Nonvenereal Sclerosing Lymphangitis of the Penis

No abstract availabl

Nonvenereal Sclerosing Lymphangitis of the Penis

No abstract availabl

Mechanical properties of stainless steel orthopaedic implants in simulated biological conditions

Brojna su propitivanja potrebe rutinskog odstranjenja metalnog implantata nakon saniranja prijeloma kosti. Pretežita indikacija za odstranjenje jest slabljenje mehaničkih svojstava i pucanje implantata prije cijeljenja kosti. Cilj ovog istraživanja bio je ispitati mehanička svojstva osteosintetske pločice izrađene od standardnoga kirurškog čelika u simuliranim biološkim uvjetima. U istraživanju smo koristili implantate nehrđajućeg čelika 316L i pohranili ih kroz godinu dana u simuliranome biološkom mediju (engl. SBF – simulated body fluid). Analizirano je 48 pločica standardnoga kirurškog čelika podijeljeno u četiri skupine. Jedna je kontrolna. Ostale su bile uronjene u otopine različitih pH vrijednosti. Uronjene pločice testirane su nakon godinu dana, a kontrolna odmah na početku istraživanja. Tijekom godinu dana analizirala se promjena mikrostrukture uronjenih pločica skenirajući elektronskim mikroskopom (SEM) u pet navrata, a kontrolna grupa samo jednom. Na pločicama koje su bile u biološkim simuliranim uvjetima, bez obzira na pH medija, značajno je veći broj jamičastih korozija kod mjerenja nakon šest mjeseci i godinu dana. Nakon godinu dana pohrane u medijima različite pH mjerene su vrijednosti mehaničkog, statičkog i dinamičkog opterećenja pločica. Niti jedno načinjeno mehaničko testiranje nije pokazalo statistički značajnu razliku između kontrolne skupine pločica i onih koje su bile u biološki simuliranim uvjetima kroz godinu dana. Nepromijenjena mehanička svojstava istraživanih implantata, unatoč značajnim promjenama mikrostrukture nastale kao posljedica jamičaste korozije u biološki simuliranim uvjetima, otklanjaju vjerojatnost slabljenja pločice kao i indikaciju za njezino odstranjenje u tom vremenskom razdoblju.Questioning the routine metal implant removal after bone fracture healing has increased. One of the main indications for removal is metal weakening in biological bone healing conditions, in addition to reports about its breakage even prior to bone healing. The aim of this study is to investigate the mechanical properties of osteosynthesis plates made out of standard surgical stainless steel in simulated biological conditions. Implants made out of 316L stainless steel were kept for one year in simulated body fluid (SBF). We analysed 48 plates made out of standard surgical stainless steel that were divided in four groups. One was the control group and the remaining were immersed in solutions with various pH values according to pH changes during bone fracture healing. The immersed plates were tested mechanically through one year, and those in the control group at the beginning of the study. During one year microstructural changes of the immersed plates were examined five times using a scanning electron microscope (SEM), and only once in the control group. There were significant microstructural pitting corrosion changes after six months and after one year in all plates that were in simulated biological conditions, regardless of the group pH value. Static and dynamic mechanical plate loading tests were performed one year after storage in solutions with various pH values. Following the complete mechanical testing no statistically significant changes were found between groups kept in simulated biological conditions for one year and the control group. The study showed no changes in the mechanical properties of the investigated implants regardless of significant microstructural changes as a consequence of pitting corrosion in simulated biological conditions, which precludes the probability of implant weakening and indication for its removal one year after fracture fixation

Trigger thumb in children

Prirodan tijek bolesti kod škljocavog palca u djece još je predmet neslaganja, a sukladno tomu i preporuke za liječenje znatno se razlikuju te ne postoje jasne i široko prihvaćene smjernice. Ovim radom pokušali smo dati trenutačni literaturni pregled spoznaja o tijeku bolesti te dijagnostičkim i terapijskim mogućnostima s naglaskom na konačnom ishodu liječenja. Škljocavi palac jedna je od najčešćih anomalija dječje šake i uglavnom se vidi u djece predškolske dobi. Karakteristično je otežano klizanje tetive fleksora policisa longusa kroz njezinu ovojnicu, što je posljedica anatomskog nesklada njihovih veličina. Tipičan klinički nalaz jest palac fiksiran u fleksijskoj kontrakturi, na razini interfalangealnog zgloba. Prvi opis dao je Notta, čije ime i danas nosi palpabilna masa tetive fleksora policisa longusa u području A1 pulleya. Dijagnoza se obično postavlja temeljem anamneze i fizikalnog pregleda, uz ultrazvuk kao korisno rano dijagnostičko sredstvo. Škljocavi palac dijagnostički treba razlučiti od dislokacije, frakture ili anomalije poznate kao deformacija palca u dlanu. Klinička istraživanja poboljšala su razumijevanje i benignost prirodnog tijeka bolesti. Terapijski postupak ovisi o izboru roditelja i liječnika. On može biti konzervativan, s pomoću udlage i izvođenjem vježba pasivne ekstenzije, ili kirurški, presijecanjem A1 pulleya, što pouzdano vraća pokretljivost interfalangealnog zgloba palca. Spontani oporavak može trajati godinama, no on pruža obiteljima voljnim čekanja mogućnost izbjegavanja stresa hospitalizacije i operacijskog liječenja.The natural course of the condition in pediatric trigger thumb is still controversial, and accordingly, the recommendations for treatment vary considerably and there are no clear and broadly accepted guidelines. In this paper, we tried to provide a current literary overview of the disease progression and diagnostic and therapeutic abilities with an emphasis on the ultimate outcome of the treatment. Trigger thumb represents one of the most common pediatric hand conditions, mostly seen in preschool children. As a result of anatomic size mismatch between the flexor pollicis longus tendon and its sheath, disrupted tendon gliding is characteristic. The interphalangeal joint of the affected thumb fixed in a flexion contracture presents typical clinical finding. The first description of trigger thumb is attributed to Notta, and the palpable nodule at the volar aspect of the interphalangeal joint flexion crease still bears his name. Medical history and physical examination are used to diagnose this deformity with ultrasound as a potential early diagnostic tool. It is possible to misdiagnose a fracture, dislocation of the thumb or thumb-in-palm deformity. Clinical investigation has improved our understanding of the natural history and its benignancy. Therapeutic treatment depends on parent and physician preference. It can be either conservative, consisting of splint therapy and passive stretching exercises, or surgical, releasing of the A1 pulley that reliably restores thumb interphalangeal joint motion. Although it may take several years for spontaneous resolution, families willing to wait are given an opportunity to avoid hospitalization stress and surgical intervention

Medical thermography (digital infrared thermal imaging - DITI) in paediatric forearm fractures - a pilot study

Trauma is the most common cause of hospitalisation in children, and forearm fractures comprise 35% of all paediatric fractures. One-third of forearm fractures are distal forearm fractures, which are the most common fractures in the paediatric population. This type of fracture represents an everyday problem for the paediatric surgeon. The three phases of fracture healing in paediatric trauma are associated with skin temperature changes that can be measured and then compared with standard plain radiographs of visible callus formation, and eventually these methods can be used in everyday practice. Thermographic assessment of temperature distribution within the examined tissues enables a quick, non-contact, non-invasive measurement of their temperature. Medical thermography is used as a screening method in other parts of medicine, but the use of this method in traumatology has still not been researched

Case report: Duplication of gallbladder in a newborn with gastroschisis

Gastroshiza je defekt trbušne stijenke kroz koji protrudiraju trbušni organi i često je udružena s drugim malformacijama. Najčešće se radi o crijevnim (tri četvrtine), rjeđe ju prate urološke, srčane i malformacije ekstrahepatičkog bilijarnog stabla. Duplikature žučnog mjehura u općoj populaciji su relativno rijetke i javljaju se 1 na 3000–4000. U ovom prikazu slučaja prezentirat ćemo slučaj novorođenčeta s gastroshizom udruženom s duplikaturom žučnog mjehura. Kod novorođenčeta je pronađena kompletna duplikatura žučnog mjehura s dva odvojena duktusa cistikusa (tip 2 po Boydenu). Smjernica za postupak kod duplikature žučnog mjehura u novorođenčadi s gastroshizom nema, mi smo postupili po smjernicama za duplikaturu žučnog mjehura u općoj populaciji. Duplikature žučnog mjehura udružene s gastroshizom ne zahtijevaju aktivno kirurško liječenje ako nisu simptomatske ili ako ne postoji druga malformacija bilijarnog sustava.Gastroschisis is a defect of the anterior abdominal wall through which viscera can protrude, and can be followed by additional malformations. Three quarters of the gastroschisis malformations are confined to the midgut. Other malformations are urologic and cardiac malformations and malformations of extrahepatic biliary tract. Duplication of gallbladder in general population is relatively rare, occurring once in every 3,000 to 4,000.In this case report we will present a case of an infant with gastroschisis accompanied with the duplication of gallbladder. In the newborn a complete duplication of gallbladder was found with two separate cystic ducts, i.e. type 2 by Boyden. Since the guidelines for duplication of the gallbladder associated with gastroschisis do not exist, we acted according to the guidelines for duplication of the gallbladder in the general population, i.e. nonsurgical intervention was performed on the biliary tree. Duplications of the gallbladder associated with gastroschisis do not require active surgical treatment, unless they are symptomatic or if there is other malformation of the biliary system