Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia

Free vascularized fibular bone grafts were used in nineteen children, seen consecutively, who had congenital pseudarthrosis of the tibia. The average age was 5.1 years (range, 1.4 to 11.4 years). Sixteen of the patients had been treated with electrical stimulation for at least one year, and the tibia had not united. All but four patients had had at least one previous operative procedure. At an average follow-up of 6.3 years (range, 2.0 to 11.0 years), eighteen (95 per cent) of the nineteen pseudarthroses had healed. The leg-length discrepancy averaged 1.6 centimeters (range, 0 to 4.0 centimeters), but ten tibiae had residual or progressive valgus or anteroposterior malalignment despite bracing. There was minimum morbidity at the donor site.     

Dispelling myths: a study of PMS and relationship satisfaction

For more than 50 years, professional literature has linked premenstrual tension (PMS) with psychoemotional symptoms, without addressing how women's roles and development may be related to PMS. This article's research examines aspects of a relationship that exemplify three reported psychoemotional concerns present in PMS women: marital-, sexual- and family-relationship satisfaction. Twenty-six PMS clients of a nurse practitioner and 26 non-PMS women completed three questionnaires about relationship satisfaction. Statistically, PMS subjects reported significantly more dissatisfaction with marital and sexual relationships. No effects linked to age were found. Results are explained within the context of women's development and roles, and implications are discussed for clinicians who provide health care to clients with PMS.     

Immunogenicity study of low-dose administration of hepatitis B virus vaccine in newborn infants: A cost reduction trial

Different doses of hepatitis B virus vaccine—prepared by Korea Green Cross Corporation, were given to healthy infants born to HBsAg-negative mothers at birth, 1 and 6 months of age. A dose of 2 μg was administered intradermally in Group A and, in the three other groups, the vaccine was given intramuscularly (i.m.). An adequate follow-up observation was possible for 9 months after birth in 22, 25, 23 and 21 infants in Groups A, B, C and D, respecvely.
Group C (5 μg, i.m.) produced seroconversion most rapidly, showing the highest rate (96%) at 9 months of age. The lowest seroconversion rate (5%) was found at the age of 1 month in Group A subjects, but the rate increased to 91% after a booster dose was given at 6 months of age.
While it can be concluded that a 5 μg i.m. dose of vaccine at 0, 1 and 6 months of age is optimum for the immunization of infants in efficacy and economy, a 2 μg intradermal dose can also be considered as an immunogenic and economical regimen, though the immune response is slower and a special technique is required for immunization.     

Developing a Documentation System That Works

A documentation system that facilitates accurate and complete recording is needed by every obstetric/neonatal nursing service. Developing an individualized system is a major undertaking. However, specific steps can be taken to ease the process. These steps are described, beginning with the assessment phase and concluding with evaluation.     

Opiate control of spontaneous locomotor activity in a urodele amphibian

An intraperitoneal injection of the preferential opiate receptor agonist (+/-) bremazocine HCl given to male rough-skinned newts acutely and dose-dependently reduced their spontaneous locomotor activity. Inversely, and contrary to the situation generally observed in other vertebrates, administration of the opiate receptor antagonist naloxone HCl dose-dependently and acutely stimulated locomotion. Given at a behaviorally active dosage, naloxone counteracted the inhibitory effect of bremazocine on locomotion. The behavioral influence of the two substances was observed using two different sampling techniques (continuous recording for 3 minutes: repeated instantaneous sampling for 60 minutes). These data are discussed in view of our current knowledge on the opiate regulation of locomotor activity in vertebrates.     

Nonvoluntary sexual activity among adolescents

Data from the 1987 round of the National Survey of Children indicate that seven percent of Americans aged 18-22 have experienced at least one episode of nonvoluntary sexual intercourse. Women were more likely than men to report having had such an experience, with just under half of all nonvoluntary experiences among women occurring before the age of 14. Multiple classification analysis reveals that white women who had lived apart from their parents before age 16, those who had been brought up in poverty, those who had had a physical, emotional or mental limitation when they were young, those whose parents had been heavy drinkers, those whose parents had used illegal drugs and those whose parents had smoked cigarettes when they themselves were teenagers were at significantly greater risk for experiencing sexual abuse. Six percent of young white women with no risk factors, nine percent of those with one, 26 percent of those with two, and 68 percent of those with three or more had been sexually abused before or during adolescence.     

Digital mucoid cyst excision by using the bilobed flap technique and arthroplastic resection

There are a number of proposed causes and treatment approaches for digital mucoid cysts. The described treatment outcomes for this cyst have been variable, with the highest success rate reported with complete excision and single-lobe skin flap closure. This report describes a bilobed flap reconstruction in conjunction with resection of the head of the middle phalanx. A retrospective review was undertaken to evaluate the recurrence rate, complications, and patient satisfaction with this combined procedure. Fifteen patients with an average follow-up of 4.6 years were evaluated. There were no recurrences, flap failures, or other major complications. The use of this flap allows for greater exposure than traditional semi-elliptical incisions while allowing the wide excisional defects to be closed primarily.