Normal instability of the hip in the neonate: US standards

In recent years, the use of real-time ultrasonography (US) has enabled dynamic evaluation of the infant hip through a range of motion and stress. Preliminary experience has suggested that a certain amount of instability in the hips of newborns is normal, but no standards have been established. In this study, a group of term neonates whose physical examinations were normal were examined with US on the 1st and 2d days of life. Each hip was imaged in the transverse plane in nonstressed and stressed positions, and movement of the femoral head under stress was quantitated. This displacement under stress was used to establish a normal range of hip instability in neonates. Patterns of hip laxity in boys and girls are identical, and in most infants hip instability diminishes between the 1st and 2d days of life. Our method of quantitating hip instability produces consistent results, with intraobserver 95% confidence intervals of +/- 1.2 mm for each measurement.     

兔膝关节软骨表面形态在短时非周期大强度运动训练后的变化

目的:观察正常软骨表面的形态结构以及短时非周期大强度运动训练对关节软骨的影响。方法:实验于2001-01/09在四川省骨科医院完成。①实验动物:10～12个月龄日本大耳白兔8只,雌雄各半,体质量(3.5±0.2)kg。②实验分组:将动物分为对照组2只,训练组6只,其中训练1,2,3周各2只。③实验干预:训练组兔在电刺激笼中进行训练,训练量为20s刺激1次,刺激时间为0.2～0.5s,动物受刺激后沿刺激笼跑跳数步并转弯。训练120min/d,每组训练60min后休息20min,训练6d/周,星期日休息,分别训练1,2,3周。对照组不放在电刺激笼中,也不进行训练。④实验评估:扫描电子显微镜下观察训练前后兔股骨和胫骨髁软骨表面形态结构的变化;MIAS99图形处理软件计算浅坑(pits)的直径和面积。结果:8只兔均进入结果分析。①正常兔膝关节软骨的表面形态结构:正常软骨表面低倍镜下显示为均匀排列的浅坑,在高倍镜下呈现一种均匀多孔状结构。②运动训练后软骨表面结构的变化:训练后浅坑形态不规则,边缘粗糙,胶原纤维增粗,孔隙不均匀增大。结论:软骨表面正常的形态结构是浅坑,短时非周期大强度训练,未引起纤维断裂和碎屑,说明不会损伤软骨表面形态结构。     

正常兔膝关节表面结构的扫描电镜观察

目的:扫描电镜观察正常兔膝关节表面的结构,为研究关节软骨表面结构提供正常参照。方法:实验于2001-01/09在四川省骨科医院完成。日本大耳白兔8只,10～12个月龄,雌雄各半,体质量(3.5±0.2)kg。通过扫描电镜对8只实验兔股骨髁、胫骨髁的软骨表面进行观察,其中4个髁用锐器划伤。结果:纳入日本大耳白兔8只,均进入结果分析。每个正常髁的表面都显示有大量的浅坑,有锐器划伤的髁则出现了垄沟及隆突。软骨表面在高倍镜下呈现一种均匀多孔状结构。结论:软骨表面唯一呈现的结构是浅坑,垄沟和隆突可能是标本的采集、制作过程中形成的赝象。     

Cutaneous nocardiosis of the chest wall and pleura--10-year consequences of a hand actinomycetoma

We report an unusual case of primary cutaneous nocardiosis due to Nocardia otitidiscaviarum presenting first as a mycetoma of the right hand and wrist. The patient refused treatment and was lost to follow-up until he showed up 10 years later with numerous discharging large sinuses and abscesses on the upper right quadrant of the chest wall and in the right armpit. Roentgenograms revealed pleural masses. Histology was in keeping with the diagnosis of mycetoma. Treatment with amikacin, rifampicin and co-trimaxole proved to be successful.     

Mal de Meleda: recessive transgressive palmoplantar keratoderma with three unusual facultative features.

Mal de Meleda (keratoderma palmoplantaris transgrediens) is a rare autosomal recessive form of palmoplantar keratoderma characterized by hyperkeratosis of the palms and soles which appears soon after birth and progressively (progrediens) involves other areas (transgrediens) of the body skin. We report the case of a patient with mal de Meleda with three unusual facultative features, i.e. prominent knuckle pads, peculiar finger-nail anomalies and pseudo-ainhum on both fifth fingers. Four other members of the family are also affected by mal de Meleda.     

Intraarterial digital subtraction arteriographic evaluation of extremity tumors: comparison with conventional arteriography

Conventional arteriography and intraarterial digital subtraction arteriography (IADSA) were compared in 36 patients with primary bone or soft-tissue tumors of the extremities. The sensitivity of IADSA was at least equal to conventional arteriography for demonstrating normal or abnormal major arteries and feeding arteries, equal to or superior for depicting tumor stains or draining veins, but slightly inferior for revealing minute tumor vessels. An increase of the matrix size from 256 X 256 to 512 X 512 improved these sensitivities. IADSA with 15% diatrizoate contrast material eliminated the contrast material-induced pain in all patients. With a computer-controlled iris setting, an average of 5 minutes of procedure time and 1.7 R of radiation (0.44 mC kg) per examination could be saved. IADSA reduced the cost of an examination by an average of $67. The results indicate that IADSA was diagnostic in all instances and can replace conventional arteriography for the evaluation of extremity tumors.