Harlequin syndrome as a complication of epidural anesthesia.

Harlequin syndrome is a rare neurological condition that results in unilateral facial flushing and sweating. Although the syndrome is generally a benign condition with complete resolution if appropriate treatment is initiated, unilateral facial flushing can be a sign of several serious conditions and should be thoroughly investigated. Sudden onset of facial flushing related to harlequin syndrome developed in a patient who had bilateral lung transplant with postoperative epidural anesthesia for pain control. Differential diagnosis includes neurovascular disease (acute stroke), malignant neoplasm of brain or lung, Horner syndrome, idiopathic hyperhidrosis, and Frey syndrome. Harlequin syndrome is often easily treated by discontinuing the anesthetic or adjusting placement of the epidural catheter.

A biodegradable lethal ovitrap for control of container-breeding Aedes.

Lethal ovitraps (LO) have been successfully deployed in dengue control operations in north Queensland, Australia since 2004. However, the current plastic-bucket LO must be retrieved before the pesticide-treated strip degrades and the trap begins producing mosquitoes. The logistics involved with trap retrieval are considerable and include recording trap location and retrieval date onto a database, locating and retrieving each trap, and examining lethal ovitraps for eggs. Collectively, these necessary activities greatly reduce the efficiency of dengue control. In response, we have developed a biodegradable lethal ovitrap (BLO) that does not need to be retrieved for the control of container-breeding Aedes, particularly Aedes aegypti. The BLOs were made by injection molding with the use of 2 proprietary blends of thermoplastic starch (TPS) polymer based on plasticised amylose maize polymers. In field trials, Ae. aegypti readily oviposited in BLOs, with those dyed black with the use of carbon black preferred. Water loss was higher in BLOs than in standard plastic LO because of weeping from the walls, although none of the BLOs failed in the 5 wk of the trial. The occurrence and rate of Ae. aegypti oviposition in both BLOs and the LO was comparable. In an accelerated standard composting trial (ISO16929:2002E), both BLOs fragmented within 4 wk, and no BLO particles were visible after 12 wk. Large numbers of BLOs could be deployed in a "set it and forget it" strategy to control Ae. aegypti and to stop dengue transmission, and could be used in a community participation program to maximize coverage.

Superficial temporal artery as an external landmark for deeper-lying brain structures.

Additional localizing superficial landmarks for intracranial structures can be of use to the neurosurgeon. This study was performed to evaluate the usefulness of the superficial temporal artery (STA) as an external landmark for deeper brain structures. Thirteen adult cadavers (26 sides) underwent latex injection of their STA bilaterally. Dissections were next carried out to identify this vessel. Once the STA and its frontal and parietal branches were skeletonized, craniectomies were performed and the underlying dura mater excised. Measurements were made between the frontal and parietal branches of the STA and deeper brain structures. The STA was found to branch on average 3 cm superior to the tragus. The bifurcation of the STA was found to commonly bifurcate at the level of the floor of the middle cranial fossa or superior temporal gyrus. The Sylvian fissure was found at a mean of 2 cm superior to the STA bifurcation. The angle between the frontal branch of the STA and the zygomatic arch had a mean of 37 degrees. The angle between the frontal and parietal branches of the STA had a mean of 87 degrees. At the level of the glabella, the frontal branch of the STA was on average 3 cm posterior to the frontal pole. The temporal tip was located a mean of 3.2 cm anterior to the frontal branch of the STA. The plane of the foramen of Monro was found to lie at a mean distance of 2.3 cm posterior to the frontal branch of the STA. The parietal branch of the STA was noted to travel more or less parallel with the central sulcus in all specimens and to travel an average of 2 cm posterior to this sulcus. At the level of the lateral attachment of the tentorium cerebelli, the parietal branch of the STA was found to travel a mean of 4.8 cm anterior to the entrance of the vein of Labbé into the transverse sinus. The parietal branch of the STA was also found to travel a mean of 4.2 cm anterior to the angular gyrus and 3.9 cm anterior to the supramarginal gyrus. Palpation or Doppler identification of the STA and its branches with subsequent mapping on the lateral cranium may prove useful as an additional superficial landmark for the neurosurgeon.

The oblique cord of the forearm in man.

There is minimal and often conflicting data in the literature regarding the oblique cord of the forearm. The current study seeks to elucidate further the anatomy of this structure of the upper extremity. In adult cadavers, the oblique cord was observed for and, when found, measurements were made of it. Ranges of motion were carried out while observation of the oblique cord was made. An oblique cord was found on 52.6% of sides. Gantzer's muscle was found on 55% of sides and, when present, had attachment into the oblique cord on five sides. The oblique cord was present on 13 sides with a Gantzer's muscle. Of the 20 sides with an oblique cord, no Gantzer's muscle was found on 10. The mean length of the oblique cord was 3.4 cm. In the majority of specimens, this cord tapered from proximal to distal. The proximal, middle, and distal widths of this structure had means 9, 7, and 4 mm, respectively. The oblique cord was found to travel approximately 45 degrees from a line drawn through the ulna and more or less traveled perpendicular to the insertion site of the bicipital tendon. This ligament was lax in the neutral position and with pronation became lax in all specimens. The oblique cord progressively became taut with increased supination from the neutral position and was maximally taut with the forearm fully supinated. Tautness of this cord was also found with distal distraction of the radius. Following the transection of the oblique cord, no discernable difference was observed in regard to maximal supination of the forearm or distal distraction of the radius. No obvious instability of the proximal forearm was found following transection of the oblique cord. Functionally, although the oblique cord may resist supination, it is unlikely that this structure affords significant stability to the proximal forearm, as it was often absent, of a very small caliber, and based on our observations, following its transection, the amount of supination of the forearm did not increase. Moreover, one would expect that this structure would never resist supination alone, as the larger overlying muscles would become taut prior to calling upon the action of this cord. Based on our findings, the function of the oblique cord appears insignificant in providing significant stability to the proximal forearm; however, further investigative studies are now necessary to confirm these data.

A note concerning acetate activation of peroxidative activity of catalases using 2,2'-azino-bis(3-ethylbenzthiazoline)-6-sulfonic acid as a substrate.

Beef liver catalases showed peroxidative activity using 2,2'-azino-bis-(3-ethylbenzthiazoline)-6-sulfonic acid as the electron donor and hydrogen peroxide as the acceptor at a pH of 5. This activity was not observed at pH 7. The reaction depended on acetate concentration, although succinate and propionate could partly replace the acetate as a catalyst. Other haem proteins also catalyzed a peroxidative effect. The reaction using syringaldazine or the coupling between dimethylaminobenzoic acid and 3-methyl-2-benzothiazolinone hydrazone was less effective and less sensitive. Evidence is presented that the reaction is associated with a conformational change of the catalase.