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The retrograde nail for distal femoral fractures in the elderly: high failure rate of the condyle screw and nut.

Displaced distal femoral fractures in elderly patients benefit from surgical fixation. We describe the use of a retrograde femoral nail to treat these fractures. The implant has a special condyle screw and nut that allows for manual compression of the fracture when there is an additional inter-condylar split. We present our results when using this implant to treat 16 patients over a 13-month period. The mean patient age was 78 years (range, 65-96 years). All 16 patients were available at the time of final follow up and proceeded to union at an average time of 11 weeks (range, 10-14 weeks). Twenty-six condyle screw and nuts were used. Ten out of 26 condyle screws in 10 out of 16 patients failed by disengaging at a mean time of 10 weeks (range, 8-12 weeks). Our union rate was unaffected by the nut and bolt disengaging. This would suggest that the condylar compression generated by the nut and bolt may not be critical for union.

Age Factors↗

Ana o 3, an important cashew nut (Anacardium occidentale L.) allergen of the 2S albumin family.

BACKGROUND: Cashew nut allergy is the second most commonly reported tree nut allergy in the United States. We have previously cloned and characterized major cashew allergens belonging to the vicilin and legumin families of seed storage proteins. OBJECTIVE: Here we set out to describe a third major cashew allergen, a 2S albumin. METHODS: The recombinant cashew 2S albumin was amplified from a cDNA library by means of PCR, sequenced, and expressed in Escherichia coli. Immunoblotting was used to screen for reactivity with patients' sera, and inhibition immunoblotting was used to identify the corresponding native cashew nut proteins. The mass of affinity-purified native allergen was determined by means of matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectroscopy. Patients' sera were used to probe solid-phase 2S albumin peptides to identify linear epitopes. RESULTS: The cloned allergen, designated Ana o 3, was identified as 2S albumin. MALDI-TOF mass spectroscopy of native Ana o 3 yielded a molecular mass of 12,598 d. Immunoblot analysis showed 21 (81%) of 26 sera from patients with cashew allergy were reactive. Three native Ana o 3 large-subunit isoforms with molecular weights ranging from approximately 6 to 10 kd were identified. Probing of overlapping synthetic Ana o 3 peptides with patients' sera identified 16 reactive peptides, 4 of which gave strong signals and one of which positionally overlaps linear epitopes in mustard and walnut allergenic 2S albumins. The overlapping cashew and walnut epitopes also share considerable homology. CONCLUSIONS: We conclude that this 2S albumin protein is a major allergen in cashew nut and demonstrates a possible basis for cross-reactivity with walnut 2S albumin.

Adolescent↗

A subchronic toxicity study of shea nut color in Wistar rats.

Shea nut color, obtained from nuts of the shea tree (Butyrospermum parkii), is used as a food-coloring agent. Flavonoid pigments are considered to be the responsible constituents. As there have been no reports of toxicological evaluation, a 13-week subchronic toxicity study was performed in Wistar Hannover rats at dose levels of 0 (control), 0.07, 0.31, 1.25 and 5% in powdered basal diet. The average of daily shea nut color intake was 51.3, 226.1, 986.8 and 3775.5 mg/kg/day for males and 56.4, 272.9, 1166.7 and 4387.7 mg/kg/day for females, respectively. During the administration period, daily observation of clinical signs and weekly measurement of body weights and food consumption were performed. After the end of the treatment, hematology, serum biochemistry, organ weight and histopathological examinations were conducted. No significant toxicological changes were observed in any parameters in this study. Hence, the no adverse effect dose of shea nut color was estimated to be greater than 5.0% for both sexes (3775.5 mg/kg/day for males and 4387.7 mg/kg/day for females).

Animals↗

Studies of various elements of nutritional and toxicological interest associated with different molecular weight fractions in Brazil nuts.

On-line hyphenation of size exclusion chromatography (SEC), UV, and inductively coupled plasma mass spectrometry (ICP-MS) was used to study the molecular weight distribution patterns of several elements in Brazil nuts (Bertholletia excelsa). This technique was used for the elemental speciation of different elements of nutritional and toxicological interests such as Mg, Fe, Co, Mo, Ag, Hg, and Pb. Elemental fractionation in Brazil nuts was studied using a Superdex peptide column with resolving capacity in the range of 14 to 0.18 kDa. Three different mobile phases, Tris buffer solution (pH 8.0), phosphate buffer (pH 7.5), and CAPS buffer solution (pH 10.0), were tried for the SEC fractionation. Size exclusion fractionation of all the extracted solutions was performed using a 50 mmol L(-)(1) Tris buffer (pH 8) as the mobile phase at a flow rate of 0.6 mL min(-)(1). Three different extractions, 0.05 mol L(-)(1) NaOH, 0.05 mol L(-)(1) HCl, and hot water at 60 degrees C, were performed, and the association of elements with various molecular weight fractions was evaluated. Total elemental concentrations in the extracted samples were determined and compared with the values obtained after total digestion to calculate the recovery values. Generally, high extraction efficiency was obtained with the NaOH solution as compared with HCl and hot water except in the case of magnesium, for which HCl was found to be a good extractant. Chromatographic elution profiles for these extractions were quite distinct from each other in most cases. Most of the elemental species were found to be associated with high molecular weight fractions. To study the differences obtained during the sample-processing step, the results obtained for nuts with shell were treated differently from those obtained for nuts purchased without shell and were compared.

Bertholletia↗

Betel nut and tobacco chewing; potential risk factors of cancer of oesophagus in Assam, India.

Cancer of the oesophagus is the most commonly diagnosed cancer in males in Assam, in north-eastern India, and ranks second for females. The chewing of betel nut, with or without tobacco and prepared in various ways, is a common practice in the region and a case-control study has been designed to study the pattern of risk associated with different ways of preparing and chewing the nuts. 358 newly diagnosed male patients and 144 female have been interviewed together with 2 control subjects for each case chosen at random from among the attendants who accompanied patients to hospital. There were significant trends in risk ratios associated with the frequency of chewing each day, with the duration of chewing in years and with the age at which the habit was started that were apparent for both males and females and which remained significant after allowance was made for other known risk factors, notably tobacco smoking and alcohol consumption. The adjusted ratios, in comparison with non-chewers, were 13.3 M and 5.7 F for chewing more than 20 times a day, 10.6 M and 7.2 F for persons who had chewed for more than 20 years and 10.3 M and 5.3 F for those who had started before the age of 20. Among the different combinations of ingredients that were chewed the adjusted odds ratios were highest for those who had been using fermented betel nut with any form of tobacco (7.1 M and 3.6 F). The risk associated with tobacco smoking and alcohol consumption, which are high in some parts of the world, were less in Assam than those associated with the chewing of betel nut.

Adult↗

Carcinogenicity examination of betel quid. II. Effect of vitamin A deficiency on rats fed semipurified diet containing betel nut and calcium hydroxide.

The effect of vitamin A deficiency on the carcinogenicity of betel quid was studied, using long-term feeding of vitamin-A-deficient and -sufficient diets with and without betel nut and calcium hydroxide in ACI rats. A high incidence of focal epithelial hyperplasia was observed in the upper digestive tract (tongue, buccal oral mucosa, esophagus, and forestomach) of rats in the group given the vitamin-A-deficient diet mixed with betel nut and calcium hydroxide. The vitamin-A-deficient group also showed a high incidence of squamous papilloma in the tongue, buccal mucosa, and forestomach. The incidence of hyperplastic lesions of the tongue and buccal oral mucosa was significantly higher in this group than in the group receiving the vitamin-A-sufficient diet with betel nut and calcium hydroxide. These results suggest that the vitamin-A-deficient condition enhanced the growth of epithelial hyperplasia that was due to the administration of the betel quid ingredients. However, vitamin A did not protect against the development of altered liver cell foci, which were frequently seen with a small number of hepatocellular neoplasms in all groups given the diets containing betel nut and calcium hydroxide (both vitamin-A-deficient and -sufficient groups).

Animals↗

Aflatoxin in betel nut and its control by use of food preservatives.

The occurrence of aflatoxins in market betel nut samples was studied. It was observed that several betel nut samples were infested with aflatoxin-producing fungus, Aspergillus flavus. Out of 32 samples collected from various places, 12 were positive for aflatoxin. Aflatoxin B1 was detected in all the positive samples. Other aflatoxins were also detected in some samples. Boric acid, propionic acid and potassium metabisulphite were used for the control of aflatoxin B1 on betel nuts. Propionic acid was most effective in inhibiting aflatoxin production on betel nut after intervals of 2 (62%) and 4 (85%) weeks. Controlling the occurrence of aflatoxin could safeguard the users from the health hazards of aflatoxins.

Aflatoxins↗

The relationship between areca nut usage and heart rate in lactating Bangladeshis.

BACKGROUND: The betel-nut quid, a piece of areca nut chewed alone or mixed with tobacco and slaked lime wrapped in betel vine leaf, is widely used in Asian populations as a stimulant (due to the cholinergic agent, arecoline) or as a relaxant (due to arecaidine and guvacine). OBJECTIVES: This study, which formed part of a larger project assessing the effect of energy expenditure on the duration of post-partum amenorrhoea, provided the opportunity to assess the role of chronic areca nut usage on heart rate and oxygen consumption during resting periods and during graded stepping tests. SUBJECTS AND METHODS: The mothers (n = 47), all of whom were lactating, were aged between 19 and 39, of low nutritional status and anaemic and they all chewed betel quid daily. RESULTS: Moderate users of betel quid (defined as more than 3 times a day) were found, on average, to have a significantly lower heart rate at rest and during exercise than low betel quid users (less than 3 times a day) but there was no modification in oxygen consumption. CONCLUSION: Chronic betel quid use does not seem to affect the assessment of 24h energy expenditure provided that subjects are denied access to betel nut usage before and during calibration.

Adult↗

Chemical and analytical aspects of areca nut.

A capillary zone electrophoretic (CZE) method for the rapid analysis of the major alkaloids (arecoline and guavacoline) in areca nut extract is described. Areca nuts were pulverized and then extracted with water by sonication in a water bath. After centrifugation, the supernatant was analysed on a fused-silica capillary with 100 mM ammonium acetate-acetic acid (pH 4.6) as the running buffer at a voltage of 20 kV and temperature of 30 degrees C. The method is applicable to the analysis of alkaloids in the nut, commercial preparations (pan masala) and in the saliva of areca nut chewers.

Alkaloids↗

Areca nut use following migration and its consequences.

Areca nut use is widespread in the Oriental countries, affecting approximately 20% of the world's population. The combined use of areca nut and smokeless tobacco (ST) is practiced particularly in the Indo-Chinese continents. While there is considerable global variation in the use of these products, migrant studies relevant to areca nut use is of considerable interest to epidemiologists in suggesting the extent to which these environment exposures are important in the aetiology of different cancers and other health-related consequences. Studies on Indian migrants to the Malay peninsula, South and east Africa and various Asian ethnic groups resident in several parts of the United Kingdom have shown that the consumption of areca nut (often mixed with ST) is highly prevalent in these communities. Available data on the prevalence of areca chewing among these migrant populations are reviewed here. The carriage of these risk factors from South Asia to other countries has resulted in excess risk of oral cancer in these new settlements. There is also a high incidence of cardiovascular disease, hypertension and late onset diabetes among Indians living in the United Kingdom and there is new evidence to suggest that the combined roles of areca and ST may be contributory. Because of their enhanced financial situation, substance abuse may increase in their new country of domicile. The two products are psychologically addictive and a dependency syndrome related to their use among Asian immigrants to the United Kingdom has been described recently.

Africa↗

Study of the genotoxicity of the total aqueous extract of betel nut and its tannin.

Frequencies of sister-chromatid exchanges (SCEs) were measured to study the genotoxicity of the total aqueous extract of betal nut and its tannin on mouse bone-marrow cells in vivo. Betal nut aqueous extract and tannin were injected i.p. into mice at doses of 12.5, 25 or 50 micrograms/g body weight and 50, 100 or 200 micrograms/g body weight respectively for 5, 10 or 15 days. Betal nut extract induced a dose-related increase in the frequency of SCEs after five daily doses of 12.5, 25 or 50 micrograms. Significant increases in SCEs were also observed in animals dosed for 10 days with 50 micrograms/g and for 15 days with 25 or 50 micrograms/g extract. After five daily doses of 50, 100 or 200 micrograms/g of betel nut tannin there was no significant induction of SCE. Mice dosed with 200 micrograms/g tannin for 10 days, or 100 or 200 micrograms/g for 15 days, showed significant increases in the frequency of SCEs.

Animals↗

Unexpectedly high activity of 228Th in excretion samples following consumption of Brazil nuts.

A worker provided a routine faecal sample for plutonium and americium analysis. In the course of this analysis 500 mBq of (228)Th was discovered. There seemed no credible occupational route for intake of thorium. Further investigation revealed that the worker consumed approximately 25 g d(-1) of nuts, including Brazil nuts. A sample of these nuts was analysed and found to contain activities of (228)Th in sufficient quantity to account for the faecal activity. However, follow-up urine samples taken from the worker showed 0.6-0.7 mBq of (228)Th. The intake of (228)Th via nuts is insufficient to account for this activity in urine. However, it is likely that the intake of (228)Th was accompanied by similar activity of the parent (228)Ra, and biokinetic calculations show that decay of (228)Ra in vivo would produce sufficient (228)Th to account for the observed urine activity.

Adult↗

A biomechanical comparison of Schuhli nuts or cement augmented screws for plating of humeral fractures.

Schuhli locking nuts can be used in poor quality cortical bone to enhance fixation stability as an alternative to cement augmented screws. This study compared the fixation strength and stability of plate constructs using Schuhli locking nuts with standard screws and cement augmented screws for fixation of simulated humeral shaft fractures in a test model with osteoporosis. The constructs were tested in axial compression, 4-point bending, and torsion to determine fixation stability. The humeri were cycled in torsion (4.5 Nm) for 1000 cycles to simulate upper extremity use during the early postoperative period and retested for stability. The Schuhli locking nuts and cement augmented screws had significantly greater fixation stability than the standard screws before (range, 6-14 times greater) and after cycling in torsional loading (range, 3-3.6 times greater). Although cement augmented screws and Schuhli augmentation showed increased fixation stability compared with the standard screws in axial and 4-point bending before cycling (range, 1.3-1.4 times greater), this was not significant. Compared with Schuhli fixation, cement augmented screws showed no significant difference in fixation stability in all loading modes before and after cycling. Schuhli locking nuts offer the stability of cement augmentation while avoiding its potential adverse effects on fracture healing with extravasation and thermal necrosis.

Biomechanical Phenomena↗

Do Nuts Have a Place in a Healthful Diet?

A wealth of nutrition information has been published during the past decade on the healthful nature of nuts. As nut consumption increases, cardiovascular disease risk decreases. This cardioprotective effect of nut consumption is beyond what would be predicted from the fatty acid profile alone. Nuts are a rich source of many other nutrients and bioactive compounds, similar to other whole-plant foods, such as fruits and vegetables. Additional studies during the next decade will delineate additional healthful nutrients of these foods.

Journal Article↗

The nut site of bacteriophage lambda is made of RNA and is bound by transcription antitermination factors on the surface of RNA polymerase.

The boxA and boxB components of the lambda nut site are important for transcriptional antitermination by the phage N protein. We show here that boxA and boxB RNA in N-modified transcription complexes are inaccessible to ribonucleases and have altered sensitivity to dimethylsulfate. N and NusA suffice to weakly protect boxB, independently of boxA and other factors. However, efficient protection of the entire nut site from ribonucleases requires boxA and boxB, N, NusA, NusB, S10, and NusG. Mutations in RNA polymerase, which inhibit antitermination by N in vivo, disallow protection of the nut site during transcription in vitro; therefore, the surface of RNA polymerase must coordinate the formation of complexes containing the antitermination factors and nut site RNA.

Bacteriophage lambda↗

Oral mucosal lesions associated with betel quid, areca nut and tobacco chewing habits: consensus from a workshop held in Kuala Lumpur, Malaysia, November 25-27, 1996.

A variety of betel/areca nut/tobacco habits have been reviewed and categorized because of their possible causal association with oral cancer and various oral precancerous lesions and conditions, and on account of their widespread occurrence in different parts of the world. At a recent workshop in Kuala Lumpur it was recommended that "quid" be defined as "a substance, or mixture of substances, placed in the mouth or chewed and remaining in contact with the mucosa, usually containing one or both of the two basic ingredients, tobacco and/or areca nut, in raw or any manufactured or processed form." Clear delineations on contents of the quid (areca nut quid, tobacco quid, and tobacco and areca nut quid) are recommended as absolute criteria with finer subdivisions to be added if necessary. The betel quid refers to any quid wrapped in betel leaf and is therefore a specific variety of quid. The workshop proposed that quid-related lesions should be categorized conceptually into two categories: first, those that are diffusely outlined and second, those localized at the site where a quid is regularly placed. Additional or expanded criteria and guidelines were proposed to define, describe or identify lesions such as chewer's mucosa, areca nut chewer's lesion, oral submucous fibrosis and other quid-related lesions. A new clinical entity, betel-quid lichenoid lesion, was also proposed to describe an oral lichen planus-like lesion associated with the betel quid habit.

Areca↗

The Nut Island effect. When good teams go wrong.

The team that operated the Nut Island sewage treatment plant in Quincy, Massachusetts, was every manager's dream. Members of the group performed difficult, dangerous work without complaint. They needed little supervision. They improvised their way around operational difficulties and budgetary constraints. They were dedicated to the organization's mission. But their hard work led to catastrophic failure. How could such a good team go so wrong? In this article, the author tells the story of the Nut Island plant and identifies a common, yet destructive organizational dynamic that can strike any business. The Nut Island effect begins with a deeply committed team that is isolated from a company's mainstream activities. Pitted against this team is its senior management. Preoccupied with high-visibility problems, management assigns the team a vital but behind-the-scenes task. Allowed considerable autonomy, team members become adept at managing themselves. Management takes the team's self-sufficiency for granted and ignores team members when they ask for help. When trouble strikes and management is unresponsive, team members feel betrayed and develop an us-against-the-world mentality. They stay out of management's line of sight, hiding problems. The team begins to make up its own rules, which mask grave problems in its operations. Management, disinclined in the first place to focus on the team's work, is easily misled by team members' skillful disguising of its performance deficiencies. The resulting stalemate typically can be broken only by an external event. The Nut Island story serves as a warning to managers who concentrate their efforts on their organization's most visible shortcomings: sometimes the most debilitating problems are the ones we can't see.

Commerce↗

Lack of correlation of betel nut chewing, tobacco smoking, and alcohol consumption with telomerase activity and the severity of oral cancer.

BACKGROUND: Oral cancer is one of the most frequent cancers. A strong association has been found between oral cancer incidence and the use of betel nut, alcohol, and tobacco. Telomerase activity (TA) has also been shown to play a role in carcinogenesis. We therefore surveyed the consumption habits of betel nut chewing, alcohol drinking, and tobacco smoking in oral cancer patients and evaluated the association of these habits with TA level and clinical stage. METHODS: In total, 154 oral cancer patients were recruited. TA was measured in paired (grossly normal and cancerous) tissues using a polymerase chain reaction-based enzyme immunoassay. Associations of these factors with clinical stage and TA level were analyzed using the Pearson chi-square test. RESULTS: In these patients, 86.4%, 61.0%, and 83.3% used betel nut, alcohol, and tobacco, respectively. For all tissue assayed, 80.5% of cancerous and 3.2% of grossly normal mucosae were positive for TA. However, neither clinical stage nor TA level in cancerous tissues had a statistical association with the use of individual substances (betel nut, alcohol, and tobacco) or their combined use. CONCLUSION: Even though the habitual uses of these substances have been previously reported to be associated with oral cancer incidence, we found a lack of correlation with TA level or with disease severity in our study. These results imply that these consumption habits might only be associated with the early stages of oral cancer development, while the later stages of cancer progression may be more associated with other external factors or dependent on host cellular factors, all of which require confirmation through further investigations.

Adult↗