Craniosynostosis: image quality, confidence, and correctness in diagnosis

The authors used the diagnosis of craniosynostosis to compare subjective evaluation of image quality with objective diagnostic utility. They studied in detail the responses of one observer, who read plain radiographs, computed tomographic (CT) scans, and three-dimensional reconstructions of CT scans (obtained with three different methods) for 82 patients with this diagnosis. The observer rated image quality and certainty in diagnosis made from each image. Subjective and objective performances were found to be strongly linked. High-quality images served as the basis for more accurate diagnoses than low-quality images. The increase in diagnostic performance results primarily from increased specificity, a fact that suggests that specificity and the concomitant diagnosis of normalcy are the focus of attention when image quality is evaluated.     

Reconstruction of Cranial Defects in Armed Forces Personnel - Our Experience

Background

The aim of this study was to evaluate the efficacy of heat cured ‘poly methyl methacrylate resin prosthesis and to assess the acceptability of the indigenously manufactured titanium mini bone plate and screws in patients treated for repair of cranial defects.

Methods

17 patients with cranial defect were treated for reconstruction of the skull defect with two types of implants i.e. Acrylic resin plate prosthesis and titanium minibone plates, either in combination or singularly. In these cases, the skull defects resulted from trauma (88.23%) or due to ablative tumour surgery (11.96%). Acrylic implant was used in 12 cases (70.85%), titanium plates and screws in 2 cases (11.76%) and a combination of both of the above in 3 cases (17.64).

Results

The primary reconstruction was carried out in 2 cases (11.96%) and secondary reconstruction was done in 15 cases (88.23%). Majority of the cases underwent secondary reconstruction because of the initial surgical emergency requiring quick debulking and closure. In 2 cases where primary reconstruction was done, the second surgery could be avoided with gratifying results.

Conclusion

70.85% underwent reconstruction with polymethyl methacrylate resin prosthesis and in the rest either titanium plates were used singly or in combination. Only in one patient, there was rejection of the implant due to infection. In 94% cases the graft was well taken up with excellent results.Key Words: Cranial reconstruction, Mini bone plates, Cranial prosthesis     

Water and DMSO membrane permeability characteristics of in-vivo- and in- vitro-derived and cultured murine oocytes and embryos

Although embryo cryopreservation is routine for many mammalian species, it is important to know how the fundamental cryobiology of these cells changes with development. Progressive cleavage divisions result in a reduction in the blastomere surface area available for water and cryoprotectant mass transport. Therefore, the membrane permeability of murine oocytes, zygotes, 2-cell, 4-cell, and 8-cell embryos to water (Lp), and dimethylsulphoxide (PDMSO), and the reflection coefficient, sigma (sigma) were determined. Oocytes or zygotes were recovered, cumulus cells removed, then cultured until use. Oocytes and embryos were immobilized and perfused with treatment solutions at 24 degrees C. Osmotically induced cell volume changes over time were videotaped followed by image analysis. The Lp values in the presence of dimethylsulphoxide (DMSO) were 0.77, 0.81, 0.94, 0.86, and 1.10 microm/min/atm, and the PDMSO values were 1.85, 2.04, 2.41, 1.95, and 1.25x10(-3) cm/min for oocytes, zygotes, 2, 4, and 8-cell embryos respectively. The Lp values in the presence of DMSO were significantly (P < 0.05) higher than those in the absence of DMSO. Treating the whole embryo as a single osmotic entity leads to significantly (P < 0.05) elevated PDMSO estimates relative to those based upon measurements of individual blastomeres. These data indicate that both Lp and PDMSO estimates are lower when predicted on an individual blastomere basis. The data also show that neither Lp nor PDMSO differ among oocytes, zygotes, 2-cell and 4-cell embryos. However, the significantly higher Lp and lower PDMSO of the 8-cell stage support the hypothesis that fundamental cryobiological differences may require developmental stage- specific embryo cryopreservation protocols.      

COMPARISON OF INTRACERVICAL PROSTAGLANDIN E2 AND INTRAVENOUS OXYTOCIN IN INDUCTION OF LABOUR

154 patients requiring induction with unfavourable cervix at varying period of gestation were studied. Patients were distributed into two groups. 76 patients were induced with 0.5 mgm single dose intracervical application of Prostaglandin E2 gel and remaining 78 patients with Oxytocin and efficacy of the two methods of induction was compared. Labour was established within 24 hours in 71.4% of primigravidas and 91.7% of multigravidas in the prostaglandin treated group compared to 65.6% of primigravidas and 89.1% of multigravidas in the oxytocin group. The study found substantial improvement in cervical score 12 hours after application of intracervical prostaglandin E2 gel and decrease in Caesarean section rate with no major adverse effect to mother or neonate.KEY WORDS: Induction, Intracervical Prostaglandin E2 gel, Oxytocin     

Prolonged Infection in Rhesus Macaques with Simian Immunodeficiency Virus (SIVmac239) Results in Animal-Specific and Rarely Tissue-Specific Selection ofnefVariants

We analyzed the sequence ofnefgenes from different tissues of three rhesus macaques that had been infected with molecularly cloned SIV_mac239 for 88 to 92 weeks. Comparison of the predicted amino acid sequences revealed that each macaque had selected out specific amino acid substitutions and that most of this variation (70%) was confined to four regions, amino acids 39 to 75, 90 to 105, 153 to 167, and 191 to 217, comprising 36% of the protein. Thenefgenes in these animals underwent extensive genetic variation with average nucleotide and amino acid substitution rates varying from 0.86 to 2.84% and 2.47 to 6.27%, respectively, although tissue-specific selection ofnefvariants occurred in only 1 of 14 tissues examined in this study. Comparison of the rate of nucleotide and amino acid substitutions in thenefgenes to those previously reported in theenvin the central nervous system (CNS) and lymph node (LN) revealed that the predicted amino acid substitution rates for Nef were much higher than for the gp120 region ofenvin the CNS and LN tissues for one macaque. In the two other macaques, the predicted amino acid substitution rates were similar between these two proteins in LN tissues, but the amino acid substitution rates in Nef were significantly higher than in the gp120 from the CNS. Comparison of the nucleotide substitutions in the region of overlap between theenvand thenefrevealed that approximately 83% of the nucleotide substitutions in this area resulted in a Nef amino acid sequence change, 26% of the nucleotide substitutions resulted in a gp41 amino acid change, and 9.5% of nucleotide substitutions resulted in amino acid sequence changes in both proteins, suggesting a preference for the selection of amino acid substitutions in the Nef in these animals. Our results indicate that in animals infected with SIV_mac239 for prolonged periods, variation in thenefoccurs at rates similar to or exceeding that observed for theenvgene.     

An Examination of Women's Alcohol Use and Partner Victimization Experiences Among Women With Protective Orders

This study examined associations of women's alcohol use with self-reported experiences of male-perpetrated intimate partner violence among a sample of women with protective orders. Participants were 676 women with a protective order against a male intimate partner from three rural areas and one urban area. Multivariate analyses indicated that women's substance use was associated with psychological abuse tactics and severity of physical and sexual victimization in the last year of the relationship. Women's alcohol use was associated with the severity of physical violence within the last year of the relationship, whereas illegal drug use had associations with the number of verbal abuse, degradation and jealousy/control tactics. There was a significant interaction of women's alcohol and drug use with the severity of sexual assault.     

In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

Background  

Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D).