全髋和全膝关节成形术后功能问题和治疗答案

虽接受全髋或全膝关节成形术的多数患者通过常规的术后康复治疗可获得极佳的临床结果，而由各种原因导致的实际功能障碍仍占患者的15％～20％。这些患者对标准的物理治疗方式没有反应，而需要采用超强的处理方案．这些治疗方案包括侵害性和非侵害性治疗。本研究的目的是识别这些功能受限的患者，评估采用定制的治疗方案治疗的结果。我们规定那些不直接与假体相关的软组织问题。通过X线片或通过本文两名作者（M．M．＆G．E．）的专门检查排除了由于力线不良或松动等所有有关假体的问题。我们列出了继全髋关节成形术和全膝关节成形术后的几个功能问题。这些问题涉及到肌无力、肌紧张、肢体不等长和神经问题。     

Assessment of the Cough Reflex Caused by Inhalation of Sodium Lauryl Sulfate and Citric Acid Aerosols

Assessment of the cough reflex caused by inhalation of sodiumlauryl sulfate and citric acid aerosols. Zelenak, J.P., Alarie,Y. and Weyel, D.A. (1982). Fundam. Appl. Toxicol. 2:177-180.Guinea pigs were exposed for thirty minutes to a particulateaerosol of sodium lauryl sulfate at concentrations of 17.3,28.9and 48.6 mg/m³. The exposure chamber in which individual guineapigs were exposed was fitted with a microphone to record coughing.As the concentration of sodium lauryl sulfate increased, thecombined number and severity of the coughs increased and a fadein the response was also observed with exposure duration. Citricacid, a tussigenic agent commonly used to test antitussive agentswas also tested using the same experimental protocol and wasfound to be about an order of magnitude less potent than sodiumlauryl sulfate. This model could be useful in assessing theirritating properties of various aerosols to the tracheo-bronchialtree.     

Toxicity of Smoke During Chair Smoldering Tests and Small Scale Tests Using the Same Materials

Toxicity of Smoke During Chair Smoldering Tests and Small ScaleTests Using the Same Materials. Alarie, Y., Stock, M.F., Matijak-Schaper,M. and Birky, M.M. (1983). Fundam. Appl. Toxicol. 3:619–626.Toxicological evaluation of smoke produced during smolderingchair tests was undertaken by exposing mice to smoke emittedprior to, as well as following, flaming ignition of the chairs.By exposing several groups of mice, using undiluted smoke fromthe room containing the chairs, as well as various dilutionsof the smoke, different levels of acute lethality were obtained.From these experiments, chairs constructed with polyurethanefoam were found to create higher toxic atmospheres than chairsconstructed with polyester or cotton fiber cushions. The samematerials (polyurethane foam, polyester and cotton fibers) werealso thermally decomposed in a small scale system and mice wereexposed to the smoke to evaluate acute toxicity. Again polyurethanefoam was found to produce smoke more toxic than smoke producedby polyester and cotton fibers. Sensory irritation monitoredin mice during the smoldering tests indicated that an intenselevel of irritation was present long before large amounts ofsmoke were generated and long before flaming ignition occurred.The phenomenon of eye, nose and throat irritation would thereforebe the first effect impeding escape attempts of individualsin a fire situation. Sensory irritation was followed by asphyxiationas evolution of carbon monoxide or hydrogen cyanide, or both,occurred. The same pattern of responses was observed with smokegenerated with the small scale decomposition system.     

Synthesis,conformation and reactivity towards p-nitrophenyl acetate of polypeptides incorporating aspartic acid,serine and histidine

Examination of β-carbons coordinates of seryl, aspartyl and histidyl residues in active sites of α-chymotrypsin and subtilisin BPN' shows that a close geometrical arrangement can be obtained in an antiparallel β-structure. Therefore some polypeptides incorporating serine, aspartic acid and histidine, poly (Gly-Ser-Asp-His-Ala-Pro) and poly [(Asp-Leu-Asp-Leu)₁₀, (His-Leu-Ser-Leu)₁], and expected to have some tendency to give rise to an antiparallel β-conformation, have been prepared and studied. The second polymer only adopts a fairly well-defined β-structure in aqueous solution. Catalytic activities of these products towards p-nitrophenyl acetate are not improved as compared to histidine. However kinetic pK of histidine side-chain depends markedly upon the nature of the product, owing probably to a hydrophobic environment effect.     

Clinical significance of circulating immune complexes in 'lone' cryptogenic fibrosing alveolitis and those with associated connective tissue disorders

The clinical, radiographic and physiological features, and progression rates of forty unselected patients with cryptogenic fibrosing alveolitis (CFA) have been studied in relation to serum immune complexes measured by a C1q binding technique. Twenty (50%) had levels greater than normal. Those with associated connective tissue disorders (twenty-four) had a higher frequency of raised C1q binding than those with ‘lone’ CFA (sixteen) (63% compared to 31%). As observed previously in this group, those with associated disorders also had higher titres of immune complexes. Twelve of thirteen with polyarthritis had immune complexes and a considerably shorter duration of disease compared with those without joint symptoms (P<0.0l). Several other observations suggest that immune complexes are especially associated with earlier disease. These include a trend towards a younger age and a lesser radiographic profusion score; a shorter duration of symptoms in relation to titres of immune complexes amongst those with raised values (P<0.05) and a higher transfer factor coefficient (Kco) (P< 0.02). The relationship between Kco and the presence of immune complexes was still observed when those with ‘lone’ CKA were analysed separately. Other clinical features including sex. severity of dyspnoea and lung volumes did not distinguish those with and without complexes, either for the whole group of patients or when those with and without associated connective tissue disorders were analysed separately. Analysis of eighteen patients followed to death showed no correlation between length of survival from first symptoms and immune complexes, neither was there any clear association with corticosteroid responsiveness and immune complexes. These studies suggest that measurement of serum C1q binding does not contribute substantially to the management of individual patients with cryptogenic fibrosing alveolitis.