Open reduction internal fixation with bone grafting for scapular body nonunion: A case report.

Scapular body fractures are rare fractures that represent less than 1 % of all fractures and are typically associated with a high energy mechanism of injury. Traditionally these fractures have been treated non-operatively, resulting in union of the fracture and acceptable patient outcomes. We present a case of symptomatic scapular body fracture nonunion following non-operative management that was treated with open reduction and internal fixation with local autologous bone grafting. Our patient went on to successful union of his fracture as well as drastic improvement in shoulder function, range of motion, strength, and patient reported outcome measures assessed throughout his treatment course. The authors believe that scapular body fracture nonunion should be of clinical suspicion in forming the differential diagnosis for a patient who had previously sustained a scapular body fracture with persistent pain and failure to improve following non-operative management. We believe that open reduction and internal fixation with bone grafting can help promote fracture union in these patients and may result in improved shoulder function post-operatively.

Tetraiodothyroacetic acid (tetrac) and nanoparticulate tetrac arrest growth of medullary carcinoma of the thyroid.

CONTEXT: Tetraiodothyroacetic acid (tetrac) blocks angiogenic and tumor cell proliferation actions of thyroid hormone initiated at the cell surface hormone receptor on integrin alphavbeta3. Tetrac also inhibits angiogenesis initiated by vascular endothelial growth factor and basic fibroblast growth factor. OBJECTIVE: We tested antiangiogenic and antiproliferative efficacy of tetrac and tetrac nanoparticles (tetrac NP) against human medullary thyroid carcinoma (h-MTC) implants in the chick chorioallantoic membrane (CAM) and h-MTC xenografts in the nude mouse. DESIGN: h-MTC cells were implanted in the CAM model (n = 8 per group); effects of tetrac and tetrac NP at 1 microg/CAM were determined on tumor angiogenesis and tumor growth after 8 d. h-MTC cells were also implanted sc in nude mice (n = 6 animals per group), and actions on established tumor growth of unmodified tetrac and tetrac NP ip were determined. RESULTS: In the CAM, tetrac and tetrac NP inhibited tumor growth and tumor-associated angiogenesis. In the nude mouse xenograft model, established 450-500 mm(3) h-MTC tumors were reduced in size over 21 d by both tetrac formulations to less than the initial cell mass (100 mm(3)). Tumor tissue hemoglobin content of xenografts decreased by 66% over the course of administration of each drug. RNA microarray and quantitative real-time PCR of tumor cell mRNAs revealed that both tetrac formulations significantly induced antiangiogenic thrombospondin 1 and apoptosis activator gene expression. CONCLUSIONS: Acting via a cell surface receptor, tetrac and tetrac NP inhibit growth of h-MTC cells and associated angiogenesis in CAM and mouse xenograft models.

Tetraidothyroacetic acid (tetrac) and tetrac nanoparticles inhibit growth of human renal cell carcinoma xenografts.

Renal cell carcinoma is the most lethal of the common urologic malignancies, with no available effective therapeutics. Tetrac (tetraiodothyroacetic acid) is a deaminated analogue of L-thyroxine (T(4)) that blocks the pro-angiogenesis actions of T(4) and 3, 5, 3'-triiodo-L-thyronine as well as other growth factors at the cell surface receptor for thyroid hormone on integrin alphavbeta3. Since this integrin is expressed on cancer cells and also on endothelial and vascular smooth cells, the possibility exists that Tetrac may act on both cell types to block the proliferative effects of thyroid hormone on tumor growth and tumor-related angiogenesis. To test this hypothesis, we determined the effect of Tetrac on tumor cell proliferation and on related angiogenesis of human renal cell carcinoma (RCC). We used two models: tumor cell implants in the chick chorioallantoic membrane (CAM) system and xenografts in nude mice. To determine the relative contribution of the nuclear versus the plasma membrane action of Tetrac, we compared the effects of unmodified Tetrac to Tetrac covalently linked to poly (lactide-co-glycolide) as a nanoparticle (Tetrac NP) that acts exclusively at the cell surface through the integrin receptor. In the CAM model, Tetrac and Tetrac NP (both at 1 microg/CAM) arrested tumor-related angiogenesis and tumor growth. In the mouse xenograft model, Tetrac and Tetrac NP promptly reduced tumor volume (p<0.01) when administered daily for up to 20 days. Animal weight gain was comparable in the control and treatment groups. Overall, the findings presented here provide evidence for the anti-angiogenic, and anti-tumor actions of Tetrac and Tetrac NP and suggest their potential utility in the treatment of renal cell carcinoma.

[Peculiarities of the stab and cut wounds caused by blades of combat cold weapons]. / Osobennosti koloto-rezanykh ran, prichinennykh klinkami boevogo kholodnogo oruzhiia.

Design philosophy of blades of Russia-made combat cold arms and of inflicted-by-them stab-and-cut wounds were characterized on the basis of a comparative-and-evaluation study. Stereomicroscopy, histology examinations as well as X-ray-spectral and fluorescence analyses were made use of while investigating the wounds with subsequent processing of the results by discriminative analysis. Form, skewness and a graze type of the wound tubber as well as presence of "edge cuts" and of central graze wound were found to be the main distinctive wound signs. The study results ensure a full-value differential diagnosis of a type of the used cold-arm sample.

[Characteristics of gunshot wounds caused by the special forces shooting knife (NRS and NRS-2)]. / Osobennosti ognestrel'nykh povrezhdenii, prichinennykh iz nozha razvedchika spetsial'nogo (NRS i NRS-2).

Gunshot wounds of skin and long cortical bones inflicted by the special intelligence knife (NRS and NRS-2: special silent cartridges SP-3 and SP-4) from different distances were examined. Stereomicroscopy, emission spectral analysis, contact-diffusion method and regression- step-by-step analysis were made use of within the case study. A lack of mechanical, thermal or chemical impact from firing gas and of fire soot as well as presence of particles of rubber, copper and sealing varnish, i.e. the most informative shot products, were found to be the main distinctive features in the said wounds. The data obtained can be used in the differential diagnosis of a type and model of the used gun.

Beverage sales and drinking and driving: the role of on-premise drinking places.

OBJECTIVE: The relationships between on-premise drinking places, beverage specific alcohol sales and drinking and driving were examined in a time series cross-sectional study of place-of-last-drink data from Perth, Western Australia. METHOD: At arrest, 2,411 drinking drivers reported their last location of consumption. Tabulated by 57 premises over 4 years, the rates at which individual premises were referenced as the place-of-last-drink were taken to reflect the relative distributions of numbers of drinking drivers coming from different premise types (hotels, taverns and nightclubs). The data were then statistically related to measures of premise types and characteristics and beverage specific alcohol sales. RESULTS: Significant cross-sectional relationships were obtained between measures of premise types, alcohol sales and drinking and driving. Greatest numbers of drinking drivers came from taverns and from places selling greater amounts of beer and spirits. Significant longitudinal effects were obtained for sales of beer, proportions of high alcohol beer sold and sales of spirits. CONCLUSIONS: As a whole, the results suggest that, at least for Western Australia, outlets selling greater amounts of beer and spirits, and greater amounts of high alcohol beer, will produce larger numbers of drinking drivers.

[Changes in the cerebral cortex in closed craniocerebral trauma of gunshot origin (experimental research)]. / Izmeneniia kory golovnogo mozga pri zakrytoi cherepno-mozgovoi travme ognestrel'nogo proiskhozhdeniia (éksperimental'noe issledovanie).

Cerebral cortex was studied morphologically in rabbits with concussion of brain induced by gunshot injury. The extent of severity was modelled by the bullet rate. No significant bleeding followed the injury allowing to observe the animals during the necessary terms (7-14 d.) Morphological study included light optical and electron microscopy. In neurons, glial cells and synapses a series of essential destructive changes in shown detectable predominantly on ultrastructural level that might be the base of psychoneurological complications of a distant period. Ballistic properties of a bullet were obviously fundamental to pathogenesis of brain concussion in these experiments as kinetic energy of the bullet was only sufficient for non significant damage of the skull soft tissue. But in contrast to the dull trauma, the blow was of a high speed and despite mild clinical characteristics caused essential diffuse structural disturbances in brain tissues.

[The cerebral cortex in severe penetrating gunshot craniocerebral trauma (an experimental study)]. / Sostoianie kory bol'shogo mozga pri tiazheloi pronikaiushchei ognestrel'noi cherepno-mozgovoi travme (éksperimental'noe issledovanie).

Gunshot disturbances of different severeness were induced in rabbit brain by means of specifically worked out experimental model. Cerebral cortex was studied using light and electron microscopy in severe gunshot craniocerebral trauma (SGCT), accompanied with cranial bones and cerebral disorders, plentiful external and internal hemorrhages and death of the animals 1-5 minutes after the shot. Peculiarities of responsiveness to trauma were demonstrated in microcirculatory bed elements, neurons and glial cells. SGCT causes rapid appearance of destructive changes in cerebral cortex with degenerative processes not following hemomicrocirculatory bed disturbances, but developing simultaneously with them.

Alcohol consumption and harm in two Western Australian regional centres.

The application of national or state alcohol harm-prevention programs at a regional level can be inappropriate. The involvement of local communities is critical if harm-prevention responses are to be sensitive to local needs. Unfortunately, individuals and agencies usually have little idea of the impact of alcohol at the local level. Alcohol consumption and harm data have been gathered for Geraldton and Bunbury, two regional centres of comparable size in Western Australia. The indices of harm presented include the nature and cost of hospital morbidity attributable to alcohol, and drink-driving charges. In Geraldton, the impact of alcohol tends to be acute and affects young adults, particularly young males. In Bunbury, the consequences of alcohol use tend to be more chronic in nature and affect older adults. These findings have been used to inform local harm-prevention responses, but more than that, this study is a practical example of how available data can be aggregated at a community level to illustrate local alcohol use and harm. This method can be replicated in any community that wants to understand better the effects of alcohol in its own local context.

[Changes in the skin and sciatic nerve after soft-tissue damage to the extremity by a high-speed small-caliber bullet]. / Izmeneniia v kozhe i sedalishchnom nerve posle povrezhdeniia miagkikh tkanei konechnosti vysokoskorostnoi malokalibernoi pulei.

The character of contusive changes has been determined in the skin and sciatic nerve after lesion of soft tissues of the extremity with a high-speed small-bore bullet. A high-speed filming, tensiometry have been used. They allow to observe and measure processes of formation of the temporal pulsating cavity appearing at the moment of injury in the block of 20% gelatin and its influence on the imitator of the vascular-neural bundle. In the investigation performed on test-animals by means of neuromorphological, histological and histochemical techniques certain contusive changes are stated in the skin and sciatic nerve at various distances from the edge of the entrance and axis of the wound canal. The investigation of the material in 1, 3, 5 days after the lesion makes it possible to differentiate initial changes connected mainly with the effect of contusion from the secondary ones.

[Wounds from modern small arms and international humanitarian law]. / Raneniia sovremennym strelkovym oruzhiem i mezhdunarodnoe gumanitarnoe pravo.

The article cites the concept, basic standards and principles of international humane law concerning the banning or restriction of some types of conventional weapons. The authors describe international methods for appreciation of destructive effects of wounding missiles. On the basis of literature and their own experiments the authors make a conclusion that actually it would be impossible to formulate a straight definition between "human" and "inhumane" bullets, as well as to establish a criterion which could determine the admissible or inadmissible limits for gunshot injuries.

[Morpho-functional changes in the vascular bed in obstructed portal blood flow]. / Morfofunktsional'nye izmeneniia sosudistogo rusla pri blokade portal'nogo krovotoka.

Clinical observations were performed in 104 patients with intrahepatic blockade and 32 patients with subhepatic blockade of portal bloodflow and experimental studies in 24 mongrel dogs with the model of dosed stenosis of the portal vein. It was found that microcirculation bed of hollow organs of the gastrointestinal tract is also involved into the circle of pathological disorders in portal hypertension. Alterations of the microcirculation bed consist in the appearance of destructive lesions of the microvessel walls, disturbance of their permeability and hemodynamics. Undoubtedly, genesis of functional disturbances is based on structural alterations.