Triple Disruption of the Superior Shoulder Suspensory Complex - A Case Report.

INTRODUCTION: Superior shoulder suspensory complex (SSSC) plays a key role in maintaining stable upper extremity- axial skeleton connection. Injury to one component is a common occurrence while double disruption leading to floating shoulder is a rare occurrence. Disruption of more than one component of this complex leads to significant morbidity and interferes with adequate shoulder function and requires surgical intervention. CASE REPORT: This case report describes a rare triple disruption of SSSC in a 40-year female in dominant shoulder involving fracture of lateral end of clavicle, Type 1 coracoid fracture, and an acromion fracture. She underwent operative fixation of all the components and reported excellent functional outcome at the end of 1-year follow-up. CONCLUSION: The triple disruption of the SSSC is an extremely rare injury comprising breakages of the ring at three distinct locations, which usually follow high-velocity injuries associated with other musculoskeletal and visceral injuries. Proper pre-operative evaluation and appropriate surgical intervention give good results and avoid long-term complications such as chronic pain, weakness, and subacromial impingement of shoulder.

Spontaneous rupture of hepatic metastasis from choriocarcinoma: a review of imaging and management.

Spontaneous rupture of hepatic metastasis causing hemoperitoneum is a rare entity. Ruptured hepatic metastasis has typical imaging findings on biphasic CT which may help in clinching the diagnosis. We present a case of rupture hepatic metastasis from choriocarcinoma in a young-female patient who was managed by transcatheter hepatic artery embolization. A brief review of the imaging features and therapeutic options for the ruptured hepatic metastases is discussed along with the case.

Heterotrophic free-living and particle-bound bacterial cell size in the river Cauvery and its downstream tributaries.

This is the first comprehensive study on planktonic heterotrophic bacterial cell size in the river Cauvery and its important tributaries in Karnataka State, India. The initial hypothesis that the mean cell size of planktonic heterotrophic bacteria in the four tributaries are markedly different from each other and also from that in the main river Cauvery was rejected, because all five watercourses showed similar planktonic heterotrophic bacterial cell size. Examination of the correlation between mean heterotrophic bacterial cell size and environmental variables showed four correlations in the river Arkavathy and two in the river Shimsha. Regression analysis revealed that 18%of the variation in mean heterotrophic free-living bacterial cell size was due to biological oxygen demand (BOD)in the river Arkavathy, 11% due to surface water velocity (SWV)in the river Cauvery and 11% due to temperature in the river Kapila. Heterotrophic particle-bound bacterial cell size variation was 28% due to chloride and BOD in the river Arkavathy, 11% due to conductivity in the river Kapila and 8% due to calcium in the river Cauvery. This type of relationship between heterotrophic bacterial cell size and environmental variables suggests that,though the mean heterotrophic bacterial cell size was similar in all the five water courses, different sets of environmental variables apparently control the heterotrophic bacterial cell size in the various water bodies studied in this investigation. The possible cause for this environmental (bottom -up) control is discussed.

Assessment of phytoplankton density in relation to environmental variables in Gopalaswamy pond at Chitradurga, Karnataka.

Surface water samples of the Gopalaswamy pond were studied at two different sites during September 1997 to January 1998 and phytoplanktons were studied in relation to ten environmental variables during this period. A total of 30 species of phytoplanktons were identified under four classes, Chlorophyceae, Cyanophyceae, Bacillariophyceae and Euglenophyceae. Among these, maximum density was recorded under Cyanophyceae, Chlorophyceae, Cyanophyceae and Bacillariophyceae showed considerable fluctuations with environmental variables.