NATURE AND HEALING OF TIBIAL SHAFT FRACTURES IN ALCOHOL ABUSERS

Alcohol abuse is associated with an increased risk of osteopeniaand fractures. Previous histomorphometric studies on iliac crestbone have found decreased bone formation and increased boneresorption in alcohol abusers but it has not been establishedwhether alcohol abuse has any effect on the anatomical locationor the healing time of tibial shaft fractures. We studied, retrospectively,199 adult male patients hospitalized for isolated tibial shaftfracture in the city of Malmö, Sweden, between 1980 and1990. Forty-nine of the patients had earlier been registeredat the Department of Alcohol Diseases and were judged to beproblem drinkers. Abusers sustained their tibial shaft fracturesmore often by falling at ground level (P<0.0001) or froma higher level (P=0.009) and the fractures were more often obliquethan transverse (P=0.002) as compared with non-abusers. Healingtime was impaired in abusers who had sustained a transversefracture (P=0.035), but no difference was observed in healingtime in those with an oblique fracture. We found no differencebetween the abusers and the non-abusers regarding duration ofhospital stay, fracture location, amount of displacement, occurrenceof open fractures or the rate of complications.     

Vasotocin analogues which competitively inhibit vasopressin stimulated uterine activity in healthy women

Summary. Three analogues of posterior pituitary hormones, 1 - deamino - 2 - D - Tyr(OEt) - 4 - Val - 8 - Om - vasotocin(dE - VVT), l-deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-vasotocin(dE-TVT) and 1-deamino-2-D-Tyr(OEt)-oxytocin(dE-OXY) were compared for their inhibitory effects on vasopressin (VP)-induced uterine activity in healthy women. At menstruation, during recording of intrauterine pressure (18 recording sessions in 11 women), intravenous infusion of lysine vasopressin (LVP, 1 ng/min/kg/body weight) induced an increase of the uterine activity and dysmenorrhoea-like symptoms. Intravenous injections of all analogues (10 μg/kg body weight) caused relief of symptoms and inhibition of uterine activity, dE-TVT was the most effective and dE-OXY was least active. With dE-TVT almost complete inhibition of contractions was seen during the first 10 min after injection. The duration of effect was also greatest with that analogue (40–50 min). Only dE-OXY had an agonist effect on spontaneous uterine activity. Pharmacokinetic studies of intravenous dE-TVT (10 ng/kg body weight) showed that the plasma half-life was approximately 16 min and the clearance 30 1/h. The bioavailability of 100 ng/kg given intra-nasally was about 5·5%. Further studies are recommended.     

Inhibition of lactation by cyclofenil and bromocriptine

Summary. In a double blind controlled study of the inhibition of lactation 13 women received 300 mg of cyclofenil and 11 women 2.5 mg of bromocriptine twice daily for 14 days. Lactation was effectively inhibited by both drugs, but with bromocriptine there was a significantly higher frequency of relapse. The plasma concentration of prolactin, which decreased rapidly with bromocriptine, returned to the pretreatment level the day after drug treatment stopped, but with cyclofenil it remained low. Plasma oestradiol followed a similar pattern. Plasma FSH increased more rapidly with bromocriptine than with cyclofenil. There was no significant difference between the treatment groups at any stage for haematology, coagulation or liver function tests. The more sustained effect of cyclofenil on prolactin secretion with a reduced frequency of relapse, and the lower oestradiol level, which might indicate a reduced risk of thromboembolism, suggest that this drug has some advantage over bromocriptine in the inhibition of postpartum lactation.     

Axonal transport in transplanted frog sciatic nerve

Axonal transport was studied in transplanted frog sciatic nerves-dorsal ganglia for periods up to three months. The ganglia were either labeled prior to, or after varying periods of transplantation and the distribution of labeled proteins compared. The survival of the preparations was assessed by studying their ability to transmit compound action potentials, to maintain axonal transport and by their ultrastructural appearance. The sensory neurons retained their fast axonal transport and excitability during the transplantation periods. Morphologically about 30% of the axons appeared normal after one month of transplantation. The amount and distribution of protein incorporated radioactivity in the ganglia and the nerve changed with time but the decrease in the ganglia was not accompanied by a corresponding increase in the nerve. There was no evidence for a distinct slow phase of transport in spite of a functional fast transport system. The results indicate that either slow transport stops when the normal balance between release, degradation and recirculation is disturbed by the presence of a ligature or that there is a continuous change in the composition of transported material with time after labeling which is not reflected in altered transport characteristics.     

Fluctuations in male ischaemic heart disease mortality in Russia 1959–1998: Assessing the importance of alcohol

Introduction and Aims. The decline in cardiovascular mortality in Russia following the Soviet anti‐alcohol campaign of 1985–1988 and the subsequent increase when these extreme alcohol controls were repealed suggested that alcohol consumption is responsible for a substantial number of ischaemic heart disease (IHD) deaths in Russia. To examine whether a similar conclusion can be drawn on the basis of a time‐series analysis covering a longer time period, namely 1959–1998. Design and Methods. Using ARIMA time‐series analysis, the male IHD mortality rates from 1959 to 1998 were analysed in relation to three indicators of alcohol consumption: estimated per capita consumption, mortality from liver cirrhosis and alcohol poisonings. Cigarette sales and lung cancer mortality were used as indicators of smoking. Results. Each indicator of alcohol consumption had positive and statistically significant relationships with male IHD mortality in bivariate autoregressive integrated moving average models. The association was stronger in models predicting changes in premature male IHD mortality (30–54 years). At least one alcohol indicator was significantly related to IHD mortality in multivariate models, and in the case of premature IHD mortality, both mortality indicators were significant. Discussion and Conclusions. The results provide additional empirical evidence supporting alcohol's conceivable negative effects on IHD in Russia and the idea that binge drinking could be the mechanism through which this effect is mediated. There were no signs of any protective effects from alcohol among Russian men.[Ramstedt M. Fluctuations in male ischaemic heart disease mortality in Russia 1959–1998: Assessing the importance of alcohol. Drug Alcohol Rev 2009;28:390–395]     

A COMPARISON OF TWO TECHNIQUES TO REACH RELATIVES OF ALCOHOLICS FOR INFORMATION OF AVAILABLE SUPPORT

Two different information techniques to reach spouses and relativesof inpatient alcoholics for information of available support,one standardized and one individualized, were compared. Eachprocedure was tested during 6 months in the same ward. In thestandardized model 18% (20/112) and in the individualized model20% (21/104) of spouses/relatives/friends attended the informationsession. In those living with a spouse, the rates were 46% and41% respectively, and among those who were not cohabiting, buthad relatives or sober friends, the figures were 11% and 17%respectively. There were no sex differences. Among preferredsupport, individual support, marital and family support andprofessional group support received the highest ratings. Atthe 1 year follow-up, more subjects in the individualized informationgroup had received support compared with those in the standardizedgroup. The low rates of informed subjects are in agreement withthe literature and considerably lower than the rates in informationprogrammes for relatives of schizophrenic patients.     

Ontogeny of class II antigen expressing cells in rat incisor pulp

Abstract— Class II antigen expressing cells are generally associated with the early phase of the immune response. Dendritic cells and macrophages expressing these cell surface antigens have recently been demonstrated and characterized in the dental pulp. The present study was undertaken to determine when the pulp receives its immunologic defense potential by examining the temporal appearance of class II antigen expressing cells in the rat incisor pulp. Pulp tissue specimens obtained at various time periods from a gestational age of 16 days to 14 wk after birth were examined by immunohistochemistry using O x 6 as a primary antibody and the ABC-technique. Comparisons were made with tissue samples from the spleen, intestine, skin and oral mucosa. At birth, all tissues, except for the pulp, presented cells expressing class II antigen with a dendritic appearance in a number and orientation resembling the mature tissue. A complete distribution of these cells was not seen in the dental pulp until 7 weeks following birth. Data show that the dental pulp acquires its ultimate structural arrangement of immune cells later than other tissues.     

Regional cerebral blood flow during experimental phobic fear

Positron emission tomographic measurements of regional cerebral blood flow (rCBF) were used to investigate central nervous system correlates of fear and anxiety. Volunteers with symptomatic snake phobia were studied while exposed to visual phobogenic, aversive, and neutral stimuli. Anxiety ratings and the number of nonspecific electrodermal fluctuations increased as a function of phobic stimulation. Phobic, compared to neutral and aversive, stimulation elevated rCBF in the visual associative cortex. The basal ganglia were not activated more by phobic than aversive or neutral stimulation. However, cortical and thalamic rCBF were always correlated during phobic but not aversive or neutral stimulation. This indicates that the thalamus could be a relay station for phobic stimulus processing and affect.     

Coarctation of the Abdominal Aorta in Elderly Patients

ABSTRACT Coarctation of the abdominal aorta as a congenital disease is infrequent, the diagnosis mostly being made at an early age because of renovascular hypertension. Patients who reach the age of 40 more often tend to have the problems located distally to the renal arteries. A 66-year-old female is described, who developed an aortic occlusion, renovascular hypertension and uremia. She was cured with a bifurcation graft and a patch angioplasty of a stenotic renal artery and nephrectomy of the contralateral kidney with an occluded artery without refilling. A literature survey is made of patients older than 40 years.