Effect of interfragmentary gap on compression force in a headless compression screw used for scaphoid fixation.

We investigated the effect of an interfragmentary gap on the final compression force using the Acutrak 2 Mini headless compression screw (length 26 mm) (Acumed, Hillsboro, OR, USA). Two blocks of solid rigid polyurethane foam in a custom jig were separated by spacers of varying thickness (1.0, 1.5, 2.0 and 2.5 mm) to simulate an interfragmentary gap. The spacers were removed before full insertion of the screw and the compression force was measured when the screw was buried 2 mm below the surface of the upper block. Gaps of 1.5 mm and 2.0 mm resulted in significantly decreased compression forces, whereas there was no significant decrease in compression force with a gap of 1 mm. An interfragmentary gap of 2.5 mm did not result in any contact between blocks. We conclude that an increased interfragmentary gap leads to decreased compression force with this screw, which may have implications on fracture healing.

Tec kinase stimulates cell survival in transfected Hek293T cells and is regulated by the anti-apoptotic growth factor IGF-I in human neutrophils.

OBJECTIVE: Previously, we showed that the phosphatidylinositol-3 kinase (PI(3)K) pathway mediates the anti-apoptotic effects of IGF-I in human neutrophils independently of its down-stream target Akt. In this study, we investigated whether IGF-I regulates Tec kinase, an alternative down-stream target of PI(3)K, in neutrophils and whether this molecule is able to affect apoptosis. DESIGN: We investigated the translocation of Tec kinases in neutrophils after stimulation with IGF-I. Furthermore, we transiently and stably transfected Hek293T cells with constructs expressing different forms of Tec kinase and measured the level of cell survival and apoptosis/necrosis through trypan blue exclusion test and Annexin-V/propidium iodide labelling, respectively. RESULTS: We show that IGF-I stimulates the translocation of Tec kinase to the membrane in neutrophils in a PI(3)K dependent matter. Overexpression of Tec kinase augments cell survival by inhibition of necrosis. The pro-survival effect is attenuated by the deletion of the kinase domain but not by inactivation of this domain by a single amino acid substitution. CONCLUSION: Tec kinase can act as a prosurvival factor and is regulated by IGF-I in human neutrophils through PI(3)K activation.

Integration of hepatitis B immunization in the Expanded Program on Immunization of the Child Survival Project.

The Expanded Program on Immunization (EPI) is a component of the Child Survival Project (CSP) whose objectives are to reduce the incidence rates of six childhood diseases (Measles, Diphtheria, Pertussis, Tetanus, Tuberculosis, Poliomyelitis) and to reduce the number of infant deaths from those diseases by increasing effective vaccination coverage. In 1991, the CSP/EPI developed a national plan to introduce national immunization of infants against hepatitis B in an attempt to control the magnitude and seriousness of the damage which viral hepatitis causes in terms of morbidity, mortality and serious sequelae as hepatitis B is an endemic disease in Egypt causing an important public health problem which requires urgent control. This presentation will discuss the integrated effort undertaken to plan and implement the program, the different challenges it faces, control studies being performed as well as the proposed objectives of the hepatitis B vaccination program.

PIP: The Expanded Program on Immunization (EPI) is a component of the Child Survival Project (CSP). Its objective is to reduce the incidence rates of measles, diphtheria, pertussis, tetanus, tuberculosis, and poliomyelitis by increasing effective vaccination coverage. In 1991, CSP/EPI developed a national plan to introduce national immunization of infants against hepatitis B, which is an endemic disease in Egypt. Hepatitis B virus (HBV) causes acute hepatitis and chronic liver disease. Studies have shown that by maturity most of the population has been infected with hepatitis A and greater than 50% with hepatitis B. The recommended series of 3 intramuscular doses of hepatitis B vaccine induces a protective antibody response (anti HBs) in 90% of healthy adults and 95% of infants, children, and adolescents. Several studies have shown that the currently licensed vaccines produce high rates of seroconversion ( 95%) and induce adequate levels of anti HBs when administered to infants at 2 months, 4 months, and 6 months of age. Scheduling was adjusted to coincide with the currently adopted 2, 4, and 6 month vaccination schedule for oral poliomyelitis virus (OPV) and diphtheria-pertussis-tetanus (DPT) to allow a delay of vaccination from 2 to 3 months following birth. Long term studies of healthy adults and children indicate the immunologic memory remains intact for at least 9 years and confers protection against HBV infection even though anti HBs levels may decline below detectable levels. Safety of hepatitis B vaccines has been verified through experience with millions of doses administered worldwide after licensure. Pain at the injection site (3-29%) and a temperature greater than 37.7 degrees Celsius have been the most frequently reported side effects among adults and children. Nearly 90% of children and 96% of newborns had no reactions to the vaccine. Any presumed risk of adverse events must be balanced against the expected risk of acute and chronic liver disease associated with hepatitis B virus infection.

Experience with thallium-201 imaging in head and neck cancer.

TI-201 chloride was used for tumor imaging in patients with head and neck cancer. It is of value in detecting the extent of tumor involvement, the presence of residual tumor after radical courses of treatment, and the presence of local recurrence and distant metastases.