Preoperative evaluation of a 12-year-old girl, previously diagnosed as having a coarctation of the aorta, revealed a rare form of isolated interruption of the aortic arch. Two-dimensional echocardiography played an important role in the delineation of the defect and significantly reduced the need for invasive techniques. It helped to anticipate problems in reaching left-sided structures at cardiac catheterization, saving time and unnecessary trauma. This technique also ruled out associated intracardiac anomalies that were not detailed at cardiac catheterization.

Aorta, Thoracic↗

PubMedDate not supplied

Recurrent congenital left atrial aneurysm in a newborn.

Recurrent congenital left atrial aneurysm presenting in a newborn as cardiac tamponade is described. Such a presentation has not been previously reported.

Cardiac Tamponade↗

PubMedDate not supplied

Estimation of age-specific rates of acquisition and loss of Wuchereria bancrofti infection.

This study uses a reversible catalytic model to estimate the age-specific rates of gain and loss of Wuchereria bancrofti infection from data collected during a control programme in Pondicherry, South India. The data describe the infection status in 1981 and 1986 of two cohorts of individuals, one living in an area where vector reduction had been achieved, and the other in a comparable endemic area. The rate of loss of infection in the absence of reinfection is estimated for the cohort in the control area, and the rate of gain of infection by the cohort in the endemic area estimated by substitution in the model. The mean expected life span of patent infection is estimated to be 5.4 years. The instantaneous rate of loss of infection is independent of age, while the rate of gain of infection exhibits a convex age-profile, peaking in the 16-20 year age-class. The reduced rate of gain in adults is largely attributable to the increasing proportion of potentially resistant individuals with clinical disease. The results suggest that the age-distribution of bancroftian filariasis is primarily determined by age-dependency in the rate of acquisition of infection.

Adolescent↗

PubMedDate not supplied

Insulinic actions of vanadate in diabetic rats.

Oral administration of sodium orthovanadate (0.3 mg/dl) normalizes blood glucose and reduces glycosylated HbA1 levels in streptozotocin induced diabetic rats without any increase in the serum insulin levels. However, diabetic condition reappears after withdrawal of vanadate. Assays of carbohydrate metabolizing enzymes clearly indicate that vanadate activates the glycolysis, glycogenesis and depresses the glycogenolysis and gluconeogenesis in diabetic rats. These results demonstrate that vanadate substitutes insulin action in chronic experimental diabetics.

Animals↗

PubMedDate not supplied

A hint from the past.

Explore the source record for details and available documents.

AIDS Dementia Complex↗

PubMedDate not supplied

Muscle-splitting posterolateral thoracotomy: a novel technique.

PURPOSE: In an effort to decrease the morbidity of a standard posterolateral thoracotomy, numerous muscle-sparing approaches have been developed. However, these incisions have been limited by the need for excessive muscle retraction with resultant neuropraxia, difficulty with exposure, and postoperative wound seroma. We report our results of a novel muscle-splitting thoracotomy incision, which affords excellent exposure without significant morbidity. METHODS: We conducted a retrospective chart review of 37 consecutive patients who underwent "muscle-splitting" thoracotomy from June 1997 to June 1998. The technique, which involves a bidirectional spread of the latissimus dorsi and serratus anterior muscles, was performed by the same attending surgeon in all patients. RESULTS: There were 22 male and 15 female patients, aged 26 to 81 (mean, 58), with a body mass index ranging from 18 to 40 kg/m(2) (mean, 25 kg/m(2)). Procedures included lobectomy/segmentectomy (19), wedge resection (5), pneumonectomy (2), Belsey IV fundoplication (5), Ivor-Lewis esophagogastrectomy (1), T8/T9 thoracic exposure (1), and miscellaneous thoracic cases (4). Operative time ranged from 90 minutes to 420 minutes (mean, 176), which was comparable with similar procedures through a standard incision. No patients required conversion to a muscle-cutting thoracotomy. CONCLUSIONS: Our technique of muscle-splitting posterolateral thoracotomy appears to provide excellent operative exposure and to avoid problems seen with current muscle-sparing incisions. A prospective, randomized trial to compare this technique with a standard thoracotomy incision would be useful in determining its viability as an alternative thoracic approach.

Journal Article↗

PubMedDate not supplied

Hypoglycemic effect of macrocyclic binuclear oxovanadium (IV) complex on streptozotocin-induced diabetic rats.

Though vanadium complexes mimic the action of insulin, owing to their toxicity, research is still in progress for a new vanadium complex with maximum efficacy at low concentration and without any side effects. A novel macrocyclic binuclear oxovanadium complex was synthesized, its composition and structure were confirmed by spectral studies and its efficacy was studied in streptozotocin-induced diabetic rats over a period of 30 days. The oral administration of the complex normalizes the blood glucose level in the diabetic rats and also maintains normoglycemia after a glucose load. The biochemical studies revealed that the complex is not toxic to the system. The nontoxic nature of this complex may be due to the presence of the vanadyl ions in an intact form. The study highlights the nontoxic and hypoglycemic effects of the new macrocyclic binuclear oxovanadium complex.

Animals↗

PubMedDate not supplied

Prospects of riboflavin carrier protein (RCP) as an antifertility vaccine in male and female mammals.

Riboflavin carrier protein (RCP) is obligatorily involved in yolk deposition of the vitamin, riboflavin, in the developing oocyte of the hen. The production of this protein is inducible by oestrogen. It is evolutionarily conserved in terms of its physicochemical, immunological and functional characteristics. It is the prime mediator of vitamin supply to the developing fetus in mammals, including primates. Passive immunoneutralization of the protein terminates pregnancy in rats. Active immunization of rats and bonnet monkeys with avian RCP prevents pregnancy without causing any adverse physiological effects of the mother in terms of her vitamin status, reproductive cycles or reproductive-endocrine profile. Denatured, linearized RCP is more effective in eliciting neutralizing antibodies capable of interfering with embryonic viability either before or during peri-implantation stages. Two defined stretches of sequential epitopes, one located at the N-terminus and the other at the C-terminus of the protein have been identified. Active immunization with either of these epitopes conjugated with diphtheria toxoid curtails pregnancy in rats and monkeys. Immunohistochemical localization of RCP on ovulated oocytes and early embryos shows that the antibodies cause degeneration only of early embryos. RCP is produced intra-testicularly and becomes localized on acrosomal surface of mammalian spermatozoa. Active immunization of male rats and monkeys with denatured RCP markedly reduces fertility by impairing the fertilizing potential of spermatozoa. These findings suggest that RCP, or its defined fragments, could be a novel, first generation vaccine for regulating fertility in both the sexes.

Amino Acid Sequence↗

PubMedDate not supplied

Ultrasound for the early diagnosis of tibial fracture healing after static interlocked nailing without reaming: histologic correlation using a canine model.

OBJECTIVE: Ultrasound is thought to be clinically useful in evaluating bone formation through its presumed identification of fracture callus. However, documentation of the actual histology of the tissue identified by ultrasound has been lacking. The purpose of this study was to determine the histologic composition of the hyperechoic tissue "seen" by ultrasound. STUDY DESIGN: Unilateral fractures were created in eight canine tibias and then fixed by using locked intramedullary nailing without reaming. The limbs were studied at two, three, four, six, and eight weeks postoperatively with plain radiographs, ultrasound, and ultrasound-directed needle biopsy. RESULTS: The presence of a hyperechoic ultrasound signal was found to have a 100 percent correlation with the presence of hard fracture callus biopsy tissue. In addition, fracture union by ultrasound criteria significantly predated radiographic fracture union (5.6 vs. 7.3 weeks, p = 0.05). CONCLUSIONS: These results support and provide a scientific basis for the clinical use of ultrasound to assess tibial fracture healing following static interlocked nailing without reaming.

Animals↗

PubMedDate not supplied

Ultrasound for the early diagnosis of tibial fracture healing after static interlocked nailing without reaming: clinical results.

OBJECTIVE: Based on the results of a pilot study indicating the potential value of ultrasound (US) as a diagnostic tool for the early assessment of fracture healing and the related need for secondary operative procedures in patients treated by statically locked intramedullary (IM) nailing without reaming, a protocol was established for a larger scale prospective trial. The purpose of this study was to evaluate the outcome of this follow-up trial. DESIGN/METHODS: All skeletally mature patients admitted to the Henry Ford Hospital (Detroit, Michigan) from January 1993 to August 1994 who had sustained an acute fracture of the tibial shaft and who were treated by statically locked IM nailing, without reaming, were candidates for study. Forty-seven patients with fifty fractures that could be evaluated by US were included. The adopted determinants for fracture healing were complete disappearance of the IM nail on US examination performed at six weeks postoperatively, or progressive disappearance of the nail noted between the initial six-week study and a second nine-week US examination, both in conjunction with periosteal callus formation. Radiographs were obtained to monitor maintenance of reduction and to further evaluate fracture healing. RESULTS: Of thirty-eight fractures with a positive US (thirty-two at six weeks, six at nine weeks), thirty-seven healed uneventfully, a positive predictive value of 97 percent. Radiographic fracture healing was not evident until, on average, nineteen weeks after injury. The single false-positive fracture progressed to nonunion. Of the twelve fractures with negative US studies, ten underwent secondary procedures (nine dynamization, one bone graft), with four progressing to nonunion. Two patients refused secondary surgery; screw failure occurred in both. Otherwise, there were no hardware failures in this series. CONCLUSIONS: The results of this study indicate that US may provide important prognostic information concerning fracture healing after unreamed tibial nailing, upon which subsequent treatment can be based.

Adolescent↗

PubMedDate not supplied

Gonococcal urethritis with bilateral tysonitis and periurethral abscess.

A case of gonococcal urethritis with bilateral tysonitis and periurethral abscess is described. The diagnosis of gonococcal urethritis was made by microscopic detection of typical gram-negative intracellular diplococci in cells of the urethral discharge. The patient was treated with oral ampicillin and probenecid for ten days together with oral oxytetracycline for seven days; he responded favorably to antibiotics, and surgical intervention was unnecessary.

Abscess↗