Giant cell tumor of bone: radiographic changes following local excision and allograft replacement

The authors retrospectively evaluated the clinical records and radiographs obtained from 41 patients who had giant cell tumor of bone and who were treated by local resection and allograft replacement. Postoperative complications developed in 41% of the patients. However, the eventual clinical outcome was considered to be satisfactory in 85% of all cases. There were no instances of tumor recurrence, and surprisingly, postoperative arthritis was not a major problem. The major complications encountered were infection and allograft fracture; bone infection accounted for most of the clinical failures. All infections were associated with the increasing soft-tissue swelling and bone resorption detected on radiographic studies. Other radiographic parameters that were associated with an increased rate of complications included osteopenia, increased periosteal reaction, and decreased bone formation at the host-donor junction site. The clinical outcome was distinctly less favorable in those cases in which the patient had had a pathologic fracture or a previous resection, or in whom the graft was implanted at the distal radius.     

X-ray intravascular reduction of blood flow along the hepatic artery in patients with portal hypertension and resistant ascites

After studying the results of embolization of the hepatic artery in 14 patients with portal hypertension and resistant ascites the authors came to the conclusion that this operation often leads to the development of hepatic insufficiency and a fatal outcome and produces a clinical effect only in a small number of patients. Celiac- and mesenteric angiography and transhepatic portography were carried out for pathogenetic substantiation of the intervention. Pressure in the portal vein, hepatic veins and arteries, and in the inferior vena cava was measured during the examination. The space velocity of the portal and arterial hepatic blood flow was determined. Clinico-angiographic examination of the patients failed to reveal criteria for predicting the efficacy of embolization of the hepatic artery. A positive result may be expected in cases in which embolization leads to a reduction in portal pressure. Embolization of the hepatic artery produced no clinical effect in initial reduction of the blood flow in the liver.     

Results of treatment of isolated and combined trauma of urogenital system

Retrospective analysis of treatment results of 608 patients with trauma of organs of urogenital system (UGS) was carried out. Beating was the cause of trauma in 55% cases, fall from height--in 17%, transport trauma--in 14.3%, knife wound--in 4.4%, gunshort wound--in 1.3%. Isolated trauma of UGS was in 481 (79.1%) patients. In other patients combined injury of UGS with injury of skeleton's bones (53), cranium and brain (25), abdominal organs (20) was diagnosed. In 29 patients severe combined trauma of UGS, abdominal organs, skeleton bones and cranium was seen. Surgeries were performed in 267 patients. Surgeries on kidney and urinary bladder due to their disruption predominated. In 44 patients these surgeries were combined with ones on abdominal organs. Surgery was performed in two stages in 25 patients with combined trauma of UGS and other organs. From 608 patients 552 (90.2%) cured. Lethal outcome was in 56 (9.2%) patients due to progressive traumatic shock.     

State of erythrocytes after long-term exposure to magnetic field

During and after exposure to a constant magnetic field of 1.6 T mice, showed variations in the size distribution of red blood cells, with their shape remaining unchanged and enlarged cells being predominant. This shift persisted till exposure day 10 and began to return to normal on days 15, 22 and 30. After irradiation the Price-Jones curve varied in a different manner and recovered by day 6. The changes in the curve were not correlated with variations in the reticulocyte and erythrocyte counts or hemoglobin content. It is concluded that an exposure to a constant magnetic field produces insignificant lesions in the red blood cell membrane. Mention should be made of a reduction of the reticulocyte count in the peripheral blood after exposure.     

Rupture of the posterior wall of the left ventricle after mitral valve prosthesis]

Rupture of the posterior wall of the left ventricle after mitral valve prosthetics is a rare (0.6%) but a dangerous and death-threatening complication. Injury to the fibrous ring in the anatomically hazardous zone (at 4-5 o'clock of an imaginary clock-face) is the most frequent cause of the ruptures. Surgical correction of this complication will be successful only with the use of extracorporeal circulation and repeated cardioplegia. Preservation of the posterior cusp and subvalvular apparatus is a reliable measure preventing rupture of the posterior wall of the left ventricle.