双氢埃托啡的燐光测定法及其应用

用药物—染料生成复合物的原理,建立了双氢埃托啡的燐光分析法?椒槊?可检测2ng。适用于动物血药、脑药分析。兔im0.1,0.2,1mg/kg双氢埃托啡后1与5min。血药,脑药与剂量成比例关系,其回归方程为:血药:Y=100.6X+17.73(1min), Y=367.8X+4.34(5min); 脑药:Y=5363 X+275.4(1 min),Y=6084 X+1022(5 min) 式中Y=药物浓度(ng/ml血或ng/g脑),X=双氢埃托啡剂量(mg/kg)。     

The Dana total shoulder arthroplasty

Fifty-six Dana unconstrained total shoulder arthroplasties in forty-seven patients were followed for a minimum of two years. The preoperative diagnoses included osteoarthritis, rheumatoid arthritis, traumatic arthritis, avascular necrosis, failed hemiarthroplasty, and failed total shoulder arthroplasty of another design. For all of the patients, the average rating for pain improved from 3 points preoperatively to 8 points postoperatively, and the average rating for function improved from 3 to 7 points. The ranges of abduction and of external rotation improved substantially in the shoulders that were affected by osteoarthritis, rheumatoid arthritis, or osteonecrosis. Ten patients were treated with a hooded glenoid component, designed to improve stability in shoulders in which the rotator cuff is deficient. In these shoulders, both the rating for pain and the rating for function improved, although the range of motion did not. Complications that required revision of the arthroplasty developed in five shoulders in which a regular component had been implanted and in two that had a hooded glenoid component. A radiolucent line developed at the bone-cement interface of the glenoid component in fifty-three shoulders, but only two revisions were done for loosening of the glenoid component.     

Treatment of primary osteoarthritis of the hip. A comparison of total joint and surface replacement arthroplasty

Of 285 total hip arthroplasties (260 patients) performed for primary osteoarthritis during a six-year period, 135 were resurfaced using a Tharies prosthesis (total hip articular replacement with internal eccentric shells) and 150 were treated with the Trapezoidal-28 total hip replacement. From each of these two groups 100 hips (ninety-one patients in the Tharies group and eighty-six in the Trapezoidal-28 group) that had been followed for two to seven years were evaluated at the time of follow-up in accordance with a predetermined protocol. The patients were younger in the Tharies than in the Trapezoidal-28 group (average ages, fifty-eight and sixty-six years), included more men (sixty compared with thirty-five), and were more active postoperatively. The average follow-up was forty-seven months for the total joint-replacement group and thirty-eight months for the surface replacement group. At follow-up the ratings for pain, walking, and function according to the University of California at Los Angeles 10-point scale and the clinical results were identical in the two groups. Heterotopic ossification (Brooker grade III or IV) developed after thirteen Trapezoidal-28 and twenty-two Tharies arthroplasties. Radiographs made at six and twelve months and at final follow-up showed that the incidence of radiolucencies about the acetabular component was higher in the resurfacing group: fifty-seven with complete radiolucent lines after an average follow-up of thirty-eight months compared with thirty-six with complete lines after an average follow-up of forty-seven months. There were three failures in the joint-replacement group: a hematogenous staphylococcal deep infection that required a Girdlestone procedure, a femoral stem fracture that required revision, and loosening of an acetabular component for which revision was performed. There was also one dislocation, successfully treated by closed reduction. Similarly, in the resurfacing group there were three failures: two loose acetabular components, revised successfully, and one loose femoral component that necessitated total joint arthroplasty. Multivariate stepwise regression analysis showed that the factors that affected the final extent and width of the acetabular radiolucencies adversely after resurfacing were: any radiolucent lines that were visible at six months, a high level of physical activity after arthroplasty, and a thin superior cement mantle.(ABSTRACT TRUNCATED AT 400 WORDS)     

Tibiotalar contact and fibular malunion in ankle fractures. A cadaver study.

Six cadaveric ankles were dissected, preserving medial and lateral ligaments; an axial load of 455N was applied to the tibia supported by the foot and ankle. The unconstrained tibia was moved through 20 degrees of flexion and extension to simulate walking. The tibiotalar contact area was defined using carbon black suspension, recorded photographically, and measured using computerized area analysis. Osteotomy of the distal fibula was performed and fixed with a specially modified plate; a selection of plates provided fixation with 0 degrees or 30 degrees of external rotation in combination with 0 or 2 mm of shortening. The contact area was measured for each of the plates and after division of the deltoid ligament. There were greater than 30 percent decreases in tibiotalar contact with both fibular shortening and external rotation, doubled with a divided deltoid ligament. Anatomic restoration of both fibular length and rotation is essential for normal ankle mechanics. The deltoid ligament has crucial effects on the stability of the ankle mortise.