Acute Osteomyelitis of the Pubic Bone Following Pelvic Surgery

Primary osteomyelitis of the pubic bone has not been recorded previously. The authors present a case of this unusual entity.     

Antennular projections to the midbrain of the spiny lobster. I. Sensory innervation of the lateral and medial antennular neuropils

The organization of sensory afferents in the antennular nerve (AN) of the spiny lobster and the central arborization of the afferents in the lateral and medial antennular neuropils (LAN, MAN) were analyzed by backfilling the AN with biocytin. The MAN receives primarily thick afferents (diameter ≥ 10 μm) with a consistent pattern of arborization from the medial of the three major divisions of the AN. The LAN, in contrast, receives many thin to medium-sized afferents (diameter ≤ 0.3–5 μm), in addition some with diameters ≥ 5 μm, from the lateral and dorsal divisions of the AN. In contrast to the consistent pattern of arborization in the MAN, afferents projecting to the LAN arborize in widely different patterns. Serially arranged, orthogonal side branches that are suggestive of topographical representation of the serially arranged sensilla on the antennule contribute to the stratification of the LAN. Together with existing electrophysiological data, these morphological findings are consistent with the idea that the MAN receives primarily mechanosensory (largely statocyst) input, as previously thought, but that the LAN receives chemosensory as well as mechanosensory input. The chemosensory input to the LAN would represent a novel pathway for processing chemosensory input from the antennule.     

Altered islet Beta-cell function before the onset of Type 1 (insulin-dependent) diabetes mellitus

Summary To define the glucose to insulin dose-response relationship before the onset of diabetes, we studied 22 nondiabetic co-twins of patients with Type 1 (insulin-dependent) diabetes mellitus and nine control subjects. All had intravenous glucose tests at 0.02, 0.1 and 0.5 g/kg and were followedup prospectively for at least 6 years. Seven twins developed diabetes a mean of 7 months later; the remaining 15 are now unlikely to develop diabetes. The seven pre-diabetic twins had higher fasting insulin levels than control subjects (4.2±2.0 vs 1.8±1.8 nmol/l; p<0.05); but lower glucose clearance (1.0±0.5 vs 1.9±0.7 %/min; p<0.05), first phase insulin response at 0.5 g/kg (21.1±23.2 vs 143±50 nmol/l; p<0.0001), and total insulin responses at 0.1 g/kg (p<0.05) and 0.5 g/kg (p<0.00005). Using a curve-fitting programme, the normal glucose to insulin relationship was lost in prediabetic twins who had lower coefficient of determination (R²) than control subjects (p<0.01). In contrast, 15 low-risk twins and their nine control subjects had similar fasting glucose and insulin levels, glucose clearance, R² and insulin secretory responses to different glucose loads. The positive predictive values of subnormal R² and subnormal first phase insulin response were 67 % and 58 % respectively. These observations demonstrate an altered glucose to insulin dose-response relationship and loss of maximum insulin secretory response to glucose before the onset of Type 1 diabetes.     

AS-5370 potently antagonizes 5-HT3 receptor-mediated responses on NG108-15 cells and on the rat vagus.

The action of a novel 5-HT3 receptor antagonist, AS-5370, has been studied on two electrophysiological models for 5-HT3 receptors: whole-cell patch-clamp recordings from mouse neuroblastoma-rat glioma (NG108-15) cells and grease-gap recordings from rat isolated vagus nerve. The 5-hydroxytryptamine (5-HT)-induced fast inward current of voltage-clamped NG108-15 cells was antagonized by 1 nM AS-5370 in an insurmountable manner. On the rat vagus, AS-5370 reduced the maximum depolarizing response to 5-HT in a concentration-dependent manner. The IC50 for AS-5370 on the rat vagus was 0.3-1.0 nM. The EC50 for 5-HT on the rat vagus was not appreciably affected by AS-5370. On the rat vagus, the (R) enantiomer of AS-5370 was about 30 times more potent than the (S) enantiomer. The antagonist action of AS-5370 on these two cell types was compared with that of (+)-tubocurarine. Unlike tubocurarine, the effect of AS-5370 on NG108-15 cells was not readily reversed during wash. On the rat vagus, tubocurarine antagonized in a competitive manner with an IC50 of 0.3-1.0 microM (pKb = 7.2). It is concluded that AS-5370 is a potent 5-HT3 receptor antagonist on both NG108-15 cells and the rat vagus, but it does not act in a competitive manner.     

Hemolytic and sphingomyelinase activities of Clostridium perfringens alpha-toxin are dependent on a domain homologous to that of an enzyme from the human arachidonic acid pathway.

The N-terminal domain of Clostridium perfringens alpha-toxin, homologous with the nontoxic phospholipase C of Bacillus cereus, was expressed in Escherichia coli and shown to retain all of the phosphatidylcholine hydrolyzing activity of the alpha-toxin, but not the sphingomyelinase, hemolytic, or lethal activities. The C-terminal domain of alpha-toxin showed sequence and predicted structural homologies with the N-terminal region of arachidonate 5-lipoxygenase, an enzyme from the human arachidonic acid pathway which plays a role in inflammatory and cardiovascular diseases in humans.     

A review of 2975 consecutive operations by one surgeon in an accredited outpatient plastic surgicentre: A Canadian experience

The present paper constitutes a retrospective review of 2975 consecutive operations performed by the author, one of the three owners of the Saskatoon Plastic Surgicentre. The unit opened in 1987; therefore, the study spans 17 years. Patients are not kept overnight, and the Surgicentre is approved and equipped as a level C facility for general anesthesia. Only patients who score 1 or 2 according to the American Association of Anesthesiologists are treated. Only certified anesthesiologists are used. Of the patients with postoperative complications, only two required transfer to a hospital. One developed a pneumothorax, which was treated on arrival at the intensive care unit with no sequelae. The other collapsed following facelift surgery. She was transferred to University of Saskatchewan hospital and died later that evening with a massive pulmonary embolus. In a properly established outpatient centre, a large number of patients can be safely treated with very few complications. However, despite placing patient safety as the first consideration and adhering strictly to the highest standards, death can occur.     

Urban Adolescents: What Are Their Health Needs?

Abstract A health needs assessment of inner-city, low-income adolescents was conducted by the staff of a nurse-managed, community-oriented primary care clinic. A multiethnic sample of 568 high school students was studied. The findings indicated that the most commonly used source of health care was the family doctor. Barriers to receiving care were fear and costs. Subjects reported insufficient knowledge about many health-related topics, and desired services in the areas of drug and substance use, reproduction and sexuality, family relations, mental health, and dental health. Eighty-four percent of the subjects were interested in using the services of a neighborhood clinic specifically for teens. Survey results were used for decision making, program planning, and implementation of a teen health clinic.