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Not all flatfeet require surgical correction. Through a careful history obtained from the child's parents, useful clues may be gathered pertaining to the disability arising from the flatfoot. There are three distinct classifications of flexible pes pronatus that require specific procedures for correction of the primary deformity. The STA-Peg, alone or in combination with other medial arch procedures, is used for correction of hindfoot pronation in the coronal planar dominant foot. The postoperative disability associated with the STA-Peg is relatively minimal, and complications are usually due to improper insertion of the implant.

Sagittal synostosis comprises a spectrum of deformities caused by premature fusion of the sagittal suture. The treatment of sagittal synostosis is dependent on the age of the patient and the characteristics of the presenting deformity. Immediate correction of the scaphocephalic deformity is the goal of operative treatment. The operative procedures proposed involve whole-vault cranial reshaping, active shortening of the anteroposterior axis, and widening of the mediolateral dimension of the skull leading to a more normal, "rounded" skull shape.

Health services research is a basic tool for the development of the National Health System. This paper presents the results of a national survey on research projects carried out in Mexican health institutions, as well as in universities and research centers, from 1984 to 1991.

In order to assess the coverage of health services for non-insured population receiving health care from the Ministry of Health (SSA), a cross-sectional study was developed. With official statistics of SSA and data from the XI General Census of Population and Housing (1990), ratios of coverage and mortality rates in hospitals were assessed. The data were processed through simple analysis. In addition, states were stratified by groups according to poverty indicators obtained through a factorial analysis with the method of multiple components. The results showed that a polarized health economy for the non-insured population in Mexico is the cause of complex difficulties in the health care provision. The low financial resources affect the distribution of health care services in the states. Seventy-six per cent of the non-insured population is concentrated in those states with the highest levels of poverty, with a potential coverage of only 34.2 per cent and just 63.4 per cent of potential population use. The coverage of health care services in the states with lower poverty indicators is 1.9 times that of the states with higher poverty indicators. It was also observed that hospital mortality rate among children less than one year old was 1.7 times higher in poor regions. In general, the health services coverage is low. Therefore, it is necessary to expand the access to health care and improve the quality of services as well as life conditions of the population in the states with the highest poverty indicators. If this occurs, it will be possible to close the gap in order to build a better National Health System.

Objective: To determine the local prevalence and optimal therapy for children with Barrett's esophagus (BE), the authors studied children with esophageal strictures or gastroesophageal reflux (GER), or both, to diagnose BE and to follow after therapy., Summary Background Data: Barrett's esophagus is seldom reported in children and therapeutic recommendations are unclear. Barrett's esophagus usually develops during the mucosal reparative process after acid-reflux injury to the esophageal mucosa. Risk factors for BE include conditions that are associated with GER such as mental retardation, esophageal stricture, esophageal atresia, and reversed gastric tube esophagoplasty. Barrett's syndrome increases the risk of esophageal adenocarcinoma by 30 to 40 times., Methods: All children with the risk factors had repeated esophagoscopy and multiple mucosal biopsies before and after therapy., Results: Eleven children have been documented with BE. The initial diagnoses were: GER, 5; esophageal atresia, 4; nasogastric intubation, 1; lye ingestion, 1. A gastric tube esophagoplasty had been performed in three patients with BE in the esophagus proximal to the anastomosis. Three children with mid-esophageal strictures and long segments of BE had total resection with colic interposition. An additional two patients with tight stricture were treated with colic-patch esophagoplasty without resection. The final three patients were treated with fundoplication alone., Conclusions: Barrett's esophagus can be caused by acid from gastric tubes but responds to H2 blockers and diet. Resection eliminates BE; esophagoplasty only controls the stricture and must be accompanied by fundoplication. Barrett's esophagus persists in patients with fundoplication alone if reflux control is incomplete. The authors conclude that acid reflux must be controlled to treat BE successfully or the involved segment must be resected. Esophagogastrostomy apparently predisposes to BE.

Methyl 1 alpha,3 alpha-dihydroxy 5 beta-cholan-24-oate was synthesized to provide a model compound for the mass spectrometric identification of 1 alpha-hydroxylated bile acids.

Endolithic unicellular blue-green algae occur under the surface of orthoquartzite rocks in the dry valleys of southern Victoria Land, Antarctica. This report of primary producers in the Antarctic desert ecosystem suggests that, in future efforts to detect life in extraterrestrial (for example, martian) environments, scientists should consider the possible existence of endolithic life forms.

The sediments that now comprise the Messel shale accumulated 47 +/- 2 million years ago in anaerobic waters at the bottom of a lake. Subsequent depths of burial have not exceeded 300 m, nor has the temperature of the shale exceeded 40 degrees C. Contents of organic carbon reach 25%, and preservation of molecular structures has been excellent. Sixteen different geoporphyrins, including three derived from bacteriochlorophylls of the d series and thus indicative of the existence in the lake of an anaerobic photic zone, have been isolated and identified. Here, we show that the carbon isotopic compositions of these and other biomarkers allow identification of specific sources for some materials and reconstruction of carbon flows within the lake and its sediments. The 13C content of organic matter synthesized by lacustrine primary producers can be estimated from the observed 13C content of the geoporphyrins derived from their chlorophylls. Total organic material in the shale is depleted in 13C by six parts per thousand relative to that input. This difference cannot be explained by selective loss of components enriched in 13C, nor, as shown by isotopic compositions of other biomarkers, by inputs from land plants surrounding the lake or from methanogenic bacteria.

This study evaluated the compressive strengths of Renaissance foil and porcelain-fused-to-metal crowns on polycarbonate test dies. Both crown types were veneered with feldspathic porcelain. The compressive strength of the PFM crowns, 1895 +/- 317 N, was statistically higher than that of the Renaissance foil crowns, 1060 +/- 89 N. Comparison of the Renaissance foil crown's compressive strength to published biting forces indicated that the Renaissance crown should function without difficulty.