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Armed Forces personnel and their families are entitled to causalty pensionary awards in the form of disability pension, special or family pension when disability or death has been due to service factors. In this article an effort has been made to make the medical officers in general and medical boards in particular aware of the existing entitlement rules, assessment guidelines, channel of processing and various authorities empowered to decide these claims. Some of the areas needing special consideration by medical boards have been highlighted.

A 38-year-old woman came for treatment with massive hemoptysis. A hilar density was observed on a chest radiograph. Transthoracic echocardiography demonstrated an intravascular pulmonary arterial mass that was studied in further detail with multiplane and panoramic transesophageal echocardiography. Surgical resection proved the mass to be a sarcoma arising from the main pulmonary artery. This case report demonstrates the utility of multiplane and panoramic transesophageal echocardiography in the study of intravascular tumors of the thorax.

Lemna paucicostata LP6 does not normally flower when grown on basal Bonner-Devirian medium, but substantial flowering is obtained when 10 mum salicylic acid (SA) or benzoic acid is added to the medium. Benzoic acid is somewhat more effective than SA, and the threshold level of both SA and benzoic acid required for flower initiation is reduced as the pH of the medium is lowered to 4.0. SA- or benzoic acid-induced flowering is enhanced in the simultaneous presence of 6-benzylaminopurine (BAP), although BAP per se does not influence flowering in strain LP6. Continuous presence of SA or benzoic acid in the culture medium is essential to obtain maximal flowering. A short-term treatment of the plants (for first 24 h) with 10 mum SA or benzoic acid, followed by culture in the basal medium containing 1 mum BAP can, however, stimulate profuse flowering. Benzoic acid is more effective than SA, and the effect is more pronounced at pH 4 than at 5.5. Thus, under these conditions, flowering is of an inductive nature. Experiments with [(14)C]SA and [(14)C]benzoic acid have provided evidence that at pH 4 there is relatively more uptake of benzoic acid than SA, thus leading to an increased flowering response. The data obtained from the experiments designed to study the mobility of [(14)C]SA and [(14)C]-benzoic acid from mother to daughter fronds indicate that there is virtually no mobility of SA or benzoic acid between fronds.

The authors assessed the impact of two cycles of preoperative chemotherapy (POCT) with intraarterial cisplatin (120 mg/m2) and continuous intravenous doxorubicin hydrochloride (Adriamycin; 20 mg/m2/day x 3 days) on the decision to perform a limb-sparing procedure (LSP) or amputation in 22 patients with high-grade bone sarcomas of the extremities. The tumor types were osteosarcoma (17), malignant fibrous histiocytoma (three), leiomyosarcoma (one), and malignant schwannoma (one). Surgical stages were IIA (three), IIB (17), and IIIB (two). The prechemotherapy surgical options chosen were 12 amputations (55% of patients) and ten LSPs (45%). The initial decisions to amputate were based on a combination of the following: improper biopsy (five cases), large tumors (ten) and those with neurovascular encroachment (six), and pathological fracture (one). Following chemotherapy, 18 LSPs (81%) and four amputations (19%) were performed. Nine of 12 patients (75%) initially deemed unresectable were converted to LSP. The median tumor response (necrosis; range, 0%-100%) was 70%; ten of 22 specimens had necrosis greater than 95%. Median tumor necrosis for the patients treated by amputation and LSPs was 45% and 88%, respectively. Following surgery, all patients received four additional cycles of cisplatin and doxorubicin. The median follow-up period is 30 months; six patients have developed metastatic disease, with a median disease-free interval of 16.6 months. The rate of local tumor control is 95% (21 of 22 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Nucleotides were purified from the extract of aseptically grown Lemna paucicostata 6746 by low-pressure column chromatography and thin-layer chromatography. In this partially purified sample, a compound has been identified, using a highly sensitive HPLC-fluorometric detection method, with chromatographic properties and substrate specificity for cyclic nucleotide phosphodiesterase similar to authentic 3',5'-cyclic AMP. The level of cAMP has been estimated to be 70-80 pmol/g fresh wt.

A primary, malignant, fibrous histiocytoma of bone occurring in association with a Hansen Street intramedullary nail occurred in a 39-year-old man. The physical and chemical characteristics of materials, in relation to the generation of secondary neoplasia are reviewed, but the problem of coincidence is difficult to exclude.

A new technique using postoperative infusional continuous regional analgesia (PICRA) for postoperative pain relief was investigated in 23 surgical patients treated by amputation (12 patients) or by limb-salvage resection operations (11 patients). Bupivacaine was delivered into peripheral nerve sheaths via catheters placed therein at the time of surgery. Only patients in whom the nerves were easily accessible were treated. Catheters were placed in the axillary sheath, the lumbosacral trunk, and the femoral nerve sheaths of patients treated with shoulder girdle and pelvic procedures (resections and amputations), and within the sciatic nerve sheath of those treated with lower extremity procedures. The anesthetic agent was delivered at controllable rates. Regional analgesia was obtained in the operative site with minimal motor or sensory decrease. To assess the efficacy of this technique, the results of this study group were compared with those of a matched group of 11 patients treated with similar surgical procedures but who received epidural morphine. Eleven of the 23 patients on PICRA required no supplemental narcotic agents. The mean level of the narcotic agents required by the remaining 13 PICRA patients was approximately one third of that required by the matched group of 11 patients receiving epidural morphine. Overall, the patients on PICRA had an 80% reduction of narcotic requirements when compared to the historical controls. The technique is reliable and can be performed by the surgeon, requiring about a ten-minute increase in operating time. It has potentially wide application in orthopedics in procedures in which the major nerves are easily accessible (e.g., pelvic fractures and revision hip surgery) and for patients with intractable pain of the extremities.

Juxtaarticular osteoid osteomas in the ankle are frequently misdiagnosed because their symptoms mimic arthritis and may precede roentgenographic findings. In addition, these tumors are rare compared to arthritis and other sources of ankle pain. Four cases of osteoid osteoma of the talus or calcaneus are reported, indicating some of the problems encountered with their identification, and suggestions are made for appropriate investigations to aid in the early and correct diagnosis. The use of plain tomograms, thin-section computed tomograms, and radionuclide scans aid an early and correct diagnosis. Arthroscopy and arthrotomy are often inappropriate.

The radiographic changes of 46 bone-ingrowth, porous-coated anatomic total hip prostheses were reviewed and compared to the clinical outcome. The average postoperative follow-up was 32 months. The radiographic features that were assessed included subsidence; periprosthetic lucencies; periosteal, endosteal, and heterotopic new bone; loose beads; implant position; and tightness of fit. Clinical results were based on the Harris hip score. All acetabular components fared well. Three of the femoral stem components needed revision. The radiographic finding that correlated best with outcome was subsidence of more than 10 mm, especially if it continued to increase more than 1 year after surgery. Other findings related to failure were loosely placed femoral stems and the presence of loose beads. However, subsidence was such a powerful predictor of clinical outcome, and the other features were so weak, that combinations of variables did not improve the assessment of outcome. Close attention should be paid to subsidence in follow-up studies.

Chondroblastoma, a rare bone tumor usually found in the epiphyseal region of long bones, appeared in the rib of a 49-year-old man. Review of the literature reveals that the most common locations for this tumor are the knee and proximal humerus. The most common age group is the second decade. Eighteen cases of chondroblastoma of the rib have been reported in the literature; the patients were older than typical patients with epiphyseal chondroblastoma and had an excellent prognosis after resection of the tumor.

We report three patients with known primary tumor in whom radionuclide skeletal imaging for metastatic disease was normal with or without clinical symptomatology referable to this area. Magnetic resonance imaging (MRI) of the spine demonstrated focal areas of abnormal signal intensity in the vertebral bodies of these patients. In all three patients, biopsy confirmed metastatic disease. All the patients received radiation or chemotherapy depending upon the etiology. These preliminary data suggest that MR imaging may be useful in evaluating patients with known primary tumor in whom clinical suspicion persists despite a negative radionuclide bone scan.

Thirty five strains of Arabidopsis thaliana (L.) Heynh. have been identified with altered phototropic responses to 450-nm light. Four of these mutants have been more thoroughly characterized. Strain JK224 shows normal gravitropism and "second positive" phototropism. However, while the amplitude for "first positive" phototropism is the same as that in the wild-type, the threshold and fluence for the maximum response in "first positive" phototropism are shifted to higher fluence by a factor of 20-30. This mutant may represent an alteration in the photoreceptor pigment for phototropism. Strain JK218 exhibits no curvature to light at any fluence from 1 μmol·m(-2) to 2700 μmol·m(-2), but shows normal gravitropism. Strain JK345 shows no "first positive" phototropism, and reduced gravitropism and "second positive" phototropism. Strain JK229 shows no measurable "first positive" phototropism, but normal gravitropism and "second positive" phototropism. Based on these data, it is suggested that: 1. gravitropism and phototropism contain at least one common element; 2. "first positive" and "second positive" phototropism contain at least one common element; and 3. "first positive" phototropism can be substantially altered without any apparent alteration of "second positive" phototropism.

Health care providers were trained to treat patients with acute diarrhoea using WHO-recommended oral rehydration therapy (ORT) in a rural area of Haryana, India. One year after the completion of the training programme, the diarrhoea management practices of these trainees were observed while they were treating 240 children with acute diarrhoea. The patients were treated by 12 Multipurpose Health Workers (MPHW), 12 Community Health Guides (CHG), and 11 childcare volunteers, called Anganwadi Workers (AWW), in 12 randomly selected villages. In addition, 9 doctors practising in Primary Health Centres and in a 50-bed hospital were also studied. The assessment of patients on the basis of the history of illness taken and the results of physical examinations varied significantly between the various health functionaries. Doctors assessed dehydration in 80% of patients, MPHWs in 65%, CHGs in 60% and AWWs in only 45% of patients (p less than 0.05). Oral rehydration solution (ORS) was given to every case. However, anti-microbial and anti-diarrhoeal drugs were used at a significantly higher rate by doctors than by other functionaries (p less than 0.05). The method of ORS preparation was explained to most (85-90%) of the parents by all types of functionaries but the quantity to be given to the child was told by doctors to 67%, MPHWs to 60%, CHGs to 63% and AWWs to only 43% of patients. Advice on feeding normal food during diarrhoea was either not given or restrictions to food intake were suggested by all types of functionaries. However, continuation of breast feeding during treatment was advised by all types of functionaries for the majority of patients.

Two mutants of Arabidopsis thaliana have been identified with decreased phototropism to 450-nanometer light. Fluence-response relationships for these strains (ZR8 and ZR19) to single and multiple flashes of light show thresholds, curve shapes, and fluence for maximum curvature in first positive' phototropism which are the same as those of the wild type. Similarly, there is no alteration from the wild type in the kinetics of curvature or in the optimum dark period separating sequential flashes in a multiple flash regimen. In addition, in both strains, gravitropism is decreased compared to the wild type by an amount which is comparable to the decrease in phototropism. Based on reciprocal backcrosses, it appears that the alteration is due to a recessive nuclear mutation. It is suggested that ZR8 and ZR19 represent alterations in some step analogous to an amplifier, downstream of the photoreceptor pigment, and common to both phototropism and gravitropism.

Diffuse, asymptomatic skeletal metastases occurred in a 46-year-old patient with liposarcoma. These metastases were detected by magnetic resonance imaging (MRI) but not by roentgenograms or radionuclide scans. Pathologic confirmation from the MRI-detected area was obtained. This observation suggests a possible explanation for the present discrepancy between the incidence of skeletal involvement in antemortem and postmortem studies in metastatic liposarcoma. MRI may be an extremely sensitive tool for detection of bone and bone marrow metastasis.

It is important to determine the bone mass in normal premenopausal women because increasing numbers of conditions have been identified that result in premenopausal osteoporosis. The relationship between age and bone density was evaluated in 57 carefully characterized normal, premenopausal women using both single energy quantitative computed tomography (SEQCT) and dual energy (DEQCT). The mean bone density measurements were 172 mg/ml K2HPO4 SEQCT and 185 DEQCT. Bone density showed no statistically significant decline between age 18 and age 44. Single- and dual-energy data were highly correlated with each other (r = 0.89), and dual energy appeared to confer no advantage. There was an inverse relation between density and age of menarche. Bone density did not correlate with ideal body weight, percentage fat, or subcutaneous fat area.

Three cases of pyogenic vertebral osteomyelitis involving only the posterior elements are presented. This unusual location creates difficulty in distinguishing vertebral osteomyelitis from neoplasms and arthridites. All three patients had involvement of the articular facet, a helpful indication against neoplasms. However, vertebral osteomyelitis should be differentiated from erosive arthridites.

Ten patients with 13 ankylosed elbows after burns are described. Six elbows, fixed in nearly full extension, had almost total functional disability; the other seven had varying amounts of deformity. In five of the 13 elbows there was a continuous bony mass with loss of the joint space; these were treated by a modified excision arthroplasty which restored good movement and useful function, though there was some lateral laxity. Six elbows had a posterior bony block; this was excised, which restored a useful arc of movement. The literature on bony ankylosis after burns is reviewed and the management of these cases in a developing country is described.

The circulating levels of sialic acid (N-acetylneuraminic acid) and glycosaminoglycans (GAGs) were measured in 69 patients with spinal disorders of orthopaedic interest (ankylosing spondylitis 17, osteofluorosis 6, idiopathic backache 10, osteoarthrosis 16, osteoporosis 20). The serum GAG levels showed no statistically significant change from control values in the five disorders investigated in the present study. Although osteoporosis and osteoarthrosis showed a decrease in serum sialic acid (SA) levels, the mean ratio (SA/GAG) demonstrated no change from control values. Idiopathic backache showed no difference in any of the parameters studied when compared with control values. Ankylosing spondylitis and osteofluorosis had a remarkable similarity in their clinical and radiological features, but a divergent mean value of ratio was noted. The mean ratio of both the conditions also showed a statistically significant difference from the control value. This suggests that the SA/GAG ratio can be used as a diagnostic test in ankylosing spondylitis.

For many musculoskeletal applications, magnetic resonance imaging (MRI) has gone beyond the stage of a promising new modality to become the imaging technique of choice. Various applications of MRI in the musculoskeletal system are discussed. It is clear that MRI fills an important need and will be a major addition to the field of musculoskeletal diagnosis.

Phototropic and gravitropic curvature by hypocotyls of Arabidopsis thaliana is minimal when the side of the hook with the cotyledons attached is positioned toward the direction of tropistic curvature, and maximal when that side of the hook is positioned away from the direction of tropistic curvature. Based on these data, it is proposed that the position of the hook with attached cotyledons affects curvature and not stimulus perception. A randomly oriented population of plants exhibited considerable heterogeneity in tropistic curvature. This heterogeneity arises at least in part from the dependence of curvature on the position of the hook.

A 36-year-old man sustained an injury that was a combination of Essex-Lopresti and Galeazzi fractures. His injuries consisted of a distal radial shaft fracture, a radial head fracture, and disruption of the distal radioulnar joint. These injuries are uncommon and this combination seems not to have been reported. The mechanism of the causative forces and the position of the forearm on impact is different in each of these injuries. These differences may explain the rarity of the combination.