Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant

CONTEXT

Few studies document how parents adapt to the experience of a very low-birth-weight (VLBW; <1500 g) birth despite societal concerns about the ethics and justification of intensive care for these infants.

OBJECTIVE

To determine the degree and type of stress experienced over time by mothers whose infants vary in degree of prematurity and medical and developmental risk.

DESIGN

Longitudinal prospective follow-up study of a cohort of mothers of high- and low-risk VLBW and term infants from birth to 3 years.

SETTING

All level III neonatal intensive care units from a large midwestern metropolitan region.

PARTICIPANTS

Mothers and infants prospectively and consecutively enrolled in a longitudinal study between 1989 and 1991. High-risk VLBW infants were diagnosed as having bronchopulmonary dysplasia, and comparison groups were low-risk VLBW infants without bronchopulmonary dysplasia and term infants (>36 weeks, >2500 g).

MAIN OUTCOME MEASURES

Standardized, normative self-report measures of maternal psychological distress, parenting stress, family impact, and life stressors.

RESULTS

Mothers of VLBW infants (high risk, n = 122; low risk, n = 84) had more psychological distress than mothers of term infants (n=123) at 1 month (13% vs 1%; P = .003). At 2 years, mothers of low-risk VLBW infants did not differ from term mothers, while mothers of high-risk infants continued to report psychological distress. By 3 years, mothers of high-risk VLBW children did not differ from mothers of term children in distress symptoms, while parenting stress remained greater. Severity of maternal depression was related to lower child developmental outcomes in both VLBW groups.

CONCLUSIONS

The impact of VLBW birth varies with child medical risk status, age, and developmental outcome. Follow-up programs should incorporate psychological screening and support services for mothers of VLBW infants in the immediate postnatal period, with monitoring of mothers of high-risk VLBW infants.

[Analysis of patients survived over ten years after resection of gastric cardia carcinoma]

OBJECTIVE

To investigate factors affecting long-term survival in patients with resected gastric cardia cancer.

METHODS

Survival was analyzed retrospectively in 584 patients with gastric cardia carcinoma who received tumor resection from 1964 through 1982.

RESULTS

The 10-year survival rate was 17.1%. The major factors influencing survival were clinical staging, degree of differentiation, gross tumor type and size (P < 0.05) and status of lymph node metatasis (P < 0.01). Residual tumor at resection edge and tumor thrombi did not significantly affect survival, nor did sex/age, and course of the disease.

CONCLUSION

Early detection, early diagnosis and early surgical resection are the key to improve 10-year survival of patients with resected cancer of the gastric cardia. Why residual tumor left at the resection edge and the presence of tumor thrombi do not influence survival needs to be further studied.

[Measurement of tibia bone content and fracture threshold by quantitative ultrasonography in normal and fractured women in Taiyuan]

OBJECTIVE

To establish the reference range of tibia bone content in normal female of Taiyuan area and to explore the diagnostic criterion for osteoporotic fracture threshold by quantitative ultrasonography (QUS).

METHODS

The tibia bone contents (QUS value) of 1,681 normal women (aged 7-92 years) and 63 fractured women (aged 46-91) in Taiyuan were measured by QUS.

RESULTS

The QUS value increased with age in normal women before age 30, and peaked at age 30-40, then decreased and reached significance after age 50. There was a negative correlation between QUS value and duration after menopause (P < 0.01). Taken the mean QUS value of normal female aged 20-40 years minus 2.5 s (3,667 m/s) as a cutoff threshold, 93.7% of the 63 fractured women had their QUS value below this threshold.

CONCLUSION

It is suggested that the above cutoff QUS value may be considered as the risk threshold of osteoporotic fracture in women.

[Gas-sensing transmittivity spectrum of two-dimension SnO2: TiO2 compound film in ammonia vapor]

In this paper, we studied the gas-sensing transmittivity spectrum of the two-dimension SnO2: TiO2 compound film in ammonia vapor. It was observed that when the gas concentration was relatively low the transmittivity decreased as the gas concentration decreased, and when the gas concentration was relatively high, the transmittivity increased as the gas concentration increased. We considered the effect of the wet vapor, and explained this phenomenon.

Prevalence of male pattern hair loss in 18-49 year old men

BACKGROUND

Previous studies investigating the prevalence of male pattern hair loss (MPHL) typically used biased samples of men recruited from clinical populations which may limit generalizability of findings to broader populations.

OBJECTIVE

To obtain an updated and improved estimate of the occurrence of MPHL in healthy men residing in the community.

METHODS

Community-based sample of healthy men aged 18-49 years participated in a study investigating the effects of MPHL. Participants completed a brief questionnaire self reporting degree of hair loss, general health-related quality of life (HRQL) and hair-loss-specific measures. A trained observer also rated each participant using standardized classification for MPHL.

RESULTS

The proportion of men with moderate to extensive hair loss (type III or greater) was 42%. The proportion of men with moderate to extensive hair loss increased with increasing age, ranging from 16% for men 18-29 years of age to 53% of men 40-49. Twelve percent of the men were classified as having predominantly frontal baldness (type A variants).

CONCLUSIONS

MPHL, especially frontal baldness, may be more common than previously reported.

[Synthesis and application of novel acrylic resin as enteric coating]

The pH sensitive two- and three-component acrylic resins were synthesized by radical solution copolymerization of methyl methacrylate (MMA), methacrylic acid (MAA) and/or butyl acrylate (BA) and their acid values were measured by acid-base titration. The dissolution of naproxen pellets coated with the synthesized resins in dissolution medium of different pH value was studied. The results show that the acrylic resin with different acid value can be prepared by adjusting the monomer ratios (MMA:MAA or MMA:MAA:BA). The smaller the acid value of the resin is, the higher pH sensitive value it has. The release of naproxen from pellets coated with these resins is greatly influenced by the pH value of the dissolution medium and the pH sensitive value of the coating resin. The three-component resins are plastic and can be used as coating material without adding plastisizers.

Functional assignment by Chimera construction of the domain affecting heterotropic activation of deoxyadenosine kinase from Lactobacillus acidophilus R-26

The heterodimeric subunits of deoxyadenosine kinase (dAK)-deoxyguanosine kinase (dGK) from Lactobacillus acidophilus R-26 exhibit contrasting conformations manifested in the nearly unidirectional heterotropic activation of dAK when dGK binds deoxyguanosine. This is mediated, in part, by the conserved Ras switch I-like sequence (residues 153-161) [Guo et al. (1997) J. Biol. Chem. 272, 6890-6897]. In an attempt to identify domains differentiating the specificities of dAK and dGK, we constructed several chimeras splicing heterodimeric dAK within this region. In Chimera-III, dAK residues 120-170 were replaced by the homologous section of dGK. dAK activity was elevated 40%, but although it retained its original specificity and Km values, it could no longer be activated by deoxyguanosine. Moreover, both the activated dAK and the "dAK" of Chimera-III exhibited (i) an increased Ks for the leading substrate ATP-Mg2+, suggesting the formation of intermediate enzyme species along their respective kinetic pathways, and (ii) broadened and lower pH optima for the dAK activities. These observations further indicate the importance of dAK residues 120-170, including the Ras-like segment, in catalysis and heterotropic activation. The other conformational properties of dAK (e.g. self-inactivity and MgATP being the leading substrate) were unaltered by this substitution, thus localizing the responsible domains even further upstream.

Role of endogenous interferon-gamma on the enhancement of splenic NK cell activity by electroacupuncture stimulation in mice

Successive electro-acupuncture (EA) stimulation applied to bilateral anterior tibial muscles, where Zusanli (ST36) acupoints are located, once a day (30 min) for 3 successive days significantly enhanced splenic natural killer (NK) cell activity in BALB/c mice. The percentage of splenic NK cells, as measured by flow cytometry, was not affected in these mice. Interferon (IFN)-gamma level in splenic aqueous extract, prepared from the ST36 acupoint-stimulated mice, was significantly higher than that of the controls. In vivo treatment with neutralizing monoclonal antibody against mouse IFN-gamma completely abrogated the increase in splenic NK cell activity induced by ST36 acupoint stimulation. The same stimulation also significantly increased the concentration of splenic beta-endorphin, which coincided with the significant increase in splenic IFN-gamma production. Pre-administration of 10 mg/kg naloxone before initiation of EA stimulation every day reduced the enhancements of NK cell activity and IFN-gamma level. These observations strongly suggest that endogenous IFN-gamma mediates the up-regulation of NK cell activity by EA stimulation at the ST36 acupoints. Furthermore, endogenous beta-endorphin secreted by EA stimulation also plays an important role in the up-regulation of NK cell function, which may be realized through regulating IFN-gamma production.

[Selection of key biological components (KBC) for Controlled Ecological Life Support System (CELSS)]

Biological components are key parts in Controlled Ecological Life Support System (CELSS), the future experimental success will depend to a large extent on the suitability of selected KBCs. For this purpose, 15 KBCs including 4 higher plants(vegetables), 5 microorganisms, 5 microalgae and 1 lower plant were selected from lots of biological species for CELSS. These results laid a solid foundation for our studies of CELSS.

[Isolation and identification of active constituent of Toddalia asiatica in cardiovascular system]

The ethereal extract from the crude ethanolic extract of Toddalia asiatica was chromatographed on silica gel and tested on biological activity. A crystalline was obtained and confirmed as an active constituent in cardiovascular system. The active constituent was identified as isopimpinellin on the basis of chemical method and spectral analysis.

[Development of new ambulatory monitor for multi-channel gastroesophageal pH combining with cardiogram]

A new ambulatory monitor for multi-channel gastroesophageal pH combining with cardiogram is introduced in this paper. Key techniques of the monitor, design of hardware and software, clinical significance are described. Clinical application shows that the monitor advantages the diagnoses of functional diseases of upper digestive tract, especially is significant to distinguish the chest pain of cardiac origin and esophageal origin.

[Effects of Chinese herbs xianzhen tablet on the deformability of erythrocyte in non-insulin-dependent diabetes mellitus patients with deficiency of both qi and yin and deficiency of kidney with blood stasis]

OBJECTIVE

To explore the effects of Xianzhen Tablet (XZT) on the hemorheology of type 2 diabetes (NIDDM) on the basis of previous studies in XZT, that have indicated its ability to deplete fasting blood glucose, to reduce the injury of free radical to the body, to improve the Na(+)-K(+)-ATPase in the erythrocyte membrane of NIDDM.

METHODS

Erythrocyte deformability and aggregation were studied with Ektacytometer in a total of 60 type 2 diabetes who were randomly divided into two groups. One was ZXT treated group, another was placebo group.

RESULTS

(1) The erythrocyte deformability of type 2 diabetes was lower than that in normal subjects (P < 0.001), but the erythrocyte aggregation increased abnormally than that of health people (P < 0.001). The correlation test indicated there were negative correlation with plasma fibronogen and positive correlation with blood cholesterol (P < 0.05). (2) The erythrocyte deformability in the ZXT treated group with 30 patients improved after 8 weeks treatment (P < 0.01), with the decreased fasting blood glucose and plasma fibrinogen (P < 0.05). Compared with placebo group, there was significant statistical difference (P < 0.01).

CONCLUSIONS

XZT could improve the erythrocyte deformability in the type 2 diabetes.

[Gene expression in vivo mediated by adenoviral vector after direct gene transfer into anastomotic rat carotid arteries]

OBJECTIVE

To observe the efficiency and time course of gene expression in vivo mediated by adenoviral vector after direct gene transfer into anastomotic rat carotid arteries.

METHODS

After being soaked in high concentration of glucose solution containing Adv5-CMV (control group) or Adv5-CMV/LacZ (treatment group) for 30 minutes, soluble stents were inserted into the lumina of cut rat carotid arteries and end-to-end anastomoses were performed. On the 2nd, 7th, 14th, 28th, 60th and 90th day after surgery, the anastomotic carotid arteries of the two groups were explanted. All samples were analyzed for the presence of beta-galactosidase activity and histochemical staining.

RESULTS

beta-galactosidase activity was not detected in the carotid arteries of the control group. Microscopic examination of sections from vessels of the control group revealed no X-gal staining. The treatment group revealed bluestaining in all anastomotic arteries and in all layers of the arterial wall explanted including the intima, media, and adventitia on the 7th, 14th day postoperatively.

CONCLUSIONS

Adenoviral vector could make foreign effectively transfer into rat carotid arteries in vivo. Mediated by adenoviral vector after direct gene transfer into anastomotic rat carotid arteries, the high level of gene expression only persisted about one month.

[Experimental study of the architecture of skin following tension traction and wound closure]

The experiment performed on domestic pig, was designed to investigate the architecture of the stretching skin and the effect of tension traction on the wound closure. An 7 cm x 3.5 cm was drawn at a standard position. Drawing horizontal and vertical lines on the traction area, points of 1 cm apart were tattooed on the lines. A traction force measuring device was used to draw the wound edges together. Measurements of the distances between the points were made. An 7 cm x 10 cm wound was made on identical sites of each hind leg. In the experiment the traction tension was applied on the edges of wound immediately after the wound debridement. The results showed the stretched distance in the two areas was 5-7 times the width of the wound. The gain of skin from traction was 61-89 percent in the width of the wound. The wounds from traction five days could be closed 5 days after traction. It was concluded that the skin which could be used for traction was abundant. Wound closure with the skin traction technique had many advantages, such as rapid decreasing the size of wound and early closing of wound.

[Clinical epidemiological research of antigastroesophageal reflux after cardiac plasty by anastomosis of esophageal mucosa and gastric wall]

A new operative method was designed for preventing gastroesophageal reflux after esophageal and cardiac cancer operation. From April, 1994 to December, 1995, sixty-one patients after resection of esophageal and cardiac cancer were randomly divided into two groups: experimental group with 34 patients and control group with the others. All patients were observed, monitored and followed up. It was found that no case in the experimental group showed symptoms of gastroesophageal reflux or marked reflux by esophagoscopy and barium meal examination. 10 patients (37%) in the control group had the symptoms of heartburn and regurgitation and inflammation and obvious gastroesphageal reflux were observed under esophagoscopy and barium meal examination. The pH values of anastomotic ostium were 7.0249 +/- 0.9996 and 4.6667 +/- 2.4573 in the experimental and control groups, respectively. Significant difference (P < 0.01) was observed between two groups with t test. The results showed that the advancement of operative method plays a key rolein prevention of gastroesophageal reflux.

[In situ hybrid detection of p16 mRNA in primary breast carcinoma: its clinicopathologic significance]

OBJECTIVE

To investigate the expression of p16 mRNA in primary breast carcinoma and its clinicopathological significance.

METHODS

In vitro transcriptional RNA probe labeled with biotin and in situ hybridization method were used in this study to detect p16 mRNA in the paraffin embedded tissue of human primary breast carcinoma from 120 cases.

RESULTS

85 breast carcinomas showed expression of p16 mRNA with a positive rate of 70.8%. The p16 mRNA expression was not obviously correlated with patient age, tumor size, estrogen and progesterone receptor status (P > 0.05), but the positive rate of 54.4% for the lymph node metastasis group was significantly lower than 85.7% of the non-metastasis group (P < 0.001). Moreover, the positive rate of 58.3% for the poor differentiate invasive duct carcinoma was also lower than that 89.7% for the well differentiated (P < 0.05). The patients after operation were followed up. The mortality of 25% (21/85) in the p16 mRNA positive group was significantly lower than that of the negative group 57% (20/35) (P < 0.01).

CONCLUSION

Abnormal expression of p16 mRNA may play an important role in the development of human breast carcinoma.

Endothelial cell loss after photorefractive keratectomy for myopia

PURPOSE

To study the long-term effect of 193 nm excimer laser photorefractive keratectomy (PRK) on the human corneal endothelial cell density.

SUBJECTS AND METHODS

One hundred and twenty-four eyes from 71 patients underwent photorefractive keratectomy for myopia or myopic-astigmatism. Endothelial cell density was examined a short time before the operation and on an average of 50 months after the operation using a contact specular microscope. A subgroup of 32 eyes from 20 patients treated only once was examined preoperatively and 7 and 52 months postoperatively. The endothelial cell densities were corrected for the changing magnification of the contact specular microscope with changing central corneal thickness and for the expected physiological cell loss with time.

RESULTS

The average endothelial cell density was preoperatively 3098+/-283 cells/mm2 (mean+/-SD) and postoperatively 3048+/-294 cells/mm2 corresponding to a change of -50+/-157 cells/mm2. This was statistically significantly different from zero in a paired t-test (n=124, t=3.58, 2p<0.001). The average changes in endothelial cell density for the subgroup were -34+/-159 cells/mm2 for the postoperative time interval 0-7 months and -20+/-188 cells/mm2 for the postoperative time interval 7-52 months. These results were not statistically significantly different from zero in a paired t-test (n=32, t=1.21 and t=0.60, 2p>0.05). A statistically significant negative correlation between preoperative cell density and the change in cell density was found (n=124, r=-0.21, 2p<0.05).

CONCLUSION

This study suggests a potentially harmful effect of PRK on the human corneal endothelium. It appears that most cells are lost during ablation or within the first period of time after PRK.

[A micro transducer for dynamic multi-location pH monitoring in upper digestive tract]

A new transducer catheter used for dynamic multi-location pH monitoring in upper digestive tract has been developed. On the catheter several antimony electrodes and an Ag-Agcl electrode are integreted. An animal experiment compared the results of gastric aspiration and dynamic recording and demonstrated the reliability of this transducer. Clinical application has shown that this technology contributes greatly to the research on digestive physiology and to the diagnosis of functional diseases such as non-cardiac chest pain.

Triterpenoid saponins from Quillaja saponaria

Three new saponins were isolated from a commercial bark extract of Quillaja saponaria Molina. These compounds were also obtained as degradation products from larger saponins in this extract when treated with strong alkali. The compounds were characterized, using mainly NMR spectroscopy, mass spectrometry and chemical methods, as quillaic acid 3-O-¿beta-D-galactopyranosyl-(1-->2)-beta-D-glucopyranosiduronic acid¿, 3-O-¿alpha-L-rhamnopyranosyl-(1-->3)-[beta-D-galactopyranosyl-(1-->2)] -beta-D-glucopyranosiduronic acid¿ and 3-O-¿beta-D-xylopyranosyl-(1-->3)-[beta-D-galactopyranosyl -(1-->2)]-beta-D-glucopyranosiduronic acid¿, respectively.

[Nitric oxide in the treatment of COPD-induced chronic cor pulmonale: therapeutic effect and mechanism]

OBJECTIVE

To study the hemodynamic and oxygen-dynamic effects and the mechanism of nitric oxide (NO) inhalation therapy in COPD-induced chronic cor pulmonale at acute exacerbation period.

METHOD

Right heart catheterization was performed in 11 cases of chronic cor pulmonale. The hemodynamic parameters and plasma endothelium-I(ET-I) level were examined and recorded before and after inhalation of 40 ppm NO for 20 minutes. The plasma level of NO and lipid peroxide Ca(2+)-Mg(2+)-ATPase(calcium pump) and Na(+)-K(+)-ATPase (natrium pump) activities of RBC membrane in 30 cases of chronic cor pulmonale and 30 healthy controls were determined synchronously.

RESULTS

After NO therapy, the average pulmonary pressure (PAPM) and pulmonary vascular resistance index (PVRI) were lowered by 16.6% and 25.9% respectively (P < 0.05). Intrapulmonary shunt was lowered by 16.3% (P < 0.05). ET-I also lowered and showed a positive correlation with PAPM (r = 0.59, P < 0.05). The activities of calcium and natrium pump were lowered when NO level declined, showing a positive correlation with NO concentration and negative correlation with lipid peroxides.

CONCLUSION

No inhalation therapy exerted favorable hemodynamic and oxygen-dynamic effects on COPD-induced chronic cor pulmonale in its exacerbation period. Suppression of ET-I release might be one of the important factors for pulmonary vessel relaxation. Dysfunction of calcium and natrium pump activities in the acute exacerbation period of chronic cor pulmonale were closely related to NO level.

[Comparison studies on pharmacodynamics of three kind of Carapax trionycis]

Three kinds of Carapax Trionycis were used in rat to prevent and treat syndrom-complex of dificiency of Yin. Compareing the improvement of symptoms of dificiency of Yin, it was found that all of them actted effectively in various degrees. The effect of ZhongHua Carapax Trionycis (ZHCT) was similar to those of Shan Rui Carapax Trionycis (SRCT), but the efficacy of Green Carapax Trionycis (GCT) was inferior to those of ZHCT and SRCT. All kinds of C. Trionycis could increase the function of responding to iriation in mice with deficiency of Yin. The intensity of ZHCT was similar to that of GCT, and superior to that of SRCT. They all could enhance phagocytic function of eticuloedothelial system obviously, promot the development of thymus in different degrees with no efect on spleen in young mice. The efficacy of increasing the immune function of ZHCT and GCT were more potent than that of SRCT. ZHCT and GCT significantly decreased the activity of SGPT in mice poisoned by CC14. ZHCT and GCT protected liver better than SRCT did.

Protein kinase B/Akt mediates effects of insulin on hepatic insulin-like growth factor-binding protein-1 gene expression through a conserved insulin response sequence

Insulin regulates the expression of multiple hepatic genes through a conserved insulin response sequence (IRS) (CAAAAC/TAA) by an as yet undetermined mechanism. Protein kinase B/Akt (PKB/Akt), a member of the PKA/PKC serine/threonine kinase family, functions downstream from phosphatidylinositol 3'-kinase (PI3K) in mediating effects of insulin on glucose transport and glycogen synthesis. We asked whether PKB/Akt mediates sequence-specific effects of insulin on hepatic gene expression using the model of the insulin-like growth factor binding protein-1 (IGFBP-1) promoter. Insulin lowers IGFBP-1 mRNA levels, inhibits IGFBP-1 promoter activity, and activates PKB/Akt in HepG2 hepatoma cells through a PI3K-dependent, rapamycin-insensitive mechanism. Constitutively active PI3K and PKB/Akt are each sufficient to mediate effects of insulin on the IGFBP-1 promoter in a nonadditive fashion. Dominant negative K179 PKB/Akt disrupts the ability of insulin and PI3K to activate PKB/Akt and to inhibit promoter activity. The IGFBP-1 promoter contains two IRSs each of which is sufficient to mediate sequence-specific effects of insulin, PI3K, and PKB/Akt on promoter activity. Highly related IRSs from the phosphoenolpyruvate carboxykinase and apolipoprotein CIII genes also are effective in this setting. These results indicate that PKB/Akt functions downstream from PI3K in mediating sequence-specific effects of insulin on the expression of IGFBP-1 and perhaps multiple hepatic genes through a conserved IRS.

[RBC-CR1 genotype polymorphism and RBC immune function in childhood ITP]

OBJECTIVE

To investigate the RBC immune functions in childhood idiopathic thrombocytopenic purpura (ITP).

METHODS

RBC-CR1 polymorphism genotype, RBC immune function and its regulator function were detected in 22 ITP, 30 allergic purpura (AP) and 50 normal children by PCR and Guo Feng's method.

RESULTS

1. There were 18 cases of high expression (82%) and 4 of medium expression (18%) of RBC-CR1 genotypes in the ITP cases. The rate of the medium expression genotype was significantly higher in ITP than that in AP and normal children (P < 0.01). 2. The rates of RBC-C3bRR and RBC-C3bRFER were much lower (P < 0.01), and the rates of RBC-ICR and RBC-C3bRFIR were significantly higher in ITP than those in normal children (P < 0.01). 3. RBC-CR1 genotypes in ITP were correlated negatively with RBC-C3bRR and RBC-C3bRFER (P < 0.05), but positively with RBC-ICR and RBC-C3bRFIR (P < 0.05).

CONCLUSION

RBC immune participated in the pathogenesis of ITP.

[Studies on the morphology of fruit-body developing of Polyporus umbellatus]

OBJECTIVE

Studying the fruit-body development of polyporus umbellatus to reveal the life-cycle of this medicinal fungus.

METHODS

Parts of materials treated by paraffin section, and examined under a light microscope; parts of materials by ultrathin section and observation under transmission electron microscope (TEM).

RESULTS

The fruit-body consists of trimitic hyphae, including generative hyphae, skeletal hyphae and binding hyphae. Generative hyphae are characterized by thin walls, dense cytoplasmic contents. Skeletal hyphae are unbranched, thick-walled, and of a narrow lumen. Binding hyphae are much-branched, tending to weave themselves among the other hyphase of flesh. The morphology of basidiospore development was also discussed in this paper.

CONCLUSIONS

The trimitic hyphae are the main component parts in the different developing stages of fruit-body of polyporus umbellatus.

Comparison of biodegradable and metallic tension-band fixation for patella fractures. 38 patients followed for 2 years

We compared the outcome of patella fractures fixed by biodegradable tension-band (B) with self-reinforced polyglycolide or self-reinforced poly-L-lactide plugs and polyester ligaments or by metallic tension-band (M) with Kirschner wires and metallic cerclage wire in a randomized study. 38 fractures (18 with B and 20 with M) were treated. The follow-up time was 24 (14-32) months. The fractures healed in all patients after a medium of 8 weeks. In the B group, the clinical outcome was good in 13, fair in 4, and poor in 1 patient. In the M group, the corresponding figures were 15, 3 and 2. There were no clinical or radiographic differences between the two methods. Patella fractures can be treated, successfully using biodegradable tension-band fixation with no need for a second operation to remove the implants after bone union.