Action of Drin Compounds on the Function of the Circulatory System Part 3. Action of Drin Compounds on Dog Blood Pressure and Rabbit Electrocardiogram

By examining the blood pressure in dogs and electrocardiogram in rabbits treated with drin compounds, the author obtained the following results: 1. Drin compounds, when injected intravenously in dogs, cause a transitory lowering of blood pressure. But when generalized convulsions occur, blood pressure rises and becomes markedly labile. 2. Administration of atropine does not inhibit the effect of drin compounds on blood pressure. 3. Simultaneous administration of dieldrin and adrenaline inhibits blood pressure lowering effect of dieldrin. 4. Ganglion blocking agents such as chlorpromazine and tetraethylammonium do not inhibit the effect of dieldrin on bood pressure. 5. Administration of drin compounds slows the heart rate in rabbits. 6. In rabbits given drin compounds, electrocardiograms often demonstrate depressed ST segments and low to inverted T waves. 7. In rabbits given a large amount of drin compounds, electrocardiograms may show left bundle branch block, atrial fibrillation, ventricular premature beat and multifocal idioventricular rhythm. 8. In rabbits treated with a small dosage of drin compounds for a prolonged period, electrocardiograms show no significant changes

Action of Drin Compounds on the Function of the Circulatory System Part 1. Action of Drin Compounds on Peripheral Blood Vessels

By studying the action of drin compounds on the peripheral blood vessels (Krakow-Pissemiski's method) of the rabbit ear, the author obtained the following results: 1. All the drin compounds (dieldrin, aldrin and endrin) induce a transitory dilatation of the extirpated peripheral blood vessels. But at high concentrations vasoconstriction is observed. 2. Atropine does not counteract the vasodilation by dieldrin. 3. With respect to the dilatation of peripheral blood vessels adrenaline acts antagonistically in contrast to the additive effect of acetylcholine. 4. Drin compounds act antagonistically against the vasoconstriction by barium chloride. It is considered that the mechanism of vasodilatation by these compounds is based on their direct action on the contractible muscle cells of the vessel wall

Bisphosphonate-Related Atypical Femoral Fractures in Patients with Autoimmune Disease Treated with Glucocorticoids: Surgical Results for 20 Limbs

Background: Glucocorticoids induce osteoporosis, while bisphosphonates treat it, yet both can lead to atypical femoral fractures. Patients on both agents may face challenges in healing from such fractures due to their pathophysiology and pharmacological effects. Methods: Intramedullary nail surgery was performed on 20 limbs in 19 patients with atypical femoral fractures and autoimmune diseases, who had received bisphosphonates for GC-induced osteoporosis. The average durations of glucocorticoid and bisphosphonate use were 17 and 9 years (standard deviation: 7.59 and 4.35), respectively, and the mean follow-up period was 66 months. Fifteen and five limbs were fractured at the subtrochanter and diaphysis, respectively. The surgical techniques (type of nail) and additional procedures performed in these cases were examined. The post-operative alignment and reduction status on radiographs were examined to determine their relationship with post-operative outcomes. Results: Cephalomedullary long nails were inserted in nine limbs and antegrade intramedullary nails in 11 limbs. As an additional surgical procedure, open reduction, bone grafting and drilling were carried out on six, two, and five limbs, respectively. Regarding malalignment on radiographs, AP images showed varus in four limbs, and lateral images showed extension in two limbs. Regarding the cortical discontinuity, the distal fragment of the 11th limb shifted posteriorly in the lateral view. Gaps at the fracture sites were observed in 11 limbs. As a result, bone union was confirmed in 13 limbs. Five of the seven nonunion limbs required additional surgery. When comparing union and nonunion, open reduction and drilling were involved in nonunion limbs. Conclusion: The surgical outcomes of atypical femoral fractures in patients with autoimmune disease and on long-term glucocorticoids and bisphosphonates were poor. Although it is not possible to affirm for sure based on these results alone, management with prophylactic surgery before complete fracture is considered to be required to improve outcomes

Does loop length change after anterior cruciate ligament reconstruction with adjustable loop cortical suspension device?: Observation of the hamstring graft completely filling the femoral tunnel

Abstract Purpose The adjustable loop cortical suspension device (ALD) is a useful femoral fixation device in anterior cruciate ligament (ACL) reconstructions, but the possibility of loosening has been suggested. The purpose of this study was to evaluate the elongation of an adjustable loop and the position of the hamstring graft inside the femoral socket. Methods The subjects were 33 patients who underwent ACL reconstruction with a hamstring tendon. The graft was fixed using ALD and completely filled the femoral socket. Magnetic resonance images were taken one week and one year after the operation. The loop length, femoral socket length, and graft length inside the socket were measured and statistically compared with the clinical outcomes. Results The loop length one week after surgery was 18.9 ± 4.4 mm, and 1 year after surgery was 19.9 ± 4.5 mm (P < 0.001). The gap between the top of the graft and femoral socket was 0.9 ± 1.8 mm one week after surgery and 1.3 ± 1.7 mm one year after surgery (P = 0.259). At one week post‐operation, a gap was found in nine patients (27.3%). The loop length and gap did not strongly correlate with clinical findings. Conclusion ACL reconstruction using ALD showed a gap between the graft and femoral socket at the one week post‐operation mark in 27.3% of participants. One year after the surgery, there were cases where the gap increased and/or decreased, but the elongation of the loop was 1 mm on average. Our findings suggest that ALD is clinically safe to use; however, has the possibility of initial loop elongation and non‐uniform changes. Level of evidence IV

Robotic device-assisted knee extension training during the early postoperative period after opening wedge high tibial osteotomy: a case report

Abstract Background Maintenance or restoration of a good range of motion of the knee is one of the most important outcomes following knee surgery. According to previous studies, opening wedge high tibial osteotomy enables better recovery of range of motion in knee flexion than that achievable after total knee arthroplasty or unicompartmental knee arthroplasty. However, few reports provide a detailed description of the postoperative recovery of knee extension range of motion after opening wedge high tibial osteotomy. We describe our experience with a knee extension training program using a single-joint hybrid assistive limb device (HAL-SJ; Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after opening wedge high tibial osteotomy. The HAL-SJ is a wearable robotic device that facilitates voluntary control of knee joint motion. Case presentation A 67-year-old Japanese woman who underwent opening wedge high tibial osteotomy for spontaneous osteonecrosis of the left medial femoral condyle received HAL-SJ-based knee extension training postoperatively. Our experience with this patient revealed that knee extension training with the HAL-SJ during the acute phase following opening wedge high tibial osteotomy is feasible. Furthermore, the patient’s knee extension range of motion improved to values similar to those seen during the preoperative stage, and her flexion range of motion was improved at 3 months after the surgery. Conclusions HAL-SJ-based knee extension training could be used as a novel post-opening wedge high tibial osteotomy rehabilitation modality. Further exploration of individualized optimal settings of the HAL-SJ is required to improve its safety and efficacy