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  • 1
    Electronic Resource
    Electronic Resource
    Premedication with dextromethorphan provides posthemorrhoidectomy pain relief (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 507-510 
    Details
    ISSN: 1530-0358
    Keywords: Dextromethorphan ; Hemorrhoidectomy ; NMDA receptor ; Preemptive analgesia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Previous studies have shown that N-methyl-D-aspartate receptor antagonists provide a preemptive analgesic effect in humans. This study was designed to examine whether premedication with dextromethorphan, an N-methyl-D-aspartate antagonist, also provided a preemptive analgesic effect that improved postoperative pain management. METHODS: Sixty patients who were American Society of Anesthesiologists status I and II scheduled for hemorrhoidectomy (modified Whitehead procedure) were included in the study. Patients were randomly assigned to the control and study groups. For the control group patients received chlorpheniramine maleate (20 mg), a component of the injection form of dextromethorphan, intramuscular injection 30 minutes before skin incision. In the study group dextromethorphan 40 mg containing 20 mg chlorpheniramine maleate (intramuscular) was given as premedication 30 minutes before skin incision. Pethidine (1 mg/kg, intramuscular) was given for pain relief as required postoperatively. The time to first pethidine injection, total pethidine consumption, worst pain score, and pethidine-related side effects were recorded for 48 hours postoperatively. RESULTS: The times to first pethidine injection (mean ± standard error of the mean) were 5.2±3 and 19.6±6 hours in the control and study groups, respectively. Total pethidine consumption was 140±11.3 and 63.5±11.8 mg in the control and study groups. The worst visual analog scale pain scores were 7.4±0.2 and 5.6±0.3 in the control and study groups during the two-day observation. The numbers of patients who required pethidine injection were 29 and 20 in the control and study groups, respectively. Two patients suffered pethidine-related side effects, such as nausea, vomiting, dizziness, and headache, in the control group, and no patient complained of any side effect in the study group. CONCLUSION: We found that dextromethorphan premedication provided a preemptive analgesic effect, thus producing reduced postoperative pain and pethidine requirement and improved recovery from hemorrhoidectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237195
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  • 2
    Electronic Resource
    Electronic Resource
    Staple augmentation to treat a humeral nonunion after failed Seidel locked nailing (1998)
    Springer
    Archives of orthopaedic and trauma surgery 118 (1998), S. 42-44 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seidel locked nailing has been successfully used to treat a humeral shaft fracture or nonunion. However, if union fails despite this treatment, the next approach to try has not been well defined. We, therefore, developed a technique using a staple to enforce the local stability without removing the failed nail. The technique was very simple, and the outcome was always satisfactory.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050308
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  • 3
    Electronic Resource
    Electronic Resource
    Effect of reaming bone grafting on treating femoral shaft aseptic nonunion after plating (1999)
    Springer
    Archives of orthopaedic and trauma surgery 119 (1999), S. 303-307 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Rigid intramdullary nailing with cancellous bone grafting provided by intramedullary reaming was prospectively used to treat femoral shaft aseptic nonunions after plating. Indications for this technique were a femoral shaft nonunion with an inserted plate, no previous infection sign in the treatment course, less than 1.5 cm shortening, and no segmental bony defects. After the plate was removed, a flexible guidewire was inserted antegradely. The local wound was closed, and intramedullary reaming was done as widely as possible until some resistance to it occurred. Finally, a rigid intramedullary nail was inserted. Twenty-four consecutive patients were treated with this regimen, and 21 were followed-up for at least 1 year (range 1–5 years). All 21 nonunions healed with a union rate of 100% (21/21). The time to union was 4.5 ± 1.0 months. There were no significant complications. We conclude that for indicated cases, reaming bone grafting is a very effective technique and avoided donor site morbidity. Therefore, whenever possible, this technique could be considered first.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050415
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  • 4
    Electronic Resource
    Electronic Resource
    Treatment of cutout of a lag screw of a dynamic hip screw in an intertrochanteric fracture (1998)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 193-196 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixteen consecutive patients with cutout of a lag screw of a dynamic hip screw fixation in an intertrochanteric fracture were treated with reinsertion of a lag screw, bone cement supplementation in the neck-trochanter, and subtrochanteric valgus osteotomy. Postoperatively, patients were permitted to ambulate with protected weight-bearing. Fourteen patients were followed-up for at least 1 year (median 2 years; range 1–3 years), and all had a solid union. The union period took a median of 5 months, with a range of 3–7 months. Usually, union of an intertrochanteric fracture was faster than that of subtrochanteric osteotomy (P 〈 0.01). There were no complications of wound infection, loss of reduction, cutout of a lag screw, or osteonecrosis of the femoral head. From clinical and theoretical considerations, we conclude that despite cutout of a lag screw of a dynamic hip screw fixation being difficult to treat, out technique still can provide an excellent outcome. Therefore, we strongly recommend its wide use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050228
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  • 5
    Electronic Resource
    Electronic Resource
    A simpler surgical technique to treat aseptic nonunion-associated femoral length discrepancy (1992)
    Springer
    Archives of orthopaedic and trauma surgery 111 (1992), S. 160-164 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective study from December 1986 to August 1989, 17 consecutive patients with femoral shortening due to aseptic nonunion of femoral shaft fractures were treated with limitedly open Gross-Kempf locking nailing with a lengthening procedure. Patients were followed up for at least 1 year (average 25 months). There was a 88.2% union rate with an average union period of 5.2 months. Average lengthening was 2.4 cm (1.0 ∼ 3.0 cm) , and average operation time 90 min (70 ∼ 130min). The blood loss was slight (average 200ml). Complications (11.8%) were 5.9% implant failure and 5.9% nonunion which were not difficult to manage. No neurovascular complications were noted. We conclude that for 5 cm shortening or less in femoral aseptic nonunion, this treatment constitutes the simplest technique and can achieve a very satisfactory result.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00388091
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  • 6
    Electronic Resource
    Electronic Resource
    A small effect of weight bearing in promoting fracture healing (1992)
    Springer
    Archives of orthopaedic and trauma surgery 112 (1992), S. 28-32 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We treated 66 consecutive type IV comminuted femoral shaft fractures with static Grosse-Kempf interlocking nails and followed them up for at least 1 year (median 27 months). Although the effect of weight bearing was completely lost, 60 fractures healed primarily without dynamization. We conclude that weight bearing contributes only an auxiliary role in promoting fracture healing, and that the most decisive role is adequate mechanical stability with sufficient nutrition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00431040
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  • 7
    Electronic Resource
    Electronic Resource
    Tibial shaft malunion treated with reamed intramedullary nailing: a revised technique (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 152-156 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty-seven consecutive adult tibial shaft malunions which had not undergone surgical treatment were prospectively treated with reamed intramedullary nailing. Indications for this treatment modality included a malunion of a tibial shaft which had only been conservatively treated, lesion level fitting for traditional or locked reamed intramedullary nail fixation, less than 2 cm shortening, and without evidence of deep infection at present. The malunions were treated with fibulotomy, closed wedge tibial osteotomy, open reaming of the marrow cavity, stable reamed intramedullary nail stabilization with or without supplementation, and cancellous bone grafting. Thirty-four (92%) patients were followed up for at least 1 year (range 1.0–4.3 years), and all achieved a solid union. The union period was 5.8±0.8 months. Complications included 2 (6%) patients with deep infection and 1 (3%) with cortical perforation. However, all 3 patients recovered completely after adequate management. In conclusion, a reamed intramedullary nail is an ideal instrument for tibial shaft malunions in indicated cases. Good exposure of the bony segments to ream the marrow cavity precisely can avoid cortical perforation. Gentle dissection of the soft tissues may lower the infection rate. Concomitant cancellous bone grafting can improve the union rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050033
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  • 8
    Electronic Resource
    Electronic Resource
    Esophageal varices in congenital heart disease with total anomalous pulmonary venous connection (2000)
    Springer
    The international journal of cardiovascular imaging 16 (2000), S. 405-409 
    Details
    ISSN: 1573-0743
    Keywords: asplenia syndrome ; computed tomography ; congenital heart disease ; esophageal varices ; total anomalous pulmonary venous connection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Total anomalous pulmonary venous connection (TAPVC) is an uncommon congenital anomaly in which the anatomical presentations vary widely among patients. We hereby present two newborns with TAPVC associated with asplenia syndrome; both had severe esophageal varices due to infradiaphragmatic pulmonary venous drainage. Ultrafast computed tomography (CT) scanning was superior to color Doppler echocardiography and cardiac catheterization as it provided a detailed portrait of the pulmonary drainage. The remarkable radiographic manifestations are presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026578412327
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  • 9
    Electronic Resource
    Electronic Resource
    Attenuation of endothelium-dependent relaxation in mesenteric artery during noise-induced hypertension (1993)
    Springer
    Journal of biomedical science 1 (1993), S. 49-53 
    Details
    ISSN: 1423-0127
    Keywords: Noise ; Endothelium ; A23187 ; Acetylcholine ; Nitroglycerin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract The present study was designed to determine whether there is a causal relationship between noise-induced hypertension and changes of endothelial function. Rats were exposed to noise stress (100 dB, 1 kHz, 4 h/day, 6 days/week) for 1–4 weeks. The systolic blood pressure was significantly increased after rats were exposed to noise stress for 3 weeks. The relaxant responses of isolated mesenteric arterial rings to endothelium-dependent vasodilators (A23187 and acetylcholine) in noise-treated rats were significantly less than those in control rats. This difference in response to acetylcholine still existed in the presence of methylene blue or Nω-nitro-L-arginine. On the other hand, the responses to the endothelium-independent vasodilator nitroglycerin were not affected in rats exposed to noise stress. The attenuation to endothelium-dependent vasodilators during noise stress may result in increasing peripheral vascular resistance and thus elevate blood pressure. This indicates that noise-induced hypertension may be partly due to the alterations of endothelial activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02258339
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  • 10
    Electronic Resource
    Electronic Resource
    Generation and evolution of interplanetary slow shocks (1996)
    Springer
    Annales geophysicae 14 (1996), S. 375-382 
    Details
    ISSN: 0992-7689
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geosciences , Physics
    Notes: Abstract It is well known that most MHD shocks observed within 1 AU are MHD fast shocks. Only a very limited number of MHD slow shocks are observed within 1 AU. In order to understand why there are only a few MHD slow shocks observed within 1 AU, we use a one-dimensional, time-dependent MHD code with an adaptive grid to study the generation and evolution of interplanetary slow shocks (ISS) in the solar wind. Results show that a negative, nearly square-wave perturbation will generate a pair of slow shocks (a forward and a reverse slow shock). In addition, the forward and the reverse slow shocks can pass through each other without destroying their characteristics, but the propagating speeds for both shocks are decreased. A positive, square-wave perturbation will generate both slow and fast shocks. When a forward slow shock (FSS) propagates behind a forward fast shock (FFS), the former experiences a decreasing Mach number. In addition, the FSS always disappears within a distance of 150R⊙ (where R⊙ is one solar radius) from the Sun when there is a forward fast shock (with Mach number \geq1.7) propagating in front of the FSS. In all tests that we have performed, we have not discovered that the FSS (or reverse slow shock) evolves into a FFS (or reverse fast shock). Thus, we do not confirm the FSS-FFS evolution as suggested by Whang (1987).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00585-996-0375-1
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