Immunoglobulin E (IgE) levels and eosinophil counts were measured in 18 former patients with burn injuries attending an outpatient clinic for hypertrophic scarring. In 15 of these 18 former patients with burns, IgG anticollagen antibodies were also measured. Earlier reports in the literature have suggested that a local immune reaction against collagen might play a role in enhancing inflammation, thereby increasing scar formation. In addition, we have previously reported an increase in allergic symptoms in patients with keloids and hypertrophic scars. Antibodies to the following collagen types were measured: human type I, human type III, bovine type I, and bovine type III. IgG anticollagen antibody levels were correlated with percentage third-degree burn, number of weeks after burn injury, and the patient's age. An increase in percentage third-degree burn and in number of weeks after burn injury was statistically significantly associated with an increase in serum anticollagen antibody level. Six of the 18 patients had higher than normal IgE levels (p value = 0.0002).

Adult↗

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The predictive value of the development of the acetabular teardrop figure in developmental dysplasia of the hip.

We reviewed the radiographs of 72 hips, 47 with developmental dysplasia of the hip (DDH), and 25 normal hips, to determine the timing of the normal appearance of the acetabular teardrop figure and the value of teardrop development after reduction of the hip in predicting outcome. In normal hips, all children had a teardrop figure by age 18 months. In the 47 hips with DDH, no teardrop figure appeared until the hip was reduced. The DDH hips were divided into two groups based on the success of the initial reduction. By using statistical analysis, we found that the appearance of the acetabular teardrop within 6 months after reduction of the hip is strongly associated with a favorable long-term outcome. We believe that the appearance of the teardrop is the earliest radiographic sign that a stable, concentric reduction of the hip has been achieved.

Acetabulum↗

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Autogenic bone marrow injections as a treatment for simple bone cyst.

Simple bone cyst (SBC) is a benign fluid-filled cavity found primarily at the proximal ends of long bones in children. Treatments proposed for SBC range from observation to intralesional curettage and bone grafting, which are all associated with uncertainty and complications. Because of these factors, a relatively noninvasive protocol with osteoinductive autogenic bone marrow was instituted. Twelve patients were identified with SBCs. Bone marrow was aspirated from the patient's iliac crests and injected into the cyst cavity. Follow-up ranged from 9 to 57 months. Eight (67%) patients demonstrated substantial healing, two (17%) showed partial healing, and two (17%) did not respond to bone marrow therapy. The advantages suggested by bone marrow injection over the currently practiced methods include a higher success rate with a single injection and earlier healing.

Adolescent↗

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Mini-dose Bier block intravenous regional anesthesia in the emergency department treatment of pediatric upper-extremity injuries.

The safety and effectiveness of the "mini-dose" Bier block, a technique of i.v. regional anesthesia using low-dose lidocaine (1.5 mg/kg) without routine premedication, was evaluated in the emergency department treatment of pediatric upper-extremity fractures and dislocations. We prospectively studied 69 patients, aged from 2 to 16 years, treated at a pediatric primary care/referral-based emergency department. Good to excellent anesthesia was achieved during closed reduction in 90% of the cases. All patients achieved an acceptable reduction, as demonstrated by follow-up radiographs. None required further treatment of the injury under general anesthesia. No significant complications were noted. We conclude that the mini-dose Bier block provides safe, reliable, and cost-effective anesthesia for the outpatient reduction of pediatric upper-extremity injuries.

Adolescent↗

PubMedDate not supplied

Developmental susceptibility to intestinal injury by platelet-activating factor in the newborn rat.

Platelet-activating factor (PAF) is an important endogenous mediator of neonatal necrotizing enterocolitis (NEC). Injection of PAF into weanling and adult rats causes ischemic bowel necrosis that is morphologically similar to NEC. The purpose of this study was to adapt the PAF model of intestinal injury to the suckling rat and to attempt to alter susceptibility to PAF-induced bowel necrosis by early weaning and formula feeds. At ages 15 to 20 days, rat pups were selected to be weaned to either formula or 5% dextrose or to nurse ad lib (total n = 54). At ages 16, 18, 20, 21, 23, or 25 days of life, animals received PAF (50 micrograms/kg) and endotoxin (1 mg/kg) by intraperitoneal injection. Animals were sacrificed 2 h after injection. Intestinal samples were submitted to be graded by a pathologist in a blinded fashion. Injury scores ranged from 0 to 10, based on the percentage of villous necrosis. Prior to age 20 days, minimal histologic injury was present (mean scores on days 16, 18 = 1.7 +/- 0.9, 1.7 +/- 0.6). Combined injury scores for weaned and nursed animals on days 20 and 23 were significantly greater than on days 16 and 18 (p = .0001). Histologic injury in the dextrose group was significantly less than the formula-fed group on day 21 and greater on day 25. Suckling rats showed resistance to PAF-induced bowel necrosis prior to 20 days of age, during the middle of the weaning period. Early weaning to formula did not alter susceptibility to injury, which suggests that PAF-acetylhydrolase from breast milk does not confer this resistance to PAF.

Aging↗

PubMedDate not supplied

Traumatic avulsion of the innominate artery. Report of a case an review of literature.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

Disc embolization from a Beall mitral valve prosthesis.

Although embolization of the disc from a Beall valve is rare, several reports in the literature have identified patients suffering this complication. This report details the clinical and radiologic course of a patient with an embolized disc from a Model 103 Beall mitral valve prosthesis. The patient lived approximately 39 hours without the disc prior to surgical correction. Depending on the cardiac reserve and the amount of pannus formation, patients may live long enough to allow surgical correction of this complication.

Embolism↗

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A collagen coated vascular prosthesis.

A woven, double velour Dacron vascular graft was made nonporous by coating it with a layer of collagen prepared from fresh, young calf skin. Grafts were implanted in the thoracic aorta of 24 mongrel dogs and were examined at intervals up to 180 days. The grafts did not require preclotting or special preparation before being implanted. They sutured easily and did not bleed. When explanted all grafts were patent and covered with neointima. The bovine collagen was almost completely resorbed by 90 days and was replaced with native tissue. The collagen was neither thrombogenic, antigenic, cytotoxic, or pyrogenic.

Animals↗

PubMedDate not supplied

A new woven double velour vascular prosthesis.

A new woven double velour vascular prosthesis designed to minimize intraoperative blood loss was implanted in 24 animals. Grafts were examined at 3 to 12 month intervals for healing and were compared to woven non-velour grafts implanted in 13 control animals. At 12 months, the velour grafts were 93 to 98% covered with neointima while the control grafts were only 86% covered with neointima. The neointima on the velour grafts was thinner (60 mu) and more vascular than that on the control grafts. Woven double velour grafts were implanted in 20 patients. Minimal bleeding occurred through the grafts which did not require preclotting, were easy to sew, and did not fray.

Aged↗

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Grice subtalar arthrodesis followed to skeletal maturity.

A retrospective review of 45 patients (62 feet) who had undergone a Grice subtalar arthrodesis and who had reached skeletal maturity was undertaken. Preoperative deformities were due to flaccid and spastic paralysis, as well as congenital abnormalities. There were failures in 32% and poor results in 61%. Unrecognized ankle valgus, overcorrection of the hindfoot into varus, uncorrected calcaneus deformity, and anterior graft orientation largely contributed to the poor results. Weight-bearing radiographs of the feet and ankles are necessary to distinguish ankle valgus from hindfoot valgus. A subtalar arthrodesis cannot be used to compensate for ankle valgus, nor can it be used to correct the calcaneus component of a deformity without appropriate muscle-balancing procedures or osteotomies.

Ankle Joint↗

PubMedDate not supplied

Mycobacterium fortuitum infections of the mediastinum.

The clinical course of a patient with M. fortuitum infection of the mediastinum following open heart surgery is presented. Cure was achieved by aggressive and thorough surgical debridement of the mediastinum (including the edges of the sternum and other involved tissues) and by the administration of antimicrobial agents which are not usually thought to be effective in the treatment of mycobacterial infections.

Amikacin↗