Mashed-muscle and oxidised regenerated cellulose (Surgicel) hammock: a quick and effective way to repair frontal air sinus.

The authors describe a simple modification of the traditional muscle-packing technique to seal exposed frontal air sinus during neurosurgical, ENT and facio-maxillary trauma and elective procedures. Oxidised cellulose hammock is used to effectively hold the muscle piece in place to seal the sinus.

'Plunging' during burr hole craniostomy: a persistent problem amongst neurosurgeons in Britain and Ireland.

The inadvertent 'plunging' of an instrument into the cranial cavity is a feared complication of drilling a burr hole and while anecdotes abound, little is known about the extent or the consequences of this problem. A survey by anonymous postal questionnaire of 304 neurosurgeons in Britain and Ireland was conducted to analyse the extent of this complication. Of respondents, 65.6% had experienced 'plunging', 22.3% having 'plunged' at least twice, indicating a high prevalence of this complication. The Cushing perforator was implicated by most. 'Plunging' carried a 12% risk of death or permanent neurological morbidity. The authors analyse the prevalence and significance of this preventable complication, and discuss various options available to minimize its occurrence.

Composition of the lipopolysaccharide of Neisseria gonorrhoeae.

Analysis of glycose and fatty acid content of lipopolysaccharide extracted from 38 strains of Neisseria gonorrhoeae indicated that glycoses common to colonial types 1 to 5 were glucose, mannose, and galactose, N-acetylneuraminic acid, 2-keto-3-deoxyoctulosonic acid (KDO), glucosamine, and galactosamine were also invariably present. Virulent colonial types 1 and 2 contained no rhamnose, in contrast to avirulent types 3 to 5 and several strains of the nonpathogenic species N. sicca and N. lactamica. Fucose, characteristic of these nonpathogenic species, was not present in the gonococci. Variation in the concentration of individual glycoses in different strains was also noted. Mannose-KDO, galactose-KDO, and glucose-KDO ratios of virulent gonococci exceeded those of avirulent organisms, except that the correlation for glucose was not quite so striking. This relationship was not found in N. sicca and N. lactamica strains. Fatty acid analyses of lipid A from gonococci showed that 10-, 12-, 14-, 16-, and 18-carbon acids, as well as 3-hydroxytetradecanoic acid, were present, but differences in concentration between colonial types, although evident in some cases, appeared less significant than glycose content.

Cultivation of type 1 N. Gonorrhoeae in liquid media.

The effect of CO2 concentration on the growth and colonial stability of Type 1 Neisseria gonorrhoeae has been investigated. Carbon dioxide at a concentration of 16 per cent in air above flasks incubated in a shaker was effective in supporting growth and 100 per cent colonial stability of Types 1, 1', 2, and 4. Lower CO2 tensions increased the generation time of the strains and were less effective in maintaining the stability of virulent variants. Of several liquid media tested, Enriched Single Phase medium, which consists of Difco GC medium base (devoid of agar and starch) to which Lankford supplement and "Isovitalex" have been added, was the most suitable for use with small inocula.

Trypsin-mediated activation of the alpha-haemolysin of Staphylococcus aureus.

Alpha protoxin of Staphylococcus aureus "Wood 46" was activated by trypsin which had been coupled to carboxymethylcellulose, as indicated by the toxin's ability to hydrolyse tosyl-arginine methylester (TAME). A Lineweaver-Burk plot of the degradation of TAME by toxin and trypsin showed that toxin had a greater affinity for the substrate than had trypsin. N-terminal amino-acid analyses of activated toxin suggested that leucine or isoleucine is the N-terminus, in contrast to protoxin, the N-terminus of which is histidine.