Microsurgical thumb reconstruction with toe transfer: selection of various techniques

Microsurgical toe transfer is an established method for reconstruction of missing thumbs. However, there is little agreement on which of the various techniques represents the ideal transfer. Basically, selection of technique requires balancing the patient's functional needs, appearance of the reconstructed thumb, and donor-site cosmesis. Based on our experience with 103 toe-to-thumb transfers performed over the past 9 years, this paper attempts to provide guidelines for appropriate selection among the four most commonly employed toe transfer techniques (e.g., second toe, total great toe, great toe wrap-around, trimmed great toe) so that optimal results and patient's acceptance can both be achieved.     

The effect of various treatments in vitro and in vivo on the binding of 125I-labeled anti-rat serum albumin Fab'' to rat tissue polyribosomes

With 125I-labeled Fab' specific for rat liver serine dehydratase it has been possible to localize polyribosomes synthesizing the enzyme under several different environmental conditions. Evidence is presented to show that, following the administration of amino acids in vivo, the relative synthetic capabilities of free and membrane-bound polyribosomes synthesizing serine dehydratase vary with time. Early during the period of induction of the enzyme by administration of amino acids or by feeding a high protein diet the majority of the newly synthesized enzyme is derived from membrane-bound polyribosomes. Later in the induction process an increasing proportion of the enzyme is synthesized by the free polyribosomes. Subcellular localization studies clearly show that serine dehydratase is synthesized by both subclasses of hepatic membrane-bound polyribosomes, the loose and tight membrane-bound polyribosomes, as well as by the free polyribosomes. It was found that the membrane-bound polyribosomes are the preferential sites of synthesis of the majority of serine dehydratase molecules in the Morris hepatomas 5123C and 7800. It is concluded that the synthesis of the enzyme, serine dehydratase, in rat liver is not discretely compartmentalized in either class of free or membrane-bound polyribosomes. Rather, the relative proportions of the serine dehydratase synthesizing polyribosomes within these two classes of polyribosomes can vary depending on the metabolic and physiologic state of the liver cell.     

A new method of treatment for mallet finger. A preliminary report

An infant with a typical Edwards syndrome and a modal chromosome number of 46 is reported. In all cells analyzed one chromosome G was missing and an additional chromosome similar to a pair No. 16 was present. The phenotype of the child indicates that the extra element is a translocation between G and 18 chromosomes as in one case described previously.     

Diphosphonate treatment of Paget's disease

Ethane-1-hydroxy-1, 1-diphosphonate (EHDP) was administered in a dose of 20 mg/kg/d to 21 patients with symptomatic Paget's disease. All patients were treated for 6 months and then followed for an additional 6 months. There was a striking decline in serum alkaline phosphatase and urinary hydroxy-proline excretion observed after 3 months of therapy which was not significantly improved in the succeeding 3 months. Concomitantly there was marked improvement in clinical symptoms and bone scans. Following cessation of therapy, continued biochemical and clinical evidence of remission persisted. Several patients on repeat treatment with EHDP appeared to respond promptly. Side effects were minimal except for a possibly related osteomalacia and increased incidence of pathologic fractures.