Reference points for radial head prosthesis size

PURPOSE: Metallic radial head implants are useful when the radial head cannot be repaired reliably and when either the elbow or the forearm is unstable. Problems arise when the radial head prosthesis is too thick, causing erosions of the capitellum and incongruity of the ulnohumeral joint. We used quantitative 3-dimensional computed tomography analysis to investigate the relative height of the radial head relative to the lateral edge and central ridge of the coronoid process as reference points for optimal insertion of a radial head prosthesis. METHODS: Seventeen computed tomography scans of the elbow were analyzed. The anatomic coronal plane of the forearm was determined using 3-dimensional images and a 2-dimensional image bisecting the articular surface of the radial head was created in this plane. The distance between the plane of the articular surface of the radial head and parallel planes at the most proximal aspect of the coronoid (the central ridge) and the lateral edge of the coronoid articular surface were measured. Negative values indicate the radial head is proximal to the coronoid. RESULTS: The average distance between the planes defined by the radial head articular surface and the coronoid central ridge was -0.8 mm. The average distance between the planes defined by the radial head articular surface and the lateral edge of the coronoid articular surface was -0.9 mm. CONCLUSIONS: Because the radial head was on average only 0.9 mm more proximal than the lateral edge of the coronoid process and because the key is to not overstuff the joint a useful general guideline would be to place the plane of the articular surface of the radial head even with or just slightly more proximal than the lateral edge of the coronoid articular surface. Considering the substantial variability of the normal height of the articular surface of the radial head with respect to that of the coronoid, preoperative radiographs of the opposite elbow may be useful to avoid overstuffing the elbow.     

Tinidazole in treatment of amoebic liver abscess in children

Tinidazole as a single drug therapy given in a single dose daily for 5 or 3 days was put to rigorous test in malnourished children. Of 25 children with amoebic liver abscess, 23 were cured. The 2 remaining cases required surgical drainage followed by other amoebicides, one subsequently dying from complicating bronchopneumonia.     

Molecular internalization of a region of myelin basic protein

The conformation of myelin encephalitogenic or basic protein (BP) was investigated with a double-antibody radioimmunoassay by studying the reaction of BP or its fragments with antibodies produced in two rabbits against peptide 43-88 linked to rabbit serum albumin. Both antisera reacted well with peptide 43-88 but showed little or no reaction with BP. Absorption of these antisera with a BP-immunoadsorbent did not remove the antibody activity against peptide 43-88. Within the region of peptide 43- 88 it was shown that peptides 68-88 and 79-88 gave an equivalent or better reaction than peptide 43-88, whereas peptides 43-67 and 64-73 had very little reactivity. In the BP fragments containing region 43-88, peptide 1-88 showed the best reactivity, peptide 20-166 showed minimal reactivity, while peptide 1-115 showed none. These data document the internal position of at least a portion of peptide 43-88 and all of residues 79-88 in the BP molecule. The much greater reactivity of peptide 1-88 as compared to peptide 1-115 suggests that the region or a portion of the region of BP containing residues 89- 115 participates in the conformational alignment of BP restricting access to peptide 79-88. After absorption with BP, neither of the antisera prepared to peptide 43-88 reacted with PNS myelin in fixed tissue sections but continued to react with CNS myelin in similarly treated sections. The present findings demonstrate the need to consider the role of shielded antigenic determinants in the investigation of antigens or of immune responses.     

Hematopoietic cell phosphatase associates with erythropoietin (Epo) receptor after Epo-induced receptor tyrosine phosphorylation: identification of potential binding sites

Erythropoietin (Epo) binding to its receptor (EpoR) induces tyrosine phosphorylation in responsive cells and this ability is required for a mitogenic response. One of the substrates of tyrosine phosphorylation is the Epo receptor (EpoR). The carboxyl region of EpoR cytoplasmic domain is required for EpoR phosphorylation and has been shown to negatively affect the response to Epo both in vivo and in cell lines. Hematopoietic cell phosphatase (HCP) has also been hypothesized to negatively regulate erythropoiesis, based on the hypersensitivity to Epo of erythroid lineage cells in moth-eaten mice that genetically lack HCP. In the studies presented here, we show that HCP binds the tyrosine phosphorylated Epo receptor through the amino-terminal src-homology 2 (SH2) domain of HCP. Using a series of phosphotyrosine-containing peptides, potential HCP binding sites in the cytoplasmic domain of the EpoR are identified. The results support the concept that, after Epo stimulation, phosphorylation of EpoR provides a docking site for HCP in the receptor complex. Recruitment of HCP to the complex and its subsequent dephosphorylation of substrates and/or associated kinases may be important to mitigate the ligand-induced mitogenic response.     

Mechanical model testing of rebreathing potential in infant bedding materials

Rebreathing of expired air may be a lethal hazard for prone sleeping infants. This paper describes a mechanical model to simulate infant breathing, and examines the effects of bedding on exhaled air retention. Under simulated rebreathing conditions, the model allows the monitoring of raised carbon dioxide (CO2) inside an artificial lung-trachea system. Resulting levels of CO2 (although probably exaggerated in the mechanical model compared with an infant, due to the model's fixed breathing rate and volume) suggest that common bedding materials vary widely in inherent rebreathing potential. In face down tests, maximum airway CO2 ranged from less than 5% on sheets and waterproof mattresses to over 25% on sheepskins, bean bag cushions, and some pillows and comforters. Concentrations of CO2 decreased with increasing head angle of the doll, away from the face down position. Recreations of 29 infant death scenes also showed large CO2 increases on some bedding materials, suggesting these infants could have died while rebreathing.     

Treatment of respiratory failure in an infant with bronchopulmonary dysplasia infected with respiratory syncytial virus using inhaled nitric oxide and high frequency ventilation

A 2-month-old, former 28-week premature infant with brochopulmonary dysplasia infected with respiratory syncytial virus was treated with nitric oxide and high frequency oscillatory ventilation after conventional therapy failed. Nitric oxide and high frequency oscillatory ventilation rapidly improved oxygenation allowing recovery without the need for extracorporeal membrane oxygenation. This treatment regimen should be considered as an option in high-risk infants with respiratory syncytial virus infection who meet extracorporeal membrane oxygenation criteria.     

人类风湿性关节炎滑膜-软骨-NOD．scid小鼠嵌合体模型的建立

目的:建立能反应自身免疫特点的类风湿性关节炎动物模型,为进一步研究该病发病机制奠定基础。方法:实验于2006-03/12在南方医科大学实验动物中心完成。①实验材料:SPF级2～4个月龄NOD.scid小鼠20只,体质量17～22g,雌雄各半;人类风湿性关节炎滑膜组织(佛山市第一人民医院风湿科提供,患者知情同意);骨关节炎滑膜及正常软骨(南方医院创伤骨科提供,患者及供者知情同意)。②实验分组:将小鼠随机分为2组,类风湿性关节炎滑膜组和骨关节炎滑膜组,雌雄不限,每组10只。③实验过程:每组小鼠背部皮下植入的正常软骨组织,随后将类风湿性关节炎滑膜和骨关节炎滑膜植入软骨之上。④造模10周后麻醉下处死小鼠,用放射免疫法检测血清中肿瘤坏死因子α含量,移植物进行组织病理学观察,并进行组织学积分。结果:①模型鼠一般情况:实验期间NOD.scid小鼠无手摸皮骨感、活动度差、毛稀疏等典型移植物抗宿主疾病表现,模型鼠在SPF环境下10周存活率100%。②肿瘤坏死因子α含量:类风湿性关节炎滑膜组鼠血清中肿瘤坏死因子α放射含量类风湿性关节炎组明显高于骨关节炎组[(0.80±0.06),(0.70±0.03)μg/L,t=4.466,P<0.001]。③组织病理学观察:苏木精-伊红染色,骨关节炎滑膜组只见少量的滑膜细胞增生和炎症细胞,移植的滑膜组织主要被纤维组织形成的条索状物代替,无明显地软骨被侵蚀破坏发生;类风湿性关节炎滑膜组可明显见到大量的滑膜细胞增生和生化中心形成,病变部位的组织结构间质变为疏松,变为境界不清晰的颗粒状或块状无结构强嗜酸性红染物质;软骨边缘被滑膜组织侵蚀破坏明显;类风湿性关节炎滑膜组滑膜增生、软骨侵蚀和软骨降解积分均高于骨关节炎滑膜组(P<0.04)。结论:在NOD.scid体内可成功建立类风湿性关节炎动物模型。