Discrimination of hip fractures by quantitative ultrasound of the phalanges and the calcaneus and dual X-ray absorptiometry

The aim of the current study was to evaluate the ability of different techniques used for the assessment of bone status to discriminate between postmenopausal women with and without hip fracture. Fifty-one postmenopausal women (mean age 64.5±6.5) who had sustained a low energy hip fracture and 51 age-matched controls (mean age 64.6±6.0) were studied. Quantitative ultrasound (QUS) assessment was carried out using the Ubis 3000 device capable of measuring broadband ultrasound attenuation (BUA) and speed of sound at the calcaneus (SOS_C) and the Sunlight Omnisense device capable of estimating speed of sound at the phalanges (SOS_P). Femoral neck bone mineral density (BMD) was assessed using dual X-ray absorptiometry. Correlations between QUS variables ranged from r=0.35 to 0.72 and between QUS variables and BMD from r=0.30 to 0.36. BMD was the best discriminator of hip fractures (odds RATIO = 3.61, area under CURVE = 0.824). All QUS variables were significant discriminators of hip fractures with odds ratios ranging from 1.88 to 2.63 and areas under the ROC curves ranging from 0.663 to 0.740. Among the QUS variables, the SOS_P showed the best odds ratio and area under curve. Comparison between the areas under the ROC curve did not show any significant difference between SOS_P, BUA and BMD. On the contrary, the difference between SOS_C and BMD was significant (P<0.05). In conclusion, BMD and QUS variables investigated in the current study were significant discriminators of hip fractures. The differentiation of the hip fractures by BMD was significantly better than that of BUA measured at the calcaneus. Moreover, BMD discriminated fractured patients better than BUA and SOS_P, although the difference did not reach statistical significance.     

Pediatric golf-related head injuries

Objectives Golf-related head injuries constitute an increasingly common mechanism of head trauma in children. We present our experience with 33 pediatric cases of golf-associated head injury, with special emphasis in the type of injury, management strategy, and outcome.Materials and methods A thorough review of all children admitted to our hospital with golf-related head injury during a period of 10 years (1 January 1994 to 31 December 2003) was undertaken. The patients’ charts, operative reports, imaging studies, and follow-up data were analyzed. A comparison of our findings with those described in the pertinent literature was subsequently performed.Conclusions Pediatric golf-related head trauma is a significant cause of sport-associated head injury, sometimes harboring a very dismal prognosis. The significance of establishing a task force for the prevention of these injuries cannot be overemphasized.     

A binocular machine vision system for three-dimensional surface measurement of small objects

Rendering three-dimensional information of a scene from optical measurements is very important for a wide variety of applications. However, computer vision advancements have not yet achieved the accurate three-dimensional reconstruction of objects smaller than 1 cm diameter. This paper describes the development of a novel volumetric method for small objects, using a binocular machine vision system. The achieved precision is high, providing a standard deviation of 0.04 mm. The robustness, of the system, issues from the lab prototype imaging system with the crucial z-axis movement without the need of further calibration and the fully automated volumetric algorithms.     

Chromatin structure and DNA methylation of the <Emphasis Type="Italic">IL-4 gene</Emphasis> in human T<Subscript>H</Subscript>2 cells

Human T_H2 cell differentiation results in the selective demethylation of several specific CpG dinucleotides in the IL-4 and IL-13 genes, which are expressed in activated T_H2, but not T_H1, cells. This demethylation is accompanied by the appearance of six DNase I hypersensitive sites within 1.4 kb at the 5'-end of the IL-4 gene. Micrococcal nuclease (MNase) digestion revealed that in both T_H1 and T_H2 cells nine nucleosomes with a repeat length of 201 bp are identically positioned around the 5'-end of the IL-4 gene. However, only in T_H2 cells are six out of the eight intervening linkers exposed to DNase I. This suggests that a major perturbation of the higher-order chromatin structure occurs above the level of the nucleosome in vivo. It is observed in cells that are poised for expression but which are not actively expressing the gene (i.e. resting T_H2 cells). Notably, all the demethylated CpGs in T_H2 cells are found in DNA that is accessible to DNase I. This may suggest that the opening of the chromatin structure allows binding of specific trans-acting factors that prevent de novo methylation. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users. Nicole Winkelmann passed away in 2004.     

Fluid distribution measurement between body compartments in primates in disclosing fluid retention during prolonged hypokinesia

Body fluid homeostasis undergoes significant changes during hypokinesia (diminished movement). Understanding of fluid transfer between body fluid compartments and its regulating mechanisms was the aim of this study for disclosing impaired fluid retention during hypokinesia (HK).Studies were done on 12 male Macaca mulatta (rhesus monkeys) aged three to five years (5.15 to 6.56 kg) during 90 days period of pre-HK and 90 days period of HK. All primates were divided equally into two groups: vivarium control primates (VCP) and hypokinetic primates (HKP). Hypokinetic primates were kept for 90 days in small individual cages that restricted their movements in all directions without hindering food and fluid intakes. Control primates were housed in individual cages without their movements being restricted.Total body fluid (TBF), intracellular fluid volume (IFV) and circulating plasma volume (CPV) decreased significantly (p < 0.05), while extracellular fluid volume (EFV) and interstitial fluid volume (IsFV) decreased significantly (p < 0.05) at the initial seven days of the HK period and after the 7th day increase progressively in HKP compared with their pre-HK values and their respective control values in VCP. Fluid excretion, urinary and plasma sodium (Na) and potassium (K) levels increased significantly (p < 0.05), while fluid intake and fluid retention decreased significantly (p < 0.05) in HKP compared with their pre-HK values and their respective controls in VCP. The measured parameters did not change in VCP compared with their pre-HK values.It was concluded that decreased IFV and CPV may demonstrate fluid depletion, while marked increase of fluid loss despite of fluid depletion may demonstrate impair fluid retention during HK. Dissociation between fluid loss and fluid depletion maydemonstrate the presence of reduced fluid retention as the mechanism ofdevelopment of fluid depletion during HK.     

Is arterial hypertension an underlying factor in the increased serum Lp(a) levels in ESRD dialyzed patients?

Except for the disorders in lipoprotein metabolism several other factors have been involved in the development of atherosclerotic changes in ESRD patients, including arterial hypertension. Serum lipid profile (total cholesterol (TC), triglycerides (TG), apolipoproteins (AI,AII,B,E) and Lp(a)) was evaluated in 109 ESRD dialyzed patients, 46 in HD and 63 in CAPD and 45 hyperlipidemic patients without renal failure (HL-group). According to the presence of arterial hypertension the dialyzed patients were divided in two groups: group A of 42 hypertensive patients, (mean age 62.3 +/- 15.5 years), which were satisfactorily controlled with anti-hypertensive medication, and group B of 67 non-hypertensive patients, (mean age 66.6 +/- 11.9 years). Lp(a) levels were statistically significantly higher than HL group in both HD (p = 0.001) and PD (p < 0.05) patients. Besides, by dividing HD and PD group in hypertensive and non-hypertensive patients, Lp(a) levels were statistically significantly higher in hypertensive patients, while such a difference was not observed among non-renal failure patients. These results indicate that arterial hypertension may play an important role in Lp(a) serum titles, in ESRD patients undergoing either HD or PD.     

A somatic mutation in the thyrotropin receptor gene in a patient with an autonomous nodule within a multinodular goiter

Thyrotropin (TSH) is the prime regulator of thyroid cell growth and function and acts through the thyrotropin receptor (TSHR) located on the surface membrane of thyrocytes. Somatic heterozygous mutations that cause TSHR activation in the absence of TSH have been found in toxic adenomas and in hot nodules of multinodular goiters. Clinically and histologically heterogeneous nodules can share common gain-of-function mutations. Mutation prevalence varies greatly and is inversely related to iodine intake of the population. We report a Greek patient presenting with subclinical hyperthyroidism due to a fast-growing autonomous hyperplastic nodule in a long-standing multinodular goiter. Direct DNA sequencing showed that the hot nodule harbored a somatic heterozygous activating TSHR mutation: substitution of glutamine for leucine in the third transmembrane helix. This mutation (L512Q) was recently described in two solitary toxic adenomas. This report expands the spectrum of mutations shared by dissimilar hot nodules, supporting a common mechanism for nonautoimmune thyroid autonomy. The identification of the L512Q substitution demonstrates that gain-of-function TSHR mutations are encountered in Greece, although iodine deficiency has been significantly corrected over the last three decades.