Transient bone loss of distal radius and ulna following clean-cut tendon injuries, repair and passive mobilisation.

The aim of this study was to investigate whether there is any significant bone loss of the ulna and radius following acute tendon-artery-nerve clean-cut injuries at the wrist level which were repaired and rehabilitated by early passive mobilisation. Fifty-eight patients who underwent such operation were enrolled in this study. Patients in Group I (n=28) had primary tendon repairs alone, in Group II (n=15) primary tendon and nerve repairs and in Group III (n=15) primary tendon, nerve and artery repairs. Bone mineral density (BMD) measurements of the ulna and radius were obtained during the first week, the sixth week, the third month and the 12th month after operation. The results demonstrated that BMD decrease in the ulna was more common than in the radius. When compared with the first week BMD measurements, the highest reduction was seen in the sixth week in Group I and during the third month, when bone loss of both the radius and ulna was considerable in Group II. The bone loss in all groups and subgroups were found to have recovered at the 12th month measurements, except in the distal region of the ulna in Group I. This study suggests that passive immobilisation is deleterious in respect of demineralisation of the forearm bones.

Effects of dexmedetomidine on the duration of anaesthesia and wakefulness in bupivacaine epidural block.

BACKGROUND: The purpose of this study was to examine the effects of intravenous dexmedetomidine on the duration of bupivacaine-induced epidural anaesthesia and level of wakefulness and the respective side-effects. METHODS: Sixty ASA I-II patients were included in the study. Consecutive patients were allocated to groups according to the last digit (odd/even) of their admission numbers. All patients had epidural anaesthesia with bupivacaine 0.5% performed by the same experienced anaesthesiologist. In the first group, the patients were administered intravenous dexmedetomidine infusion just after the epidural block and continued during the operation, while those in the second group were administered physiologic saline infusion at the same amount and duration. RESULTS: The recovery time of sensory block was significantly longer in the first group. The bispectral index values were lower in the first group than in the second. Also, heart rate was significantly lower in Group I than in Group II. Regarding side-effects, shivering was significantly less frequent in the first group, whereas there was a significant increase in the requirement of atropine in the first group as dexmedetomidine caused bradycardia. CONCLUSION: Intravenous administration of dexmedetomidine prolonged the duration of epidural anaesthesia, provided sedation and had few side-effects.

Calculating colon transit time with radionuclide-filled capsules in constipated patients: a new method for colon transit study.

BACKGROUND: Colon motility disorders require reliable methods for calculating segmental colonic transit time. This study evaluated bowel transit time by means of a safe, easy, cheap, non-digestive, and non-disintegrating radionuclide-filled capsule that provided accurate and clear images. METHODS: Radionuclide-filled mini-containers (MCs) were prepared from infusion sets by an apparatus used for sealing blood bags or plasmapheresis sets. In vitro stability studies were performed by immersing 5% methylene blue dye-filled MCs in buffers of variable pH and enzymes simulating the conditions in the stomach and the small bowel. Colon transit scintigraphy was performed with MCs filled with iodine 131 (n = 5) and thallium 201 (n = 8) that were placed in a commercially available capsule. RESULTS: By in vitro acid, base, and intestinal enzyme resistance tests, no methylene blue leakage was determined visually and by spectrophotometric analysis. Accurate and clear images were obtained for colon transit study in constipated patients. After excretion of MCs in the feces, abdominal, myocardial, thyroid, and urinary bladder region counts were found to show the same activity as the background. Radionuclide leakage from MCs was not determined in vivo by gamma camera. CONCLUSIONS: This is a suitable, safe, easy, and cheap method to provide accurate and clear images for colon transit study in constipated patients.

Effects of the chorda tympani damage on submandibular glands: scintigraphic changes.

The aim of this study is to compare the scintigraphic results of a denervated submandibular gland with the contralateral normal side in patients with unilateral chorda tympani damage. Sixteen patients (11 women and five men with a mean age of 27) with unilateral proven chorda tympani damage during their previous ear surgery were included in the study. The perfusion ratio (PR), concentration ratio (CR) and stimulated excretion ratio (SER) were calculated scintigraphically and the results from the salivary glands on opposite sides were compared. For submandibular glands, the perfusion ratio (PR), concentration ratio (CR) and stimulated excretion ratio (SER) were found to be 0.65 +/- 0.21, 0.70 +/- 0.21, 0.79 +/- 0.37, respectively. All ratios resulted from statistically decreased radioactivity accumulation on the affected side (p<0.05). Chorda tympani damage negatively affects the function of the ipsilateral submandibular glands despite the absence of atrophy. Dynamic salivary gland scintigraphy is a practical and valuable method of disclosing the decreased capacity of perfusion, concentration and secretion function in unilateral neurological deprivation.