Familial back shape in adolescent scoliosis. A photogrammetric population study

A stereophotogrammetric technique (ISIS scanning) was used to assess the back shape of children with adolescent idiopathic scoliosis (index cases), their unaffected relatives, normal adults and children, and children with small idiopathic scoliotic curves (Cobb's angle less than 30 degrees) to detect any familial trends that may predispose to scoliosis. The analysis revealed a characteristic three-dimensional scoliotic back shape; no differences in unaffected relatives as regards sex or a positive family history of scoliosis; similar back shapes in unaffected parents and normal adults, both of whom differ from index cases and children with small curves. Unaffected siblings had a sagittal profile between those of normal children and children with small curves. This may represent an inherited tendency to scoliosis.

Regulation of breakdown of canavanyl proteins in Escherichia coli by growth conditions in lon+ and lon- cells

In vivo rates of proteolysis of canavanyl proteins were compared in lon+ and lon- Escherichia coli strains following growth in a variety of media. Both lon+ and lon- cells grown rapidly in complex media possessed higher levels of constitutive degradative activity than when cultured in minimal media. Pre-growth of lon+ cells in the presence of canavanine induced proteolytic activity following growth in minimal media as did stress agents such as heat, alcohol and puromycin: the lon mutant did not show the increased activity following canavanine treatment. The results suggest the presence of a proteolytic activity which selectively degrades aberrant proteins which does not involve protease La, the product of the lon gene, and which furthermore is regulated in part by growth conditions independently of the stress response.

Surface stereophotogrammetry of thoracic kyphosis

The thoracic kyphosis angles of 16 normal individuals, 10 patients with Scheuermann's disease and 11 with adolescent idiopathic scoliosis were measured both radiographically and from Integrated Shape Imaging System (ISIS) scans obtained by surface stereophotogrammetry. There was a high correlation between the two measures. The method of kyphosis measurement from ISIS scans was then used for 30 patients with adolescent idiopathic scoliosis who underwent corrective surgery. A significant reduction in thoracic kyphosis was observed postoperatively. In another group of 28 patients managed conservatively by bracing, some hypokyphosis developed after treatment. However, we found no association between hypokyphosis and curve progression.

Back shape in brace treatment of idiopathic scoliosis

This preliminary study has shown that bracing may improve the cosmetic appearance of a scoliotic back although the underlying curve remains unchanged. Thirty-two patients treated with the Boston brace for adolescent idiopathic scoliosis were assessed both roentgenographically and by integrated shape imaging system scanning before and after treatment. The mean follow-up time was 16 months. Surface shape improved in 41% of the patients, whereas roentgenographic improvement occurred in only 9%. Roentgenographic measurements should, therefore, be considered in conjunction with corresponding surface shape measurements in the assessment of brace treatment of scoliosis.

Correction of body height in scoliotic patients using ISIS scanning

Measurement of height in scoliotic patients is complicated by changes in spinal shape in both the coronal and sagittal planes. A method is described by which these changes can be measured and compared with the shape of the normal spine, using an automated stereophotogrammetric technique (ISIS). The resultant height change may be of use in the prediction of respiratory function.

The blood supply of the calcaneal tendon

The microvascular anatomy of the calcaneal tendon was investigated in cadaver tendons by injection of barium sulphate and indian ink and a quantitative study of intratendinous blood supply was made, using a computer-assisted image analysis system. There was a reduction in both the number and the mean relative area of vessels in the mid-section of the tendon. This area of reduced vascularity may be of significance in the pathogenesis of rupture.

Acromioclavicular dislocation associated with fracture of the coracoid process

Two cases of acromioclavicular dislocation associated with fracture of the coracoid process are described. This association is unusual and the coracoid fracture may only be recognised on an axillary radiograph of the shoulder. Both the cases were treated conservatively, with good results. The management and outcome of other cases described in the literature are reviewed and discussed.

The blood supply of the osteocutaneous free fibular graft

The use of an osteocutaneous free fibular graft as a single-stage reconstructive procedure for composite tissue loss is increasingly common. Detailed anatomical study in cadavers of the blood supply to the graft demonstrates cutaneous arteries arising from the peroneal artery and then passing along the posterior surface of the lateral intermuscular septum. These vessels pierce the crural fascia and then ramify to supply the skin. Knowledge of the vascular anatomy of the skin overlying the fibula is essential to the success of the graft.

Male choriocarcinoma of the spleen: a case report

The success with treatment of extragonadal germ cell tumours is well recognized and emphasizes the need for an early diagnosis. In young men presenting with undifferentiated carcinoma a non-testicular germ cell tumour should be considered. We report a case of choriocarcinoma involving the spleen.

Pyoderma gangrenosum after cholecystectomy

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Histochemical study of aminopeptidase activity in the human breast

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