The Cylapinae (Insecta, Hemiptera, Heteroptera: Miridae) of India: review of the subfamily with description of new species.

The subfamily Cylapinae (Insecta, Heteroptera: Miridae) from India is reviewed. Three tribes, seven genera and nineteen species are cited from the country, keyed and described. Six species are described as new: Fulvius kadapaensis sp. nov., Peritropis kodava sp. nov., Peritropis pathaki sp. nov., Peritropis sangai sp. nov., Peritropis yasunagai sp. nov. and Rhinomiris prathapani sp. nov. A new synonymy is published: Peritropis lewisi (Distant, 1904) (valid name) = Peritropis indicus Gorczyca, 2006b (new junior subjective synonym).

Arterial supply and venous drainage of the choroid plexus of the human lateral ventricle in the prenatal period as revealed by vascular corrosion casts and SEM.

The topography of the arterial supply and venous drainage was visualised by corrosion casting and scanning electron microscopy in the human foetal (20 weeks) choroid plexus of the lateral ventricle. Although secondary villi were not yet present at that developmental stage, the topography of the large arteries and veins almost fully corresponded to that described in adult individuals. The only major difference observed was a lack of the typical tortuosity of the lateral branch of the anterior choroidal artery and of the superior choroidal vein, which probably develops during further expansion of the vascular system associated with the formation of secondary villi.

The microvascular architecture of the choroid plexus in fetal human brain lateral ventricle: a scanning electron microscopy study of corrosion casts.

The microvascular architecture of developing lateral ventricle choroid plexus was investigated by corrosion casting and scanning electron microscopy in human fetuses aged 20 gestational weeks. The areas with different microvascular patterns corresponded to the particular parts of the mature plexus: anterior part, glomus, posterior part, the villous fringe and the free margin. In the posterior part, densely packed parallel arterioles and venules were surrounded by sheath-like capillary networks. Other areas contained compact capillary plexuses of the primary villi: the most prominent, protruding basket- and leaf-shaped plexuses were observed in the villous fringe, whilst less numerous and smaller plexuses occurred in the anterior part and glomus. The capillaries of the plexuses had a large diameter and sinusoidal dilations, and showed the presence of occasional short, blind sprouts indicative of angiogenesis. Short anastomoses between arterioles supplying the plexuses and venules draining them were only rarely observed. In the upper area of the choroid plexus, the superior choroidal vein was surrounded by a capillary network forming small, glomerular or rosette-shapes plexuses. The free margin of the choroid plexus was characterized by flat, multiple, arcade-like capillary loops. The general vascular architecture of the human choroid plexus at 20 gestational weeks seems to be similar to that of postnatal/mature plexus, still lacking, however, the complex vascular plexuses of the secondary villi.

Vascular architecture of normal human urinary bladder and its remodeling in cancer, as revealed by corrosion casting.

The vasculature of normal human urinary bladder wall and its tumors were studied using corrosion casting and scanning electron microscopy. In the normal wall, a regular organization of highly tortuous horizontal and vertical vessels allows accommodation of the vascular system to spatial changes resulting from the filling/voiding cycle. The vasculature of tumors is a result of remodeling of preexisting wall vessels associated with gradual growth of the neoplastic tissue. The shape and arrangement of blood vessels in different regions of the tumor seem to reflect a variable dynamics of tumor development and possible influence of various angiogenesis-promoting growth factors.

Vascular system of the human spinal cord in the prenatal period: a dye injection and corrosion casting study.

The vascularization of the spinal cord was investigated in 50 human fetuses aged from 10 to 28 gestational weeks using dye injection methods and corrosion casting accompanied by scanning electron microscopy. In the investigated period of fetal development, the general vascular architecture of the spinal cord, corresponding to that described postnatally, seemed to be already established. The observed changes included: (1) remodeling of the supplying (extrinsic) arterial branches, (2) transformation of the posterior anastomotic chain into two distinct posterior spinal arteries, and (3) development of the capillary networks in the gray and white matter. The remodeling of the radicular arteries supplying the spinal cord was accompanied by a decrease in their number and transition from regular to irregular distribution (appearance of intersegmental differences in their frequency). The anterior spinal artery and regular array of the central arteries were already present in the youngest fetuses examined, but the final remodeling of the posterior anastomotic chain into two posterior spinal arteries occurred between 15th and 20th week of fetal life indicating that the vascularization of the anterior region of the spinal cord in the investigated period of fetal life was more advanced as compared with that of the posterior region. The capillary network of the gray matter in the youngest fetuses had the form of discrete glomerular plexuses supplied by groups of central arteries and mainly vascularizing the anterior horns. Successively, the plexuses fused to form a continuous system along the anterior columns and the system expanded to fully vascularize the posterior horns. The white matter in the earlier fetal period seemed to be partially avascular, later the density of capillaries vascularizing those areas was still much lower than in the gray matter. The veins showed considerably greater variability than the arteries, as far as their topography and distribution was concerned. High tortuosity characterized the superficial veins, especially in the younger fetuses, although the degree of tortuosity differed even between individual fetuses. Only anterior spinal and central arteries were usually accompanied by their venous counterparts, the other veins seemed to have no regular topographical relations with the arteries.

Open reduction internal fixation after displacement of a previously nondisplaced acromial fracture in a multiply injured patient: case report and review of literature.

SUMMARY: A twenty-eight-year-old multiple trauma patient had a nondisplaced acromion fracture that was not detected until after it had displaced. Open reduction internal fixation was performed without complication and the patient achieved excellent shoulder abduction strength. Nondisplaced acromion fractures may displace if not protected. Open reduction internal fixation of displaced acromion fractures should be considered if deltoid muscle strength is important to the patient.

Late arthroscopic debridement of metal fragments and synovectomy after penetrating knee joint injury by low-velocity missile: a report of two cases.

Retained metal debris from intraarticular missile injury to the knee may produce mechanical symptoms and synovitis. Arthroscopic debridement and thorough synovectomy can relieve symptoms and allow early return of function.

Irreducible lateral dislocation of patella due to an intact retinaculum.

Lateral dislocation of the patella is a common injury that can be treated successfully nonoperatively. The authors present a patient with lateral dislocation of the patella in which the patella rotated 90 degrees about its vertical axis. The retinaculum had been avulsed from the anterior aspect of the patella but was otherwise intact. Because the intact retinaculum prohibited closed reduction, open reduction was performed. The patient has returned to full, unrestricted activities.

Supracondylar humerus fractures in children. Comparison of operative treatment methods.

A retrospective analysis was performed of 87 children treated operatively for supracondylar humerus fractures by 18 different surgeons during a 6-year period. No patient suffered from compartment syndrome or Volkmann's ischemic contracture. Early postoperative fracture displacement occurred in four (7%) of 60 patients with Type III fractures, and in one (4%) of 23 patients with Type II fractures. Displacement occurred in one (2%) of 52 Type III fractures stabilized with crossed medial and lateral Kirschner wires, whereas displacement occurred in two (28%) of seven Type III fractures stabilized with lateral wires only. Thirty-four patients could be located for long-term followup; complete examination of both upper extremities was performed on these 34 patients at an average of 33 months postoperatively. The long-term results were excellent in 19 (56%), good in seven (21%), fair in one (3%), and poor in seven (21%) patients. Five additional patients were not available for followup at the time of the current study, but had followup of at least 6 months available. Of the 39 patients with followup of at least 6 months, five patients' fractures (13%) healed with coronal plane malalignment greater than 10 degrees which resulted in gunstock deformity. There was no statistically significant relationship between treatment method and gunstock deformity. However, none of the patients with gunstock deformity had compromised activity because of the deformity, and all had full elbow extension and at least 130 degrees elbow flexion.

Musculoskeletal trauma in tobacco farming.

The incidence of musculoskeletal injury sustained during tobacco farming has been poorly documented. Using the trauma registry for all farm-related injuries occurring during a 16-month period, hospital charts, radiographs, and clinic charts were reviewed to identify those patients sustaining tobacco farming-related injury. Twenty-three of 24 persons who sustained a farm-related injury during the study period were injured while farming tobacco. Seventeen (74%) were injured in falls from vented tobacco-drying barns, and 18 (75%) sustained skeletal injury. Extreme heat, humidity, and poor barn design and maintenance contribute to the incidence of falling. These injuries, largely underreported, may be substantially reduced by improvements in barn design and construction.

Effect of acute reamed versus unreamed intramedullary nailing on compartment pressure when treating closed tibial shaft fractures: a randomized prospective study.

OBJECTIVE: To compare anterior and deep posterior compartment pressures during reamed and unreamed intramedullary nailing of displaced, closed tibial shaft fractures. DESIGN: Randomized prospective study. SETTING: University Hospital/Level I trauma center. PATIENTS: Forty-eight adults with forty-nine fractures treated with intramedullary nailing within three days of injury. INTERVENTION: After intraoperative placement of compartment pressure monitors, the tibia fractures were treated by either unreamed intramedullary nailing or reamed intramedullary nailing. A fracture table and skeletal traction were not used in any of these procedures. MAIN OUTCOME MEASUREMENTS: Compartment pressures and deltaP ([diastolic blood pressure] - [compartment pressure]) were measured immediately preoperatively, intraoperatively, and for twenty-four hours postoperatively. RESULTS: Compartment syndrome did not occur in any patient. Peak average pressures were obtained during reaming in the reamed group (30.0 millimeters of mercury anterior compartment, 34.7 millimeters of mercury deep posterior compartment) and during nail insertion in the unreamed group (33.9 millimeters of mercury anterior compartment, 35.2 millimeters of mercury deep posterior compartment). The average pressures quickly returned to less than thirty millimeters of mercury and remained there for the duration of the study. The deep posterior compartment pressures were lower in the reamed group than in the unreamed group at ten, twelve, fourteen, sixteen, eighteen, twenty, twenty-two, and twenty-four hours postoperatively (p < 0.05 at each of these times. A statistically significant difference between anterior compartment pressures could not be shown with the numbers available. The deltaP values were greater than thirty millimeters of mercury at all times after nail insertion in both the reamed and unreamed groups. CONCLUSION: These data support acute (within three days of injury) reamed intramedullary nailing of closed, displaced tibial shaft fractures without the use of a fracture table.

Architecture of blood vessels in human fetal gastric corpus: a corrosion casting study.

Vascular architecture of the gastric corpus was investigated in 16-24 wk human fetuses using a corrosion casting technique and the scanning electron microscopy. The general distribution of blood vessels seen in adults has already been established in the fetus, with three major vascular plexuses located in the serosa, submucosa and mucosa. The serosal plexus, supplied and drained by large extramural vessels, contained anastomosing, arcade-like arrays of arteries and veins with their branches piercing the muscularis and communicating with the compact submucosal plexus. Vertical arterioles and capillaries were sent by submucosal arteries to supply a very dense capillary plexus which surrounded the gastric pits and consisted of wide, sinusoidal vessels showing morphological manifestations of angiogenesis by intussusceptive growth. The plexus was drained by vertical venules emptying into submucosal veins. In contrast to the richly vascularized upper half of the mucosa, the lower half showed a relative paucity of blood vessels, probably due to the thinness of the fetal mucosa allowing an effective diffusion of oxygen and nutrients from the upper half. Neither arteriovenous anastomoses, nor end-arteries were found in the fetal stomach. Results of this study support one of the two existing models of mucosal vascularization in the human stomach: i.e. the model postulating the presence of short and long arterioles and two distinct, albeit interconnected capillary networks in the upper and lower zones of the mucosa respectively. In human fetuses, the latter network is absent; it probably develops by remodelling of the preexisting vertical capillaries in the last phase of pregnancy, prior to the onset of gastric gland function.

A mechanical comparison of subtrochanteric femur fracture fixation.

OBJECTIVE: To determine whether the mechanical properties of first-generation interlocking femoral nails are different from those of second-generation interlocking femoral nails in a subtrochanteric femur fracture model. DESIGN: Randomized laboratory investigation using a synthetic subtrochanteric femur fracture model. SETTING: Simulated stable and unstable fractures were created at three levels in the subtrochanteric region of synthetic femora. Instrumented specimens were tested elastically in a biomaterials testing system. INTERVENTION: Synthetic femora were instrumented with either a statically locked first-generation femoral nail or a statically locked second-generation femoral nail. MAIN OUTCOME MEASUREMENTS: Elastic stiffness for both the stable and unstable fracture groups was measured in both compression and torsion. Unstable fracture specimens were tested to failure in compression, and load to failure was measured. RESULTS: Throughout the subtrochanteric region, second-generation femoral nail constructs were consistently stiffer in compression and torsion than were statically locked first-generation femoral nail constructs. In general, second-generation constructs also withstood larger loads to failure in the unstable fracture model. CONCLUSIONS: Second-generation nails provided significantly enhanced mechanical stiffness compared with first-generation femoral nails when used to treat both stable and unstable subtrochanteric femur fractures. Although these results were obtained by using a well-controlled, mechanically consistent model, clinical validation of an increased incidence of fracture unions or of decreased time to union is required before we can recommend that second-generation nails be used routinely to treat subtrochantenic femur fractures.

Microcirculation of human fetal posterior root ganglia: a scanning electron microscopic study of corrosion casts.

The vasculature of lumbar posterior root ganglia was investigated in human fetuses aged 17-24 weeks; using the corrosion casting technique and scanning electron microscopy. The arterial supply consisted of one main artery and occasional arterioles entering the ganglion at its pole and running axially, while the venous drainage was located at the periphery of the ganglion, thus indicating a centrifugal pattern of blood flow. The dense capillary network of the ganglion showed the roughly parallel course of the vessels in the central zone and an irregular arrangement in the peripheral zone where capillaries formed "nests", probably surrounding individual perikaryons of ganglionic cells. The capillaries had a sinusoidal character with numerous dilatations about twice the normal capillary size, as well as occasional larger vascular spaces resulting from capillary interconnections and suggesting the intussusceptive type of angiogenesis.

The architecture of internal blood vessels in human fetal vertebral bodies.

The internal vascular system of vertebral bodies was investigated in 17-24 wk human fetuses by acrylic dye injection and by corrosion casting/scanning electron microscopy. The regions of intervertebral spaces did not contain blood vessels. The radial metaphyseal vessels were at the stage of centripetal ingrowth into the vertebral body cartilage and their terminal, blindly ending segments had a form of cuff-like capillary plexuses. The anterolateral equatorial arteries communicating with the vessels of the ossification centre were only rarely found. The centre was usually supplied by 2 posterior (nutrient) arteries which branched into an arcade-like array of arterioles equipped with occasional sphincters and giving origin to a dense network of peripherally located capillaries. Numerous blind capillary buds formed the advancing border of the ossification centre. The veins usually accompanied the arteries. In the ossification centre the venous compartment consisted of sinuses drained by larger posterior veins. In the 17 wk fetus, an axial avascular area was observed in the place of notochord localisation, indicating the formation of a ring-shaped ossification centre around the notochord remnants at earlier stages of fetal development.

The strength of iliosacral lag screws and transiliac bars in the fixation of vertically unstable pelvic injuries with sacral fractures.

This study compares the relative strengths of iliosacral lag screws and transiliac bars in the fixation of vertically unstable pelvic injuries with sacral fractures. A vertical sacral fracture was artificially induced by vertical loading in eight pelvises from cadavers, which were then fixed with two 6.5 mm iliosacral lag screws or two 6.4 mm transiliac bars. The pelvises were then loaded again to failure. The mean strength of iliosacral lag screw fixation was 819 newtons and for transiliac bars it was 1066 newtons, but the study was too small for the difference to be judged as statistically significant. Various advantages and disadvantages of each method of fixation are discussed.

Unrecognized foreign body in the hip joint.

A 40-year-old woman involved in a motor vehicle accident sustained a left acetabular fracture and a dislocated left hip with a large ipsilateral traumatic hip wound. Multiple plain radiographic films of the pelvis and a pelvic computed tomographic scan were obtained. None of these images showed a 25 x 20 x 12-mm piece of the gearshift that was found in the hip joint at the time of the surgery. Hence, we present this case highlighting an unusual phenomenon in which a large foreign body was not recognized on preoperative radiographic studies.