[Hand infection by Eikenella corodense].
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Biomedical subjects
Publications and source records attributed to M Nyska.
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Subchronic oral exposure of dogs to Oxodipine, a new calcium channel blocker of the dihydropyridine-type, resulted in dose-related gingival hyperplastic changes. The doses at which an effect was elicited were 24 and 73 times the intended therapeutic dose for man. The effects were first noted after 7 weeks of treatment, and were limited to the high and intermediate dose groups of both sexes. Macroscopically, a generalized enlargement of the maxillary and mandibular facial and lingual gingivae were noted. The histological changes were similar to those described in man for Nifedipine and hydantoin-related drugs. An increase in the activity of alkaline phosphatase and a decrease in alanine aminotransferase was demonstrated. This article is the first to describe gingival hyperplasia in dogs induced in a dose-dependent manner by a calcium channel blocker.
A growth rate analysis of lung metastases of benign giant cell tumor (GCT) of bone, histologically indistinguishable from the primary benign tumor, is presented. The doubling time (DT) was 186 days in the first 13 months of growth, and 465 days in the last 4 months. These DTs are much longer than DT of lung metastases of any other tumors, and have a good correlation with a long survival time. Backward extrapolation showed that the lung metastases began to develop years before the primary tumor was diagnosed and treated. If this can be confirmed in a larger number of patients, it could be concluded that there will be no indication for amputation as a treatment for benign GCT whether or not lung metastases are present. The growth rate analysis supports the concept that these metastases might represent a benign process, and as such are a unique histologic and clinical phenomenon.
Disseminated intravascular coagulopathy is a serious complication of numerous pathological conditions, particularly metastatic cancer. It is rarely encountered in orthopaedic surgery. Prompt recognition and treatment is required to prevent death. We describe two patients with pathological fractures of the proximal femur due to metastatic disease who died from disseminated intravascular coagulation after operation. A high index of suspicion, careful monitoring of the clotting mechanism and prompt treatment are required.
In order to improve gliding function of damaged flexor tendons in chickens, we topically applied enriched collagen solution (ECS) to the tendon sheaths of severed tendons. Previous studies using the same experimental model showed improvement of gliding function in the damaged tendons biomechanically and increased collagenolytic activity in the area of the damage after application of ECS. In the present study we evaluated the influence of ECS on peritendinous adhesion formation and on the healing process of the tendons histologically. We found that topically applied ECS reduced adhesion formation, mostly during the first week, without adversely affecting tendon healing or scar maturation.
A rare combination of an ulnar fracture with posterior dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral navicular fracture is presented. To the best of our knowledge, no such case has been reported. The mechanism of this fracture combination is discussed with respect to its role in producing the Monteggia type II fracture. Treatment consisted of a combination of closed and open reduction with external fixation.
Reports of spondylolysis in vertebrae other than those of the lower lumbar spine are rare. We report 32 patients with upper lumbar spondylolysis who have been studied clinically, radiologically and scintigraphically. Twenty patients had bilateral lesions, and seven of those with unilateral lesions had structural changes or anomalies in the opposite posterior arch. Positive scans were found to be associated with a short clinical history, and indicated stress-related lesions. Our findings suggest that mechanical factors may play a role in the aetiology of spondylolysis in the upper lumbar spine similar to that which they play in the lower lumbar spine, and that local structural anomalies may contribute to abnormal loading of these vertebrae.
Eikenella corrodens, a gram-negative, slow-growing rod, belongs to the normal flora of mucous membranes. Infections of the hand including this pathogen, are described in human bite and clenched fist injuries. Our case demonstrates another possibility of wound contamination with normal oral flora causing Eikenella corrodens infection. The consequences due to the delay of appropriate therapy are discussed.
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Seven cases of femoral fractures in head-injured children with spasticity and/or decerebrate posturing and seizures were treated with external fixation. The fractures healed with good alignment, maintenance of length, and without infection. The technique is recommended both for its simplicity and lack of complications relative to other management approaches.
A case report of a metallic foreign body in the foot which was not found in surgery following X-ray localization and fluoroscopy is described. CT detected the precise localization of a radio-opaque foreign body in a second exploration, after a negative exploration based on standard X-rays.
To verify the role of collagenase in reduction of peritendinous adhesion by topical application of exogenous collagen, the flexor tendons of 30 chickens were severed and sutured. Exogenous, native enriched collagen solution (ECS) was introduced in the tendon sheath via a polyethylene catheter. The effect of ECS on collagenolytic activity in the healing tendon was assessed 1, 2, and 3 weeks later both by determining the relative amounts of dialyzable protein and hydroxyproline and by using the collagen film collagenase assay. The results obtained indicated a significant increase in both dialyzable hydroxyproline level and collagenolytic activity in the ECS-treated tendons as compared with the untreated controls. It is suggested that the effect of the topically applied exogenous collagen on increasing the collagenolytic activity may be directly related to previously observed increased gliding capacity of the tendons in the same experimental model.
Osseous involvement is usually not appreciated in de Quervain's stenosing tenosynovitis. A case of stenosing tenosynovitis accompanied by significant local osteoporosis in the radial styloid area and a corresponding positive area on a technetium-99m polyphosphonate bone scan provoked the authors' interest in this entity. In seven consecutive patients with de Quervain's disease, six had evidence of osseous involvement of the radial styloid as demonstrated by roentgenographic studies and/or technetium bone scanning. In the process of differential diagnosis of a lytic lesion in the radial styloid area, de Quervain's tenosynovitis should be included.
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In an attempt to define more precisely the various mechanisms involved in antidiuretic hormone (ADH) release during positive end-expiratory pressure ventilation (PEEP), experiments were performed on seven groups of dogs. PEEP-10 and PEEP-15 cmH2O caused significant elevations of plasma ADH from basal values of 24.9 +/- 5.2 pg/ml (mean +/- SE) to 64.6 +/- 14.2 and 106.0 +/- 20.6, respectively (P < 0.02, P < 0.005). The ADH levels returned to basal values after cessation of PEEP. This rise in ADH levels was prevented by an infusion of dextran prior to PEEP. The fall in blood pressure and cardiac output that occurred during PEEP was also prevented by the dextran infusion. Changes in ADH levels were unrelated to lung volume, left transmural pressure, and serum osmolality. Bilateral vagotomy and carotid sinus denervation was followed by an attenuated rise in ADH levels in terms of the percent rise above base line, but it did not significantly alter the absolute rise in ADH during PEEP. ADH levels were, however, reduced significantly by decreasing intracranial pressure by the removal of cerebrospinal fluid during PEEP. Propranolol administration prior to PEEP completely blocked plasma renin activity. Although the peak ADH levels were unaffected by propranolol, the rise was delayed. The results obtained indicate that a number of physiological factors may affect plasma ADH levels during PEEP. These include the carotid body and aortic arch baroreceptors as wells as sensors of intracranial pressure.