Treatment concepts in knee malposition within the scope of primary neurologic diseases]

Disease and trauma to the central and peripheral nervous system can result in various disturbances to the stability and mobility of the knee joint. The aims of orthopaedic treatment in flaccid paralysis, spasticity, rigidity, athetosis and ataxia are discussed. The effect on the musculo-skeletal system is most severe when the damage occurs prenatally. The tendency to deformity in perinatal cerebral spastic disorders of movement can be considerably reduced by early systematic functional treatment. Active and passive exercise, corrective and reflex inhibiting casts and orthoses have proved their value in the prevention and treatment of muscle contractures in flaccid paralysis and spasticity. The dangers of treatment, such as subluxation of the knee and hip joint, osteoporotic fractures, and traction paralysis, must be taken into account. Muscle contractures often hinder function, both in spasticity and in flaccid paralysis, more than the underlying disease. The operative treatment of flexion contractures and impaired knee flexion in the swing phase of the step is discussed. Gait analysis facilitates the planning of treatment. The hip, knee and ankle joints must be treated as a single functional unit.     

Review of neurologic diseases for the urologist

This article reviews the neurologic conditions associated with a high prevalence of bladder dysfunction and about which significant advances in understanding have occurred in recent years. The importance of the frontal lobes for bladder control has been confirmed through functional brain imaging, and recent findings in the elderly with incontinence suggest the problem may result from disconnection of important frontal areas caused by white matter disease. The very different urologic profile of the two sometimes-confused conditions, multiple system atrophy and Parkinson's disease, is clarified. The advances in treatments for multiple sclerosis in recent years have been remarkable and are briefly described.     

Ion channel abnormalities ("channelopathies") in neurologic diseases

THE ROLE OF IONIC CHANNEL DYSFUNCTION: During various neurological diseases has been evoked for many years on electro-physiological data. Molecular biology has led to great progress in neurology, and can be considered "functional" since it is surpasses the classical anatomo-clinical methods. IONIC CHANNEL DYSFUNCTION: Can be determined genetically, resulting from the mutation of a gene code of a channel sub-unit. CHANNELOPATHIES ARE RESPONSIBLE: For muscular diseases (myotonia, familial periodic paralysis, malignant hyperthermia and congenital myasthenia), but also for central nervous system disorders such as familial hemiplegic migraine, hereditary paroxystic ataxia and certain forms of Mendel's law hereditary epilepsy. ACQUIRED IONIC CHANNEL DYSFUNCTION: Resulting from auto-immune aggression is implied in diseases such as Lambert-Eaton's myasthenic syndrome and Isaac's neuromyotonia syndrome. It probably plays a part in the clinical, and particularly the sensitive expression (paresthesia and pain) of some peripheral neuropathies and certain central nervous system affections, such as multiple sclerosis.     

Sacrum fracture associated with neurologic complications]

A care of the patient, aged 39, who sustained a fracture of the sacrum complicated by compression of the roots L5 and S1 is reported. Surgical treatment on root decompression was performed. Following 9 months neurological signs subsided, but some intermittent low back pain persisted.     

脊髓型颈椎病与神经系统相关疾病的鉴别诊断

脊髓型颈椎病多发生于中老年人,早期缺乏特征性表现,不易早期诊断治疗,易误诊为神经系统其他疾病。此外,其他疾病也易误诊为颈椎病,其以中脑梗死、运动神经元病、周围神经病最为多见。因此,骨科医师需要掌握脊髓型颈椎病与其他疾病的鉴别诊断,减少对颈椎病的误诊误治。本文就脊髓型颈椎病与神经系统相关疾病的鉴别诊断进行综述。     

Synovial cyst of the hip with revealing neurologic symptoms]

The authors report an exceptional case of a ganglion cyst of the hip revelated by sciatica. They recall the usual clinical expression of this pathology, her diagnostic tests and her treatment. They open the discussion about ganglion cyst and mucoid pseudocyts.     

NMR in the diagnosis and treatment of neurologic lesions in decompression sickness]

The case of a decompression sickness in woman, diving to 26 meter depth is reported. The patient was helped by instructor's computer (error!) and she presented risk factors for embolic disease (obesity, smoke, estroprogestinic therapy). She presented with many symptoms of decompression sickness during immersion and during re-ascent (headache, vertigoes and paresthesias). She was not treated on the place of incident, but only 36 hours later at our center of hyperbaric medicine. Her Magnetic Resonance imaging showed hyperintensity lesions of white matter.     

Surgical diseases in acute poisonings]

Under analysis there were 104 case histories of patients with surgical diseases diagnosed in a toxicological center. In 34 patients the surgical diseases or mechanical traumas were combined with poisoning, in 106 patients they appeared due to acute poisoning. In the first group most frequent were closed craniocerebral injuries and acute destructive pancreatitis. In the second group prevailing were gastroesophageal bleedings.     

Laser therapy in surgical diseases]

Laser therapy proved to be effective in the treatment of patients with trophic ulcers, deforming arthrosis of the I and II degree, and particularly, in early stages of inflammatory processes (infiltrative stage) and in some surgical diseases, as well. So, there are all the grounds for further and more broad and profound experimental and clinical study of laser therapy in various diseases, surgical ones, in particular.     

Bacterial toxic shock in urological diseases]

It is a review of present-day and historical aspects of bacterial toxic shock arising in urological setting. It is noted that conditions of its onset are changing, therapeutic approaches undergo revision, critical care facilities are updated. Among the causes of this complication the authors single out endoscopic procedures, transurethral interventions in the presence of infectious process, hospital infection, long stay at hospital. Forty-eight cases of bacterial toxic shock are reviewed in relation to classification, causes of development, treatment, bacteriological evaluation.