Results of magnetic resonance and computerized tomography studies of augmentation plastic surgery of the anterior cruciate ligament using carbon fibers. II

19 patients out of those described in part I were examined by MRI and CT. We quote MRI as an excellent new mean of imaging without exposure to ionising radiation which renders sufficient information about the internal knee-structures without surgical invasion. The signal density for the neoligament as well intraarticular as in the "over the top"-position gives evidence for the ingrowth of mesenchymal structures. The MRI diagnosis was proved by histological examination in 2 cases. Very good correspondence between clinic examination and the CT-images could be found. On top of that the tibial drilling holes could be shown in an excellent way. The CT-scan is a fine instrument to judge the postoperative state of the anterior cruciate ligament. The density measurement inside and outside the bone gives evidence for mesenchymal growth inside the carbon fibre structure and the existence of a new natural ligament.     

Unicameral cyst of the calcaneus: surgical indications, biomechanical calculations and results of follow-up studies

Between April 1986 and August 1988, 7 patients (6 men, 1 woman) with unicameral calcaneal cysts were seen at the Trauma Hospital in Meidling. In one case both calcanei were affected. In all cases the findings were accidental, as a result of minor injuries. No familial preponderance was observed. The mean age of the patients was 26.6 years (19 to 33). In 3 patients, filling of the cyst was indicated due to risks from sport or occupational activities. Four cysts were therefore filled with fibrin-spongiosa (homologous bone chips). The mean follow-up interval was 19 months. No recurrent cyst formation was observed, and the patients had no complaints. Nor were there any complications. The importance of CT for preoperative diagnosis and postoperative verification of the result is indicated. On the basis of a strut framework model, it is proved mathematically that cyst formation is not of major importance for the "vertical load case"; on the other hand, bending moments occurring in "inclined load cases" (pronation, supination, extension, flexion), are substantially reduced if the cancellous bone in the cavity region is taken into account. As a logical consequence, surgery is indicated in individuals as risk due to occupational or sports activities; in cases which are not subject to stress peaks, however, therapy is unnecessary.     

Rehabilitative techniques for athletes after reconstruction of the anterior cruciate ligament

A wide spectrum of protocols is available for rehabilitation after anterior cruciate ligament reconstruction, and little agreement exists on the specifics of strengthening exercises or the sequence of activities. In this article, we discuss the current rehabilitative techniques used at the Mayo Clinic for athletes who have undergone anterior cruciate ligament reconstruction. These techniques are based on established principles of rehabilitation, clinical experience, and new information about the related biomechanics of the knee. An illustrative case reflects the benefits of this rehabilitation program, which lasts up to 1 year and is divided into five stages. The early stages focus on protected mobilization and a strengthening program that emphasizes closed rather than open kinetic chain exercises. Later, neuromuscular-proprioceptive training and sport-specific agility training redevelop the reaction time and the "coordination engrams" necessary for athletic competition. High-quality surgical care and a closely supervised rehabilitation program, based on kinesiologic and biomechanical factors as they pertain to the anterior cruciate ligament, are necessary for a successful outcome.     

Nasotracheal enterococcal carriage and resistomes: detection of optrA-, poxtA- and cfrD-carrying strains in migratory birds,livestock, pets,and in-contact humans in Spain

European Journal of Clinical Microbiology & Infectious Diseases - This study determined the carriage rates and antimicrobial resistance (AMR) genes of enterococci from...     

Soft-Tissue Tumors: Diagnosis, Evaluation, and Management

Benign soft-tissue neoplasms and tumorlike conditions of the musculoskeletal system are common. Sarcomas are less frequent, with only 5,000 new cases diagnosed each year in the United States. After plain radiographs of the affected area have been obtained, magnetic resonance (MR) imaging (both T1- and T2-weighted sequences) is the best imaging modality for detecting and characterizing the lesion. Although MR imaging is not specific in determining whether lesions are benign or malignant, it can be useful in evaluating other characteristics, such as size, pattern of growth, integrity of natural boundaries, and homogeneity. Biopsy must be done carefully, so as not to adversely affect the outcome. Technical considerations include proper location and orientation of the biopsy incision, meticulous hemostasis, and frozen-section analysis to ensure that diagnostic material has been obtained. Effective treatment requires close coordination between the surgeon, the radiation oncologist, the pathologist, the plastic surgeon, and the diagnostic radiologist. Limb-salvage surgery has resulted in a local control rate greater than 90%. High-grade tumors that are larger than 5 cm in diameter have the worst prognosis. The role of chemotherapy remains controversial and unresolved.     

IMPACTED RIGHT UPPER CENTRAL INCISOR AND TRANSPOSITION OF TWO OTHER ANTERIOR TEETH ON THE SAME SIDE (A Case Report)

A young boy presented with an uncommon finding of impaction of upper right central incisor and transposition of canine and lateral incisor on the same side. Esthetic management of his cosmetic problem which included fixed appliance therapy followed by light cure restorations is discussed.KEY WORDS: Impaction, Transposition     

Rivastigmine: a review

The acetylcholinesterase inhibitors are the first useful and useable drugs for palliative treatment of dementia of the Alzheimer type. This article reviews the second-generation carbamate cholinesterase inhibitor, rivastigmine (EXELON, Novartis, Basel) whose distinctive pharmacology is not only of immediate clinical relevance but also the key to some tantalizing therapeutic possibilities.