Internal derangements of the temporomandibular joint: findings in the pediatric age group

Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years (range, 8-16) and the average duration of symptoms was 21.4 months (range, 3 mo.-5 yr.). Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that treatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities.     

Ureterovesical obstruction and megaloureter: diagnosis by real-time US

Forty infants and children were accurately diagnosed with real-time ultrasound (US) as having megaloureter secondary to ureterovesical junction (UVJ) obstruction by an adynamic, distal ureteral segment. Characteristic US findings were dilatation of the distal ureter, often disproportionate to the appearance of the upper collecting system; lower ureteral hyperperistalsis; and a sharply tapered, incurving, distal adynamic segment, 1-3 cm long. Real-time US, used routinely in preliminary evaluation of the urinary tract in children, can facilitate early diagnosis of UVJ obstruction and thus prevent significant loss of renal function.     

知母中呋甾皂甙的研究

自知母 Anemarrhena asphodeloides Bge.根茎的乙醇提取物中,经硅胶柱层析和制备型HPLC分得四种呋甾皂甙。用化学反应和波谱(IR,FAB-MS,EI-MS,¹HNMR,¹³CNMR,DEPT,一维多重接力CoSY,二维接力HOHAHA,¹H-¹H COSY,¹H-¹³C COSY和NOE差谱)解析,确定其结构为知母皂贰B(anemarsaponinB,I),(25S)-26-O-β-D-吡喃葡萄糖基-5β-呋甾-20(22)-烯-3β,26-二醇-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃哺葡萄糖甙(Ⅱ),(25S)-26-O-β-D-吡喃葡萄糖基-22-羟基-5β-呋甾-3β,26-二醉-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃半乳糖甙(Ⅲ),(25S)-26-O-β-D-吡喃葡萄糖基-22-甲氧基-5β-呋甾-3β,26-二醇-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃半乳糖甙(Ⅳ)。Ⅱ为一新的呋甾皂甙,命名为知母皂甙C;化合物Ⅳ为首次从知母中分离得到,命名为知母皂甙E。初步的药理实验显示,化合物1～Ⅳ均有一定的清除羟自由基的作用。     

Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis

A prospective study of thoracic and lumbar spinal fracture distribution and its relationship to thoracic kyphosis was performed in 87 women with osteoporosis. Anterior wedge fractures were most commonly seen in the midthoracic spine and about the thoracolumbar junction, whereas central compression fractures were most common from the first to the fourth lumbar levels. Solitary wedge fractures did not occur above the seventh thoracic vertebra, suggesting that a cause other than osteoporosis must be suspected in any patient with an isolated high thoracic fracture. Analysis of the spinal radiographs obtained in an additional 16 women without osteoporosis revealed that both forms of fracture were unusual in this small group with normal spinal mineralization. The number of anterior wedge fractures in the thoracic spine correlated (r = .546) with the degree of thoracic kyphosis. However, 19% of the women with no thoracic fractures still had thoracic hyperkyphosis. The authors conclude that the hyperkyphosis of osteoporotic women is related to anterior compression fractures but also has contributing nonskeletal factors.     

Intrathecal administration of nitroxides as potential contrast agents for MR imaging

The diagnosis of various disorders of the cerebrospinal fluid (CSF) with magnetic resonance (MR) imaging may require the intrathecal administration of a paramagnetic contrast agent. Furthermore, the CSF route provides direct access to the brain, circumventing the blood-brain barrier. Three nitroxides, two charged and one uncharged, were administered intrathecally to dogs to assess their potential as contrast agents for MR imaging of the CSF. Nitroxide concentrations and proton T1 values were measured in samples of CSF removed at various times after nitroxide administration, and pharmacokinetic curves were constructed. The charged nitroxides had considerably longer half-lives than the uncharged compound. On in vivo MR imaging of the CSF (surrounding the upper cervical cord and brain stem) in one dog, use of a charged nitroxide as contrast agent led to considerably higher CSF signal intensity than was observed in the nonenhanced, baseline T1-weighted images. This effect was achieved at low doses (20 mumol) and sustained for at least 90 minutes. The intrathecal use of nitroxides as contrast agents for MR imaging warrants continued investigation.     

Epidemic syncope in jazz bandslogistic aspects of an investigation

Summary At a fete at Hollinwell, in the District of Ashfield, Nottinghamshire, on Sunday, 13 July 1980, children in the marching bands section were taken ill. Persons attending a gymkhana in the same field at the same time were unaffected. The first children collapsed at 10.30 a.m., and new cases occurred over the next 21/2 hours. Members of the St John Ambulance and Police gave immediate assistance but were overwhelmed by numbers and eventually 414 persons were taken to 4 hospitals, 67 by ambulance and the rest by coach or private vehicle. The episode was dramatic and alarming to all those present. No organic cause was found to account for the incident. During the following week a few new or return cases attended hospital but all patients were discharged after a few hours or at the most in a day or two. The main features of the incident, its investigation and the considerable public interest aroused by it, are described.