Aplasia cutis congenita: a report of 12 new families and review of the literature.

Aplasia cutis congenita (ACC) is a heterogeneous group of disorders whose common characteristic is focal absence of skin. In the majority of instances this is limited to the scalp, although other areas of the body may also be involved. Other congenital malformations have been reported to occur with ACC; limb defects appear to be a specific association. Given our experience with ACC, we suggest a classification based on genetically distinct entities. Type I ACC is limited to the scalp. Type II involves body or scalp; IIA involves body or limb defects. Type III is limited to the scalp or limbs. Type IV is associated with epidermolysis bullosa; type IVA is Bart syndrome. Although most reported cases have been sporadic, there are many familial occurrences of all types of ACC. Most published pedigrees are consistent with autosomal dominant inheritance with reduced penetrance, or autosomal recessive inheritance. Careful examination of family members of affected individuals is warranted.     

Enumeration and characterization of virus-specific B cells by multicolor flow cytometry

To better characterize B cell responses induced to influenza virus, we developed an assay to directly quantify and characterize virus-specific B cells. We used purified and biotinylated whole virus as well as the major influenza virus surface antigen, hemagglutinin (HA) to label virus-specific B cells induced by immunization of mice with whole influenza virus in adjuvant. Immunization with adjuvant alone caused non-specific binding of whole virus to a large number of B cells in the draining lymph nodes as assessed by flow cytometry. This precluded the use of whole virus as a specific staining reagent. In contrast, staining with bromelain-cleaved purified and biotinylated influenza virus HA identified a small population of B cells (roughly 1%) only in the draining lymph nodes of virus-immunized mice. FACS-purification and subsequent ELISPOT analysis showed that HA-labeled B cells contained the vast majority of virus-specific antibody-secreting cells at day 10 after immunization. Overall, virus-specific antibody-secreting cells comprised roughly 10% of the HA-labeled cells. Using HA-staining in conjunction with 8-color flow cytometry we further demonstrated that close to 90% of the HA-labeled cells were CD19+ IgD- CD23- CD24high CD38low germinal center B cells, many of which had incorporated bromodeoxyuridine, indicating recent cell division in vivo. We conclude that viral HA can be used in conjunction with cell surface and intracytoplasmic stains in multicolor flow cytometry to provide detailed phenotypic and functional information on virus HA-specific B cells.     

COMPARATIVE STUDY OF BONE HEALING FOLLOWING BONE CUTS USING SURGICAL BURS AND MICROSAWS

Bone cuts on the tibia of 6 healthy dogs were studied using surgical burs and microsaws arranged in two groups by random selection to assess the speed of cutting, precision and bone healing. Bone cuts in Group A were made with surgical burs of 1.6 mm diameter using micromotor at 40,000 revolutions per minute (RPM) whereas in Group B they were created using Stryker microsaws of 0.75 mm width at the speed of 40,000 RPM. In each group, the dogs were sacrificed at the end of 8, 12 and 16 weeks and a section of the tibia containing the fracture site was removed to assess healing histopathologically. Based on clinical, radiological and histopathological examination, the results of this study indicate that microsaws have their best use in osteotomy procedures in terms of precision and thermal injury to bone whereas ostectomy procedures are more convenient with surgical burs.KEYWORDS: Bone cuts, Bone healing, Microsaws, Surgical burs     

ARTHROSCOPIC EVALUATION AND MANAGEMENT OF MENISCAL INJURIES OF THE KNEE

50 cases of isolated meniscal injuries of the knee were evaluated and managed arthroscopically. 56% of the cases were in 25–35 year age group. In 80% of the cases military training and contact sports was the mode of injury. Maximum (42%) patients reported late (> 2 years) after the injury. On presentation, they had an average Lysholm knee score of 53.76. Medial meniscal lesion was seen in 74%. Commonest pattern of tear encountered was a longitudinal tear (40%). Depending on pattern and extent of lesion, partial meniscectomy (60%), subtotal meniscectomy (14%) and total meniscectomy (26%) were performed. Patients were followed up at six months and one year. The average Lysholm score at 6 months was 83.3 and at one year 79.5. At one year, the patient satisfaction level was 82% and patients who underwent partial meniscectomy had the best results.KEY WORDS: Arthroscopy, Meniscal tear