Elemental analysis of femoral bone from patients with fractured neck of femur or osteoarthrosis.

The elemental composition of bone has been determined by inductively coupled atomic emission and mass spectrometry to test the hypothesis that changes in major or minor elemental concentrations may contribute to the risk of fracture. Femoral bone was obtained from patients at operation for the treatment of fracture and compared with that of patients with osteoarthrosis and a necropsy control group. The data suggest that there are no major differences in bone elemental composition in patients with fractures compared with the control group.

Serial changes in serum vitamin K1, triglyceride, cholesterol, osteocalcin and 25-hydroxyvitamin D3 in patients after hip replacement for fractured neck of femur or osteoarthritis.

Serum vitamin K1 concentrations were measured at presentation (just before surgery) and then at weekly intervals for 3 weeks in two groups of elderly patients requiring either hemiarthroplasty for fractured neck of femur (FON, n = 13) or total hip replacement for osteoarthritis of the hip (OA, n = 16). In comparison with healthy elderly volunteers (n = 25), serum vitamin K1 concentrations were significantly lower in both groups at presentation, and fell significantly within 24 h after surgery to concentrations approaching non-detectable, subsequently returning to pre-operative values within 3 weeks. Serum vitamin K1 tended to be lower in the fracture group both before and after operation, although calculation of a vitamin K1-triglyceride ratio reduced the apparent difference as triglyceride concentrations were lower in the fracture group.

Mode of inhibition of rat liver tryptophan 2,3-dioxygenase by melatonin.

Liver tryptophan 2,3-dioxygenase is a cytosolic enzyme that plays a crucial role in the regulation of circulating levels of tryptophan. Stimulation of the activity of this enzyme by heme enhances the catabolism of tryptophan, making less tryptophan available for uptake into the brain. Melatonin, the major hormone of the pineal gland, is shown to cause competitive inhibition of this enzyme (Ki = 2.

Controlled trial of an ankle support (Malleotrain) in acute ankle injuries.

A randomized, controlled parallel-group trial has assessed 14 days' use of a new ankle support (Malleotrain, Bauerfeind, Aldershot, UK) in 220 patients (118 Malleotrain, 102 control group) with acute ankle injuries. Self-assessed pain levels were significantly lower in the group using Malleotrain at the end of the trial (P less than 0.05), as were median times taken for reduction of symptom scores to 10% (P less than 0.

Controlled trial of a back support ('Lumbotrain') in patients with non-specific low back pain.

A randomized, controlled, parallel-group clinical trial was carried out in general practice to assess the clinical efficacy of a new back support ('Lumbotrain') compared with 'standard therapy' of advice on rest and lifestyle in the treatment of patients with non-specific low back pain. A total of 216 patients entered this study (111 'Lumbotrain' group, 105 control group). All patients were allowed to take 1 g paracetamol up to 4-times daily if necessary for control of pain.

Tibia recurvatum as a complication of Osgood-Schlatter's disease: a report of two cases.

Premature fusion of the anterior part of the upper tibial epiphyseal plate is a rare complication of Osgood-Schlatter's disease. The resulting deformity is both unsightly and difficult to treat. We report two further cases and highlight the need for regular screening for this rare complication of a common disease.

Acute meningococcal infection--a case of monoarthrosis.

A case of septic arthritis in the right knee of a six-month-old girl is described. Neisseria meningitidis was grown from the purulent exudate from the knee joint. No other manifestations of meningococcal disease were observed.

Contralateral percutaneous adductor tenotomy. An aid to peroperative fluoroscopy in hip fracture fixation.

In 6 elderly patients with femoral neck fractures, contralateral hip disease made lateral fluoroscopy difficult. Percutaneous adductor tenotomy of the contralateral hip facilitated screening of guide-wire placement during the fixation of the fracture.

Low blood manganese levels in Liverpool children with Perthes' disease.

The aetiology of Perthes' disease of the hip, avascular necrosis of the head of the femur, is unknown. Children with the disease have a generalised abnormality of growth. A similar disproportionate growth is found in chicks given a diet deficient in manganese.

Etiology of Freiberg's disease: ? trauma.

Freiberg's disease is osteochondritis of the metatarsal head(s) commonly occurring in adolescent girls. The true etiology is unknown. The authors present a case precipitated by a form of folk dancing popular among British schoolgirls.

Galeazzi fractures in children.

We have reviewed 41 children under 15 years of age with a fracture of the radius and disruption of the inferior radio-ulnar joint. Despite the fact that the joint injury had not at first been recognised in 41% of cases and a variety of treatments had been used, the final results of conservative management were generally good. The more distal the radial fracture, the greater were the problems encountered.

Is laparotomy for small bowel obstruction justified in patients with previously treated malignancy?

We report 53 patients who developed small bowel obstruction some time after the treatment of a primary malignant tumour. Previous treatment of the primary tumour in these patients had been by abdominal surgery (22 patients) or pelvic radiotherapy (20 patients) but 11 of the patients had not received previous abdominal surgery or radiotherapy. All the patients had a laparotomy in an attempt to relieve the obstruction.