Magnetic resonance imaging in planning limb-salvage surgery for primary malignant tumors of bone

In defining the linear extent of a malignant tumor in a long bone, radiographs, computerized tomography, and scintigraphy are routinely employed, especially when non-ablative surgery is being considered. The drawbacks of these modalities in defining the true intracompartmental extent of disease within a bone can largely be overcome with the use of magnetic resonance imaging. We did a prospective analysis of magnetic resonance imaging in sixteen consecutive patients with a primary malignant tumor of a long bone, and it showed that this modality has clinical promise of being more precise than the other modalities in defining the true proximal and distal extent of a tumor in a long bone. Coronal images permit easier planning of surgical techniques for salvage of a limb using an allograft than do a multiplicity of transverse images.     

Intracranial mycotic aneurysm due to Aspergillus species.

BACKGROUND: Intracranial true mycotic aneurysms are uncommon and usually fatal. We report two patients with basilar mycotic aneurysms due to Aspergillus species following surgical interventions. Both patients had subarachnoid hemorrhage and diagnosis was made at autopsy only. The literature regarding etiology, clinical presentation, predisposing conditions and outcome of intracranial true mycotic aneurysms is reviewed from 1990-2005. A high index of clinical suspicion with prompt diagnosis and early treatment may improve patient outcome.     

Amputation of a crossover 2nd toe in the presence of hallux valgus

Background: There are many surgical procedures for the correction of hallux valgus and crossover 2nd toe deformity. Amputation of a crossover 2nd toe is often performed as a salvage procedure if the primary 2nd toe corrective procedure fails.Aims: To assess the outcomes of amputating a crossover 2nd toe in the presence of hallux valgus in elderly patients above 70 years old; as a primary procedure.Materials and methods: Seven patients (8 ft) underwent amputation of their crossover 2nd toe. A disease specific questionnaire using a Visual Analogue Scale (VAS) was implemented measuring pain, deformity, discomfort, and walking distance.Results: The mean age of the patients was 82 years old, range 74–89 years old. Amputation of the 2nd toe significantly reduces pain, discomfort and the appearance of deformity, there was no difference in the patient’s walking distance after surgery.Conclusion: We recommend this type of surgery as a primary procedure in elderly patients above 70 years old, if the first ray is not causing symptoms.     

Sodium depletion of pregnant ewes and its effects on foetuses and foetal fluids

1. Some effects of sodium depletion were investigated in sheep at different stages of pregnancy ranging from 55 to 139 days. Sodium depletion was induced by draining the saliva from one parotid gland for a period of 6 days. Foetal samples were collected at the end of the depletion period.2. Sodium depletion of the ewe resulted in a fall in saliva Na(+) level and a rise in saliva K(+) level, a fall in plasma Na(+) and K(+) levels, a 35% reduction in plasma volume and a 16% reduction in body weight.3. In the Na(+) depleted ewes the sodium levels of the foetal plasma and amniotic fluid were lower and the volume of the allantoic fluid greater than those in the control ewes.4. It is concluded that sodium depletion of the ewe leads to a deficiency of sodium in the foetus.5. On the basis of these experiments and other reports it is postulated that a sodium deficient foetus, like a sodium deficient adult, responds to the deficiency by restricting sodium losses in the urine and by excreting water.     

Cutaneous cryptococcosis among HIV infected patients

Five patients with HIV associated cutaneous cryptococcal infection are reported.     

Differential interaction of anti-lymphocyte serum with sub-populations of lymph node cells

Interaction of normal and Salmonella typhi `H'-sensitized rat lymph node cells with two different types of anti-lymphocyte serum (ALS) has been studied. One type of ALS, named as ALS(N), was prepared by immunizing rabbits with normal non-sensitized lymph node cells while the other, ALS(I), was produced by injecting rabbits with sensitized cells.

The histogram of electrophoretic mobilities (EPM) of ALS(N)-treated normal cells resolves into two Gaussian components corresponding to Class `A' and Class `B' cells respectively. ALS(N) brings about a significant reduction in the mean EPM of both these components indicating that ALS(N) binds to both the functional cell types with equal avidity. Analysis of the histogram of EPM of ALS(N)-treated sensitized cells reveals that ALS(N) leaves the mean EPM of antibody-producing Class `C' cells unchanged. ALS(I), on the other hand, is effective in binding to Class `C' cells in addition to the other cell types. These investigations thus demonstrate that ALS(N) has a differential action on the antigen-sensitive cells as compared to the antibody-producing cells. Further, this lack of interaction with Class `C' cells appears to be a result of a radically different surface-antigenic configuration of these cells.