RESUMEN
A systematic approach to the clinical history, physical, and arthroscopic examination of patellofemoral disorders will lead to improved diagnostic accuracy and clinical treatment success. We review important aspects of physical and arthroscopic examination of patellofemoral disorders Basic and advanced physical examination techniques are presented, and their clinical significance is reviewed. Arthroscopic examination of the patellofemoral joint is used as an adjunct to physical examination to evaluate chondral lesions of the patella and femoral sulcus and to visualize patella tracking. Techniques to assess patellar tracking and the integrity of patellar restraints and to grade chondral lesions are outlined. Utilization of these techniques will improve clinical studies on the treatment of patellofemoral disorders.
Asunto(s)
Artropatías/diagnóstico , Articulación de la Rodilla , Rodilla , Dolor/etiología , Examen Físico/métodos , Artroscopía , Fémur , Humanos , Artropatías/diagnóstico por imagen , Artropatías/fisiopatología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/fisiopatología , Dolor/diagnóstico , Dolor/fisiopatología , Rótula , RadiografíaRESUMEN
Giant gastric ulcers (greater than 3 cm in diameter) have traditionally been considered to be refractory to medical therapy and were commonly thought to initially appear as life-threatening hemorrhage requiring emergent operative therapy. This study was undertaken to evaluate the results of medical and surgical treatment of benign, giant gastric ulcers and the validity of these traditional teachings. A retrospective review of 44 patients with giant gastric ulcers was performed to evaluate the results of medical and surgical therapy at Hartford Hospital (Hartford, CT). The majority of these patients received medical therapy. Over 57 per cent received only medical therapy, while 25 per cent received primary, operative therapy. Contrary to popular belief, the authors found that patients who received initial medical therapy did not have high morbidity or mortality rates. Therefore, while the necessity of early surgical intervention following perforation or in patients with signs of hemorrhagic shock can not be refuted, the authors conclude that medical therapy of benign, giant gastric ulcers is often effective and not unduly hazardous. Giant gastric ulcers, in and of themselves, are not an indication for surgery.
Asunto(s)
Antiulcerosos/uso terapéutico , Gastrectomía/normas , Úlcera Gástrica/terapia , Vagotomía/normas , Adulto , Anciano , Anciano de 80 o más Años , Antiulcerosos/administración & dosificación , Protocolos Clínicos/normas , Connecticut/epidemiología , Gastrectomía/mortalidad , Mortalidad Hospitalaria , Hospitales Universitarios , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidad , Recurrencia , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Úlcera Gástrica/complicaciones , Úlcera Gástrica/patología , Resultado del Tratamiento , Vagotomía/mortalidad , Cicatrización de HeridasRESUMEN
These experiments show that mussel adhesive protein (MAP) enhances the attachment of osteoblasts and epiphyseal cartilage cells to plastic culture dishes and Vitallium. When MAP was applied to culture plate surfaces, there were two- to fivefold increases in the numbers of cells attaching compared to control surfaces (no MAP). Results were confirmed using two different cell attachment assay techniques. Osteoblast replication and culture on MAP is possible, suggesting that MAP is not toxic to cells. MAP also holds applied cells to surfaces as initially attached.