Wrist Arthroplasty to Facilitate Communication in the Hearing Impaired.

Management of wrist arthritis may involve many options, including motion preserving and motion sacrificing procedures. Total wrist arthrodesis is often considered the gold standard for severe wrist arthritis, failing non-operative management. We present the first case to our knowledge of total wrist arthroplasty (TWA) for patient with rheumatoid arthritis who is also deaf, requiring sign language for communication with excellent results.

Deep Transverse Metacarpal Ligament Reconstruction Using Suture Button and A1 Pulley.

Rupture of the deep transverse metacarpal ligament (DTML) can result in pain, impaired grip strength, and undermine functional performance of the hand. We describe the case of a patient whose right hand came into contact with a boat propeller. He sustained a complete disruption of the DTML between the second and third ray in addition to soft tissue injury and open metacarpal fractures.

A surgical approach in the management of mucormycosis in a trauma patient.

Mucormycosis as a consequence of trauma is a devastating complication; these infections are challenging to control, with a fatality rate approaching 96% in immunocompromised patients. We present a case where a proactive approach was successfully employed to treat mucormycosis following complex polytrauma. Aggressive repeated surgical debridement, in combination with appropriate antifungal therapy, proved successful in this instance.

N-[6-amino-2-(heteroaryl)pyrimidin-4-yl]acetamides as A2A receptor antagonists with improved drug like properties and in vivo efficacy.

In the present article, we report on a strategy to improve the physical properties of a series of small molecule human adenosine 2A (hA2A) antagonists. One of the aromatic rings typical of this series of antagonists is replaced with a series of aliphatic groups, with the aim of disrupting crystal packing of the molecule to lower the melting point and in turn to improve the solubility. Herein, we describe the SAR of a new series of water-soluble 2,4,6-trisubstituted pyrimidines where R1 is an aromatic heterocycle, R2 is a short-chain alkyl amide, and the typical R3 aromatic heterocyclic substituent is replaced with an aliphatic amino substituent.

Lead optimization of 4-acetylamino-2-(3,5-dimethylpyrazol-1-yl)-6-pyridylpyrimidines as A2A adenosine receptor antagonists for the treatment of Parkinson's disease.

4-Acetylamino-2-(3,5-dimethylpyrazol-1-yl)-pyrimidines bearing substituted pyridyl groups as C-6 substituents were prepared as selective adenosine hA2A receptor antagonists for the treatment of Parkinson's disease. The 5-methoxy-3-pyridyl derivative 6g (hA2A Ki 2.3 nM, hA1 Ki 190 nM) was orally active at 3 mg/kg in a rat HIC model but exposure was poor in nonrodent species, presumably due to poor aqueous solubility.

An efficient process for production of N-acetylneuraminic acid using N-acetylneuraminic acid aldolase.

N-acetyl-D-neuraminic acid (Neu5Ac) aldolase (EC 4.1.3.

The squalestatins, novel inhibitors of squalene synthase produced by a species of Phoma. V. Minor metabolites.

The isolation and structure determination of 3H and 13C NMR and MS of 24 novel squalestatins from cultures of Phoma sp. C2932 is described.

Enzymatic production of optically pure (2'R-cis)-2'-deoxy-3'-thiacytidine (3TC, lamivudine): a potent anti-HIV agent.

Although equipotent in terms of antiviral activity, the two enantiomers of 2'-deoxy-3'-thiacytidine (BCH 189) differ markedly in their cytotoxicity. (2'R-cis)-2'-deoxy-3'-thiacytidine (3TC) is substantially less toxic than its optical antipode, and is undergoing development for the therapy of HIV infection. Cytidine deaminase from Escherichia coli is shown here to deaminate 2'-deoxy-3'-thiacytidine enantioselectively to leave 3TC essentially optically pure.

Valve data collection: problems and pitfalls.

Since 1981, the Department of Medical Physics and Clinical Engineering at the University of Sheffield has been responsible for the organization, management and data collection associated with the largest multicentre heart valve implant patient follow-up study in the Western world. At the present time, the database comprises information on over 16,000 valve implants, which have been provided by 57 surgeons working at 22 centres in the UK. All this data is available for in-depth statistical analysis.

Pancreatitis associated with pancreas divisum: results of surgical intervention.

The embryologic defect that results when the ventral and dorsal anlages of the pancreas do not fuse has been referred to as pancreas divisum. The patients who present with recurrent pancreatitis or pancreatitis-like pain in association with pancreas divisum should be investigated to determine the presence of minor papilla stenosis. In the present study of 11 patients, 9 became asymptomatic with surgical decompression of the dorsal pancreatic duct.

Cytomegalovirus infection of the gastrointestinal tract in a patient with late onset immunodeficiency syndrome.

An adult with the late onset immunodeficiency syndrome developed intractable diarrhea. Widespread cytomegalovirus (CMV) infection of the gastrointestinal tract was detected antemortem with detailed morphological studies and viral culture. The CMV-type cells were especially numerous in his severely ulcerated colon.

Endoscopic laser treatment. II. Comparison of the efficacy of high and low power photocoagulation in control of severely bleeding experimental ulcers in dogs.

The coagulative efficacy of a "high power" argon laser which delivers 6.5 +/- 1.0 w was compared to that of a "low power" argon laser which delivers 1.

Cytomegalovirus-associated gastric ulcer.

A patients with a cytomegalovirus (CMV) post-transfusion syndrome developed upper gastrointestinal tract bleeding; subsequently, a gastric ulcer was found. CMV was searched for in the gastroscopic biopsy material because the gastric ulcer had occurred in a setting of CMV mononucleosis. CMV cells were found in gastroscopic biopsy sections and CMV was also cultured from biopsy material.

A reproducible animal model of acute bleeding ulcer-the "ulcer maker".

An instrument has been developed which creates an experimental model of an acute bleeding gastric ulcer. The diameter and depth of these gastric ulcers are reproducible. The instrument can be used endoscopically or at laparotomy.