Effect of Toxic Metal Ions on Photosensitized Singlet Oxygen Generation for Photodegradation of Polyaromatic Hydrocarbon Derivatives and Inactivation of Escherichia coli.

Here, we report an experimental study of the effect of toxic metal ions on photosensitized singlet oxygen generation for photodegradation of PAH derivatives, Anthracene-9,10-dipropionic acid disodium salt (ADPA) and 1,5-dihydroxynapthalene (DHN) and photoinactivation of Escherichia coli bacteria by using cationic meso-tetra(N-methyl-4-pyridyl)porphine tetrachloride (TMPyP) as a singlet oxygen photosensitizer. Three s-block metals ions, such as Na , K and Ca and five toxic metals such as Cd , Cu , Hg , Zn and Pb were studied. The s-block metal ions showed no change in the rate of photodegradation of ADPA or DHN by TMPyP, whereas a dramatic change in the photodegradation of ADPA and DHN was observed in the presence of toxic metals.

Single-Stage Flexor Tendon Grafting: Refining the Steps.

Single-stage tendon grafting for reconstruction of zone I and II flexor tendon injuries is a challenging procedure in hand surgery. Careful patient selection, strict indications, and adherence to sound surgical principles are mandatory for return of digital motion.

Current options for treatment of hypothenar hammer syndrome.

Hypothenar hammer syndrome is a rare vascular condition resulting from injury to the ulnar artery at the level of Guyon canal. The ulnar artery at the wrist is the most common site of arterial aneurysms of the upper extremity and is particularly prone to injury. Signs and symptoms include a palpable mass, distal digital embolization to long, ring, or small fingers, pain, cyanosis, pallor, coolness, and recurrent episodes of vasospasm.

Proximal interphalangeal joint injection through a volar approach: anatomic feasibility and cadaveric assessment of success.

Purpose: The proximal interphalangeal (PIP) joint is a challenging joint to access reliably for corticosteroid injection. Literature has confirmed both a relatively high failure rate for injections performed with the traditional dorsal approach and an improved clinical response rate for confirmed intra-articular injections. We describe a technique for injecting the PIP joint through a volar approach, assess its reliability through cadaveric dissection, and determine its reproducibility by comparing success rates with the dorsal approach in a cadaver model.

Arterial conduits for distal upper extremity bypass.

Vascular bypass is an accepted surgical procedure for treatment of hand and digital ischemia that is the result of identifiable arterial disease. Although vein grafts have traditionally been used as vascular conduits for reconstruction, arterial grafts present a better alternative, physiologically, for reconstruction and may result in superior outcomes. Arteries suitable for grafts are not abundant and, therefore, upper extremity surgeons must be informed about possible donor sites and techniques for harvest.

Reconstruction for ulnar artery aneurysm at the wrist.

Arterial aneurysms of the upper limb most commonly involve the ulnar artery at the wrist. Hypothenar hammer syndrome is the usual cause of arterial trauma that forms the aneurysm. After excision of the aneurysm, vein or arterial conduits bridge the arterial gap.

Vascular insufficiency of the upper extremity.

Vascular insufficiency of the upper extremity can be due to acute vascular injury, chronic vasospastic disease, and occlusive disease. Its treatment requires a thorough understanding of the vascular anatomy of the upper extremity, diagnostic modalities, and medical and surgical management options. Promising advances continue to be made in surgical treatment and medical therapy.

Early results of transcutaneous injection laryngoplasty with micronized acellular dermis versus type-I thyroplasty for glottic incompetence dysphonia due to unilateral vocal fold paralysis.

Medialization thyroplasty (type I) has become the gold standard to improve glottic closure due to unilateral vocal fold paralysis. A newer injection method utilizing homologous collagen from cadaveric human tissue has been described as an attractive alternative as no donor site is required, there is a very low risk of hypersensitivity, and the intact, acellular collagen fibers may suffer a reduced long-term reabsorption rate. Preliminary results on eight patients comparing presurgical and postsurgical parameters (perceptual, stroboscopic, acoustic, and aerodynamic) revealed comparable results when compared with a control group of individuals, age- and sex-matched, that had undergone standard medialization thyroplasty (type I).

A rare case of mucoepidermoid carcinoma of the nasal cavity.

Mucoepidermoid carcinoma of the nasal cavity is rare. We report the case of a 57-year-old man who was evaluated for a rapidly enlarging subcutaneous mass on the nasal bridge. The tumor was diagnosed as a mucoepidermoid carcinoma.

Reconstruction of an ulnar-sided thumb in central deficiency: a case report.

The thumb, which is normally located on the radial border of the hand, requires adequate sensibility to perceive its environment and adequate mobility to oppose to the other digits. We present a case in which the most ulnar digit of the hand was surgically augmented to function as a thumb.

The use of simultaneous free latissimus dorsi tissue transfers for reconstruction of bilateral upper extremities in a case of purpura fulminans.

We report a case of extensive purpura fulminans destroying the soft tissue over the posterior aspect of both elbows. Simultaneous, bilateral free latissimus dorsi muscle transfers were used to close both wounds in a single procedure. The wounds resulting from severe purpura fulminans can be extensive and limb threatening.

Innervation of the metacarpophalangeal and interphalangeal joints: a microanatomic and histologic study of the nerve endings.

Six pairs of fresh human cadaver hands were dissected under the surgical microscope at x28 to x32 and selectively silver stained. In addition, 18 proximal interphalangeal and metacarpophalangeal joints of fresh cadaver hands were processed with protein gene product 9.5 for measurement and analysis of nerve endings in those joints.

The effects of free fat grafts on the stiffness of the rat sciatic nerve and perineural scar.

We developed a new quantitative rat sciatic nerve model to test whether free fat grafts can reduce postoperative perineural scar formation. Epineurectomies of sciatic nerves were performed to create scar. The force required to distract the nerve a unit distance was measured after surgery to determine the time of maximal scar formation.

Microarterial anatomy of the lesser toe proximal interphalangeal joints.

Successful free tissue transfer requires detailed knowledge of the pertinent microvascular anatomy of the donor site. The lesser toe proximal interphalangeal joints are a source of vascularized autologous tissue. In 20 adult cadaver feet, the arterial anatomy of the second, third, and fourth toes was studied using colored latex and India ink injection.

Infection in the presence of skeletal fixation in the upper extremity.

Infection is infrequent after open fractures of the upper extremity. Treatment begins with prevention through the appropriate use of prophylactic antibiotics, adequate wound debridement, and timely soft-tissue coverage. If infection supervenes, the surgeon must identify the responsible bacteria and administer antibiotics accordingly.

The use of dermal-fat grafts.

Recurrent carpal tunnel syndrome is a difficult problem facing hand surgeons today, and its incidence is rising. In selected cases, re-exploration, median nerve neurolysis, and dermal-fat grafting are beneficial. The surgeon should anticipate 30% to 50% absorption of the graft.

The Mitek Mini G2 suture anchor: biomechanical analysis of use in the hand.

We inserted 36 Mitek Mini G2 suture anchors (Mitek Surgical Products, Westwood, MA) into various sites of 14 fresh cadaver hands. A single-strand 0-Ethibond suture (Ethicon, Sommerville, NJ) was threaded through each anchor, inserted into bone, and loaded to failure. In all cases, either the anchor pulled out (11 of 36) or the suture broke (25 of 36).

A medieval casebook: hand cures documented in the Icelandic Sagas of bishops.

The Sagas of Icelandic bishops composed in and around the 13th century reveal something of the incidence and treatment of various hand conditions in the medieval period. A selection from the relevant material is translated and discussed.

Long-term recovery following surgical treatment for ulnar artery occlusion.

Fourteen patients were surgically treated for ulnar artery occlusion. Digital blood pressure measurements obtained pre- and intraoperatively helped guide the choice between ligation or reconstruction of the ulnar artery following resection of the occluded segment. The digital brachial index (DBI) was derived by calculating the ratio of digital blood pressure to the simultaneous brachial artery pressure.

Upper extremity tourniquet tolerance.

Twenty unsedated volunteers were tested to compare the relative tolerance of an arm tourniquet on one side and of a forearm tourniquet on the other. The forearm tourniquet was tolerated an average of 13 minutes (45%) longer and was consistently rated as less painful during and immediately after the test. No subject tolerated the arm tourniquet longer than the forearm tourniquet.

Tumors and aneurysms of the upper extremity.

A group of surgical abnormalities more diverse than vascular tumors would be difficult to find. These lesions are growths and are identified by cellular or gross appearance. They range in size from tiny glomus tumors to massive arteriovenous fistulas.

Drug and alcohol use in emergency hand patients.

Two hundred eleven adult emergency hand patients were prospectively tested over a 1-year period for drug and alcohol use. On admission, blood and urine samples were sent for quantitative alcohol and qualitative toxicology screens, respectively. In 44% of all patients tests were positive for one or more drugs or alcohol.