Obstetrical brachial plexus palsy: an analysis of 105 cases.

Obstetrical brachial plexus palsy (OBPP) remains a dramatic consequence after complicated childbirth. An increasing number of methods are being developed for the physical therapy and the early repair of the nerve lesions in OBPP, including neuroma excision and nerve grafting, neurolysis and neurotization. Secondary deformities of the shoulder, forearm, and hand can be reconstructed using soft tissue and skeletal procedures. In this article we analyze our approach to 105 patients to obtain optimal functional outcome in patients with OBPP.

Experimental induction of osteosarcoma by subperiosteal radioactive phosphorus injections in rats.

In search of a predictable experimental model for the study of therapeutic modalities for osteosarcoma, a group of rats had injections of phosphorus-32 (P-32) colloid subperiostally and were followed for the occurrence of malignant bone tumors until death or for 18 months. Of 50 rats, 26 died of unrelated causes and only 24 were included in the study. Two cases of osteosarcomas, one occurring in month 16 and the other at month 18 were induced; one case demonstrated multiple lung metastases. Clear evidence of the sarcoma inducing effect of P-32 has been obtained in this study. However, a high yield experimental osteosarcoma model was not produced.

Tuberculous spondylitis and intermittent chemotherapy in childhood.

The general characteristics and treatment of childhood tuberculous spondylitis are reviewed. Most of the patients (79 per cent) were under 5 years old with girls being in greater number. Twenty-six patients used classical antituberculous chemotherapy and five were given intermittent chemotherapy. There was no significant difference in the mean period of inactivation of the disease (2.8 v. 2.9 months) or in post-treatment angle of kyphosis (33 degrees v. 37.6 degrees) between the classical and intermittent chemotherapy groups. In addition to drug therapy, plaster jacket and immobilization were adequate in four children whereas 27 underwent surgery with only two requiring radical operations. In children with tuberculous spondylitis, intermittent drug treatment is a good alternative due to effectiveness and convenience of use and radical surgery should be reserved for selected cases.

Technetium-99m-MIBI uptake in benign and malignant bone lesions: a comparative study with technetium-99m-MDP.

The potential of hexakis (methoxyisobutylisonitrile) technetium (1) (MIBI) for the imaging of various bone pathologies and for assessment of effectiveness of therapy were investigated in a prospective study. MIBI was evaluated in comparison to MDP bone scans in 73 bone lesions (31 benign, 42 malignant). With MIBI, all but six malignant lesions were clearly visualized and the mean lesion/contralateral (L/C) ratio (2.21 +/- 1.17) was significantly higher than that of benign counterparts (1.26 +/- 0.40) (p less than 0.0005). No such significance was detected on corresponding MDP bone scans (4.86 +/- 3.48 versus 3.11 +/- 1.52). Ten cases with malignant tumor underwent both pre- and post-therapy MIBI evaluation and it was demonstrated that radiotherapy and/or chemotherapy significantly inhibited MIBI uptake. Moreover, post-therapeutic MIBI uptake was a good reflection of the effectiveness of therapy as confirmed by histopathological evaluation. Thus, with a strikingly higher uptake in malignant bone lesions MIBI might have good potential for the detection of malignant bone pathologies as well as for assessing tumor response to therapy.