The osseous structure of the carpal groove

Summary Transverse osseous structure of the carpal groove was studied using serial sections and microradiography. The width and area of the carpal groove were measured in x-ray films of each section. The wrist and carpal region was divided into six levels: 1) radio-ulnar joint level, 2) proximal level of the carpal bones, 3) intermediate level of carpal bones, 4) distal level of carpal bones, 5) the first C-M joint level, and 6) bases of the metacarpal bone level. The width of the carpal groove averaged 32 mm at the inlet and became narrower toward the outlet. Both inlet and outlet areas were small, the largest area was observed at the middle part. Although the carpal bones did not support the body weight, a remnant of the trajectorial architecture of the trabeculae was observed.

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La structure osseuse de la gouttière carpienne

Résumé La structure transversale des os de la gouttière carpienne a été étudiée à l'aide de coupes et par microradiographie. L'épaisseur et la superficie de la gouttière carpienne ont été mesurées sur des clichés aux rayons X de chacune de ces coupes. La région du poignet et du carpe a été divisée en six rangées: 1) la rangée de l'articulation radiocubitale, 2) la rangée proximale des os du carpe, 3) la rangée intermédiaire des os du carpe, 4) la rangée distale des os du carpe, 5) la rangée de la première articulation C-M et 6) la rangée de la base des os du métacarpe. L'épaisseur moyenne de la gouttière carpienne atteignait 32 mm à l'entrée, se rétrécissant en direction de la sortie. Tant la zone d'entrée que celle de sortie étaient de superficie réduite, la superficie la plus importante étant observée dans la partie médiane. Si les os du carpe ne supportent pas le poids du corps, un reste de structure trajectorielle des travées a cependant été observé.

     

High-frequency ultrasound examination of the wrist and hand

High-frequency ultrasound (US) is an efficient, rapid and inexpensive altenative to magnetic resonance imaging (MRI) for investigation of diseases in the soft tissues of the wrist and hand. US allows detection of foreign bodies and the reliable identification of a variety of traumatic lesions affecting tendons, annular pulleys, ligaments, vessels and nerves. Inflammatory diseases of tendons, including acute and chronic tenosynovitis and some degenerative conditions in the wrist and hand, can also be diagnosed. In entrapment neuropathies, US is able to identify nerve shape changes and possible extrinsic space-occupying lesions that may cause nerve compression within the tunnels. In patients with localized swelling of the hand or wrist, US is able to assess the presence of an expansile lesion and to characterize its nature in most cases. The objective of this article is to review the main findings and the primary indications of US in the investigation of disorders of the hand and wrist. Received: 10 September 1998 Accepted: 24 November 1998     

腹膜透析相关性感染状况及预后分析

目的:了解腹膜透析(PD)相关性腹膜炎、隧道感染的菌种及预后.方法:统计腹透患者腹膜炎及隧道感染的发生率、细菌种类、治疗效果和预后.结果:自2000年始至今收住的46例腹透患者共发生腹透相关性腹膜炎27人次,病原菌以金黄色葡萄葡球菌(37.0%)和表皮葡萄球菌(25.9%)为主,隧道感染7人次(3例金葡菌、2例绿脓杆菌、1例表葡菌、1例大肠杆菌).经治疗,25人次腹膜炎治愈,2例因严重的霉菌性腹膜炎而拔管,6人次隧道感染治愈,1例绿脓杆菌感染合并腹膜炎未愈而拔管.结论:感染的病原菌种类影响预后.     

隧道式拖线加内口切挂术治疗后位马蹄型肛瘘46例

采用隧道式拖线加内口切挂术治疗后位马蹄型肛瘘 4 6例 ,4 4例为一次性治愈 ,2例经一次扩创后治愈 ,平均疗程 (2 6± 3)天。     

长期接触低浓度二硫化碳者正中神经损害的电生理研究

目的:探讨CS2接触者和腕管综合征患者正中神经损害的区别。方法:接触组为40例长期接触CS2的患者,对照组为30例腕管综合征患者(未接触CS2),两组进行临床及正中神经电生理检测观察。结果:运动神经检测显示接触组与对照组无显著差异(P>0.05),感觉神经和F波检测显示有显著性差异(P<0.05)。神经传导各检测项目可见:两组SCV有极显著差异(P<0.01);DML、F-CV、F波出现率有显著差异(P<0.05);SNAPA和dCMAPA则无显著差异(P>0.05)。结论:尽管接触组与对照组均有正中神经损害,但病因和临床表现不同,神经电生理检测,尤其是SCV的差异表现可为二者的鉴别诊断提供较客观的依据。     

Utilizing Tunnel Boring Machine (TBM)-Crushed Limestone as a Construction Material

Tunnel boring machine (TBM) materials are usually crushed powder obtained during tunnel excavations for subways and transportation networks. Huge quantities of crushed rock powder are generally treated as waste. This study is aimed at assessing proposed mixtures of TBM and granular material for use in construction. This approach will help in a greener environment and reduce the need for crushed aggregates used in sub-base and subgrade layers of pavements. Assessment is executed using dynamic and static strength tests, including the modulus of resilience and the California bearing ratio (CBR). The TBM-crushed material can be sorted and screened on site to optimize its use as a construction material. The blending ratios for the 3/8-inch aggregate (G1) to the material-passing sieve number 4 (P4) were found to influence the pavement design parameters. This study recommends sorting the TBM-crushed limestone by an on-site sieving operation. A guide to optimizing the quality of the material is suggested by blending 3/8-inch aggregate with the crushed limestone fine-powder material at a specified percentage ranging from 5 to 10% by weight. The stability and durability tests conducted on the TBM-crushed powder material confirmed its suitability as a pavement construction material for subgrade and sub-base layers. Modulus of resilience, CBR values and compressive strength tests were carried out for different suggested mixtures.     

Amyloidosis of the Heart and Kidney

Amyloidosis encompasses a collection of disorders of pathological protein folding. The extracellular location where these “amyloid fibril” proteins are deposited determines the clinical presentation of the disease. The abnormal architecture of these fibrils makes them insoluble and not easily removed, leading to disruption of normal tissue structure and interference with normal physiology. Amyloidosis of the heart and kidney can be inherited, secondary to unrelated diseases, or due to a plasma cell disorder. This review will focus on immunoglobulin light chain amyloidosis, which is life-threatening and must be diagnosed as early as possible by employing precise and accurate typing to ensure timely and frequently curative therapy.     

跗管综合征的神经电生理诊断价值

目的探讨神经电生理检测对于跗管综合征的诊断价值。方法回顾性分析2019年1月至2021年11月于复旦大学附属华山医院就诊的32例(35侧)跗管综合征病人的神经电生理检测资料:(1)足内肌(小趾展肌或展肌)的复合肌肉动作电位(compound muscle action potential,CMAP);(2)足底内侧皮神经的感觉神经动作电位(sensory nerve action potential,SNAP);(3)足内肌的肌电图(electromyography,EMG)检测结果。结果足内肌CMAP的潜伏期为(6.4±2.0)ms,较健侧延长47.6%,波幅为(7.5±5.2)mV,较健侧降低59.7%;足底内侧皮神经SNAP的潜伏期为(2.4±0.6)ms,较健侧延长30.5%,波幅为(3.1±3.1)μV,较健侧降低78.4%;EMG检测结果:29侧足内肌出现自发电活动,34侧出现不同程度的主动募集反应减弱。结论 CMAP、SNAP、EMG检测对诊断跗管综合征均有重要价值,其中SNAP的波幅变化最为显著。     

腕管镜及改良小切口松解法治疗糖尿病腕管综合征的疗效分析

目的 探讨腕管镜腕管松解术和改良小切口腕管松解术治疗糖尿病腕管综合征的临床疗效和安全性差异.方法 回顾性分析腕管综合征合并糖尿病患者86例,其中43例患者行双孔道腕管镜腕管松解术(A组),43例患者行改良小切口腕管松解术(B组),随访10 ～ 24个月,统计两组患者的手术时间、住院时间、恢复工作时间、术后并发症和临床疗效.结果 A组和B组患者的优良率分别为93.02％和90.70％,两组的优良率比较差异无统计学意义(P＞0.05);A组患者的住院时间[(5.5±2.7)vs(6.8±2.9)d]及术后恢复工作时间[(19.3±3.1)vs(21.5±3.3)d]少于B组,差异有统计学意义(P＜0.05),而两组患者的手术时间、术后并发症发生率比较均差异无统计学意义(P＞0.05).结论 腕管镜腕管松解法和改良小切口腕管松解法均是治疗糖尿病腕管综合征的有效且安全的手术方法,腕管镜腕管减压术患者住院时间短、术后恢复快,对于机体修补能力较差的糖尿病患者更为适合.     

I期根治术联合隧道式拖线法治疗马蹄型舡周脓肿临床观察

目的 观察I期根治术联合隧道式拖线法治疗马蹄型肛周脓肿的临床疗效。方法 将79例病例随机分为治疗组（43例）和对照组（36例）,治疗组采用I期根治术联合隧道式拖线法治疗,对照组采用肛周脓肿I期根治术;观察两组临床疗效及术后创面愈_合时间、瘢痕面积及肛门功能情况。结果 治疗组、对照组总有效率均为100％;组间临床疗效比较,差异无统计学意义（P〉0．05）。两组创面愈合时间、瘢痕面积及肛门钥匙孔样改变、肛门功能情况比较,差异均有统计学意义（p〈0．01）。结论 I期根治术联合隧道式拖线法具有疗效好、创伤小、创面愈合快及并发症少等特点,可有效用于马蹄型肛周脓肿的临床治疗。