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A severe form of an extremely unusual injury, ipsilateral fracture dislocation of the radial shaft head associated with elbow dislocation, is described. Radial shaft fracture was irreducible even after the radial head and the elbow were reduced. Open reduction and internal fixation are viable options.

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THE JOURNAL OF UROLOGY® was measured using a specific enzyme immunoassay. Samples were frozen immediately and stored frozen until assayed. The bladder strips were dried and weighed.RESULTS : The rapid production of PGE2 in the tissue bath was triggered by stimulation with BK. The induction occurred within the first minute and continued to increase during the first 10 min (t 112 = 6 min). Receptor activation by BK produced a larger magnitude PGE2 response than SP. Pre-incubation with ketoprofen for 10 min blocked the BK-stimulated PGE, response. Ketoprofen also inhibited BK-induced muscle contraction. Dose-response analysis demonstrated a progressive maximal reduction in contraction amplitude, about 70% at 10 ILM ketoprofen. The IC50 for inhibition of BK-contraction corresponded closely to the IC50 for inhibition of BK-induced PGE2 (0.58 ILM). Flurbiprofen was also an effective inhibtor, although less potent (IC50 = 25 ILM). COX-2 selective inhibitors (DuP-697, SC-58125) were not effective (< 50% at 301LM).CONCLUSIONS: These results demonstrate that rapid production of PGE2 is triggered by bradykinin acting on rat bladder smooth muscle in vitro. BK stimulated PGE2 release occurs concurrently with smooth muscle contraction. A non-selective COX inhibitor, ketoprofen, simultaneously inhibits the rapid production of PGE2 and smooth muscle contraction.