Scaphoid waist fractures fixation with staple. Retrospective study of a not widespread procedure.

INTRODUCTION: In carpal scaphoid fractures, the surgical treatment with screw is considered the gold standard; shape memory staple however presents substantial advantages. The authors report a study on unstable fractures of the scaphoid waist (type B1, B2, B5, according to Herbert classification) treated with shape memory staple on a large sample of patients, with the aim to confirm the usefulness of this method, the quality of reduction and fixation, the functional results, the time of union and the possible complications. MATERIALS AND METHODS: A retrospective analysis of 131 patients with scaphoid waist fractures with minimum follow-up 1 year was performed. Staples were used in all cases; technical details are discussed. Outcome measures were: postoperative pain, flexion-extension wrist range, hand grip strength, radiographic consolidation, work absence. Herbert and Fisher Grading System was used to assess subjective, objective and radiographic results. RESULTS: Consolidation was achieved in all cases of primary fractures (0-30 days) within three months after surgery, and within eight months in all but two cases of delayed unions (operated within 6 months of the injury). Pain was absent at follow-up in 79% of cases, never severe or unbearable, the average flexion-extension range achieved was 112°. Handgrip strength values were comparable to those of contralateral wrist in 75% of cases. Mean time lost at work was 7.4 weeks. No algo-distrophy or malunion were observed. Discussion CONCLUSIONS: Scaphoid waist fractures' treatment with shape memory staple should be considered as an excellent alternative to screw fixation.

Plasmocitoma ganglionar primario y otras infiltraciones plasmocitarias ganglionares / Extramedullary plasmocytoma and other lymph node plasmocytomas

Se presenta un paciente de 48 años, portador de Plasmocitoma extramedular ganglionar primario (PEGP) inguinal con los propósitos de alertar sobre esta forma inusual de neoplasia de células plasmáticas y de revisar las diferencias existentes con otras infiltraciones plasmocitarias ganglionares.(AU)

Plasmocitoma ganglionar primario y otras infiltraciones plasmocitarias ganglionares / Extramedullary plasmocytoma and other lymph node plasmocytomas

Se presenta un paciente de 48 años, portador de Plasmocitoma extramedular ganglionar primario (PEGP) inguinal con los propósitos de alertar sobre esta forma inusual de neoplasia de células plasmáticas y de revisar las diferencias existentes con otras infiltraciones plasmocitarias ganglionares.

Effects of carnitines on rat sertoli cell protein metabolism.

The influence of carnitine on male reproductive function is well established. However, the molecular mechanism by which carnitines control male fertility have not yet been clearly identified. In the present study, we studied the role of carnitines at testis level by examining their effects on protein metabolism in cultured rat Sertoli cells. Our results demonstrate that L-carnitine and, in particular, L-acetylcarnitine administration affects overall protein synthesis, inducing a dose-dependent decrease in amino acid incorporation and consequently an increase of the intracellular amino-acid pool useful to speed up Sertoli cell energy metabolism. We also observed significant effect on the expression of specific proteins involved in the regulation of glucose uptake and Insulin-like Growth Factor (IGF) biological activity. Actually, an increased expression of the mRNA coding for the membrane Glucose Transporter-1 (GLUT-1) and a decreased expression of mRNA coding for the negative modulator insulin-like growth factor-binding protein-4 (IGFBP-4) were induced by in vitro treatment with L-carnitine and L- acetylcarnitine separately and in combination; in fact, the effects observed were far more pronounced following concomitant treatment with both compounds. Taken together, these data indicate that the influence of carnitines on male fertility could be partly mediated by an activity at Sertoli cell level.

Prolactin effect on pre-pubertal Sertoli cell proliferation and metabolism.

Direct effects of PRL on Sertoli cell proliferation were investigated by using Sertoli cell primary cultures isolated from both prepubertal rat and porcine testes. PRL metabolic effects were analyzed in rat Sertoli cell primary cultures. Exposure to physiological doses of PRL resulted in a significant increase (+50-60%) of basal DNA synthesis, as reflected by the pattern of [3H] thymidine incorporation during culture; significant increases in lactate secretion (about 50%), androgen binding protein (ABP) production (about 30%) and basal protein synthesis (25-30%), as reflected in the augmented [14C] valine incorporation, were also evident. Taken together, our present findings, indicating significant effects of PRL on Sertoli cell proliferation and metabolism, demonstrate that Sertoli cells are a potential target for PRL action at testicular level during pre-pubertal development.

[Prevention of infections in patients with lymphoproliferative syndromes and myeloma by nebulization of an IgA concentrate]. / Prevención de infecciones en pacientes con síndromes linfoproliferativos y mieloma por nebulización de un concentrado de IgA.

Infection of the upper respiratory tract is a major cause of morbidity and mortality in patients with lymphoproliferative syndromes and multiple myeloma. Nebulizations with IgA tested in a randomized double blind trial to evaluate its efficacy to prevent respiratory infections in patients with lymphoproliferative syndromes and multiple myeloma. Forty nine patients were evaluated (chronic lymphocytic leukaemia, 22; multiple myeloma, 11; lymphoma, 8; HCL, 6; Waldenström and lymphoepiteliod tymoma, 1 patient each) were randomized to receive nebulizations every 12 hours during 3 months of IgA or placebo. Seven infectious episodes (4 respiratory tract infections) in 25 IgA treated patients and 25 episodes (16 respiratory tract infections) in 24 control patients were recorded (p <0.0002). Eighteen patients belonging to the treated group remained free of infections against only 5 from the control group (p < 0.001). No difference related to the grade of infections was observed between groups. The arithmetic media for the first infection observed in each group was 45.6 +/- 22.0 days for the IgA treated and 28.6 +/- 17.5 days for the placebo (p < 0.025). According to this study, IgA nebulization therapy was useful to prevent respiratory tract infections and also delay the onset of infection in patients with lymphoproliferative syndromes and myeloma.