Incubation of curing brines for the production of ready-to-eat, uncured, no-nitrite-or-nitrate-added, ground, cooked and sliced ham.

Salt concentration, vegetable juice powder (VJP) concentration and temperature were investigated to determine necessary conditions for incubation of curing brines including VJP and a starter culture containing Staphylococcus carnosus prior to production of naturally cured, no-nitrate/nitrite-added meat products. Subsequently, incubated brines were utilized to produce no-nitrate/nitrite-added sliced ham in which quality characteristics and residual nitrite concentrations were measured to determine feasibility of brine incubation for nitrate conversion prior to injection. Two ham treatments (one with VJP and starter culture; one with pre-converted VJP) and a nitrite-added control were used. No differences (P>0.05) were found for color in the VJP treatments. Control sliced ham was redder after 42 days of storage, retaining significantly (P<0.05) greater a* (redness) than either of the VJP treatments. Residual nitrite concentration was greater (P<0.05) in the control hams during the first week of storage. While the nitrite-added control retained greater red color and initially had more residual nitrite than the VJP treatments, the two VJP treatments did not differ from each other.

Medial unicompartment knee replacement. Minimum five year follow-up.

Forty-four medial Marmor unicompartment knee arthroplasties were performed at the Hutt Hospital from 1976 to 1983 on 35 patients. Seventy-five per cent were rated as excellent or good, using the Hospital for Special Surgery Knee Rating System. Four arthroplasties were revised at an average of 6 years (range: 2-8), two for late degenerative change in the lateral compartment, one for malposition and one for loosening. There was one late deep infection requiring an arthrodesis at 2 years. It is concluded that medial compartment knee arthroplasty provides satisfactory treatment in the elderly patient, although attention must be directed to technical aspects and patient selection, to afford long-term success.

Natural history of Osgood-Schlatter disease.

The natural history of untreated Osgood-Schlatter disease is presented in the retrospective study of 69 knees in 50 patients. Seventy-six percent of the patients believed they had no limitation of activity, although 60% still could not kneel without discomfort. Two groups of patients were identified: those who presented with radiologic fragmentation and had either separated ossicles or an abnormally ossified tuberosity at review, and those who presented with soft tissue swelling without radiologic fragmentation and were asymptomatic at review. There was a low incidence of patellar instability or anterior knee pain, and no case of premature proximal tibial epiphyseal arrest.

The possible role of vascular congestion in carpal tunnel syndrome.

A study of interstitial pressures within the carpal tunnel using a slit catheter found that, in some patients, an initial rise in pressure is recorded when the wrist is passively extended and this continues to rise to a plateau if the position is maintained. A rise above a critical pressure brought about by congestion would explain the clinical picture of predominantly nocturnal symptoms and no electro-physiological evidence with the wrist in a neutral (resting) position. The results also bring into doubt published results of the pressure within the carpal tunnel with the wrist flexed or extended, since the pressure can be changed at will, depending on the flexion or extension force used.

Dorsal root entry zone radiofrequency lesion for pain relief in brachial plexus avulsion.

Brachial plexus root avulsion is one of the important causes of intractable pain in young individuals following road traffic accidents. A procedure using radiofrequency coagulation lesion of the substantia gelatinosa of Rolando (Nashold's procedure) was performed in seven patients with excellent relief of pain in two, good relief in three and poor result in two patients.

Gluconeogenic enzymes in fibroblasts from infants dying of the sudden infant death syndrome (SIDS).

The activities of mitochondrial phosphoenolpyruvate carboxykinase (PEPCK), pyruvate carboxylase (PC), and total malic enzyme (ME) were determined in cultured fibroblasts from 74 infants diagnosed as having died from the Sudden Infant Death Syndrome (SIDS) and 36 infants who died from known causes. In addition, the glycemic state of infants was measured by determining the 'maximum' glucose present in plasma and cerebral spinal fluid (CSF) based on the following formula: glucose (maximum) = glucose + 1/2 (lactate). There were no statistical differences between SIDS and control infants in any of the three enzymatic activities measured in fibroblasts or in the estimated 'maximum' glucose values in plasma or CSF. The present results do not support the involvement of hypoglycemia as a cause of death in SIDS.

Low-dose propranolol for the protection of the left ventricle from ischaemic damage.

Global myocardial ischaemia improves intracardiac operating conditions but damages the myocardium. Propranolol should reduce this damage but may impair postoperative myocardial contractility. An assessment of its protective effect during 90 minutes of normothermic ischaemia in canine hearts has been made. The early and late changes of contractility caused by low-dose propranolol were also recorded. A comparison of cardiac isovolumic contractile force, velocity, and compliance was made in three groups of dogs given 30 microgram/kg of propranolol with or without 90 minutes of cardiac ischaemia, or cardiac ischaemia without propranolol. Contractile force and velocity were significantly reduced by the propranolol, but recovered fully after 90 minutes. Ischaemia without propranolol reduced force and velocity of contraction significantly more than ischaemia with propranolol. Propranolol thus reduces operative ischaemic damage without itself impairing postoperative function.

Protection of the ischaemic myocardium by glucose-insulin-potassium infusion assessed by ventricular function and electron microscopy.

The protective effect of GIK infusion on the ischaemic myocardium was assessed by isovolumic function tests and electron microscopy. There were two control groups, group 1 hearts underwent 2 hours of continous normothermic cross-perfusion and group 2 hearts endured 2 hours of ischaemia. Group 3 hearts were administered GIK solution prior to ischaemic arrest. The group 3 hearts showed less loss of contractile force and contractile velocity from the ischaemic period compared to group 2 hearts, but no benfit was shown in terms of compliance. Electron microscopic examination showed slightly less damage in the group 3 hearts compared to group 2 hearts. Group 1 hearts maintained better function than either of the other two groups. Ultrastructure was not examined in group 1 hearts. A slight protective effect of GIK on the ischaemic myocardium was thus confirmed.

Is coronary artery surgery so expensive?

Severe angina may lead to complete invalidism, with reliance on social security payments and accumulated savings. The average cost of this situation to the patient is $4-6000 pa and to the State $3-4000 pa. Reputedly expensive cardiac operations are cheaper, at under $2000, than unoperated invalidism, and thus rapidly repay their cost in addition to their non-financial attributes.

Protective effect of methylprednisolone on ischaemic myocardium assessed by ventricular function.

Intracardiac surgical procedures are best carried out when the heart is still and bloodless. This condition, however, produces myocardial cellular damage with loss of contractility and compliance unless some protection can be provided. Myocardial contractility and compliance is best studied by isovolumic ventricular function tests, which were used to evaluate the protective effect of methylprednisolone on the isolated cross-perfused canine heart made ischaemic for 2 hours. Control experiments included 2 hours of ischaemia without methylprednisolone, and 2 hours of continuous normothermic cross-perfusion. The methylprednisolone-treated hearts had probably significantly better ventricular function after 2 hours of ischaemia than did hearts without the methylprednisolone, while the cross-perfused hearts were best overall. This work suggests that methylprednisolone may have a protective effect on the ischaemic myocardium of the intact canine heart.