There are differences of opinion about the pathogenesis of Perthes' disease. All are agreed that it is due to ischaemia, but the cause of this and the size and number of infarctions are in dispute. Through the generosity of the contributors six whole femoral heads and core biopsies of five other cases have been studied radiographically and histologically. The findings ranged from an ischaemic arrest of ossification in the capital articular cartilage without infarction to multiple complete infarctions of the epiphysial bone. The ensuing reparative process contributes to the pathology, which is of a range to warrant grading or grouping.
During four days of snow and ice in which more than 70% of pavements in the Cardiff area were covered by slippery hard snow and ice the number of patients who attended the accident and emergency department at this hospital with fractured bones increased 2-85 times as compared with those who attended during four control days with comparable hours of sunshine and four control calendar days a year later. Fractures of the arm were increased 3-7 times and of the forearm and wrist 7-3 times. For a town population of one million people who may walk on untreated slippery and icy pavements this means that on average in a single day 74 more people than usual sustain a fracture unnecessarily.This traumatic epidemic has all the characteristics of a "major accident" and should be treated as such, since mobilisation of additional facilities, staff, and reserves might be necessary. Snow and ice injuries, however, differ from injuries sustained in a major accident in one important point: they may be predicted and prevented. The mass media should warn the population about the oncoming hazards and give practical advice on safer walking on slippery surfaces. The most important aspect of prevention, however, is instant cleaning of pavements around buildings, shops, and houses, especially in town centres and other areas busy with pedestrians.
Experiments have been performed on rabbits and sheep which demonstrate that pure carbon, in a flexible and filamentous form of great strength, can be used successfully to induce the formation of new tendons. A concept fundamentally different from that underlying the use of other artificial tendon replacements is involved, in which rapidly developing tendon-like tissue is induced to form around the implant. This gradually takes over the function of the implant. The early results in rabbits and the late results in sheep suggest that filamentous carbon may have a place in the replacement of the calcaneal tendon and the collateral ligaments of the knee.
1. Dissection of forty-four developing human hip joints has shown that while the embryonic acetabulum is a deeply set cavity which almost totally encloses the head it gradually becomes more shallow as birth approaches. During the same period the femoral head becomes less globular and at the end of foetal life is almost hemispherical. The cover afforded to the femoral head by the acetabulum also becomes decreased. 2. After birth these trends reverse: the acetabulum becomes deeper again and the femoral head more globular. This process continues throughout childhood. 3. The findings provide a possible explanation for the increased liability to dislocation of the infantile hip.
A new modification of the tetrachrome method for bone osteoid in paraffin sections has been designed. The modified tetrachrome method suitable for routine use in any histology laboratory retains the simplicity of the original method and gives good results on the freshly fixed, decalcified, paraffin embedded material. Osteoid tissue is stained deep blue and normally mineralized bone is stained red. Defectively mineralized bone stains pale blue or pink and the cellular population is clearly identifiable. The ability to distinguish the osteoid tissue from mineralized bone and connective tissue and cartilage makes diagnosis of osteomalacia or osteoid producing tumors or assessment of ossification process straightforward, without the need for undecalcified sections. By displaying simultaneously irregularities in the mineralized matrix and morphology of bone cells, the method also permits the diagnosis of conditions recently described in patients with osteoporotic fractures, such as osteocytic degeneration and bone tissue defects.
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