Femoral component fixation with and without intramedullary plug A 6-year follow-up

A total of 113 patients underwent a cemented total hip replacement (THR) operation involving femoral component fixation either without the use of a distal intramedullary plug (n = 57, group 1) or with the plug (n =56, group 2). We studied the femoral component fixation radiographically at on average 6 years after THR. The cement coating was assessed as technically good in 86% and 95% of groups 1 and 2, respectively. There was radiographically diagnosable loosening of the femoral component at the follow-up in 25 cases in which stems were inserted without the intramedullary plug, and in 6 cases in those with the plug (P < 0.0008), and the mean subsidence of the femoral component was 5 mm in group 1 and 1.5 mm (P < 0.0003) in group 2, respectively. Osteolytic changes around the femoral component were noticed in both groups in equal numbers and with no statistical difference. The use of a distal intramedullary plug in the cementation of the femoral stem results in a better cement coating, reduces femoral component subsidence and ameliorates the loosening rates.     

Protein and energy relationships in the diet of the American alligator (Alligator mississippiensis)

First-year alligators (Alligator mississippiensis) averaging 377-857 g body weight were fed diets containing various levels of protein, fat and carbohydrate. In experiment 1, nine diets arranged in a centrally rotatable composite design contained 0-36% extruded corn and 4-20% total fat. Response surface analysis predicted maximum responses in performance criteria at 6.3-18.8% corn and 15.8-27.4% fat. Corn inclusion at up to 27-36% of diet resulted in equal or improved performance compared to carbohydrate-free diets of equal fat content. Energy digestibility averaged 84.3%. Protein digestibility averaged 86.7%. Maximum responses in performance criteria were predicted at 42.5-48.7% digestible protein and 4367-4421 kcal/kg digestible energy. In two additional experiments, alligators were either fasted or fed for various numbers of days/week. Carbohydrate-supplementation of high protein diets led to equal or significantly improved performances. Performance was maximized by feeding the alligators 5-6 d/w. Regression of body weight changes against energy and protein intake yielded estimates of daily maintenance requirements of 5.7-8.4 kcal and 0.49-0.89 g protein/kg live body weight. Dietary fat and carbohydrate in the forms and amounts fed to young alligators were well-utilized. Optimal digestible energy:crude protein ratios (8.2-10.9:1 kcal/g protein) were similar to those of other aquatic ectotherms of equal size.     

Antisperm antibodies and lymphocyte subsets in semen—not a simple relationship

The significance of white blood cells in the ejaculate remains a matter of controversy. Several authors have suggested that such cells are important in the modulation of an antisperm antibody response, i.e. a predominance of suppressor/cytotoxic to helper/inducer T cells may prevent the development of antisperm antibodies. In order to examine this relationship further we have documented the white blood cell types, with emphasis on the T-lymphocyte populations, in the ejaculates of men from infertile couples with and without antisperm antibodies; the latter group was divided further into two groups--vasovasostomized men and idiopathic men. All seven of the men without antisperm antibodies had a predominance of suppressor/cytotoxic T cells to helper/inducer T cells in the ejaculate. However, only in some of the men with antibodies was there a predominance of T-helper/inducer cells. It is clear that the relationship between antisperm antibodies and seminal leucocytes is therefore not as straightforward as has been proposed.     

Prospective comparative study of cefotetan with piperacillin for prophylaxis against infection in elective colorectal surgery

This study compared one dose of cefotetan with three doses of piperacillin as prophylaxis against wound infection in 153 patients undergoing elective colorectal surgery. The patients were randomized into two groups: the first received 2 g cefotetan intravenously with induction of anaesthesia (n = 75), and the second received three doses of 2 g piperacillin (n = 78). Wound infection was defined as the presence of an abscess or discharging pus from the wound. In the cefotetan group there were 14 (19%) wound infections and 13 (17%) in the piperacillin group. There were three septic deaths, one in the cefotetan group and two in the piperacillin group. Both groups were comparable with regard to age, sex, nature of pathology and pre- and perioperative risk factors. No significant haematological or biochemical abnormalities were detected. The only adverse reaction was one patient who had an allergic reaction (rash) to piperacillin. These data suggest that single-dose cefotetan is as effective as triple-dose piperacillin in prophylaxis against infection in elective colorectal surgery.     

The effect of surgical intervention on the state of the immune system in brain tumors

In patients with benign and malignant brain tumors before the operation, the suppression of the immune system, in particular, proliferative response of lymphocytes to T- and B-mitogens was established. Preoperative preparation of the patients aggravated this process. At day 8-10 after the operation, normalization of the main indices of immunity in patients with benign tumors was noted. In malignant tumors after the operation, the increase in the contents of T- and B-lymphocytes against the background of decrease in their proliferative activity was observed.