The postauricular way-station for tubed pedicles from the chest

A method is described for staging the transfer of a tube pedicle from the chest to the head by means of a preliminary attachment to the postauricular region. The advantages of this method are that it increases the range of the pedicle, provides a delay or at least a proof of the vascularity of the distal portion of the flap at the same time as the inset, and prevents downward gravitational pull on the pedicle and limitation of the patient's cervical motion, which have been difficulties with chest pedicles in the past.     

A virtual matching technique for three-field breast irradiation using 3-D planning

Patients with breast cancer are often treated with radiation to the breast (or chest wall) and draining regional lymph nodes. This is typically performed with a three-field technique in which an anterior supraclavicular field is matched to opposed tangent fields. A single isocenter technique is not always possible. Several techniques have been described to create a perfect match using a conventional simulator. We describe and test a simple, fast and accurate technique to estimate the couch and collimator angles required for a perfect geometric match using 3-D treatment planning software. This method requires no mathematical formulae and is verifiable relative to patient anatomy.An external skin contour is created on the axial slice at the match line and displayed with a 3-D representation. Using a beam's eye view (BEV) of a tangent field, small couch and collimator rotation adjustments are made sequentially until the contour edges are superimposed. The virtual external contour technique was easy to use, gave verification of the match in the BEV and yielded estimates of couch and collimator rotations very close to those calculated using published formulae.     

Site-specific mutagenesis using asymmetric polymerase chain reaction and a single mutant primer.

A method is described for preparing site-specific mutants using a polymerase chain reaction (PCR) based protocol. The protocol requires a single mutant primer, and has been used to introduce mutations into DNA fragments ranging in size from 200 bp to 1569 bp in length in the GM-CSF, beta-actin, human growth hormone and erythropoietin genes. Sequence analysis of PCR derived mutant fragments shows an error rate of less than one bp change per 1500 bp incorporated. Single base pair mutations have been introduced into these genes which create unique restriction sites. We demonstrate that these mutant templates may be used for competitive PCR to quantitate mRNA and DNA. This method thus offers a rapid means for producing competitive templates for use in quantitative PCR.     

Primary Hodgkin's disease of the lung. Case report and review of the literature

A patient with primary Hodgkin's disease of the lung is described. Special features of this case were alcohol-induced chest pain as the main presenting clinical symptom and the documentation of the evolution of the pulmonary mass by serial X-rays. Complete remission was achieved by lobectomy and subsequent MOPP-therapy. Since then the patient has been in unmaintained remission for 36 months.     

Myocardial infarction in closed-chest dogs: a simplified method for production.

Due to our need, we sought a simple method to reliably create myocardial infarction in the closed-chest dog. Previous techniques were dangerous, time consuming, unreliable, and costly. Here we described a new coaxial catheter method by which occluded catheter plugs are embolized selectively to branches of the left coronary artery in closed chest dogs anesthetized with sodium pentobarbital (10 mg/lb). Infarcts varying in size from 3 to 27 g, 2-27% of the left ventricle, were reliably created in dogs weighing 26-70 lb. Complications were rare with only a single fatality in the last 15 procedures. The method proved safe, simple, quick, versatile, reproducible, and inexpensive.     

Dendrochronological analysis of an English chest: Contributing to knowledge about wood supply and chest production in 16th century England

Historic furniture has a great ethnographic and historical value, as styles and designs responded to specific uses, fashion trends and the social status of the buyer or the commissioner. Placing it in an exact chronological and geographical production context increases our knowledge about preferences for materials, designs, and woodworking practices for household commodities. Here we present the results of dendrochronological research carried out on an English chest from a private collection. The chest is of a hybrid construction, with boarded sides and back, and a joined front with four carved linenfold panels. It had been described as made of Baltic oak and dating to the mid-16th century, a crucial transition period for which only a few early chests have been analysed. Our results demonstrate, however, that the wood from the lid, side boards and back originates from the south of England. Heartwood/sapwood border in the left side board has allowed an estimated felling date for the tree of between 1520 and 1552. Terminus post quem dates of the rest of the elements pre-dating this interval indicate that the chest was likely made in the second quarter of the 16th century, as initially described. Three linenfold panels show typical features of Baltic wood, whereas the fourth one has different characteristics and could have been made with English oak, but the lack of access to the tree-ring patterns hampers verifying this hypothesis. Mixture of provenances suggests a production workshop in London, although other town in the south with a major timber market cannot be discarded. The construction features are described, and two distinct marks found in the chest are discussed in the regional context of its production. To allow the compilation and inventory of such marks, the ‘Marks on Wood’ community has been created in Zenodo and is presented here.     

The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck.

A compound flap is described that utilizes skin from the anterior chest on a narrow segment of pectoralis major muscle, with its underlying axial neurovascular bundle. This flap has been used successfully to reconstruct large defects in 4 consecutive patients. Our experience with this flap suggests that it may be more versatile than the deltopectoral flap.     

Open otoplasty

The fundamental challenge in correcting protruding ears is to create an anthelix fold that has a natural appearance: evenly rounded and without sharp edges. More or less favorable results have been reached using different methods of excision, superficial incision, suturing, and cartilage tubing. A good method must also fulfill some additional requirements. It must be simple and not too time-consuming. In addition, it should be comfortable for the patient, easily adapted to different anatomical conditions, and have a minimal recurrence rate. The following technique to be described has been used by the author for more than 30 years. He has operated on approximately 870 patients with the open technique. In this article, the last 80 consecutive patients are reported after their follow-up visits. Over the years, the technique has been modified in some details. The auricular cartilage is incised along the lateral border of the anthelical fold. The entire anterior surface of the anthelix is dissected free and abraded. The cartilage bends backward, and a natural anthelix fold is created.     

An improved technique for experimental infections with skin penetrating nematode larvae (Necator americanus)

An improved technique for experimental infections with skin penetrating nematode larvae (Necator americanus). International Journal for Parasitology16: 461–464. Conventional techniques for infecting experimental animals with skin penetrating nematode larvae create inconsistencies and variation in parasite establishment. A method is described which has been used to improve considerably the degree of uniformity of infection of laboratory rodents with the larvae of N. americanus. Infective larvae were placed onto the gauze of a surgical plaster and attached to the shaved backs of adult hamsters and mice. These were secured with a further layer of tape encircling the animal and removed 24 h later.     

The N-degron approach to create temperature-sensitive mutants in Schizosaccharomyces pombe

Conditional mutants are a vital tool for analysis of gene function. The use of temperature-sensitive mutants in Schizosaccharomyces pombe has significantly promoted understanding of many cellular processes. A portable heat-inducible amino-terminal degron (N-degron) for conditional degradation of a gene product has been previously described in Saccharomyces cerevisiae. This paper describes the adaptation of the N-degron method to create temperature-sensitive (ts) mutants in S. pombe. A ts derivative of the mouse dihydrofolate reductase with an amino-terminal arginine (Arg-DHFR(ts)) previously described in S. cerevisiae was fused to the N-terminus of Bir1p, a nuclear protein involved in mitotic chromosome segregation in S. pombe. This fusion allele, referred to as bir1-td, conferred a chromosome segregation defect at 36 degrees C, as with previously described alleles of bir1. Deletion of the S. pombe E3 ubiquitin ligase (N-recognin), Ubr11p, reversed the temperature-dependent lethality of bir1-td, providing evidence for N-end rule mediated destruction of Bir1p. The methods we describe should therefore facilitate analysis of essential genes in fission yeast for which conditionally lethal mutants are unavailable.     

Management of radiation necrosis of the chest wall following mastectomy: a new treatment option

A technique for covering areas of osteoradionecrosis in the medial aspect of the chest wall has been described. Utilizing a tissue expander, the skin was stretched sufficiently to obtain a suitable length whereby the medial defect could be covered and the donor site closed primarily. Such an operative approach should be considered when the patient presents with a medially located ulcer of small to moderate size and when nonirradiated skin is regionally available. Using this technique, long myocutaneous flaps that require extensive dissection, loss of functioning muscle, and resulting donor defects are avoided.     

Construction of a DNA library from chromosome 4 of rice （Oryza sativa） by microdissection

A simple method to create a chromosome-specific DNA librqary of rice,including microdissection,amplification,charterization and cloning,is described.Rice chromosome 4 from a metaphase cell has been isolated and amplified by the Linker Adapter PCR (LA-PCR).The PCR products were labeled as probes with DIG-11-dUTP using the random priming method.Southern blot analysis with rice genomic DNA and specific RFLP markers demonstrated that the PCR products were derived from rice chromosome 4.A large library comprising over 100,000 recombinant plasmid microclones from rice chromosome 4 was constructed.Colony hybridization showed that 58% of the clones contained single or low-copy sequences and 42% contained repetitive sequences.The size of inserts generated by PCR ranged from 140bp to 500bp.This method will facilitate cloning of the specific chromosome DNA markers and important genes of rice.     

Diagnosis of adenoid cystic carcinoma of the lung by bronchial brushing: a case report

BACKGROUND: A diagnosis of pulmonary adenoid cystic carcinoma on exfoliative cytology specimen is very uncommon. The diagnostic cytologic material typically is obtained following a tissue biopsy. No previous report of the diagnosis has been made on bronchial brushing cytologic material when the procedure preceded a tissue biopsy. CASE: A 44-year-old man who used to smoke cigarettes and was otherwise well complained of persistent cough for the past 6 months. A chest radiograph revealed a mass lesion in the left hilum. Computed tomography of the chest disclosed an irregular and spiculated soft tissue mass in the left apical anterior segment. Bronchial brushing via bronchoscope was performed, revealing carcinoma cells consistent with an adenoid cystic carcinoma on cytology. A bronchial biopsy and subsequent left upper lobectomy were performed, confirming the diagnosis of adenoid cystic carcinoma of the lung associated with tumor extension to the epithelial surface. CONCLUSION: A diagnosis of bronchial adenoid cystic carcinoma is possible on bronchial brushing. However, as a method in exfoliative cytology, the usefulness of bronchial brushing in diagnosing this tumor is limited by the neoplasm's proximity to the mucosal surface and whether the mucosa has been breached.     

Mutagenic inverted repeat assisted genome engineering (MIRAGE)

Here we describe a one-step method to create precise modifications in the genome of Saccharomyces cerevisiae as a tool for synthetic biology, metabolic engineering, systems biology and genetic studies. Through homologous recombination, a mutagenesis cassette containing an inverted repeat of selection marker(s) is integrated into the genome. Due to its inherent instability in genomic DNA, the inverted repeat catalyzes spontaneous self-excision, resulting in precise genome modification. Since this excision occurs at very high frequencies, selection for the integration event can be followed immediately by counterselection, without the need for growth in permissive conditions. This is the first time a truly one-step method has been described for genome modification in any organism.     

Affinity directed assembly of multilayers of pectinase

Numerous approaches to creating protein multilayers have been described for a variety of applications. In this work, the affinity of the enzyme pectinase towards a natural polysaccharide alginate has been exploited to create affinity directed enzyme multilayers on alginate beads. The biocatalyst has been characterized in terms of catalytic efficiency and kinetic parameters. Atomic force microscopy provided a good insight into multilayer formation at the molecular level. It was seen that enzyme layering was not uniform all over the bead. Thus, achieving high catalytic efficiency was an ‘average performance’ of the enzyme molecule, which was part of different layers. The results show that it is possible to create layered biocatalyst designs without using expensive lectins/antibodies for constructing affinity layers.     

MEDICAL NEWS in Brief

Excision of an empyema sac and thickened pleura from the lung and chest wall has been performed for over 70 years. The most appropriate fields of application of this procedure are in treatment of tuberculous empyema, empyema complicating pneumonic processes (most frequently caused by staphylococcal infection), and clotted hemothorax following chest injury. The authors'' experience with 33 such decortications in the past five years is described, observations concerning the techniques, complications, and end results of the procedure are discussed, and illustrative case reports are presented.     

Use of Ultrasound for Creation of Highly Targeted Immune Response

A simple method for creating a highly targeted immune response has been proposed. It has been shown that under the impact of low- and moderate-intensity ultrasound it is possible to strip antigens off the cell surface (surface antigens). It has been found that the immunogenicity of these surface antigens is no lower than the immunogenicity of intact cells. These results imply that it may be possible to create a specific highly targeted immune response against tissues and cells from whose surface the antigens were stripped, in particular, a targeted immune response against malignant tumors.     

Solvability of the electrocardiology inverse problem for a moving dipole

New formulations of the direct and inverse problems for the moving dipole are offered. It has been suggested to limit the study by a small area on the chest surface. This lowers the role of the medium inhomogeneity. When formulating the direct problem, irregular components are considered. The algorithm of simultaneous determination of the dipole and regular noise parameters has been described and analytically investigated. It is shown that temporal overdetermination of the equations offers a single solution of the inverse problem for the four leads.     

"Apron" flap and re-creation of the inframammary fold following TRAM flap breast reconstruction

To the best of our knowledge, the recreation of an inframammary fold after TRAM flap breast reconstruction has not yet been described. This article offers a technique for the creation of an inframammary fold as a secondary procedure. The technique has been performed thus far in two patients with good aesthetic outcomes and no postoperative complications. It may also be suitable for adding bulk to the TRAM flap, especially in bilateral breast reconstruction, and for other minor chest deformities.     

Clinical Results of Real-Time Ultrasonic Scanning of the Heart Using a Phased Array System

This report describes the operating characteristics and initial clinical results of a new echocardiographic system that produces real-time, high resolution, cross-sectional images of the heart. This system relies upon phased-array principles to rapidly steer and focus the ultrasound beam through the cardiac structures under investigation. A hand-held, linear array of 24 transducers is manipulated on the patient''s chest to direct the interrogating plane at various cardiac structures. Images of high line density are presented in selectable sector arcs to a maximum of 90 degrees. This imaging system has been used clinically in over 2,000 patients in the past two and one-half years. Its use in the detection of altered states of ventricular and valvular pathology has been described.