Experience with the deltopectoral flap.

The deltopectoral flap is a most versatile source of skin coverage or mucosal lining (or both). There is remarkable safety in the use of this flap in relation to its size, and there is only limited need for delay--because it pedicle is an axial flap. Nonetheless, the terminal part requires the attention to detail which any random flap requires--such as the avoidance of hematoma and infection and the prevention of tension, kinking, and angulation. This not only will ensure the safety of the flap, but also will prevent the rather common and annoying minor complications that delay the patient's convalescence.     

Structure of the yeast ribosomes. Proteins associated with the rRNA.

Polyamines have been shown to bind to doubled stranded regions of rRNA [3]. Therefore, ribosomal proteins that can be cross linked to these molecules in the ribosomes structure must be bound to or located in the vicinity of the RNA. This technique is the first to yield results on the proteins associated with the rRNA in the eukaryotic ribosome where the lack of purified ribosomal proteins does not allow the use of direct binding studies as in bacterial systems. Proteins S7, S10, S13, S21, S22 and S27 in the small subunit and L2/3, L5, L10/12, L19/20, L22, L23, L36/37, L42 and L43' in the large subunit are labelled when cross linked to [14C]spermidine using 1,5-difluoro 2,4-dinitrobenzene and are good candidates to be RNA-binding proteins in ribosomes from Saccharomyces cerevisiae.     

Chronorhythms of the circulating erythrocytes and leukocytes--correlation with the E.S.R. cycles

2750 healthy and fasting subjects, 20-30 years old, were studied over a half-year period in 1980. Considering the mean day value as a basic piece of information for statistics, the Erythrocyte Sedimentation Rate (E.S.R.) and the blood counts (erythrocytes, leukocytes, polymorphonuclears, lymphocytes, monocytes and eosinophils) were compared. The timeless relation between E.S.R. and each cell type number or percentage is rectilinear. The stronger slope and relation apply to the polymorphonuclears (PMN) or to the overall leukocytes. The chronological normalized variations of the E.S.R. and of the PMN or leukocyte number or percentage are highly correlated. E.S.R. is less correlated with monocytes, eosinophils and Lymphocytes. Contrary to what could have been expected, the erythrocyte situation is but an intermediate one. The spectra derived from the time variations show that all the cell types, whatever they are, are to be taken into account to explain the E.S.R. value and variation with time, even if, for a given cell type, the correlation and timeless relation were but faint ones. Each cell type has a specific spectrum. Erythrocytes are subject to low frequency variations (316-158 days). PMNs oscillate with time within the medium frequency range (90 days). Lymphocytes, monocytes and eosinophils fluctuate more quickly (53 days).     

Dealing with the difficult older patient.

Physicians are often asked to intervene when elderly patients in acute or long-term care facilities are disruptive, demanding or abusive. Though medication may be the immediate response, it often fails to solve the problem, which, being situational and behavioural, calls for a situational and behavioural solution. An organized approach to solving such problems is presented that takes into account the interactions among the patient, family, staff, setting and circumstances. The role of the physician as leader in the process is also discussed.     

Neuronal interactions with the extracellular matrix.

The interactions of neurons with extracellular cues are important in directing the formation of precise neuronal networks during the development of the nervous system. This review will focus on recent progress towards the understanding of the molecular machinery involved in the interactions of neurons with the extracellular matrix.