Orthopedic Implant Retrieval—Imperatives and Possibilities

Premature orthopedic implant failure occurs for a variety of reasons. In such scenarios implant retrieval is an issue that has a potential for further investigation leading to redesign of components and to improve implant longevity. While strict standards must be adhered to in order to gain FDA approval to use an implant, capturing, and recording the contributing factors leading to explantation and that of retrieved implant is neither strictly adhered to nor enforced. This article presents data illustrating implant standards both pre-market approval as well as in the retrieval scenarios. This paper provides a compilation of specific specifications on implant retrieval handling and storage, compelling imperatives and possibilities at national or global scale. The need for a user-definable, searchable interface is proposed in this paper to facilitate such an important task.     

Antineoplastic agents. 489. Isolation and structures of meliastatins 1-5 and related euphane triterpenes from the tree Melia dubia

The bark of the giant neem tree Melia dubia was found to contain 11 euphane-type triterpenes. Five new compounds, meliastatins 1-5 (1-5), proved to inhibit growth of the P388 lymphocytic leukemia cell line (ED(50) 1.7-5.6 microg/mL). Four of the others, the previously known methyl kulonate (8), kulinone (9), 16-hydroxybutyrospermol (10), and kulactone (11), were also found to inhibit (ED(50) 2.5-6.2 microg/mL) the P388 cancer cell line. In addition, two new euphane triterpenes were isolated and named dubione A (6) and dubione B (7). Structures for each of the 11 euphane triterpenes were established by spectral techniques that included HRMS and 2D NMR.     

Does ceramide play a role in neural cell apoptosis?

Ceramide is a lipid second messenger, that is generated in response to stimulation of the cell death pathways by a number of ligands binding to surface receptors, growth factor withdrawal, treatment with chemotherapeutic agents, or high doses of ionizing radiation or oxidizing agents. Depending on the target cell, ceramide induces diverse biological responses including apoptosis, cell-cycle arrest, differentiation, and also proliferation. In this review we consider the evidence for its role in apoptosis in cells of the nervous system.     

An atypical intronic deletion widens the spectrum of mutations in hereditary spastic paraplegia

OBJECTIVE: To identify the genetic mutation responsible for autosomal dominant spastic paraplegia (HSP) in a large family with a "pure" form of the disorder. BACKGROUND: The disease locus in most families with HSP is genetically linked to the SPG4 locus on chromosome 2p21-p22. Some of these families have mutations in the splice-site or coding regions of the spastin gene (SPAST). METHODS: Linkage and mutational analyses were used to identify the location and the nature of the genetic defect causing the disorder in a large family. After the disease phenotype was linked to the SPG4 locus, all 17 coding regions and flanking intronic sequences of SPAST were analyzed by single-strand conformation polymorphism analysis (SSCP) and compared between affected and normal individuals. Direct sequencing and subcloning methods were used to investigate incongruous mobility shifts. RESULTS:The genomic sequence of SPAST showed a heterozygous four--base pair deletion (delTAAT) near the 3' splice-site of exon three in all 11 affected individuals but not in 21 normal family members or in 50 unrelated controls (100 chromosomes). CONCLUSIONS: This study identifies an atypical intronic microdeletion in SPAST that causes HSP and widens the spectrum of genetic abnormalities that cause the disorder.     

Cocaine use in pregnancy in Amsterdam

To study the effects of cocaine use in pregnancy in Amsterdam, clinical data on cocaine-using pregnant women ( n = 21) and their offspring ( n = 23) were obtained retrospectively (1987–1994) at the Academic Medical Center, Amsterdam. Infants exposed to cocaine had a median gestational age of 39 weeks and a median birth weight of 3090 g. There were six preterm infants, two small-for-gestational-age infants and five infants with a small head circumference. Three infants had a congenital malformation. One infant (Potter's syndrome) died shortly before birth. One infant had congenital syphilis, four had intracerebral abnormalities on ultrasound and four had abnormal neurologic symptoms in the neonatal period. One infant died after 21 days of life. At follow-up four infants showed abnormal development. In 12 of the 23 infants (52%), one or more possible effects of cocaine were found.     

Asymptomatic bacteriuria in infants and children

Summary Screening for asymptomatic bacteriuria was done no 264 neonates, infants and children by an examination of the wet urine sediment for pyuria, Gram’s staining of the urine smear for organisms, and urine culture. Bacteriologically 8 urines were positive for asymptomatic bacteriuria (3.3%). In these 8 cases pyuria of more than 5 leukocytes was also present and Gram’s staining of the urine smear showed more than 3 organisms per field. Pyuria was seen in 3 other cases who were bacteriologically cally negative. It is stressed that asymptomatic bacteriuria may be searched for in the pediatric age period at every visit to the doctor for a routine check up, by a simple test which could be easily done in the doctor’s clinic by a trained technical person. For this an examination of the urine sediment for pyuria is a reliable test. Culture of the urine may be limited only to these cases to demonstrate the type of organism and its response to currently used antibiotics for effective treatment. From the Department of Pathology and Bacteriology, G.S.V.M. Medical College, Kanpur.