Characteristics of the receptors in the isolated capsule of the hip in the cat

Summary The properties of the afferent fibres from the capsule of the hip joint have been studied in the cat in situ, in relation to joint rotation, and in an isolated capsule preparation which was opened and stretched directly with an actuator.In situ two types of afferent fibres were found, those having a full range of sensitivity and others having only a limited range in response to the joint rotation. When studied in isolated tissue the afferent fibres of the capsule were uniform in threshold and sensitivities, and no full range receptors were found. We conclude that the full range receptors which enter the articular nerve of the hip are spindle afferents and not capsule receptors. On the basis of these and previous results in animals and man the role of joint receptors in kinaesthesia and position sense is discussed.

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Résumé Les auteurs ont étudié les propriétés des nerfs afférents à la capsule de la hanche, chez le chat en imprimant à l'articulation des mouvements de rotation et sur des préparations de capsule isolée et ouverte en l'étirant directement grâce à un dispositif mécanique.In situ, on a trouvé deux types de nerfs afférents, les uns ayant en réponse à la rotation articulaire une étendue complète de sensibilité et les autres seulement une sensibilité limitée. Sur la capsule isolée les nerfs afférents sont indentiques en ce qui concerne le seuil et la sensibilité et on ne trouve aucun récepteur complet. On en conclut que les récepteurs de toute l'étendue de la sensibilité qui pénètrent les nerfs articulaires de la hanche sont des fibres en fuseau d'origine musculaire et non des récepteurs capsulaires. Sur ces bases et sur les résultats précédemment obtenus chez l'animal et chez l'homme, les auteurs discutent le rôle des récepteurs articulaires dans la cénesthésie et le sens des positions.

     

Wear of the cup in the Charnley LFA in the young patient

Since wear and loosening of the ultra-high-molecular-weight polyethylene cup are factors which limit the life of an arthroplasty we have attempted to identify factors associated with either low wear (0.02 mm/year or less) or high wear (0.2 mm/year or more). In a series of 1434 Charnley low-friction arthroplasties (1092 patients) 190 (13.2%) showed low wear while 149 (10.4%) showed high wear. We used chi-squared test to assess the significance of various factors. The significant factors of the low-wear group were female gender (p = 0.042), rheumatoid arthritis (p = 0.014), Charnley grade C (p = 0.03) and varus position of the stem (p = 0.003). The use of acetabular cement pressurisation (p = 0.07) and medialisation of the cup (p = 0.07) approached significance. In the high-wear group there was a predominance of men (p = 0.042) with osteoarthritis (p = 0.006) as the underlying hip pathology, and the stem in a valgus position (p = 0.023). Support of the cup by the rim of the acetabulum approached significance (p = 0.07). There was no statistical significance between the two groups for revision for aseptic loosening of the stem or fracture of the stem (p = 0.49). There was a highly significant difference (p < 0.0001) between the two groups for revision for wear and aseptic loosening of the cup, 5.3% compared with 39%. Changes in the cup geometry are probably sufficient to explain the increasing incidence of loosening and revisions with the increasing depth of penetration of the cup. There is much to be gained from the use of a low-wearing ceramic-ultra-high-molecular-weight combination. Tissue reaction to the polyethylene particles cannot be the cause of aseptic loosening of the stem.     

Ethical concerns in the management of pain in the neonate

The debate about the management of pain in the neonate has continued to evolve over the past 30 years. This controversy can be understood as evolving through now three eras of thought about the effect of pain and its management in newborns and infants. The first generation was characterized by a widespread belief that newborns lacked the complete development of the neuroanatomical and neuroendocrine components necessary to perceive pain. During this period, newborns often received inadequate anesthesia and analgesia for painful procedures, if not no treatment at all. The second generation was heralded by research that demonstrated that newborns did demonstrate similar or even exaggerated physiological and hormonal responses to pain compared with those observed in older children and adults and that exposure to prolonged or severe pain may increase neonatal morbidity. Controversy in this generation focused around the dosage of analgesia to newborns as well as the risks and benefits of pain management techniques. We are now in a third generation of thought about pain in the neonate, defined by intense debate over the significance of a growing number of studies in immature animal models that demonstrate degenerative effects of several anesthetics on neuronal structure. The challenge of this era is to integrate the advances in diagnosis and treatment achieved in previous generations with ongoing adaptation of clinical practice as dictated by research advances in the field. In this review, we examine the evolution of medical thought and ethical concerns regarding pain treatment in the neonate.     

Uromucoid in the rat: Its isolation,localization in the kidney and concentration in the urine

Summary Based on the finding that rat uromucoid cross reacts with antihuman uromucoid, rat uromucoid was isolated by means of immune absorption chromatography. Using a monospecific antiserum obtained with the use of this preparation, uromucoid was shown to be present in the distal tubules of the kidney. a quantitative immunological determination was made from the urine of 30 normal rats.     

阴茎勃起的信号通路研究进展

对国内外近年来参与阴茎勃起过程中的四条信号通路及分子机制的研究进行回顾，从平滑肌收缩和舒张两方面进行总结，以期能更好地理解ED的发生机制。     

Skeletal changes in the hand in the Ehlers-Danlos Syndrome

We report a woman patient with Ehlers-Danlos Syndrome who presented with trapezio-metacarpal subluxation and whose hands exhibited several other skeletal features of Ehlers-Danlos Syndrome, including acro-osteolysis.