Biomechanics of the Ilizarov fixator for fracture fixation.

Compression, distraction, and torsion stiffness of the Ilizarov external fixator was measured in two fracture models in autopsy specimens of tibia and fibula. A transverse model was tested in six frame constructions with the osteotomy site preloaded in four different positions. An oblique model was tested in four frame constructions also with four preloaded positions. Stiffness was more dependent on bone preload than wire number, wire type, or frame design. High stiffness was achieved by bone preloading, by compressing the rings together, by increasing the number of wires, and by using olive wires. The stiffness can be decreased (dynamization) by separating the rings and by removing wires. This data is helpful for frame design of the Ilizarov fixator.     

Antisocial personality disorder, HIV risk behavior and retention in methadone maintenance therapy

In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome.     

Atypical antipsychotics to treat the neuropsychiatric symptoms of dementia

Neuropsychiatric symptoms are common in older adults with dementia and can be associated with a rapid decline in cognitive and functional status. This article reviews the current literature supporting the use of atypical antipsychotic medications in this population. Among the currently available atypical antipsychotics, risperidone and olanzapine have been the most widely studied in double-blind, randomized, placebo-controlled clinical trials. Despite the common use of other atypical antipsychotic medications, their efficacy and safety in older adults with dementia has not been as extensively studied. Some controversy surrounds the use of atypical antipsychotic agents in older adults with the suggestion that they may increase the incidence of stroke or even death. Despite the potential for increased risk of harm from the use of these medications, atypical antipsychotics are often effective in treating troublesome neuropsychiatric symptoms refractory to other treatments. Whenever possible, these atypical antipsychotic drug treatments should be combined with non-pharmacological treatments to limit the need and dose of antipsychotic drugs and constant monitoring for potential harms should be maintained. The choice of which atypical antipsychotic agent can be guided by the nature and severity of the target symptom and the medication least likely to cause harm to the patient.     

胃癌组织中核基质蛋白的变化

目的：研究胃癌组织核基质蛋白的改变。方法：应用SDS－PAGE技术及Geneools定量分析软件，对22例胃癌组织及正常组织的核心基质蛋白进行了研究，结果：胃癌组织与正常组织比较，Mr为30000，28000的核基质蛋白表达量明显减少（P＜0．05），不同分化类型及不同临床分期胃癌组织间比较，此种核基质蛋白表达量差异无统计学意义（P＞0．05），结论：胃癌组织中核基质蛋白的改变可能在肿瘤的早期已经发生，是胃癌发生的早期分子事件。     

Slipped capital femoral epiphysis

Slippage of the capital femoral epiphysis typically presents as hip pain in a child. Radiographic examination demonstrates translocation of the upper femoral epiphysis away from its normal anatomic position on the neck of the femur. Slipped capital femoral epiphysis can result in permanent deformity if it is not promptly corrected. Closed pinning is the treatment for acute slips, but treatment options are complex when the condition is chronic.     

Pharmacokinetics of peptide T in patients with Acquired Immunodeficiency Syndrome (AIDS)

1. The pharmacokinetics of Dalal-peptide T-NH2 (peptide T) was determined during phase I clinical trials in patients with acquired immunodeficiecy disease (AIDS) and AIDS related complex (ARC). Drug levels were determined by specific RIA, and in some cases with HPLC analysis, after intraveneous (i.v.) or intranasal (i.n.), via metered sprayer, administration.

2. The plasma kinetics appeared to be bi-phasic with a first compartment half-life of 30 to 60 minutes and a second plasma clearence rate of 4 to 6 hours, observed for both routes of administration. Peptide T, in one individual was confirmed to be present at 6 hrs in plasma, determined after HPLC isolation followed by specific RIA.

3. Bioavailabilty, determined for a 2 mg test dose in six individuals was 9.3 ± 6.9 nmol/L. Peak plasma levels of 41 ± 30 nmol/L after 10 mg i.n., 2.8 ± 5.9 nmol/L after 2mg i.n., and 0.13 ± 0.07 nmol/L after 0.4 mg i.n. were observed. In two individuals tested, peptide T was detected in CSF at levels 20% of the corresponding plasma level 90 and 145 minutes post i.v. administration. Peptide T was not detected in urine. I.N. administration was well tolerated for times up to 21 months.     

Classification of injuries to the thoracolumbar spine

Significant advances have been made over the past 40 years in the understanding of the pathoanatomy, biomechanics, and neurophysiology of thoracolumbar injuries. These improvements are reflected in the sophisticated classifications currently in use. Yet, we remain in a transitional phase of our classification of these fractures. Future schemes will probably offer two precise classifications--one neurologic and one structural--for every injury.