Effects of a silicone-coated polyamide net dressing and calcium alginate on the healing of split skin graft donor sites: a prospective randomised trial.

An open randomised prospectively controlled trial was performed to assess the healing efficacy, slippage rate and degree of discomfort on removal of calcium alginate and a silicone-coated polyamide net dressing on split skin graft donor sites. Sixteen patients were randomised to the calcium alginate group and 14 to the silicone-coated group. The donor sites were assessed at days 7, 10, 14 and up to day 21.

Squamous cell carcinoma of the finger masquerading as an abscess. Case report.

A 43-year-old man presented with an abscess on his left ring finger, which recurred despite multiple drainage procedures. Histological examination of the lesion was unhelpful; it was only on histopathological examination of the finger after ray amputation that the diagnosis of cutaneous squamous cell carcinoma was established. This case illustrates the need to consider malignancy when dealing with chronic finger infections.

Microneurovascular transfer of contralateral latissimus dorsi in Poland's syndrome.

A 2-year-old girl with Poland's syndrome presented with syndactyly of the first, second and third webs of the left hand and ipsilateral absence of the sternocostal portion of pectoralis major. Latissimus dorsi on the same side was also absent. A microvascular free contralateral latissimus dorsi muscle transfer was undertaken to reconstruct the chest wall and anterior axillary fold.

Plastic surgery and pseudoxanthoma elasticum.

Pseudoxanthoma elasticum is a cause of abnormal skin laxity. A case of lower face and neck skin laxity is presented with its treatment by cutaneous rhytidectomy.

Outcome measurement of the treatment of maxillary fractures: a prospective analysis of 100 consecutive cases.

We performed a prospective study of 100 consecutive patients presenting to our unit with complex maxillary fractures. Fracture severity was assessed according to the alpha-numeric scoring system of Cooter and David and correlated with outcome. Regional maxillary and total fracture scores demonstrated a positive correlation with complication rates, with correlation coefficients of 0.

Recurrent cervical carcinoma: typical and atypical manifestations.

After treatment of cervical carcinoma, recurrent disease may be observed in multiple sites at imaging. Both typical and atypical manifestations of recurrent disease occur. Typical manifestations of recurrent cervical carcinoma involve the pelvis and lymph nodes.

The role of low-profile titanium miniplates in emergency and elective hand surgery.

We report our experience of a low-profile mini-plating system in the treatment of fractures of the hand in 57 consecutive patients (five children and 52 adults). Thirteen procedures were performed electively, and 44 procedures were performed on an emergency basis. Indications for plating included fixation of metacarpal (36) and phalangeal (eight) fractures, bony fixation following rotation osteotomy (six) digital replantation (two) or free toe transfer (two).

Analyses of prostaglandin D2 metabolites in urine: comparison between enzyme immunoassay and negative ion chemical ionisation gas chromatography-mass spectrometry.

Measurements of the prostaglandin (PGD2) metabolite 9 alpha, 11 beta-PGF2 in unextracted urine performed by enzyme immunoassay (EIA) were compared with values obtained by negative chemical ionisation gas chromatography-mass spectrometry (NCI GC-MS). Values determined by NCI GC-MS were in the same range but consistently lower than those obtained by EIA, suggesting that other endogenous compounds could be contributing to the immunoreactivity. Isoprostanes were generated by autoxidation of arachidonic acid and the 9 alpha, 11 beta-PGF2 antibody demonstrated less than 0.

On the role of PGD2 metabolites as markers of mast cell activation in asthma.

Prostaglandin D2 (PGD2) is the major cyclooxygenase metabolite of arachidonic acid released after stimulation of mast cells. Quantification of metabolites of PGD2 can be used as an objective indices of PGD2 production and hence mast cell activation in vivo. The aim of this thesis was to investigate the feasibility of measuring the primary urinary metabolite of PGD2, 9 alpha,11 beta-PGF2 with enzyme immunoassay (EIA).

Exposure of healthy volunteers to swine house dust increases formation of leukotrienes, prostaglandin D2, and bronchial responsiveness to methacholine.

Background: Acute exposure of healthy subjects to swine house dust causes increased bronchial responsiveness to methacholine but no acute bronchoconstriction. The role of cysteinyl leukotrienes and mast cells in increased bronchial responsiveness is unclear.

Methods: Ten non-asthmatic subjects were exposed to swine dust for three hours while weighing pigs in a piggery.

Stress in perioperative nursing: sources, frequency and correlations to personality factors.

Psychological stress in perioperative nursing is a complex phenomenon that is often reported in the literature as having potentially detrimental consequences. However, little specific research has been conducted into the causes and possible mediating processes involved in the stress response. The aims of this pilot study were firstly, to identify the range of stressors encountered by a group of perioperative nurses (n = 47) and secondly, to investigate the relationship of the reported interpersonal stressors to the personality construct of lifestyle proposed by individual Psychology (IP).

N-carbamoyl analogs of Zafirlukast: potent receptor antagonists of leukotriene D4.

Exploration of the indole nitrogen region of Zafirlukast (1) has uncovered a potent series of cysteinyl leukotriene D4 (LTD4) antagonists. These studies showed that a variety of functionality could be incorporated in this region of the molecule without sacrificing potency. Efforts to exploit this site in order to improve oral efficacy are discussed.

Urinary excretion of inflammatory mediators during allergen-induced early and late phase asthmatic reactions.

Background: It is generally accepted that the early asthmatic response to inhaled allergen is a result of IgE-mediated mast cell activation. In contrast, the underlying mechanism of the late asthmatic response is much less clear.

Objective: In order to investigate the pattern of mediator release during the early and late asthmatic responses to allergen, measurements of the urinary excretion of the mast cell markers 9alpha,11beta-PGF2 and Ntau-methylhistamine were made.

Is there still a role for traditional methods in the management of fractures of the zygomatic complex?

With the introduction of low-profile mini-plating systems, a trend has developed towards open reduction and rigid internal fixation (ORIF) of fractures of the cranio-facial skeleton. The current policy for management of zygomatic fractures in our unit is to attempt primary reduction by traditional methods, and proceed to ORIF in the event of unsatisfactory fracture stability or alignment. Over a one-year period, 109 patients underwent surgical correction of fractures of the zygomatic complex.

Evidence for mast cell activation during exercise-induced bronchoconstriction.

Controversy remains about the causative mediators in the bronchoconstrictive response to exercise in asthma. This study examined whether mast cell activation is a feature of exercise-induced bronchoconstriction by measuring urinary metabolites of mast cell mediators. Twelve nonsmoking subjects with mild asthma and a history of exercise-induced bronchoconstriction exercised on a stationary bicycle ergometer for 5 min at 80% maximum work load.

Primary ovarian leiomyosarcoma in an adolescent following radiation for medulloblastoma.

Primary ovarian leiomyosarcomas are rare neoplasms of the ovary, particularly in the pediatric population. Their occurrence following radiation therapy for previous malignancy has important implications. We present a case of primary ovarian leiomyosarcoma in an adolescent following therapy for medulloblastoma.

Is it possible to predict limb viability in complex Gustilo IIIB and IIIC tibial fractures? A comparison of two predictive indices.

The patient with severe lower limb trauma presents a management dilemma; whether to amputate primarily or to attempt limb salvage. In recent years, many predictive indices have been published which purport to identify limbs which are non-viable. We retrospectively applied two recently described indices, the Mangled Extremity Severity Score (MESS) and the Limb Salvage Index (LSI), to 54 limbs in 50 patients with either Gustilo IIIB or IIIC complex tibial fractures.

Bilateral spontaneous rupture of flexor digitorum profundus tendons.

Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

An unusual variant of the levator claviculae muscle encountered in exploration of the brachial plexus.

The levator claviculae muscle is a vestigal muscle which occurs in less than 2% of humans. The embryological origin of this muscle is controversial. We report a case in which an unusual variant of this muscle was encountered during exploratory surgery following a brachial plexus injury.