Technical report: fluoroscopically guided retrograde ureteric stent retrieval and replacement using a guide catheter directed snare.
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At the request of the Council on Education of the Deaf (CED) and the American Speech-Language-Hearing Association (ASHA), the Annals is publishing in its entirety and verbatim the report of a joint CED/ASHA committee designed to provide information to professionals about the services to deaf and hard of hearing children below three years of age and their families mandated by the Individuals with Disabilities Education Act-Part H, as Amended. This information should be of benefit to all professionals providing services through an individual family service plan. The report has also been published in the August, 1994 issue of the ASHA Journal.
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An improved technique for performing sialography in difficult cases is described. This is based on the passage of a cannula into the salivary duct ostium over a thin, flexible, blunt guide-wire.
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Initial experience with a new 10 F gauge version of the Nolan enteroclysis tube is reported. The mean intubation fluoroscopy time in 80 patients was 1.53 min. The more flexible smaller gauge tube is ideal for rapid duodenal intubation via the nasal route.
The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have been excellent.
This statement is a revision of a previous statement on prophylactic knee bracing and provides information for pediatricians regarding the use of various types of knee braces, indications for the use of knee braces, and the background knowledge necessary to prescribe the use of knee braces for children.
This document is the first recommendation on the presentation of properties in reproduction and fertility and their values in clinical laboratory sciences from The International Society of Andrology, IFCC and IUPAC. It forms part of the ongoing effort to standardise requests and reporting of laboratory data for transmission across cultural and linguistic domains, without attempting to standardise the language used by clinicians and laboratory practitioners. The document is accessible on Internet from C-NPU home page address: http://inet.uni-c.dk/ home/ifcc_iupac_cnpu.
Venous access catheters are employed for a wide variety of reasons. On removal of the catheter, the subcutaneous catheter cuff can be difficult to extract; retention of the cuff has recognized complications. We describe a simple ultrasound technique that assists in the identification of the cuff within the subcutaneous tissues, simplifying subsequent cuff removal. This may lead to a reduction in associated complications.
A growing body of scientific literature demonstrates that children who grow up with 1 or 2 gay and/or lesbian parents fare as well in emotional, cognitive, social, and sexual functioning as do children whose parents are heterosexual. Children's optimal development seems to be influenced more by the nature of the relationships and interactions within the family unit than by the particular structural form it takes.
Small bowel enteroclysis (SBE) is considered to be diagnostically superior to the conventional barium follow through examination (Sanders and Ho 1976; Maglinte et al., 1982; Herlinger, 1982) and would be more generally acceptable if jejunal intubation could be undertaken rapidly with minimum fluoroscopy and patient discomfort. Using a modified Merck 'Coresafe' tube 75 out of 80 patients referred for SBE were intubated, with considerably reduced fluoroscopic and intubation times. No tube related difficulty was encountered and patient tolerance was good.
A simplified technique of fallopian tube catheterization is described in which the tube is recanalized with a guidewire alone. The technique has been used to treat 13 infertile women, age range 27-39 years (mean 32 years), with a diagnosis of proximal tubal obstruction. One tube was perforated; all other tubes were successfully recanalized. Three women conceived within 10 months of the procedure. The technique has results similar to the standard coaxial catheter method but is simple and quick.
Malpositioned central venous catheters need to be repositioned so as to avoid local toxicity from chemotherapeutic and other agents and to prevent venous thrombosis. We describe a simple, safe and effective technique for repositioning silicone central venous catheters, by using a hand injection of sterile saline. It was successful in all nine patients in whom it was attempted, with no complications. Five catheters were single lumen and four were double lumen. We feel that this method should be attempted prior to the use of more invasive techniques.
When residual ridge atrophy of the edentulous mandible and maxilla is accompanied by a skeletal Class III jaw relationship, surgical correction is necessary for optimal functional, phonetic, and esthetic results whenever implant-supported prostheses are to be placed. A method is described in which a single procedure combines the endosseous placement of nonsubmerged titanium implants in appropriate prosthetically predetermined locations with defined advancement of the maxilla. Preoperative diagnostic examinations, cast simulation, and transfer of the latter to the site of surgery are of the utmost importance.
Pulse oximetry is widely used during anaesthetic practice to monitor heart rate and oxygenation and has been recommended as a monitor when sedative techniques are used. We monitored 25 patients receiving sedation for chemonucleolysis and showed that 17 became hypoxaemic at some stage of the procedure, none of whom had clinically detectable signs of respiratory depression. We recommend that monitoring with pulse oximetry is used in all patients receiving sedation for radiological procedures and that all radiologists administering sedation be trained in airway management.
Axial radiographs were performed on 59 children and adolescent patients with patellar malalignment using the method described by Laurin. A special frame was used to keep the knees in 20 degrees flexion and to maintain standard conditions. Radiological indices were measured before realignment surgery. A statistically significant difference (P < 0.0001) in the lateral patellofemoral angle was observed comparing malaligned and control patellae. Laurin's technique using a special frame provides a method of obtaining standard radiological measurements of patellar malalignment for use in surgical planning.
Metastases to vertebrae often cause bone destruction leading to instability and neural compression. Anterior surgical approaches allow tumor resection and direct neural decompression. For patients with a short life expectancy, vertebral body replacement with methyl-methacrylate polymerized in situ can be used for load sharing in the axial plane. Screws hung from the rod into the corpectomy site are incorporated into the acrylic cement. The technique described in this article allows for immediate spinal stabilization and provides a protective environment for the neural elements. All the patients tolerated the procedure well and were able to ambulation without an orthoses.