Removal of a broken guide wire entrapped in a fractured femoral neck

Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS).Breakage of a guide wire during operation is a very rare condition.We met such a dilemma in DHS ...     

Long-term consequences of anorexia nervosa

Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed.     

Developmental Differences Between Cranial Bones in the Zebrafish ( Danio rerio ): Some Preliminary Light and TEM Observations

To test whether cartilage bones and dermal bones, which belong to two different units of the vertebrate skeleton, have distinct developmental programs possibly reflected in a different molecular control of their ossification process, we currently investigate the development of some selected cranial bones in the zebrafish, Danio rerio. Here we present some light microscopical and ultrastructural findings with respect to the maxillary bone (a dermal bone that is edentulous in the zebrafish) and the basioccipital bone (a cartilage bone, i.e., with a perichondral phase followed by endochondral invasion). The two bones differ in (a) the area where matrix is first deposited--an unstructured extracellular domain in the former versus intermingling of bone matrix elements with cartilage matrix in the latter--and (b) the progression of ossification--continuously from an initium in the former versus through fusion of separate anlagen in the latter. These findings seem to support the hypothesis that the two types of bone have at least some distinctive features in their developmental programs.     

氟中毒大鼠骨组织细胞核转录因子-kB相关基因mRNA和蛋白表达改变

目的 探讨氟对骨组织中细胞核转录因子-kB(NF-kB)相关基因mRNA和蛋白表达的影响.方法 健康SD大鼠36只,体质量100 ～ 120 g,按体质量随机分为3组,每组12只.对照组饮用自来水(含氟量＜1 ag/L),低氟组和高氟组分别饮用含5、50 mg/L氟化钠的自来水.大鼠饲养8个月,建立慢性氟中毒模型,股动脉放血处死.取大鼠股骨干骺端,光镜观察骨组织形态学改变;采用灰化-氟离子选择电极法检测骨氟;采用酶联免疫吸附法检测血清抗酒石酸酸性磷酸酶5b(TRACP 5b)水平;采用Real-time PCR和免疫组织化学方法检测骨组织中p50、p65、ⅠkBα mRNA和蛋白表达水平.结果 染氟大鼠股骨干骺端呈骨质硬化表现.低氟组、高氟组骨氟[(6.32±1.23)、(10.89±1.56)mg/kg]显著高于对照组[(3.06±1.01 )mg/kg,P均＜0.05],且高氟组显著高于低氟组(P＜0.05).低氟组血清TRACP 5b水平[(3.45±1.85)U/L]显著高于对照组[(1.26±0.23)U/L,P＜0.05],高氟组[(2.74±1.85)U/L]较低氟组降低(P＜0.05).低氟组p50、ⅠkBα mRNA表达水平(4.41±0.44、1.15±0.25)显著高于对照组(1.46±0.10、0.26±0.07,P均＜0.05),高氟组(0.69±0.09、0.14±0.03)较低氟组降低(P均＜0.05).低氟组p50、ⅠkBα蛋白表达水平(152.96±7.87、156.20±9.75)显著高于对照组(125.63±9.85、118.97±6.94,P均＜0.05),高氟组(120.56±9.57、114.50±7.61)较低氟组降低(P均＜ 0.05).结论 氟可致NF-kB通路相关基因表达改变,后者可能参与氟致骨骼损伤的发生机制.     

Sonography of acute osteomyelitis in rabbits with pathologic correlation

RATIONALE AND OBJECTIVES: Ultrasonography (US) has a potential role in the diagnosis of osteomyelitis. The purpose of this study was to determine the characteristic sonographic features of acute osteomyelitis and correlate them with pathologic findings. MATERIALS AND METHODS: An experimental model of acute osteomyelitis was produced in the tibiae of 20 rabbits. Daily US and plain radiography were performed for 2 weeks. The authors evaluated periosteal reaction, subperiosteal fluid collection, and soft-tissue changes seen with US. A hypoechoic band and a hyperechoic line lying along the cortex were considered positive signs of subperiosteal fluid collection and periosteal reaction, respectively. The findings of periosteal reaction were compared for US and radiography, and pathologic findings were also correlated. RESULTS: The most common sonographic finding was a hypoechoic band along the cortex (21 [75%] of 28 tibiae), usually associated with a linear periosteal reaction (20 [71%] of 28). This juxtacortical abnormal echogenicity corresponded to periosteal elevation with loose fibrovascular connective tissue and granulation, associated with subperiosteal abscess formation. The periosteal reactions were detected with US before they were seen on radiographs. The periosteum showed gradual thickening during the disease process. In 50% of infected tibiae, inflammation or abscess formation was observed in the surrounding soft tissue. CONCLUSION: US readily demonstrates juxtacortical abnormal echogenicity and soft-tissue infection related to acute osteomyelitis. The abnormal echogenicity correlated well with the pathologic findings of periosteal reaction and subperiosteal abscess.     

MEBO治疗骨外露创面临床疗效观察

目的观察、总结湿润烧伤膏(MEBO)治疗骨外露创面的临床疗效,探寻骨外露创面的有效治疗方法。方法60例骨外露患者创面清创后,全部采用MEBO治疗,观察治疗效果。结果骨外露创面自行愈合,新生皮肤肤色接近正常,无瘢痕挛缩,无关节强直,无感染加重及骨髓炎等并发症的发生。结论 MEBO可减轻创面感染,减少瘢痕形成,预防并发症发生,是治疗骨外露创面的有效药物。     

Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings

Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease. Computed tomography showed a calcified rim of the lesion which may be a useful feature to rule out osteosarcoma in this condition. Received 7 August 1997; Revision received 17 November 1997; Accepted 24 December 1997