Distal, metaphyseal radius fractures. Results after open reduction, internal plate fixation and cortico-cancellous iliac bone grafting

Summary Conservative treated distal radius fractures with extended metaphyseal void and missing cortical support resulted in loss of reduction. From 1988 till 1994 117 fractures of the distal radius were treated by open reduction, filling the metaphyseal void with a cortico-cancellous iliac bone graft and plate fixation. In this retrospective study results after surgical reconstruction were evaluated radiologically and clinically and were discussed to conservative treatment. 30 patients suffering from extraarticular metaphyseal distal radius fracture were evaluated after a mean of 42 months (minimum 20, maximum 68 months) after surgery. Ulnar variance was restored in 70 % to the uninvolved side. Ulnar minus variance up to 2 mm persisted in 30 %. Radial joint angles were restored to normal in 53 %. In 40 % of the patients a loss of reduction up to 10 ° and in 7 % up to 25 ° occured. Active range of motion in the sagittal and frontal plane was equivalent to the non involved side in 30 %. 70 % of the patients showed reduced range of motion up to 20 %. Rotation was unlimited in 77 %, reduced up to 10 % in 23 %. Subjective results were excellent in 90 %, good in 10 %. Compared to conservative therapie, surgery showed superior results.      

Monitoring the biomechanical response of individual cells under compression: A new compression device

Skeletal muscle cells are sensitive to sustained compression, which can lead to the development of pressure sores. Although it is known that this type of tissue breakdown depends on the magnitude and duration of the applied load, the exact relationship between cell deformation and damage remains unclear. To gain more insight into this process, a method has been developed, that incorporates the use of a new loading device and confocal microscopy. The loading device is able to compress individual cells, either statically or dynamically, while measuring the resulting forces. Experiments can be performed under ideal environmental conditions, comparable with those of a CO₂ incubator. First compression experiments on C₂C₁₂ mouse myoblasts showed the shape changes that cells undergo during static compression by the loading device. Calculations using the three-dimensional confocal images showed no change in volume and an increase in the surface area of the cell as a result of compression. The device presented here provides a useful way to monitor the biomechanical response of skeletal muscle cells during long-term compression experiments. Therefore it will contribute to the knowledge about strain-induced cell damage, as seen in pressure sores and other mechanically induced clinical conditions.     

骨疏康治疗骨质疏松性脊椎压缩性骨折64例临床观察

目的 观察中药骨疏康在骨质疏松性脊椎压缩骨折治疗中的作用。方法 对94例临床诊断为骨质疏松性脊椎压缩骨折患者进行随机对照单盲研究。其中治疗组64例,服用骨疏康颗粒和钙制剂加维生素D;对照组30例服用钙制剂和维生素D治疗,持续6个月。治疗结束时进行疗效评价。疗效以腰背痛消失情况和躯体活动是否受限,以及下地活动时间、行走距离为判断指标。结果 治疗组64例中,显效51例(79.7％),有效11例(17.2％),无效2例(3.1％);对照组30例中,显效19例(63.3％),有效10例(33.3％),无效1例(3.3％)。经统计学处理,两组显效率差异显著(P<0.05),治疗组优于对照组。结论骨疏康可以有效治疗骨质疏松性脊椎压缩骨折引起的疼痛,加快骨折愈合。     

Visually lossless threshold determination for microcalcification detection in wavelet compressed mammograms

The aim of this study was to determine the visually lossless threshold of a wavelet-based compression algorithm in case of microcalcification cluster detection in mammography. The threshold was determined by means of observer performance using a set of digitized mammograms. In addition, the transfer characteristics of the compression algorithm were assessed by means of image-quality parameters using computer-generated test images. The observer performance study was based on rating performed by four independent radiologists, who reviewed 68 mammograms, from the Digital Database for Screening Mammography (DDSM), at six different compression ratios. Receiver operating characteristics (ROC) analysis was performed on observers' responses and the area under ROC curve (A_z) was calculated at each compression ratio for each observer. The parameters used for assessment of transfer characteristics of the compression algorithm were input/output response, noise, high-contrast response, and low-contrast-detail response. The computer-generated test image, used for this assessment, mimicked mammographic image characteristics (pixel size, pixel depth, and noise) as well as microcalcification characteristics (size and contrast). The ROC analysis for microcalcification cluster detection indicated a threshold at compression ratio 40:1, as Student's t-test shows statistically significant differences in A_z values (p<0.05) for compression ratios 70:1 and 100:1. Observers' grading of mammogram quality lowers this threshold at 25:1. Low-contrast-detail detectability in the transfer characteristics study indicate a threshold of 35:1, whereas non-perceptibility of image-quality-parameters degradation lowers this threshold to 30:1. The ROC and transfer characteristics analysis provided comparable thresholds, indicating the potential use of the latter in limiting the target range of compression ratios for subsequent observer studies.     

Cervical Myelopathy in C.P.P.D. Deposition Disease

Cervical Myelopathy is a rare manifestation of calcium pyrophosphate dihydrate (C.P.P.D.) deposition disease. A case is presented where radiographically non-calcified extradural masses containing C.P.P.D. crystals were present at the C7 level, producing cord compression and neurological symptoms. These masses are thought to represent para-articular deposits related to the adjacent facet joints.     

加压内固定取板术后骨结构的分析

本文报告自1992年开始用X射线源的双能骨密度仪测定10例加压内固定、骨折Ⅰ期愈合患者骨密度的变化,对加压钢板取出后骨结构的变化及应力遮挡效应作用进行分析、前臂骨折中,钢板固定超过18个月的患者,其钢板下骨密度与对照侧无明显差异。说明无明显骨萎缩发生。固定少于18个月的1例患者(13个月),其钢板下骨密度明显低于对照侧。结果表明,固定18个月后,钢板下的血循环已恢复正常。固定13个月的患者,其钢板下血循环尚未完全恢复,引起骨密度下降。说明加压内固定应在术后1.5—2年取板。     

颈脊膜脊髓受压的生物力学分析

本实验采用新鲜成年尸体完整脊柱７具，以小型压力传感器模拟颈椎外伤后颈脊膜脊髓受压，观察不同致压深度下颈脊膜脊髓的受压程度，并对脊髓受压状态下的应力分布和变化规律进行分析。结果表明。颈脊膜脊髓受压时脊髓承受复杂应力：受压产生的剪力在脊髓中央最大；压力主要局限于颈脊膜脊髓前部。椎板切除对来自脊髓前方的压迫无明显减压作用。     

Coprocessing via spray drying as a formulation platform to improve the compactability of various drugs

It was evaluated if coprocessing via spray drying can be used as a formulation platform to improve the compactability of formulations containing drug substance (acetaminophen, ibuprofen, cimetidine) and excipients (carbohydrates, disintegrant, glidant, surfactant). Experimental design was applied to optimise the drug concentration and solid content of the feed suspension. In addition, scaling-up of acetaminophen- and ibuprofen-containing formulations was performed on a production-scale spray dryer. Optimised acetaminophen (drug concentration: 70% w/w), ibuprofen (drug concentration: 75% w/w) and cimetidine (drug concentration: 70% w/w) powders were obtained via co-spray drying of aqueous suspensions with a high solid content of the feed (35% w/w) and the resulting powders were directly compressed. Scaling-up of optimised acetaminophen and ibuprofen formulations was performed successfully, resulting in a robust and reproducible manufacturing process. It can be concluded that a combination of mannitol, erythritol, Glucidex^® 9, Kollidon^® CL, colloidal silicon dioxide and polyoxyethylene 20 sorbitan monooleate allowed the spray drying of highly dosed drug substances (acetaminophen, ibuprofen, cimetidine) in order to obtain ‘ready-to-compress’ powder mixtures on lab-scale and production-scale equipment.     

Compression of the inferior vena cava with thrombus: a rare complication of solitary liver cyst

Because of the increase of ultrasonographic exams, nonparasitic cyst of the liver is frequently encountered. Some giant cysts have complications. The surgical treatment for complicated forms consists in resection of the protruding part. We report a case of a giant non parasitic cyst of the liver which was responsible of a compression of the inferior vena caval with thrombus. The resection of the thrombus was performed after a double control of the vena cava and a control of the aorta. The fenestration of the cyst was performed in a second time.     

经皮椎体后凸成形术治疗骨质疏松性椎体骨折效果分析

目的:探讨经皮椎体后凸成形术治疗骨质疏松性椎体骨折的临床效果。方法:对11例骨质疏松性椎体骨折患者共15个椎体,在C-型臂X线机透视下行经皮经椎弓根球囊扩张注入骨水泥椎体后凸成形术。对术前、术后1天和术后6月的椎体前缘高度、Cobb角和疼痛评分进行统计学分析。结果:本组11例患者15个椎体手术均取得成功,未出现神经损害、骨水泥外渗和肺栓塞等并发症。术后随访6～20个月,平均10.3个月,所有患者腰背痛症状均在术后基本缓解,椎体前缘高度、Cobb角较术前有显著改善。结论:采用经皮椎体后凸成形术治疗骨质疏松性椎体骨折操作简单、安全,可有效缓解疼痛。