Oxytocin reduces alcohol consumption in prairie voles.

Alcohol use disorder (AUD) negatively affects millions of people every year in the United States, and effective treatments for AUD are still needed. The neuropeptide oxytocin has shown promise for reducing alcohol drinking in mice and rats. Because oxytocin also plays a key role in complex prosocial behaviors like bonding and attachment, we tested the effect of oxytocin on alcohol drinking in prairie voles, a species that both consumes high amounts of alcohol and forms oxytocin dependent social bonds in a manner similar to humans. Oxytocin treatment (1.0, 3.0, and 10.0mg/kg, i.p.) reduced alcohol consumption in male and female prairie voles in animals that had access to 15% ethanol vs water every other day for 12 alcohol drinking sessions. In animals with continuous access to 15% alcohol and water, oxytocin (3.0mg/kg) reduced alcohol consumption only in the first hour of access after treatment, with no significant effects on consumption over the 24-hr period. In an open field locomotor test, oxytocin (1.0, 3.0, and 10.0mg/kg, i.p.) did not affect overall locomotor activity; however, ethanol (2g/kg, i.p.) increased locomotor activity in males and females, and produced anxiolytic effects (increased time in the center of an open field) in females only. Because prairie voles have been shown to match the alcohol consumption of their cage mate, we evaluated the relationship between cage mates' alcohol drinking. There was an overall pattern of social facilitation (consumption by one cage mate predicted consumption by the other cage mate); however, we found significant individual differences across cages in which many cages did not show significant matching, and, in some cases one cage mate's consumption negatively predicted the other cage mate's consumption. Overall, our data provide support for the potential of oxytocin as a treatment to reduce alcohol consumption.

Surgical treatment of the duplicated thumb.

Fifteen patients with 18 duplicated thumbs were treated surgically at The Shriners Hospital for Crippled Children, Springfield Unit, between 1925 and 1990. We compared the outcome of patients treated by ablation of the extra thumb with that of patients treated by ablation and radial collateral ligament reconstruction. Three patients with four duplicated thumbs, all from the ablation-only group, required additional surgical treatment for the following reasons: joint instability, contracture, angulation of the digit, and bony prominence. No patient from the ablation-plus-ligament-reconstruction group has required further operative treatment.

Radial head dislocations in children with below-elbow deficiencies.

Two thirds of the children who have below-elbow deficiencies, congenital or acquired, have concomitant radial head dislocations. The direction of the dislocation depends largely on the length of the residual limb. The dislocation does not require specific surgical treatment and rarely necessitates prosthetic modification.

Soft tissue sarcoidosis of the hand: a case report.

A tumour of the hand may be the first manifestation of systemic sarcoidosis. In our patient, this mass involved only the soft tissues; more commonly, there is bone involvement as well.

Two-stage correction of thumb adduction contracture in Freeman-Sheldon syndrome (craniocarpotarsal dysplasia).

Freeman-Sheldon syndrome is a rare congenital anomaly that is characterized by facial, hand, and foot deformities. We describe a female infant who had severe adduction contractures of the thumbs. A two-stage reconstruction was done. The first web space soft tissues were stretched with a transversely oriented external skeletal distractor, then a conventional first web space deepening and release was performed.

Nerve suture and grafting.

Nerve anatomy, terminology, and techniques for nerve restoration are reviewed in sufficient detail to allow the reader to quickly update his or her knowledge in this area. Ideas for future directions of study are presented.

Transfer of the flexor carpi ulnaris to the radial wrist extensors in cerebral palsy.

Fourteen patients with cerebral palsy who had had transfer of the flexor carpi ulnaris (FCU) to the extensor carpi radialis longus (ECRL) and/or extensor carpi radialis brevis (ECRB) were examined. Two questions were posed: (1) What was the postoperative arc of active wrist motion? and (2) Did the procedure improve the grasp and release mechanism in hand function? The procedure was successful in the majority of patients; wrist arc of motion was improved and grasp and release was enhanced after operation.

Giant cell reparative granuloma of the hand.

A case of recurrent giant cell reparative granuloma of the hand is reported. The radiographs showed a lytic, expansile lesion that extended from the secondary ossification center proximally to the articular surface distally. Treatment consisted of excision of the involved proximal phalanx and interposition bone graft. The histopathologic findings were typical for this benign, nonneoplastic process: a cellular fibrous stroma with many giant cells. The differentiation of giant cell reparative granuloma from giant cell tumor, aneurysmal bone cyst, and brown tumor of hyperparathyroidism is reviewed.

Proximal row carpectomy in arthrogrypotic wrist deformity.

We studied five patients who had proximal row carpectomy for the correction of wrist deformity secondary to arthrogryposis multiplex congenita. Three patients subsequently had wrist arthrodesis for recurrent or persistent deformity. We analyzed those factors we thought might influence the final result, including age at time of surgery, adequacy of correction of deformity, position of immobilization, and duration of immobilization. We concluded that despite attention to the details of intraoperative correction of deformity and postoperative immobilization, the results are unpredictable.

Heterotopic ossification of the shoulder following head injury. A case report.

Heterotopic ossification of the shoulder following head injury is a rare occurrence. In a 26-year-old woman with a head injury and extraarticular ossification of the glenohumeral joint, the heterotopic bone was resected surgically when the mass had matured. A vigorous physical therapy program was instituted early after operation to maintain shoulder mobility. Despite the formation of adhesions, the partial reformation of heterotopic bone, and an axillary neuropraxia, the patient achieved an excellent range of active shoulder motion ten months after operation.

Ulnar deficiency.

Twenty-nine patients with 34 ulnar deficient limbs were studied; the average follow-up was 7.7 years. To permit early determination of prognosis and decisions regarding treatment, four subtypes of this condition have been identified. Progressive ulnar deviation of the wrist was not observed in any case, and the fibrocartilaginous ulnar anlage was resected only to correct fixed deformities of the wrist. The most useful operation was humeral or radial osteotomy to correct the hand on flank deformity. A group of patients who were optimally treated with prosthetic fitting is discussed.

Angulation occurring during the distraction lengthening of digits.

Distraction lengthening of congenitally short digits is an accepted reconstructive procedure in hand surgery. A previously unreported complication of angulation occurring during distraction was treated by open reduction and insertion of a longitudinally placed, smooth Kirschner wire. The wire functioned as a spindle along which the distraction of the osteotomized bone fragments was continued. A satisfactory result was achieved.

Anterior dislocation of the shoulder in patients over 50 years of age.

Six patients over 50 years of age were treated and followed for traumatic, first-time anterior dislocation of the shoulder. Early post injury examination following the subsidence of acute pain due to the injury demonstrated passive motion that exceeded active motion. Later follow up, however, revealed that active motion was equal to passive motion. The author concludes that these patients injured their rotator cuffs at the time of the shoulder dislocation and that such rotator cuff injuries healed satisfactorily without surgical repair.