Fracture of the scaphoid is the most common injury of the carpus. Inadequate treatment frequently leads to non-union, which causes pain and serious disability. In the present study 134 scaphoid fractures treated during the period 1961-70 are reviewed. In fresh fractures less than 4 weeks old, bony union occurred in 95% with proper conservative treatment. The vexed question of whether a high or low circular cast should be used may not really be so important. In the present study, both methods of external splintage have given favourable results. It is indisputable, however, that other factors, such as the age of the fracture, its type and location are of great importance for the final result. It was also found that fracture dislocation greater than 1 mm regularly led to pseudarthrosis. Operative treatment is suggested in these cases, and the Matti-Russe technique has proved to be an excellent method for treatment of pseudarthrosis of the scaphoid. The study further confirmed that fractures of the scaphoid in children are more common than is usually supposed. They were all located in the distal two-thirds of the bone and it is suggested that this pattern of distribution is typical of childhood.

The composition of encrustations precipitated on long-term indwelling urethral catheters was analysed using a newly developed wet chemical method that allows determination of small sample volumes. In contrast to earlier studies, the major portion of the encrusted material could be identified; ammonium magnesium phosphate and calcium phosphates (brushite and apatite) were the major components. The effect of allopurinol was also investigated and it was found to decrease significantly the amounts of urate and calcium phosphate but not to lower significantly the total amount of material precipitated on the catheters.

A radioimmunoassay for measurement of human pancreatic secretory trypsin inhibitor in nanogram quantities has been developed. The sensitivity of the assay now permits examination of the inhibitor content of various body fluids, wherein other methods exhibit serious shortcomings.In healthy blood donors the serum level was 8.1 Mg//. In patients with acute pancreatitis levels as high as 320 Mg// have been measured, and patients who underwent endoscopic retrograde cholangiopancreatography showed an elevated inhibitor level in serum immediately after the examination without any clinical signs of disease, the highest registered value being 128 Mg//. In peritoneal lavage fluid from patients with severe acute pancreatitis levels of 5-304 Mg// have been measured. In urine the inhibitor level is about 14 Mg// in healthy persons. The urine from one patient with proteinuria of glomerulo-tubular type contained 380 Mg//· Ein Radioimmunoassay zur Bestimmung des sekretorischen Trypsininhibitors aus menschlichem Pankreas in verschiedenen KörperflüssigkeitenEs wurde ein Radioimmunoassay zur Bestimmung von Nanogramm-Mengen des sekretorischen Trypsininhibitors aus mesnchlichem Pankreas entwickelt. Seine Empfindlichkeit erlaubt die Messung des Inhibitorgehalts verschiedener Kör-perflüssigkeiten, bei denen andere Methoden versagen. Bei gesunden Blutspendern beträgt der Blutspiegel 8.1 Mg//· Bei Patienten mit akuter Pankreatitis wurden Werte bis 320 Mg// gemessen und bei Patienten nach endoskopischer retrograder Cholangio-Pankreatographie ohne klinische Symptome Werte bis 128 Mg//· In peritonealer Spülflüssigkeit von Patienten mit akuter Pankreatitis betrugen die Werte 5-304 Mg//. Der Urin gesunder Personen enthielt 14 Mg des Inhibitors//, der Urin eines Patienten mit Proteinurien vom glomerulo-tubularen Typ 380 Mg Ii-

A B S T R A C T The secretory pancreatic proteins in serum were analyzed in a group of cigarette smokers and a control group of nonsmokers before and after intravenous secretin stimulation. None of these persons had any signs of pancreatic disease. In the control group, serum total amylase activity, pancreatic isoamylase, cationic trypsinogen, and pancreatic secretory trypsin inhibitor concentrations varied within the normal range before and after secretin injection. In contrast, the concentrations of these pancreatic proteins in all the cigarette smokers elevated from normal to abnormally high serum concentrations after secretin stimulation. The results indicate a probable toxic effect of cigarette smoking on the exocrine pancreas.

Plasma samples from 32 patients with severe acute pancreatitis contained cleavage products of C3, and the C3 levels were significantly lower than those of control subjects. Peritoneal exudate from all patients showed complete degradation of C3 on crossed immunoelectrophoresis. Alpha 1-Antitrypsin and alpha 2-macroglobulin showed no signs of complex formation in plasma. However, in the peritoneal exudate, 5%-25% of the alpha 1-antitrypsin and 45%-100% of the alpha 2-macroglobulin were in complex. Trypsin-alpha 1-antitrypsin complexes were demonstrated in all peritoneal exudates. All patients showed significantly decreased levels of alpha 2-macroglobulin in their plasma. Alpha 1-Antitrypsin levels varied greatly, but the mean value was not significantly increased compared with those of normal controls. Orosomucoid, another acute-phase reactant, was present in increased concentration in the plasma of all patients. The addition of increasing amounts of human trypsin to serum in vitro resulted in the appearance of cleavage products of C3 upon saturation of alpha 2-macroglobulin, when the alpha 1-antitrypsin was found to be only about 40% saturated. Taken together, these data are evidence of complement catabolism in acute pancreatitis and suggest that this process takes place mainly in the abdominal cavity as a result of a protease-antiprotease imbalance. Alpha 2-Macroglobulin, but not alpha 1-antitrypsin, can protect against C3 degradation caused by trypsin in vitro.

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