Shuitsu Hoshi

Plasma tumour necrosis factor-α (TNF-α) levels in patients with burns

Abstract Levels of plasma tumour necrosis factor-α (TNF-α) were determined consecutively in 42 patients with burns > 20 per cent of the total body surface area using an enzyme-linked immunosorbent assay. In the early period after injury (including the period of burn shock), 24 patients had detectable TNF-α levels in their plasma. However, the plasma TNF-α levels at the time of admission were very low and did not correlate with the extent of the burn or the prognosis. In contrast, the maximum plasma TNF-α level over the whole clinical course was significantly correlated with the area of the burn and the prognosis. No correlation was found between the plasma TNF-α and plasma endotoxin levels. TNF-α may be produced locally in infected burns and monitoring of plasma TNF-α levels may be a useful prognostic indicator for burns patients.

Cervical spinal cord injury associated with ossification of the posterior longitudinal ligament

Among 231 patients with cervical injuries treated over 12 years, 15 had cervical spinal cord injury associated with ossification of the posterior longitudinal ligament. All of them were male and most had injuries due to a relatively weak external force. Four of them underwent surgery. There was little difference in improvement of paralysis between the conservatively and the surgically treated group.

Evaluation of recombinant human granulocyte colony-stimulating factor (rhG-CSF) therapy in granulopoetic patients complicated with sepsis.

A study was carried out to investigate the efficacy of therapy with recombinant human granulocyte colony-stimulating factor (rhG-CSF) in 24 patients with granulocytopenia and sepsis who had failed to respond to antibiotics. The mean leukocyte count at the start of the study was 911 +/- 334/microliter. Patients were injected subcutaneously with 75 micrograms rhG-CSF once daily for a mean of 5.2 days. The plasma G-CSF concentration was measured by ELISA. The leukocyte count increased approximately 9-fold after 1 week in 19 patients and the percentage of granulocytes rose from 46.2% to 78.9%. These 19 patients survived, while the 5 patients with no leukocyte response to rhG-CSF died. High plasma G-CSF levels were found in patients with granulocytopenia. Plasma G-CSF levels decreased as levels of granulocyte increased in survivors. A high plasma G-CSF concentration persisted in the 5 non-responding patients resulting in a fatal outcome. This study suggests that rhG-CSF both increased the leukocyte count and was a useful therapeutic manoeuvre for sepsis.

Bilateral traumatic hip dislocation in a child

SummaryTraumatic dislocation of in children occurs less frequently than in adults, and bilateral dislocation is extremely rare. Manual reduction was performed in a 3-year-old girl with bilateral traumatic hip dislocation. The recovery course has been favorable for about 1 year.

A case of dorsal dislocation of the proximal interphalangeal joint of the fourth toe

Dislocation of the interphalangeal joint of a toe is a rare injury, and when it does occur it usually involves the great toe. Dislocation of other toes without fracture is quite rare. We present here a case of dorsal dislocation of the proximal interphalangeal (PIP) joint which was reduced by manipulation.

Two cases of closed dislocation of the interphalangeal joint of the thumb.

Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation.