ABSTRACT
The present study sought to test the hypothesis that the second factor (consisting of Failure-to-Maintain-Set and other scores) found in two recent factor analyses of the Wisconsin Card Sorting Test reflects attentional function. The effect of color overlays (an experimental manipulation known to influence neural systems linked to attention) was examined in 17 normal control and 14 attention-disordered children (ages 8 to 12). Group and Color main effects were found for Factor 1 (which consists largely of measures of perseveration) and a Color main effect was observed for Factor 2. The Color effect for Factor 2 supported the contention that this factor reflects attentional processes. A hypothesis concerning the relationship between problem solving and attention on the WCST is offered and a means for testing it is discussed.
ABSTRACT
BACKGROUND: We describe the transpelvic rectus abdominis musculocutaneous flap for closing large, often irradiated, perineal defects in patients with cancer. METHODS: We studied 9 men and 17 women who underwent wide excision of advanced T3 and T4 tumors and who had preoperative chemotherapy, radiotherapy, or both. After tumor ablation, we used a transpelvic rectus abdominis musculocutaneous flap to fill pelvic dead space and primarily close the perineal wounds. Twelve simultaneous vaginal reconstructions were performed. RESULTS: Wounds healed promptly in 14 patients. Healing was delayed in the remaining 12 patients due to poor flap adherence to irradiated tissue beds (9), complete flap loss (2), or partial flap loss (1). Delayed healing was associated with the combination of obesity and prior irradiation. Other perioperative complications included localized abdominal wound infection (2), enterocutaneous fistula (1), and abdominal herniation (1). Local disease was controlled in 20 of 26 patients. Mean follow-up was 22 months. CONCLUSION: Transpelvic rotation of the rectus abdominis musculocutaneous flap facilitates healing large, difficult, perineal wounds, resulting from cancer ablation.
Subject(s)
Anus Neoplasms/surgery , Perineum/surgery , Rectal Neoplasms/surgery , Rectus Abdominis/transplantation , Skin Transplantation , Adult , Aged , Female , Humans , Male , Middle Aged , Pelvic Neoplasms/surgery , Surgical Flaps , Urethral Neoplasms/surgery , Wound HealingABSTRACT
A case of free fibula transfer for mandibular reconstruction in a cardiac transplant patient is described. The reconstructive microsurgeon should be aware of the special requirements of these immunosuppressed patients and flap transfer should be performed in specialized centers with the interaction of different specialties to make the procedure safe and successful.
Subject(s)
Bone Transplantation/methods , Fractures, Spontaneous/surgery , Heart Transplantation , Mandibular Fractures/surgery , Surgical Flaps/methods , Child , Elective Surgical Procedures , Female , Fibula , Heart Transplantation/immunology , Humans , Immunocompromised Host , Mandibular Neoplasms/radiotherapy , Microsurgery , Sarcoma, Ewing/radiotherapyABSTRACT
A clinical survey of 56 patients was conducted at four different centers in Canada to evaluate the effect of extremely low frequency pulsed magnetic fields (PMF) on ununited fractures of the tibia. All ten patients with delayed union and 84% of the 44 patients with nonunion healed. One case with a traumatic pseudarthrosis and one with a congenital pseudarthrosis failed to respond to treatment. These results compare favorably to those reported by others using a system with different pulse characteristics. Prolonged immobilization is necessary and poses problems of rehabilitation. Nonunions with a gap between the tibial fragments and pseudarthroses are better treated with bone grafting and internal fixation prior to electrical stimulation.
Subject(s)
Fractures, Ununited/therapy , Magnetics , Tibial Fractures/therapy , Adolescent , Adult , Aged , Canada , Child , Chronic Disease , Combined Modality Therapy , Electromagnetic Phenomena/instrumentation , Electromagnetic Phenomena/therapeutic use , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Pseudarthrosis/therapy , Time Factors , Wound HealingABSTRACT
A non-invasive method of electrical stimulation of healing in ununited fractures of the tibia by pulsed magnetic fileds has been evaluated. In a series of 17 patients all but two of the fractures united within 4 to 10 months, with an average time of just under six months. The method is sufficiently promising to merit further clinical investigation.
Subject(s)
Electric Stimulation Therapy/methods , Fractures, Ununited/therapy , Tibial Fractures/therapy , Adolescent , Adult , Electric Stimulation Therapy/instrumentation , Electromagnetic Fields , Female , Follow-Up Studies , Humans , Male , Middle Aged , Wound HealingABSTRACT
The object of this experimental work was to evaluate the effect of a noninvasive method of electrical stimulation on the healing of freshly-created osteotomies of the rabbit radius. The apparatus consisted of a solid core electromagnet energized by a square wave unidirectional current. The magnetic field was pulsed transversely across the osteotomy site of the radius while the animal was confined to a restraining device 6 hours daily for 5 days per week. In one group of animals the influence of different pulse frequencies, using 0.1 Hz, 1 Hz, and 4 Hz, was evaluated, while the period of stimulation was kept constant at 2 weeks. In another group of animals, exposure was continued for 3 and 4 weeks while the pulse frequency was kept constant at 1 Hz. Histologic and radiologic comparison with control animals revealed that the initiation of the healing process can be accelerated in magnetic fields pulsed at 1 Hz, but that this effect is not maintained, and that the total period of time required for union is not significantly shortened. In view of these findings, this form of treatment is not recommended for clinical use in the treatment of recent fractures of long bones.
