Comparação entre a técnica de substituição do ligamento redondo por implante de fascia lata bubalina preservada em glicerina e o uso de pino transarticular na redução e na estabilização da luxação coxofemoral experimentalmente induzida em cães / Comparation between the technique of substitution of the round ligamentum by glycerin-preserved bubaline fascia lata implant and the use of transarticular pin in the redution and stabilization of experimentally induzed coxofemoral luxation in dogs

Compararam-se duas técnicas cirúrgicas de redução e estabilização da articulação coxofemoral experimentalmente luxada em cães. Dois grupos de animais, submetidos às respectivas técnicas após a indução cirúrgica da luxação, foram acompanhados clínica e radiograficamente por um período de 60 dias, findos os quais, realizaram-se avaliações macroscópica e histológica e teste de tensiometria das articulações. Cada grupo foi constituído por oito animais, clinicamente sadios, com pesos entre 5 e 20kg. Os animais submetidos ao implante de fáscia apresentaram, ao exame físico, evolução da deambulação significativamente precoce em relação aos do grupo submetido ao implante de pino de Steinmann, além de menor grau de atrofia muscular. Os testes de tensiometria, as avaliações macroscópicas e radiográficas e os exames histológicos não diferiram entre os grupos, evidenciando também que ambas as técnicas não geraram alterações deletérias à articulação operada. Conclui-se que a técnica de estabilização da articulação coxofemoral com implante de fascia lata foi clinicamente eficaz e vantajosa quando comparada à técnica do pino transarticular.

It was compared both surgical techniques of reduction and stabilization of experimentally luxated coxofemoral join in dog. Two groups were submitted to the techniques after surgical induction of the luxation. All animals were clinically and radiografically observed during 60 days. After that, a macroscopic study, an histological exam, and a tensiometry test in the articulations were performed. Each group had eight healthy animals, weighting from 5 to 20kg. The most important advantage was related to the deambulation, which the animals submited to the facia lata implant showed a faster evolution after the surgery at the physical exam, and muscular atrophy in a smaller degree. The tensiometry tests, the radiographic and the histological exams did not present important differences between both groups, but they were useful to show that the two techniques did not cause alterations in the studied articulation. It can be concluded that the stabilization of the coxofemoral articulation using bubaline fascia lata implant was clinically efficient and more advantageous compared to the transarticular pin technique.

Comparação entre a técnica de substituição do ligamento redondo por implante de fascia lata bubalina preservada em glicerina e o uso de pino transarticular na redução e na estabilização da luxação coxofemoral experimentalmente induzida em cães / Comparation between the technique of substitution of the round ligamentum by glycerin-preserved bubaline fascia lata implant and the use of transarticular pin in the redution and stabilization of experimentally induzed coxofemoral luxation in dogs

Compararam-se duas técnicas cirúrgicas de redução e estabilização da articulação coxofemoral experimentalmente luxada em cães. Dois grupos de animais, submetidos às respectivas técnicas após a indução cirúrgica da luxação, foram acompanhados clínica e radiograficamente por um período de 60 dias, findos os quais, realizaram-se avaliações macroscópica e histológica e teste de tensiometria das articulações. Cada grupo foi constituído por oito animais, clinicamente sadios, com pesos entre 5 e 20kg. Os animais submetidos ao implante de fáscia apresentaram, ao exame físico, evolução da deambulação significativamente precoce em relação aos do grupo submetido ao implante de pino de Steinmann, além de menor grau de atrofia muscular. Os testes de tensiometria, as avaliações macroscópicas e radiográficas e os exames histológicos não diferiram entre os grupos, evidenciando também que ambas as técnicas não geraram alterações deletérias à articulação operada. Conclui-se que a técnica de estabilização da articulação coxofemoral com implante de fascia lata foi clinicamente eficaz e vantajosa quando comparada à técnica do pino transarticular.(AU)

It was compared both surgical techniques of reduction and stabilization of experimentally luxated coxofemoral join in dog. Two groups were submitted to the techniques after surgical induction of the luxation. All animals were clinically and radiografically observed during 60 days. After that, a macroscopic study, an histological exam, and a tensiometry test in the articulations were performed. Each group had eight healthy animals, weighting from 5 to 20kg. The most important advantage was related to the deambulation, which the animals submited to the facia lata implant showed a faster evolution after the surgery at the physical exam, and muscular atrophy in a smaller degree. The tensiometry tests, the radiographic and the histological exams did not present important differences between both groups, but they were useful to show that the two techniques did not cause alterations in the studied articulation. It can be concluded that the stabilization of the coxofemoral articulation using bubaline fascia lata implant was clinically efficient and more advantageous compared to the transarticular pin technique.(AU)

Graduate medical education into the 1990's. A call for debate.

The authors have reviewed the present system of graduate medical education, including independent, affiliated, and integrated residency training programs. Advantages and disadvantages are considered in light of recent changes in health-care delivery systems. Structure, historical development, present status, and limitations of the programs are discussed. Personnel resources of the residency program are classified as United States citizens and non-citizens, American medical school graduates, United States citizen graduates of foreign medical schools, and alien foreign medical school graduates, and their different educational backgrounds are compared. Financial aspects of these programs are considered, and the need to increase university control over residency programs, especially in multi-institutional affiliated residency training programs is discussed. The authors recommend upgrading the status of residents from that of student to that of full-fledged medical doctor with concomitant authority and responsibility.

Congenital myopathies with "diagnostic" pathological features.

This addition to the classification of myopathies is a result of the improved diagnostic techniques in muscle pathology in recent years, largely through the application of electronmicroscopy and histochemistry. After summarizing the clinical picture, the authors call for classification: (1) Congenital myopathies due to developmental arrest: myotubular myopathy, congenital fiber type disproportion. (2) Congenital myopathies due to persistent organellar regression: focal loss of cross striation, myopathy with lysis of myofibrils, nemaline body myopathy, zebra body myopathy, spheroid body myopathy, myopathy with tubular aggregates, satellite cell myopathy. (3) Congenital myopathies due to metabolic errors: mitochondrial myopathy, mitochondria-lipid-glycogen disease. (4) Congenital myopathies due to the lack of the trophic influence of innervation: central core disease, multicore, minicore disease. These congenital myopathies have been taken from the ill-defined heterogeneous conglomeration known as amyotonia congenita or floppy infant syndrome and given a place of their own.