Adaptation of postural control to perturbations--a process that initiates long-term motor memory.

The objective was to investigate postural control adaptation during daily repeated posturography with vibratory calf stimulation. The posturography was performed with eyes open and closed daily for 5 days and after 90 days on 12 healthy subjects. The postural control adaptation could be described as two separate processes, a rapid adaptation during the test progress and a long-term habituation between consecutive test days. The adaptive improvements gained during the 5 days consecutive testing, largely remained 90 days later but seemed restricted to the same test situation. The findings suggest that balance rehabilitation should include a variety of repeated exercises, which are sufficiently long to induce habituation.     

Hepatic artery occlusion for liver cancer

The survival of patients with tumour growth in the liver is very restricted. Interruption of the arterial blood supply to the liver is one method used to control tumour growth. This method is based on the findings that liver tumours are mainly nourished by the hepatic artery. Different methods are used in order to interrupt the arterial blood supply to the liver. Hepatic artery ligation (HAL) has been found in animal experiments to be the most reproducible method to temporary retard tumour growth. Survival has been shown to be prolonged in animals with liver tumours subjected to HAL compared with untreated controls. In humans no effect on the survival time has been observed, but the quality of life of these patients has been claimed to be improved especially those with the carcinoid syndrome. Although interruption of the hepatic arterial blood supply has been used clinically for more than 15 years the method is still an experimental procedure. Further clinical research in this field requires properly designed randomized studies.     

Isolated hepatic perfusion for liver metastases of malignant melanoma

The objective was to analyze the outcome of three treatment strategies using isolated hyperthermic liver perfusion (IHP) with melphalan for liver metastases of malignant melanoma. It was designed as an exploratory study. The setting was a single-center study in a university hospital. The study was carried out on 27 patients. IHP was used with modifications during three different time periods (IHP I, IHP II and IHP III), in technique and temperature (amount of melphalan: 0.5, 1.0 and 2 mg/kg body weight in the perfusate; 41, 40 and 40 degrees C). Tumor response was estimated according to WHO criteria with computed tomography or MRI. Mortality and morbidity were secondary measures. Six of 11 patients in the IHP I cohort experienced a partial response (PR). In the IHP II cohort, two patients of 11 experienced a complete response and five a PR. In the IHP III cohort, five of five patients experienced a PR. Six postoperative deaths were reported (27%) (three in the IHP I and three in the IHP II series), secondary to liver insufficiency and multiorgan failure. Treatment of liver metastases of malignant melanoma with isolated hyperthermic melphalan perfusion has shown an impressive tumor response rate, which seems to be higher than the response rates reported for other systemic chemotherapy regimens. The maximum tolerated dose for melphalan in the perfusate was surpassed with a 2 mg/kg body weight. By modifying the technique and restricting the allowed tumor burden, the response rate remained high and the mortality was reduced.     

Risk factors for injuries associated with damage claims following groin hernia repair

Hernia - Surgical repair of groin hernia should be carried out with minimal complication rates, and it is important to have regular quality control and accurate means of assessment. The Swedish...     

Bone mineral density in women and men with early rheumatoid arthritis

OBJECTIVE: To study bone mineral density (BMD) in patients with early rheumatoid arthritis. METHODS: Dual x-ray absorptiometry was performed in 227 patients, 149 women and 78 men, with rheumatoid arthritis (RA) of no more than 12 months duration. RESULTS: Women, as well as men above 60 years of age, had a BMD at spine and hip comparable with age and sex matched reference populations. Men younger than 60 years had a tendency to lower BMD. Although the proportion of female patients with osteoporosis was not higher than in the reference, population the proportion of patients with reduced bone mass was increased, and this was found also in men. There was no significant association between BMD and disease duration, disease activity or disability. CONCLUSION: Untreated patients with early RA have a BMD in spine and hip not significantly different from that of normal reference populations. However, an increased number of the patients had reduced bone mass already at disease onset.