Small bowel obstruction secondary to paravesical hernia.

BACKGROUND: Bowel obstruction in the setting of the unscarred abdomen can be due to a wide variety of causes. Internal hernias are a rare cause of bowel obstruction with paravesical hernia being exceedingly rare. Paravesical hernia should form part of the differential diagnosis in the patient presenting with bowel obstruction. Prompt management and reduction of the incarcerated bowel are essential. This will prevent further complications especially related to bowel ischemia. CASE SUMMARY: The patient presented with a classical history of small bowel obstruction. Abdominal X-ray revealed distended loops of small bowel and absence of air in the rectum. An exploratory laparotomy revealed a paravesical internal hernia. A loop of terminal ileum had incarcerated and was the cause of the bowel obstruction. The defect was repaired after reducing the bowel and the patient made an uneventful recovery. CONCLUSION: Internal paravesical hernia although extremely rare should form part of the differential diagnosis in the patient presenting with small bowel obstruction especially in the previously unscarred abdomen. If the obstruction is complete then prompt exploration via laparotomy or laparoscopy is required. Delays in definitive management may result in marginally viable bowel becoming ischemic and requiring bowel resection.

Intra-Pelvic Migration of Sliding Hip Screw During Osteosynthesis of Hip Fracture: A Rare Avoidable Intraoperative Complication.

INTRODUCTION: Hip fractures, which are common among old patients, are classified into two groups: intracapsular and extracapsular fractures. Extracapsular fractures can be treated with extramedullary implants [e.g. dynamic hip screw (DHS)] or intramedullary nails. Dynamic hip screw is the treatment of choice in stable pertrochanteric fractures. Intrapelvic migration of the sliding screw is a very rare complication. CASE REPORT: We report a case of a 90-year old Caucasian woman who had an unusual intraoperative complication during osteosynthesis procedure for extracapsular hip fracture fixation. In fact, the sliding hip screw went deep into the pelvis during surgery. This mishap required an abdominal surgical approach by the general surgeon to remove the screw. CONCLUSION: Taking into consideration the poor quality of the bone in very old patients, we emphasize the importance of following every single step of the surgical procedure, in order to minimize the risk of this complication.

Transcriptional map of the 2.5-Mb CBR-ERG region of chromosome 21 involved in Down syndrome.

The region of chromosome 21 between genes CBR and ERG (CBR-ERG region), which spans 2.5 Mb on 21q22.2, has been defined by analysis of patients with partial trisomy 21. It contributes significantly to the pathogenesis of many characteristics of Down syndrome, including morphological features, hypotonia, and mental retardation. Cosmid contigs covering 80% of the region were constructed and EcoRI maps produced. These cosmids were used for exon trapping and cDNA selection from three cDNA libraries (fetal brain, fetal liver, and adult skeletal muscle). Isolated exons and cDNAs were mapped on the EcoRI map, organized into contigs, sequenced, and used as probes for Northern blot analysis of RNA from fetal and adult tissues. We identified 27 genuine or highly probable transcriptional units evenly distributed along the CBR-ERG region. Eight of the transcriptional units are known genes.

Microbiological assessment of dentin stained with a caries detector dye.

The purpose of this study was to assess microbiologically the efficacy of 1% acid red in propylene glycol dye to stain carious dentin. Thirty teeth with primary carious lesions involving dentin were chosen. Cavity preparation using the conventional visual and tactile criteria was done and the dye was applied to the prepared cavity. Dentin samples were collected, from carious dentin prior to cavity preparation, dye stained areas and unstained areas. The total colony forming units (CFU) in each sample were then assessed microbiologically. The results showed a highly significant difference in the total colony forming units in dye stained and dye unstained dentin samples. The 1% acid red dye in propylene glycol dye was found to be effective as an adjunctive aid in the diagnosis of carious dentin.

3.6-Mb genomic and YAC physical map of the Down syndrome chromosome region on chromosome 21.

The Down syndrome chromosome region (DCR) on chromosome 21 has been shown to contain a gene(s) important in the pathogenesis of Down syndrome. We constructed a long-range restriction map of the D21S55-D21S65 region covering the proximal part of the DCR. Pulsed-field gel electrophoresis of lymphocyte DNA digested with three rare cutting enzymes. NotI, NruI, and MluI, was used to establish two physical linkage groups of 5 and 7 markers, respectively, spanning 4.6 Mb on the NotI map. Mapping analysis of 40 YACs allowed the selection of 13 YACs covering 95% of the D21S55-D21S65 region and spanning 3.6 Mb. The restriction maps of these YACs and their positioning on the genomic map allowed 19 markers to be ordered, including 4 NotI linking clones, 9 polymorphic markers, the CBR gene, and the AML1 gene. The distances between markers could also be estimated. This physical map and the location of eight NotI sites between D21S55 and D21S17 should facilitate the isolation of previously unidentified genes in this region.

Are university students more depressed than nonuniversity students?

Rimon's Brief Depression Scale was administered to examine the associations of university status and gender on depression among 1728 subjects ages 17 to 40 years and residing in Sydney, Australia. Analysis showed the 912 women were significantly more depressed than the 816 men; however, no significant difference was found between 744 university students and 984 nonstudents. These findings were interpreted in terms of various theories proposed in the literature.