Traumatic brain injury in children and adolescents.

Traumatic brain injury is an insult to the brain caused by an external force that results in an impairment (transient or permanent) of cognitive, behavioral, emotional, or physical function. Traumatic brain injury encompasses shearing injury, which might be seen in a shaken infant, as well as penetrating injury from a foreign body, such as a bullet. This article addresses the recovery phase and functional sequelae following traumatic brain injury. Research and clinical experience over the past decade have led to a better understanding of the pathophysiology of head injury and, in turn, improved management.

The Pulfrich effect in optometric practice.

The Pulfrich effect can occur spontaneously, giving severe symptoms of changed visual perception in a variety of conditions in which an interocular latency difference has occurred. The symptoms principally involve misjudgements on the location of objects, especially when driving. Interocular latency differences can inadvertently be created in patients in practice and this study has investigated the Pulfrich effect in anisocoria, uniocular mydriasis, and with uniocular tint (X-chrom lens). In all cases a Pulfrich effect was consistently evident and compared to the size of the effect provoked by neutral density filters. The results show that with anisocoria, uniocular mydriasis and the X-chrom lens, the provoked Pulfrich effect is similar to that found reported previously in cases of trauma. These cases had severe visual symptoms so that care should be exercised in practice, where procedures likely to provoke the Pulfrich effect are contemplated. Specifically, patients who have received uniocular mydriasis in practice should be cautioned about the possible visual effects and advised not to drive until the effect of the mydriatic has finished and equal pupil sizes have been restored.

The Osteomed M3-X Fixation System: a new bone screw with applications in foot surgery.

The purpose of this article is to familiarize the reader with the Osteomed M3-X Fixation System. The authors present a description of the instrumentation and design characteristics of this system, as well as some comparisons to other similar fixation devices. The indications for the screw's use and the correct techniques of insertion are also discussed. In addition, a review of over 200 forefoot procedures utilizing this system, and performed by the podiatric surgeons at Hutzel Hospital, is presented.

Bizarre parosteal osteochondromatous proliferation. An unusual bone tumor.

Bizarre parosteal osteochondromatous proliferation of bone is a rare, benign bone tumor. The authors discuss two cases involving the bones of the feet, and review clinical, radiographic, and histopathologic characteristics. Awareness of this lesion is essential as bizarre parosteal osteochondromatous proliferation of bone can be mistaken for a malignancy.

Minimal effects of free fatty acids on the competitive protein-binding assay of serum thyroxine on reusable Sephadex columns.

In rats; following oral administration of cream and intravenous heparin, plasma free fatty acids and triiodothyronine Sephadex uptake were elevated. Simultaneously apparent serum thyroxine, measured by the Tetrasorb-E kit, was increased, but not when measured using reusable Sephadex columns. Addition of oleate to a human serum albumin solution or to human serum produced similar effects; appreciable rises in apparent thyroxine were noted in the kit assay but only minor changes occurred when Sephadex columns were used. In the latter procedure almost all [14C]oleic acid added to serum was removed in the first barbital buffer wash, before application of the thyroxine-binding globulin solution. In the serum thyroxine assay on reusable Sephadex columns, there is minimal interference by free fatty acids because they are removed by the first barbital buffer wash.