Preoperative localization of low-density foreign bodies under CT guidance

A simple technique for the localization of foreign bodies using a spring hook wire under computed tomographic (CT) guidance is described. The advantages of CT in detecting foreign bodies of near water density and in planning a surgical approach which avoids important anatomical structures are emphasized.     

An analysis of noise-induced hearing loss in Army helicopter pilots

Hearing loss in the aviation environment has been attributed to a variety of factors ranging from aircraft noise exposure to the aging process. Consequently, this study was conducted to determine the relative contribution of age, total flight hours, type of aircraft, and use of hearing protection to hearing loss in U.S. Army aviators. Information from a survey of the aviators in an aviation brigade was combined with audiometric records to create the data file. The final study group, 83% of the unit aviators, was evaluated for hearing loss using two criteria: 1) existing U.S. army standards, and 2) four empirical categories of significant threshold shift. Data analysis suggests that hearing loss is primarily a function of noise exposure as measured by total flight hours. Age was found to be a less significant factor; aircraft type had no significant effect. The results indicate that combination hearing protection appears to significantly lower the risk of hearing loss.     

Variable results of calcium blockade in post-ischaemic renal failure

The effects of three chemically dissimilar calcium-blocking drugs were studied in experimental post-ischaemic renal failure, in the rat. After 45 min unilateral clamping and contralateral nephrectomy, post-ischaemic verapamil administration protected renal function (p less than 0.025), but flunarizine, either before or after ischaemia, was not beneficial. Following 60 min bilateral renal pedicle clamping, nifedipine administration was not beneficial. Verapamil was the only calcium-blocking drug which attenuated the post-ischaemic renal dysfunction. Calcium blockers which differ in their modes of action, differ in their ability to protect the kidney from ischaemia.     

Endogenous Growth Factors as Cosmeceuticals

Background. Research into the pathophysiology of photodamaged skin has revealed correlations with certain aspects of acute and chronic wound healing. In wound healing, growth factors accumulate at the wound site and interact synergistically to initiate and coordinate wound healing.
Objectives. To review the effects of topical growth factors in wound healing and their potential use in treating photodamaged skin.
Methods. A mixture of multiple growth factors derived from human fibroblasts was applied topically to 14 patients twice daily for 60 days to stimulate the remodeling phase of wound healing.
Results. A total of 78.6% of patients with photodamaged skin showed clinical improvement at 60 days. New collagen formation increased by 37%, and epidermal thickening increased by 27%.
Conclusions. These data, as well as other studies of growth factors in wound healing, demonstrate positive cosmetic and clinical outcomes of topical application of growth factors for the treatment of photodamaged skin.
DR. FITZPATRICK IS THE FOUNDER OF SKIN MEDICA AND OWNS STOCK AS WELL AS STOCK OPTIONS.     

A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.     

New view of the organization of the pulvinar nucleus in Tupaia as revealed by tectopulvinar and pulvinar-cortical projections

The projections of the superficial layers of the superior colliculus to the pulvinar nucleus in Tupaia were reexamined by injecting WGA-HRP into the tectum. The main result was finding two different patterns of terminations in the pulvinar nucleus: a zone remote from the lateral geniculate nucleus, which occupies the dorsomedial and caudal poles of the pulvinar nucleus, was almost entirely filled with terminals in every case irrespective of the location of the injection site; and a second division of the pulvinar nucleus, adjacent to the lateral geniculate nucleus, contained irregular patches--much more densely populated--and the distribution of patches varied from case to case. We call the first projection "diffuse" and the patchy projection "specific." Next we injected several divisions of the extrastriate visual cortex to find the cortical target of each pathway. The diffuse path terminates in the ventral temporal area (Tv). The specific path terminates in the dorsal temporal area (Td) and area 18. We speculated about the significance of the two pathways: the specific path may be responsible for the preservation of vision after removal of the striate cortex; the diffuse path may have an important place in the evolution of the visual areas of the temporal and occipital lobe. We argued that the target of the diffuse path is in a position to relate limbic and visual impulses and relay the product of such integration to the other visual areas, striate as well as extrastriate cortex.