The cementless femoral stem revisited

Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent advances in antibiotics and aseptic techniques and with improvement in surgical technique, the incidence of infection has decreased tremendously. Subsequently, the issues of wear and osteolysis have become the main concern. Initially attributing these problems to so-called "cement disease," clinicians sought out alternative methods of fixation; hence arose cementless femoral stem fixation. This article provides an overview of our modern understanding of cementless femoral stem fixation, focusing on design issues and outcomes. Particular attention is paid to three areas of continuing controversy with regard to the uncemented femoral stem: geometric design, material composition, and type and extent of porous coating.     

Hip pain in a case of hypophosphatemic osteomalacia

Hypophosphatemic rickets, a rare metabolic bone disease, presents mainly in children but has also been reported in several adults. In this report, we describe the case of a man presenting with hip pain and weakness, both of several months' duration, and tested for hypophosphatemic rickets. The patient was eventually referred to a tertiary-care center, where he was diagnosed with bilateral subtrochanteric femoral stress fractures and severe osteopenia secondary to hypophosphatemic osteomalacia. The patient was treated with closed reduction and internal fixation and vitamin D and phosphorus. Outcomes were good at 7-month follow-up.     

Macrophage-derived chemokine expression in classical Hodgkin's lymphoma: application of tissue microarrays.

Hodgkin's disease (HD) is a lymphoid malignancy characterized by the presence of Reed-Sternberg (RS) and Hodgkin's cells in a background of mixed inflammatory cells and stromal reaction. Studies have documented that HD is a neoplasm associated with abnormal cytokine and chemokine production. To define the expression of macrophage-derived chemokine (MDC) in HD, 57 cases (18 lymphocyte predominant, 11 mixed cellularity, 28 nodular sclerosis) were stained for MDC by immunohistochemistry and compared with reactive lymph nodes as controls. MDC was expressed by RS cells in classical HD (CHD) and showed a distinct cytoplasmic and Golgi localization. Accumulating evidence suggests that lymphocyte-predominant HD (LPHD) represents an entity distinct from CHD, with different biological properties and clinical course. On the basis of the high level of MDC staining alone, CHD could be distinguished from LPHD (P <.001), which showed only faint staining of scattered histiocytes similar to control tissues. CHD cases with high MDC mRNA levels showed high levels of MDC protein expression by immunohistochemistry (P <.001) and significant eosinophil infiltration, suggesting that MDC may represent another molecule that plays a critical role in eosinophil recruitment. We also analyzed 102 cases of non-Hodgkin's lymphoma and normal spleen, lymph node, and thymic tissue. High levels of MDC expression were specific to CHD cases because only low levels of MDC were observed in a minor subset of LPHD, NHL or normal lymphoid tissues.     

Quantitative comparisons of lung structure of adult domestic fowl and red jungle fowl, with reference to broiler ascites

A stereological comparison has been made of the structure of the lungs of the adult female domestic fowl and its wild progenitor the Red Jungle Fowl. The volume of the lung per unit body weight of the domestic bird is between 20 and 33% smaller than that of the wild bird. The domestic fowl has partly compensated for this by increasing the surface area for gas exchange per unit volume of exchange tissue. However, the blood-gas tissue barrier is about 28% thicker in the domestic fowl than in the Red Jungle Fowl, and this has led to a 25% lower anatomical diffusing capacity for oxygen of the blood-gas tissue barrier per unit body weight in the domestic fowl. These structural characteristics may make the modern domestic fowl vulnerable to stress factors such as altitude, cold, heat or air pollution by predisposing to hypoxaemia and perhaps thence to ascites.     

Analysis of volatile flavour compounds and acrylamide in roasted Malaysian tropical almond (Terminalia catappa) nuts using supercritical fluid extraction

Considering the importance of tropical almond nuts as a snack item, a study was conducted to identify the flavour volatiles and acrylamide generated during the roasting of the nuts. The supercritical fluid extracted flavour components revealed 74 aroma active compounds made up of 27 hydrocarbons, 12 aldehydes, 11 ketones, 7 acids, 4 esters, 3 alcohols, 5 furan derivatives a pyrazine, and 2 unknown compounds. While low levels of acrylamide (8–86 μg/kg) were obtained in the roasted nuts, significant (P < 0.05) increases occurred in concentration with increased roasting temperature and time. Carboxylic acids were the most abundant volatiles in the roasted almond nuts and less significant (P > 0.05) concentration of acrylamide was generated with mild roasting and shorter roasting period.     

Inhibition of platelet aggregation by 5-nitro-2-furaldehyde diacetate with observations on structure-activity relationships.

Nitrofurantoin [1-(5'-nitro-2'-furfurylideneamino)-2, 4-diketoimidazole] is a potent inhibitor of primary ADP-induced platelet aggregation. The nitro group on the furan ring and the specific arrangement of the two keto groups on the imidazole ring are the molecular characteristics of nitrofurantoin critical to its inhibitory effect. The present studies report that 5-nitro-2-furaldehyde diacetate is also a potent inhibitor of primary ADP-induced platelet aggregation. 5-Nitro-2-furaldehyde diproprionate, 5-nitro-2-furaldehyde dibutyrate, and 5-nitro-2-furfuryl acetate are essentially inactive. These results indicate that a diacetate moiety can replace the diketoimidazole moiety of nitrofurantoin and form a compound that fully retains the inhibitory effect upon primary ADP-induced platelet aggregation.