Repair of central slip avulsions using Mitek Micro Arc bone anchors. An in vitro biomechanical assessment.

In this study we evaluated the pullout strength of the Mitek Micro Arc anchor for the reconstruction of central slip avulsions at the proximal interphalangeal joint of the finger. Forty paired fresh frozen cadaver fingers were randomized into treatment (anchor) and control groups (horizontal mattress repair) and subjected to tensile loading to failure. The mean (SD) failure loads of the repairs were: Mitek repair group 22.3 (4.7) N, and control group 24.7 (5.5) N. There were no statistically significant differences between the failure loads or the failure mechanisms of the two repairs. The pullout strength of the isolated anchor-bone complex was evaluated by refitting five anchors with stainless steel wire. The mean failure load of the isolated anchor was 400% higher than the tendon-suture-anchor complex, indicating that the weakest link of the system is not the bone-anchor interface.

Effects of musculoskeletal neoplasms on patient self assessment of health status.

Eighty-five consecutive patients referred to the Musculoskeletal Tumor Service completed a standardized short form questionnaire to evaluate their health status and function. Each patient completing the Short Form-36 questionnaire had a diagnosis of musculoskeletal neoplasm, including benign soft tissue and bone tumors, malignant soft tissue and bone tumors, and metastatic tumors. The results of this preliminary study show that the authors' patient population experienced health status and functional deficits in each of the eight Short Form-36 assessed domains. Data show that the most severe deficits were experienced by patients who had diagnoses of bone tumors and malignant tumors. This study shows that the Short Form-36 is a practical and effective method for documenting perceived deficits in health status in patients with musculoskeletal tumors. These data allow the physician to understand the presenting condition from the patient's perspective. This is an important and often neglected aspect of the overall assessment of the health of patient on presentation. An understanding of these deficits is critical for effective planning of treatment and evaluation of treatment effectiveness.

Transferrin receptors in the human gastrointestinal tract. Relationship to body iron stores.

Fluorescently labeled antibodies were used to identify transferrin receptors and mucosal transferrin in human gastrointestinal biopsy sections. Transferrin receptors were evident in the villous epithelium and the crypt areas of duodenum, ileum, and colon, predominantly in the basal-lateral area. In 7 subjects with low iron stores, the intensity of duodenal villous staining for receptor, on a scale of 0-4, was 2.1 +/- 0.3 (mean +/- SD). This value was significantly higher than the value in 13 subjects with normal iron stores (1.1 +/- 0.4). In 5 patients with hereditary hemochromatosis, duodenal transferrin receptor staining was not significantly different from that in the subjects with normal iron stores. Transferrin staining was found in the apical cytoplasm of epithelial cells in the duodenum, ileum, and colon, but observer assessment was not sufficiently reproducible to make a quantitative analysis. Our results suggest that iron deficiency is accompanied by an increase in transferrin receptors in duodenal absorptive cells, and the genetic lesion in hemochromatosis does not involve an increase in transferrin receptors in the intestinal mucosa compared with subjects with normal iron stores.

Dual-isotope method for determination of human zinc absorption: the use of a test meal of turkey meat.

The percentage of 65Zn taken up (absorbed) from extrinsically labeled turkey meat was calculated from the amounts of 65Zn and a nonabsorbed 51Cr marker present in the body or in a single stool specimen after 1-2 d. 51CrCl3 proved to be a suitable marker for unabsorbed 65Zn and so the early determination of 65Zn absorption was possible. With stool counting, 65Zn absorption data from first stool samples after 1-2 d were accurate as judged by correlation with the amount of 65Zn in the body 7-10 d later (retention); results from subsequent stools gave lower absorption values due to the early excretion of some absorbed 65Zn. The dual-isotope method gave reproducible results when four successive tests of zinc absorption were carried out in a group of six subjects. The average (mean +/- SD) 65Zn absorption from turkey meals containing 31 mumol (2 mg) and 46 mumol (3 mg) of zinc was 39 +/- 8% and 29 +/- 6%, respectively, measured by stool counting; 65Zn absorption and retention correlated well in both studies. A series of different beverages was given in place of water with the turkey meal. Orange juice significantly reduced 65Zn absorption and milk also showed this tendency, but tea, whiskey, wine or beer had no significant effect on the absorption of 65Zn from the turkey meal. In groups of subjects the mean ratio of 65Zn absorption from extrinsically labeled turkey meat on two occasions (1.06) was not significantly different from that of the absorption of extrinsic to intrinsic 65Zn labels (1.16). The dual-isotope technique with either stool or body counting is suitable for the rapid determination of 65Zn absorption from extrinsically labeled turkey within 2 d.