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Extra-articular ulna shortening osteotomy, in principle, is an accepted treatment option for symptomatic degenerative and traumatic triangular fibrocartilage complex (TFCC) tears. Despite the benefits of this surgical approach, potential disadvantages include risk of nonunion, soft tissue irritation, and the need for future hardware removal. A recently introduced low profile ulna shortening system was designed to decrease these potential complications. A single-surgeon prospective study was performed to evaluate this system. Ten consecutive patients undergoing ulna shortening for ulnar-sided wrist pain compatible with TFCC pathology participated in the study. Subjective, objective, and radiographic assessments were performed preoperatively and up to 24 weeks postoperatively. Based on visual analog scale (VOS) ratings (0 to 10), pain scores significantly improved (p < 0.05) and average patient satisfaction was 8.7. DASH and PRWE scores improved at three month follow-up (p < 0.05). Osteotomy healing time averaged 10.3 weeks, and there were no nonunions. Average discomfort associated with palpation of the plate at final follow-up was 3.3 (using VOS), and one patient requested removal of the hardware. In this short-term follow-up study, the assessed ulna shortening system appears effective and, in general, well tolerated.

Management of persistent edema with the common treatment methods reported in the literature is not always successful. Manual edema mobilization (MEM) is a relatively new treatment regimen derived from established European and Australian lymphedema reduction regimens. It includes the use of exercises, light skin-tractioning massage techniques following the lymphatic pathways, and the use of low-compression garments. The typical patient who may benefit from the use of MEM has a presumed healthy lymphatic system, is an active participant, and performs some of the techniques independently between therapy sessions. This case report describes the use of MEM on a patient with multiple trauma, which resulted in a significant reduction--78%--of the persistent edema in the affected upper limb. A theoretic rationale is offered for each MEM technique.

The interpretation of prenatal screening and follow-up diagnostic testing for neural tube defects is relatively complex and presents unusual demands in terms of informed utilization by pregnant women. Such demands could impact differentially on individuals of different socioeconomic status or cultural values. Accordingly, a two-part questionnaire, interrupted by presentation of educational material on neural tube defects and prenatal screening, was presented to female sophomore medical students and to reproductive-age women whose children were served at Howard University Hospital. Student subjects favored prenatal testing, whereas clinic subjects were divided on testing both before and after reading the educational material. Both groups anticipated prenatal screening in future pregnancies, but clinic subjects were ambiguous about the need for diagnostic follow-up after the determination of high maternal serum alpha-fetoprotein. Clinic subjects were more hesitant than students to employ abortion as a means of intervention and did not distinguish between spina bifida and anencephaly in this regard.

The latency to display penile reflexes was significantly reduced in male rats tested one day following treatment with 6-hydroxydopamine (6-OHDA; 75 mg/kg, administered via acute tail vein injection). Eight days following treatment the latency to the first reflex in 6-OHDA treated males did not differ significantly from saline treated control subjects. There were no significant differences in the mean number of erections or flips displayed by 6-OHDA subjects when compared to saline treated control subjects. On tests one day after 6-OHDA administration, treated subjects displayed significantly fewer cups than control subjects on the corresponding tests. Chemical sympathectomy was verified by extreme reduction of peripheral norepinephrine levels. Results of this study are consistant with those reported for spinally transected rats tested under similar conditions (that is, one day following spinal transection), and suggest sympathetic inhibition of the onset of penile reflexes.

1. The concentrations of six monoamines or monoamine metabolites were measured in six brain regions of six shark species using high performance liquid chromatography with electrochemical detection. 2. Serotonin concentrations were greatest in the hypothalamus and tegmentum, intermediate in the midline ridge formation, spinal cord and forebrain, and lowest in the cerebellum in all species. 3. Specie differences in dopamien concentration were significant only in the forebrain; species differences in the levels of the norepinephrine, epinephrine and 5-hydroxyindoleacetic acid were significant in most brain regions, including the midline ridge formation. 4. Differences and similarities to the mammalian pattern of monoamine distribution in the brain are discussed.