Shoulder joint: arthrographic CT and long-term follow-up, with surgical correlation

One hundred two computed tomographic (CT) arthrograms of the shoulder were retrospectively reviewed and compared with conventional double-contrast arthrograms from 101 patients (24 females and 77 males aged 9-70 years). One- to 4-year follow-up was obtained in 84 patients, 40 of whom underwent open-shoulder surgery or arthroscopy. Morphology of the normal portions of each labrum was categorized according to length, width, and tip shape. Correlation between morphology and age was weak, but abnormal labra were more common in younger patients. Conventional radiography was more accurate for detecting bony glenoid margin fractures, but CT was more accurate for detecting Hill-Sach fractures. CT was also more reliable than conventional arthrography in the detection of rotator cuff tears. Hence, few if any conventional radiographs are necessary between contrast material injection and CT imaging. A reduction in the number of images obtained will result in decreased radiation dose, less cost, and shorter examination time without loss of diagnostic accuracy.     

Cerebrovascular ultrastructural alterations after intra-arterial infusions of ouabain,scilla-glycosides,heparin and histamine

Cardiac glycosides which inhibit Na/K-ATPase (ouabain, scilliroside, scillirosidin) as well as heparin and histamine were infused into a cannulated branch of the middle cerebral artery or by isolated head perfusion in cats and dogs. Ouabain permeating the blood-brain barrier (BBB) caused the same selective swelling of astrocytes and of certain presynaptic elements as after direct application to the brain tissue. The other cellular elements of brain tissue and the vascular endothelium did not react, although the latter was exposed to the highest drug concentrations (about 10-3 M ouabain). By the swelling about one third of the capillaries became more or less constricted accompanied by an increase in endothelial vesiculation and in the number of osmiophilic inclusions in all cells of the vascular wall and of the pericapillary tissue. Osmiophilic material resembling plasma proteins occured in widened intercellular clefts indicating an increased BBB permeability after survival times (40 min). In contrast to the capillaries some terminal vessels are dilated which may correspond to shunt vessels causing an inhomogeneous, even increased cerebral blood flow after ouabain. Scilliroside and scillirosidin cause essentially the same changes as ouabain, but of smaller intensity and extent. In the present study, neither histamine nor heparin caused any structural change of the vessels or brain tissue.     

早期慢性肾病患者血管内皮功能及肾脏病理相关性研究

目的：研究早期慢性肾病患者的血管内皮功能损害程度及其与肾脏病理损伤的关系。方法：60例研究对象分为3组：A组为20例正常对照组;B组为20例早期慢性肾病患者血压正常组;C组为20例早期慢性肾病患者肾性高血压组。对各组患者应用高频超声检测肱动脉充血前后管径变化率,评价早期慢性肾病患者血管内皮功能损害程度。对病例组行超声引导下穿刺活检,并对肾组织损伤程度行半定量积分,分析血管内皮功能与年龄、血压、肾脏病理损伤的关系。结果：①C组血流介导的血管舒张功能（Flow-mediated dilation,FMD）低于A组和B组（P＜0.05）,A组与B组之间FMD无差异性（P＞0.05）;②FMD与收缩压、肾小球损伤积分、肾间质损伤积分有相关性（P＜0.05）,与年龄、舒张压无相关性（P＞0.05）。结论：①肾性高血压患者在肾功能损害之前已经存在血管内皮功能的异常;②血管内皮功能紊乱对肾脏的病理损伤有一定的促进作用;③高频超声早期检测慢性肾病患者的血管内皮功能有重要的临床意义。     

Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter,prospective, double blind,placebo controlled,randomized trial

Background  

The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.