Assessment of brain oxygenation in term and preterm neonates using near infrared spectroscopy.

PURPOSE: The aim of this study was to determine brain oxygenation in full-term and preterm neonates using near infrared spectroscopy. MATERIAL AND METHODS: A total of 88 full-term and preterm newborn infants without hypoxic-ischaemic disorders admitted to the NICU were examined using NIRS on the first day of life and on day 28 of life. Additional measurements were taken at the end of the first week of life in the premature neonates group. Measurements of oxyhaemoglobin (HbO2), deoxyhaemoglobin (Hb), total haemoglobin (HbT) concentration and tissue oxygen saturation (Ox) were performed in 5 brain regions. Right and left frontal areas, the occipital area and right and left temporal areas were measured. RESULTS: In full-term healthy neonates a marked decrease in HbO, Hb and HbT values was observed on day 28 of life in all brain regions except the occipital area. In the neonatal period the greatest changes in brain oxygenation occurred in the right and left frontal regions of the brain. In preterm neonates constant values of HbO2 and Ox were observed in the first 28 days of life. In preterm newborn infants, as well as in full term newborn infants, similar Ox and HbO2 values were obtained on day 28 of life. CONCLUSIONS: NIRS is a safe method and can be used to evaluate brain oxygenation in newborn infants. The results of these measurements are in accordance with changes in brain oxygenation in the first month of life, which are predicated on the basis of the neonate's physiology.

High tibial osteotomy and debridement of the knee joint in treatment of varotic gonarthrosis.

UNLABELLED: BACKGROUND OF THE PROBLEM: We perform high tibial osteotomy with knee debridement and forage. GOAL: We evaluated the results of operations in 47 patients, who were operated from 1st January 1998 to 31st of December 2000. RESULTS: We examined the patients before operation and 2, 4, 6, 12, 24 and 30 months after it. The follow up was from 6 months to two and a half years after operation. The results after the operation were evaluated by both the patient (pain) and the doctor. The doctor evaluated the axial state of the extremity, the range of movement in the knee joint, present synovitis and the X-ray. The youngest woman was 52 years old, the oldest woman was 71 years old. The average age was 63.3 years. The youngest man was 25 years old, the oldest was 67 years old. The average age was 57.2 years. Patient's evaluation after the operation: 34 percent had no pain, 43 percent felt pain after excessive loading at the joint, 19 percent did not register any change and 4 reported increased pain. Doctor's evaluation: In 23 percent of patients, excellent results were achieved, 47 percent had good results, in 21 percent, they were satisfactory and in 9 percent, unsatisfactory results were recorded. CONCLUSION: After the theoretic analysis and evaluation of the group of operated patients, the authors indicate the possibility to perform high tibial osteotomy with debridement and forage as a joint saving knee operation in varotic gonarthrosis. (Fig. 1, Ref. 6.)