Aesthetic total lower eyelid reconstruction

This article describes the reconstruction of the lower eyelid in two layers. Mucosa is provided by mobilizing the bulbar conjunctiva; the cutaneous layer is furnished by a laterally based myocutaneous flap from the ipsilateral upper lid. The tarsal plate is no longer taken into consideration. In 24–48 hours, the eyepad is removed and the patient can use the eye. The unaltered neurovascular supply to the flap provides good eyelid function and tone, and the aesthetic result is satisfactory.     

SCHMORL'S NODES

Histological examinations were conducted on specimens of 368 intervertebral discs (TU/12-L5/S1), using X-ray photography and discography. Specimens were obtained from 61 individuals (36 males and 25 females) whose ages ranged from 25 to 85 years. Fifty-four Schmol's nodes were found in 28 of the patients (19 males and 9 females), and in 43 discs. In the peripheral regions of Schmorl's nodes, where the vertebral bodies were In contact with the node, growth of cartilaginous cells was seen in many cases. Thickened bone trabeculae were also seen in three nodes accompanied by syncytia. These three nodes were detectable by X-ray photography of all discs containing Schmorl's nodes, and 35 were subjected to discography. Among these discs, 10 showed a limited form of shadow and 25 showed a diffuse form, and Schmorl's nodes were detected in 11 that showed a diffuse form of shadow. It was possible to detect Schmorl's nodes when they were contiguous with a degenerated annulus flbrosus adjoining the nuclear cavity. Pathogenetically, the presence of Schmorl's nodes in patients of middle and advanced age is interpreted to be one of the symptoms of age-related changes in the cartilaginous plate.     

慢性撞击对骨骺软骨板的影响

本文用自行设计的自控撞击装置,对幼兔前肢远端进行慢性损伤实验,建立囊外压力骨骺软骨板慢性损伤的动物病理模型,并报导了桡骨远端骺板慢性损伤的病理变化为增生、变性、萎缩,病变部位为生发层、增殖层、骨化沟和软骨膜环,发生机制为外力的反复撞击引起局部缺血、缺氧等。     

蒲黄等促纤溶活性的探讨

本文将10多种活血化瘀中药经脱脂、去杂质后的水提取液,用纤维蛋白平皿法研究发现,蒲黄水提取液及其复方失笑散有促纤溶作用,说明它能直接分解纤维蛋白,不依赖纤溶酶系的存在。实验性颈静脉血栓模型的家兔口服蒲黄水浸液后,24小时血栓溶解率显著增强。血浆纤维蛋白原和血浆纤溶酶原含量无明显变化;代表血液优球蛋白溶解时间的血纤溶活力在服药2～5h内却显著增强。     

Cytoplasmic modifications at the contact zone of osteoclasts and calcified tissue in the diaphyseal growing plate of foetal guinea-pig tibia

Longitudinal sections of foetal guinea-pig tibia prepared from decalcified and undecalcified samples were examined in the electron microscope. Osteoclasts in contact with calcified tissue in the growing plate of the diaphysis showed a modified oval-shaped cytoplasmic zone, situated at the brim of the cup-like depression containing the ruffled border, with dense material arranged either in parallel bands or in a loose network according to the section observed. This modified zone, interpreted as roughly ring-shaped around the edge of the resorption region, probably participates in the development of the ruffled border and thus contributes to the extension of the surface of active resorption.     

An animal model for the study of neuromuscular injury induced beneath and distal to a pneumatic tourniquet

A well-controlled animal model is presented for the study of neuromuscular injury induced by a pneumatic tourniquet. This model comprises a curved tourniquet surrounded by a stiff exterior shell, both of which were specifically designed to fit the conical and oblong shape of the rabbit hindlimb. Computed tomographic imaging was used to assess transverse tissue displacement induced by tourniquet compression. The curved tourniquet/shell configuration occluded the distal arterial blood flow to the extremity at a significantly lower cuff inflation pressure than a straight tourniquet of equal width. The magnitude and distribution of tissue pressures in the subcutaneous and deep tissues beneath the tourniquet were similar to those recorded in previous human cadaver studies of tourniquet compression. This animal model will facilitate the quantitation and analysis of tissue injury induced beneath and distal to a pneumatic tourniquet. Such data can help define the critical pressure and time limits for the safe use of pneumatic tourniquets in extremity surgery.     

Pharmacological characterization of recombinant N-type calcium channel (Cav2.2) mediated calcium mobilization using FLIPR

The N-type voltage-gated calcium channel (Ca(v)2.2) functions in neurons to regulate neurotransmitter release. It comprises a clinically relevant target for chronic pain. We have validated a calcium mobilization approach to assessing Ca(v)2.2 pharmacology in two stable Ca(v)2.2 cell lines: alpha1(B), alpha2delta, beta(3)-HEK-293 and alpha1(B), beta(3)-HEK-293. Ca(v)2.2 channels were opened by addition of KCl and Ca(2+) mobilization was measured by Fluo-4 fluorescence on a fluorescence imaging plate reader (FLIPR(96)). Ca(v)2.2 expression and biophysics were confirmed by patch-clamp electrophysiology (EP). Both cell lines responded to KCl with adequate signal-to-background. Signals from both cell lines were inhibited by omega-conotoxin (ctx)-MVIIa and omega-conotoxin (ctx)-GVIa with IC(50) values of 1.8 and 1nM, respectively, for the three-subunit stable, and 0.9 and 0.6nM, respectively, for the two-subunit stable. Other known Ca(v)2.2 blockers were characterized including cadmium, flunarizine, fluspirilene, and mibefradil. IC(50) values correlated with literature EP-derived values. Novel Ca(v)2.2 pharmacology was identified in classes of compounds with other primary pharmacological activities, including Na(+) channel inhibitors and antidepressants. Novel Na(+) channel compounds with high potency at Ca(v)2.2 were identified in the phenoxyphenyl pyridine, phenoxyphenyl pyrazole, and other classes. The highest potency at Ca(v)2.2 tricyclic antidepressant identified was desipramine.     

Pain sensitivity is altered in animals after subchronic ketamine treatment

Rationale Clinical observations have shown that pain sensitivity is altered in some schizophrenic patients.Objectives To study alterations in pain sensitivity, the ketamine model in schizophrenia research was employed.Materials and methods Rats were subchronically injected with the dissociative anaesthetic ketamine (Ket, ten injections of 30 mg/kg, one injection per day over a period of 10 days). Two weeks after treatment completion, the animals’ pain sensitivity was assayed in the hot plate test and they were subjected to electrical stimulation of the tail root. In addition, the effect of morphine was studied.Results In group-housed animals, there was no difference between Ket-injected animals and control rats as measured in both nociceptive tests. In singly housed Ket-injected rats, pain threshold was increased in the electrical stimulation test. This suggests that stress due to single housing might be essential for modifications of pain sensitivity. Moreover, the antinociceptive effect of morphine was modified after single housing. Interestingly, the effect of morphine on locomotor activity was similar in both groups. In group-housed rats, μ receptor binding was unchanged in the frontal cortex, whereas Ket-injected animals had decreased levels in the hippocampus. In singly housed animals, μ receptor binding in Ket-injected rats increased in the frontal cortex and decreased in the hippocampus. ³⁵S-GTPγ-S binding increased in the frontal cortex in both singly housed groups, but remained unchanged in the hippocampus.Conclusions The data suggest that the ketamine model might be useful for studying altered pain sensitivity in schizophrenia. Moreover, the data suggest that modifications in μ opioid receptor binding contribute to this phenomenon.     

Fractures involving the distal epiphyseal plate of the femur

Summary Forty-two fractures involving the distal femoral epiphyseal plate in 41 patients were reviewed. The average age at injury was 11.2 years. The follow up period ranged from one year to 20.3 years, with an average of 6.3 years. The Salter-Harris classification of epiphyseal plate injuries proved to be a good indicator of the mechanism of injury and prognosis. Using stringent criteria to classify the end results, 2 out of 3 of the total group and 3 out of 4 of 29 Salter-Harris Type 1 and Type II injuries had good or excellent results. Type V crushing injuries of the growth plate, open injuries, fractures caused by high velocity motor vehicle accidents with severe displacement or multiple associated fractures, and incompletely reduced epiphyseal injuries gave only poor or fair results. Major problems responsible for poor or fair results were varus or valgus angulation, loss of joint motion and shortening due to premature epiphyseal closure. Orthoradiographs revealed the presence of some degree of shortening in 20 of 29 Salter-Harris Type I and Type II injuries which averaged 1.0 cm, but was of no clinical significance in most patients. These injuries must be reduced accurately. In the Type II epiphyseal separations unsatisfactory results were due to inadequate reduction or to associated injuries.

---

Résumé Quarante-deux fractures, chez 41 malades, atteignant le cartilage épiphysaire de l'extrémité inférieure du fémur ont été colligées. L'âge moyen était de 11,2 ans. La période de surveillance a varié de 1 à 20,3 ans, avec une moyenne de 6,3 ans. La classification de Salter et Harris des lésions traumatiques du cartilage de conjugaison s'est avérée un bon indicateur du mécanisme et du pronostic. En utilisant, pour définir les résultats finaux, des critères rigoureux, on a trouvé que 2 patients sur 3 dans l'ensemble, et 3 sur 4 dans les 29 lésions des types I et II, avaient de bons ou d'excellents résultats. Le type V: écrasement du cartilage de conjugaison, les traumatismes ouverts, les fractures liées à des accidents de véhicules à grande vitesse, avec des déplacements importants ou chez les polytraumatisés, et les lésions épiphysaires incomplètement réduites, ont seuls donné des résultats médiocres ou mauvais. Les éléments principaux, facteurs de ces mauvais résultats, sont les désaxations en varus ou en valgus, la perte de la mobilité articulaire et le raccourcissement dû à une épiphysiodèse prématurée. Les orthoradiographies ont montré l'existence d'un certain degré de raccourcissement dans 20 des 29 types I et II, de l'ordre d'un cm, mais sans traduction clinique dans la majorité des cas. Ces lésions doivent être réduites avec précision. Dans le type II, les résultats insuffisants sont dus à une réduction incomplète ou à l'existence de traumatismes associés.

     

Juxtaepiphyseal aneurysmal bone cyst

Nine cases of aneurysmal bone cyst arising in juxtaepiphyseal locations with gross invasion of the adjacent growth plate are reported. In five of these patients an abnormality of growth, due to premature fusion of the affected growth plate, ultimately developed. Treatment of these lesions should attempt to avoid this complication, which appears to be more common than has been appeaciated in the past. These nine cases represent 23% of 39 cases of aneurysmal bone cyst occurring in a long bone adjacent to an open epiphyseal plate. This series was extrapolated from a total of 198 cases of aneurysmal bone cyst in the files of the Istituto Ortopedico Rizzoli, Bologna, Italy.