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BACKGROUND Syndactyly is a common congenital condition that can present sporadically or in relation to an underlying genetic condition. Little contemporary published data exists detailing specific rates of presentation and surgical intervention, especially in Western European population. This is the first published review of operative intervention rates for the condition over time in Northern Ireland. METHODS A ten-year retrospective review of electronic operative records from January 2007 - October 2017 was carried out within Northern Ireland's regional tertiary centre Royal Belfast Hospital for Sick Children (RBHSC). All congenital hand surgery in the country was performed here during the period reviewed, by a single surgeon. Patient age at surgical intervention, their sex, digits involved and clinical grade of syndactyly was recorded. RESULTS One hundred and twenty four cases were returned following the review. On individual analysis 22 cases were excluded as they were not primary congenital syndactyly. The remaining 102 cases were all Caucasian. Six cases were toe syndactyly while 96 cases involved the upper limb digits. The group consisted of 70 males and 32 female infants. Age range at time of surgical intervention was 8 months to 14 years with a median age of 26 months. For clinical grade of upper limb syndactyly; 35 cases in the data set were classed as simple incomplete, 34 cases as simple complete, 17 as complex and 5 cases as complicated syndactyly. The remaining 5 cases lacked clear documentation. The most common site of syndactyly was between the ring and middle finger (40/102). Annual frequency of operative intervention has trended upwards in the period studied. CONCLUSION This case review adds epidemiological data on the operative incidence of syndactyly cases in Northern Ireland - a relatively isolated genetic population. Overall rates of incidence have increased over the past 10 years. It remains unclear if this is due to new environmental influences on the developing population or increased referral for surgical intervention over time. [ABSTRACT FROM AUTHOR]

Determines the effectiveness of blood-pool radionuclide scanning and x-ray phlebography methods in detecting deep venous thrombosis. Agreement of the methods in scan being and specificity; Significance of the patients red cells labelled with 99m technetium; Disadvantages of phlebography.

Background: Dyspnea secondary to acute upper airways airflow limitation (UAAFL) represents a clinical emergency that can be difficult to recognize without a suitable history; even when etiology is known, parameters to assess the severity are unclear and often improperly used., Objectives: The aim of this study was to assess the role of peripheral oxygen saturation (SpO 2 ) as a predictor of severity of upper airway obstruction., Methods: The authors propose an experimental model of upper airway obstruction by a progressive increase of UAAFL. Ten healthy volunteers randomly underwent ventilation for 6 min with different degrees of UAAFL. SpO 2 , heart rate, respiratory rate (RR), tidal volume, accessory respiratory muscle activation, and subjective dyspnea indexes were measured., Results: In this model, SpO 2 was not reliable as the untimely gravity index of UAAFL. Respiratory rate, visual analogue scale (VAS), and Borg dyspnea scale were statistically correlated with UAAFL (p < 0.0001 for RR and p < 0.05 for VAS and Borg scale). No significant changes were observed on heart rate (p > 0.05) and tidal volume (p > 0.05); a RR ≤ 7 breaths/min; VAS and Borg scale showed statistically significant parameters changes (p < 0.05)., Conclusions: RR, VAS, and Borg dyspnea scales are sensitive parameters to detect and stage, easily and quickly, the gravity of an upper airways impairment, and should be used in emergency settings for an early diagnosis of a UAAFL. SpO 2 is a poorer predictor of the degree of upper airways flow limitation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Phospholipase C-η2 (PLCη2) is a novel enzyme whose activity in a cellular context is largely uncharacterised. In this study the activity of PLCη2 was examined via [(3)H]inositol phosphate release in COS7 cells expressing the enzyme. PLCη2 activity increased approximately 5-fold in response to monensin, a Na(+)/H(+) antiporter. This was significantly inhibited by CGP-37157 which implies that the effect of monensin was due, at least in part, to mitochondrial Na(+)/Ca(2+)-exchange. Direct activation of PLCη2 by <1μM Ca(2+) was confirmed in permeabilised transfected cells. The roles of the PH and C2 domains in controlling PLCη2 activity via membrane association were also investigated. A PH domain-lacking mutant exhibited no detectable activity in response to monensin or Ca(2+) due to an inability to associate with the cell membrane. Within the C2 domain, mutation of D920 to alanine at the predicted Ca(2+)-binding site dramatically reduced enzyme activity highlighting an important regulatory role for this domain. Mutation of D861 to asparagine also influenced activity, most likely due to altered lipid selectivity. Of the C2 mutations investigated, none altered sensitivity to Ca(2+). This suggests that the C2 domain is not responsible for Ca(2+) activation. Collectively, this work highlights an important new component of the Ca(2+) signalling toolkit and given its sensitivity to Ca(2+), this enzyme is likely to facilitate the amplification of intracellular Ca(2+) transients and/or crosstalk between Ca(2+)-storing compartments in vivo., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Discriminant and regression analyses were employed to determine the influence of a large number of clinical and laboratory indices on outcome of treatment in a series of 158 adults presenting with acute leukaemia between 1970 and 1977. Induction therapy had been most commonly cytosine arabinoside plus daunorubicin, vincristine and prednisolone. This induced complete remission in 42% of non-lymphoblastic, and in 58% of lymphoblastic plus undifferentiated leukaemias. Some induction failures who had non-lymphoblastic leukaemia were treated with cytosine arabinoside plus 6-thioguanine, which induced remissions in 46%. Advanced age was the factor most strongly associated with failure either to achieve or to sustain complete remission. Thrombocytopenia, promyelocytic leukaemia, high percentage of marrow blasts, and absence of metaphases in marrow cytogenetic preparations were also associated with poor survival. A number of other factors which appeared to be associated with poor prognosis were found by the analysis to lack significance as independent variables.

The effectiveness of intensive bedside teaching of techniques of physical examination of the alimentary system to students commencing their clinical training was assessed. All students viewed a videotape demonstrating these techniques and then participated in a morning practice examination session but only half of the class received afternoon bedside teaching of physical examination in addition. Teaching in history taking was used as a 'placebo' for the control group, and half the students in each of the study and control groups were taught in units of four, the other half in units of eight. Thus the effect of group size could also be estimated. After 1 week, the students' performance of a physical examination was assessed using a standardized scoring chart which demonstrated good reliability. The study group performed significantly better than the control and within the study group there was a trend for the students taught in smaller units to perform better.

A videotape demonstration of the physical examination of the alimentary system was used, in place of a traditional lecture, in the first week of a teaching programme for half of a group of commencing, clinical students. At the end of the week, these students obtained higher scores than the matched controls in a clinical assessment which utilized an objective scoring-chart especially for this study.