The effect of fracture-related factors on the functional outcome at 1 year in distal radius fractures

Sixty-nine cases of distal radius fracture were studied retrospectively for various factors that might affect the functional outcome. Patients were treated with various techniques including plaster immobilization, external fixation, open reduction and internal fixation and percutaneous pinning. Functional assessment was made at 1 year after the injury. The most important factor affecting the functional outcome was radial length, followed by volar tilt. Carpal instability was an indicator of poor functional results. The relative movement of the lunate with respect to the distal radial articular surface, when defined as an effective radio lunate flexion of more than 25 degrees, was also associated with poor functional results.     

Immunoglobulin and T-cell receptor gene-gene rearrangement in pleural cavity-based T-cell rich B-cell lymphoma in an immunocompetent patient

Body cavity-based lymphomas are fluid-based lymphomas that are not associated with a tumor mass or adenopathy which could explain the origin of the lymphomatous effusion. A distinct lymphoma that grows in the body cavity as a lymphomatous effusion in the absence of a tumor mass has been identified as a primary effusion lymphoma. This almost exclusively occurs in patients with acquired immunodeficiency syndrome (AIDS), who invariably have a history of Kaposi sarcoma. We report a rare case of a recurrent pleural effusion in an immunocompetent patient. There was no evidence of lymphadenopathy or an associated mass on computerized tomography of the chest, abdomen and pelvis. Serology for HIV, HHS-8, EBV and HTLV-1 were negative. Cytologic examination of the pleural fluid showed an elevated white cell count with 97% lymphocytes, mostly with T-cell markers. Bone marrow aspirate and biopsy were negative and bronchoscopy was unrevealing. Pleural biopsy was significant for >70% T-lymphocytes and some large atypical cells. Which had CD19, CD20 and weak bcl-2 positivity. Kappa and lambda light chains did not show distinct clonality. A preliminary diagnosis of T-cell rich B-cell lymphoma (TCRBCL) of the pleural cavity was made. The diagnosis was confirmed with DNA studies done on the pleural biopsy specimen using PCR and southern blot. Dual rearrangement of Ig heavy chain region and TCR-beta genes were identified. The patient responded to combination chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisone. Our case is the first known case of pleural cavity-based TCRBCL and illustrates the role of gene rearrangement studies in such patients.     

Transmastoid superior semicircular canal occlusion.

OBJECTIVE: The traditional surgical repair for superior semicircular canal dehiscence (SSCD) involves either canal plugging or resurfacing via the middle cranial fossa approach. We describe a novel transmastoid occlusion technique. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients with symptomatic computed tomography-proven SSCD. INTERVENTION: Transmastoid superior semicircular canal occlusion using bone pate in 2 fenestrations, with 1 placed on either side of the dehiscence. MAIN OUTCOME MEASURES: Hearing and vestibular symptoms. RESULTS: Two patients were primary cases of SSCD, and a third patient had failed a previous middle fossa occlusion using fascia at an outside institution. In all 3 cases, the 2 sides of the superior semicircular canal adjacent to the dehiscence were occluded using bone pate, formed from a mix of bone dust and fibrin sealant. This allowed for a permanent bony partition to be achieved between the dehiscence and the remainder of the labyrinth. In all cases, hearing was either preserved or improved, and the procedure was successful in controlling vestibular symptoms. CONCLUSION: Transmastoid superior semicircular canal occlusion is a viable alternative to the customary middle fossa approach for superior canal dehiscence. Meticulous technique and the use of bone pate may help maximize auditory and vestibular results. Advantages of this technique include obviating a craniotomy, preclusion of temporal lobe retraction, familiarity of the approach for experienced otologists, and the ability to occlude the canal without manipulating the defect. The transmastoid approach for superior canal occlusion may not be possible when the dura is low hanging or when there is extensive cranial base dehiscence requiring reconstruction.     

High-dise standardization service of the IAEA

The mandate of the International Atomic Energy Agency (IAEA) includes assistance to Member States to establish nuclear technologies safely and effectively. In pursuit of this, the International Dose Assurance Service (IDAS) was initiated as a key element of the high-dose standardization program of the IAEA. The standardization of dosimetry for radiation processing provides justification for the regulatory approval of irradiated products and their unrestricted international trade. In recent times, the IAEA dosimetry laboratory has expended considerable effort in establishing a quality assurance program for its transfer dosimetry used for the IDAS.     

Suitability of LLC-PK1 pig kidney cells for the study of drug action on renal cell cholesterol uptake: identification and characterization of low-density lipoprotein receptors

INTRODUCTION: The purpose of this study was to identify and characterize the presence of low-density lipoprotein receptors (LDLr) in LLC-PK(1) cells. METHODS: LLC-PK(1) cells were assessed for the presence of LDLr by conducting dose-response, LDL specific binding and competitive studies with DiI-LDL, and Western blot and RT-polymerase chain reaction (PCR) analyses. Assay conditions with IgG-C7, a monoclonal antibody (mAb) to the LDLr, were optimized, including temperature, preincubation time, and concentration in LLC-PK(1) cells. RESULTS: LLC-PK(1) cells express LDL receptors as determined by LDL specific and competitive binding studies and Western blot and RT-PCR analysis (specific binding 0.5 ng DiI-LDL/mug of cellular protein). DISCUSSION: Taken together, these findings confirm the presence of LDL receptors on LLC-PK1 cells and support the appropriateness of using these cells in studies involving renal cell cholesterol uptake and metabolism.     

A systematic review of drug therapy to delay or prevent type 2 diabetes

OBJECTIVE: To systematically review the evidence for the prevention of type 2 diabetes by pharmacological therapies. RESEARCH DESIGN AND METHODS: Randomized controlled trials and cohort studies examining the effect of oral hypoglycemic agents, antiobesity agents, antihypertensive agents, statins, fibrates, and estrogen on the incidence of type 2 diabetes were identified from MEDLINE, EMBASE, the Cochrane Controlled Trials Registry, and searches of reference lists. Two reviewers independently assessed studies for inclusion and performed data extraction. RESULTS: Ten studies of oral hypoglycemic agents and 15 studies of nonoral hypoglycemic agents were found. Oral hypoglycemic agents and orlistat are the only drugs that have been studied in randomized controlled trials with diabetes incidence as the primary end point. In the largest studies of 2.5-4.0 years' duration, metformin (relative risk [RR] 0.69, 95% CI 0.57-0.83), acarbose (0.75, 0.63-0.90), troglitazone (0.45, 0.25-0.83), and orlistat (hazard ratio [HR] 0.63, 95% CI 0.46-0.86) have all been shown to decrease diabetes incidence compared with placebo; however, follow-up rates varied from 43 to 96%. Current evidence for statins, fibrates, antihypertensive agents, and estrogen is inconclusive. In addition, the critical question of whether drugs are preventing, or simply delaying, onset of diabetes remains unresolved. CONCLUSIONS: Currently, no single agent can be definitively recommended for diabetes prevention. Future studies should be designed with diabetes incidence as the primary outcome and should be of sufficient duration to differentiate between genuine diabetes prevention as opposed to simple delay or masking of this condition.