Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases

Background

Intramedullary nailing is considered a “gold standard” for treatment of tibial shaft fractures. However, some types of fractures are typically considered as “difficult for nailing”. This group includes the periarticular fractures, fractures of both bones at the same level, comminuted and segmental fractures of the tibia. Fixator-assisted nailing (FAN) is an effective method treatment of these types of fractures. The main requirements for the ideal reduction device are an ease of its installation and an ability of multiplanar fracture reduction. Fixator-assisted nailing (FAN) with the use of two perpendicular to each other monolateral tubular frames perfectly meets these requirements. In this study we present this new surgical technique and the analysis of first 30 cases.

Solitary bronchioloalveolar carcinoma: CT criteria

The computed tomographic (CT) scans of 30 patients with solitary bronchioloalveolar carcinoma were reviewed. Common features at CT included the peripheral or subpleural location of a pulmonary mass (25 cases), pseudocavitation (18 cases), heterogeneous attenuation (17 cases), irregular margins forming a star pattern (22 cases), and pleural tags (21 cases). Using these CT criteria, four independent observers attempted to identify cases of bronchioloalveolar carcinoma from a larger sample of lung cancers and benign lesions by categorizing a series of test cases into four probability categories. Although the bronchioloalveolar carcinomas were correctly ranked in the two highest probability categories 75% of the time (in 45 of 60 cases), there was considerable overlap with other lung lesions, particularly with adenocarcinoma and large cell undifferentiated carcinoma. However, even though the typical features of bronchioloalveolar carcinoma are not invariable or highly specific, they are characteristic enough to suggest the diagnosis.     

Impact of clinical history on fracture detection with radiography

The effect of knowledge of localizing symptoms and signs in the detection of fractures was studied. Forty radiographs of the extremities were examined twice by seven radiologists; the sessions were separated by 4 months. In 26 cases, a subtle fracture was present; 14 cases were normal. In half of the cases at each session, the precise location of pain, tenderness, or swelling was provided. The observer was asked to determine if the case was normal or abnormal (provide the exact location of the fracture) and to indicate the degree of confidence in the diagnosis. Responses were converted to a numeric scale for analysis. Analysis of receiver operator characteristic parameters indicates that clues regarding location of trauma facilitate detection of fractures. The improvement is based largely on an increased true-positive rate without an increased false-positive rate, regardless of the decision criteria of the radiologist (overall willingness to "overread" or "underread"). This has direct clinical applicability and reinforces the plea of radiologists for precise clinical information.     

Angiomyolipoma of the kidneys

59 angiomyolipomas were studied: immunohistochemistry (IHC) was used in 24 cases, electron microscopy (EM) in 6 cases. 57 tumors had a typical structure, 2 did not contain fat component. Premelanosomes were found by EM in one tumor. Smooth muscle actin was found in all tumor cells. Involvement of lymph nodes was observed in 2 patients. Histogenesis of this tumor is discussed.     

Morphochemical characteristic of rat brain structures after exposure to delta-sleep inducing peptide following long-term amphetamine administration

The aim of this work, that was carried out using Wistar rats, was to characterize the response of neurons of different morphofunctional types to amphetamine administration and to study the possibility of correction of these changes by delta-sleep inducing peptide (DSIP). Single intraperitoneal injection of 60 microg/kg of DSIP following a long term amphetamine administration (2.5 mg/kg for 3 weeks) was shown to result in normalization of brain metabolism, that was disturbed by the drug. The correcting DSIP effect was found in rat brain structures judging by the parameters of the state of proteins in neurons of sensomotor cortex and caudate nucleus and by the activity of enzymes of neurotransmitter metabolism, such as type A and B monoamine oxidases and acetylcholine esterase, that was determined in subfractions of the same brain structures. DSIP modulating effect in phenamine stereotypy supports its role as an adaptogen of intercenter relations in CNS pathology.     

Morphology of the microencapsulated form of measles vaccine based on pH-dependent polymers

Morphology of microparticles of the microencapsulated measles vaccine was studied by cryofractography, transmission electronic microscopy and by atomic force microscopy; co-polymers of polyacrylic acid and of sodium-alginate (spermidine) complexes were used as the matrix. The different-composition microcapsules had clear-cut borders and a certain range of sizes; but they were different in morphology, and their structures and densities varied identically with regard for a medium acidity, which is apparently preconditioned by some conformation-type alterations of matrix molecules. The studied preparations can, probably, protect the viral material in the stomach aggressive medium and release the material to ensure its contact with the intestine lymph tissue; thereof, they can be referred to as promising for further study of mucosal vaccines.