Glenoid labrum: preliminary work with use of radial-sequence MR imaging

The authors describe a magnetic resonance imaging method for examination of the glenoid labrum of the shoulder joint that utilizes a radial fast-imaging sequence. Seven shoulders were examined: a total of five in three healthy asymptomatic volunteers, one in a symptomatic patient not suspected of having a lesion of the glenoid labrum, and one in a patient with recurrent shoulder dislocation and surgical proof of an extensive tear of the labrum. The preliminary results suggest that this technique may advantageously demonstrate pathologic changes in the glenoid labrum and may contribute to the evaluation of the unstable and painful shoulder.     

Failure of target heart rate to accurately monitor intensity during aerobic dance

Fourteen untrained females (age 19 +/- 1, range 18-21) were studied to examine the heart rate-VO2 relationship during a single aerobic dance training session. These findings were used to help explain the changes in VO2max resulting from an aerobic dance training program. VO2max and body composition were determined before and after an 8 wk training period. In addition, the heart rate-VO2 responses to an aerobic dance training session were monitored and compared to the heart rate responses of treadmill jogging performed at the same VO2. The aerobic dance session elicited a significantly lower oxygen pulse than did treadmill exercise (7.2 +/- 0.3 vs 8.1 +/- 0.8 ml.beat-1; P less than 0.01). There were no significant changes in percent body fat, whereas VO2max increased by 11% (34.4 +/- 0.9 vs 38.1 +/- 0.8 ml.kg-1.min-1; P less than 0.05). No significant changes in any of the parameters tested were observed in 10 untrained controls. These findings indicate that the heart rate elicited from aerobic dance represents a lower relative exercise intensity (VO2) than that of running. Therefore, the assumption that aerobic dance training produces the same cardiovascular adaptations as running training when performed at the same target rate may be unwarranted.     

Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique

Background

Many surgical technique have been described to assess the outcome of anatomical reconstruction of the lateral ligaments using Gracillis tendon. This technique aims to restore the stability of the ankle by reconstruction of the talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) using the Gracillis tendon.

Methods

From January 2004 to February 2008; inclusive, 16 patients; 11 male and 5 female, underwent an anatomic reconstruction of the lateral ankle ligament for chronic ankle instability. Their ages ranged from 18 to 29 giving a mean age of 25 years. Patients were then subjected to radiologic and clinical assessments for a period of at least 33.5 months. For pain scoring the Americans Orthopaedic Foot and Ankle Society (AOFAS) scores were used; whilst subjective symptom was evaluated using the Olerud and Molander ankle scoring system.

Results

All patients returned for the final evaluation and subjective excellent or good results were recorded on self-assessment, pain scores, AOFAS and Karissons scores. Additionally Olerud and Molander ankle scoring was also done. During the final follow-up, the mean post-operative AOFAS score was 96 (range 80–100), the Visual analog score was 6 (range 0–4), Karissons score was 94.7 (range 80–100) and last but not least Olerud and Molander score was 87.5 (range 70–100). It was noted that the ankle range of motion was not affected by lateral ankle reconstruction. The talar tilt was reduced from a mean of 12–4° (p < 0.0001) and the anterior drawer was reduced from a mean of 11–4 mm (p < 0.001) by the ankle ligament reconstruction.

Conclusion

Anatomical reconstruction of the lateral ligaments of chronic ankle instability using Gracillis tendon graft resulted in successful results, excellent ankle stability, significant reduction in pain and negligible loss of ankle and hind foot motion.     

经关节入路微创钢板固定技术治疗股骨远端C型骨折

目的探讨经关节入路微创钢板固定(MIPPO)技术治疗股骨远端C型骨折的临床疗效。方法2002年4月～2005年2月,应用MIPPO技术治疗股骨远端C型骨折14例,按AO/ASIF分类：C1型3例,C2型6例,C3型5例。先行关节内骨折切开复位、松质骨螺钉固定,再行髁上部分骨折间接复位、经关节内切口插入髁支撑钢板或LISS钢板桥接固定骨折。结果12例患者获得10～32个月(平均18．4个月)随访,骨折均获愈合,愈合时间10周～12个月,平均4．6个月。按Kolmert和Wulff的评价标准：优4例,良5例,可2例,差1例,优良率为75%。结论应用MIPPO技术治疗股骨远端C型骨折实现了微创操作,具有创伤小、软组织干扰少、骨折愈合快等优点,疗效满意。     

腹腔镜巨大前列腺囊腺瘤切除一例报告并文献复习

目的提高对巨大前列腺囊腺瘤的认识。方法回顾性分析收治的1例巨大前列腺囊腺瘤并成功进行腹腔镜切除的临床资料,结合文献复习进行讨论。结果本例患者成功行腹腔镜完整切除,手术时间125min,出血量60ml,术中双侧精囊输精管完整保留,术后会阴部坠胀不适消失,复查精液常规精子数目及活动度正常。已随诊12个月,肿瘤无复发。结论巨大前列腺囊腺瘤罕见,最终确诊要依靠病理诊断,其最有效的治疗是手术完整切除,而腹腔镜途径可作为完整切除的微创手段。     

高气压暴露对大鼠血浆内皮素-1含量、血清一氧化氮含量、一氧化氮合酶活性的影响

目的 探讨高气压暴露对大鼠血浆内皮素-1(endothelin-1,ET-1)含量、血清一氧化氮(nitric oxide,NO)含量、一氧化氮合酶(nitric oxide synthase,NOS)活性的影响.方法 40只SD大鼠随机分为5组.A组为对照组,B组0.7 MPa空气暴露后缓慢减压,C组0.7 MPa空气暴露后快速减压,D组0.147 MPa纯氧暴露后减压,E组0.250 MPa纯氧暴露后减压.各组暴露时间均为60 min.采用放射免疫方法测定血浆ET-1含量,硝酸还原酶法测定血清NO含量,比色法测定血清NOS活性.结果 与对照组相比,安全减压组和高压氧组的血浆ET-1含量明显升高(P<0.05),原因可能与高分压氧有关(PO2=0.147 MPa/0.250 MPa);快速减压组血清NO含量、NOS活性明显升高(P<0.05),与血浆ET-1含量升高的3个组相比,血清NO、NOS升高得更为显著(P<0.01).结论 NO与ET-1在机体对高气压暴露的反应中呈拮抗关系.高气压与高压氧暴露导致血浆ET-1的释放增加,但快速减压刺激血管内皮细胞产生更多的NO,这种机制可能是通过提高血浆中的NOS活性实现的,这个现象可能是血管内皮系统对血管内气泡产生的应激性反应之一.     

Detection of the Philadelphia chromosome in acute lymphoblastic leukemia by pulsed-field gel electrophoresis

The Philadelphia (Ph1) chromosome is an acquired abnormality in the malignant cells of 10% to 25% of patients with acute lymphoblastic leukemia (ALL). Unlike chronic myelogenous leukemia (CML), where the molecular detection of the Ph1 chromosome is relatively straightforward using conventional Southern hybridization analysis, the detection of the Ph1 chromosome in ALL is complicated by the existence of several molecular subtypes, and the fact that translocation breakpoints are dispersed over a large genomic area. To circumvent these difficulties, we investigated pulsed-field gel electrophoresis (PFGE) to determine if this method could be used directly on clinical samples to detect the Ph1 chromosome in ALL. We report that, in a study of seven patients with Ph1-positive ALL, we could easily detect the Ph1 using only a single PFGE analysis, regardless of the Ph1 subtype, and we could confirm that the translocations occur either within or very near the BCR gene in all seven. We conclude that PFGE is a useful technique for the detection of the Ph1 in ALL, which ultimately may find wide applicability in the detection of other chromosomal abnormalities in other malignancies.