Phytotherapy of Benign Prostatic Hyperplasia. A Minireview

Benign prostate hyperplasia (BPH) is a common condition affecting older men, with an incidence that is age‐dependent. Histological BPH, which typically develops after the age of 40 years, ranges in prevalence from >50% at 60 years to as high as 90% by 85 years of age. Typical symptoms include increased frequency of urination, nocturia, urgency, hesitancy, and weak urine stream. Conventional medicines used for the treatment of BPH include alpha blockers and 5‐alpha reductase inhibitors. This articles review the mode of action, the efficacy, and the safety, including herb‐drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β‐Sitosterol) in controlling the lower urinary tract symptoms associated to BPH. Copyright © 2013 John Wiley & Sons, Ltd.     

Is a helical shaped implant a superior alternative to the Dynamic Hip Screw for unstable femoral neck fractures? A biomechanical investigation

Background

The Dynamic Hip Screw is well established for the treatment of femoral neck fractures. However, cut-out occurs in 1–6% of all cases. This study compared the biomechanical performance of a helical shaped implant (DHS-Blade) to the Dynamic Hip Screw in an unstable femoral neck fracture model.

Methods

Ten pairs of human cadaveric femora were either instrumented with a DHS-Blade or a Dynamic Hip Screw. Osteotomies were created using a custom-made saw-guide. Cyclic loading was performed by introducing in vivo measured load-trajectories to the femoral head. Starting at 1500 N, the load was stepwise increased until failure of the construct. Radiographs were taken in 5000 cycles increments to identify onset of femoral head migration with respect to the implant. A survival analysis was performed on the cycles to onset of migration. A paired t-test was carried out on the displacements of the femoral head relative to the shaft as determined by optical motion tracking.

Findings

One hundred percent migrations occurred for the Dynamic Hip Screw compared to 50% for the DHS-Blade. The survival probability in terms of implant anchorage was found higher for the blade (P = 0.023). However, significant higher deformation of the repair construct was observed for the DHS-Blade (P = 0.004).

Interpretation

The study showed superior implant anchorage of the DHS-Blade compared to the DHS, which might reduce the cut-out risk. Nevertheless, the blade allowed higher deformation of the femur mainly resulting in shortening of the neck, which might be due to a systematic loss of fracture reduction.     

Evaluation of motion correction effect and image quality with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique in the upper abdomen

PURPOSE: To evaluate motion correction effect and image quality in the upper abdomen with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique. MATERIALS AND METHODS: A total of 50 consecutive patients underwent abdominal MR imaging. Fat-saturated T2-weighted turbo spin-echo sequences were obtained by respiratory triggering. The subjects were examined with three different conditions of echo train length (ETL), blade width, and percent k-space coverage in the same scanning time: 19/30/100%, 30/30/100%, and 30/52/175%, which were designated as L/C(1), L/C(2), and L/C(3), respectively. The parallel imaging acquisition technique was used to either reduce ETL from 30 to 19 in L/C(1) or increase k-space coverage from 100% to 175% in L/C(3) compared with L/C(2). Motion and streak artifacts, and overall image quality were evaluated visually by two radiologists, independently. RESULTS: Motion and streak artifacts were mostly reduced in L/C(3) condition. The L/C(3) image also gave the best overall image quality compared with other conditions (P < 0.001). The inter-rater reliability for each evaluation agreed well. CONCLUSION: In upper abdominal BLADE MRI, it was possible to reduce image artifacts and obtain better image quality by increasing the k-space coverage with parallel imaging in the same scanning time.     

环锯加盖植骨法在后路腰椎椎间植骨融合中的应用

在腰椎手术术后稳定性的重建中,后路椎间植骨融合是一种较其它脊柱融合术更为理想的脊柱融合方法。然而目前常用的术式仍存在一些缺陷,如能自体取骨效果最好,但取骨增加了手术时间和手术并发症;异体骨移植和使用椎间融合器效果虽好,但增加医疗费用,同时异体骨移植还可能传播疾病。因此,我们尝试探求一种有效而且经济的手术方法——环锯加盖植骨法。     

Tumor growth potential after tumoral and instrumental contamination: an in-vivo comparative study of T-saw, Gigli saw, and scalpel

In the field of spinal tumors, intralesional tumor cutting is sometimes inevitable. The purpose of this study was to compare the potential for tumor growth after intralesional cutting by T-saw, Gigli saw, and scalpel. Tumors, prepared by the subcutaneous injection of human HT 1080 fibrosarcoma cells in nude mice, were harvested and cut with a T-saw, Gigli saw, or scalpel. A 3-cm wound was created in the skin on the back in another group of nude mice. The cut surface of the tumor was rubbed for 10 s against the subcutaneous tissue in this second group of nude mice. In the same manner, the instrument used for tumor cutting was rubbed against the subcutaneous tissue in the 3-cm wound in the back of a third group of nude mice for 10 s. Other instruments used for tumor cutting were immediately washed in culture medium, and the total number of tumor cells was counted. Tumor blocks and single-cell suspensions prepared from tumor tissues of the same weight were inoculated and injected into a fourth group of nude mice. The incidence of tumor growth after the rubbing of the subcutaneous tissue with the tumor surface cut with a T-saw, Gigli saw, and scalpel was 16.7%, 50.0%, and 33.3%, respectively. The corresponding figures after the rubbing of the subcutaneous tissue with a T-saw, Gigli saw, and scalpel was 16.7%, 33.3%, and 33.3%, respectively. The mean numbers of tumor cells attached to the T-saw, Gigli saw, and scalpel were 1.88 × 10⁵, 5.02 × 10⁵, and 4.92 × 10⁵, respectively. Finally, the incidence of tumor growth after the inoculation of tumor blocks and single-cell suspensions was 100% and 77.8%, respectively. These findings show that tumor recurrence is less likely after intralesional tumor cutting with a T-saw than after such cutting with a Gigli saw or scalpel. Received: January 25, 2001 / Accepted: April 16, 2001     

椎体钉重建脊柱前方稳定性的失误与预防

椎体间内固定钉（椎体钉）已广泛应用于脊柱前方固定术。为了总结椎体钉内固定术的经验，随访了２９８例患者。其中用于胸腰椎骨折前路固定术１８１例，胸腰椎结核６３例，胸腰椎椎体肿瘤４３例，腰椎滑脱５例，强直性脊柱炎伴驼背畸形２例，青春期骨骺炎驼背畸形２例，半椎体畸形１例，腰椎发育不良伴驼背畸形１例。总的治疗效果满意。但有一部分椎体钉植入的位置不理想。最常见的是椎体钉的一臂或两臂进入椎间盘或部分钉臂进入椎间盘，其次是椎体钉的位置倾斜或伴有轻度侧弯、椎体劈裂或椎体钉脱出的发生。详细分析了失误发生的原因，并提出了预防方法。     

人工骨折治疗掌指关节电锯劈裂伤

采用人工骨折法治疗掌指关节电锯劈裂伤4例，无明显并发症。术后患者不同程度地恢复了功能，掌指关节活动范围平均可达60°，效果满意。避免再次手术．减轻了患者的身体和经济上的负担。