Operative treatment was performed in nine patients with cervical spondylotic myelopathy complicating athetoid cerebral palsy. The first two patients were freated by laminectomy, and the other seven by anterior interbody fusion. The symptoms in both the laminectomy patients improved after operation, but became worse again when cervical instability developed; they then had to have an anterior fusion in addition. In six of the seven patients who had primary anterior fusion a halo-cast (or a halo-vest) was used to keep the cervical spine immobile, and good bony fusion was obtained with satisfactory results. However, in one patient no halo apparatus was used, bony union did not occur and the radiculopathy reappeared. In cervical myelopathy complicating athetoid cerebral palsy laminectomy is contra-indicated; anterior fusion combined with a halo apparatus is, however, satisfactory.

The initial examination of the cerebrospinal fluid (CSF) taken on the third day following admission was unremarkable. However, the second CSF test 3 weeks later revealed xanthochromia and a protein level of 4-12 g/l, without pleocytosis.Following the myelogram the patient developed dyspnoea and respiratory insufficiency and underwent endotracheal intubation. Although he subsequently required a tracheostomy and artificial ventilation, there was no appreciable bulbar palsy. He could change the pattern of ventilation for himselfand could stop breathing or even sigh to some degree. Throughout the total of25 months that the patient remained in hospital there occurred no significant neurological changes, except that the respirator could be withdrawn after 8 months. He eventually died of bronchopneumonia. At necropsy the only significant general abnormalities were the findings in the lungs and nephrosclerosis. NeuropathologyThe spinal cord at the C5-6 level was discoloured brown and very thin ventro-dorsally. On sectioning, multiloculated old haematomas, surrounded by partly necrotic and sclerotic 382 by copyright.

Purpose: Arthroscopic treatment of shoulder instability has some advantages (including short surgical time, less morbidity, less postoperative pain, reduced hospitalization time, and decreased risk of complications) compared with open procedures. We performed a prospective study comparing open repair with arthroscopic repair for recurrent anterior shoulder instability. The aim was to clarify the relative effectiveness of open Bankart repair plus inferior capsular shift (OBRICS) and arthroscopic Bankart (AB) repair without augmentations with approximately 5 years of follow-up. Methods: We investigated 32 shoulders of 30 patients (24 men and 6 women) undergoing OBRICS (15 shoulders of 17 patients; two patients were bilateral) and AB (15 shoulders of 15 patients). The average follow-up was 5 years and 2.5 months (range: 60-66 months). The clinical evaluation included recurrent instability rate, range of motion, and postoperative rehabilitation. All patients were assessed using the scoring systems of Rowe and the University of California at Los Angeles (UCLA) preoperatively and during the final evaluation. Results: Recurrent instability rates were significantly different between the OBRICS (0%) and AB (26.6%) groups (p ¼ 0.022). There were fewer limitations of external rotation (ER), ER at 90 abduction, and horizontal extension for AB than for OBRICS postoperatively (p < 0.05). The mean Rowe and UCLA scores for both methods were not significantly different at final follow-up. Conclusion: Our data suggest that OBRICS leads to a lower rate of recurrent instability. However, those with AB had fewer ER and horizontal extension limitations.

The three-dimensional linear instability of Kirchhoff’s elliptic vortex in an inviscid incompressible fluid is investigated numerically. Any elliptic vortex is shown to be unstable to an infinite number of short-wave bending modes, with azimuthal wave number m=1. In the limit of small ellipticity, the axial wave number of each unstable mode approaches the value obtained by the asymptotic theory of Vladimirov and Il’in, indicating that the instability is caused by a resonance phenomena. As the ellipticity increases, the bandwidth broadens and neighboring bands overlap each other. The maximum growth rate of each mode, except for that of the longest one, agrees fairly with that of the elliptical instability modified by the influence of a Coriolis force. The growth rate of these three-dimensional modes are larger than those of the two-dimensional modes when ellipticity is smaller than a certain value.

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