Accuracy of localization of cervical intervertebral disk extrusion or protrusion using survey radiography in dogs.

Sixty-four dogs with histories and clinical signs consistent with cervical intervertebral disk disease were presented for evaluation. Survey spinal radiographs were obtained, followed by myelography. In 61% of the survey radiographs, evaluators identified sites of disk extrusion or protrusion based on radiographic findings. Of those radiographs where a site was identified, ability to accurately identify the correct site of disk extrusion ranged from 53% to 67%, with an average of 58%. Therefore, the overall accuracy rate for correct identification of the site(s) of disk extrusion for all survey radiographs was 35%. Twelve cases had more than one site of disk extrusion or protrusion evident myelographically. In cases where multiple sites of extrusion were confirmed myelographically, the ability to localize at least one of the sites on the corresponding survey radiographs ranged from 63% to 80%, with an average of 70%. The major site of disk extrusion or protrusion was incorrectly identified in 16% to 31% of the survey radiographs, with an average of 26%. The use of survey radiographs alone is an inaccurate means for localization of cervical intervertebral disk extrusion or protrusion.

Longitudinal myotomy of the supraspinatus muscle: a new approach to the supraglenoid tubercle of the scapula.

A lateral approach to the shoulder joint via a longitudinal myotomy of the supraspinatus muscle was used in the surgical treatment of four cases involving avulsion fractures of the supraglenoid tubercle of the scapula. This approach was developed using cadaver specimens and was compared to previously reported approaches to the supraglenoid tubercle. This approach gave excellent, visualized exposure and permitted accurate reduction and fixation for this type of fracture. Excellent results were achieved in four clinical cases.

Dorsal laminectomy in the treatment of cervical intervertebral disk disease in small dogs: a retrospective study of 30 cases.

Dorsal laminectomy was used to treat 30 dogs with cervical intervertebral disk disease. A variety of breeds were represented, and all animals weighted 15 kg or less. Myelography was utilized to locate each solitary disk herniation. All 30 cases progressed to complete recovery which indicates that dorsal laminectomy may be performed with success in small dogs with intervertebral disk disease.

Repair of acute scapho-lunate dissociation facilitated by the "TAG" suture anchor.

A case of acute scapho-lunate dissociation is described in which the operative treatment was facilitated by the use of the "TAG" suture anchor.

Incidence and prognosis of Krukenberg tumour in Northern Ireland.

The case notes of 15 patients with Krukenberg tumours were studied to determine the incidence, presentation, clinical findings and prognosis of the disease in Northern Ireland. Patients tended to be young and premenopausal. A short history of abdominal pain was the most frequent presenting complaint, abdominal swelling being second. Menstrual irregularities occurred infrequently and no patient was virilized. Tumours tended to be large, bilateral and associated with ascites. The stomach was the commonest primary site. The overall prognosis was poor, especially if the primary tumour remained covert at the time of diagnosis. The prognosis was unaffected by subsequent discovery of the primary source; extensive investigation is inconvenient for the patient and wasteful of resources. The incidence of the tumour in Northern Ireland was 0.16 per 100,000 per annum: it will be rarely encountered by general surgeons.

Sleep pattern and night awakening in healthy infants.

Sleep pattern and night-awakening were studied in 500 healthy infants by a semistructured interview method. A total of 92.2% infants shared bed with their mothers, 6.8% with grand parents and 1% with fathers. Paternal participation at bedtime was observed to be insignificant. Infants of non-working mothers and families with vegetarian habits slept significantly more as compared to the working mothers and families with non-vegetarian habits. Night-time awakening was reported in 96% of the infants. If a child is functioning well in other areas of life, parents can be assured that the problem is not of serious concern and unnecessary medication of infants should be avoided.

A comparative study of sterilisation acceptors.

PIP: This study was conducted retrospectively at the Family Welfare and Post Partum Center, Dayanand Medical College and Hospital, Ludhiana. The data on sterilization acceptors for 1986-87 to 1989-90 were utilized. The acceptors were divided into: 1) direct acceptors (women who accept a family planning method before leaving the hospital or within 3 months of delivery or abortion); 2) indirect acceptors (women who adopt a family planning method 3 months later); and 3) total acceptors (direct acceptors plus indirect acceptors). During 1989-90, 97.80% of sterilizations were performed on females, while only 2.20% were performed on males. The acceptance of vasectomy was highest in 1987-88 (14.55%) owing to an enhanced incentive. Females aged 25-29 years were the most receptive group for tubectomy, followed by those aged 30-34 years. During 1987-88, 40.78% of women accepted tubectomy at 25-29 years of age vs. 33.98% at 30-34 years. During 1989-90, 44.58% of females accepted sterilization at 25-29 years of age vs. 30.85% at 30-34 years. The difference between direct and indirect acceptors was statistically highly significant (p 0.001). There were 78.20% direct and 21.80% indirect acceptors during 1988-89. In 1989-90, 48.93% and 24.04% of direct acceptors and 42.08% and 32.02% of indirect acceptors with 3 and 4 living children, respectively, accepted sterilization. However, in all years, sterilization remained the ideal choice for all acceptor couples with 3 living children. During 1988-89, 33.50% of direct and 36.07% of indirect acceptors had tubectomy at parity 2, as compared to 17.64% and 23.42% at parity 4, respectively. A highly significant correlation was observed between the age of the mother and the number of living children (r = 0.95). Surprisingly all the vasectomy cases were indirect acceptors. In 1986-87, 87.86% accepted tubectomy after abortion and delivery vs. only 12.14% after the discharge from the hospital. 59.30% of these immediate acceptors had tubectomies postpartum and only 40.65% after abortion. Tubectomy acceptance along with abortion rose to 76.90% and 71.50% during 1988-89 and 1989-90, respectively. Most couples opted for tubectomy concurrently with abortion after having 3 living children.^ieng

Chronic granulomatous disease presenting with osteomyelitis: favorable response to treatment with interferon-gamma.

A 3-year-old boy with chronic granulomatous disease presented with abscesses related to underlying osteomyelitis. Treatment with appropriate antibiotics resulted in resistance of the organisms. Treatment with interferon-gamma was encouraging in that it caused the osteomyelitis to heal and prevented its relapse when used as long-term prophylaxis.

Stressful family life events and nonspecific somatic complaints in school children.

The relationship between stressful family life events and somatic complaints in 477 school children was studied. There was a significant association between life events and somatic complaints, with a general trend for somatic complaints to increase in almost direct proportion to the number of family life events. Overall occurrence of these nonspecific symptoms was more in girls. The somatic complaints were significantly more in children from nuclear families and of illiterate or poorly educated mothers. No significant association was observed between somatic complaints and number of children in the family or socio-economic status. Assessment of psychodevelopmental tasks and family environment during routine check up of children by the school health teams and their appropriate training in this field should be stressed upon.

A review of 100 consecutive Richard's total knee replacements.

One hundred consecutive Richard's Maximum Contact (RMC) knee replacements were performed in Belfast between 1978 and 1982. Most of the 100 knees (86 patients) involved had been in severe pain, had marked stiffness or gross knee deformity, or were chairbound because of the knee. They were reviewed between five and eight and a half years (mean five years and eleven months) after operation. Thirteen patients (13 knees) died before review leaving eighty seven knees in 73 patients available for study. Using a modification of the British Orthopaedic Association knee function assessment chart, 26 knees (30%) were graded as excellent, 22 (25%) as good, 19 (22%) as fair and nine (10%) as poor. There were five implant failures, four the result of deep infection, one due to loosening. Six patients were chairbound at review and were also graded as failures. These results support the view that total knee replacement approaches the predictability and success of arthroplasty of the hip.

Effect of child loss on contraception acceptance.

PIP: In India, interviews were conducted with 250 couples who had at least 2 living children and at least 1 son so researchers could examine the effect of child loss on contraceptive usage. The interviewees lived in the area served by the rural health center in Pohir. 67 couples had lost a child. The child loss group had an acceptance rate for contraception of 41.7% compared to 44.8% for the group who had not experienced child loss. The difference was insignificant. Caste, literacy, and parity did not affect contraceptive usage. These findings suggest that child loss does not play a crucial role in contraception acceptance. On the other hand, some studies show that it is a barrier to fertility limitation. Additional studies are needed to resolve the issue of child loss and fertility.^ieng

Adolescent girls' anxieties -- role of stressful life events.

PIP: The study aim was to examine stressful events among 300 adolescent girls 11-17 years old enrolled in school in India. 50.33% had illiterate mothers. 22.33% had mothers who had a primary education and 25.34% who had a secondary education. 82.33% (247) were from nuclear families, and 17.67% (53) were from joint families. The largest proportions reported financial problems (38.67%) followed by household moves (30.33%) and a close relative's death (27.33%). Other concerns reported were parental frequent change or loss of job (12.33%), involvement in a court case (4.67%), death of one or both parents (4.33%), and frequent parental arguments (1.33%) and serious family accidents (1.33%). No stressful events were reported by 31.69% (95 girls); 68.34% reported stressful family events. A significant correlation was found between anxiety and life in a nuclear family (p 0.001). Anxiety was also higher, but not statistically significantly so, among families with an illiterate mother and lower socioeconomic status. More anxieties were reported among girls with working mothers (68%) than non-working mothers (32%). A significant correlation was found between the score of life events and the number of girls reporting anxieties. Individual anxieties were reported for inadequate height (15.66%), fear of boys' teasing (12.33%), losing hair (11.60%), menstrual tensions (10.33%), weak eyesight (9.66%), pimples (9.33%), weakness (8.88%), lack of study time (5.67%), excessive weight (3.67%), dark complexion (2.66%), and bad teeth (2.00%); 55.34% reported these anxieties.^ieng

"Safe motherhood and child survival" -- making the possibility become a reality through a relevant medical curriculum.

PIP: More than 66% of the population in the developing world consists of mothers and children. 250,000 children die each week, or approximately 15 million each year. 1400 women die daily during childbirth. Most child mortality is, however, preventable. Preventive measures and the promotion of safe motherhood could be achieved through actions which are universally affordable and based upon already existing knowledge. Top-level government commitment, physicians to provide motivation and leadership for child survival and safe motherhood programs, and adequate manpower at the grassroots level are required to get the job done. Unfortunately, doctors have not been trained in integrated maternal and child health, and are currently ill-equipped to launch an era of improved child survival and maternal health in India. Major change is needed in the medical curriculum, especially with regard to pediatrics, obstetrics, and social medicine, if safe motherhood and child survival are to become realities. Integrated, problem-based, community-oriented training in maternal and child health care is called for.^ieng

Glycosaminoglycans of bovine aorta endothelial cells: identification and localization by use of a platelet factor 4-fluorescein probe.

We utilized platelet factor 4 (PF4) conjugated to fluorescein to stain the proteoglycans of permeabilized fixed bovine aorta endothelial cells in monolayer culture. Treatment of the monolayers with chondroitin ABC lyase and/or a preparation from Flavobacterium heparinum was used to remove chondroitin sulfate and/or heparan sulfate before staining, with resultant separate identification and partial localization of these glycosaminoglycans. When PF4-fluorescein was utilized with untreated control monolayers, fairly uniform reticular, perinuclear, and cell surface fluorescence was seen. After treatment with chondroitin ABC lyase, fluorescence was retained only on the cell surface. In contrast, treatment with the F. heparinum preparation resulted in the loss of all cell surface fluorescence. Use of both glycosaminoglycan lyases together resulted in loss of essentially all the fluorescence. The cell surface heparan sulfate observed by fluorescence after removal of cell surface chondroitin sulfate appeared to be unevenly distributed, with a heavier accumulation at one pole of each cell. This technique offers a specific method for identification and partial localization of cell surface heparan sulfate.

The influence of fetal number on antepartum uterine activity.

Home uterine activity monitoring was performed by 54 women with singleton, 30 with twin, and 34 with triplet gestations. Data were analyzed to determine the relationship between antepartum uterine activity, preterm labor, and fetal number. Preterm labor in singleton and twin gestations was preceded by significant increases in pre-labor contraction frequency (P less than .01). However, in triplets, preterm labor was not preceded by increased pre-labor contractions. Triplet and twin gestations with term labor were associated with higher baseline contraction frequencies than were high-risk singleton gestations with term labor (P less than .05). Fetal number had no impact on pre-labor contraction intensity, although triplet gestations had a significantly greater proportion of uterine activity occupied by low-amplitude, high-frequency contractility.

Investigation of the mechanical properties of bone using ultrasound.

This paper examines the serial use of ultrasonic velocity measurement to monitor fracture healing. New Zealand White rabbit tibiae were fractured using a constant-energy technique and the ultrasonic velocity along the bone measured in animals sacrificed at 16 day intervals up to 96 days from fracture. In parallel with these measurements the mechanical performance of the healed tibiae were determined using a three-point bending test. Regression analysis failed to show a sufficiently good correlation between ultrasonic velocity measurements and the bending properties of healing fractures for the method to be of use clinically.