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We have developed a method for stabilisation of polyelectrolyre gene delivery vectors by crosslinking their surfaces with biodegradable multivalent copolymers based on N-(2hydroxypropyl)methacrylamide (HPMA). The resulting nanoparticulate vectors resist attack by serum proteins and can be modified for cell-specific delivery by incorporation of targeting ligands onto the polymer coating. Here we show that vascular endothelial growth factor (VEGF), transferrin and basic fibroblast growth factor (bFGF) can each be linked to polyHPMA-coated poly(L-lysine)/DNA complexes. All ligandtargeted complexes demonstrated increased uptake into receptor-positive cells (measured using plasmids containing [sup 32]P-dCTP), that could be antagonised with excess free ligand. Targeted complexes also showed increased transfection, resistant to inhibition by serum, suggesting the possibility of effective application in vivo. Analysis using fluorescence microscopy confirmed enhanced uptake of ligand-targeted complexes (using Texas Red-labelled plasmid DNA), although VEGF- and transferrin-targeted complexes were restricted to cytoplasmic or perinuclear distributions. In contrast, bFGF-targeted complexes showed efficient delivery into the nucleus, with accumulation of more than 100 000 plasmids per cell within distinct intranuclear compartments. This method permits versatile targeting of genes to selected cells and may also permit manipulation of intracellular trafficking. It should find several important applications in gene delivery systems both in vitro and in vivo. [ABSTRACT FROM AUTHOR]

The author focuses on the breast reconstruction after mastectomy. It is asserted that there are few surgeons who do not agree with the benefits of breast reconstruction and they also do not let their patients to have it other than an external prosthesis following breast cancer surgery. The author emphasizes that most of the women who underwent mastectomy accept the residual deformity, as well as external prosthesis. The three forms of mastectomy are also considered.

As a result of a previous trial in which factors influencing swelling of the hand after fasciectomy were studied it was found that unacceptable oedema occurred in hands elevated in a roller towel by night and a high sling by day. An alternative system of elevation in a vacuum splint was investigated and found to reduce post-operative oedema. The advantages and disadvantages of the vacuum splint in the management of the hand after surgery or injury are discussed. [ABSTRACT FROM PUBLISHER]

Two groups of patients with Dupuytren’s disease were treated by limited fasciectomy. A tourniquet was used for one group, and an elevated hand table without tourniquet for the other. Taking into account other factors controlling oedema it was discovered over a post-operative period of twenty-eight days that “Tourniquet” hands remained significantly increased in volume compared to “Non-Tourniquet” hands. Other facts of clinical interest also emerge from the trial and are discussed. It is concluded that the use of the elevated hand table without tourniquet, not only allows an unlimited and uninterrupted period for hand surgery, but also reduces the subsequent oedema. [ABSTRACT FROM PUBLISHER]

By means of a surgical expedition involving an independently financed team of surgeons, anaesthetists, nurses, orthodontists and speech therapists, 195 patients in Sri Lanka with cleft lip and palate were treated over a period of 4 weeks while over 300 patients were examined in detail to assess facio maxillary growth, components of speech and the psychosocial impact of the untreated deformity in childhood and adult life. Lip surgery proved to be simple and safe but in certain older patients palatal closure was complicated by wide palatal shelf displacement, mucosal fibrosis and heavy bleeding. This is a preliminary report and much data has yet to be analysed but there is little doubt that impaired facial growth following palatal repair is predominantly an iatrogenic deformity. [ABSTRACT FROM AUTHOR]

It has been recognised for a long time that damage to the median or ulnar nerves is usually followed by slowing of growth of the fingernails. In the past, this has always been ascribed to immobilization of the appropriate digits, rather than to a neurotrophic factor. No other nail changes appear to have been described in association with nerve damage. We present two patients with marked nail changes following median nerve injury, in which immobilization does not appear to be responsible. [ABSTRACT FROM PUBLISHER]

The article offers information about several papers discussed at a symposium on the concept, practice and implications of day care surgery in Great Britain. This conference was arranged and organized by the Royal Society of Medicine's Section of Plastic Surgery. Many of the speakers had contributed to the "Guidelines for Day Case Surgery" from The Royal College of Surgeons of England, and had been invited in order to reemphasize certain aspects of day care management.

Compares the accuracy of flow cytometry with PFA-100,a point-of-care testing in testing platelet function in patients with intermittent claudication. Use of PFA-100 in monitoring antiplatelet therapy in patients with vascular disease; Comparison of the techniques with different antiplatelet treatments in patients; Detection of an increased platelet inhibition with combination therapy by flow cytometry but not in PFA-100.