The difficult primary hip

Hip arthroplasty is a common orthopaedic procedure with proven long-term success and reliable results. A wide range of associated conditions may affect the outcome of the arthroplasty and the surgeon has to keep these in mind when planning the surgery. In this article, such situations are discussed and recommendations are drawn from the evidence available in literature.     

Parotid gland leiomyosarcoma in a child: an extremely unusual neoplasm.

We report the case of an 8-year-old boy with a parotid mass diagnosed to be a leiomyosarcoma. Considering the unresectable extent of the mass, the patient was subjected to radiotherapy. The patient developed distant metastasis following the course of radiotherapy and was put on chemotherapy. The child was lost to further follow up. To our knowledge, this is the first reported case in the English-language literature of such an entity in the pediatric age group.     

Improvement in semen quality and sperm fertilizing ability after filtration through the L4 membrane: comparison of results with swim up technique.

The L4 filtration membrane was used at our laboratory on 30 semen specimens (19 from suspected subfertile patients and 11 from fertile donors) to assess changes in semen quality after routine sperm washing and swim up versus filtration through the L4 membrane. Of these 30 samples 17 (11 suspected subfertile patients and 6 fertile donors) were chosen to evaluate differences in sperm fertilizing ability between the 2 sperm preparation methods. Liquified specimens were analyzed on a Cell Soft semen analyzer. Semen specimens were divided equally, and 1 aliquot was processed by sperm washing and the swim up technique and the other by filtration. In all subjects the results of semen analysis and the hamster-egg penetration test showed significant improvement in sperm quality and fertilizing ability after filtration through the L4 membrane. Sperm motility was 58% after the swim up technique compared to 79% after filtration (p less than 0.0001) and velocity was 47 mu. per second after the swim up method compared to 52 mu. per second after filtration (p less than 0.048). Penetration rate and penetration index also showed a significant increase after filtration over values for the swim up method. Our results demonstrate that sperm filtration through the L4 membrane provides results superior to those of the traditional swim up technique. Due to significant savings in time associated with its use the L4 membrane can be used during sperm processing for intrauterine insemination and in vitro fertilization procedures.     

Clastogenic effect of fenfluramine in mice bone marrow cells in vivo

Fenfluramine, an amphetamine derivative used in the treatment of obesity, has been evaluated in vivo in the bone marrow cells of Swiss albino mice using two cytogenetic endpoints for assessing its genotoxic and clastogenic potentials. Concentrations of 0.75, 1.5, 3.0, and 5.0 mg/kg b.w. were administered orally for the study of sister chromatid exchange frequencies and chromosome aberrations (CA). SCE frequencies showed a positive dose response; 1.5 mg/kg being the minimum effective concentration. Fen caused a prolongation of cell cycle at all concentrations. Except for the minimum therapeutic dose (0.75 mg), all other doses (1.5, 3.0, and 5.0 mg) showed a significant increase in the percentage of damaged cells over that of the vehicle control. The degree of clastogenicity was directly proportional to the dosage used and inversely related with the duration of treatment. A gradual reduction of the clastogenic potential was observed after 12 and 24 hr of exposure, indicating that the maximum effect occurs at the middle or late synthetic phase of the cell cycle. This study, probably the first detailed screening of the drug for its genotoxicity, shows that Fen is moderately clastogenic and a DNA damaging agent in vivo.     

A case of Sturge-Weber syndrome in association with phacomatosis pigmentovascularis and developmental glaucoma.

Sturge-Weber syndrome is a rare neurocutaneous disorder characterized by a facial nevus flammeus and extensive angiomatous changes involving the leptomeninges, the dura, and vessels of the gray and white matter. Oculodermal melanocytosis is characterized by hyperpigmentation of the facial skin in the distribution of the ophthalmic, maxillary, and occasionally mandibular division of the trigeminal nerve.