Cat Distal Forelimb Joints and Locomotion: An X-ray Study

The complex construction of the joint apparatus of the cat distal forelimb, which allows the paw three degrees of freedom, poses special requirements on the neural signals controlling the paw position. To understand the electromyography (emg) signals of the distal forelimb muscles during locomotion, it is necessary to know the kinematics of the forelimb joints in detail. As no such information is available, we used the pulsed X-ray technique in trained cats during treadmill locomotion to analyse the angular excursions of the wrist, the metacarpophalangeal (MCP) and the proximal interphalangeal (PIP) joints. X-ray illuminations were done in either the parasagittal or the frontal plane. At the beginning of the stance phase the wrist (WR) and the MCP joints extended slowly, and the PIP joints flexed. Whereas the WR and the PIP joints maintained a constant angular position of approximately 200 degrees and 60 degrees, respectively, throughout the stance phase, extension continued in the MCP joints from 240 degrees at touch-down to 300 degrees at the end of the stance phase. Slightly before lift-off (100 ms) the WR and the MCP joints flexed rapidly. This flexion changed approximately 150 ms after lift-off into a slow extension. The PIP joints extended rapidly at the beginning and at the end of the swing phase, during the interposed period of the swing phase they displayed a slow flexion. Rotatory movements of the forelimb in the radioulnar joints were present during the swing and stance phases. During the swing phase the limb first supinated (starting 100 ms after lift-off); pronation occurred immediately before ground contact. During the stance phase the supination angle was kept constant until 100 ms before lift-off, when a short pronation was found. The paw was kept in an ulnar deviated position throughout the complete step cycle. Ulnar deviation decreased at the end of the swing and stance phases. The results of this study increase our understanding of how the body weight is transmitted on to the ground. They suggest four main functions for the skeletomotor apparatus and the underlying neural commands to secure the forward movement of the animal during the stance phase: (i) preparation and stabilization of a force-transmitting platform; (ii) stabilization of the wrist and the carpal/metacarpal joints; (iii) stabilization of the supination angle; (iv) antigravity control of the extension in the MCP.     

The ONG capsular lens,report of 100 implantations

This Capsular Lens (ONG, type IV, to be called O.C.L.) has been developed for routinely performed extracapsular cataract extraction with lens implantation. The fundamental surgical procedure was based on continuing experience with the bimanual aspiration-irrigation technique and system developed by the author in 1971. The biomechanical properties of the asymmetric partly flexible, haptic loops are designed to give tensionfree fixation in two capsular pockets. The plano-anterior position of the lens ensures well-defined irido-lenticular clearance and proper alignment of the convex side with the posterior capsule. Consequently no iridectomy or iridotomy is needed for proper aqueous flow.     

Treatment of vertebro-basilar aneurysms

Summary In continuation of investigations on classification and treatment of ICA-system aneurysms and on the classification of the vertebro-basilar-system aneurysms their treatment has been discussed. Based on this, classification has been improved and the preoperative topographic diagnosis and the choice of approach have been influenced. The operative management has been pioneered by C. G. Drake, who described the technique in detail on hand of his enormous experience with 469 aneurysms of the vertebro-basilar-system (13). The necessity of a normal aneurysm neurosurgeon treating such aneurysms requires certain modifications of indication, approach and dissection. In a personal statement based on 35 VB-aneurysms (6 per cent) the strategy of handling these aneurysms has been developed (45). Microsurgical technique is regarded absolutely necessary. Thetransoral transclival access to aneurysms of the lower clivus should be included in the approaches, similarly to the transsphenoidal operations. It facilitates the direct isolation in a very difficult region.Electrothermic dissection of the aneurysm diminishes the risk of rupture during the isolation of the sack and facilitates the isolation of the neck. The statistics of Drake provide full data for the prognosis of these aneurysms. It is to note that in the recent time the results reported from different centres became more and more similar. The embolization of large bulbous or spheric and giant aneurysms by inflatable balloon-technique possibly may replace some risky direct or indirect operations.

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Zusammenfassung In Fortsetzung unserer Untersuchungen über die mikrochirurgische Klassifikation und Behandlung der Aneurysmen des A. carotis interna-Systems, sowie die Klassifikation der Aneurysmen des Vertebro-Basilaris-Gebietes befaßt sich der Beitrag mit der Therapie letzterer. Die moderne Klassifikation und parallel dazu die präoperative angiographische Diagnostik haben die Wahl der Craniotomie und des direkten Zugangs zum Aneurysma unmittelbar beeinflußt. Die operative Behandlung ist im wesentlichen das Werk eines Mannes — Charles Drake — der die Technik anhamd seines großen Krankengutes von derzeit 469 Fällen im Detail beschrieben hat. Die Notwendigkeit für den normalen Aneurysma-Neurochirurgen, derartige Aneurysmen zu behandeln, erfordert nach meiner Überzeugung gewisse Modifikationen der Indikation, des Zuganges und der Präparation. In einer persönlichen Stellungnahme, die sich auf eine Erfahrung von 35 Aneurysmen des Vertebro-Basilaris-Gebietes stützt (6%), werden die Prinzipien des Vorgehens erläutert. Die mikrochirurgische Technik ist unerläßlich.Dertransorale transclivale Zugang sollte für bestimmte Aneurysmen der A. basilaris ebenso durchgeführt werden, wie der transsphenoidale Zugang für Hypophysenadenome selbstverständlich geworden ist. Er erleichtert die direkte Freilegung in dem sehr risikoreichen Gebiet von Brücke und Hirnnerven.Dieelektrothermische Dissektion verringert das Risiko der Ruptur während der Präparation und erleichtert die Isolierung des Aneurysmahalses.Drake's Statistik enthält alle Einzelheiten über die Prognose der verschiedenen Vertebro-Basilaris-Aneurysmen als Maßstab für das eigene Resultat. Erfahrungen der letzten Jahre aus verschiedenen Kliniken zeigen, daß die Ergebnisse sich mehr und mehr angleichen.DieEmbolisation großer bulböser und sphärischer Aneurysmen und der Riesenaneurysmen durch die Ballon-Technik erscheint geeignet, risikoreiche direkte oder indirekte Operationen zumindest teilweise zu ersetzen.

     

Changes in blood flow and vasculature of the dog kidney undergoing normothermic and hypothermic ischaemia

Summary In 11 mongrel dogs both kidneys have been subjected to a 2 h ischaemic period. One kidney was cooled by perfusing the renal artery at 4°C while the contralateral normothermic kidney was clamped for 2 h. Studying the renal blood flow using the Xenon wash out technique, sequential renal scanning and angiography, marked differences between hypo- and normothermic ischaemia kidneys were observed. One or two hours following hypothermic perfusion a marked decrease of blood flow in the first compartment and vasoconstriction was evident, while within this period following normothermic ischaemia an enhanced renal blood flow was observed. After 24 h renal blood flow and renal function tested by ¹³¹I-Hippuran clearance returned to normal values. Angiographic studies corresponded to the preoperative findings. In contrast, normothermic ischaemia kidneys showed a decreased renal blood flow, impairment of kidney function in isotope studies and pathological angiographic changes.Supported by Deutsche Forschungsgemeinschaft     

胸骨上举术的固定方式与结果

目的：分析胸骨上举术的不同固定方式与手术效果的关系。方法：１４８例经胸骨上举术治疗的漏斗胸患儿，术中分别用自制金属支杠、三点式悬吊和塑料及金属制成的支架背心悬吊固定胸骨。结果：其中８４例患儿获术后６个月至６年（平均２年）随访观察，绝大部分效果满意，仅２例复发。２７例保留金属支杠于术后１０～１２个月拔除者，无复发，外观更满意。结论：胸骨上举术治疗漏斗胸的效果肯定，手术安全。用自制金属支杠固定上举的胸骨操作简便，术后护理方便。保持金属支杠于手术后１０～１２个月才拔除，有利于防止复发，胸廓外形更满意。三点式悬吊固定对较小的轻度患儿适用。支架背心悬吊固定法术后护理不便，影响患儿日常生活，使用受限     

Depiction of anomalous coronary vessels and their relation to the great arteries by magnetic resonance angiography

Three-dimensional respiratory-gated coronary MR angiography (MRA) allowed accurate analysis of the anatomy of the coronary arteries and their relation to the adjacent anatomic structures in two patients with anomalous origin and proximal course of the coronary vessels. Together with functional tests, it decisively influenced further therapy. Received: 16 November 1999; Revised: 4 April 2000; Accepted: 3 May 2000     

Glue embolization of a ruptured celiac trunk pseudoaneurysm via the gastroduodenal artery

Percutaneous transcatheter embolization of splanchnic artery aneurysms is a minimally invasive and alternative therapy to conventional surgical intervention. Due to a high-grade stenosis at the origin of the celiac trunk, a retrograde approach to the celiac trunk pseudoaneurysm via the gastroduodenal artery was necessary. To prevent undesirable embolization into the peripheral left gastric artery initial occlusion of the central portion of the left gastric artery was performed with microcoils using a Tracker catheter. Complete occlusion of the celiac trunk itself and the short adjacent segments of the celiac artery was achieved by using a mixture of N-butyl-2-cyanoacrylate and ethiodized oil as the embolizing agent. Received: 22 June 1999; Revised: 7 September 1999; Accepted: 1 October 1999     

A catheter technique in ophthalmic regional anaesthesia. Cadaver experiments

BACKGROUND: Regional anaesthesia for ophthalmic surgery is generally accomplished by peri- or retrobulbar techniques. Depending on the duration of ophthalmic surgery, reblock might become necessary. Our goal was to invent a catheter technique for ophthalmic regional anaesthesia that enables the user to administer local anaesthetics intraoperatively into the peri- or retrobulbar space continuously. METHODS: Twenty-five adult cadaver orbits of normal size and anatomy were used for the experiments. A flexible catheter was introduced transcutaneously or transconjunctivally into the extra- or intraconal space. Methylene blue solution was injected through the catheter. RESULTS: Using the same transcutaneous retro- and peribulbar technique, it was possible to introduce flexible catheters into a proper position of the cadaver orbits. The injected dye was found intra- or extraconally. CONCLUSION: Examining the spread of the dye in the orbit, we concluded that it is possible to provide ophthalmic anaesthesia for surgery through an indwelling catheter. We proved that continuous or intermittent administration of a local anaesthetic agent into the extra- or inraconal space can be achieved and this technique may allow us to maintain anaesthesia as long as it is necessary.     

A catheter technique in ophthalmic regional anaesthesia. Clinical investigations

BACKGROUND: Usually general anaesthesia is chosen if ophthalmic surgery of longer duration is expected. Our goal was to introduce a flexible catheter preoperatively into the extra- or intraconal space and to provide sufficient anaesthesia by continuous administration of a local anaesthetic via the catheter. METHODS: The continuous anaesthetic technique was applied in 28 patients undergoing vitreoretinal surgery. An indwelling catheter was introduced in 20 patients into the intraconal and in 8 patients into the extraconal space. In 6 patients, the position of the catheter was controlled by ultrasound examination prior to the injection of the local anaesthetic agent. RESULTS: For all patients adequate anaesthesia could be achieved and maintained with continuous retrobulbar administration (CRA) of a local anaesthetic by catheter. There were two patients who experienced moderate pain intraoperatively during continuous peribulbar administration (CPA). No complications occurred with the placement of the catheters. The catheter did not disturb the surgeon or the process of the ophthalmic surgery. CONCLUSIONS: Continuous administration of a local anaesthetic agent via an indwelling catheter into the intraconal space allowed ophthalmic anaesthesia without time restriction. Thus, CRA is a good alternative to general anaesthesia for patients undergoing long-lasting ophthalmic surgery.     

Marked enhancement of anti-allodynic effect by combined intrathecal administration of the adenosine A1-receptor agonist R-phenylisopropyladenosine and morphine in a rat model of central pain

BACKGROUND: There is often no satisfactory treatment for chronic pain after spinal cord injury. We have previously reported that intrathecal (i.t.) administration of the adenosine A1-receptor agonist R-phenylisopropyl-adenosine (R-PIA) or the opioid morphine has anti-allodynic effects in a model of presumed chronic central pain after photochemically induced spinal cord injury in rats. In the present study, we set out to investigate the possible interaction between i.t. R-PIA and morphine in spinally injured rats. METHODS: Sprague-Dawley rats displaying allodynia-like behaviors to mechanical and cold stimuli after photochemically induced spinal cord injury with minor motor deficits were used. R-PIA and morphine, either alone or in combination, were administered i.t. through an implanted catheter to lumbar spinal cord. RESULTS: Cumulative doses of R-PIA or morphine dose-dependently reduced the mechanical allodynia-like behavior, with a threshold of 1 nmol and 1.5 nmol, respectively. When co-administrated, R-PIA and morphine produced marked suppression of mechanical allodynia at doses of 5 pmol and 7.5 pmol, respectively. The effect of i.t. co-administration of R-PIA and morphine on cold allodynia was comparable to i.t. R-PIA alone. The combination of R-PIA and morphine did not increase adverse effects such as motor deficits in comparison to either drug alone. CONCLUSION: These results demonstrate a supra-additive interaction between the adenosine A1-receptor agonist R-PIA and morphine to reduce mechanical allodynia-like behavior in rats with chronic spinal cord injury. The combination of R-PIA and morphine administered spinally may be superior to R-PIA or morphine alone for treating such pain.