A comparison of fixation screws for the scaphoid during application of cyclical bending loads.

UNLABELLED: Matched pairs of scaphoids from cadavera were stressed with ramped intensity cyclical bending loads after osteotomy and fixation of one scaphoid with a Herbert screw and fixation of the other with an AO 3.5-millimeter cannulated screw, a Herbert-Whipple screw, an Acutrak cannulated screw, or a Universal Compression screw. The AO screw, Acutrak screw, and Herbert-Whipple screw demonstrated superior resistance to cyclical bending loads compared with the Herbert screw. The Universal Compression screw did not provide better fixation than the Herbert screw because of fractures that occurred at the time of insertion. The AO screw and the Herbert screw were then tested in a separate setup in which a segment of volar cortex had been removed in addition to the simple osteotomy. The loss of volar cortex greatly diminished the quality of the fixation provided by both of the screws during application of ramped intensity cyclical bending loads. CLINICAL RELEVANCE: A fixation device in the scaphoid must be able to withstand the stresses that are placed on the scaphoid as a result of its position spanning the proximal and distal carpal rows. Also, because of the prolonged time required for healing of fractures or non-unions of the scaphoid, the device must be able to withstand many such cycles of stress. The present study demonstrates that commonly used screws for fixation of the scaphoid vary significantly (p < 0.005) in their ability to resist cyclical bending loads.

Talocalcaneal coalition resection: a 10-year follow-up.

Eight patients (nine feet) who underwent resection of persistently symptomatic talocalcaneal middle-facet coalitions were reevaluated > or = 10 years after surgery. Satisfactory results persisted in eight of nine cases with no deterioration of symptom relief. There was no loss of motion or development of degenerative joint changes. No patient required a secondary surgery. It appears that resection of symptomatic talocalcaneal coalition provides satisfactory results in the majority of patients, and its benefits are maintained 10 years after the procedure.

Gypsy/Ty3-class retrotransposons integrated in the DNA of herring, tunicate, and echinoderms.

Eight new examples of retrotransposons of the Gypsy/Ty3 class have been identified in marine species. A 525-nt pol gene-coding region was amplified using degenerate primers from highly conserved regions and has extended the range of recognition of Gypsy/Ty3 far beyond those previously known. The following matrix shows the percentage AA divergence of the translations of this segment of the pol gene coding region. [table: see text] The underlines separate three groups of retrotransposons that can be recognized on the basis of this amino acid sequence. The new upper group shows surprising amino acid sequence similarity among members from the DNA of herring, sea urchin, starfish, and a tunicate. For example, the herring element differs by only 41% from the Ciona element and 46% from the sea urchin element. The group between the lines includes members close to previously known elements (marked by asterisks) and has so far been found only in sea urchins. The two upper groups differ from each other by 55-60% and yet members of both groups (e.g., Spr1 and Spr2) are integrated into the DNA of one species--S. purpuratus. Below the lower underline is listed the only known representative of a very distant group, which occurs in starfish DNA. In spite of large divergence, amino acid sequence comparisons indicate that all of the elements shown in the array are members of the LTR-containing class of retrotransposons that includes Gypsy of Drosophila and Ty3 of yeast. Of all known mobile elements this class shows the closest sequence similarity to retroviruses and has the same arrangement of genes as simpler retroviruses.

Ruptured teratoid tumor in the pineal region.

Distinctive plain X-ray and computer assisted tomography (CAT) findings led to the diagnosis in a case of teratoma in the pineal region and helped avoid invasive investigations. The demonstration by CAT of the location and size of the tumor as well as the presence of marked hydrocephalus directed the patient's therapy to ventriculoperitoneal shunting and radiation.