Survival of microvascular free flaps in head and neck surgery after early interruption of the vascular pedicle.

Six to nineteen days after insertion of free flaps in oral defects three patients had secondary haemorrhages that necessitated the abolition of venous drainage in two cases and venous and arterial connections in the third. The flaps survived.

A randomized controlled trial of knifelight and open carpal tunnel release.

A randomized controlled trial was done to compare the results of carpal tunnel decompression using the standard open approach and the Knifelight technique. Twenty-six patients with bilateral carpal tunnel syndrome requiring operation were selected for the study and the operative technique was randomized for the first hand. Six weeks later, the second hand was operated upon using the alternate technique.

Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: a biomechanical study.

The radiographs of a sample of patients who had canulated hip screw fixation for intracapsular femoral neck fractures were reviewed in our region. There were six different types of configurations used in these fixations which are divided into two groups: (I) triangular configurations, consisting of two parallel screws with a third screw placed either superiorly, inferiorly, anteriorly or posteriorly; and (II) linear configurations with two or three screws in a vertical line. In our study, we tested the relative strength of each configuration in a laboratory setting using synthetic bone models.

Late-onset mitochondrial disorder with electromyographic evidence of myotonia.

We describe a patient with chronic progressive external ophthalmoplegia (CPEO) due to a deletion of mitochondrial DNA (mtDNA) who had electromyographic evidence of myotonic discharges. Myotonia has not previously been described in association with mitochondrial disease and this report extends the known phenotypic expression of these disorders.

Locating broken dental needles.

Broken dental needles are a rare event. They are difficult to find and remove. We report two cases in which broken needles were located using a simple stereotactic method with the aid of an image intensifier.

A clinical questionnaire for the diagnosis of carpal tunnel syndrome.

This prospective study compared the sensitivities of a scored questionnaire and electrophysiological examination in the diagnosis of carpal tunnel syndrome. Patients were assessed by a hand surgeon using a scored questionnaire, and then underwent an electrophysiological assessment by an experienced neurophysiologist (blinded to the questionnaire results). Patients diagnosed as having carpal tunnel syndrome by either the questionnaire, the electrophysiological examination or both underwent decompression.

The embedded ring injury - case report and review of literature.

Embedding ring injury is a very rare injury. Patients will mental illness should be considered at risk.

The objective diagnosis of early tennis elbow by magnetic resonance imaging.

Objective: To identify the salient magnetic resonance imaging (MRI) features of tennis elbow. An objective diagnosis is important when managing work-related incapacity due to ill-defined lateral arm pain.

Method: Twenty-three symptomatic and 17 asymptomatic elbows in 20 patients with tennis elbow, no evidence of other pathology and no previous treatment were imaged using established MRI sequences.

The impact of interventional neuroradiology on service in a neurosurgical unit.

Endovascular treatment of cerebral aneurysms has rapidly evolved and has transformed neurosurgical practice. We evaluated the influence of an interventional neuroradiology service on cerebral aneurysm management. We performed a retrospective analysis of all aneurysms treated in our unit before and after the establishment of endovascular treatment.

Neurogenic thoracic outlet syndrome.

Current concepts for the diagnosis of neurogenic thoracic outlet syndrome are presented together with the surgical experience and results in series of 51 patients caused by a cervical rib. Surgical treatment is recommended in patients with persistent and disabling symptoms not responding to conservative therapy. In carefully selected patients good to excellent results can be achieved.

The impact of interventional neuroradiology on neurosurgical training.

Aneurysmal subarachnoid haemorrhage carries a high mortality and morbidity. Surgical treatment (craniotomy and clipping of the aneurysm) has been, until recently, the gold standard treatment. Endovascular embolisation treatment has rapidly evolved and the evidence available suggests that the results are as good as surgery.

Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols.

We compared two protocols of early mobilisation for minimally displaced radial head fractures through a single-blinded, prospective randomised trial. Sixty patients were randomly allocated to either immediate active mobilisation or 5-day delay before active mobilisation was commenced. Patients were reviewed at 7 days, 4 weeks and 3 months after injuries.

A comparison of the index of complexity outcome and need (ICON) with the peer assessment rating (PAR) and the index of orthodontic treatment need (IOTN).

Aim: To evaluate any relationship between ICON, IOTN and PAR. To establish whether or not ICON could replace these indices as a measure of orthodontic treatment complexity, outcome and need.

Method: The study models of 55 consecutively treated cases were examined and PAR, IOTN and ICON recorded.

Seroprevalence of antibodies to herpes simplex virus types 1 and 2 among two sexually active female populations in Middlesbrough, England.

Herpes simplex virus (HSV) infection occurs worldwide but its epidemiology varies between different countries and between groups of individuals. Seroprevalence of HSV-1 and HSV-2 antibodies is a more accurate method of determining epidemiology of this infection. In this cross-sectional study, 467 blood samples were obtained from women attending the genitourinary medicine clinic (GUM) and antenatal clinic (ANC) in Middlesbrough, England.

A comparison of two methods for detection of Chlamydia trachomatis in the male urethra.

Several methods have been put forward for screening people for Chlamydia trachomatis infection of the urogenital tract. It is often believed that culture is the gold standard. However, newer and faster methods are being developed.

Day-case conventional discectomy: a randomised controlled trial.

A prospective randomised trial compared the results of conventional lumbar discectomy performed as day cases with those performed on an in-patient basis. The aim of the study was to investigate whether conventional discectomy can be performed safely on a day-case basis. Thirty-one patients were included in the study; 18 were randomised to day-case treatment and 13 to in-patient stay.

Audit of hepatitis B immunization at the genitourinary medicine department in Middlesbrough, UK.

The outcomes of hepatitis B immunization programme at the genitourinary medicine (GUM) department in Middlesbrough during a period of five years were examined. The majority of those immunized were male homosexuals who had earlier requested an HIV test. All participants had preimmunization hepatitis B serology, and were negative.

Cause-specific mortality in a population with diabetes: South Tees Diabetes Mortality Study.

Objective: To describe the mortality of a population with diabetes compared with the local nondiabetic population, using age-, sex-, and cause-specific death rates and relative and absolute differences in death rates.

Research Design And Methods: A population-based cohort of 4,842 people with diabetes living within South Tees, U.K.

Malignant transformation in congenital sebaceous naevi in childhood.

Sebaceous naevi are uncommon congenital skin lesions with a well-recognised potential for neoplastic change. They should be considered premalignant lesions as malignant degeneration, most commonly basal cell carcinoma and squamous cell carcinoma, occurs with a lifetime risk of between 5% and 22%. This incidence is equal to that of actinic keratosis and exceeds that of oral leukoplakia.

Asymptomatic HIV patient with cardiomyopathy and nephropathy: case report and literature review.

We report a previously asymptomatic HIV patient with high CD4 lymphocyte count and low HIV1 viral load who developed cardiac and renal disease. Management with ACE inhibitor, diuretics and triple antiretroviral combination therapy yielded a rapid clinical response. An understanding of the spectrum of renal and cardiac derangements is essential for clinicians in managing patients with HIV disease.