Cartilaginous abrasion and debridement: correlation between type of cartilaginous injury and results in patients with a 4 to 9-year follow-up.

It is the purpose of this study to verify whether or not there is a correlation between some parameters for cartilaginous injury (width, depth, and type of injury), analyzed separately, and the medium to long-term prognosis of the same. Thus, the parameters were analyzed, correlating them individually with the results obtained when a self-evaluation form was used, and the Lysholm-Gillquist score system. The small number of patients (because of the strict criteria for inclusion) does not allow for a statistically valid analysis of the results obtained. At any rate, the following considerations may be made: the depth parameter for the injury may be a valid element alone in determining a medium- to long-term prognosis; this agrees with what is reported in the literature. The parameter for width of the injury, based on our results, does not appear to be a sufficient element to determine a correlation with future prognosis. As for the type of lesion parameter, this could be correlated with the prognosis. Studies conducted in this sense with higher numbers of patients could determine the type of injury with the worst prognosis.

Hemiarthroplasty of the shoulder. Clinical experience in 18 cases treated by the Neer monoblock prosthesis.

The authors report the results of 18 hemiarthroplasties of the shoulder performed between 1990 and 1994 using the Neer II monoblock prosthesis, emphasizing the technical and surgical problems encountered. The patients treated numbered 13 for traumatic pathology (acute fractures: 7; sequelae of fracture of the proximal epiphysis of the humerus: 6), and 5 for degenerative lesions (arthrosis: 3; rheumatoid arthritis: 2). An evaluation of the results was based on the Constant method and isokinetic testing. Results based on follow-up obtained after 2 to 6 years were satisfactory in 83% of the cases.

Isokinetic testing to evaluate patients submitted to surgery for the treatment of surgical lesion of the rotator cuff.

A total of 100 cases surgically treated for rupture of the extra-rotator cuff were evaluated by isokinetic testing. Results were evaluated after a period of time ranging from 1 to 4 years, based on the Constant system, defining the type of lesion of the cuff based on the Snyder classification system, and measuring strength postsurgery using isokinetic testing after 3 and 6 months, and 1 year. Isokinetic testing made it possible to accurately evaluate which patients are capable of obtaining better recovery, and how much time is required for physiotherapy for postoperative rehabilitation, also allowing for correction on an individual basis of any muscular imbalance.

Highly constrained neural networks for industrial quality control.

In this work we investigate techniques for embedding domain-specific spatial invariances into highly-constrained neural networks. This information is used to drastically reduce the number of weights which have to be determined during the learning phase, thus allowing us to apply artificial neural networks to problems characterized by a relatively small number of available examples. As an application of the proposed methodology, we study the problem of optical inspection of machined parts. More specifically, we have characterized the performance of a network created according to this strategy, which accepts images of parts under inspection at its input and issues a flag at its output which states whether the part is defective. The results obtained so far show that the proposed methodology provides a potentially relevant approach for the quality control of industrial parts, as it offers both accuracy and short software development time, when compared with a classifier implemented using a standard approach.

Microsurgery in the treatment of crural and sciatic pain due to disc and bone compression: considerations on the first 100 cases.

The authors present the results they obtained in the first 100 operations performed between January 1989 and November 1990 for the treatment of lumbar sciatic pain related to disc and/or bone compression: microsurgery according to the Caspar method was used. A total of 113 spaces were submitted to surgery; discectomy at two levels was performed in 13 patients. Nerve root compression observed was based on three causes: 1) pure disc hernia (57.5%), 2) pure lateral stenosis (15.9%), 3) combined pathology (hernia+stenosis) (25.6%). In one of the cases the pathology remained unknown. At an average two-year follow-up there were 94 excellent or good results, 2 fair results, and 4 poor results. Complications included dural lacerations in 3 cases, with no sequelae. Eight patients were submitted to further surgery for recurrence of symptoms; the final results after reintervention were excellent in 7 cases, and fair in 1. The authors emphasize the advantages to using microsurgery as compared to macrosurgery, and stress a frequent finding of pure lateral stenosis or associated with disc pathology (47 out of 113 levels operated, equal to 41%), as well as the reliability of CT scan when dealing with disc pathology (97% positive diagnosis) but its unreliability when diagnosis is lateral stenosis (19 out of 47, equal to 40%).

Fracture of the coracoid process associated with fracture of the clavicle: description of a rare case.

The authors report on a case of fracture of the coracoid process associated with fracture of the clavicle. Open reduction and internal fixation of the coracoid process lead to a good clinical and radiographic outcome.

Prenatal diagnosis of cardiac structural abnormalities.

The history of antenatal diagnosis of congenital cardiac defects using ultrasound is briefly reviewed. A series of 277 pregnancies were prospectively examined; 203 were normal and 19 diagnosis of congenital heart disease were made. A correct diagnosis of the anomaly was made in 14 cases and the diagnosis was partially correct in 4 cases. There was 1 false-positive.

The innervation of the skin on the antero-medial region of the knee.

The frequency of operations on the knee, particularly on the antero-medial aspect, involving damage or section of sensory nerves, prompted the authors to carry out an accurate research on the innervation of this region. This revealed many variations of the normal anatomy which have been classified and illustrated in detail.

Prenatal diagnosis of endocardial fibroelastosis.

In a case of fetal heart failure caused by endocardial fibroelastosis, prenatal echocardiography clearly demonstrated a thickened endocardium. We therefore suggest that an abnormal endocardium may be detected in utero by ultrasound, thus representing an important clue in the differential diagnosis of fetal nonimmune hydrops and in the evaluation of pregnancies at risk for endocardial fibroelastosis.

Articulated prosthesis for the head of the femur in subcapital fractures of the neck of the femur.

The introduction of christiansen's prosthesis for the head of the femur has altered the balance between the two alternative surgical solutions for subcapital fractures of the neck of the femur (osteosynthesis and endoprosthesis). The writers report their results on the first forty-five patients treated surgically with the new prosthesis, illustrating its functional advantages as compared with the "single block" endoprosthesis. The risk of wear and tear of the acetabulum is practically abolished.

[Tetralogy of Fallot associated with total anomalous pulmonary venous drainage. Case report (author's transl)]. / Tetralogia di Fallot associata a drenaggio anomalo totale delle vene polmonari. Descrizione di un caso.

A case of a 12 year old girl who presented tetralogy of Fallot (T. o F.) associated with Total Anomalous Pulmonary Venous Drainage (TAPVD) is described. This association is extremely rare, only four autopsied cases being reported in literature. TAPVD is associated with complex cyanotic congenital heart diseases in about one third of cases; asplenia or polysplenia are generally present. Double outlet right ventricle (DORV) is the commonest trunco-conal malformation associated with TAPVD; extremely rare is T. o F. Pulmonary outflow tract obstruction can avoid the haemodynamic consequences due to obstruction on the venous channel, or progression to pulmonary hypertension. The association of the two malformations can masquerade the clinical and Xray picture of TAPVD and make difficult the diagnosis during cardiac catheterization.