution. The intraoperative histological exam found the same kind of malignant tumor in the pancreas and liver. We present the case for his rarity.     

新疆温宿县成年人胆囊结石患病率调查

目的 了解新疆温宿县成年人胆囊结石的发病情况。方法 2003年7月至2004年7月对多级抽样的18岁以上3199名温宿县居民作空腹胆囊超声检查及问卷调查。统计分析采用SPSS11．5软件包。卡方检验，多因素分析采用Logistic逐步回归。结果 2．4％已行胆囊切除术；温宿县成年人胆囊结石的患病率为13．2％（男性为6．6％，女性为16．6％），其中无症状者占70．9％（292／412）；胆囊结石患病率随年龄的增加而升高，40岁以后高发；维吾尔族（13．7％）和其他少数民族（12．6％）均显著高于汉族（3．8％）（P〈0．001），每日肉食摄入量〉100g者（16．4％）高于肉食摄入〈50g者（14．4％），喜欢油腻食物者（15．6％）显著高于不喜欢油腻食物者（9．6％），脑力劳动者（13．4％）高于体力劳动者（11．8％）。睡眠时间不足8小时者（16．2％）高于超过8小时者（11．6％），肥胖指数〉25者胆囊结石患病率20．9％，高于肥胖指数为23-25者（15．8％）和〈23者（10．0％）。结论 新疆温宿县成年人胆囊结石患病率较高，多因素分析显示胆囊结石发病率与性别、年龄、民族、饮食结构、营养状况、工作性质、睡眠时间、肥胖指数等相关。     

Causes of unfavorable outcome of surgical treatment of injuries of the menisci of the knee joint]

The results of meniscetomy in 480 patients are analysed. Late results were folowed up in 435 of them. Poor issues were noted in 19 cases (4.4%). The main causes of failure were as follows: a delayed and inadequately radical surgery.     

发育性髋脱位手术并发症的原因分析

本文总结了我院手术治疗的发育性髋脱位236例280髋的临床资料,其中男77例94髋,女159例186髋,患者年龄1岁10个月～38岁,平均7岁9个月,术后随访1～11年,平均3年10个月,共有58髋发生了不同种类的并发症,包括再脱位9髋,股骨头缺血性坏死11髋,关节僵硬31髋,骨性关节炎7髋。文中对各种并发症产生的原因进行了较全面的分析。     

Pathophysiology of the ototoxicity of cis-diamminedichloroplatinum

The electrophysiologic and histopathologic changes in the inner ear caused by the administration of cis-diamminedichloroplatinum (CP) were studied in guinea pigs. The endocochlear dc potential (EP) gradually decreased after the intravenous injection of CP and reached approximately 0 mV on the fourth day, but the EP did not become negative. The cochlear microphonics also diminished and could not be recorded on the fourth day. The negative potential of the organ of Corti remained in the normal range during the experiment. A large negative summating potential (SP) was observed one day after injection, but the amplitude of the negative SP became small on the second day. Light microscopic examination demonstrated that the outer hair cells are destroyed in the basal turn of the cochlea and are preserved in the upper turns, while the inner hair cells are almost completely preserved in all turns. The stria vascularis was found to be slightly atrophic. Severe collapse of Reissner's membrane was observed in the basal turn.     

血浆D-二聚体在预测扭转睾丸存活力中的价值

目的:探讨睾丸扭转后患者血浆D-二聚体(D-dimer)对扭转睾丸存活力的预测价值.方法:选取2014年1月-2020年2月我院收治的51例睾丸扭转患者为研究对象.根据治疗结果分为睾丸坏死组(29例)和睾丸存活组(22例),另随机选取本院同年龄段正常体检者20例为对照组.记录患者的睾丸扭转时间以及睾丸的扭转程度.收集并...     

The influence of strategy of treatment of obturation colonic tumor obstruction on short-term results and quality of life of patients

The results of treatment of 120 patients with colonic tumor obstruction, included in the main group, with the formation at the first stage of decompressive double-barrel colostomy were analyzed as well as resection of the colon with ablation of the tumor and simultaneous liquidation of the stoma on the second stage. The overall postoperative lethality was 1.6%. Operations of the second stage were made in 96.7% of the patients. The interval between operations was 18.3 days. The control group consisted of 182 patients with Hartmann operations fulfilled at the first stage and liquidation of the double-barrel colostomy at the second stage. Postoperative lethality was 9.9%. Restorative operation was made in 83.5% of patients. The average term of colostomy was 196.3 days. A comparative assessment of quality of life of the patients fulfilled with the MOS SF-36 questionnaire demonstrated better results in the main group of the patients.     

An assessment of the accuracy of modern endoscopic diagnosis of oesophageal stricture

The results of 135 fibreoptic endoscopic examinations of oesophageal strictures carried out in a district general hospital are reported. The endoscopic diagnosis was correct in 90 per cent, uncertain in 3 per cent and incorrect in 7 per cent of these cases. This study indicates that endoscopic examination should include tissue sampling; this not only allows a precise tissue diagnosis to be made but also is shown to increase the accuracy of diagnosis. Tissue sampling should include cytological as well as histological material. Analysis of cases of stricture correctly diagnosed has shown that target biopsy and brush cytology each makes a significant contribution to diagnosis. The routine collection of cytological specimens in addition to the more commonly obtained histological specimens in addition to the more commonly obtained histological speciments is strongly advocated. The natural history of malignant oesophageal strictures in this study is reviewd. The mean survival in 58 cases was 6.9 months.     

Effect of Intratesticular Administration of Serum on the Physiological Status of Rat Testis

The effect of loss of integrity of seminiferous tubules on intracellular mechanisms in the testis of rats was studied after intratesticular administration of homologous serum. The increased weights of ventral prostate, seminal vesicles and increased activity of beta glucuronidase in kidney reflected an increased availability of testosterone to the target organs. The pulse labelling of 32P in the nucleic acid fraction of testis was significantly increased. The concentration of testicular DNA was increased while the ascorbic acid was slightly decreased. Activities of the lysosomal enzymes, acid phosphatase and beta glucuronidase increased. The involvement of lysosomal enzymes in the testicular function under altered condition was indicated.     

Epidemiological study of 314 cases of cancer of the bladder in the administrative department of Bas-Rhin,France

Summary This study is composed of two epidemiological investigations. The first concerns the geographical distribution of cancer of the bladder in the department of Bas-Rhin. The geographical distribution of 314 cases of cancer of the bladder in the eight districts of the Bas-Rhin has been studied. The resultant map shows considerable variations in morbidity. The urban predominance may be due to environmental factors. The second enquiry concerns the frequency of multiple cancers of different primary sites occurring in cases of cancer of the bladder. Nine such cases have been identified. There may be a common predisposing factor in such cases. All patients were heavy smokers.Travail réalisé par le Service de Chirurgie Urologique, C. H. U., Strasbourg, France     

Results of operative treatment of fractures of the posterior wall of the acetabulum

BACKGROUND: The purpose of this study was to determine the clinical outcome in patients in whom a displaced fracture of the posterior wall of the acetabulum had been treated by open reduction and internal fixation. METHODS: One hundred patients who had had open reduction and internal fixation of an unstable unilateral fracture of the posterior wall of the acetabulum were studied. Ninety-four patients were assessed at a mean of five years (range, two to fourteen years) after the injury. Six patients with a poor result were followed for less than two years. The functional outcome was evaluated with use of the clinical grading system adopted by Letournel and Judet with incorporation of modifications by Matta. Patient, fracture, and radiographic variables were analyzed to identify possible associations with functional outcome. RESULTS: The reduction of the fracture, as determined with plain radiography, was graded as anatomic in ninety-seven patients and as imperfect in three. The clinical outcome at the time of final follow-up was graded as excellent in fifty-five patients, very good in twenty-five, good in nine, fair in one, and poor in ten. The radiographic result was excellent in eighty-one patients, good in five, fair in four, and poor in ten. There was a strong association between the clinical outcome and the final radiographic grade. Variables identified as risk factors for an unsatisfactory clinical result included a delay of greater than twelve hours before reduction of an associated hip dislocation, an age of fifty-five years or older at the time of injury, intra-articular comminution, and osteonecrosis. CONCLUSIONS: The uncomplicated radiographic appearance and relatively simple operative approach for fractures of the posterior acetabular wall belie the risk of poor results. Prompt reduction of an associated hip dislocation is imperative. Fractures in elderly patients and those with extensive comminution are more likely to have a poor clinical result. However, a high likelihood of a long-term good-to-excellent result can be expected following anatomic reduction and internal fixation of these fractures.     

Methods of evaluation of the functional results of flexor tendon repair of the fingers

The methods used by Buck-Gramcko, Kleinert and Tsuge in evaluating the functional results of flexor tendon repair were each applied to assess the functional outcome in sixty-seven fingers where both tendons had been severed in "no man's land". The method of Buck-Gramcko gave the highest rating, and the three methods showed evident differences in the results of evaluation after surgery. The study suggests a need for one standard method of measurement and recording, if a comparison of results after flexor tendon repair is to be of value. We found that the method of Buck-Gramcko incorporated the most essential features in the functional evaluation.     

乙肝病毒感染与肝癌自发性破裂相关性研究的进展

目的探讨乙肝病毒感染与肝癌自发性破裂出血的相关性及其机理。方法采用文献回顾的方法，对肝癌自发性破裂患者的有关血管病变资料加以整理并综述。结果肝癌自发性破裂患者的小动脉存在管壁受损，这与乙肝病毒感染引起的血管免疫性破坏密切相关。结论乙肝病毒感染引起的血管免疫性破坏可能是肝癌自发性破裂的重要原因。     

Potentialities of hemodilution and photocorrection of blood in treatment of patients with obliterating atherosclerosis of lower extremities

The state of microcirculation in the ischemized extremity fingers was studied in 89 patients with obliterating atherosclerosis of the lower extremity vessels treated by conservative rheological therapy with rheopolyglucin and intravascular laser irradiation of blood in order to define their application alone, or in combination or in succession. The work has shown evident effectiveness of their using alone and in succession, while a combined use of the methods in question was found to be not expedient. The successive use of these methods can be considered expedient when monotherapy had proved to be helpless.     

Treatment of primary pyogenic abscess of the psoas: retrospective study of 18 cases]

The primitive abcess of psoas muscle is a rare affection which involves mainly the young. The authors report 18 cases of primitive pyogenic abcess of psoas collected during a period of six years in the urology service of UHC Ibn Rochd Casablanca. The purpose of this review is to discuss the different therapeutic attitudes. The study concerned 11 men and seven women, their mean age was 35 years. The mean delay of evolution was 45 days. The physical exam found a psoitisis (five cases) and a flunk swelling (14 cases). The ultrasound exam showed the collection which was hypoechogenic in seven cases and heterogenous in 11 cases. The CT scan showed an heterogenouse hypodense collection without enhansment in seven cases. The use of antibiotherapy alone (four cases) and percutaneous drainage (four cases) permitted the recovery just respectively in one and two cases. Fifteen patients (83%) were operated through a postero-lateral lumbotomy route without costal resection. The bacteriological exam of the pus found a Staphylococcis aureus (ten cases) and Escherichia coli (two cases). The evolution was favorable in 14 cases; one patient was dead at fifth day post operatively by heart infarction. For the authors, the surgical drainage remains the treatment of choice.