Accurate Intermolecular Potentials Obtained from Molecular Wave Functions: Bridging the Gap between Quantum Chemistry and Molecular Simulations.
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Biomedical subjects
Publications and source records attributed to O Engkvist.
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Twelve children with triggering of 17 digits other than the thumb were seen in our department during an 8-year period. There were 8 children with single-finger involvement; the remaining patients had more than 1 triggering finger. Seven fingers in 5 children were not treated surgically; 1 of these patients had residual triggering in all 3 involved fingers. Ten fingers in 7 children were treated surgically. In contrast to the operative findings in children with triggering thumbs, no nodules were found in these cases. The surgical procedure necessary to relieve the triggering was often more extensive than an incision of the A-1 pulley alone and required separation of the inserting slips of the flexor digitorum superficialis tendon and release of the proximal A-2 pulley.
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PURPOSE: This retrospective investigation reviewed the ultrasound images of 96 benign soft-tissue tumours of the hand and forearm. The aim of the investigation was to determine whether there was any correlation between the ultrasound picture and the histopathological diagnosis. MATERIAL AND METHODS: Five common types of benign tumour in the hand and forearm were studied: localized villonodular synovites, haemangiomas, lipomas, nerve tumours, and glomus tumours. Only tumours that had been operated on and sent for histopathological examination were investigated. RESULTS AND CONCLUSION: The study found 5 key ultrasound characteristics that were important for differentiating the tumours: existence or not of vessels, existence or not of a capsule, echogenicity, echo structure, and pattern of growth. Taking these traits into consideration should make it easier for the examiner to make the right diagnosis with a reasonable degree of accuracy.
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Six months' experience of ultrasonographic diagnosis of the hand has proved it to be a valuable method for diagnosis of ganglions, tendon ruptures, synovitis, tumours, and the presence of foreign bodies. We are exploring ways of increasing its scope, in the light of the technical innovations that are being made.
Osteoid osteoma is infrequently localized to the hand. Initially the lesion causes unspecific symptoms, and the radiographic changes are discrete. Three cases were seen during a period of 5 years. Bone scintigraphy was a useful diagnostic tool, and CT facilitated the identification of the nidus. One of the lesions was a double nidus osteoid osteoma of the scaphoid bone. Only 12 instances of multifocal osteoid osteomas have been reported, none of which was localized to the carpal bones.
Thirty-three arthrodeses were performed for arthrosis of the first carpometacarpal joint in 29 patients. The patients were reexamined 5 (2-10) years after the operation. Twenty arthrodeses were clinically satisfactory, although two had failed to unite. Analysis of this group showed that a painless stiff carpometacarpal joint causes some functional impairment, considered negligible by most patients. The remaining 13 cases were unsatisfactory due to pain caused by arthrosis in the peritrapezoidal joints (7 cases), nonunion (4), radial nerve neuroma (1), and unknown reason (1).
An experimental study was performed in rabbits to find out whether fibrin glue, used to simplify the procedure for graft fixation in perichondrial arthroplasty, would also allow earlier mobilization of the grafted joint, thereby reducing the risk for postoperative stiffness of the joint. The results indicate the possibility of reducing the time used for postoperative fixation from three weeks originally to one week, and still achieve the same results regarding graft healing and cartilage regeneration. Immediate post-operative mobilization caused loosening of the graft and endangered the results.
A case of traumatic dislocation of the scaphoid bone treated by open reduction is reported. The bone remained vital, being nourished by a slender connection to the surrounding tissue. Experience from the few cases reported in the literature shows that closed reduction is often successful. If surgery is necessary it seems that it should be limited to simple reduction of the dislocation and that there is no need for primary arthrodesis or arthroplasty. Stable fixation is necessary to avoid re-dislocation and later wrist instability.
In the present report of a cold injury both feet showed symmetrical lesions. One foot was treated with medical sympathectomy by repeated regional intravenous guanethidine blocks, while the other foot served as control. No difference between the feet was observed with regard to pain, demarcating, healing or eventual loss of tissue.
In twenty-four patients with intolerance to cold after partial or complete finger amputations, lower skin temperature together with cold and vibration allodynia (allodynia = pain due to a non-noxious stimulus to neural skin) were found in the cold intolerant area compared with the corresponding area in the uninjured hand. When treated with regional intravenous guanethidine block nine patients became free from symptoms for up to twelve weeks, which is longer than would be expected from the duration of the known pharmacological effects of guanethidine. The patients had several features in common with reflex sympathetic dystrophies, and we suggest that neurogenic rather than vascular disturbances are mainly involved in the post-traumatic cold intolerance syndrome.
Thirty-nine patients with painful impaired forearm rotation and reduced grip strength after malunited fracture of the distal radius were treated with corrective osteotomy of the distal radius, bone grafting and internal fixation and followed for an average of 1.5 years. All patients stated that they were improved by the procedure. At follow-up 36 patients were graded as excellent or good, implying no pain, moderate limitation of motion and grip strength not less than 70% of the uninjured hand. Two patients were graded as fair and one as poor. It is concluded that surgical correction of the deformity is a good procedure when treating disabilities in the distal radio ulnar joint following malunited fractures of the distal end of the radius.
Defects in a sectioned tibial nerve were bridged by a new method using a polyglactin mesh-tube and compared with conventional nerve grafting in the rabbit. The capability of healing was evaluated by morphometrical observations and repeated EMG-recordings. Only minor differences between the two different techniques were observed and the possible advantage of the polyglactin method is discussed.
The investigation is a retrospective analysis of 2756 skiing injuries from two centers in a Swedish skiing area during the years 1972 to, and including, 1979. The relative frequency of lower extremity injuries successively diminished, while a corresponding increase of upper extremity injuries was found. The relative frequency of ankle and foot injuries declined, while the frequency of knee injuries did not change, knee injuries still being the most common skiing injury. The relative frequency of fractures of the lower leg showed a statistically significant decrease, but, in children, constituted 16% of all injuries at the end of the investigation period. Further studies, with special regard to the children's prerequisites, seem to be necessary to define the desired characteristics of an optimally functioning safety binding for children.