Lower extremity replant--a preliminary report

The amputated lower right extremity of an 11-year-old girl, severed 10 cm above the knee, was reimplanted on New Year's Eve, 1978. Three skin grafting procedures were required. Seven months later, all wounds healed. There was callus formation at the fracture site and soft tissue contracture at the amputation level. The patient is up and about on a partial weight-bearing brace with a molded foam shoe to protect her foot. There is excellent circulation in the entire lower extremity. At 6 months postinjury, cable sural nerve grafts for sciatic nerve repair were done elsewhere. This will be the subject of a subsequent report.     

Dacryocystantrostomy. A preliminary report

A new operative technique is described in which the lacrimal sac is drained into the maxillary sinus. The advantages of the procedure, especially of avoiding a facial incision, are emphasized. Five patients suffering from long-standing epiphora underwent surgery. Two patients had chronic dacryocystitis. Two other patients presented with a mucocele of the lacrimal sac. In the fifth patient, there was obstruction in the nasolacrimal duct. Short term follow-up results suggest its usefulness as a first line of surgical treatment in cases of epiphora due to obstruction in the lacrimal sac or the naso-lacrimal duct.     

Cerebro-spinal fluid cytomorphology in tuberculous meningitis--a preliminary report

The morphology of cells in centrifuged cerebrospinal fluid (C.S.F.) of 25 patients with tuberculous meningitis (T.B.M.) in different stages of the illness is presented. Blood brain barrier studies were also done in 6 patients. Maximum variability of cells in the initial stages of the illness and persistence of polymorphs in the later stages of the illness is noted. No correlation was established between cerebrospinal fluid cytomorphology and complications of the illness.     

Radioisotope choroid plexography. A preliminary report

Radioisotope plexography seems as easy and innocuous as routine brain scanning. An introductory method is given which could be improved. The choroid plexuses of the four ventricles were well visualized in 15 patients. Consideration is given to the possible labeling process. Besides its morphological value, the test could give interesting clues in the dynamic study of hydrocephalus.     

Colonic anastomosis-a new approach: preliminary report

A case of fetal death from abruptio placentae is reported in which the placenta was the seat of multiple chorangiomata. This association is believed not to have been fortuitous and a possible mechanism is suggested by which chorangioma may contribute to the pathogenesis of placental abruption. The incidence, morphological variation and clinical manifestations of placental chorangiomata are briefly discussed.     

Noninvasive perfusion MRI in Alzheimer's disease: a preliminary report

We performed functional MRI using the echo-planar imaging and signal targeting with alternating radio frequency (EPISTAR) technique in 11 patients with Alzheimer's disease (AD) and 8 age-matched control subjects. Seven of the AD patients had qualitatively apparent focal areas of hypoperfusion in the posterior temporoparietal-occipital regions. At the earliest inversion time producing cortical enhancement, the ratios of parieto-occipital and temporo-occipital to whole slice signal intensity were significantly lower in the AD patients than in the controls. Parieto-occipital hypoperfusion correlated with dementia severity as measured by the Blessed Dementia Scale. EPISTAR may prove to be a rapid, noninvasive alternative to other functional neuroimaging modalities in the evaluation of patients with dementia.     

Bunionette correction by metatarsal osteotomy: preliminary report

A preliminary report is presented of 17 patients who underwent 27 fifth metatarsal osteotomies. Oblique osteotomy without internal fixation was used. Union of the osteotomy without external immobilization occurred in 16 of the patients. Correction was effected in a case of delayed union in one foot because it was symptomatic. Improvement and normal function were the result in 26 of the 27 osteotomies. Delayed union did not seem to mean failure of relief. No painful scars occurred.     

Radioaerosol inhalation lung cine-scintigraphy: a preliminary report

"Radioaerosol inhalation lung cine-scintigraphy", a cinematographic display of the lungs following radioaerosol inhalation has been found to be extremely helpful not only to the visual assessment of mucociliary clearance in the lungs but also to the setting of regions of interest and to the interpretation and analysis of clearance curves over the regions of interest in the lungs. It is expected that this procedure offers an important means to the study of mucociliary clearance in health and disease in man.     

Male cases of incontinentia pigmenti: case report and review

Male patients with Bloch-Sulzberger incontinentia pigmenti (IP type II) are rare and more severely affected than their female counterparts, with a significant occurrence of sex chromosome aneuploidy. This document introduces a new male IP type II patient and reviews 48 males reported with IP. Twenty-eight of the 49 patients meet current criteria for diagnosis of IP type II. The phenotype is variable and the incidence of documented developmental delay is 25%. Five patients had Klinefelter syndrome (47,XXY). Most patients were reported prior to 1961 when chromosome analysis was not available. Biopsy and laboratory reports considered to be "consistent with" the diagnosis of IP were seen in patients meeting criteria as well as those who would not currently be given the diagnosis. The histologic findings considered diagnostic are varied. This variability may be accounted for by differences in stage of disease, biopsy site, histologic technique, and reporting style. Conversely, this may indicate that the diagnostic weight given to the biopsy should be reconsidered. Eosinophilia was not a consistent finding. Overall, differences in reporting, ascertainment, and length of follow-up lead to difficulty in interpreting or predicting the natural history of males with IP type II. Based on the existing literature, they appear to have a higher rate of mental retardation than the general population, but there does not appear to be a correlation between severity of physical and mental involvement. The presence of sex chromosome aneuploidy documented in the more recent cases emphasizes the need for chromosome analysis in any male patient suspected of IP type II.     

Inferior alveolar nerve repositioning in implant dentistry: a preliminary report

The surgical repositioning of the inferior alveolar nerve facilitates the placement of implants in the posterior mandible. The entire height of the posterior mandible is made available and enables implants to be anchored in two cortical plates, improving the primary fixation and increasing the area of the bone-implant interface. The posterior mandible can thus be predictably treated with implants in those cases where posterior support is considered important for occlusal stability and masticatory efficiency. The rapid and total recovery of sensation to the lip following nerve repositioning renders the procedure more acceptable to both the patient and the clinician.     

A preliminary report on Borrelia burgdorferi infection in the Taiwan area

A 68-year-old man presents slight memory problems and behavioural change over a period of a year. A history of boxing is identified. Neuropsychological examination confirms slight frontal cognitive damage and damage at the level of the motor signs of the upper left hemicorpus. This symptomatology should, in differential diagnosis, raise the possibility of chronic punch-drunk syndrome. Further studies should be done to better document this little-characterized clinical entity and arrive at a clearer definition of this syndrome.     

Micturition by functional magnetic stimulation in dogs: a preliminary report

The effectiveness of functional magnetic stimulation (FMS) technology on bladder contraction and bladder emptying was evaluated in ten normal neurologically intact male dogs. In seven animals, FMS of the bladder was performed by using a commercially available magnetic coil (non-water-cooled) for stimulating the sacral nerves or over the suprapubic region. With sacral stimulation, the mean change in bladder pressure (Pves) was 68.0 +/- 12.96 cm H2O; with suprapubic stimulation, the mean change in Pves was 40.7 +/- 8.08 cm H2O. This change in Pves by sacral stimulation was higher than suprapubic stimulation (P < 0.01). In three additional animals, voiding was demonstrated by using a specialized water-cooled magnetic coil and by stimulating the sacral nerves with an intermittent stimulation sequence. Voiding occurred in all three animals and was reproducible. In summary, FMS of the bladder has the potential to be a useful non-invasive technology for bladder emptying and bladder training in patients with neurogenic bladder.