Comminuted femoral shaft fractures treated by closed intramedullary nailing and functional cast bracing

Eighty-one patients with comminuted femoral shaft fractures were treated by closed unlocked Küntscher nailing and functional cast bracing for 1 to 4 weeks postoperatively depending on the degree of comminution. The mean follow-up period was 27.6 months. The average time required for fracture healing was 14 weeks. There was one delayed union. One fracture united with more than 10 degrees of rotational malalignment; shortening of more than 1 cm was present in four cases. Two patients had more than 20 degrees of limitation of hip and knee movement.

Quantitative structure-activity relationship studies on benzodiazepine receptor binding: investigation of interaction model

With a view to providing perfection to the benzodiazepine receptor model proposed earlier [S P Gupta, R N Saha & V Mulchandani (1992) J. Mol. Recog, 5, 75-80] a few more QSAR studies on a series of 9-benzylpurines and tetracyclic 1,4-benzodiazepine derivatives have been made. The models showing the interaction of these compounds with the receptor are proposed. It is found that the receptor model, unlike the one proposed earlier, requires the presence of a polar site along with all the other essential sites.

Determination of medial epicondylar epiphyseal angle for supracondylar humeral fractures in children

A new radiographic angle, the medial epicondylar epiphyseal (MEE) angle, was studied in 100 anteroposterior (AP) radiographs of normal children aged 3-12 years. The mean value was 38.2 degrees +/- 4.17 degrees (SD) (range 25 degrees-46 degrees), and the MEE angle could be drawn satisfactorily in 96 radiographs. The MEE angle did not vary significantly from this value in 25 Jones' view radiographs (paired t test, t = 0.06). The MEE angle was useful in assessing the accuracy of reduction of 20 supracondylar fractures of the humerus with satisfactory final results.

In vitro effect of testosterone propionate on lactate dehydrogenase and malate dehydrogenase in brain and gonads of Channa punctatus

The activities of lactate dehydrogenase (LDH), malate dehydrogenase (MDH), and protein levels were measured in vitro incubation of tissue homogenate of brain and gonads with testosterone propionate (TP) in Channa punctatus (teleost). The activities of LDH and MDH were found to be highest in the ovarian tissues in comparison to the testis and the brain in control fish. TP (2 micrograms-4 micrograms/ml) stimulated testicular tissue with increases in LDH by 10-fold and MDH by 15-fold approximately, the ovary with significant increase in LDH and a decrease in MDH and the brain showed only an increase in MDH.

Experience in 4500 cases of laparoscopic sterilization

Laparoscopic sterilization under local anaesthesia was found to be a safe and effective procedure and the most popular method of voluntary sterilization in rural India. The difficulties encountered included omental emphysema and prolapse, bleeding from the mesosalpynx, cervix and abdominal wound, oedematous fallopian tubes and their bisection. In 3 cases, Verres needle penetrated the colon but it was diagnosed before inserting the trocar and cannula. Cardiac and respiratory arrest occurred in one case each but the patients could be revived and there was no mortality. In 3 cases, laparoscopy had to be abandoned because the laparoscope could not be passed into the peritoneal cavity. The failure rate was 0.5 percent.

Quantitative structure-activity relationship studies on benzodiazepine receptor binding: recognition of active sites in receptor and modelling of interaction

A quantitative structure-activity relationship study was carried out for the binding of a series of 'classical' benzodiazepines (BZs) and some beta-carbolines with BZ receptors to investigate the active sites in the latter and the nature of the binding of compounds with them. Using the Hansch approach, an attempt was made to correlate binding affinities of compounds with various physico-chemical and electronic properties of substituents. The correlations obtained showed the main roles were played by the hydrophobic constant pi and the Hammett constant sigma (an electronic parameter) of various substituents. This led to the suggestion that BZ receptors have many additional hydrophobic, hydrogen bonding and polar sites other than those suggested by Hollinshead et al. (1990). From the present study, the Hollinshead model of interaction was found to be inadequate to account fully for the binding of all types of compounds.

An unusual presentation of oesophageal tuberculosis

Oesophageal tuberculosis secondary to tuberculous mediastinal lymphadenopathy is a very unusual presentation of adult tuberculosis. We report a young patient who presented with anorexia and weight loss. The chest radiograph and CT scan revealed mediastinal lymphadenopathy causing extrinsic oesophageal compression on the barium swallow. This was confirmed by upper gastrointestinal endoscopy. Four weeks later, because of spontaneous partial relief in dysphagia, upper gastrointestinal endoscopy was repeated and revealed an ulcerated lesion with nodular margins at the mid-oesophagus. Biopsy from the ulcer margin revealed non-caseating granulomas. The patient had complete relief of dysphagia and other symptoms within 3 weeks of start of antituberculosis therapy.

Management of childhood femoral neck fractures

Forty-three children with displaced transcervical femoral fractures were reviewed at a mean follow-up of 7.2 years and results were assessed using Ratliff's criteria. Of 22 patients treated by internal fixation alone, 10 had good, 6 had fair and 6 had poor results. The results in 21 children treated by internal fixation along with primary transverse intertrochanteric undisplaced osteotomy were: 14 good, 5 fair and 2 poor, but none improved to a statistically significant level (P = 0.139). However, the osteotomy improved the fracture union significantly and no delayed union or non-union was noted in this group (P = 0.05). There were no complications related to the osteotomy itself.

Residual poliomyelitis of lower limb-pattern and deformities

The pattern of muscle paralysis and paresis in the lower limbs has been studied in 1356 children with 1800 poliomyelitic limbs, revealed that more than two-third (68 = 55%) muscles were affected, with the ratio of paresis and paralysed muscles were 1.89:1.00. The muscles most frequently affected were tibialis anterior (1516), quadriceps (1465) and tibialis posterior (1435) while tibialis anterior (1070), tibialis posterior (820) and quadriceps (766) were most commonly paralysed in descending order. The tibialis anterior which leads in paralysis group, has come last in order of frequency of paresis. The highest segmental incidence of affection of muscles found in second to fourth lumbar segments while muscle paralysis is found in fourth lumbar spinal segment. The commonest deformities encountered in residual poliomyelitis are flexion-abduction contracture hip, flexion contracture knee and valgus deformity foot.

Tibial condylar fractures treated with traction and early mobilisation (report on study of 75 cases)

Seventy-five cases of tibial condylar fractures irrespective of type of fractures were treated on a purely conservative line of management, consisting of traction and early mobilisation. The follow-up ranged from 6 months to 10 years; 67 cases had satisfactory results. Causes of unsatisfactory results were stiff knee, flexion deformity, osteo-arthritis and ligamentous instability.

A quantitative structure-activity relationship study on the inhibitory effects of local anesthetics on sodium flux, phosphoinositide breakdown, and binding to sodium channels

The inhibitory effects of a series of nonspecific local anesthetics on batrachotoxin-elicited sodium flux, batrachotoxin-elicited phosphoinositide breakdown, and on the binding of [3H]batrachotoxin-A 20 alpha-benzoate to sodium channels in guinea pig cerebral cortical synaptoneurosomes are shown to be well-correlated with the molecular size and the hydrophobic character of the molecules. These correlations lead us to suggest that the drug-receptor interaction involves a dispersion interaction, and that the overall effects of local anesthetics is dependent upon their ability to reach the receptor site.

Quantitative structure-activity relationships of salicylamide neuroleptic agents

The in vitro antidopamine activity of substituted N-[(1-alkyl-2-pyrrolidinyl)methyl]-6-methoxysalicylamides was found to be well correlated with the hydrophobic and electronic nature of substituents at the 3-position, and with the steric nature of groups replacing the hydrogen atom of the salicyl hydroxy group. In contrast, only the hydrophobic and steric characteristics were found to be important in the in vivo activity of these neuroleptics. This difference suggests that different mechanisms are probably involved in their in vitro and in vivo actions, and that the relevant receptors are slightly different in structure. The in vitro results suggest that electron donation by the 3-substituent strengthens the formation of a hydrogen bond between the carbonyl group of the amide moiety and a hydrogen of the receptor.

A quantitative structure-activity relationship study for local anesthetic activity of mono-and diaryl-2-quinuclidinylcarbinols

The local anesthetic activity of a series of arylquinuclidinylcarbinols is shown to be significantly correlated with their lipophilic character, suggesting that lipophilicity is an important factor for the local anesthetic action of drugs.

Quantitative structure-activity relationship study on some 5-lipoxygenase inhibitors

A quantitative structure-activity relationship (QSAR) study has been made on some lipoxygenase inhibitors belonging to the series of omega-phenylalkyl hydroxamic acids, omega-naphthylalkyl hydroxamic acids, eicosatetraenoic acids, and 1H.benzimidazole-4-ols. It was found that the hydrophobic character of the molecules and the size of their substituents selectively govern their lipoxygenase inhibitory activity. The enzyme active site possesses a non-heme ferric ion, a hydrophobic domain, and a carboxylic acid binding site. It was found that while the functional group of inhibitors must interact with the ferric ion, the substituent on one side of it would be involved in hydrophobic interaction and that on the other side in van der Waals interaction with the enzyme so leading to an enhancement in the inhibitory activity of the inhibitors.

A QSAR study on renin inhibitors

Quantitative structure-activity relationships (QSAR) were studied in a series of chain-modified peptide analogues of the active site of angiotensinogen. The activity of these renin inhibitors was found to be significantly correlated with Kier's first-order valence molecular connectivity index (1 chi v) and with the molecular weight (MW) of the molecules. The activity was less well correlated with the van der Waals volume (Vw), and not at all with the hydrophobic character (log P) of the molecules. These findings suggest that there is a strong dispersion interaction between the inhibitor molecules and the enzyme, and that hydrophobicity plays little part in the interaction.

Ipsilateral supracondylar fracture of humerus and forearm bones in children

A total of 34 children with ipsilateral supracondylar fractures of the humerus and forearm were studied over an 8-year period. Of these, 19 patients had fractures of the distal quarter of the forearm bones while eight patients had a distal radial epiphyseal injury. Five of the patients had undisplaced supracondylar fractures. One patient had an anterior supracondylar fracture. All forearm fractures were treated by closed reduction. Nine displaced supracondylar fractures which could not be reduced by closed manipulation were treated by olecranon pin traction in two cases and by percutaneous pinning in seven cases. Excellent or good results were found in 29 children after an average follow-up of 3.8 years.

A quantitative structure-activity relationship study on some pyrazolo[4,5-c]quinolines acting as inhibitors of benzodiazepine-receptor binding

By a quantitative structure-activity relationship (QSAR) study, the ability of a series of 1-arylpyrazolo[4,5-c]quinolin-4-ones to displace specific [3H]-flunitrazepam from bovine brain membranes is shown to be significantly correlated with steric and hydrophobic constants of aryl subtituents, suggesting that substituents of 2- and 6-positions produce dominant steric effects and that those of 3- and 5-positions are involved in strong hydrophobic interaction with the receptor.

Quantitative structure-activity relationship study on some dihydropteridine reductase inhibitors

The dihydropteridine reductase (DHPR) inhibitory potencies of some 4-phenyltetrahydropyridines, 4-phenylpiperidines, and 4-phenylpyridines, are analyzed in relation to their physico-chemical and molecular properties. They are found to have significant correlation with Hammett constant sigma and the van der Waals volume Vw. The correlation is linear with sigma and parabolic with Vw. Hence, it is argued that DHPR inhibition involves dispersion interaction and is enhanced by electron donation from the substituents but hindered by steric effects produced by large substituents. It is also found that these electronic and steric effects are significant only when they are produced by substituents being at specific position in the molecules.

A quantitative structure-activity relationship study of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors

A quantitative structure-activity relationship study has been made of some 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors. The HMG-CoA reductase inhibition activities of mevinolin analogs and 6-substituted 4-hydroxypyran-2 ones have been mostly found to be significantly correlated with the molecular size of substituents. In one case, however, the inhibition potency was found to be related to the hydrophobicity of molecules. These findings led us to suggest that the enzyme HMG-CoA reductase possesses an active site which is involved in dispersion interaction and another site which is involved in hydrophobic interaction with inhibitor molecules, depending upon the proper orientation of the latter towards these sites. Furthermore, the results indicate that both active sites possess limited steric bulk tolerance.

Quantitative structure-activity relationship study on amsacrine derivatives

Various biological activities of amsacrine derivatives were analyzed in relation to various physico-chemical parameters. The in vitro activity parameters like DNA-binding and cell inhibition constants were found to have significant correlations but with varying physico-chemical parameters. DNA-binding constants were found to be the function of van der Waals volume and the cell inhibition constant to be the function of the hydrophobic parameter. But the in vivo antitumor activity parameters like optimal dose administered intraperitoneally in mice injected with P388 leukemia cells and the percentage increase in life span of treated animals over that of control animals were not found to be related with any property of the molecules.