Study of ten anatomical variants of the foot and ankle

This study examined the occurrence rate of ten lower extremity anatomical variants occurring over a 6-year period from 1988 to 1994 in a sample range of 166 to 279 cadavers at the University of Osteopathic Medicine and Health Sciences. Literature review of these anomalies shows similar findings for all presented structures with the exception of two. The peroneus quartus muscle was found to be significantly less prevalent than previous studies have indicated. This difference may be attributed to the larger sample size used in this study or differences of interpretation of the definition of the peroneus quartus muscle. Additionally, the flexor digitorum brevis tendon to the fifth digit was found to be absent much more than Sarrafian reports in a total sample size of 926. The importance of these anatomical variants, both in surgery and while using advanced diagnostic imaging such as computed tomography and magnetic resonance imaging, should be realized by the podiatric physician. Awareness of these variants will decrease confusion when considering treatment options.

Two flavonol triglycosides from flowers of Indigofera hebepetala

Two new flavonol triglycosides, kaempferol 3-omicron-alpha-L-rhamnopyranosyl(1->2)-beta-D-galactopyranoside-7-O- alpha-L-arabinofuranoside and kaempferol 3-O-alpha-rhamnopyranosyl(1-->6)-beta-D-galactopyranoside-7-O- alpha-L-arabinofuranoside were isolated from the flowers of Indigofera hepepetala, together with three known glycosides, kaempferol 3-omicron-alpha-L-arabinopyranoside-7-O-alpha-L-rhamnopyranoside, kaempferol 3-O-alpha-L-rhamnopyranoside-7-O-alpha-L-arabinopyranoside and kaempferol 7-rhamnoside. The structures were determined by means of Rf values, UV, EI-mass spectrometry, FAB-mass spectrometry, 1H NMR, 13C (B.B and DEPT) NMR, NOE difference measurement and 1H-1H COSY spectral data.

The nPCR detection of Chlamydia pneumoniae and Chlamydia trachomatis in children hospitalized for bronchiolitis

Nasopharyngeal aspirates from children admitted with the diagnosis of bronchiolitis, were screened for Chlamydia pneumoniae, and C. trachomatis. The nested PCR was found to be more sensitive that amplified the DNA extracts of up to two elementary bodies of the test strains. Using this technique, C. pneumoniae was detected in two (1.3%), and C. trachomatis in 26 17.1%) of the 152 samples tested. This study indicated C. pneumoniae infections to be unusual in children with bronchiolitis.

In-vitro corrosion and wear of titanium alloys in the biological environment

Cyclic anodic polarization studies were undertaken for several titanium alloys of varying composition and phase structures. All materials were exposed to an accelerated corrosion test using a potentiostat and their electrochemical behaviour was analysed within a potential range of 0 to 5000 mV. The electrolyte used was a phosphate buffered saline (PBS) solution at pH = 5, 7.4 and 9. The polarization curves obtained represented both the passive and active regions of the materials and these curves were used to compare the resistance to pitting corrosion of each material. The sliding-wear of these materials was studied in both non-corrosive and corrosive environments. A simple pin-on-disc type wear apparatus was designed and built to simulate the co-joint action of corrosion and sliding-wear. Using this apparatus, it was also possible to evaluate the effect of wear-accelerated corrosion, which was also evaluated by wearing the surface of the specimens prior to corrosion. It was evident that the mixed phase alpha-beta alloys (Ti-6AI-4V and Ti-6AI-7Nb) possessed the best combination of both corrosion and wear resistance, although commercially pure titanium and the near-beta (Ti-13Nb-13Zr) and beta (Ti-15Mo) alloys displayed the best corrosion resistant properties.

Effect of permeation enhancers on the release of ketoprofen through transdermal drug delivery systems

Feasibility studies were performed to prepare membrane controlled transdermal drug delivery system of ketoprofen containing Carbopol 934p gels. The ability of permeation enhancers such as oleic acid, polyethylene glycol 400 and propylene glycol to provide improved performance has been investigated. The variables studied were drug loading, type of the permeation enhancers, and their concentration. Diffusion studies across Spectra/por 1 membranes were performed using Franz diffusion cells. The medium employed was pH 7.4 phosphate buffer. The permeation parameters such as flux, enhancement ratio, permeation and diffusion coefficients have been evaluated. The results indicated a zero or near zero-order release kinetics. The studies indicated that oleic acid in a concentration of 35% w/w provided the maximum permeation when the ketoprofen concentration in the patches was 5%. Corresponding values of flux,enhancement ratio, permeability and diffusion coefficients were 6.22 micrograms/cm2/h, 8.57, 1.09 x 10(-3) cm/h, and 3.13 x 10(-6) cm3/h respectively. Further, an increase in ketoprofen loading from 5 to 10% increased the permeation.

[The combined action of sinusoidal modulated currents and ultrasound in the treatment of chronic gastroduodenitis in children]

The paper summarizes the results of clinical observations and special examinations conducted in 45 children with chronic gastroduodenitis by using combined exposure to sinusoidal modulated currents and ultrasound. The dynamics of clinical symptoms, functional status of the stomach and its adjacent gastroduodenal organs, endoscopic findings, morphological status of the gastroduodenal mucosa, gastric mucosal dissemination of Helicobacter pylori, systemic and regional humoral immunological parameters, abdominal echography indicate high therapeutical efficiency of the combined therapy as compared to that performed in controls (without physiotherapy). Mechanisms of formation of therapeutical action are clarified, differentiated indications are defined.

Siderophore-mediated iron uptake in Alcaligenes eutrophus CH34 and identification of aleB encoding the ferric iron-alcaligin E receptor

Siderophore production in response to iron limitation was observed in Alcaligenes eutrophus CH34, and the corresponding siderophore was named alcaligin E. Alcaligin E was characterized as a phenolate-type siderophore containing neither catecholate nor hydroxamate groups. Alcaligin E promoted the growth of siderophore-deficient A. eutrophus mutants under iron-restricted conditions and promoted 59Fe uptake by iron-limited cells. However, the growth of the Sid- mutant AE1152, which was obtained from CH34 by Tn5-Tc mutagenesis, was completely inhibited by the addition of alcaligin E. AE1152 also showed strongly reduced 59Fe uptake in the presence of alcaligin E. This indicates that a gene, designated aleB, which is involved in transport of ferric iron-alcaligin E across the membrane is inactivated. The aleB gene was cloned, and its putative amino acid sequence showed strong similarity to those of ferric iron-siderophore receptor proteins. Both wild-type strain CH34 and aleB mutant AE1152 were able to use the same heterologous siderophores, indicating that AleB is involved only in ferric iron-alcaligin E uptake. Interestingly, no utilization of pyochelin, which is also a phenolate-type siderophore, was observed for A. eutrophus CH34. Genetic studies of different Sid- mutants, obtained after transposon mutagenesis, showed that the genes involved in alcaligin E and ferric iron-alcaligin E receptor biosynthesis are clustered in a 20-kb region on the A. eutrophus CH34 chromosome in the proximity of the cys-232 locus.

[Inhalation and peroral mucolytic therapy in mucoviscidosis in children]

The paper summarizes the results of clinical studies of 98 children with mucoviscidosis whose age was 7 to 18 years. There is research evidence for possibility and expediency of using new classes of mucolytic agents in the therapy of mucoviscidosis in children. Analysis of the rheological properties of sputum showed the advantage of inhalation route of mucolytics over their oral administration. There is evidence for the advantage of mucosolvan over carbocysteine and unithiol via all routes of administration, the optimal methods of administration and differentiated indications have been developed.

Lipid lowering therapy and military aviators

This article discusses the role of the newer lipid lowering agents (statins and fibrates) for the treatment of hyperlipidemias in military aviators. Special emphasis will be on long-term safety and the effects of these drugs on CNS functions pertinent to aviators. We propose that these new lipid lowering agents, such as hydrophilic statins and newer fibrates are reasonably safe in aviators with restricted flying duties, subject to long-term surveillance by a specialist.

Primary mediastinal and testicular seminomas: a comparison of K-ras-2 gene sequence and p53 immunoperoxidase analysis of 26 cases

Primary mediastinal seminomas (MS) are rare tumors. Histologically, they are similar to their counterpart in the gonads. The survival rate has varied from 50% to 85% in different series. However, large series of these tumors primarily in the mediastinum are lacking. At the molecular level, a few reports document K-ras mutations in up to 40% of testicular seminomas (TS), localized predominantly to codon 12. Reports on TS p53 immunohistochemistry (IHC) range from negative to overexpression approaching 90% of cases, and by sequence analysis one small series showed a 23% mutation rate. To date, no analyses have been performed for either K-ras mutations or p53 immunohistochemical expression in primary MS. The authors studied 13 cases each of primary MS and TS from archival formalin-fixed, paraffin-embedded sections in which adequate tumor sampling and clinical history, including serological studies, and histological, histochemical, and IHC staining, were performed to confirm the diagnosis. p53 immunoperoxidase staining using citrate buffer/microwave antigen retrieval was performed. Topographic genotyping was performed on 5-microns-thick tissue sections up to 17 years old, in which the neoplastic cell population was sampled. Additionally, multiple sites within a given cases were sampled to determine clonality of the tumor cell population. Polymerase chain reaction and subsequent sequence analysis of the K-ras-2 exon-1 gene was used for mutation analysis. Focal weak staining with p53 IHC was observed in 4 of 13 (31%) MS and 10 of 13 (77%) TS cases, with all remaining cases being negative (P < .05). Only one MS case (8%) showed K-ras mutation (codon 13 GGC > GAC; glycine > aspartate), which is in contrast to 2 of the TS cases (15%), showing codon 12 mutations. All the remaining cases were wild type. Therefore, primary mediastinal seminomas appear to be different in their K-ras sequence and p53 immunostain profile from TS. Codon mutation type may be useful in determining primary versus metastatic origin of a mediastinal seminoma.

Comparison of ultrasonography and cholangiography (ERCP/PTC) in the differential diagnosis of obstructive jaundice

Diagnostic accuracy of ultrasonography and cholangiography (ERCP/PTC) was compared in determining the site and nature of obstruction in obstructive jaundice. Ultrasound was performed in 50 patients with clinical diagnosis of obstructive jaundice. All patients subsequently underwent ERCP/PTC and/or surgery. ERCP was performed in 38 and PTC in 15 patients. The positive predictive value for the site and etiology of obstruction by ultrasonography was 94% and 86% respectively. In comparison, the cholangiography (ERCP/PTC) had positive predictive value of 100% in site and 98% in etiology. High degree of accuracy and non-invasiveness makes ultrasound as the primary radiological tool in the differential diagnosis of obstructive jaundice. ERCP is the gold standard for determining the precise level and cause of obstruction. PTC adds further to ultrasound based diagnosis of obstructive jaundice particularly in proximal obstruction and in ERCP failure.

Further evidence for genetic anticipation in familial rheumatoid arthritis

OBJECTIVE

To determine whether preliminary evidence supporting features of genetic anticipation in familial rheumatoid arthritis (RA) could be replicated in independent and larger samples.

METHOD

Data were obtained from records of 59 multicase families from the Arthritis and Rheumatism Council (ARC) National Repository in Manchester, 65 multicase families from Cleveland, Ohio, USA, and 253 consecutive patients with RA attending clinics in Nottingham.

RESULTS

Mean ages of disease onset in the parents affected with RA were consistently greater than those in the probands. In the ARC data, the mean age difference in disease onset between the affected mother and proband pairs was 16.0 years (95% confidence interval (CI) 7.2 to 24.8 years, n = 11); in the Cleveland data it was 7.8 years (95% CI 0.9 to 14.7 years, n = 24), and in the Nottingham data it was 10.4 years (95% CI 2.8 to 18.0 years, n = 28). Similar results were found in the limited number of father-proband pairs. Unlike the findings of earlier work, there was no correlation between proband age at disease onset and age of the parent at conception of the proband.

CONCLUSION

In independent and larger familial RA data sets, features of genetic anticipation were replicated. Our findings support the case for further research at a molecular level into genetic anticipation in those families with two successive generations affected by RA.

Factors affecting use of contraception in Matlab, Bangladesh

This study examines the relationship between family planning, perceived availability of contraceptives, and sociodemographic factors in rural Bangladesh. Data are from the 1990 KAP survey in the Matlab treatment and comparison areas, using a sample of about 8500 married women of reproductive age. The contraceptive prevalence rate was 57% in the treatment area but substantially lower in the comparison area where mainly traditional methods of family planning were used by women who did not know of a source of supply of contraceptives. Education has no effect on contraceptive use in the treatment area but in the comparison area, modest but consistent differentials in use by level of education were found. Number of living children is the best predictor for contraceptive use, followed by number of living sons, and the attitude of respondents and their husbands towards family planning.

Spondyloarthropathies-spondylarthropathies

A committee of the European League Against Rheumatism has recommended that the term spondylarthropathy (without the letter "o" in the middle) should be avoided and is of the opinion that the use of the radical spondylo makes it clear that spondyloarthropathy is a composed word to refer to a disease that affects the spine and (peripheral) joints. The committee points out that the term spondyloarthritis (plural is spondyloarthritides) is more accurate because it means association of spondylitis with (peripheral) arthritis. The known number of subtypes of HLA-B27 continues to grow. The latest two additions are HLA-B*2710, identified in an American Caucasian family with spondyloarthropathy, and HLA-B*2711, discovered in a healthy Japanese person.