Fixation of canine tendons to metal

For the purpose of developing a method to attach tendons directly to the prosthesis, canine supraspinatus tendons were attached in vitro to a metallic surface, using 3 different fixation devices: a spiked polyacetal washer (Synthes), a spiked soft tissue fixation plate (Synthes), and a newly designed Enhanced Tendon Anchor (ETA), which straddled the tendon with interlocking spikes oriented at a 20-degree angle. 2 methods were used: 1) the tendon was fixed directly to the metallic surface, or 2) a bone block containing the tendon insertion was fixed to the metallic surface. The specimens were tested for initial fixation strength in tension to failure; intact bone-muscle-tendon-bone units were used as controls. Bone block fixations were stronger than direct tendon fixations when the spiked washer or the ETA was used; this was not true of the fixation plate. The ETA was stronger than the other techniques in ultimate strength in both direct tendon fixation and bone block fixation. The soft tissue fixation plate was found to be weaker than the other techniques in bone block fixation.     

Sinonasal undifferentiated carcinoma: a ray of hope

In 1987, we published a case series of a newly-described, highly malignant neoplasm, termed sinonasal undifferentiated carcinoma, in which treatment results were poor. In this updated study, we report the followup for the original three surviving patients and for six additional cases whose tumors were diagnosed between January 1987 and October 1991. These data suggest that the prognosis for patients with localized disease may be better than originally described.     

Double contrast technique in the proximal stomach

The double contrast technique is of particular value in the proximal stomach, where one is able to detect ulcers and masses not recognized on a conventional upper gastrointestinal series. Pseudotumors which may occur in the fundus with the conventional barium technique are readily resolved. When a lesion in the proximal stomach is suspected by conventional radiography, immediate use of double contrast radiography may confirm or better delineate the lesion. Double contrast examination of the proximal stomach may thus be used as a primary or immediate secondary procedure to increase radiologic accuracy.     

Arthroscopy of the knee under general anesthesia: an aid to the determination of ligamentous instability

During a 34-month period (March 1976 through December 1978), 790 patients underwent arthroscopic examination of the knee under general anesthesia. Preoperative assessment of ligementous instability was compared with the ligamentous examination while under general anesthesia. Eight percent of the patients with no preoperative instability first demonstrated ligamentous instability under general anesthesia. Thirty-six percent of the patients with preoperative instability and 27% of the patients with previous surgery had either an increased grade or additional component of instability found when examined under general anesthesia. Information gained from arthroscopy without a comprehensive ligament examination under anesthesia may result in an incomplete diagnosis and ineffective treatment. Patients at high risk include those with acute injuries, preoperative instability, or previous surgery.     

Radioimmunoassay of bromperidol and haloperidol in human and canine plasma

In order to check the specificity of a radioimmunological assay for haloperidol and bromperidol reported by Michiels et al. (1) and commercialized by IRE (Fleurus, Belgium), the assay was performed on canine and human plasma samples with and without extraction. After a single dose of bromperidol in dogs, plasma levels obtained with and without extraction were similar. In man the plasma levels for bromperidol after a single administration were markedly lower after extraction. The same was true for haloperidol plasma levels after chronic dosing in man. The findings suggest that the direct radioimmunoassay of haloperidol or bromperidol with the commercialized kit, lacks specificity of humans, possibly because of the presence of one or more polar metabolites.