How does a pure muscle cross-leg flap survive? An unusual salvage procedure reviewed.

An exceptional indication for a cross-leg gastrocnemius flap used as a pure muscle flap in the distal third of the lower leg is presented. The vascular status of the patient after the accident and extensive colonized wounds in the injured lower leg did not favor any microvascular reconstruction. Because no cross-leg muscle flap has been mentioned in the literature so far, technical details of the procedure are explained.

Phase variation of Haemophilus influenzae lipopolysaccharide: characterization of lipopolysaccharide from individual colonies.

The lipopolysaccharide (LPS) of Haemophilus influenzae expresses a number of core oligosaccharide epitopes on its outer surface. The expression of individual epitopes is subject to frequent (approximately 1% bacteria/generation) reversible phase variation, as determined by colony immunoblots. We have used a microtechnique for the extraction of LPS from individual colonies, whose LPS antigenic phenotype has been identified, so that the LPS can be studied by tricine sodium dodecylsulphate polyacrylamide gel electrophoresis (T-SDS-PAGE).

The efficiency of processing and secretion of the thermolysin-like neutral protease from Bacillus cereus does not require the whole prosequence, but does depend on the nature of the amino acid sequence in the region of the cleavage site.

Using deletion mutants, it is shown that part of the prosequence, the omega-peptide (-4, -24), of the thermolysin-like neutral protease (TNP) from Bacillus cereus, Cnp, is not required for efficient processing and secretion of fully functional mature protease. It is demonstrated that the rate and selectivity of proprotein processing is dependent on both the flexibility and primary sequence of the processing site. Processing is found to be particularly sensitive to the nature of the amino acid three residues upstream from the site of cleavage.

[Abdominal pain in children caused by lactose intolerance. Prospective use of the hydrogen breath test].

Objectives: We performed the breath hydrogen test in children consulting for abdominal pain in order to determine the minimal quantity of lactose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test.

Methods: The breath hydrogen test after lactose intake was performed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.

Epidemiological data and costs of burn injuries in workers in Switzerland: an argument for immediate treatment in burn centres.

A complete statistical evaluation of epidemiological data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5 per cent of the burn victims are admitted to a hospital, 0.

Pain management for the geriatric patient.

Pain is a common and complex problem in the geriatric population. Successful pain management in this patient population requires a comprehensive approach involving both pharmacologic and nonpharmacologic interventions.

Flurbiprofen local action transcutaneous (LAT): clinical evaluation in the treatment of acute ankle sprains.

One hundred and thirty-one male and female outpatients, aged 18-70 yr, with acute pain in the ankle joint caused by a post-traumatic sprain, entered a multicentre, randomised, double-blind, parallel-group, study. The patients were assigned to a 40 mg flurbiprofen patch (n = 65) or a non-medicated (but otherwise identical) control (n = 66), 12-hourly over 7 days, and were assessed at entry and after 3 and 7 days treatment. On day 7, spontaneous pain (the prime efficacy parameter), as evaluated by the patient on a visual analogue scale in the physician's office, showed significant improvement in the 40 mg flurbiprofen patch group compared to control (change from baseline) (p = 0.

Perianal extramammary Paget's disease. Report of two cases.

Perianal (extramammary) Paget's disease is rare and corresponds to an intraepithelial adenocarcinoma arising from dermal apocrine sweat glands. Biopsy reveals the diagnosis. The condition is often associated with an underlying malignancy (carcinoma of the apocrine or eccrine glands, rectal carcinoma, anal carcinoma).

Serological characterisation of Neisseria gonorrhoeae by co-agglutination technique.

Antibiotic susceptibility pattern in cases of acute gonococcal urethritis, was studied by single disc diffusion technique and minimum inhibitory concentration (MIC) by agar dilution technique were determined for 5 antibiotics, viz penicillin, ampicillin, tetracycline, gentamicin and norfloxacin. All the penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains were sensitive to norfloxacin. 72% of the isolates belonged to serogroup WII/WIII by co-agglutination technique.

[Burns in workers in Switzerland: epidemiology and financial sequelae].

A complete statistical evaluation of epidemiologic data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5% of the burn victimes are admitted to a hospital, 0.

The molecular study of bacterial virulence: a review of current approaches, illustrated by the study of adhesion in uropathogenic Escherichia coli.

Pathogenic bacteria coexist with their hosts in a relationship which most frequently allows persistence of the bacteria without causing disease. In a small proportion of colonised individuals the complex mutual interaction between microbe and host is upset, leading to disease in the host. The investigation of bacterial virulence determinants and their genetic control at the molecular level is an important facet of the development of strategies to combat disease.

The neurosensory musculocutaneous tensor fasciae latae flap: long term results.

In 1971 we started covering pressure sores and unstable scars with transposition-rotation-muscle and musculocutaneous flaps. In 1980 we published the first results with 6 neurosensory musculocutaneous tensor fasciae latae flaps. Until April 1989, 31 tensor fasciae latae flaps (TFL) were used, and we review a consecutive series of 19 neurosensory TFL-flaps.

The role of the pro-sequence in the processing and secretion of the thermolysin-like neutral protease from Bacillus cereus.

The Bacillus cereus cnp gene coding for the thermolysin-like neutral protease (TNP) has been cloned, sequenced, and expressed in Bacillus subtilis. The protease is first produced as a pre-pro-protein (M(r) = 61,000); the pro-peptide is approximately two-thirds of the size of the mature protein. The pro-sequence has been compared with those of six other TNPs, and significant homologies have been found.

Why the denervated gastrocnemius muscle flap should be encouraged.

The superiorly based, denervated gastrocnemius muscle flap is able to perform an aesthetically excellent and functionally good cover for defects of the upper one-third of the calf, including the knee, and the lower one-third of the thigh. A consecutive series of 41 muscle and musculocutaneous gastrocnemius flaps was analyzed. Thirty-six patients (88% of the patients who underwent surgery) could be reexamined.

The sensory tensor fasciae latae flap: a 9-year follow-up.

From January 1979 to April 1989, 19 neurosensory tensor fasciae latae flaps were used to cover ischial pressure sores in paraplegic patients. This flap provides protective sensation and improves the sensory control of the filling status of the rectum and the sitting control in a wheelchair. Patients were reexamined between 12 and 110 months; no recurrence or new pressure sores were seen.

The metabolic response to rapid intravenous glucose injection in acute falciparum malaria.

Because hypoglycaemia is common in severe malaria, intravenous glucose is often given empirically to patients on admission to hospital. To investigate the metabolic response to rapid glucose injection in acute malaria, 50 ml of 50% w/v (25 g) dextrose was given over 5 min to 10 adult patients (7 males, 3 females; mean age 30 years) with acute falciparum malaria. Five patients with severe infections were studied between doses of intravenous quinine; 5 cases were uncomplicated and previously untreated.

Salmonella phage types in Bombay from 1983 to 1987.

A total of 156 strains of Salmonella isolated at T.N. Medical College and B.

[Facial injuries in bicyclists: epidemiological analysis and prophylactic consequences].

Bicycle accidents in adults are common and concern frequently injuries to head and face. 150 of totally 216 patients with cycle accidents in a six month' prospective study at the Basel University Hospital showed face and head trauma. 85 severe facial injuries treated operatively by the Clinic for Reconstructive Surgery between 1985 and 1989 are analysed in detail.

Nosocomial infection surveillance in a vascular surgery unit.

An epidemiological nosocomial infection surveillance program was conducted in the Vascular Surgery Unit of Purpan University Hospital, Toulouse, France, involving 389 patients hospitalized between June 1 and November 30, 1988. The methodology and inclusion criteria used were those of the Centers for Disease Control of Atlanta. Twenty-six patients had 30 nosocomial infections according to these criteria, a prevalence of 6.

Quinine induces reversible high-tone hearing loss.

Serial audiometry was performed in ten patients receiving quinine treatment for acute falciparum malaria. Quinine reduced high tone auditory acuity in all patients, resulting in flattening of the audiograms. The effect was rapid in onset, usually unnoticed (although tinnitus was reported in seven patients), and resolved completely after treatment was completed.

[Follow-up of extensive burns in an HIV positive patient. Case report].

The case of a 33-year-old HIV-positive patient who suffered from second- and third-degree burn injuries involving 30% of the body surface is reported. She was treated by early tangential excision of the burnt skin and split-thickness mesh grafting. The burn wounds healed without complications within the usual time, with excellent cosmetic and functional results.

Inhaled terbutaline administered via a spacer fully prevents exercise-induced asthma in young asthmatic subjects: a double-blind, randomized, placebo-controlled study.

The effects of inhaled terbutaline, a beta 2-adrenergic agonist, administered via a 750-ml spacer device were studied in young asthmatic subjects with exercise-induced asthma. A double-blind, randomized, placebo-controlled study of the effects of inhaled 0.5 mg terbutaline and placebo was conducted in 10 asthmatic children (age range 6-16 years) with documented exercise-induced asthma.