Showing papers by "Catholic University of the Sacred Heart published in 1993"
TL;DR: The results confirm the high correlation between the A → G transition at position 8344 and the MERRF syndrome, but they also show that this mutation can be associated with other phenotypes, including Leigh's syndrome, myoclonus or myopathy with truncal lipomas, and proximal myopathy.
Abstract: We looked for the A-->G transition at position 8344 of mtDNA in 150 patients, most of them with diagnosed or suspected mitochondrial disease, to assess the specificity of this mutation for the MERRF phenotype, to define the clinical spectrum associated with the mutation, and to study the relationship between percentage of mutation in muscle and clinical severity. Our results confirm the high correlation between the A-->G transition at position 8344 and the MERRF syndrome, but they also show that this mutation can be associated with other phenotypes, including Leigh's syndrome, myoclonus or myopathy with truncal lipomas, and proximal myopathy. The absence of the mutation in four typical MERRF patients suggests that other mutations in the tRNA(Lys) gene, or elsewhere in the mitochondrial DNA, can produce the same phenotype.
206 citations
TL;DR: Results suggest that continuous oxygen therapy does not prevent or only partly prevents cognitive decline in COPD, and a distinct cognitive profile was found in a large fraction of patients with COPD and it differs in several aspects from those of both normal and demented subjects.
Abstract: In order to characterize the neuropsychologic profile of patients with hypoxic-hypercapnic chronic obstructive pulmonary disease (COPD), the performance of 36 patients with COPD 69 +/- 10 yr of age (mean +/- SD) on 19 tests exploring eight cognitive domains was compared with those of 29 normal adults (69 +/- 7 yr of age), 20 normal elderly adults (78 +/- 2 yr of age), 26 patients with Alzheimer-type dementia (72 +/- 6 yr of age), and 28 with multi-infarct dementia (MID) (70 +/- 8 yr of age). The discriminant analysis of cognitive test scores showed that 48.5% of patients with COPD had a specific pattern of cognitive deterioration characterized by a dramatic impairment in verbal and verbal memory tasks, well-preserved visual attention, and diffuse worsening of the other functions. The remaining patients with COPD were functionally classified as normal adults (12.1%), normal elderly adults (15.2%), those with MID (12.1%), and those with Alzheimer-type dementia (12.1%) according to discriminant analysis. Cognitive impairment was significantly and positively correlated with age (p < 0.05) and duration of hypoxic-hypercapnic chronic respiratory failure (p < 0.05). Because patients with COPD were receiving oxygen therapy from the beginning of oxyhemoglobin desaturation, results suggest that continuous oxygen therapy does not prevent or only partly prevents cognitive decline in COPD. Although some analogies between age-related and COPD-related cognitive decline are evident, a distinct cognitive profile was found in a large fraction of patients with COPD and it differs in several aspects from those of both normal and demented subjects.
192 citations
TL;DR: Effect of dietary yeast culture on milk production and composition, ruminal fermentation, blood parameters, and milk manufacturing properties of 24 midlactation Holstein-Friesian cows was determined in a 6-wk experiment.
177 citations
TL;DR: Evidence is provided for enhanced thromboxane biosynthesis in homocystinuria and for its partial dependence on probucol-sensitive mechanisms and the elevated TXA2 formation in homocytes is likely to reflect, at least in part, in vivo platelet activation.
Abstract: Homocystinuria due to homozygous cystathionine beta-synthase deficiency is an inborn error of metabolism characterized by a high incidence of thrombosis and premature atherosclerosis. We evaluated TXA2 biosynthesis in vivo and several in vitro tests of platelet function in 11 homocystinuric patients and 12 healthy controls. In vitro, patients' platelet aggregation was within control values as were TXB2 formation, fibrinogen binding, and ATP secretion in response to thrombin. In contrast, the urinary excretion of 11-dehydro-TXB2, a major enzymatic derivative of TXA2, was > 2 SD of controls in all patients (1,724 +/- 828 pg/mg creatinine, mean +/- SD, in patients vs. 345 +/- 136 in controls, P 80%. The recovery of 11-dehydro-TXB2 excretion over the 10 d that followed aspirin cessation occurred with a pattern consistent with the entry into the circulation of platelets with intact cyclooxygenase activity. Prolonged partial reduction in the abnormally high excretion of both 11-dehydro-TXB2 and 2,3-dinor-TXB2, was also observed in seven patients who ingested 500 mg daily for 3 wk of the antioxidant drug probucol. These results provide evidence for enhanced thromboxane biosynthesis in homocystinuria and for its partial dependence on probucol-sensitive mechanisms. Furthermore, the elevated TXA2 formation in homocystinuria is likely to reflect, at least in part, in vivo platelet activation.
156 citations
TL;DR: Cryotherapy is an effective, low-risk approach to keloid treatment associated with a low rate of recurrence and complete flattening was achieved in 48 scars, most of which were less than 2 years old.
Abstract: background. Numerous approaches are used to treat keloids, but none is ideal for all scars and recurrence after treatment is frequent.
objective. The purpose of this study was to evaluate the efficacy of cryotherapy for treatment of these scars.
methods. Sixty-five lesions of various sizes and ages were treated with a hand-held liquid nitrogen spray unit; freeze times and number of sessions varied. Scar volume was measured before and after treatment.
results. Complete flattening was achieved in 48 scars (73%), most of which were less than 2 years old. Unacceptable responses were seen in six scars. No recurrence was seen during follow-ups ranging from 17 to 42 months. Side effects were limited to hypopigmentation and slight to moderate atrophy in three cases.
conclusion. Cryotherapy is an effective, low-risk approach to keloid treatment associated with a low rate of recurrence.
139 citations
Journal Article•
TL;DR: This is the first demonstration of the existence of a B-cell immune response to selected epitopes of polymorphic epithelial mucin and constitutes the basis for the use of synthetic peptides as a vaccine in cancer patients.
Abstract: Human antibodies generated by Epstein-Barr virus immortalized B-cells from tumor-draining lymph nodes of an ovarian cancer patient were screened for reactivity in enzyme-linked immunosorbent assay with a synthetic peptide corresponding to the protein core of the polymorphic epithelial mucin. Epitopes within this region are in fact considered tumor specific since they are selectively exposed in tumor cells due to aberrant glycosylation. Human antibody BB5, thus selected, reacts in enzyme-linked immunosorbent assay and immunohistochemistry with polymorphic epithelial mucin-expressing tumor cells. This is the first demonstration of the existence of a B-cell immune response to selected epitopes of polymorphic epithelial mucin and, together with the cytotoxic T-cell response already demonstrated, constitutes the basis for the use of synthetic peptides as a vaccine in cancer patients.
116 citations
TL;DR: Complete sequencing of the prion protein open reading frame of a 68‐year‐old woman affected by a familial form of Creutzfeldt‐Jakob disease revealed a new mutation at codon 210 resulting in the substitution of isoleucine for valine, suggesting that in Italy, familial CJD is more common than previously reported.
Abstract: Complete sequencing of the prion protein open reading frame of a 68-year-old woman affected by a familial form of Creutzfeldt-Jakob disease (CJD) revealed a new mutation at codon 210 resulting in the substitution of isoleucine for valine. Moreover, a new 24-bp deletion encompassing codons 54 to 61 or 62 to 69 was found in the other allele. Four of the 17 asymptomatic relatives tested carry the 210 mutation. Two of them were 81 and 82 years old. Four of 22 patients with CJD whose recorded familial history was negative for demented illnesses, but none of 103 healthy control subjects, tested positive for the 210 mutation. These data suggest that the 210 mutation is associated with CJD, but that environmental factors or incomplete penetrance may contribute to the development of the disease. This finding also suggests that in Italy, familial CJD is more common than previously reported.
115 citations
TL;DR: The pattern of lymphatic spread was evaluated in 81 previously untreated ovarian cancer patients undergoing systematic aortic and pelvic lymphadenectomy and found that all lymphatic tissue surround the aorta, the cava, and the pelvic vessels should be removed if a cytoreductive intent is pursued.
115 citations
TL;DR: This study aimed to assess whether patients with an exaggerated blood pressure response to the doctor's presence also display a pattern of enhanced blood pressure reactivity to mental stress and physical exercise and to determine the presence of left ventricular structural and filling abnormalities in patients with white coat hypertension.
Abstract: This study aimed 1) to assess whether patients with an exaggerated blood pressure response to the doctor's presence ("white coat" effect) also display a pattern of enhanced blood pressure reactivity to mental stress and physical exercise and 2) to determine the presence of left ventricular structural and filling abnormalities in patients with white coat hypertension. We studied 56 (40 men) consecutive patients (mean [SD] age, 46.4 [9.1] years) whose clinic blood pressure was repeatedly high. Patients were classified as having white coat hypertension (n = 20) if both their mean daytime (from 7 AM to 11 PM) ambulatory systolic and diastolic blood pressures were less than 134 and 90 mm Hg, respectively. Patients were considered to have persistent hypertension (n = 36) if daytime systolic blood pressure was 134 mm Hg or more or diastolic blood pressure was 90 mm Hg or more. Eighteen subjects with clinic blood pressure lower than 140/90 mm Hg served as a normotensive control group. Blood pressure reactivity from baseline to mental arithmetic, isometric handgrip, and cycle ergometry did not display any difference among the three groups. The white coat hypertensive group had left ventricular mass index lower than the persistent hypertensive group but higher than the normotensive group. Doppler indexes of left ventricular diastolic filling displayed similar abnormalities in the white coat and persistent hypertensive groups compared with the normotensive group.(ABSTRACT TRUNCATED AT 250 WORDS)
112 citations
TL;DR: The vestibular primary afferent projection to the cerebellum of the rabbit was studied with retrograde and orthograde tracers and cells in Scarpa's ganglion were labeled retrogradely following uvula‐nodular injections.
Abstract: The vestibular primary afferent projection to the cerebellum of the rabbit was studied with retrograde and orthograde tracers. We injected individual lobules of the cerebellum with horseradish peroxidase (HRP) or wheat germ agglutinin-HRP (WGA-HRP). Following these injections the numbers of labeled and unlabeled cells in Scarpa's ganglion were counted. Approximately 64–89% of the cells in Scarpa's ganglion were labeled retrogradely following uvula-nodular injections. About 2% of the cells in the ipsilateral Scarpa's ganglion were labeled after injections of the flocculus. Virtually no cells were labeled following injections of the ventral paraflocculus.
The vestibular primary afferent projection to the uvula-nodulus is so extensive that it must be part of a collateral system that also innervates the vestibular nuclei. This collateral projection pattern was confirmed by using fluorescent tracers injected into the uvula-nodulus and vestibular complex. Fluorogold was injected into the uvula-nodulus and peroxidaserhodamine isothiocyanate was injected into the vestibular complex. More than 50% of the neurons in Scarpa's ganglion were double labeled by these subtotal injections.
The dense vestibular primary afferent projection to the uvula-nodulus was confirmed by using the C fragment of tetanus toxin (TTC) injected into the labyrinth as an orthograde tracer. With the TTC technique, the vestibular primary afferent projection to the uvula-nodulus terminated exclusively in the ipsilateral granule cell layer of lobules 9d and 10. Much sparser vestibular primary afferent projections were found in the banks of major cerebellar sulci. A barely detectable projection was found to the flocculus and ventral paraflocculus. © 1993 Wiley-Liss, Inc.
108 citations
TL;DR: Branching enzyme activity was assayed in muscle, peripheral nerve, and leukocytes from 2 Ashkenazi‐Jewish patients with adult polyglucosan body disease and 1 African‐American and 3 Caucasian patients with the same clinical and pathological features to confirm a branching enzyme deficiency and show that the defect is tissue‐specific, suggesting that adult poly glaucoma body disease has more than one biochemical basis.
Abstract: Branching enzyme activity was assayed in muscle, peripheral nerve, and leukocytes from 2 Ashkenazi-Jewish patients with adult polyglucosan body disease and 1 African-American and 3 Caucasian patients with the same clinical and pathological features. Branching enzyme activity was normal in the muscle specimens from both Jewish and non-Jewish patients. However, the activity was markedly decreased not only in the leukocytes from the 2 Jewish patients (confirming previous findings), but also in peripheral nerve specimens, whereas it was normal in nerve tissue and leukocytes from all non-Jewish patients. These data confirm a branching enzyme deficiency in a subgroup of patients with adult polyglucosan body disease, and show that the defect is tissue-specific, suggesting that adult polyglucosan body disease has more than one biochemical basis.
TL;DR: The inferior olive is divided into several subnuclei that receive specific sensory information, and the caudal dorsal cap of the medial accessory subdivision of the inferior olive receives horizontal optokinetic information from the nucleus of the optic tract.
Abstract: The inferior olive is divided into several subnuclei that receive specific sensory information The caudal dorsal cap of the medial accessory subdivision of the inferior olive receives horizontal optokinetic information from the nucleus of the optic tract The immediately subjacent b-nucleus receives vertical vestibular information mediated by a GABAergic pathway originating from the ipsilateral descending and medial vestibular nuclei None of the transmitters to the dorsal cap have been identified
Using choline acetyltransferase (ChAT) immunohistochemistry, we have identified a cholinergic pathway that terminates exclusively in the dorsal cap of rats and monkeys No other division of the inferior olive received a significant cholinergic innervation In the rabbit, immunostaining for ChAT reveals a weaker and more diffuse cholinergic innervation of both the dorsal cap and the subjacent b-nucleus
In rats and rabbits we injected iontophoretically the orthograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L) into the medial and descending vestibular nuclei (MVN, DVN) as well as the nucleus prepositus hypoglossi (NPH) in order to trace the possible origin of the cholinergic projection PHA-L injections into the NPH and medial aspect of the MVN labeled terminals within the contralateral dorsal cap PHA-L injections in the central and lateral aspects of the MVN as well as the DVN labeled the ipsilateral b-nucleus
Pressure injections of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) in the caudal dorsal cap of the rabbit inferior olive demonstrated a predominantly contralateral projection to the dorsal cap from the lateral aspect of the NPH However, pressure injections of HRP into the caudal dorsal cap combined with ChAT immunohistochemistry in the rabbit demonstrated that most of the neurons of the NPH that projected to the dorsal cap were not cholinergic, and that most of the ChAT-positive neurons within the NPH occupied a more ventral location than the neurons within the NPH that were retrogradely labeled from the HRP injection into the contralateral dorsal cap
In the rat, we made lesions in the MVN, DVN and NPH by injection of ibotenic acid (03–05 ml), in an attempt to deplete the dorsal cap of the inferior olive of its cholinergic input Lesions confined to the NPH and medial aspect of the MVN of the rat caused a loss of ChAT staining in the contralateral dorsal cap Lesions placed more laterally within the MVN or DVN failed to deplete ChAT-positive terminals in the contralateral or ipsilateral dorsal caps
The dorsal cap of the rat and monkey receives a discrete cholinergic projection In the rat, this projection originates from the contralateral NPH In the rabbit, the caudal inferior olive receives a weak cholinergic projection The dorsal cap receives a projection from the contralateral NPH However, this projection is mediated by a non-cholinergic transmitter © 1993 Wiley-Liss, Inc
TL;DR: The aim is to better redefine the diagnostic criteria, describe the natural history, and confirm the genetic cause of the Costello syndrome, whose pattern of inheritance is most likely autosomal recessive.
Abstract: In 1977 Costello described two unrelated children with poor postnatal growth, mental retardation, curly hair, coarse face of similar appearance, and nasal papillomata, suggesting the existence of a previously undescribed syndrome of uncertain familial nature [Costello, Aust Paediatr J 13: 114-118, 1977]. The existence of this syndrome as a separate entity was substantiated several years later by two additional reports by Der Kaloustian et al. [Am J Med Genet 43:678-685, 1991] and Martin and Jones [Am J Med Genet 41:346-349, 1991]. More recently Borochowitz et al. [Am J Med Genet 43:678-685, 1992] described a new "multiple congenital anomalies/mental retardation syndrome with facio-cutaneous-skeletal involvement." Whether this condition should be considered separately from the Costello syndrome is currently a matter of debate. We present three cases, two of whom are sibs, who support the identity of the two syndromes. Our aim is to better redefine the diagnostic criteria, describe the natural history, and confirm the genetic cause of the Costello syndrome, whose pattern of inheritance is most likely autosomal recessive.
TL;DR: D Duchenne muscular dystrophy carriers are reported with dilated cardiomyopathy, increased serum CK, and no symptoms of muscle weakness in heart biopsies of both patients, and dystrophin was absent in many fibers.
Abstract: Cardiomyopathy was reported in a few Duchenne muscular dystrophy (DMD) carriers with clinical evidence of myopathy. We report two carriers with dilated cardiomyopathy, increased serum CK, and no symptoms of muscle weakness. In heart biopsies of both patients, dystrophin-the protein product of DMD locus--was absent in many fibers. Dilated cardiomyopathy may be the only manifestation of dystrophin gene mutation in carriers.
TL;DR: Investigating crossed-uncrossed differences in speed of simple visuomotor responses to lateralized flashes in one subject with total section of the corpus callosum and two subjects with complete callosal agenesis confirms that a callosal contribution is important for the execution of fast distal and unilateral proximal responses to a visual stimulus directed to the hemisphere ipsilateral to the responding hand.
Abstract: Normally, simple digital or manual responses to a light stimulus in the right or left visual hemifields are performed faster with uncrossed hand-field combinations than with crossed hand-field combinations. Because of the organization of visual and motor pathways, the integration of uncrossed responses is assumed to occur within a single hemisphere, whereas a time-consuming inter-hemispheric transfer via the corpus callosum is considered to be necessary for the integration of crossed responses. However, callosal transfer may be dispensable for those crossed responses which can be controlled through ipsilaterally descending motor pathways by the hemisphere receiving the visual stimulus. We investigated crossed-uncrossed differences (CUDs) in speed of simple visuomotor responses to lateralized flashes in one subject with total section of the corpus callosum and two subjects with complete callosal agenesis. We recorded the reaction times as well as the premotor times, as indicated by the electromyographic latencies of the prime movers, of three types of responses: a distal response involving a thumb flexion, a proximal response chiefly involving a forearm flexion and an axial response involving a shoulder elevation. Further, the three types of responses to a single lateralised flash were performed both unilaterally and bilaterally. The three acallosal subjects showed CUDs greatly exceeding normal values on distal responses, either unilateral or bilateral, and on unilateral proximal responses. These abnormally long CUDs stood in sharp contrast to the insignificant CUDs exhibited by the same subjects on bilateral proximal responses and on unilateral and bilateral axial responses in agreement with correspondingly insignificant CUDs reported for normal subjects. These results confirm that a callosal contribution is important for the execution of fast distal and unilateral proximal responses to a visual stimulus directed to the hemisphere ipsilateral to the responding hand. By contrast, the other types of crossed responses appear to be efficiently coordinated across the midline without the aid of the corpus callosum. This is in keeping with the hypothesis that they are governed by a bilaterally distributed motor system which is preferentially activated for the execution of symmetrical bilateral movements, employing axial and proximal limb muscles.
TL;DR: The role of CD34 + bone marrow progenitor cells in vivo, in the pathogenesis of AIDS‐related haematological abnormalities, is evaluated to account for the defective haemopoiesis in HIV‐1 infected patients.
Abstract: We evaluated the role of CD34+ bone marrow progenitor cells in vivo, in the pathogenesis of AIDS-related haematological abnormalities. The clonogenic activity of CD34+ cells from seven patients with HIV-1 infection, without bone marrow involving opportunistic infections or neoplasms, was assessed in semisolid cultures. The number of CFU-GM was significantly reduced as compared to the controls (P = 0.017), independently from myelotoxic therapy, while the number of BFU-E was not. The presence of retroviral sequences in CFU-GM colonies from four patients and in the total population of CD34+ cells from six patients with advanced stage HIV infection was investigated using the polymerase chain reaction. The presence of HIV-1 sequences was also searched for in a purified suspension of CD34+ cells after 3 weeks liquid culture. All these cells were always HIV-1 negative, while viral sequences were always detected in bone marrow mononuclear cells from these and other patients. The number of HIV-1 DNA copies decreased with increasing enrichment. At most 1:10,000 CD34+ cells are infected in vivo. Other mechanisms than direct viral infection of progenitor cells must account for the defective haemopoiesis in HIV-1 infected patients.
TL;DR: If the stretching is maintained at a constant level during repeated coronary occlusions, the cardiac pain is entirely predicted by the severity of myocardial ischemia and therefore does not appear to be directly modulated by the mechanisms responsible for the ischemic preconditioning.
TL;DR: Doppler ultrasound was used to study the main uterine artery flow velocity waveforms in an unselected population of 272 primiparous women at 22 weeks' gestation and the best result was obtained for the prediction of pregnancies affected by both gestational hypertension and intrauterine growth retardation.
Abstract: Doppler ultrasound was used to study the main uterine artery flow velocity waveforms in an unselected population of 272 primiparous women at 22 weeks' gestation. The incidences of subsequent complications were as follows: gestational hypertension alone, 4.4%; intrauterine fetal growth retardation alone, 4%; and gestational hypertension with intrauterine growth retardation, 3.6%. The flow velocity waveform was considered abnormal when the resistance index in the uterine artery was greater than 0.58. This identified 9.5% of the population as ‘at risk’ and predicted either of the above outcomes with an overall sensitivity of 74% (kappa index, 0.72). The sensitivity of prediction for gestational hypertension alone was 50% while for proteinuric gestational hypertension it was 88%. The best result was obtained for the prediction of pregnancies affected by both gestational hypertension and intrauterine growth retardation, where the sensitivity was 100%. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
TL;DR: During 1984-1989, 116 cases of omphalocele and 42 cases of gastroschisis were detected among 736,760 consecutive births in the area covered by five Italian congenital malformation registries.
Abstract: During 1984-1989, 116 cases of omphalocele and 42 cases of gastroschisis were detected among 736,760 consecutive births in the area covered by five Italian congenital malformation registries. The prevalence rate was 1.6 per 10,000 for omphalocele and 0.6 per 10,000 for gastroschisis. Three additional cases were detected among spontaneous abortions, giving a total of 117 cases of omphalocele and 44 of gastroschisis. No variations in prevalence rates were observed among registries. A cluster of omphalocele was found in 1989 in Firenze. All cases were sporadic except for one infant with two sibs with Beckwith-Wiedemann syndrome. A predominance of male infants was observed for both defects. This study confirms the very young maternal age for isolated gastroschisis as compared to that for omphalocele and controls. Birth weight and the percentage of small-for-date is different among isolated gastroschisis, omphalocele and controls. Associated anomalies occurred in 45 cases of omphalocele and 11 cases of gastroschisis. Our data confirm the association of omphalocele with trisomies 13 and 18. Twelve cases of omphalocele and gastroschisis with associated limb defects were classified as limb body wall complex. The possible differences in etiopathology between omphalocele and gastroschisis, both isolated and associated, are discussed.
TL;DR: This map of HC 21 represents a highly informative and dense meiotic linkage map and will be useful in linking disease phenotypes to loci on this chromosome.
TL;DR: The presence of pesticide residues in rain, throughfall, stemflow and in ambient air in two Italian forests affected by the forest damage phenomenon were investigated and Herbicides were more frequent than insecticides, and their concentrations were higher.
TL;DR: Results show that retroviral vectors can be used to transfer foreign genes with high efficiency into normal or abnormal primary human myogenic cells, leading to stable expression into mature muscle.
Abstract: Primary human myogenic cells isolated from fetal and adult muscle were infected with a high-titer, Moloney murine leukemia virus (MoMLV)-derived retroviral vector expressing a bacterial beta-galactosidase (beta-gal) gene under long terminal repeat (LTR) control. Gene transfer efficiency averaged 50% in both fetal myoblasts and adult satellite cells, as revealed by beta-gal staining. The reporter gene was stably integrated, faithfully inherited, and expressed at significant levels in myogenic cells for at least 10 generations under clonal growth conditions, and throughout the culture life span upon differentiation into myotubes. Comparable gene transfer efficiency was obtained in myogenic cells from muscle biopsies of patients affected by a number of genetic or acquired myopathies, including Duchenne muscular dystrophy. Transduced normal human satellite cells were injected into regenerating muscle of immunodeficient mice, where they formed new muscle fibers in which the product of the reporter gene was detectable for 2 months after injection. These results show that retroviral vectors can be used to transfer foreign genes with high efficiency into normal or abnormal primary human myogenic cells, leading to stable expression into mature muscle. Satellite cells engineered in this way might represent an effective tool for gene therapy of muscular dystrophies as well as for systemic delivery of recombinant gene products for correction of inherited and acquired disorders. The human-mouse model described here will allow in vivo testing of such gene therapy approaches.
TL;DR: NACT+RS had an acceptable morbidity but the therapeutic results were less encouraging than expected with a 3-year survival of 24% and stage, pathological T downstaging, and N status all significantly affected survival.
TL;DR: It is concluded that assigning a geriatrician to assist with the medical care of elderly Orthopedic patients in orthopedic wards is associated with increased operation rate, decreased mortality and shortened length of stay.
Abstract: The aim of this study was to assess whether assigning a geriatrician to provide daily medical care to geriatric patients in the orthopedic ward can improve the prognosis and reduce the length of stay. Time series analysis was performed in two parts: (1 prospective analysis of two years’ workload, and 2) retrospective analysis of data collected over the 4 years prior to the intervention. Intervention and control populations were pooled, and the effects of geriatric care and patient- related factors on outcome measures were assessed by logistic regression analysis. All subjects were patients aged ⩾ 70 years who attended the orthopedic ward in a university hospital in years 1989–90 (studied group: 287 cases) and in years 1985–88 (control group: 474 cases). In the study period, mortality was 8.4% compared to 18% in 1985–86 (p<0.0006) and 14% in 1987–88 (p<0.01). The operation rate in the study period was 89.9% vs 83.8% in 1985–86 (p<0.02) and 81.8% in 1987–88 (p<0.005). Length of stay was 26.2± 14.4 days vs 32.9± 30.9 days in 1985–86 (p<0.05) and 26.9± 16.5 days in 1987± 88 (NS). Length of stay was more strikingly shortened in the subset of patients with femoral fracture undergoing surgical management (28.5± 12.7 vs 37.6± 32.6 days in 1985–86, p<0.003, and 30.8± 15 days in 1987–88, p<0.02). Given the positive relationship between geriatric care and operation rate (o.r.=1.5, CI=1.1–1.9), the protective effect of surgical treatment on mortality (o.r.=0.6, CI=0.4–0.8) to some extent may mask the collinear effect of geriatric care. We conclude that assigning a geriatrician to assist with the medical care of elderly orthopedic patients in orthopedic wards is associated with increased operation rate, decreased mortality and shortened length of stay. (Aging Clin. Exp. Res. 5: 207- 216, 1993)
TL;DR: The increased LVMI the authors observed may represent a possible link between diabetic autonomic neuropathy, nocturnal blood pressure levels, and higher cardiovascular mortality rate.
TL;DR: The present data show that a chronic administration of low doses of MPTP brings about biochemical and morphological abnormalities that occur acutely in terminals and are reverted early after discontinuance of exposure to the toxin.
TL;DR: Results of the surgical treatment of 50 consecutive displaced acetabular fractures were reviewed after a minimum of 2 years and a maximum of 6 years, and excellent and good results were noted in 76% of the patients.
Abstract: Results of the surgical treatment of 50 consecutive displaced acetabular fractures were reviewed after a minimum of 2 years and a maximum of 6 years. Twenty-five fractures were complex, and 15 were treated at > or = 3 weeks postinjury. The quality of the reduction was anatomic in 74% of the patients. The rate of osteonecrosis of the femoral head was 10%. Heterotopic bone appeared in 24% of the patients, but function was impaired in only three. Excellent and good results were noted in 76% of the patients. Fractures operated on at > or = 3 weeks (delayed) had a failure rate of 40% compared with 17% for fresh fractures. The failure rate of delayed fractures was negatively influenced by nonoperative treatment initiated before surgery in other centers. Surgical treatment is considered the method of choice for displaced acetabular fractures, provided it is performed by knowledgeable and proficient surgeons.
TL;DR: Protection was reflected by statistically significant increases in survival rate of mice immunized with MoAb KT4 which showed variable serum levels of yeast killer toxin‐like anti‐Id antibodies.
Abstract: Anti-Id antibodies were raised in mice against a monoclonal antibody (MoAb KT4) that neutralized the in vitro activity of a Pichia anomala yeast killer toxin. Monoclonal antibody was administered to BALB/C syngeneic mice with different schedules of immunization before intravenous challenge with increasing amounts of yeast killer toxin-sensitive Candida alhicans cells. The course of candidosis was studied in comparison with mice non-immunized and immunized with an isotypc-matched unrelated MoAb subdivided into control groups. Protection was reflected by statistically significant increases in survival rate of mice immunized with MoAb KT4 which showed variable serum levels of yeast killer toxin-like anti-Id antibodies. MoAb KT4 affinity chromatography purified mouse anti-Id antibodies were capable of killing in vitro the yeast ceils of the Candida albicans strain used for the experimental infection.
This is the first report of antimicrobial protection that exploits the role of anti-idiotypic antibodies presumably acting in vivo as antibiotics (idiotypic vaccination).
TL;DR: The model reproduces lesions similar to those of human posttraumatic osteomyelitis and can be reliably used in pathophysiological and therapeutic studies.
Abstract: A rat model of chronic staphylococcal osteomyelitis was developed. Fibrin glue (5 microliters) and Staphylococcus aureus (2 x 10(6) CFU/5 microliters) were inoculated into the proximal metaphysis of the tibia. The rats were killed at intervals of between 1 and 6 months, and the tibias were removed. Induced lesions were evaluated by radiographic, macroscopic, and histological examinations and bacterial counts. Roentgenograms revealed osteomyelitis in more than 90% of the tibias. Gross bone pathology revealed skeletal deformation, new bone formation, abscesses, and draining skin fistulas in more than 80% of cases. Histological examination revealed osteomyelitis in more than 90% of cases, and bacterial counts were positive in 86% of cases. Only fibrin glue (5 microliters) was inoculated into controls. Controls showed no osteomyelitic lesions, and counts were negative in seven of eight control tibias. The main feature of this model is the use of fibrin glue instead of the sclerosing agents and foreign bodies used in other models. The model reproduces lesions similar to those of human posttraumatic osteomyelitis and can be reliably used in pathophysiological and therapeutic studies.
TL;DR: DNA amplification by the polymerase chain reaction (PCR) is a promising method for the detection of Pneumocystis carinii in immunosuppressed patients, but at the present time, it is believed that it is clinically useful for detection of the disease in BALF samples.
Abstract: Summary. DNA amplification by the polymerase chain reaction (PCR) is a promising method for the detection of Pneumocystis carinii in immunosuppressed patients. The sensitivity and specificity of the PCR technique has been assessed in comparison with the immunofluoresence method (IF) on bronchoalveolar lavage fluid (BALF). Results correlated in 43 (78·8%) of 52 cases studied. P. carinii PCR gave positive results with BALF from all 32 patients found to have P. carinii pneumonia (PCP); IF gave positive results with 26 of them. PCR was more sensitive and as specific as IF. However, at the present time, we do not believe that it is clinically useful for detection of P. carinii in BALF samples. P. carinii DNA amplification by PCR should be reserved for testing IF-negative BALF samples from patients judged clinically to have PCP.