Photometrics: a new method of measuring the cross-sectional area of the subglottis.

A new endoscopic method of measuring the cross-sectional area of a subglottic stenosis is presented. The method was tested against existing techniques using a model. By standardizing the distance from the objective of the endoscope to the stenotic area we were able to measure the cross-sectional area using a graduated grid held against the video screen. This technique was then compared with the standard one of estimating the diameter of a stenosis from the external diameter of the bronchoscope which can be passed through the stenosis. The methods were found to be equally accurate in measuring the lumen diameter. However, when measuring the minimum cross-sectional area, three of five observers were significantly better (P less than 0.01) using the photometric method rather than the standard method (Wilcoxon's rank sum test for paired data). The photometric technique of measuring the cross-sectional area of the subglottis is easily performed, non-traumatic, and allows a visual record to be kept.     

External Iliac Endofibrosis in Endurance Athletes: A Novel Case in an Endurance Runner and a Review of the Literature

BACKGROUND: There is increasing recognition that high-performance athletes can develop symptomatic arterial flow restriction in one or both (15%) legs due to kinking and/or endofibrosis of their iliac arteries. METHODS: Case report and review based on a Medline search of the literature. RESULTS: A 51-year-old female, 24-hour endurance runner presented with a six-month history of rapidly progressing intermittent claudication affecting her right thigh and calf in the absence of classical risk factors for atherosclerosis. On the basis of invasive and non-invasive investigations, a provisional diagnosis of endofibrosis was made and she was treated successfully with angioplasty. CONCLUSIONS: The epidemiology, optimal investigation and treatment of iliac endofibrosis in endurance athletes is poorly described. Each individual unit's experience is likely to be very small. A European register of such cases would increase our understanding of the condition and improve patient outcomes.     

Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction.

OBJECTIVE: Female athletes who are at increased risk for anterior cruciate ligament (ACL) injury demonstrate biomechanical differences between limbs during athletic tasks that may persist following anterior cruciate ligament reconstruction (ACLR). This may limit an athlete's potential for safe return to sports competition. The purpose of this study was to determine if female athletes demonstrate lower limb asymmetries in landing and takeoff force following ACLR and clearance for return to competitive sports participation. We hypothesized that females following ACLR would demonstrate side-to-side differences in landing and jumping kinetics after their return to sport (2+ years) that would not be observed in a group of healthy female controls. DESIGN: Case control study. SETTING: The Sports Medicine Biodynamics Center at Cincinnati Children's Hospital Medical Center. PATIENTS: Fourteen female athletes at a mean of 27 months following ACLR and 18 healthy female athletes participated in the study. ASSESSMENT: All subjects executed a drop vertical jump (DVJ) task onto 2 force plates. Vertical ground reaction force (VGRF) was measured during landing and takeoff and was used to calculate landing phase loading rates. A 2-way analysis of variance was used to determine differences between the involved, uninvolved, and control limbs. RESULTS: Females who had undergone ACLR demonstrated increased VGRF (P = 0.001) and loading rate (P < 0.001) on the uninvolved limb during landing when compared with the involved limb and the control group. During takeoff, the involved limb showed significantly less ability to generate force (P = 0.03) than the uninvolved limb and the control limbs. CONCLUSIONS: Female athletes who have undergone ACLR and returned to sport may continue to demonstrate biomechanical limb asymmetries 2 years or more after reconstruction that can be identified during landing.     

Catastrophic failure of modular Zirconia—Ceramic femoral head components after total hip arthroplasty

Catastrophic failure of two zirconia—ceramic modular femoral heads occurred, despite the theoretical improved toughness of zirconia—ceramic relative to alumina—ceramic. This experience led the authors to return to cobalt—chromium as the metal of choice for articulation against polyethylene in total hip arthroplasty.     

Paediatric Anaesthesia and Critical Care in the District Hospital: a Practical Guide

I do not think that the title of this book of nearly 300 closelyprinted pages really does it justice, as it might not attractthose anaesthetists, of all grades, for whom it could be anextremely useful addition to the personal library. The bookis written     

The updated electrostatic potential for cytosine completes the qualitative explanations of base alkylation regiochemistry

The relationship between the structures of different alkylatingagents and the relative extents to which they modify the oxygenand nitrogen centers of nucleic acid bases has been discussedin the literature from several points of view, although eacheffectively attributes the increasing preference for oxygenalkylation to the increasing importance of electrostatic interactionsbetween the reacting moieties. This is in direct contradictionto the published electrostatic potential data for cytosine whichindicate the most attractive potential to lie in the vicinityof the 3-nitrogen. However, we have discovered the latter tobe an artefact of the use of inadequate levels of theory. Whenthe electrostatic potentials of cytosine are computed usingmore sophisticated ab initio Hartree-Fock/6–31G^* calculationsthe global minimum does indeed lie in the vicinity of the O²-positionas required by the various rationalizations of the alkylationdata.