Monteggia and equivalent lesions in childhood

One hundred two children with acute Monteggia lesions treated over a 25 year period were reviewed. Using the Bado classification system, type 1 (53%) and type 3 (26%) fractures were the most common. The type 1 equivalent injury associated with a proximal radius fracture is more common in children than previously reported. The majority of injuries could be treated with closed reduction, except the type 1 equivalent lesions, which required operative treatment in 10 of 14 children. Varus angulation of the ulna was the most common deformity after closed treatment. Nerve injuries occurred in 11% of the injuries, and resolved in all cases without operative treatment.     

Teratomas and ovarian lesions in children

Ovarian pathology in children is common and the pathology can be quite diverse. The most common benign ovarian tumor in childhood is a teratoma. In this article, we discuss the origin of these germ cell tumors followed by a complete discussion of ovarian pathology.     

Estrogen and progesterone receptors in thyroid lesions

Background: Given the higher incidence and better prognosis of thyroid cancers in women, the possibility arises that these lesions may be influenced by sex hormones. With the development of monoclonal antibodies to the estrogen and progesterone receptor proteins, receptor status can now be determined by immunohistochemical methods that allow direct localization of receptors in tissue. Methods: Using this technique, we have studied tissues of 11 patients, 2 of them pregnant, with thyroid lesions. Paraffin-embedded tissues were used. Positive controls consisted of known estrogen- and progesterone-positive breast carcinomas. Results: Examination of both the thyroid lesions and adjacent uninvolved thyroid tissue showed no nuclear reactivity with either estrogen or progesterone receptor antibodies. Our study did not confirm the previously reported incidence of estrogen and progesterone receptors in thyroid lesions. Conclusions: We conclude that contrary to earlier indications, estrogen and progesterone receptor proteins are neither significantly detectable nor pertinent for follow-up or prognosis in the patient with thyroid neoplasia.The opinions and assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Navy or the Department of Defense.     

Musculoskeletal lesions in yaws

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.     

Laser surgery in colonic and anorectal lesions

Endoscopic laser therapy for diseases of gastrointestinal tract in general, and lesions of colon, rectum, and anus in particular, is in its infancy. Advances are expected to be made to define those lesions that are amenable to lasers and those that are not. In this process, it is hoped that the relative merits and demerits of the various modes of endoscopic therapy might be brought to light. With the advent of contact Nd:YAG laser technology, it is increasingly realized that such a mode of operation could be used to great advantage in both endoscopic and open surgery related to lower-gastrointestinal tract diseases. Furthermore, contact Nd:YAG laser therapy definitely appears to be efficient and safe and compares favorably with other therapies available. How such an effective modality should be sequenced in combination with other available therapies has yet to be worked out. There is more to be done in this arena, which holds high promises.     

Nodular lesions and mesangiolysis in diabetic nephropathy

Diabetic nephropathy is a leading cause of end-stage renal failure all over the world. Advanced human diabetic nephropathy is characterized by the presence of specific lesions including nodular lesions, doughnut lesions, and exudative lesions. Thus far, animal models precisely mimicking advanced human diabetic nephropathy, especially nodular lesions, remain to be fully established. Animal models with spontaneous diabetic kidney diseases or with inducible kidney lesions may be useful for investigating the pathogenesis of diabetic nephropathy. Based on pathological features, we previously reported that diabetic glomerular nodular-like lesions were formed during the reconstruction process of mesangiolysis. Recently, we established nodular-like lesions resembling those seen in advanced human diabetic nephropathy through vascular endothelial injury and mesangiolysis by administration of monocrotaline. Here, in this review, we discuss diabetic nodular lesions and its animal models resembling human diabetic kidney lesions, with our hypothesis that endothelial cell injury and mesangiolysis might be required for nodular lesions.     

Pain and internal hypertension in bone lesions

Internal pressures of bone tumors and tumorous conditions were measured in 20 patients. High pressures were frequently found in patients with painful bone lesions while low pressures were common in patients with no pain. Internal hypertension may be a causative factor of aching bone pain at rest.     

Missed and iatrogenic nerve lesions in surgery

Missed and iatrogenic nerve lesions are not encountered very often. Nevertheless, they represent an increasingly important subject because of their implications for the patient and the physician and their legal aspects. We present an overview of the patients with missed or iatrogenic nerve lesion treated at the Division for Plastic and Reconstructive Surgery of the Inselspital in Berne from 1980 to 1989. After a look at the legal aspects a few typical lesions and their treatments are illustrated. The diagnosis of a missed or iatrogenic nerve lesion differs in no way from that in other nerve lesions. Therefore, we favor an early surgical revision in all cases where the possibility of a transsected nerve must be suspected postoperatively.     

Macroscopic and microscopic lesions in bronchial asthma

Bronchial asthma is a chronic inflammatory disease characterized by reversible airways obstruction, inflammation, and increased bronchial hyperresponsivennes. The aim of this study was to evaluate the macroscopic and microscopic airways lesions, using bronhoscopy followed by biopsy in 38 cases of Outpatient Department from Clinic of Pulmonary Diseases Ia?i, investigated between January 2005 - June 2008. Patients distribution according to the degree of severity was performed, using the international recommendations for asthma management of the Global Initiative for Asthma (GINA): intermittent (n=7 patients), mild persistent (n=10 patients), moderate persistent (n=16 patients), and severe persistent (n=5 patients). 23,68% of patients had a chronic disease of more than 15 years. The endoscopic changes of the peripheral airways were represented by edema, congestion, bronchial stenosis and mucus hypersecretion. Microscopic routine exam showed epithelial lesions (epithelial desquamation, goblet cell hyperplasia, squamous metaplasia), basement membrane thickening, edema, increased vascularisation, glandular and muscular hypertrophy and bronchial inflammatory infiltrate. Although bronhoscopy exam offers important information regarding changes of the airway mucosa in bronchial asthma, it concomitantly provide bioptic control, as microscopic examination still represents the "gold standard" assessment of bronchial wall remodeling process.     

CSF-endorphines in acute and chronic brain lesions

In order to answer the question of an opioid influence on consciousness, a radio-immuno-assay (n = 852) of beta-endorphin and beta-LPH (beta-lipotropic hormone) in both ventricular CSF and blood plasma was carried out in 101 neurosurgical patients. The following results were obtained: I) beta-END and beta-LPH levels were found to be lower in the CSF than in blood plasma. II) beta-END and beta-LPH in the CSF was the same in both sexes. III) beta-END levels in the CSF decreased with age. IV) beta-END and beta-LPH levels showed a diurnal rhythm with a maximum in the late a. m. hours. V) beta-END levels in the ventricular CSF tend to decrease parallel to a drop in conciousness as well as with longlasting comatous states. VI) beta-END in ventricular CSF becomes higher with increasing systolic arterial blood pressure. VII) beta-END and beta-LPH levels in ventricular CSF are not correlated with the type of the disease, CSF pressure, body temperature or respiratory changes.     

Galeazzi-equivalent lesions in adolescence

Two cases of a Galeazzi-equivalent lesion in adolescence are described. Accurate diagnosis of the epiphyseal injury of the distal ulna, rigid fixation of the distal radius, and stabilization of the distal radioulnar joint are keys in obtaining a good result in the treatment of Galeazzi-equivalent lesion in adolescence.     

Epithelium and bacteria in periapical lesions.

OBJECTIVE: The purpose of this study was to evaluate 50 human periapical lesions for bacteria and epithelium in a case study in dental practice. STUDY DESIGN: Specimens were obtained from the extraction of 50 untreated teeth that had lesions attached to their apices. The specimens were histologically evaluated using serial sections. RESULTS: Bacteria were found in all teeth, colonizing necrotic tissue in the main canal, dentinal tubules, or apical ramifications, and in the body of the periapical lesion in 18 abscesses or cysts. Twenty-one lesions were epithelialized; 14 abscesses, 20 granulomas, and 16 cysts were distinguished. In 18 root canals inflamed tissue was found in the apical part of the canal. A single foramen was present in 13 cases while apical ramifications were found in 37 cases. CONCLUSIONS: Granulomas were most common, and most epithelialized lesions were cysts. Bacteria were only detected periapically in abscesses or cysts. Inflamed tissue was present in the apical root canal in one third of cases.     

Physical therapy and rehabilitation in chondral lesions

Although most patients with articular cartilage defects are asymptomatic, some may have symptoms such as pain, effusion, muscle weakness, and limited range of motion. The goals of rehabilitation in chondral lesions are to relieve clinical symptoms, obtain painless full range of motion and muscle strength, and improve function. The key point in the rehabilitation program is to improve sensorimotor function and decrease pain and disability without increasing cartilage degeneration. Basic principles in the postoperative rehabilitation period are the same as those in conservative treatment. However, the rehabilitation program should be modified depending on the surgical procedure. Each phase of the rehabilitation program should be designed considering the type of surgical procedure, estimated healing time, restoration of joint mobility and muscle strength, and the extent of pain and effusion. Exposing the healing cartilage to shear stress under compression may have adverse effects on the healing process. For this reason, the early stage of rehabilitation (0-6 weeks) is comprised of passive, active-assistive and non-weight bearing range of motion exercises. Postoperative weight-bearing depends on the size, nature, and location of the lesion and the surgical procedure. Restriction in weight bearing is recommended in all treatment procedures except for cartilage debridement. For a successful outcome, open communication should exist between the rehabilitation team and the surgeon and the rehabilitation program should be individualized.