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Osteoporotic patient has low bone quality and often occur unstable fracture. Conventional dynamic hip screw method can provide good result on stable femoral fracture. On the unstable femoral fracture, it has high failure rate. The purpose is to investigate the biomechanics analysis for dynamic hip Screw on osteoporotic and unstable proximal femoral fracture. The specific aims are to :(1) develop the osteoporotic and unstable proximal femoral fractures model,(2) investigate the influence of lesser trochanter fixation on stress and deformation distribution.

Background: Contrast-medium extravasation injuries may be self-limited to catastrophic. Adequate prophylactic measures are enforced when risk factors for extravasation are present, and prompt treatment can avoid serious complications. Purpose: To describe the squeeze maneuver, an effective method for the treatment of symptomatic contrast-medium extravasation. Material and Methods: Over a 3-month period, eight patients with >50 ml contrast-medium extravasation resulting in vascular compromise of the fingers were managed with the squeeze maneuver as follows. The intravenous catheter used for contrast-medium injection was removed, and the skin around the insertion site was cleaned with povidone-iodine. An 18-gauge needle was then used to puncture five to eight openings near the catheter insertion site as deeply as possible. We then began squeezing from the periphery of the swelling toward the needle holes. As the contrast medium drained, it was swabbed away with iodine-soaked cotton swabs. Results: In all eight patients, the maneuver was successful with immediate resolution of the vascular compromise. Conclusion: The squeeze maneuver provides an easy way to manage radiological contrast-medium extravasation and can be performed immediately in the CT suite.

Conventional percutaneous procedures for treating patients with recurrent hepatolithiasis associated with complicated intrahepatic biliary strictures require multiple dilation sessions before stone extraction. We modified the approach, reducing the number of dilation sessions required and using newer lithotripsy and irrigation methods. We suggest that the modified procedures are superior to conventional management and demonstrate their utility in clearing hepatolithiasis.Percutaneous transhepatic stricture dilation and cholangioscopic lithotripsy were performed to treat patients with right recurrent hepatolithiasis with complicated intrahepatic biliary strictures. Conventional methods were used in 40 patients (Group A). Modified methods, including simplification of tract establishment and stricture dilation and electrohydraulic lithotripsy (EHL) were used in 60 patients (Group B).Group B patients had fewer complications (massive hemobilia: 0% versus 15%, P = 0.0032, cholangitis: 0% versus 17.5%, P=0.0012), tolerated the procedures better (intolerable pain: 0% versus 12.5%, P=0.0087), had a higher rate of success (residual stones: 3.3% versus 20%, P=0.0132; remaining asymptomatic and stone-free: 81% versus 50%, P = 0.0021), a shorter hospital stay (17.8 +/- 4.4 days versus 36.2 +/- 5.5 days, P0.001) and lower overall expense (USD 2689 versus USD 3848) than Group A patients.We believe that the modified methods are superior to conventional treatment in that they effectively decrease procedural complications and cost, and significantly improve treatment results.

Biliary stricture represents a challenging problem in the treatment of hepatolithiasis because of its association with treatment failure and stone recurrence. The long-segment type of stricture is difficult to manage and is likely to recur. To investigate the necessity for biliary stenting after balloon dilatation therapy, 20 consecutive patients with long-segment strictures who had 22 stents (group 1) were compared with ten patients who refused stenting (group 2). The long-segment strictures in group 1 were located on the right side in 80 per cent of patients, on the left side in 10 per cent, and were bilateral in 10 per cent. The stents, varying from 8 to 12 Fr, were retained for at least 6 months. They were inserted through the routes of a matured T tube track (five cases), percutaneous transhepatic track (14 cases), a jejunal limb (two cases) and a fistula (one case). Complications of stenting consisted of dislodgement (one case), haemobilia (two cases), cholangitis (two cases) and intrahepatic abscess (one case). The cumulative probability of stricture recurrence in group 1 was 10 per cent, 15 per cent and 21 per cent at 2, 3 and 4 years, respectively, whereas in group 2 it was 80 per cent at 2 years (P < 0.003). The results suggest that intrahepatic biliary stenting after balloon dilatation appears necessary and helpful in the management of hepatolithiasis with long-segment biliary strictures.

The distribution of succinic dehydrogenase (SDH) activity and the changes of SDH activity after injection of gentamicin (GM) were observed in the organ of Corti using non-decalcified frozen sections of the guinea pig's cochlea. The distribution of SDH activity was found to increase from the apex to the basal turn. At each turn, SDH activity of the inner hair cells, the inner supporting cells and the nerve endings surrounding the supporting cell and on the hair cells presented a greater activity than that found in the outer hair cells, adjacent Deiter's cells and associated nerve endings. It was further observed that GM had a greater effect on SDH activity in the basal turn than the other turns. At each turn, a more sensitive area of response to GM was found on the nerve endings one each hair cell, especially on the outer hair cells of the basal turn.