Bone loss and forms of tibial condylar fracture

Summary Bone loss and fracture type were determined in 358 tibial condylar fractures. Degree of osteoporosis at the knee was defined by analogy to Singh's grades of osteoporosis at the hip and to Jhamaria's classification of osteoporosis at the calcaneum: grade V — normal; grade IV — slight reduction of trabecular bone; grade III — osteoporosis, predominantly of trabecular bone; grade II — osteoporosis of trabecular and cortical bone. Five fracture types were distinguished, with the component of trabecular bone compression increasing from a to e: a — pure split fractures; b — split fractures with displacement of a piece of the articular surface; c — split compression fractures; d — local compression fractures; e — compression of a whole condyle. There was a highly significant rank correlation between the two sets of ordered categories. Fractures in osteoporotics tended to involve the lateral condyle; this is explained by the fact that crush fractures occurred more frequently at the lateral condyle. The influence of bone loss on fracture type was demonstrated to be independent of age. A clear understanding of these associations concerning three variables at a time was reached by the use of log-linear-model analysis for cross-classified qualitative data.

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Zusammenfassung Bei 358 Frakturen der proximalen Tibia wurden der röntgenologisch erkennbare Knochenschwund und die Frakturform festgestellt. Entsprechend dem Singh-Index zur Bestimmung der Osteoporose am proximalen Femur und der Klassifikation der Trabekelstruktur am Fersenbein nach Jhamaria wurden folgende Osteoporosegrade am Knie definiert: Grad V — normal, Grad IV — Spongiosastruktur leicht vermindert, Grad III — Osteoporose betrifft vorwiegend die Spongiosa, Grad II —Osteoporose von Spongiosa und Kompakta. Fünf Frakturformen wurden unterschieden, wobei das Ausmaß der Spongiosakompression von a bis e ansteigt: a — reine Spaltfrakturen, b — Spaltfrakturen mit Abscherung eines Gelenkflächenteiles, c —Spaltkompressionsfrakturen, d — Frakturen mit lokaler Kompression, e — Frakturen mit Kompression eines ganzen Kondyls. Zwischen diesen beiden Merkmalen, deren Ausprägungen Rangklassen bilden, war eine hochsignifikante Rangkorrelation nachzuweisen. Brüche osteoporotischer Knochen betrafen vermehrt den lateralen Gelenksknorren, was dadurch statistisch zu erklären war, daß dieser sich für Kompressionsfrakturen als anfälliger erwies. Die Beziehung zwischen Osteoporose und Frakturform war nicht abhängig vom Lebensalter. Solche Zusammenhange zwischen je drei Variablen konnten übersichtlich dargestellt wurden, indem die Häufigkeitstabellen durch Log-lineare Modelle interpretiert wurden.

     

Adenocarcinoma of the lower esophagus. A disease primarily of white men with Barrett's esophagus

Sex and racial predilection, social history, and histology were analyzed in a biopsy-proven adenocarcinoma of the lower esophagus/esophagogastric junction collected over a 5-year period in two teaching institutions with different patient populations. Adenocarcinoma occurred in 11% of patients with biopsy-proven esophageal cancer. The disease occurred only in males at one center, and in a 7:1 ratio of males to females at the other center. Clear racial predilection was seen, since 12 of 13 patients with adenocarcinoma of the esophagus were white, whereas less than 20% of patients with squamous carcinoma of the esophagus were white. The finding of Barrett's epithelium in eight of the 13 cases strongly supports the theory that in white males, Barrett's epithelium is a precursor lesion of adenocarcinoma of the esophagus/esophagogastric junction.     

Trans fatty acids– Metabolic and nutritional significance

'Trans' fatty acids are unsaturated acids with special structural features that occur naturally in dietary fats from animal and plant sources and in fats processed by catalytic hydrogenation. They are readily metabolized by the human body. Thus, although when consumed in the diet they are incorporated into body fat (including depot and milk fats), they are subject to rapid 'turnover'. In physical properties, trans monounsaturatedfatty acids are intermediate between cis-monounsaturated and saturated acids, and they tend to be treated either as saturated or cis-monounsaturated acids in metabolic pathways. The author argues in this article that any adverse effects on health or metabolism that may have been observed can be ascribed to an imbalance between the intake of trans and essential fatty acids. Such imbalances, could also occur with non-essential fatty acids other than trans fats. Normally, the amounts eaten in average diets would not pose serious problems and only when products have excessively high trans contents and make a significant contribution to the diet need trans acids be highlighted on labels.     

Bovine cumulus-oocyte disconnection in vitro

Summary Cumulus-oocyte complexes were obtained from cows by aspiration of small (1–6 mm in diameter) antral follicles after slaughter. Complexes with a compact multilayered cumulus investment were cultured and processed for transmission electron microscopy after different periods of culture including a 0 h control group. In 0 h control oocytes the cumulus cells had numerous projections which penetrated the zona pellucida and established gap junctions with the oolemma. A partial loss of these junctions was noticed as an early event of oocyte maturation occurring within the first 3 h of culture. A low frequency of gap junctions was maintained until 12–18 h of culture where the junctional contact was completely disrupted. This decrease in intercellular communication was parallelled by resumption of oocyte meiosis.     

The expression of 3-fucosylated-N-acetyl lactosamine carbohydrate determinants in renal tumours

The distribution in renal tumours of 3-fucosyl-N-acetyl lactosamine has been studied by using the monoclonal antibodies AGF 4.36 and AGF 4.48 and immunoperoxidase methods on tissue sections. Seven of 19 nephroblastomas and 12 of 30 renal cell carcinomas contained the epitope. In nephroblastomas the epitope was found on the terminals of type B tubules in six cases and in one case on the type A or neoplastic tubules. In renal carcinoma the antigen was found on the surface of tumour cells. The results suggest that in kidneys bearing nephroblastomas ureteric bud elements may grow into the tumour from the adjacent kidney.