Pendelluft flow in symmetric airway bifurcations.

We propose a mathematical model for pendelluft flow in a single airway bifurcation. The model is motivated by an apparatus used in an experimental study of the pendelluft by Ultman et al. (1988). We derive differential equations governing the fluid flow, which directly connect physiological parameters to the variables determining the pendelluft; this approach allows us to include nonlinearity in the model. If nonlinearity is neglected, our model is identical to the R-I-C circuits used by previous investigators. If nonlinearity is retained, we show that pendelluft can occur even in perfectly symmetric airway bifurcations. For the specific apparatus used in the experiments of High et al. (1991), we demonstrate that two qualitatively different pendelluft flows can occur in the system.     

Supporters and survivors: the people without AIDS.

Over the past 10 years the AIDS crisis has produced a large volume of writing. Much of this is documentary. Dozens of studies of AIDS from various clinical and political perspectives have been complemented by just as many published diaries, autobiographies, novels, plays, and poems. A few of these works have risen to the surface not only as extraordinarily valuable testimonies to the changes AIDS has wrought in individual and collective life but also as first-rate literary works, worth reading because beyond their immediate purposes they articulate with extraordinary lucidity and compassion some deep truths about the human--and the modern--condition. Paul Monette's Borrowed Time is among the most distinctive of those. It speaks not only for the community of people with AIDS and those who support them but for a generation.     

Vascularized full-thickness parietal bone grafts in maxillofacial reconstruction: the role of the galea and superficial temporal vessels

Reconstruction of bony structures of the face is always a problem as big as the defect and the function that must be replaced. Everything from simple grafts to sophisticated distant bone flaps has been used. Based on the studies of Cutting et al., Psillakis et al., and Casanova et al., we have developed the full-thickness galeoparietal bone flap, initially for mandibular reconstruction, but of great use for all maxillofacial reconstructions. From July of 1987 to December of 1988, 14 patients have been operated on. The experience with this flap is shown in four patients as follows: primary reconstruction of a mandible as a result of ameloblastoma, secondary reconstruction of a mandible with associated old fractures and malalignment of segments, bilateral malar reconstruction in a patient with Treacher Collins syndrome, and severe sequelae of an already treated Romberg case. Small variations could be made to best accommodate the technique used to the defect we were treating. Some technical details, the experience, the results, and possible sequelae or complications are also discussed.     

Trigger finger secondary to anomalous lumbrical insertion: a case report and review of the literature

Trigger finger is a relatively common clinical entity, most frequently caused by stenosing tenosynovitis. Several other conditions not related to tenosynovitis also have been described as a cause of triggering, and these have been reviewed. We present a rare anomaly of the fourth lumbrical muscle insertion as a cause of triggering of the right little finger. This was completely relieved following excision of the anomalous muscle. This rare anatomic variant should be added to the list of potential causes of trigger finger.