[Distal transfer of the greater trochanter among other surgical procedures for the treatment of hip deformity]. / Obnizenie kretarza wiekszego wsród innych metod leczenia operacyjnego deformacji biodra.

Distal greater trochanteric transfer is a rarely used procedure for treatment of hip deformity. Surgical technique is described. Potential for changing morphology of proximal end of the femur is underlined and pitfalls indicated. The main advantage of the procedure is reconstruction of the femoral neck. It is biomechanically more sound than valgus osteotomy done frequently in similar cases. Advantages of trochanteric transfer are confirmed by other authors who after this procedure achieved clinical and radiological improvement in patients with degenerative disease of the hip.

The value of distal greater trochanteric transfer in the treatment of deformity of the proximal femur owing to avascular necrosis.

A series of 49 patients (55 hips) who had distal greater trochanteric transfer at the mean age of 13.9 years because of the deformity of the proximal femur after treatment for developmental dislocation of the hip was reviewed to verify the value of the procedure. Mean follow-up was 8.8 years. Clinical and radiologic assessment was supplemented with strain-gauging evaluation of the muscles involved. Good results were achieved in patients who had good range of movement or isolated restriction of abduction before the operation. After surgery, a 22% increase of abductors torque was found, the Trendelenburg sign disappeared in 30 individuals, and 15 patients regained normal gait. No complications were observed. Our study confirmed the value of distal transfer of the greater trochanter in treatment for proximal femur deformity owing to avascular necrosis after management of developmental dislocation of the hip and clarified indications for this procedure.

Experimental determination of electric-field-induced differences in structure-factor phases of the order of 2%

In order to understand the induced electron-density response of covalently bonded materials to an externally applied electric field, the change of structure-factor phases of several weak reflections of GaAs has been measured by three-beam interferences. Using a modulation technique, phase variations of the order of 1 degrees for a field strength of 1 kV mm(-1) were determined. Although the statistics of these first experiments are rather poor, the experiment verifies qualitatively the predictions of a semi-empirical bond-charge model. The measured phase variation is the smallest value determined up to now.

[Osteoid osteoma of the lower extremity]. / Kostniak kostnawy (osteoma osteoides) konczyny dolnej.

Forty patients (27 males and 13 females) aged 18 months-41 years with preliminary diagnosis of osteoid osteoma localized within lower limb were reviewed. All underwent surgery. Histopathology confirmed previous diagnosis in 29 patients but in 11 cases (30%) histology either gave different diagnosis (despite clinical and radiological changes typical for osteoid osteoma) or was inconclusive. Three types of radiographic picture were distinguished: within cancellous bone the change was either osteolytic or oval, sclerotic; within cortical bone it was spindle-shaped, sclerotic. In 5 cases radiological symptoms were present prior to the pain. In 3 cases observed several years before surgery natural growth of osteoid osteoma could be traced. The key role of prostaglandin synthesized by osteoid osteoma in its pathology was emphasized.

[Hip joint deformity caused by osteochondrosis in the course of treatment of congenital dysplasia of the hip]. / Deformacja stawu biodrowego spowodowana osteochondroza w przebiegu leczenia wrodzonej dysplazji.

A series of 73 patients with avascular necrosis complicating surgical or nonsurgical treatment for congenital hip dysplasia is presented. The femoral head, neck and subcapital growth plate has been damaged in all cases. A-P radiographs of proximal femur revealed three types of growth disturbances: lateral, medial and total one. Localization of growth plate damage determined the type of growth disturbances. Mutual features for all types were: shortening of the femoral neck and growth disproportion between femoral head and greater trochanter. In 43 hips the greater trochanter grew over the femoral head and constituted the most proximal part of the femur (trochanter altus). Growth disturbances of the acetabulum coexisted (primary and secondary acetabular dysplasia). Radiological parameters of deformed hips have been compared with normal values.

[Greater trochanter epiphyseodesis in treatment of hip deformity]. / Epifizjodeza kretarza wiekszego w leczeniu deformacji biodra.

A series of 29 patients (33 hips) after greater trochanter epiphyseodesis in treatment for hip deformity has been reviewed. An indication for this surgery was increasing proximal femur deformity due to the damage of subcapital growth plate (avascular necrosis) during the treatment for congenital dysplasia of the hip. The age of patients at surgery was mean 8.1 years, mean follow-up was 10.1 year. Clinical and radiological assessment revealed ineffectiveness of greater trochanter epiphyseodesis in treatment for increasing hip deformity due to avascular necrosis in the age group in question.

[Early results of surgical treatment for congenital hip dislocation in children using Degi's method in children under 18 months of age]. / Wczesne wyniki leczenia operacyjnego wrodzonego zwichniecia stawu biodrowego metoda degi u dzieci ponizej 18 miesiaca zycia.

Early results of surgical treatment of congential hip dislocation by the Dega method in 18 children (20 hips) aged from 6 to 17 months are presented. Following the excision of the soft tissue obstructions and Dega transiliac osteotomy stable reduction of the hip has been achieved in all cases. Proximal femoral osteotomy has been performed in 6 cases only. Clinical results were markedly superior over radiological ones. Fair radiological outcomes resulted from surgical errors or avascular necrosis of the femoral head due to the previous conservative treatment. Avascular necrosis after operative treatment has not been noted.

[Treatment of idiopathic scoliosis with Texas Scottish Rite Hospital instrumentation (TSRH)--preliminary report]. / Leczenie operacyjne skoliozy idiopatycznej przy uzyciu instrumentarium Texas Scottish Rite Hospital--doniesienie wstepne.

General principles of construction of TSRH instrumentation and its use for treatment of idiopathic King type III scoliosis have been presented. Surgical technique has been described on the basis of procedure performed in the case of 13 years old girl with primary right sided thoracic adolescent scoliosis.

[Early results of surgical treatment for congenital dislocation of the hip by the Degi method in young children]. / Wczesne wyniki operacyjnego leczenia wrodzonego zwichniecia biodra metoda Degi u malych dzieci.

The early results of surgical treatment of congenital dislocation of the hip by complex Dega method in children aged from 18 to 30 months has been presented. The reduction of the hip after all the obstacles and the elements of dysplasia has been removed was very stable. Derotation osteotomy of the femur in the hips of less than 50 degrees anteversion was not necessary. Avascular necrosis after surgical treatment alone was not observed, however its presence after previous conservative management worsened the results after the operation.

[Late results of surgical treatment of infantile idiopathic scoliosis by Harrington's method]. / Odlegle wyniki leczenia operacyjnego skolioz idiopatycznych wczesnodzieciecych metoda Harringtona.

The late results of surgical treatment of infantile scoliosis by the Harrington method have been presented in 43 patients. The patients age at surgical treatment ranged from 11 to 21 years (14.1 years in the average). The patients age at final follow up examination ranged from 18 to 34 years (25.4 years on the average). The curvature angle at operation was 102.1 degrees according to Cobb on the average. 43.7 per cent of curvature was corrected. Although an improvement of posture was present in all the patients, only 51 per cent of the patients, had good posture. After the treatment 81 per cent of the patients worked.

Effect of somatostatin on gastrointestinal secretions and peptic ulcer production in cats.

In conscious cats with chronic gastric and pancreatic fisulas, the effect of somatostatin (GH-RIH) on gastric and pancreatic secretion and peptic ulcer formation was examined. GH-RIH infused intravenously in graded doses (range: 0.62 to 5.0 microng/kg-hr) inhibited dose-dependently gastric acid response to pentagastrin but failed to affect acid response to histamine. GH-RIH caused a marked inhibition of pepsin secretion induced by both pentagastrin and histamine and decreased pancreatic bicarbonate but not protein response to exogenous secretin or intraduodenal acid. It effectively prevented the formation of duodenal ulcers produced by prolonged administration of both pentagastrin or histamine.

Comparison of vasoactive intestinal peptide and secretin in stimulation of pancreatic secretion.

Pancreatic volume flow as well as bicarbonate and protein secretion have been measured in chronic pancreatic fistula cats and dogs in response to I.V. infusion of VIP and secretin or duodenal perfusion of sodium oleate and HCl solution. 2. VIP and secretin infused I.V. in cats produced superimposable pancreatic dose-response curves for volume flow and bicarbonate secretion, reaching almost identical observed and maximal calculated outputs with both peptides. In dogs, VIP was shown previously to be a much less effective stimulant of pancreatic secretion than secretin and the maximal observed bicarbonate output in response to VIP was only about 17% of that to secretin (Konturek, Thor, Dembinski & Król, 1975). It is condluded that VIP in cats is a secretin-like full agonist, whereas in dogs it is a partial agonist of pancreatic bicarbonate secretion. 3. In cats, secretin and VIP showed equal efficacy and their combination exhibited an augmentatory action on pancreatic bicarbonate secretion with additive kinetics, whereas in dogs, VIP was found to have a lower efficacy than secretin and to inhibit competitively secretin-induced pancreatic secretion. These results might be explained by the interaction of VIP and secretin, two chemically related peptides, on a common receptor site of the exocrine pancreas. 4. Caerulein, an analogue of CCK-PZ, infused I.V. in cats and dogs caused a negligible pancreatic bicarbonate secretion and a potent dose-dependent protein secretion. The combination of graded doses of VIP or secretin with a background dose of caerulein resulted in significantly higher bicarbonate and protein outputs than those induced by VIP or secretin alone. 5. Duodenal perfusion of sodium oleate soap in cats and dogs produced pancreatic dose-response curves for volume flow and bicarbonate output similar to those evoked by VIP in these species. Pancreatic protein secretion in response to luminal oleate was slightly higher than could be accounted for by the action of VIP alone. This might be attributed to the release by oleate not only of endogenous VIP but also CCK-PZ or to the vago-vagal reflexes from gut to pancreas. The results of our combined study on cats and dogs suggest the possibility that oleate releases VIP from the gut and that this peptide may play a physiological role in the stimulation of pancreatic secretion.

Comparison of natural and synthetic prostaglandins on gastric and pancreatic secretions and peptic ulcer formation in conscious cats.

In conscious cats with chronic gastric and pancreatic fistulas, the natural prostaglandins (PGs) of the E (PGE1 and PGE2) and F (PGF1 alpha and PGF2 alpha) series and synthetic 15-methyl analog of PGE2, 15(S) 15-methyl-PGE2 methylester were compared with regard to their action on gastric and pancreatic secretions and peptic ulcer formation. This study indicates that in comparison with natural PGs, the synthetic 15-methyl analog of PGE, is a more potent inhibitor of gastric secretion regardless of the route of administration and the mode of gastric stimulation. It more effectively prevents the formation of peptic ulcers in conscious cats.