Biomedical subjects
Publications and source records attributed to I Matev.
A rare case of contracture of the long head of biceps femoris in a soccer player is described. Degeneration was probably caused by repeated corticosteroid injections. He made a full recovery after release of the shortened long head.
A child with congenital fibrosarcoma in the forearm, of microscopically differentiated type, is described. Early radical extirpation of the fibrosarcoma with the periosteum led to an apparent cure after 15 years.
A twenty-year experience with a surgical procedure, previously described, for dynamic correction of spastic thumb-in-palm deformity in cerebral palsy is reported. The procedure includes lengthening of the long flexor of the thumb, proximal thumb intrinsic release and augmentation of abduction-extension of the thumb. Bone-stabilising operations are not performed. 56 patients have been followed up for an average period of 4 years and 11 months after the treatment (range 2 to 15 years). Correction of the deformity is recorded in 82% of the patients.
The author reports a forty year old man presenting with Dupuytren's contracture affecting both hands, feet and auricular conchae. The patient is epileptic having been treated for twenty eight years with phenobarbitone and phenytoin. He had histologically proven Dupuytren's disease on both hands, but unfortunately no material was available from the ears. The follow up to date suggests that the auricular lesions have progressed slowly.
The survival rate was followed up of S. typhimurium, S. enteritidis, S. aureus, and E. coli in the organs of M. galloprovincialis L. in experimental conditions. A vat was used with 30 mussels in 10 l of sea water contaminated with 10 cm3 broth culture in conc. of 2.10(4) bacterial cells per cub. cm. The water was changed at 24-hour intervals. Microbiologic studies were carried out of the gills, liver, and meat of the mussels and of the sampled sea water. Lowest survival rate showed S. aureus--up to the second day, S. typhimurium and S. orientalis--up to the 4th days (in the gills only), and E. coli--up to the sixth day (in the gills and liver). None of the experimental strains to the sixth day (in the gills and liver). None of the experimental strains was isolated from the meat. With regard to the periods of investigation cited M. galloprovincialis L. could play the role of a carrier, resp. vector of the infection and could bring about a disease after consumption. Stated is the important part played by mussels as biofilter, and, at the same time, as source of pathogenic bacterial microflora.
Two patients treated by an osteocutaneous radial island flap with retrograde blood flow are described. Rotation of the flap and its distal vascular pedicle by nearly 180 degrees caused no impairment of the arterial flow, but it may interfere with the venous return through the radial veins, as observed in one of our cases. Therefore, it is safer to include in the skin flap an additional vein, suturing it to a superficial vein in the recipient zone, thus ensuring normal venous flow to the flap as well. The purpose of this paper is to present two patients treated by the use of an osteocutaneous radial artery forearm flap.
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The results of delayed primary suture of flexor tendons cut in the digital theca in twenty five patients, thirty three affected fingers, are given. The patients had their skin closed at another hospital immediately after the injury. One to six days later the skin stitches were removed and tendon suture was performed. Excellent and very good results are obtained in 79.7% of all thirty three fingers operated upon.
The double-innervated flap is raised from the dorsal surface of the index in a width of three to four centimeters and includes both dorsal digital nerves. This flap provides for tactile sensation to the major part of the prehension area of the thumb including the first web. It seems that this flap has a functional advantage over the various island flaps used to restore sensibility to the thumb pulp.
The distraction method proves successful in reconstructive surgery of the hand: 1. For reconstruction of the thumb and fingers after amputation. 2. For elongation of a hypoplastic thumb or finger. 3. In cases of congenital deformities of the hand including correction of contractures, dislocation, and clinodactyly. 4. For reduction of old dislocations of finger joints.
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Two boys with entrapment of the median nerve in the elbow joint after closed reduction of a posterior dislocation with fracture of the medial epicondyle showed a characteristic radiological sign in the anteroposterior radiograph after two to three months. The sign was a depression in the cortex on the ulnar side of the distal humeral metaphysis, with interruption of the local periosteal reaction. At operation in both patients the depression was found to correspond with the place where the median nerve reached the posterior surface of the humerus. Radiographs taken after transverse section of the nerve above and below the joint capsule and end-to-end suture showed gradual disappearance of the cortical depression.
Various areas in 7 local flaps and in 6 free skin grafts from the back, abdomen and thigh, applied to the palm and fingers and retained for periods extending from several months to 17 years are studied. After the second year, the transplants display virtually complete recovery of the sensation for pain, touch, pressure and temperature. The hair roots in the transplants have varying thickness and reveal changes in the structure of the connective-tissue and outer epithelial sheath (Figs. 1, 2). The sebaceous glands are enlarged. Isolated sebaceous glands are encountered which do not communicate with the hair roots. In the upper layers of the corium bundles of myelin nerve fibers are observed, giving off small groups of 2-4 fibers each, with slightly ascending direction relative to the hair roots (Fig. 3). The nerve fibers break down into branches which are furthermore ramified into smaller branches, forming palisade-like endings along the outer epethelial sheath of the hair root (Figs. 4-8). They number 15-25, being usually thin, with a discrete number of thickenings, and resemble the normal fibers running along the hair roots of the donor site (Figs. 9, 10). No capsulated receptors, characteristic of the surrounding skin, are noted in the transplants. Hence, it is assumed that most likely, the endings of the regenerated nerve fibers along the hair roots, although uncapsulated and with identical structure, provide for perceiving the types of sensation, inherent of the hairy and glabrous human skin.
Studies was the role played by ticks of the Argas persicus species in the epizootiology of pullorum disease in birds. Use was made of microbiologic, radiometric, and autoradiographic methods to follow up the period of carrying Salmonella gallinarum-pullorum, the localization and routes of elimination of the causative agent as well as the possibility of transmitting the infection by ticks. The pathogen was found to persist in the alimentary tract for a long time (at least 8 months--as long as the observation period lasted) without altering its pathogenicity, being excreted through the feces. No Salmonella-carriers were found among ticks in pullorum infection foci, and this points to the fact that their part as disease-transmission factors is limited. Regardless of what has already been established, however, the long term of harbouring pathogenic Salmonellae by ticks necessitates the organization of sanitation measures including such which aim to destroy the ticks on infected poultry farms.
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