Excellent results of a femoral press-fit stem cemented with a thin mantle: 116 hips followed for 11–18 years

We report the outcome of a femoral stem designed for press-fit insertion and cemented with a thin mantle. During the years 1986–1992 we performed 346 primary total hip replacements in 305 patients. Their mean age at the time of the surgery was 75 (range, 52–91 years). During the follow-up, 206 patients had died (227 hips) and 3 were lost. This left us with 96 patients (116 hips), who were followed for a mean of 13 years (range, 11–18 years). Stem survivorship according to Kaplan–Meier analysis indicated a total survival of 0.982 (confidence intervals, 0.952–1). The mechanical survival rate was 0.985 (confidence intervals, 0.955–1) at 17 years with one patient at risk. Fifty-nine (70%) of the surviving patients were very satisfied with the operated hip, 22 (26%) were satisfied, 2 (2.5%) were content, and 1 (1.5%) was dissatisfied. Then, the press-fit stem allowing minimal cement has a 17-year survival rate of 0.98.     

Attempts to isolate virus from human trigeminal and facial ganglions

Herpes virus hominis type 1 was isolated from the trigeminal ganglion (ganglion semilunare, gasservian) in three out of 20 randomly selected autopsies. Two of the three patients had been treated with immunosuppressive or cytostatic agents. Clinical signs of herpes infection were not observed during the previous 6 months. No virus was isolated from the facial ganglion (geniculate ganglion) in the same 20 cases. The findings are discussed in relation to the viral etiology of acute peripheral facial palsy.     

The “Scandinavian Star” ferry disaster 1990 -a challenge to forensic odontology

Summary With 158 victims, the fire on board the Scandinavian Star was one of the world's worst ferry disasters. A team of identification experts, including dentists, were employed to secure evidence for identification and to remove the victims from the ferry. Four parallel teams, each with 2 dentists, examined and autopsied the victims at the Institute of Forensic Medicine, University of Oslo. Using the INTERPOL Disaster Victim Identification forms and aided by computers, all victims were identified within 17 days. Dental identity could be established in 107 cases (68%).     

Fibrosarcoma in Children: A Rare Tumour with Long-Term Survival even with Advanced Disease A Report of 3 Cases

Fibrosarcoma is a rare tumour in children. The potential of malignancy has been questioned. We present three cases of fibrosarcoma in children. The follow-up periods range from 10 to 37 years. The first patient had pulmonary metastases at the time of diagnosis in 1958. The primary tumour in fossa ischio-rectalis was resected in 1960. Lung metastases were resected in 1960 and 1989. Radiotherapy was given in 1992. He is still alive with metastases 37 years after the first manifestation of disease. The second patient had a primary tumour and several local recurrences in the mandible. He is alive without evidence of disease 4 years after resection of pulmonary metastases and 21 years after resection of the primary tumour. The third patient has no signs of recurrence or metastasic spread 10 years after a wide excision of subcutanous tumours of the left upper arm. The cases demonstrate a special tumour-entity of low-grade malignancy, which show a good prognosis and a wide spectrum of biological behaviour.     

Household composition and suicidal behaviour in the adult population of Belgium

Purpose

We aimed to estimate the prevalence of suicidal behaviours, i.e. ideation and attempt, in the adult population of Belgium, and to explore their association with household composition.

Methods

Data of 4,459 adults (25–64 years) from the 2004 Belgian Health Interview Survey were used for analyses. Bivariate and multivariate logistic regressions were used to calculate the odds of engaging in suicidal behaviours according to household type, further controlling for age, sex, income, employment status and social support.

Results

Lifetime prevalence of ideation and attempts was 14 and 4.7 %, respectively. Current prevalence of ideation was 4.0 % and past year prevalence of attempts was 0.5 %. Compared to other household compositions, living alone (A) and as lone parent (P) increased the odds of lifetime and current suicidal thoughts (OR_A 2.3, 95 % CI 1.7–2.9 and OR_P 3.8, 95 % CI 1.9–7.7) and lifetime attempts (OR_A 2.3, 95 % CI 1.4–3.6 and OR_P 4.5, 95 % CI 2.4–8.5). When controlling for confounders, single person and single parent households still presented increased adjusted-odds of lifetime and current suicidal thoughts (a-OR_A 1.8, 95 % CI 1.1–2.9 and a-OR_P 2.3, 95 % CI 1.0–5.5). The likelihood of ever attempted suicide was also higher among single parent households (a-OR_P 4.5, 95 % CI 2.4–8.5) after adjustment, but not among those living alone (a-OR_A 1.4, 95 % CI 0.8–2.8).

Conclusion

Living alone or as lone parent place adults at higher risk for suicide behaviour, and this is only partly explained by lower socio-economic status or poor perceived support.     

Cephalometric analysis in patients with obstructive sleep apnoea syndrome: II. Soft tissue morphology

Oropharyngeal soft tissue profiles were studied by cephalometric analysis in 25 patients with obstructive sleep apnoea syndrome (OSAS) and 10 controls. The length of the soft palate was significantly higher in patients (48.0 +/- 4.3 mm. (mean +/- SD) than in controls (35.3 +/- 4.6 mm.) (p less than 0.001), as was the distance of close contact between the tongue and the soft palate (23 +/- 12 mm. and 10 +/- 8 mm., respectively) (p less than 0.01). The area of the soft palate, measured in the sagittal plane, was 4.85 +/- 0.80 cm.2 and 2.88 +/- 0.62 in the patient and the control group, occupying 39 +/- 8 per cent and 21 +/- 5 per cent of the pharyngeal area (p less than 0.001). The lower outline of the tongue, represented by the line between vallecula (V) and the hyoid bone (AH) was more inferiorly positioned in patients, apparently giving the tongue a more upright position with more of the tongue tissue at the hypopharyngeal level than found in normals. The pharyngeal airway space had significantly reduced anteroposterior dimensions both at the nasopharyngeal and velopharyngeal level (P less than 0.001) as well as the hypopharyngeal level (p less than 0.05). Cephalometric analysis is highly recommended as a valuable tool in the presurgical evaluation of OSAS patients.     

A new method for the remote collection of nasal and exhaled nitric oxide.

STUDY OBJECTIVES: The present study introduces a method that has been developed to improve the remote collection and transportation of gas samples from the nose and lungs. DESIGN: Assessment of agreement between two methods of clinical measurements. SETTING: Noninvasive exhaled gas measurement at a respiratory research laboratory. PARTICIPANTS: Ten nonsmoking adult volunteers (median age, 44 years; age range, 33 to 53 years; men, 6; women, 4) were recruited. MEASUREMENTS AND RESULTS: Exhaled nitric oxide (ENO) and nasal nitric oxide (NNO) outputs were measured directly (on-line) and remotely (off-line). With the velum closed, lung air was exhaled at fixed flows (ie, 6, 8, and 10 L/min) (ENO) or room-air was aspirated through the nose in series at one fixed flow (ie, 5 to 8 L/min) (NNO). The off-line nitric oxide (NO) measurements were achieved by a gas collection tube system, which consisted of a flow control unit, a tube reservoir with one-way valves at both ends, and an interrupter valve allowing the trapping of gas inside the tube and eliminating the inclusion of "dead space." After clamping, the reservoir may store and transport the gas samples for delayed analysis. The coefficient of variation of three consecutive NO measurements was < 3% for both on-line and off-line ENO and NNO. The correlations between on-line and off-line measurements in both ENO and NNO outputs were high (r = 0.99; R(2) = 0.99), and, unlike previous studies using bag-collection, the ENO outputs for on-line and off-line measurements were in good agreement (Bland-Altman test) at all flows tested. CONCLUSIONS: The tube gas collection system eliminates the dead space and contamination during the gas sampling and permits the cost-effective and reliable off-line collection of both nasal and exhaled gas samples.     

Accuracy of acoustic rhinometry

OBJECTIVES: The objective of this study was to evaluate the ability of acoustic rhinometry (AR) (Rhin2100, Rhinometrics, Lynge, Denmark) to accurately determine the dimensions (cross-sectional areas and volumes) of the curved and complex slit-like geometry of the nasal airway. MATERIALS AND METHODS: A plastic model representing the replicate of a decongested nasal airway was produced by stereolithographic techniques from a 3-D MRI-scan. The exact dimensions of this model was determined from a high resolution CT-scan. Dimensions perpendicular to the curved course of the acoustic pathway were compared with dimensions inferred from parallel sections. The impact of sound loss to the paranasal sinuses and the ability to detect posterior volume changes was tested in the same model. RESULTS: The error in volume determination was < 14% for the MCA and < 8% for the volumes, whereas the error reached 52% for dimensions calculated from parallel sections in the coronal plane. The influence of the simulated maxillary sinuses depend primarily on the size of the ostia and may represent an important source of error for posterior measurements, in particular after decongestion. CONCLUSIONS: The accuracy of acoustically derived dimensions of the 3-D model depend on the orientation of the planes used to calculate the dimensions of the model. Volume estimates based on the smallest cross-sectional areas in points along the acoustic pathway correlate well with acoustically derived volumes, whereas single cross-sectional areas are more susceptible to error. Sound leakage to patent sinus ostia reduce the accuracy of posterior measurements.