Parascapular fasciocutaneous flap for covering an above-elbow amputation stump

The successful use of a parascapular fasciocutaneous flap to cover an above-elbow amputation stump with exposed bone is described. Better stability of the stump to pressure (or manipulations), a relatively early one-stage surgical procedure and diminished possibility of later contracture leads to a better long-term outcome.

Hepatic membranolytic stability alteration by metalloporphins in rats

The mothers of experimental neonates were administered excess bilirubin for a month, and the neonates were suffering from hyperbilirubinemia. The studies were conducted on the effect of excess bilirubin and metalloporphyrins on plasma membrane and mitochondrial membrane. We have isolated, separated, and estimated phospholipids, and also assayed the activity of phospholipase A2 from whole liver and mitochondrial and microsomal fractions. Excess of bilirubin administration decreased the total phospholipid level and inhibited the phospholipase A2 activity. Cr-PP (chromium protoporphyrin) induces the phospholipase A2 activity which is inhibited by simultaneous bilirubin administration. However, Zn-PP (zinc protoporphyrin) and Mn-PP (manganese protoporphyrin) showed a reverse pattern.

The medial upper arm fasciocutaneous flap. An alternative flap to cover palmar defects of hand and distal forearm

Cutaneous defects on the palmar aspect of the hand and distal forearm can usually be covered by split skin grafts or, if the defect is small, by local flaps. However, for larger defects, especially in acute injuries where preservation of functional parts like nerves and tendons is in jeopardy and particularly when further surgery is contemplated, flap coverage becomes essential. Such a flap, besides being uniformly dependable and cosmetically acceptable, must have a reasonable position of immobilization, must be easy to nurse and must not hamper the daily routine of the patient. The medial upper arm fasciocutaneous flap, both distally based and proximally based appears, after a critical evaluation, to be the best answer to this problem short of a microvascular free flap.

Postburn contracture of the neck--our experience with a new dynamic extension splint

Twenty-eight examples of postburn contracture of the neck managed during the last 5 years gave us a better understanding of the problems of anaesthesia, contracture release, skin grafting, splintage and maintenance of the fully release state. The severe contracture should be incised before intubation under a local anaesthetic agent. The release should include the adjoining contractures of mandibular and pectoral regions lest the skin graft is pulled by the existing contracture. Haemostasis should be meticulously secured to avoid graft loss. Splintage should be a static splint for 4-6 weeks followed by a dynamic splint until the applied graft becomes soft, supple and wrinkle free. Ideally, however, contractures should be prevented by nursing the patient with a neck extension in the acute phase and wearing a cervical collar during the subacute phase of wound healing.

Alzheimer disease: measuring loss of cerebral gray matter with MR imaging

The distributions of the cerebral gray matter, the white matter, and the intracranial cerebrospinal fluid (CSF) were measured in 14 patients with Alzheimer disease (AD) and in 14 healthy control subjects. The measurements, derived from two specifically designed magnetic resonance inversion-recovery sequences, compensate for partial signal averaging. The percentage of the gray matter in the brains of AD patients (44.9% +/- 4.4) was significantly lower than in control subjects (50.2% +/- 3.2). The most significant reduction (P less than .001) occurred in the temporal lobes (13.8%) and a central region (12.8); the reduction in frontal lobe (11.2%) and occipital lobe (9.2%) was also statistically significant (P less than .01). There was an increase in the CSF volume in the temporal, occipital, and frontal regions; no region showed a significant difference in the white matter content. The findings of diffuse changes and temporal lobe involvement in AD are consistent with pathologic observations of cortical cell loss.

Expansion of the infant subglottis by external cricoid distraction: an animal model

A technique is described to expand the subglottis by anterior cricoid split (ACS) combined with external cricoid distraction (ECD) using a posterior belly of digastric muscle sling. This technique was used on 5-week-old rats that were killed 6 weeks after surgery, and the larynges were examined histologically and compared with those of rats who underwent ACS alone. Information was available from ten animals in the ECD group and five in the ACS alone group. Separation of the cut ends of the cricoid was found to be maintained in all animals after ECD, the gap having been filled by fibrous tissue lined by respiratory epithelium. A lesser degree of cricoid separation was seen in the animals that underwent ACS alone.

Determinants of depression in recent onset pediatric inflammatory bowel disease

Thirteen children with new-onset inflammatory bowel disease were given a Kiddie-SADS-E interview. Three were depressed at diagnosis. Six mothers had a history of depression based on Adult-SADS-L interviews. The depressed children were less severely ill than the nondepressed children and had not required steroids. However, the depressed children had significantly more life events and their families showed more evidence of conflict than did the nondepressed children.

Growth inhibition in vitro of Mycobacterium smegmatis by ten N-aryl glycyl hydrazides

N-(4-amino-2-nitro-toluinyl) glycyl hydrazide and N-(biphenyl) glycyl hydrazide partially inhibited the growth of M smegmatis at 20 micrograms/ml and showed a total inhibition at 100 micrograms/ml. Replacement by a nitro or halogen group lowered the activity.

Sex bias in immunization coverage in an urban area of U.P

Two hundred and ten female and two hundred and ten male children aged 1-2 years were identified using 30 cluster random sampling technique in the Nagar Palika of Sitapur. The immunization status was determined to assess differences, if any, in the coverage in accordance with the sex of the child. Except for measles, a significantly higher vaccination coverage was observed for male children as compared to females for every vaccine, this being 65.2 and 60.9%, respectively for DPT III and OPV III for males as compared to 51.9 and 49.5%, respectively for girls. The drop out rates for DPT and OPV were also found to be higher (p greater than 0.05) in female children. However, no difference was observed in the reasons for non-immunization between the female and male children.

The lateral thoracic region flap

The lateral thoracic region flap is based at the level of the 3rd rib on multiple direct cutaneous perforators. It has an excellent vascularity with a dependable length/width ratio of 3:1. The donor area, which lies in a concealed region, can often be closed primarily. The flap is hairless and can be used anteriorly to cover raw areas over breast and axilla and posteriorly over scapula and chest wall. As a distant flap it can be used to resurface raw areas on the ipsilateral upper arm and forearm and contralateral hand. The successful use of the flap in 40 cases in this series confirms its reliability, versatility and convenience.

Evaluation of filarial skin test with Brugia malayi larval antigen in the field

To obtain comparable and reproducible results by filaria skin test with B. malayi larval antigen, standard procedure has been evolved. Antigen protein of 2 micrograms per test, injected intracutaneously, was found optimum for positive skin reaction. The reaction ratio based on increase of wheal area by 2 times or more was found to be statistically significant for interpreting positive results. However, in larger field trials, the simpler measurement of increase of wheal diameter by 1 1/2 times or more was found to be equally reliable. Patients treated with diethylcarbamazine citrate, antihistaminics and anti-inflammatory drugs are likely to be unresponsive to filarial antigen and will yield incorrect information.

Depression and anxiety in pediatric inflammatory bowel disease and cystic fibrosis

The lifetime and current prevalence of depression and anxiety disorders was determined in 41 children with Crohn's disease, 12 children with ulcerative colitis, and 52 children with cystic fibrosis, using the Kiddie-Schedule for Affective Disorders and Schizophrenia interview. The lifetime prevalence of depression was 29% in Crohn's disease, 21% in ulcerative colitis, and 11.5% in cystic fibrosis. The difference in the prevalence of depression between Crohn's disease and cystic fibrosis was significant (p less than 0.05). The lifetime and current prevalence of dysthymia was significantly greater in ulcerative colitis than Crohn's disease (p less than 0.01) or cystic fibrosis (p less than 0.01). The lifetime prevalence of atypical depression was significantly greater in Crohn's disease than cystic fibrosis (22% versus 5.8%, p less than 0.05) and was also greater in ulcerative colitis than cystic fibrosis (21% versus 5.8%, p = 0.1). There was no difference between the groups in the current prevalence of major depression or atypical depression, or in the lifetime or current prevalence of anxiety disorders.

Coagglutination test: a simple and rapid diagnostic technique for goat pox

The coagglutination test was standardised using Staphylococcus aureus strain Cowan I (containing Protein A) coated with anti-goat pox serum for the detection of goat pox antigen of infected goat skin or kid kidney cell culture antigen. Agglutination was observed within 10 seconds in virus dilutions up to 10(-6). As the test is easy to perform it can be used for rapid diagnosis of goat pox.

Documentation of the first web space angle

We describe a new method of measuring adduction contractures of the thumb by using stent mould casts of the first web, which are sectioned sagittally to give an accurate clinical angle at their cut section. This can be recorded from ink impressions. This method has been used successfully in 65 cases and appears more accurate than other methods.

Obsessive-compulsive symptoms in childhood inflammatory bowel disease and cystic fibrosis

The Leyton Obsessional Inventory-Child Version was administered to 33 children with Crohn's disease, 11 with ulcerative colitis, and 46 with cystic fibrosis. Subjects with ulcerative colitis scored significantly higher on total number of obsessional symptoms and degree of resistance to symptoms than subjects with Crohn's disease. Scores of subjects with cystic fibrosis were intermediate between those of the ulcerative colitis and Crohn's disease groups. However, neither the ulcerative colitis group nor the Crohn's disease group differed significantly from the cystic fibrosis group that were statistically significant. Duration of illness was negatively correlated with symptoms in Crohn's disease and ulcerative colitis. The results suggest that obsessive-compulsive symptoms are not specific to Crohn's disease or ulcerative colitis and that obsessive-compulsive symptoms in pediatric chronic illness may be secondary to the demands of the illness.

Documentation of the First Web Space Angle

We describe a new method of measuring adduction contractures of the thumb by using stent mould casts of the first web, which are sectioned sagittally to give an accurate clinical angle at their cut section. This can be recorded from ink impressions. This method has been used successfully in 65 cases and appears more accurate than other methods.

Role of lithium carbonate in pancytopenia following cytotoxic therapy

Twenty-four patients presenting with pancytopenia following cytotoxic therapy were studied. Seventeen of them were given 900 mg/day of lithium carbonate apart from other supportive measures. Seven patients were used as controls and were not given any lithium. After 2 weeks, granulocyte count was significantly higher (p less than .05) in lithium-treated group. Platelet count was also higher though not statistically significant.