Cast-brace treatment of ankle sprains

Forty-two severely sprained ankles treated by a cast-brace have been reviewed. This method was devised to avoid the disadvantages of immobilization. Diagnosis was based on the history and clinical signs. Strain films were taken in 31 patients but it is submitted that this investigation may be misleading unless general anaesthesia is used. The results of the treatment by cast-brace compare favourably with those by other methods and it is considered that patients were able to return to sport in a shorter time.     

Radiation dose reduction during hysterosalpingography: an application of scanning-beam digital radiography

Hysterosalpingography was performed in 31 patients by means of a low-dose scanning-beam digital radiographic system. The technique permits adequate evaluation of gynecologic abnormalities while allowing significant reduction in radiation: 2.4-mR (6.1 X 10(-7) C/kg) exposure to the skin and 0.7-mrad (7 X 10(-6) Gy) mean dose to the ovaries per image obtained. Sixteen patients demonstrated readily recognizable and documented abnormalities, corroborated by laparoscopy, laparotomy, or other supportive evidence.     

Influence of complement on sperm motility

Isolated sperm from normo-, oligo- and astheno-spermic men were incubated for 20 h in medium supplemented with 8% heat-inactivated or untreated human serum, and in medium with heated or untreated serum deficient in complement factor C3. Before and after incubation, sperm motility was assessed by means of a computer-assisted semen analyser. The results did not show significant differences between the motility of sperm incubated in heated or untreated serum. It is concluded that heating of homologous serum is not necessary for preserving sperm motility and in some cases may even be disadvantageous.     

Reduction of scrotalized skin improves the cosmetic appearance of feminising genitoplasty

A modified labioplasty to improve the cosmetic appearance after feminizing genitoplasty is described. Good results were obtained in all five patients in whom the technique was utilized.     

Testicular descent. III. The neonatal mouse gubernaculum shows rhythmic contraction in organ culture in response to calcitonin gene-related peptide.

The effects of calcitonin gene-related peptide (CGRP) and CGRP 8-37 on the neonatal mouse gubernaculum were examined in organ culture, with the aim of seeing whether CGRP has a direct effect on the gubernaculum. A total of 440 gubernacula were studied. Two hundred and fifty gubernacula were treated with CGRP in concentrations ranging from 0-714 nM/liter. With increasing doses of CGRP the percentage of gubernacula showing vigorous contraction increased from 18-50%. The total percentage of gubernacula showing any form of contraction increased from 76-96%. One hundred and fifty gubernacula were exposed to the CGRP analog CGRP 8-37. Increasing concentrations of CGRP 8-37 from 179-714 nM/liter decreased the rate of vigorous contraction from 18-4%. The percentage of gubernacula showing any degree of contraction decreased from 76-14%. Forty gubernacula removed from testicular feminization (TFM) mice were exposed to varying concentrations of CGRP. In the absence of exogenous CGRP no contractility was observed. By contrast, in the presence of CGRP the gubernacula showed vigorous contractility increasing from 38-90%. The total number of gubernacula showing contraction increased from 75-100%. These studies demonstrated that the neonatal mouse gubernaculum exhibits a high level of endogenous contractility, which can be enhanced in a dose responsive manner with exogenous CGRP. CGRP 8-37 caused a dose responsive inhibition. The androgen-insensitive gubernaculum from the TFM mouse showed no endogenous contraction, but on exposure to CGRP showed an enhanced rate of contractility. These results are consistent with the hypothesis that androgens may control gubernacular migration indirectly via release of CGRP from the genitofemoral nerve in the inguinoscrotal region. The failure of gubernacular motility in vitro and migration in vivo in the TFM mouse may indicate lack of CGRP release from the genitofemoral nerve.     

Decreased trabecular width and increased trabecular spacing contribute to bone loss with aging

Resistance to fracture depends not only on the total amount of trabecular bone but also on the size and distribution of the trabeculae. We used an image analysis computer to make direct measurements of trabecular width and separation in 33 normal subjects, aged 20 to 80 years. Multiple regression analysis showed that an increase in the distance between adjacent trabeculae accounted for 67.6% of the reduction in trabecular bone area in normal subjects with advancing age, with an additional 23.2% attributed to decreased trabecular width (P less than 0.001). The role of trabecular atrophy in the loss of bone with age was clearly established from the direct relationship between trabecular bone area and the independently measured trabecular width (r = 0.763, P less than 0.001). Effective treatment could increase trabecular bone by thickening the remaining trabeculae. It is, however, unlikely that treatment would replace trabeculae that have been removed or would restore biomechanical strength to the skeleton.     

Subcellular distribution of branched-chain aminotransferase activity in rat tissues

The activity of branched-chain aminotransferase in mitochondria isolated from rat tissues was examined, and the mitochondrial contribution to total tissue branched-chain aminotransferase activity was calculated using the mitochondrial marker enzyme citrate synthase. Mitochondrial aminotransferase activity was highest in heart followed by skeletal muscle, kidney and brain. In heart muscle all of the aminotransferase activity was accounted for by the mitochondrial fraction. Activity was found to be mitochondrial in skeletal muscle with high red fiber content and also in kidney cortex. Activity was predominantly cytosolic in brain and muscles with high white fiber composition. Thus, the distribution of branched-chain aminotransferase activity in skeletal muscle was dependent on fiber type. No branched-chain aminotransferase activity was detected in liver mitochondria, and in liver tissue activity was too low to be relevant at physiological concentrations of branched-chain amino acids. Within a tissue, regardless of the subcellular distribution of aminotransferase activity, the relative rates of transamination with subsaturating or "saturating" concentrations of KIV or isoleucine were similar. Finally, amino acid preference was also similar within a tissue, but not necessarily between or among different tissues.     

Image-directed percutaneous biopsies with a biopsy gun

Core tissue for histologic study is believed by many pathologists to be more diagnostic than material from needle aspiration. Recently, a biopsy "gun" has been introduced, which simplifies core biopsies. With this device, 182 biopsies of multiple anatomic sites were performed with ultrasonic, computed tomographic, and fluoroscopic guidance and 18-gauge needles. High-quality histopathologic specimens were obtained in 177 of the biopsies, and diagnostic target tissue was obtained in 167. Only three significant complications occurred: one bleeding complication that required transfusion and two cases of pneumothorax that necessitated placement of chest tubes. The biopsy gun eliminated the disjointed movements of conventional "skinny" needle biopsies, and none of the samples demonstrated significant "crush" artifact or obscuring blood, problems that are commonly associated with manual biopsy techniques. Patient discomfort was decreased with this system compared with that of manual biopsies, and the total procedure time was reduced. Because of these distinct advantages, the authors now use the biopsy gun exclusively for all percutaneous biopsies and recommend that other institutions consider the use of this biopsy method.