Transnasal endoscopic excision of midline nasal dermoid from the anterior cranial base

We recommend that every patient with a midline nasal dermoid be evaluated preoperatively by fine-cut CT scan, in the axial and coronal planes, using both bone and soft-tissue algorithms. Because of CT limitations for assessing soft tissue at the cranial base, a complementary thin-section, high-resolution, multiplanar MRI scan should be considered. Transnasal endoscopic excision of midline nasal dermoid should be used if the dermoid is located within the nasal cavity, and there is minimal or no cutaneous involvement. This approach can be combined with a short vertical midline lenticular excision of a cutaneous punctum. Vertical cutaneous excision should be limited; the best location is the nasal tip. Vertical nasal scars over the bony pyramid invariably widen no matter what intradermal suture is used. Endoscopic removal should be considered even if preoperative radiologic studies show extension to the anterior cranial fossa. Endoscopic excision could also be used to resect a dermoid extending between the dural leaves of anterior fossa. However, a combined intra-extracranial approach is necessary if the dermoid is in the falx cerebri. We agree with other authors that frozen sectioning the superior margin of the specimen should be done to ensure that there is no intracranial extension. Valsalva maneuver during endoscopic visualization of the cranial base is a valuable means of ruling out a cerebral spinal fluid leak.     

New polymorphic microsatellite markers place the haemochromatosis gene telomeric to D6S105

The haemochromatosis gene (HFE) is linked to both HLA-A and D6S105 on the short arm of chromosome 6 but these markers are separated by approximately 2 Mb of DNA. Most chromosomes carrying HFE have a common haplotype which extends from HLA-A to D6S105 and includes HLA-F. To localise the gene more precisely we have examined 10 microsatellite markers extending over a genetic distance of approximately 5 cM from D6S265 (within 100 kb of HLA-A on the centromeric side) to D6S299 (telomeric). The order of markers is D6S265, HLA-F, D6S258, D6S306, CS3, D6S105, D6S464, CS5, D6S461 and D6S299. We confirm that haemochromatosis appears to originate from a founder mutation which has multiplied in the population through successive generations. This mutation is associated with the haplotype D6S306-5, CS3-3, D6S105-8, D6S464-9 and CS5-4 which is found on approximately 70% of HFE chromosomes. We have applied a new and powerful, likelihood analysis for linkage disequilibrium. The maximum value of lambda (proportion of total possible association between a marker and disease) is 0.74 for marker CS5 (allele 4). A multipoint analysis also gives a maximum likelihood near marker CS5. We conclude that the HFE gene is likely to be located telomeric of D6S105 and close to CS5.     

Recurrent hypernatremia; a proposed mechanism in a patient with absence of thirst and abnormal excretion of water

A 7-year-old girl twice developed severe hypernatremia (serum sodium values up to 194 mEq/l) without obvious cause. The ability of her kidneys to conserve water was normal, and increasing her plasma osmolality stimulated an appropriate ADH response. Unable to excrete a water load, her kidneys continued to conserve water even with a serum sodium concentration of 133 mEq/l. She was never thirsty and did not ingest sufficient fluid by choice. Although there was no demonstrable anatomic lesion, we postulate a localized defect of her thirst center. This may have modified release of ADH and resulted in an inability to dilute the urine by interrupting a pathway that could exist from the thirst center to the supraoptic nuclei. A therapeutic regimen based on these studies has prevented further hypernatremia.     

Performance analysis of large systems

A hybrid analytic and experimental approach to the analysis of large systems is described. The approach is iterative under the assumption that a correct analysis will not be made first time. It is primarily aimed at the analysis of the performance effect of proposed changes prior to coding them. The requirement is for a fairly approximate analysis that is easy to make. The approach is illustrated by an experiment on a relational database system but we believe it to be applicable to many kinds of large systems. The different reasons for analysing performance of a system are discussed and then the ways of approaching the analysis, with an outline of our approach. The details of our approach are given, and illustrated by our experiment.     

A method for stabilising technetium-99m exametazime prepared from a commercial kit

Technetium-99m exametazime (99mTc-d,l-HMPAO), prepared by the reconstitution of the Ceretec kit, is widely used in the investigation of regional cerebral blood flow. The radiochemical purity specification of not less than 80% lipophilic complex requires that the kit is used within 30 min of reconstitution. In certain circumstances this imposes restrictions on its clinical availability. A number of approaches to extending the 30-min shelf life have been proposed and these are discussed. A method of stabilising the kit by the addition of 200 micrograms cobalt chloride hexahydrate (CoCl2 x 6H2O) in 2 ml of water is described. The addition of this solution can extend the shelf life of the reconstituted kit to at least 5 h post reconstitution.     

Estimation of rib waveguide radiation losses

An estimative procedure given recently for approximating radiation losses from indiffused waveguides is adapted to rib waveguides and compared with a recent Huygens-type solution for bending loss. The implications for the wider application of the estimative procedure are favourable     

A theory for the diffusion of large molecules in amorphous polymers above Tg

A general theory of diffusion of large molecules in rubbery amorphous polymers is of interest for the scientific understanding and with regard to material design and process optimization. A broadly applicable model would be useful in developing controlled transport of plasticizers and other additives through polymeric substances. A diffusion model is presented which has been developed for large molecular penetrants above the T_g of the amorphous polymer allowing for required increase in redistribution of the free volume of the polymer structure, as well as the penetrant size and shape. Applicability of the model is demonstrated by comparing theoretically developed diffusion curves for DNOP and DNDP in PVC vs. their weight fractions at 82°C and 91°C. These theoretically derived plots are compared with experimental D vs. w₁ curves for these systems generated at lower temperature.     

Surface-wave probe for measuring electron densities in a gaseous plasma

A dielectric rod enveloped in gaseous plasma can act as a supporting structure for electromagnetic surface waves. The dielectric constant of the plasma and hence the electron number density in the vicinity of the rod may be determined from measurements of the phase-change coefficient of the EH11 mode supported by the plasma-clad rod. Measurements of radial density distribution have been carried out in an unmagnetised argon afterglow plasma at 35Gc/s and compared with double-probe measurements.     

Asymptotic stability and the method of linear bounds

If x? = Ax is asymptotically stable, it is possible to find linear bounds for g(x); so that x? = Ax + g(x) is also asymptotically stable. An explicit expression is given for functions which satisfy these bounds.     

Parentally provided alkaloid does not protect eggs ofUtetheisa ornatrix (Lepidoptera: Arctiidae) against entomopathogenic fungi

Eggs ofUtetheisa ornatrix proved equally vulnerable to fungal infection (Beauveria bassiana, Paecilomyces lilacinus) whether they contained parentally provided pyrrolizidine alkaloid (monocrotaline) or were free of such alkaloid. In in vitro tests, monocrotaline, either as free base or N-oxide, had no inhibiting effect on fungal cultures.Report No. 99 of the series Defense Mechanisms of Arthropods; No. 98 is Attygalle et al.,Experientia (in press).