Graft Harvesting for Revascularization in the Head and Neck

The techniques for revascularization in the neurocranium, skull base, and neck continue to evolve at an exciting pace. In this body of literature, however, techniques for harvesting radial artery and saphenous vein grafts are mainly reported using traditional open techniques. Minimally invasive procedures are fast becoming an alternative to open techniques in many fields and have the potential to become the standard of care. The cardiovascular literature is replete with reports of endoscopically harvested vascular grafts. This article reviews both methods, since the current state of the art involves knowledge of open and endoscopic harvesting techniques.     

Implosive therapy for the treatment of combat-related PTSD

Implosive therapy for the treatment of post-traumatic stress disorder is based on the principle of exposing the patient to trauma-related cues until there is a reduction in the anxiety associated with the cues. It is a relatively specialized procedure regarding which few clinicians receive extensive supervised training, despite the numerous case studies that demonstrate its effectiveness. The present paper addresses a number of procedural issues and offers guidelines for conducting implosive therapy with traumatized combat veterans. Elements of controversy regarding the application of implosive therapy are discussed.     

Pregnancy: Oral misoprostol versus placebo for cervical dilatation before vacuum aspiration in first trimester pregnancy

Intravaginal misoprostol has been shown to be effective forcervical priming before a surgically induced abortion. The objectivewas to investigate the effectiveness of oral misoprostol incervical dilatation prior to vacuum aspiration between the 6thand 12th weeks of pregnancy. The results showed that in nulliparouspatients, the median cervical dilatation in the treatment group(7.8 mm) was significantly greater than that in the placebogroup (3.7 mm). In multiparous patients, the difference wasalso statistically significant (9.8 versus 6.0 mm). The easeof dilatation, assessed subjectively by the operating surgeons,was significantly improved in the treatment group. There wasalso a significant reduction in the duration of the operationand in the mean blood loss in the treatment group. The side-effectsencountered in the treatment group were mild and well acceptedby the women. Oral misoprostol is an effective and safe methodfor cervical dilatation prior to vacuum aspiration in firsttrimester pregnancy.     

STRESS IN THE RURAL EMERGENCY ROOM

ABSTRACT: This study identifies stress-producing factors reported by registered nurses (RNs) attending serious incidents in an Australian rural hospital's emergency room. A Delphi approach was used to determine the six most significant stress-producing factors, and these factors were then ranked by two groups of nurses. The rankings were compared using the Spearman Rank Order Coefficient of Correlation and were found to be dependent on years of nursing experience of the RNs taking part in the study. The more experienced group nominated 'anxiety about nursing a family member or close friend' as the most significant stress-producing factor, while the less experienced group reported 'concerns about nursing a child' as the most important stress-producing factor. Possible reasons for the variation in rankings are discussed, and recommendations are made in the light of the study's findings.     

Crystalline morphology of block-copoly(oxypropylene/oxyethylene/oxypropylene) by small-angle X-ray and Raman scattering

Block-copoly(oxypropylene/oxyethylene/oxypropylene)s, with central-block lengths of 39 and 75 oxyethylene units and end-block lengths in the range 1 to 13 oxypropylene units, were investigated in their solid states by small-angle X-ray diffraction and low-frequency Raman spectroscopy, supplemented by differential scanning calorimetry. Low-frequency Raman transitions were assigned to longitudinal modes (LAM) of either unfolded or once-folded chains. The solid state comprised stacked monolayer lamellae in which the chains were usually tilted with respect to the lamellar end plane.     

The effect of surface chemistry modification of titanium alloy on signalling pathways in human osteoblasts

Establishing and maintaining mature bone at the bone–device interface is critical to the long-term success of prosthesis. Poor cell adhesion to orthopaedic and dental implants results in implant failure. Considerable effort has been devoted to alter the surface characteristics of these biomaterials in order to improve the initial interlocking of the device and skeleton. We investigated the effect of surface chemistry modification of titanium alloy (Ti–6Al–4V) with zinc, magnesium or alkoxide-derived hydroxy carbonate apatite (CHAP) on the regulation of key intracellular signalling proteins in human bone-derived cells (HBDC) cultured on these modified Ti–6Al–4V surfaces. Western blotting demonstrated that modifying Ti–6Al–4V with CHAP or Mg results in modulation of key intracellular signalling proteins. We showed an enhanced activation of Shc, a common point of integration between integrins and the Ras/Mapkinase pathway. Mapkinase pathway was also upregulated, suggesting its role in mediating osteoblastic cell interactions with biomaterials. The signalling pathway involving c-fos (member of the activated protein-1) was also shown to be upregulated in osteoblasts cultured on the Mg and CHAP modified Ti–6Al–4V. Thus surface modification with CHAP or Mg may contribute to successful osteoblast function and differentiation at the skeletal tissue–device interface.     

Signet-ring lymphoma: report of a case

Signet-ring lymphoma is a rare entity in which the synthesis or secretion of immunoglobulins is impaired, producing a signet-ring appearance to the lymphoma cells. A case of this type of lymphoma is described, and the cytologic aspects of the cells obtained from the fixative fluid are described.     

Autosome and Sex Chromosome Diversity Among the African Pygmy Mice, Subgenus Nannomys (Murinae; Mus)

The African pygmy mice, subgenus Nannomys, constitute the most speciose lineage of the genus Mus with 19 recognized species. Although morphologically very similar, they exhibit considerable chromosomal diversity which is here confirmed and extended by the G-banding analysis of 65 mice from West and South Africa. On the basis of their karyotype and distribution area, the specimens were assigned to at least five species. Extensive differentiation both within and between species was observed that involved almost exclusively Robertsonian translocations, 23 of which are newly described. Two of the rearrangements were sex chromosome-autosome translocations, associated in some cases with partial deletions of the X or Y chromosomes. Several authors have predicted that the highly deleterious effect of this rearrangement would be reduced if the sex and autosomal segments were insulated by a block of centromeric heterochromatin. The C-banding analyses performed showed that among the species carrying X-autosome translocations, one followed the expected pattern, while the other did not. In this case, functional isolation of the sex and autosome compartments must involve other repetitive sequences or genomic traits that require further molecular characterization. Such studies will provide insight into the causes and consequences of the high diversity of sex chromosome rearrangements in this subgenus.