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At least 127 records · Page 7Linked to original sources

Rehabilitation of Caisson's disease with spinal cord involvement.

Fifteen cases of Caisson's Disease or Decompression Sickness with spinal cord involvement treated at the Department of Rehabilitation Tan Tock Seng Hospital, from 1973 to 1978 are described. All the cases had bladder and bowel function involvement. Five cases developed bone complications, one of whom was referred to us primarily for rehabilitation after he had an operation for collapsed right femoral head which occurred two years after the incident.

Adult↗

Regional distribution of circulating microspheres in the femur of the rabbit.

In an attempt to explain the distribution of lesions of caisson disease of bone in the human femur, the regional distribution of circulating microspheres which had been labelled with scandium-46 was studies in the femur of the rabbit. Microspheres with a diameter of 15 microns were equally distributed between the two ends of the bone and between the upper and lower halves of the shaft. However, microspheres with a diameter of 50 microns congregated in the upper end of the femur and in the lower half of the shaft, the two sites most commonly affected by caisson disease. A large percentage of the microspheres in the shaft, especially the larger spheres, were retained in the marrow. It is suggested that the microcirculation of the marrow may act as a filter and that the nature and distribution of its vessels determine the site of impaction of circulating emboli. This would explain why lesions of the shaft mainly affect the medulla of the bone and not the cortex.

Animals↗

Nontraumatic osteonecrosis of the humeral head.

The humeral head is the second most common site for nontraumatic osteonecrosis after the femoral head, yet it has attracted relatively little attention. Osteonecrosis is associated with many conditions, such as corticosteroid use, sickle-cell disease, alcoholism, dysbarism (or caisson disease), Gaucher's disease, and other systemic conditions. The diagnosis is a clinical and radiographic one, the latter forming the basis for its staging. Treatment depends on the chronicity and severity of symptoms, as well as the degree of clinical and radiographic progression. Surgical treatment includes arthroscopic debridement and core decompression for early osteonecrosis and hemiarthroplasty or total shoulder arthroplasty for more advanced disease. This report reviews osteonecrosis of the humeral head, with an emphasis on current treatment options.

Arthroplasty↗

A case of aseptic vertebral necrosis in the context of metastatic lumbar disease.

Aseptic bone necrosis has many well recognized etiologies: caisson disease, corticosteroids, alcohol, Gaucher's disease and sickle cell anemia being a few of a long list. Little attention has been paid to metastatic disease as a possible cause and we were unable to find reference in the literature to this association. We present imaging features of metastatic Ewing's sarcoma involving the vertebral spine, which, in certain aspects, mimics other well-known entities of this region, such as Kümmell's and Scheuermann's diseases.

Adult↗

[The radiological findings of caisson-induced bone infarcts. The relationship between acute arthralgia and bone infarcts (author's transl)].

The radiological features, such as calcification in long bones due to infarcts, resulting from Caisson disease are described by the author on the basis of an extensive experience. The similar localisation of acute "arthralgia" and bone infarcts make it appear probable that the infarcts play a primary role in the production of "osteo-articular" pain. The author stresses the advisability of examining the adjacent portions of the tibia and femur at the initial pre-employment examination, since bone infarcts can be caused by a variety of conditions other than work in Caissons.

Bone and Bones↗

Diseases of unusual occupations: an historical perspective.

A compilation of conditions deemed unusual from previous eras serves to highlight now obsolete jobs and remind that even relatively prevalent occupational disorders of today will be viewed retrospectively as strange in the proximate future. Discussed are coal miners' nystagmus, scrotal cancer in chimney sweeps, phossy jaw, hatters' shakes, painters' colic, potters' rot, chauffeurs' knee, glanders, caisson disease, and others.

Europe↗

Malignant fibrous histiocytoma and pleomorphic sarcoma in association with medullary bone infarcts.

A malignant fibrous histiocytoma arose in the proimal tibia of a 40-year-old man who had multiple, symmetrically distributed, medullary bone infarcts of unknown etiology, involving the distal femora and the tibiae. Despite amputation and chemotherapy, widespread metastases developed and death occurred 19 months after surgery. A polemorphic sarcoma, probably representing an anaplastic malignant fibrous histiocytoma, arose in association with a single medullary infarct in the proximal humerus of a 33-year-old woman. She remains well without evidence of disease five years after treatment by radical radiotherapy followed by shoulder disarticulation. Sarcoma arising in association with bone infarction is a rare entity. Sixteen cases reported in the medical literature, including our own, are reviewed. The sarcomas arose in the tibia in nine cases, the femur in six cases and the humerus in one case. The patients were usually older individuals and 13 of the 16 were male. All but two had multiple bone infarctions. Four of the patients had caisson disease, three had what is probably an hereditary bone dysplasia, one had sickle cell disease and eight had infarcts of unknown etiology. Most patients have had a rapidly fatal outcome. Thirteen of the sarcomas have been fibrosarcomas or malignant fibrous histiocytomas, both of which are rare primary bone tumors. Analysis of the published cases of bone infarction-related sarcomas suggests that the risk of developing a sarcoma is greatest in infarcts with large medullary components.

Adult↗

[Otologic aspects of diving].

Ear diseases are the most common of all occupational diseases of diving. Otitis externa is the most frequent and troublesome infection in divers especially when the environment is humid. During compression, failure to equalize the pressure of the air-filled cavities surrounded by bone (middle ear, sinus) deprives the middle ear (or sinus) of aeration. Middle ear barotrauma is the most common barotrauma encountered in divers while external ear barotrauma (reversed ear) and inner ear barotrauma (with rupture of the round or oval window) are less common. Decompression sickness (Caisson disease) is primarily the result of inert gas bubbles; deafness and vertigo may result if the inner ear is involved. The most dramatic cause of disorientation under water is that due to vertigo. This vertigo is commonly a transient effect due to unequal caloric stimulation of the two labyrinths. The physical examination of the ear and nose necessary for assessment of diving fitness are discussed. A list of ENT contra-indications is presented which mandate temporary or permanent disqualification from diving.

Barotrauma↗