Acute rupture of extensor pollicis longus tendon due to avulsed fracture of the second metacarpal base: a case report.

Acute tendon rupture of the extensor pollicis longus (EPL) is rare. We present acute EPL tendon rupture associated with avulsed fracture of the second metacarpal at the insertion of extensor carpi radialis longus. Tendon rupture of the EPL was repaired with end-to-end suture and avulsed fracture of the second metacarpal base was treated with open reduction and internal fixation.     

Spinal antinociceptive effects of adenosine compounds in mice

The effects of injecting ATP, ADP, AMP, adenosine and adenine intrathecally on the pain response induced by the injection of substance P (10 ng/mouse) intrathecally were studied. All the compounds except adenine inhibited the pain response in a dose-related manner. The ED50 values of ATP, ADP, AMP and adenosine were 2.10, 0.93, 0.88 and 0.48 micrograms/mouse, respectively. Pretreatment with theophylline at a dose of 100 mg/kg p.o. markedly diminished all the antinociceptive effects. The effect of adenosine was not affected by s.c. injection of naloxone. These results suggest the existence of adenosine receptors which modulate spinal nociceptive sensory processing, independently of the endogenous opiate system.     

Investigation of basic imaging properties in digital radiography. 8. Detection of simulated low-contrast objects in digital subtraction angiographic images

We investigated the effects of imaging and display conditions on the detectability of low-contrast objects in digital subtraction angiographic (DSA) images. The test images were produced by superimposition of low-contrast objects on a uniform noisy background obtained with a DSA system. We employed 18-alternative forced-choice (18-AFC) experiments and predictions based on statistical decision theory to study the dependence of the threshold contrasts of the test objects on the object size, incident x-ray exposure, display window width, and display medium. The results indicated that the threshold contrast decreased with increasing object size, and that the detectability of an object of a given size increased with increasing incident x-ray exposure and decreasing width of the display window. We found that the signal-to-noise ratio (SNR) obtained from the perceived statistical decision theory model, which includes the observer's internal noise, can accurately predict the detectability of low-contrast objects in DSA images. The threshold SNR corresponding to 50% correct detection in the 18-AFC experiments had a constant value of 3.8, in agreement with results reported previously for screen-film systems. The theoretical model will be useful for prediction of the performance of a DSA system based on its physical characteristics, and for evaluation of the tradeoff between patient exposure and diagnostic accuracy for a given DSA unit.     

Effect of feeding peptic digest of soy protein isolate on rat serum cholesterol

Growing rats were fed ad libitum soy protein isolate (SPI) or its peptic (SPI-P) or tryptic digest (SPI-T) for a month and their sera were examined for cholesterol and triglyceride levels and enzyme activities such as cholinesterase, glutamate-pyruvate transaminase (GPT) and alkaline phosphatase. The rats fed SPI-P or SPI-T were inferior in growth to those fed SPI. Similarly, the serum glyceride level was lower in the SPI-P and SPI-T groups than in the SPI group. On the other hand, a significant difference was found in the serum cholesterol level between the SPI-P and SPI or SPI-T groups but not between the SPI and SPI-T groups. A similar tendency was observed for serum GPT and alkaline phosphatase activities, although there were no significant differences among dietary groups in small intestinal enzyme activities. As for the atherogenic index being a risk factor inducing atherosclerosis, the order of its value was SPI-P less than SPI less than SPI-T.     

Time and cost involved in the care of newly registered patients with diabetes mellitus and other lifestyle diseases at diabetes clinics in Japan (JDDM 4).

AIMS: To study the time and cost involved in the care of newly registered outpatients with Type 2 diabetes mellitus (DM), compared with patients with hypertension and/or hyperlipidaemia (HTL). METHODS: A total of 313 patients with DM and 58 patients with HTL without diabetes were registered on their first visits to 11 diabetes clinics across Japan. The time and cost involved in their care was recorded over the following 5 months. RESULTS: In the first 3 months, there was an extensive time commitment to both groups. The time spent by physicians was 1.5 times longer for DM than for HTL. The total care time spent by all the care providers for DM was twice that for HTL. The cost of DM care was twice that for HTL, with the cost of medicines excluded. However, half of the cost for DM was for laboratory tests. When these were excluded, and the remaining cost divided by the time spent, the amount for DM was half of that for HTL. Over the 5 months, mean glycated haemoglobin (HbA(1c)) in DM patients improved from 8.0% to 6.5%, and 72% of DM patients achieved the glycaemic target of HbA(1c) < or = 6.5%. CONCLUSIONS: DM care in a diabetes clinic requires a great deal more time and resources than HTL to achieve the best outcome. An educational system for self care, presently lacking in the primary care setting in Japan, would improve glycaemic control for DM patients in the community.     

Osteochondritis dissecans of the humeral head.

A rare case of osteochondritis dissecans (OCD) occurring in the humeral head is presented. As there are only six available records in the literature concerning OCD in the humeral head, clinical features, treatment, and etiology of OCD involvement of this anatomical part remains unclear. These points are discussed on the basis of the previous cases and ours. Osteochondritis dissecans of the humeral head commonly affects middle-aged and young males rather than females. The prevalent location of involvement is the anterosuperior aspect of the humeral head. We propose that repetitive microtrauma is one of the important causes of OCD in the humeral head. Moreover, we suggest that the most authentic treatment for OCD with a partial detached osteochondral fragment is removal of this fragment and drilling.     

Coronary artery bypass in dextrocardia with situs inversus totalis--a case report

A 71-year-old woman was admitted to our hospital by ambulance, because of right chest pain and hypotension. Chest X-ray and standard 12-lead ECG showed mirror-image dextrocardia with situs inversus totalis. ECG with right-left reversal of all leads showed acute inferior myocardial infarction. The patient underwent coronary bypass surgery due to postinfarction angina, and she is now doing well 2 years following the operation. Mirror-image dextrocardia with situs inversus totalis is very unusual. But the patients are believed to have normal longevity, and presumably have an incidence of atherosclerotic coronary artery disease similar to the general population. To our knowledge, this is the first case of coronary bypass surgery on a patient with mirror-image dextrocardia in Japan.     

Visual perception--a hypothesis

Based on the results of after-image experiments, it can be concluded that the retinal perception of image position is linked to head position information, since this affects after-image positioning. Why actual perception of object position is not affected is hypothesised as a resetting of the retinal horizon, from information received on head position. Tilting of the after-image is thus explained as superimposition of the former image on a reset (tilted) horizon (axis).     

Digital radiography of subtle pulmonary abnormalities: an ROC study of the effect of pixel size on observer performance

Forty conventional radiographs with examples of mild interstitial infiltrates and subtle pneumothoraces and 40 normal studies of the chest were selected and digitized, with pixel sizes of 1.0, 0.5, 0.2, and 0.1 mm. Observer performance tests were carried out using receiver operating characteristic analysis. Conventional radiographs and digitized images were compared. The results indicate that, in such cases, diagnostic accuracy increases significantly as the pixel size is reduced, at least to the 0.1-mm level. We conclude that, for digital systems using screen-film or similar image receptors, use of a pixel size substantially larger than 0.1 mm may result in some loss of diagnostic accuracy.