Bilateral ovarian fibromas in children

The case of bilateral ovarian fibromas occurring in an 8-year-old black girl is reported. These lesions occur rarely in premenarchal females and may be a manifestation of Nevoid Basal Cell Syndrome. Calcifications are reported to occur rarely in ovarian fibromas but seem to occur frequently in fibromas in children. Management is guided by the benignity of the lesion and consists of surgical excision of the fibroma. Preservation of normal ovarian tissue is recommended with the acknowledged risk of recurrence of the fibroma.     

Does a tensioning device pinned to the tibia improve knee anterior–posterior load‐displacement compared to manual tensioning of the graft following anterior cruciate ligament reconstruction? A cadaveric study of two tibial fixation devices

Devices that are pinned to the tibia to tension an anterior cruciate ligament (ACL) graft produce joint reaction loads that in turn can affect the maintenance of graft initial tension after tibial fixation and hence knee anterior-posterior (AP) load-displacement. However, the effect of these devices on AP load-displacement is unknown. Our objectives were to determine whether tensioning by device versus tensioning by hand causes differences in AP load-displacement and intraarticular graft tension for two commonly used tibial fixation devices: a bioresorbable interference screw and a WasherLoc. AP load-displacement and intraarticular graft tension were measured in 20 cadaveric knees using a custom arthrometer. An initial tension of 110 N was applied to a double-looped tendon graft with the knee at extension using a tensioning device pinned to the tibia and a simulated method of tensioning by hand. After inserting the tibial fixation device, the 134 N anterior limit (i.e., anterior position of the tibia with respect to the femur with a 134 N anterior force applied to the tibia) and 0 N posterior limit (i.e., AP position of the tibia relative to the femur with a 0 N force applied to the tibia) were measured with the knee in 25 degrees flexion. Intraarticular graft tension was measured at extension. These limits and intraarticular graft tension were also measured after cyclically loading the knee 300 times. Compared to a simulated method of tensioning by hand, tensioning with a device pinned to the tibia did not decrease the 134 N anterior limit and did not cause posterior tibial translation. However, intraarticular graft tension was maintained better with a tensioning device pinned to the tibia for the Washerloc, but not the interference screw. For two commonly used tibial fixation devices, a tensioning device pinned to the tibia does not improve AP load-displacement at 25 degrees flexion over tensioning by hand when the graft is tensioned at full extension, but does improve the maintenance of intraarticular graft tension for the Washerloc.     

Prevalence of atopy and range of bronchial response to methacholine in 7 and 11 year old schoolchildren.

A sample of 397 from 2503 children aged 7 and 11 years, who took part in an earlier questionnaire study of respiratory symptoms in Southampton, was chosen for methacholine bronchial provocation and allergen skin testing. Results were obtained from 330 (84%). A good level of repeatability was achieved for bronchial provocation testing giving a 95% confidence interval equivalent to 1.74 doubling concentrations. The main problem encountered with methacholine was its bitter taste in high concentrations. The proportion of children, in whom the dose of methacholine which produced a fall of 20% in the forced expiratory volume in one second (PD20 methacholine) was less than or equal to 6.4 mumol, fell from 29.1% at 7 years to 16.5% at 11 years. The prevalence of atopy increased from 26% at 7 years to 31.6% at 11 years. A highly significant association was found between bronchial responsiveness to methacholine and atopy, which was independent of symptoms or age group.     

Drinking patterns of black and white men in the West Midlands

The limited amount of evidence available from mortality statistics, mental hospital in-patient admission rates and community surveys appears to indicate that people of African-Caribbean origin resident in Britain have fewer alcohol-related problems than the white population. However, there are no systematic data on the normal drinking habits of random and representative samples of the black population of Britain, or the true extent of alcohol-related problems in the whole population. A survey of the drinking habits and alcohol-related problems of random samples of 200 black men and 170 white men from the Birmingham and Wolverhampton areas is reported. Black men were much less likely to report regular drinking and to report drinking large amounts of alcohol. They were far less likely to have got drunk in the past year, and scored lower on most items of an Alcohol Problems Scale. Age was the only demographic variable associated with drinking levels in both groups, and the link was more tenuous in the black than the white group. There were no generational differences found. Religious observance and belonging to a Pentecostal Church were found to be major differences between the black and white groups, and strongly associated with moderation in relation to aleohol.     

Diagnostic performance of nocturnal penile tumescence studies in healthy, dysfunctional (impotent), and depressed men

Nocturnal penile tumescence (NPT) studies were evaluated in 17 men with a clinical diagnosis of organic erectile dysfunction in comparison to age-matched healthy controls (n = 17) and depressed men (n = 17). The dysfunctional group had significantly fewer NPT episodes and reduced maximal penile tip changes when compared to healthy controls and depressed patients. Further, the dysfunctional group had significantly diminished erectile fullness and reduced penile rigidity. Diagnostic performance of polygraphic (night 1) and visual inspection (nights 2 or 3) components of the NPT protocol were examined in these criterion groups. A diagnostic classification based on polygraphic measures successfully discriminated 73.5% of dysfunctional and healthy control subjects, but classified 47% of depressives in the dysfunctional range. Use of visual inspection indices correctly identified 88% of the dysfunctional sample and 94% of normal controls, and reduced the "false-positive" rate in depression to only 18%. Results support the diagnostic utility of NPT studies, particularly when enhanced by visual inspection procedures. Nevertheless, the presence of major depression may confound interpretation of such studies.     

Inclusion of satellites in an 18/21 translocation chromosome shown by ammonical-silver staining (sat-banding) in case of partial trisomy 18.

A male infant with a partial trisomy 18 and a 46,XY, --21, t(18;21)(18qter replaced by 18q12::21 p13 replaced by 21 qter) chromosome complement is described. The translocation chromosome is of special interest because it includes the satellites of chromosome 21. This was shown by differential satellite staining with the ammoniacal-silver technique.