Juxta-articular myxoma of the knee in a 5-year-old boy: a case report and review of the literature (2009: 12b).

Juxta-articular myxoma (JAM) is a relatively rare variant of myxoma that occurs in the vicinity of large joints. It is composed of fibroblast-like cells that produce an excessive amount of glycosaminoglycans rich in hyaluronic acid. The peak incidence is between the 3rd and 5th decades of life. In this report we describe an extremely rare case of JAM in the knee of a 5-year-old child. The clinical presentation, radiological features and histopathologic findings are described, and the relevant literature is reviewed.

The versatility of progress testing assessed in an international context: a start for benchmarking global standardization?

Sharing and collaboration relating to progress testing already takes place on a national level and allows for quality control and comparisons of the participating institutions. This study explores the possibilities of international sharing of the progress test after correction for cultural bias and translation problems. Three progress tests were reviewed and administered to 3043 Pretoria and 3001 Maastricht medical students. In total, 16% of the items were potentially biased and removed from the test items administered to the Pretoria students (9% due to translation problems; 7% due to cultural differences). Of the three clusters (basic, clinical and social sciences) the social sciences contained most bias (32%), basic sciences least (11%). The differences that were found, comparing the student results of both schools, seem a reflection of the deliberate accentuations that both curricula pursue. The results suggest that the progress test methodology provides a versatile instrument that can be used to assess medical schools across the world. Sharing of test material is a viable strategy and test outcomes are interesting and can be used in international quality control.

Effect of nematode burden as assessed by means of faecal egg counts on body condition in goats farmed under resource-poor conditions in South Africa.

A longitudinal study was conducted of the nematode faecal egg counts (FECs) and body condition scores (BCSs) of goats of resource-poor farmers at Rust de Winter, Gauteng Province, Impendle, KwaZulu-Natal Province, and Kraaipan, North-West Province, South Africa. Periods of higher FECs occurred from December/January to March/April at Rust de Winter and at Impendle and from January to March at Kraaipan. Seasonal variations in body condition were evident in the goats at Impendle with the animals showing lower BCSs from June to October. The goats at Rust de Winter and at Kraaipan did not show clear seasonal variations, although the goats at Rust de Winter showed lower BCSs from mid-July to early December. The BCSs for Rust de Winter where the animals were grazed on a private farm were generally higher than those of the other sites, where communal grazing is practised.

Incidence of Haemonchus spp. and effect on haematocrit and eye colour in goats farmed under resource-poor conditions in South Africa.

The diversity and predominance of nematode genera in goats of resource-poor farmers at Rust de Winter, Gauteng Province, Impendle, KwaZulu-Natal Province, and Kraaipan, North-West Province, South Africa, was determined by means of a longitudinal study of the nematode faecal egg counts (FECs) and differential third-stage nematode larvae. The animals were bled for haematocrit determination and scored for pallor of ocular mucous membranes using the FAMACHA( Copyright) method, an assay for clinical evaluation of anaemia caused by Haemonchus spp. Animals considered to be in danger of dying from anaemia caused by haemonchosis were selectively treated with an anthelmintic. Lower haematocrit values were registered during periods of heavier Haemonchus infection, which occurred from December/January to March for Rust de Winter; from December to March/April for Impendle; and from November/December to February or April for Kraaipan. There was agreement too between the lower haematocrits and paler mucous membranes scored according to the FAMACHA( Copyright) method. The use of this system may be recommended as part of an integrated approach to worm control in goats kept in the resource-poor areas studied.

Haemonchus spp. in sheep farmed under resource-poor conditions in South Africa--effect on haematocrit, conjunctival mucous membrane colour and body condition.

A longitudinal study was conducted on the differential faecal egg counts, haematocrits and body condition scores of sheep belonging to resource-poor farmers at Rust de Winter, Gauteng province, and Kraaipan, North West Province, South Africa. The animals were scored for level of anaemia using the FAMACHA method, an assay for the clinical evaluation of anaemia caused by Haemonchus spp. Periods of higher Haemonchus egg counts occurred from October to March for sheep at Rust de Winter and from September/October to February or April for sheep at Kraaipan. Lower haematocrit values were registered during these periods as was a higher incidence of anaemic conjunctival mucous membrane colour scores compared to the period April to September. No clear relationship between the faecal egg counts and the body condition scores was evident. Although wider application of the FAMACHA system in sheep raised by resource-poor farmers should be investigated, the present study indicates that this method may certainly prove to be a valuable worm control strategy for such livestock owners.

Testing for clinical anaemia caused by Haemonchus spp. in goats farmed under resource-poor conditions in South Africa using an eye colour chart developed for sheep.

A novel clinical assay for the assessment and subsequent treatment of Haemonchus infection in sheep to slow down the development of anthelmintic resistance--the FAMACHA system--has been developed, tested and validated in South Africa. The system is based on a colour chart with five colour categories depicting varying degrees of anaemia that are compared with the colour of the mucous membranes of the eyes of sheep. The animal is then scored from severely anaemic (pale) through anaemic to non-anaemic (red) and those animals considered in danger of succumbing to the effects of haemonchosis are treated. This method was tested in goats farmed under resource-poor conditions in South Africa. Analyses in goats performed during the summers of 1998/1999 and 1999/2000 show a test sensitivity of 76 and 85%, respectively, meaning that the system may be used to identify correctly 76-85% of those animals in need of treatment with an anthelmintic. However, the test specificity remains low at 52-55%. This means that a large proportion of those animals that would not require treatment would in fact be treated. However, when the use of the FAMACHA system is compared with conventional dosing practices where all the animals are treated, using the FAMACHA system would result in a large proportion of the animals being left untreated. The untreated animals are then able to deposit the eggs of anthelmintic-susceptible worms on the pasture, while the treated ones should pass very few ova, given an effective anthelmintic. This maintains a reservoir of susceptible larvae in refugia, and should slow down the development of anthelmintic resistance. The validation of the FAMACHA system for goats for use by resource-poor farmers, which this paper describes, may have wide application in the tropics and subtropics of sub-Saharan Africa and elsewhere.

The effect of frog pressure and downward vertical load on hoof wall weight-bearing and third phalanx displacement in the horse--an in vitro study.

A shoe was designed to combine the advantages of a reverse shoe and an adjustable heart bar shoe in the treatment of chronic laminitis. This reverse even frog pressure (REFP) shoe applies pressure uniformly over a large area of the frog solar surface. Pressure is applied vertically upward parallel to the solar surface of the frog and can be increased or decreased as required. Five clinically healthy horses were humanely euthanased and their dismembered forelimbs used in an in vitro study. Frog pressure was measured by strain gauges applied to the ground surface of the carrying tab portion of the shoe. A linear variable distance transducer (LVDT) was inserted into a hole drilled in the dorsal hoof wall. The LVDT measured movement of the third phalanx (P3) in a dorsopalmar plane relative to the dorsal hoof wall. The vertical component of hoof wall compression was measured by means of unidirectional strain gauges attached to the toe, quarter and heel of the medial hoof wall of each specimen. The entire limb was mounted vertically in a tensile testing machine and submitted to vertical downward compressive forces of 0 to 2,500 N at a rate of 5 cm/minute. The effects of increasing frog pressure on hoof wall weight-bearing and third phalanx movement within the hoof were determined. Each specimen was tested with the shoe under the following conditions: zero frog pressure; frog pressure used to treat clinical cases of chronic laminitis (7 N-cm); frog pressure clinically painful to the horse as determined prior to euthanasia; frog pressure just alleviating this pain. The specimens were also tested after shoe removal. Total weight-bearing on the hoof wall at zero frog pressure was used as the basis for comparison. Pain-causing and pain-alleviating frog pressures decreased total weight-bearing on the hoof wall (P < 0.05). Frog pressure of 7 N-cm had no statistically significant effect on hoof wall weight-bearing although there was a trend for it to decrease as load increased. Before loading, the pain-causing and pain-alleviating frog pressures resulted in a palmar movement of P3 relative to the dorsal hoof wall compared to the position of P3 at zero frog pressure (P < 0.05). This difference remained statistically significant up to 1300 N load. At higher loads, the position of P3 did not differ significantly for the different frog pressures applied. It is concluded that increased frogpressure using the REFP shoe decreases total hoof wall weight-bearing and causes palmar movement of P3 at low weight-bearing loads. Without a shoe the toe and quarter hoof wall compression remained more constant and less in magnitude, than with a shoe.

Nerve injury after hip arthroplasty. 5/600 cases after uncemented hip replacement, anterolateral approach versus direct lateral approach.

In 600 consecutive uncemented total hip replacements, 2 surgical approaches were used: the direct lateral Hardinge approach in supine position (group I: 241 cases) or in a lateral position (group II: 280 cases) and the anterolateral Watson-Jones approach in supine position (group III: 79 cases). 5 patients had clinically evident peripheral nerve injuries confirmed with EMG: none in group I, 1 lesion of the nervus ischiadicus and nervus femoralis in group II and 4 nervus femoralis lesions in group III, of which 1 was combined with an obturator nerve injury. The nerve injuries were evaluated with EMG. All 4 nervus femoralis lesions recovered spontaneously, but the one patients in group II had a persistent palsy of the peroneal nerve. The anatomical basis for the higher prevalence of nervus femoralis lesions in the anterolateral Watson-Jones approach is described.