Insulin autoimmunity associated with vitiligo: a rare case presentation.

Summary: Insulin autoantibody syndrome (IAS) or Hirata's disease is a rare condition characterized by recurrent fasting hypoglycaemic and postprandial hyperglycaemic episodes. Insulin autoantibodies are diagnostic for the condition. Hirata's disease has been seen to be associated with other autoimmune conditions.

Expression of inducible nitric oxide synthase in muscle flaps treated with ischemic postconditioning.

Background/objective: Preconditioning has been considered promising for the treatment of ischemic flaps. In this study, the therapeutic effect of postconditioning was compared with that of preconditioning during ischemia/reperfusion (I/R) injury, and a role of inducible nitric oxide synthase (iNOS) in postconditioning treatment was also explored.

Methods: Sixty rats were randomly divided into four groups with 15 rats in each group.

"The chisel test"--a useful operative, technique for determining adequate, compression during arthrodesis.

Healing of an arthrodesis occurs optimally when the prepared joint surfaces are held rigidly under compression [1]. We routinely use the "Chisel test" intra-operatively to determine whether we have achieved adequate compression and rigidity after fixation of our foot and ankle fusions. This previously un-reported technique uses tools already on hand when performing an arthrodesis and takes seconds to perform.

The use of Integra with a sensate fasciocutaneous pedicled flap for the salvage reconstruction of a below knee amputation after pedestrian vs train multi-planar degloving injury.

Degloving injuries occur when there is sufficient tangential force to a body surface to disrupt the structures connecting skin and subcutaneous tissues to the superficial fascia. There may also be associated injuries to the underlying soft tissues, bone, nerves and vessels. The injury may be so severe that the limb is non-viable and requires amputation.

Cobb procedure and Rose calcaneal osteotomy for the treatment of tibialis posterior tendon dysfunction.

Forty-three patients with stage 2 posterior tibialis tendon dysfunction underwent surgical reconstruction in the form of a Cobb procedure and Rose calcaneal osteotomy between 1997 and 2003, and were evaluated pre- and postoperatively. The average age was 57 years, and the mean followup time was 51 months (range 10-83). The average AOFAS score preoperatively was 58 and improved to 85 postoperatively (p < 0.

Ocular microtremor during general anesthesia: results of a multicenter trial using automated signal analysis.

Ocular microtremor (OMT) is a fine physiologic tremor of the eye related to neuronal activity in the reticular formation of the brainstem. The frequency of OMT is suppressed by propofol and sevoflurane and predicts the response to command at emergence from anesthesia. Previous studies have relied on post hoc computer analysis of OMT wave forms or on real-time measurements confirmed visually on an oscilloscope.