The stiff proximal interphalangeal joint

The anatomical factors causing stiffness at the proximal interphalangeal joint are considered, a rational approach to the surgical treatment is proposed, and the results in thirty joints are presented.     

Reevaluation of the linkage between acute hemorrhagic shock and bacterial translocation in the rat

The present study was undertaken to determine the conditions under which acute periods of hemorrhagic shock induce bacterial translocation. Rats (at least six per group) were anesthetized intraperitoneally with the barbiturate, pentobarbital (50 or 65 mg/kg), or the inhalation anesthetic methoxyflurane. Following anesthesia, the femoral artery was catheterized, from which blood was withdrawn to maintain a mean arterial blood pressure of 30 mmHg for 30, 60, or 90 min, followed by reinfusion of shed blood. Instrumented, but nonshocked animals served as controls. Rats were sacrificed at 0, 2, or 24 hr postshock, and quantitative bacterial cultures of the mesenteric lymph node complex (MLN), liver, and spleen were made. Within groups, the effects of heparinization were also determined. In pentobarbital-treated animals, regardless of the extent of heparinization, consistent translocation to both MLN and distant organs occurred when shock was prolonged for 90 min, and assessment of translocation was made 24 hr after reinfusion of shed blood. Furthermore, a mortality rate of approximately 30% was found in rats subjected to this protocol. The magnitude of translocation was less consistent, and did not differ from that in sham shock controls, under other conditions of shock and evaluation. In rats anesthetized with methoxyflurane, no mortality occurred, and no statistical significance between the incidence or degree of translocation in shocked animals vs. sham shock controls could be demonstrated, regardless of the shock protocol. In additional studies, effects of these anesthetics on intestinal morphology and superior mesenteric arterial (SMA) flow in the context of hemorrhagic shock were assessed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pharmacologic management of patients with diseases of the endocrine system

Endocrine disorders are commonly seen in the general population. This article discusses the physiology, pathogenesis, and the medical and dental management of patients with thyroid, parathyroid, and pituitary gland disorders. In addition, the pharmacologic treatment, common side effects, and dental drug interactions of concern are discussed.     

Lipopolysaccharide-induced reductions in food intake do not decrease the efficiency of lysine and threonine utilization for protein accretion in chickens

Exposure of animals to infectious agents induces immune responses that result in reductions in food consumption and weight gain. The effect of these changes on amino acid requirements and utilization remains unclear. Three assays were conducted with young chicks with Escherichia coli lipopolysaccharide (LPS) used to stimulate the immune system. An initial study was conducted to evaluate the effects of LPS on animal performance. In a daily or alternate day injection regimen for 9 d, chicks were given intraperitoneal injections of sterile saline containing 0, 100 or 400 microgram LPS. Administration of 100 or 400 microgram LPS daily, or every other day, decreased both weight gain and food consumption. In two subsequent growth assays, chicks were fed graded levels of lysine or threonine and injected with either 0 or 400 microgram LPS every other day to evaluate the effect of LPS administration on the efficiency of amino acid utilization. At the three lowest amino acid doses, whole-body protein accretion was a linear function of supplemental lysine or threonine intake, and slopes of the accretion curves were not altered by LPS administration. The dietary lysine concentration required to maximize protein accretion was unaffected by LPS, but the absolute lysine intake required to maximize chick performance was lower in LPS-injected chicks than in saline-injected chicks. These results show that LPS administration reduces weight gain, food intake, efficiency of food utilization and the absolute quantity of lysine required to maximize these criteria. However, LPS administration does not affect the efficiency of amino acid utilization, nor does it affect the concentration of dietary lysine required to maximize performance.     

Endoscopic application in aesthetic and reconstructive facial bone surgery

Twenty-three cases of endoscopically assisted facial bone surgery were performed over the past 3 years. Our series is consistent with 16 cases of aesthetic contouring surgery and 12 treatments of facial bone fracture, including three cases for recontouring of frontal bone, three cases for recontouring of zygoma, endoscopically assisted correction of three zygomatic and blowout fractures, four cases for rhinoplasty and septoplasty for deviated nose, and three cases for mandible contouring surgery. To accomplish this technique, a rigid 4-mm, 30-degree down-angled endoscope was used. The frontal bone or zygomatic arch was approached endoscopically through two or three small incisions on the frontal or temporoparietal scalp. All endoscopic instruments were then manipulated through these incisions. The approach for endoscopically assisted rhinoplasty is the same as with standard rhinoplasty procedures. The approach for zygoma complex and maxillary sinus needs an intraoral incision. Recontouring of zygoma, mandible, and nasal dorsum by an air-driven burr and rasp was performed with endoscopic visual assistance. A plate and screw fixation for zygomatic arch fracture requires an additional small skin incision over the plate for the trocar method. The duration of follow-up ranged from 6 months to 30 months. The postoperative course was satisfactory with a few complications. The extra time needed for the endoscopic procedures was less than 1 hour. Endoscopically assisted facial bone surgery can be performed with adequate visualization and direct manipulation of all facial bones. Complications usually associated with extensive incisions in the bicoronal approach may be avoided. Poor visualization in the conventional approach for operation of orbit, nose, maxillae, and mandible may be avoided by use of the endoscope. This technique may prove to be ideal for aesthetic surgery for facial skeleton with smaller scar and less morbidity.     

Site-directed mutations in the third domain of Bacillus thuringiensis delta-endotoxin CryIAa affect its ability to increase the permeability of Bombyx mori midgut brush border membrane vesicles

A series of mutant Bacillus thuringiensis CryIAa delta-endotoxin proteins was prepared by replacing the first, second, and last arginine residues of the conserved third-domain sequence, R-521 YRVRIR-527, with other amino acids. The stable mutant proteins were bioassayed against Bombyx mori larvae and found to all be approximately half as active as wild-type CryIAa. The toxins were also tested by means of a light-scattering assay for their ability to increase permeability of larval B. mori midgut brush border membrane vesicles. Three of the mutant toxins were as active as the wild-type toxin in the vesicle permeability assay.