Lateral closed wedge osteotomy for cubitus varus deformity

Background:

Lateral closed wedge (LCW) osteotomy is a commonly accepted method for the correction of the cubitus varus deformity. The fixation of osteotomy is required to prevent loss of correction achieved. The fixation of the osteotomy by the two screw and figure of eight wire is not stable enough to maintain the correction achieved during surgery. In this prospective study we supplemented the fixation by Kirschner''s (K-) wires for stable fixation and evaluated the results.

Materials and Methods:

Twenty-one cases of the cubitus varus deformity following supracondylar fractures of the humerus were operated by LCW osteotomy during February 2001 to June 2006. The mean age of the patients at the time of corrective surgery was 8.5 years (range 6.6-14 years). The osteotomy was fixed by two screws with figure of eight tension band wire between them and the fixation was supplemented by passing two to three K-wires from the lateral condyle engaging the proximal medial cortex through the osteotomy site.

Result:

The mean follow-up period was 2.5 years (range seven months to 3.4 years). The results were assessed as per Morrey criteria. Eighteen cases showed excellent results and three cases showed good results. Two cases had superficial pin tract infection.

Conclusion:

The additional fixation by K wires controls rotational forces effectively besides angulation and translation forces and maintains the correction achieved peroperatively.     

Effect of cranberry juice consumption on urinary stone risk factors

PURPOSE: We evaluated the effect of cranberry juice on urinary stone risk factors. MATERIALS AND METHODS: A total of 12 normal subjects and 12 calcium oxalate stone formers underwent 2, 7-day phases of study in random order while on a controlled metabolic diet. Subjects ingested 1 l of cranberry juice (CBJ) daily in 1 phase and 1 l of deionized water in the other phase. On the last 2 days of each phase 2, 24-hour urine collections and blood samples were obtained for stone risk factors and serum chemistries. RESULTS: No significant differences were found between normal subjects and stone formers in response to CBJ and, therefore, the groups were combined. CBJ significantly increased urinary calcium (from 154 to 177 mg per day, p =0.0008) and urinary oxalate (from 26.4 to 29.2 mg per day, p =0.04), thereby increasing urinary saturation of calcium oxalate by 18%. Urinary citrate was unchanged and urinary magnesium increased slightly. Urinary pH decreased (from 5.97 to 5.67, p =0.0005), and urinary ammonium, titratable acidity and net acid excretion increased during CBJ ingestion. Urinary uric acid decreased (from 544 to 442 mg per day, p <0.0001) as did serum uric acid. Thus, the urinary saturation of brushite and monosodium urate was reduced by CBJ but the amount of undissociated uric acid increased. CONCLUSIONS: CBJ exerts a mixed effect on urinary stone forming propensity. It reduces urinary pH likely by providing an acid load and decreases urinary uric acid perhaps by retarding urate synthesis. Overall CBJ increases the risk of calcium oxalate and uric acid stone formation but decreases the risk of brushite stones.     

Failure to collect oocytes in assisted reproductive technology: a retrospective

While there is much information and discussion on pregnancy failure after assisted reproductive technologies, less emphasis is placed on the failure to collect oocytes after apparently successful ovarian stimulation. This retrospective survey reviewed 4973 treatment cycles in order to obtain information about the likelihood of this event. Overall 42 women (43 treatment cycles) failed to have oocytes collected [0.86% of treatments started and 0.92% of women given human chorionic gonadotrophin (HCG)]. However, in only six cases was this failure unexpected (0.1%) with no obvious potential clinical reason (i.e. all six cases had: HCG administered; more than two follicles >15 mm in diameter; oestradiol values >2000 pmol/l; <38 years old; normal body mass index). Indifference concerning uncommon events is fraught with peril, as although rare, the particular outcome may be devastating to the individual, both economically and psychologically. Eighteen of the 42 women did not return for on-going treatment suggesting increased contact by clinic staff may be required when oocyte retrieval is not achieved. These data suggest that the failure to collect oocytes after apparently successful ovarian stimulation is rare and random. The information has proved useful in allaying the fears of couples contemplating assisted reproductive technologies.      

温度、缓冲液对基因变异检出灵敏度的影响

在临床分子生物学诊断中，聚合酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）技术是一种有效的检测基因变异的方法［１，２］，我们使用自动电泳和分离系统Ｐｈａｓｔｓｙ－ｓｔｅｍ进行电泳分离，结合银染进行ＤＮＡ分析，特别适用于迅速检出含有变异序列的外显子。１材...