[Osteochondritis dissecans of the scaphoid (Preiser's syndrome): 2 case reports]. / L'osteocondrite dissecante dello scafoide (sindrome di Preiser): descrizione di due quadri clinici.

Preiser's syndrome is a rare osteochondrosis affecting the carpal scaphoid, frequently related with an avascular necrosis. Osteoarthritic changes of the articular cartilage, local synovitis, and loose fragments are the most common findings associated with this syndrome. We report here two patients with Preiser's syndrome, one with and one without a traumatic history, both presenting with pain, swelling and functional impairment of the wrist. In one patient radiography was sufficient for the diagnosis, in the other NMR was necessary to clearly establish type and extension of the lesion. Differential diagnosis may be sometimes difficult and the therapeutic approach depends on several aspects, including etiology and type of occupational activity.

Subcutaneous rupture of the tendon of the long head of the biceps brachii in subacromial impingement syndrome.

Ruptures of the long head of the biceps brachii are mostly of degenerative nature, secondary to subacromial impingement and morphological changes in the bicipital groove. Clinical findings are typical. Treatment is controversial, as it may either be surgical or non-surgical. The authors considered only those cases in which tendinous rupture was the first manifestation of pathology caused by wearing, with typical deformity of the profile of the arm. The favorable results of surgical treatment in 14 patients aged from 38 to 70 years, followed-up after an average of 10.9 years, are reported. Among surgical methods used, tenodesis at the bicipital groove currently constitutes the method of choice.

Preliminary chemical, biochemical, and pharmacological characterization of a low molecular weight dermatan sulphate.

The aim of this study was to set up a depolymerization process which resulted in the formation of a low molecular weight dermatan sulphate (LMWDS), retaining the chemical properties possessed by native dermatan sulphate (DS), fundamental for the expression of its specific biological activity. The depolymerization of DS by a beta elimination process led to the production of oligosaccharide chains having a 4,5 unsaturated uronic acid at the nonreducing end. The chemical evaluation has shown that the most important parameters (degree of sulphation, sulphate to carboxyl ratio, and specific rotation) have not undergone any particular modification compared to native DS. The biochemical results demonstrate that the LMWDS obtained retains most, if not all, of the specific biological activity. The reduction in molecular weight significantly enhanced the bioavailability of the product after subcutaneous administration.

The superficial anastomosis on the palm of the hand between the ulnar and median nerves.

The communications between the median and ulnar innervated territories on the palm of the hand have been studied anatomically and microscopically. A communicating branch is well appreciated but its description has had little emphasis in anatomical or surgical literature. 50 cadaveric palms were dissected in both sexes and an anastomotic branch was found in 45 hands. In 43 of them it originated proximally from the ulnar nerve and proceeded distally to enter the third common digital nerve; in the other two hands it left the median nerve to reach the fourth common digital nerve. By microscopic dissection we have seen that the ulnar fibres of the anastomotic branch which join the median nerve may contribute to the sensory innervation of the radial half of the ring finger and ulnar side of the middle finger on its palmar surface. We have therefore described a cutaneous area on the palm where care must be taken to avoid surgical damage to this branch.

[Dermatotenodesis in the treatment of "mallet finger"]. / La dermatotenodesi nel trattamento del "Mallet finger".

"Tenodermodesis" is a surgical technique devised and recommended in order to correct chronic mallet finger deformity. In the last ten years, at the I Orthopedic Clinic of Padua University, tenodermodesis combined with a longitudinal transarticular Kirschner wire fixation has been used for treating a total of 25 mallet fingers: 20 acute and 5 chronic lesions. This lesion was always due to a simple tendon injury with a flexion deformity up to 45 degrees. Based on the results, the authors suggest the use of this techniques for treating acute lesions especially in young people, whatever finger has been injured. The reason why the authors themselves are not capable of giving a significant opinion on the validity of the method in the treatment of chronic mallet deformity is the small number of patients treated.

Osteosynthesis of fractures of the upper end of the radius.

Osteosynthesis of fractures of the head of the radius is regarded with disfavour by many ortophaedic surgeons, who prefer excision of the fractured head. However, osteosynthesis is capable of producing excellent results, as long as the correct indications are observed and it is carried out with minimal trauma, and by simple, small methods of synthesis. The authors report 13 cases treated by this method.

Osteochondritis dissecans of the talus. A report on 7 cases.

The clinical and radiological findings in 7 cases of osteochondritis dissecans of the talus indicate that this is a potentially progressive condition. Surgical treatment was carried out in 4 cases while the remaining 3 were treated conservatively. Surgery produced good clinical and radiological results. The conservative treatment consisted of immobilisation and abstention from weight-bearing. This was unsuccessful in 2 adult patients but in a 9 year old girl it led to a virtually complete recovery in 3 months.

Verapamil and propranolol: a comparison of two antihypertensive agents.

Verapamil, a calcium antagonist, was compared with propranolol, a widely used beta-adrenoreceptor blocker, in hypertensive patients with respect to its antihypertensive efficacy and incidence and severity of adverse effects. Both drugs caused similar blood pressure reductions without interfering with pulse pressure. The hypotensive effect of verapamil was not accompanied by any effect on heart rate, while after propranolol there was a significant bradycardia. ST-segment and T wave abnormalities at rest and after exercise were partially or completely reverted by both drugs. The incidence and severity of adverse effects was very low and no patient was withdrawn from the study because of complaints due to the active drugs. Verapamil can be compared as antihypertensive drug to the beta-blocker propranolol and this may justify, together with the absence of negative effects on lipids, blood sugar, serum electrolytes and renal function, its use as an antihypertensive drug of first choice.

[Leukemic reticuloendotheliosis. Problems in differential diagnosis apropos of our study of 1 case]. / La reticoloendoteliosi leucemica. Problemi di diagnosi differenziale a proposito di una nostra osservazione

A case of leukaemic reticuloendotheliosis is reported. The clinical and histocytological picture of the disease is discussed in relation to the complex problems of differential diagnosis it involves with other forms of systemic involvement of the spleen. The electivity of splenectomy is stressed.