Continuous passive motion after knee-joint arthrolysis under catheter peridural anesthesia

Summary The results of arthrolysis of a stiff knee are often poor because postoperative pain prevents the early active mobilization that is so essential. Adequate analgesia may be ensured by the use of continuous anesthesia via a peridural catheter; in combination with continuous passive motion, such analgesia is able to maintain, and often improve, the range of movement obtained at surgery. Twenty-two patients treated in this way showed improvement in the range of movement between 39° and 120°. Patients with post-traumatic knee stiffness achieved an average improvement in the range of movement of 93%, while those with stiffness following infection improved by only 55% on the average. The preoperative loss of movement does not appear to determine the end result; the etiology of the stiffness is more important.     

Congenital intercoronary arterial anastomosis. Apropos of a case and review of the literature

The authors report a case of coronary arterial anastomosis between the right coronary and left circumflex arteries in the absence of other coronary pathology. This is an exceptionally rare congenital malformation which is situated either in the atrioventricular groove or at the apex in the interventricular groove. It constitutes a diagnostic pitfall because, in contrast to a collateral circulation, it is not an indirect sign of occlusive coronary artery.     

Bone healing stimulated by plasma factor XIII. Osteotomy experiments in sheep

Sheep had their right metatarsals osteotomized midshaft and stabilized by plate and screws. One group was injected with 1250 units of Factor Thirteen for 9 days postoperatively, and a control group received placebo injections. After 8 weeks, the bones were evaluated biomechanically, histomorphologically and by densitometry. The bones of the treated group had a significantly higher tensile strength than the bones of the control animals. The correlation of biomechanical and morphological results demonstrated that the tensile strength increased with an increasing number of osteons crossing the osteotomy gap. The hydroxyapatite content of the bone healing zone was 7.3 per cent higher for the treated bones than for the control bones.     

Morphometric analysis of fetal rat lung development

Applying the zone concept described previously, we quantitatively analyzed fetal rat lung development. The zone concept allowed us to coherently define reference spaces in the developing lung, a prerequisite for morphometric analysis. The peripheral zone I corresponds to a zone of growth of yet undifferentiated tissues; zone II arises from zone I and represents a region of structural and cellular differentiation; zones III and IV comprise the conducting airways and vessels. Lungs of fetal rats aged 17–23 days and 20 hours postnatal were fixed with OsO₄ and glutaraldehyde and processed for light and electron microscopic morphometry implemented by point and intersection counting. Fetal lung volume grew in proportion to body weight. Zone II being the largest compartment, its volume changes largely determined lung growth rates. Zone II increased in mass owing to differentiation processes at the interface to zone I where the proximal portions of zone I were continuously shifted into zone II by differentiation. New tissue was generated within zone I. Due to these combined processes zone I changed little in volume until it disappeared at the end of the canalicular stage. The presence in the pseudoglandular stage of half of the parenchymal epithelial mass available around birth indicated that parenchymal development started earlier than assumed so far. While the endothelial surface increased most at birth, the epithelial surface grew by more than 600% at day 21, reflecting the onset of canalisation. The study confirmed the usefulness of the zone concept for morphometry and provided some new insights into lung development. © 1993 Wiley-Liss, Inc.     

Magnetic resonance in preterm and term newborns: 1H-spectroscopy in developing human brain.

Localized proton magnetic resonance spectra were recorded from human cerebellum in vivo with a 1.5-T magnet. The spectra from healthy adults and preterm and term babies showed resonances from N-acetylaspartate, creatine and phosphocreatine, choline-containing compounds such as phosphocholine and glycerophosphocholine, taurine, and inositol. The age-dependent changes of in vivo molar concentrations of N-acetylaspartate, choline, taurine, and inositol were estimated in preterm babies, babies at term, and adults. The range of postconceptional age in the studied babies was 31 to 45 wk. Taking the biochemically measured creatine concentrations in age-corresponding autopsy material as an internal standard, the in vivo concentrations of the other metabolites were calculated from the proton spectra. N-acetylaspartate showed an increase from 1.9 mM in preterm babies to 3.1 mM in term babies and to 6.5 mM in adult brain. Taurine was noted to increase from 1.1 mM in preterm infants to 2.3 mM in term infants and did not decrease significantly in adult brain. Choline and inositol concentrations did not change significantly throughout the studied age groups. These new data on in vivo, localized 1H-spectroscopy show that it is a sensitive method for studying early metabolic brain development in humans.