Particle tracking microrheology of gel-forming amyloid fibril networks.

Microrheology is a technique that is increasingly used to investigate the local viscoelastic properties of complex fluids non-invasively, by tracking the motion of micron-sized probe spheres. In this work, passive Particle Tracking Microrheology (PTM) is used to study network formation in the milk protein beta-lactoglobulin at 80 degrees C and pH 2. In these conditions the protein aggregates to form thread-like structures known as amyloid fibrils, which can further aggregate into elastic networks. Using PTM, gels were observed to form at significantly lower concentrations than determined by bulk rheometry, where the oscillatory shear forces may disrupt either fibril or network formation. During incubation, the Mean Square Displacement (MSD) of the probe particles exhibited time-cure superposition, allowing the critical relaxation exponent to be calculated as approximately 0.63, consistent with other biopolymer gels. Combined with the gel-like appearance of the complex modulus at long incubation times, this confirms that a true gel is forming, with physical or chemical crosslinks forming between the fibrils, refining the conclusions of other workers in the field.

Comparative study of the ipsilateral full thickness forearm skin graft in closure of radial forearm flap donor site defects.

The early experience of our unit with the technique of ipsilateral full thickness forearm skin grafting of the radial forearm flap donor site defect is described. The technique provides the advantages of a full thickness skin graft whilst avoiding the need to harvest skin from a remote area. We have compared the results with that of split skin grafts used contemporaneously for the same purpose in our unit; the advantages and disadvantages are outlined. Continued success has encouraged us to utilize this technique routinely with certain modifications which we describe.

The use of the compound radial forearm flap in oro-mandibular reconstruction.

The radial forearm flap may be used as an osteo-cutaneous unit to replace the bone of the mandible and the overlying mucosa. The technique and its complications are described and illustrated by three case reports.

Cutaneous CD30 positive large T cell lymphoma of the upper lip: a rare presentation.

Primary cutaneous CD30 positive large T cell lymphomas (PCLCL) are very rare in the head and neck region. We report a case which presented on the right upper lip in a 48-year-old male. This was an isolated cutaneous lesion and in these circumstances this otherwise aggressive lymphoma has an excellent prognosis.

Management of first branchial cleft anomalies: report of two cases.

Embryological anomalies of the first branchial apparatus result in rare forms of developmental abnormality of the head and neck. Their presentation may be similar to other conditions and they may easily be overlooked by the unwary when considering the differential diagnosis of a parotid swelling or a neck sinus. Consequently, they may be mismanaged on one or more occasions. We encountered two patients in whom such problems arose and conclude that appropriate investigation and management by a team skill ed in surgery of this region is necessary if a satisfactory outcome is to be achieved.

UK National Third Molar project: the initial report.

The National Third Molar (NTM) project was set up to assess current clinical practice in the UK concerning the management of third molar teeth. Patients were recruited from both hospital and general dental practice. During the one month study period 9248 patients with 26,577 third molars were recruited. In this report we present the findings in the 8298 patients with 25,001 third molars who were referred to hospital for assessment. Over half of all patients referred for assessment had either no extractions or a single third molar extracted. Less than a quarter of all patients referred underwent removal of all four third molars. Twenty per cent of all third molars assessed were not extracted. Of all lower third molars listed for extraction, 9574 (78%) were associated with symptoms or disease. Pericoronitis was the commonest indication for extraction and was cited in 39.5% of all extractions. Almost 70% of third molar extractions were done under general anaesthesia while less than a quarter were performed under local anaesthesia alone.

Computed tomography in the diagnosis of maxillofacial trauma.

A study of 34 patients who were investigated for maxillofacial trauma using high resolution computed tomography (CT) scanning is presented. The areas where this increasingly available technique offers more accurate information than conventional plain radiographs are discussed.

Cervical screening in an inner city area: response to a call system in general practice.

To determine whether a cervical screening call system based in general practice in a deprived inner city area would increase the numbers of women who came forward for cervical smears the response to letters of invitation for screening was monitored for one year in one general practice in the Paddington and North Kensington district of London. Women aged 20-64 were identified from the computerised age-sex register. Only 16% of these women had had a smear test. A total of 750 call letters was sent out. Initially the response was poor (57 women; 22%), and 85 (32%) letters were returned marked "address unknown." After the age-sex register was updated the response to call was 330 women (44%). The response of women aged over 35 was better than the response of women aged 35 and under (229 (53%) v 101 (32%)). In the year of the study the number of women aged 20-64 on the revised register who had been screened rose by 330 (14%). A general practice based call system can improve uptake of cervical screening even in a highly mobile, socially underprivileged population.

Fracture of the hyoid bone presenting as a dislocated mandible.

A case report is presented of a fractured hyoid bone which was missed in the first instance and incorrectly diagnosed as a dislocation of the mandible.

Unusual presentation of a monomorphic adenoma.

This case is presented as an example of the diagnostic difficulty that can be associated with radiolucencies around the apices of teeth. The discovery of a monomorphic adenoma within bone was unexpected because of its very rare occurrence.

Septic osteoradionecrosis of the mandible associated with pathological fracture: report of two cases.

Osteoradionecrosis of the mandible is a recognised pathological sequel to radiotherapy in the cervico-oro-facial region. Two cases of septic osteoradionecrosis which progressed to pathological fracture are described along with their subsequent clinical management.