Habitual patella dislocation and Goldthwait's surgery]

In this study 17 patients with recurrent dislocation of the patella were followed up 10 years after Goldthwait-operation. The subjective and clinical findings were excellent rsp. good in 70%, whereas the x-ray findings showed osteoarthritis of the femoropatellar joint in 60%. Concerning the aetiopathological factors we found an increased external torsion of the afflicted extremity measured by computed tomography.     

Stressors and coping behaviors of homeless, poor, and low-income mothers

Homeless mothers and their children have become a highly politicized issue. This article presented a study comparing the stressors and coping behaviors of homeless women with their domiciled counterparts, low-income and poor mothers. The results of the study indicated that although homeless, poor, and low-income mothers cope in a similar manner, homeless mothers were considerably more disadvantaged in terms of education, family size, and work history, and were besieged by many more stressors. These results suggest that CHNs must design interventions that are not only interdisciplinary in nature and use the expertise of many professional groups but also influence the communities' political and decision-making bodies.     

Hilar cholangiocarcinoma: comparative study with sonography and CT

Fifty-one patients were studied to determine the relative accuracy of sonography and computed tomography (CT) in the evaluation of hilar cholangiocarcinoma. Both sonography and CT permitted detection of intrahepatic bile duct dilatation in all patients. Nonunion of right and left intrahepatic bile ducts was identified with sonography in 90% and with CT in 94% of patients. The tumor per se was depicted by sonography in 21% and by CT in 40% of patients. Forty tumors (78%) were of the infiltrating type, seven (14%) were exophytic, and four (8%) were polypoid. With sonography, infiltrating and exophytic tumors were difficult to depict, whereas polypoid tumors were well identified. With CT, infiltrating tumors were more difficult to depict than were exophytic or polypoid tumors. On CT scans, depicted tumors of the infiltrating type showed high attenuation and an indistinct margin, whereas exophytic and polypoid tumors showed low attenuation and a well-defined margin. Sonography and CT were comparably accurate in determining the level of obstruction in hilar cholangiocarcinoma even when no mass was depicted. CT was superior to sonography in depicting tumor per se and in demonstrating associated findings.     

Alterations in cerebral blood flow and oxygen consumption during prolonged hypocarbia

The effect of prolonged (2 h) hypocarbia on cerebral blood flow, oxygen delivery, extraction, and consumption was studied in eight, 1- to 4-day-old piglets. Hyperventilation to PaCO2 less than 20 mm Hg acutely (30 min) decreased cerebral blood flow and oxygen consumption. Cerebral oxygen consumption was subsequently restored via increases in cerebral blood flow and thus, cerebral oxygen delivery. Cerebral oxygen extraction rose from a normocarbic baseline of 50 to 75% with acute hypocarbia and was maintained at this level. The percent decrease in blood flow to the cerebrum was greater than that to other brain regions during hypocarbia.