A review of 100 closed head injuries associated with facial fractures.

One hundred closed head injuries associated with facial fractures treated over a 78-month period at a level I trauma center in Northeast Ohio were reviewed. The incidence of closed head injury in patients with facial fractures was 17.5%. Males suffered closed head injuries four times more often than females, and sustained severe intracranial injuries eight times as often. The 16- to 30-year age group predominated (59%). Although motor vehicle accidents were the most frequent cause of injury (61%), motorcycle accidents were associated with the most severe head injury. The mandible/midface fracture ratio (1.3:1) was almost half that of the non-head-injured population (2.1:1). Facial fracture complications were found to have a similar incidence (14%) as in the non-head-injured population, but were associated with more severe intracranial injuries.     

Ultrastruttura del rene nel diabete spontaneo dell'hamster cinese (cricetulus griseus)

Riassunto La presente indagine sulla ultrastruttura del rene di hamsters cinesi diabetici ha fatto rilevare fini lesioni glomerulari, consistenti in ispessimento non omogeneo delle membrane basali dei vasi capillari, alterazioni delle cellule del mesangio, dilatazione irregolare delle anse vascolari. A carico della parte tubulare, accumulo di glicogeno nel citoplasma delle cellule del tratto distale e del tubulo collettore; presenza di glicogeno nel nucleo negli animali con diabete grave e chetosi.

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Summary This study of the ultrastructure of the kidney of diabetic Chinese hamsters revealed fine glomerular lesions, namely: irregular thickening of the basement membranes of the capillary vessels, mesangial cell changes and irregular dilatation of the vascular loops. Glycogen accumulation was found in the cytoplasm of the cells of the distal convoluted tubule and of the collecting tubule. Glycogen was present in the nucleus in the animals with severe diabetes and ketosis.

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Zusammenfassung Die vorliegende Studie über die Ultrastruktur der Niere bei diabetischen chinesichen Hamstern hat Veränderungen der Glomeruli gezeigt und zwar ungleichmässige Verdickung der Basalmembran der Kapillargefässe, Veränderungen an den Zellen des Mesangiums, unregelmässige Verdickung der Gefäßschlingen. Im distalen Teil der Tubuli contorti und in den Sammelröhren fanden sich Glykogenhäufungen im Zytoplasma; bei Tieren mit schwerem Diabetes und Ketose wurde das Glykogen auch im Zellkern vorgefunden.

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Resumen La presente investigación sobre la ultraestructura del riñón del hamster chino diabético, ha dado la posibilidad de poner en evidencia sutiles lesiones glomerulares, consistentes en el engrosamiento no homogéneo de las membranas basales de los vasos capilares, en alteraciones de las células del mesangio, en la dilatación irregular de las ansas; y, a cargo de la parte tubular, en una acumulación de glicógeno en el citoplasma de las células del tramo distal y del túbulo colector y en la presencia de glicógeno en el núcleo de los animales con diabetes grave y quetosis.

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Résumé Cette enquête sur l'ultra-structure du rein de hamsters chinois atteints de diabète a permis de relever des lésions glomérulaires légères, consistant en un épaississement non-homogène des membranes basales des vaisseux capillaires, des altérations de cellules de la mésange, une dilatation irrégulière des anses vasculaires. Sur la partie tubulaire, une accumulation de glycogène dans le cytoplasme des cellules de la partie distale et du tube collecteur ainsi que la présence de glycogène dans le noyau des animaux atteints d'un grave diabète et de kétose.

     

Awareness, treatment, and control of hypertension in the elderly in a general practice experience. Study Group on Hypertension in the Elderly

In 3858 ambulatory elderly people (age greater than or equal to 65 years) prevalence of hypertension was 67.8%. The hypertensive status was unknown to both the doctor and the patient in 21.4% of cases. More than 90% of known hypertensives were treated, but hypertension could be considered as controlled in less than 30% of them.     

ACTH and corticosterone secretion following indomethacin, in intact, adrenalectomized and dexamethasone-pretreated male rats

The present study was designed to determine the role of glucocorticoids in the mediation of the stimulatory effect of indomethacin (IM) on the hypothalamo-hypophyseal-adrenal axis. Intact male rats were treated with a single injection of either dexamethasone (Dex; 20 micrograms/100 g body weight), IM (5 mg/100 g body weight), or IM + Dex or their respective vehicles. In Dex-treated rats, ACTH and corticosterone (CS) were significantly reduced over a period of 20 h as compared to the vehicle-treated group. As we have previously demonstrated, injection of IM markedly elevated serum ACTH and CS for at least 20 h. Administration of Dex 2 h prior to IM treatment delayed the stimulatory effect of IM for 5 h; subsequently, however, Dex was without effect. In adrenalectomized rats, ether stress elicited a marked rise in serum ACTH levels. On the contrary, IM was completely ineffective in these rats. These studies suggest that the mode of action of IM in causing hypersecretion of ACTH and CS is by interfering with the negative feedback effects of the glucocorticoids.     

Therapeutic approach to the unilateral occlusive iliac artery disease. Preliminary results

BACKGROUND: The different therapeutic approaches to unilateral occlusive iliac artery disease are analyzed. METHODS: In the period from September 1999 to September 2001, a total of 43 patients (38 males and 5 females) has been treated for unilateral iliac artery occlusive disease. Thirty-four cases (79%) underwent an endovascular procedure, and the remaining 9 cases (21%) had a surgical intervention. Endovascular techniques included 11 cases of percutaneous transluminal angioplasty (PTA) of common iliac artery (25.6% of whole series), 5 PTA of external iliac artery (11.6%), 8 PTA+stenting of common iliac artery (18.6%) and 10 PTA+stenting of external iliac artery (23.2%). In 9 cases a surgical revascularization was performed: 6 patients underwent a femoro-femoral cross-over bypass (14%); 2 cases were treated with aorto-bifemoral reconstruction (4.7%) and one patient was operated with ilio-femoral graft (2.3 %). RESULTS: The analysis of the follow-up of our series showed, in the group of 34 patients treated with endovascular procedures, successful results were obtained in 79.4% (27 cases); in the 9 patients operated with surgical revascularization the success rate was 88.9% (8 cases ); failure rate was 20.6% for endovascular procedures and 11.1% for surgical interventions. CONCLUSIONS: The conclusion is drawn that endovascular approach (PTA, stenting) is usually the procedure of choice in the treatment of unilateral well localised lesions of the iliac artery. Conventional surgical intervention is effective for revascularizing an extensive involvement of the iliac segment or in case of bilateral disease.