RESUMEN
Traumatic tetraplegia is an overwhelming injury often requiring permanent adaptations by patients and families. The greatest potential for improving the quality of life lies with rehabilitation and restoration of upper extremity function. Functional surgery of upper limb following tetraplegia is individualized based on functional level and can significantly improve hand functional quality of life. We haveobserved a 46-year old man with a C5 complete spinal cord injury and the patient had achieved functional improvement of upper extremity by functional surgery of upper limb for tendon transfer of posterior deltoid to triceps muscle and biceps tendon release.
Asunto(s)
Humanos , Persona de Mediana Edad , Contractura , Codo , Mano , Cuadriplejía , Calidad de Vida , Rehabilitación , Traumatismos de la Médula Espinal , Transferencia Tendinosa , Tenotomía , Extremidad SuperiorRESUMEN
OBJECTIVE: To investigate the immediate effect of dorsal penile nerve (DPN) stimulation on detrusor pressure (Pdet) and blood pressure (BP) during hyper-reflexic contractions of the bladder in patients with cervical spinal cord injury (SCI). METHOD: The subjects were eight male patients with cervical SCI who had symptoms of autonomic dysreflexia. During water-cystometry, BP was monitored using an intra-arterial catheter into the radial artery, and was recorded simultaneously with the Pdet. Electrical stimulation was applied to the DPN, using surface electrodes each time a bladder contraction was detected. Baseline BP and BP at the first and the last hyper-reflexic contractions of bladder were measured with Pdet, respectively. RESULTS: As Pdet increased, the BP increased in all cases. The reflex contractions of the bladder were effectively suppressed by DPN stimulation, and as the Pdet decreased during stimulation, radial arterial pressure also decreased immediately and significantly. CONCLUSION: DPN stimulation can lower both Pdet and the elevated BP.
Asunto(s)
Humanos , Masculino , Presión Arterial , Disreflexia Autónoma , Presión Sanguínea , Catéteres , Estimulación Eléctrica , Electrodos , Nervio Pudendo , Arteria Radial , Reflejo , Traumatismos de la Médula Espinal , Vejiga Urinaria , Vejiga Urinaria NeurogénicaRESUMEN
Congenital self-healing reticulohistiocytosis (CSHR) is a rare variant of cutaneous reticulohistiocytosis. We report a newborn who had about 25 reddish brown papulonodular lesions on whole body at birth. No extracutaneous involvement was found. All skin lesions involuted within 4 months spontaneously. Biopsy of a skin lesion showed marked aggregated histiocytic infiltration with some eosinophils. S-100 protein and lysozyme were positive. Electron microscopy revealed numerous dense bodies, often with a myelin-like core and some Birbeck granules. We described a detailed clinical features of this case and reviewed the literatures.