The role of shock in the pathogenesis of fat embolism after trauma.

Experimental studies and pathological investigations indicate that intrusion of fat into the circulation is common after trauma. This may not have any effect unless frank hypovolaemia supervenes upon changes in the blood vessels, manifested by a deficient vasomotility in shock. After fat embolism disseminated intravascular coagulopathy may occur as a consequence of the haematological changes and disturbances of capillaries. The morphological appearance of massive post-traumatic fat embolism evolves from the compensatory effect of accumulated synergistic factors that primarily induced the changes. From this point of view fat embolism should be recognized in the additional important role of an epiphenomenon of post-traumatic shock.

Effects of ice and recovery time on maximal involuntary isometric torque production using electrical stimulation.

This study was conducted in partial fulfillment of the requirements of the U.S. Army-Baylor University Graduate Program in Physical Therapy, Academy of Health Sciences, Fort Sam Houston, TX. The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or representing the views of the Department of the U.S. Army or the Department of Defense. The purpose of this study was to investigate the effects of 30-minute ice treatments to the quadriceps femoris muscle and subsequent recovery time on involuntary isometric torque production (the dependent variable) using the Electrostim 180-2. Twenty healthy, male subjects (age 18-35) on active military duty completed the study. Each subject served as his own control. Collected data included maximum current tolerated during electrical stimulation and maximum involuntary isometric torque production pretreatment, immediately posttreatment, and 90 minutes posttreatment. From the statistical analysis, it was concluded that ice application did not significantly affect an individual's ability to tolerate more electrical current or to produce higher maximum involuntary isometric contraction (MIIC) torque values. Results showed a wide variation in subjective response to electrical stimulation. Suggestions for further research and implications for the clinical use of ice in combination with electrical stimulation modalities are discussed. J Orthop Sports Phys Ther 1991;13(5):240-248.

[Circular transhepatic drainage as a palliative surgical measure in central bile duct obstruction]. / Die endlose transhepatische Drainage als palliativ-chirurgische Massnahme beim zentralen Gallengangsverschuss.

A transhepatic drainage tube was used in 27 patients suffering from echinococcus alveolaris of the liver of malignant process of the portal fissure from 1967 to 1978. If an hepatocholangioenterostomy is not possible, another surgical palliative procedure is necessary for drainage of the bile. The transhepatic drainage tube is a simple palliative method. The technique of this procedure, the indications, the possible complications, and the advantages are reported.

Emotions and psychopathology.

Few psychological assessment instruments exist for Jamaicans. Studies that address the appropriateness of foreign instruments for Jamaicans are sparse and empirical focus on psychopathology and its aetiology in Jamaican adults is virtually nonexistent. The present study addressed these deficits via Confirmatory Factor Analyses (CFA) which revealed that factors on the Toronto Alexithymia Scale (TAS-20) and Brief Symptom Inventory (BSI) were not replicated for a Jamaican sample (N = 352). Exploratory Factor Analyses (EFA) on the TAS-20 revealed one factor labelled Unawareness and Confusion Regarding Emotions (UCRE). Also, EFA yielded six BSI dimensions labelled Somatic Complaints, Paranoia, Hostility, Mild Depression/Dysthymia, Major Depression with Psychotic Features, and Agoraphobia with Panic. Regression analyses on the Jamaican-based TAS-20 and BSI factors revealed a positive relationship between UCRE and each BSI factor and total BSI score. Mild Depression, Agoraphobia with Panic, Paranoia, Hostility, Mild Depression and Major Depression were higher for women and younger Jamaicans, respectively, but younger Jamaicans with higher UCRE scores had higher scores on Paranoia, Major Depression, and total score. The findings suggest that Jamaican mental health policy and programmes should focus on the difficulties some Jamaicans experience in recognising and expressing their emotions.

[Results of operative treatment of proximal femoral fractures in the aged using the Ender and Simon-Weidner spring nailing technic]. / Ergebnisse der operativen Versorgung hüftgelenksnaher Oberschenkelfrakturen bei alten Menschen durch Feder-Nagelung nach Ender und Simon-Weidner.

Results are presented after operative treatment of 195 patients with extracapsular proximal femoral-bone-fractures. After accident early operation time is requested. Operation risk being small, this treatment is regarded as treatment of first choice.