Heterotopic ossification after cemented or uncemented bateman bipolar hemiarthroplasty

BACKGROUND: This is a retrospective study to evaluate the incidence of heterotopic ossification (HO) in cemented and uncemented femoral neck fractures treated with Bateman bipolar hemiarthroplasty. METHODS: From October 1985 to July 1990, there were 451 cases of displaced intracapsular fractures of the femoral neck treated with Bateman bipolar hemiarthroplasty (261 uncemented vs 190 cemented) at the Veterans General Hospital-Taipei. RESULTS: After an average follow-up of 46 months, there was more HO in the cemented group than in the uncemented group (p = 0.014, chi-squared test). The average surgical time was approximately 20 minutes longer and the average blood loss was approximately 160 ml more in the cemented Bateman bipolar hemiarthroplasty group. CONCLUSIONS: HO formation is more common in cemented Bateman bipolar hemiarthroplasty than in the uncemented procedure. The incidence of HO is not related to age or sex.     

CAG repeat expansion in autosomal dominant familial spastic paraparesis: novel expansion in a subset of patients

Autosomal dominant familial spastic paraplegia (FSP) is a genetically heterogeneous neurodegenerative disorder displaying anticipation for which three loci have been mapped to the chromosomal positions 14q11.2-q24.3 (SPG3), 2p21-p24 (SPG4) and 15q11.1 (SPG6). The repeat expansion detection (RED) method has been used to demonstrate expanded CAG repeats in some FSP families that map to SPG4. We analyzed 20 FSP families, including four for which there is evidence for linkage to SPG4, and found that in most cases the repeat expansion detected by RED is due to non-pathogenic expansions of the chromosome 18q21.1 SEF2-1 or 17q21.3 ERDA1 locus. Polymorphic expansions at SEF2-1 and ERDA1 appear frequent and may confound RED studies in the search for genes causing disorders demonstrating anticipation. In six FSP families, however, CAG repeat expansion was detected in a subset of affected and at-risk individuals that did not result from expansion of the SEF2-1 and ERDA1 loci. Overall, 11 of 37 (30%) of the FSP patients with a CAG/CTG repeat expansion are unaccounted for by the SEF2-1 and ERDA1 loci, compared with two of 23 (9%) of the unaffected at-risk individuals and none of 19 controls. In the majority of cases these novel expansions were shorter than those previously reported.     

The extravesicular domain of synaptotagmin-1 is released with the latent fibroblast growth factor-1 homodimer in response to heat shock

The heparin-binding fibroblast growth factor (FGF) prototypes lack a classical signal sequence, yet their presence is required in the extracellular compartment for the activation of cell-surface receptor-dependent signaling. Early studies with FGF-1 demonstrated its presence in bovine brain as a novel high molecular weight complex, and subsequent studies identified a second heparin-binding protein that co-purified with FGF-1. Polypeptide sequence analysis revealed that this heparin-binding protein corresponded to the extravesicular domain of bovine synaptotagmin (Syn)-1, a transmembrane component of synaptic vesicles involved in the regulation of organelle traffic. Since FGF-1 is released in response to heat shock as a mitogenically inactive Cys-30 homodimer, we sought to determine whether this heparin-binding protein was involved in the release of FGF-1. We report that a proteolytic fragment of the extravesicular domain of Syn-1 is associated with FGF-1 in the extracellular compartment of FGF-1-transfected NIH 3T3 cells following temperature stress. By using heparin-Sepharose affinity to discriminate between the monomer and homodimer forms of FGF-1 and resolution by conventional and limited denaturant gel shift immunoblot analysis, it was possible to identify FGF-1 and Syn-1 as potential components of a denaturant- and reducing agent-sensitive extracellular complex. It was also possible to demonstrate that the expression of an antisense-Syn-1 gene represses the release of FGF-1 in response to heat shock. These data indicate that FGF-1 may be able to utilize the cytosolic face of conventional exocytotic vesicles to traffic to the inner surface of the plasma membrane where it may gain access to the extracellular compartment as a complex with Syn-1.     

Rapid diagnosis of tuberculous meningitis by polymerase chain reaction assay of cerebrospinal fluid

A polymerase chain reaction (PCR) method for the rapid diagnosis of tuberculous meningitis (TBM) was used to study prospectively 47 cerebrospinal fluid (CSF) samples from 45 patients. Twenty CSF samples were from patients with clinically suspected TBM and another 27 samples came from patients without clinically suspected TBM. Mycobacterial DNA was detected in 15 CSF samples (14 from patients with clinically suspected TBM and 1 from a patient not suspected of having TBM). Of the PCR-positive samples, 4 were also positive for mycobacterial culture. However, 32 PCR-negative samples were all culture-negative. All samples were negative for the acid-fast bacillus by direct smear. The single PCR-positive patient in the clinically unsuspected TBM group was initially diagnosed as suffering from aseptic meningitis on the basis of his clinical features. The mycobacterial culture of his CSF specimen was also positive and a revised diagnosis of an aseptic type of TBM was made. The estimations of specificity and sensitivity in this study were 100% and 70% respectively. The results showed that using a PCR to detect mycobacterial DNA in CSF for the early diagnosis of TBM is not only a rapid but also an accurate method.     

Total hip arthroplasty with use of second-generation cementing techniques. An eighteen-year-average follow-up study

In this report, we present the results of a further follow-up of a series of 140 consecutive patients (161 hips) who had had a primary total hip arthroplasty with insertion of a bead-blasted monoblock femoral component with use of so-called second-generation cementing techniques. The average age of the patients at the time of the arthroplasty was sixty-one years (range, twenty-one to eighty-five years). Sixty-seven patients (seventy-seven hips) died less than seventeen years after the index operation. The remaining seventy-three patients (eighty-four hips) were followed for an average of eighteen years (range, seventeen to twenty years). No patient was lost to follow-up. In the entire group of 161 hips, over the twenty-year span of the study, eight femoral components (5 percent) and twenty-eight acetabular components (17 percent) had been revised because of aseptic loosening. Of the seventy-seven hips in the sixty-seven patients who died, four had been revised because of aseptic loosening of the acetabular component only; one, because of aseptic loosening of the femoral component only; and one, because of aseptic loosening of both components. Of the eighty-four hips in the seventy-three patients who were alive at least seventeen years after the index arthroplasty, twenty-four hips (29 percent) in twenty-one patients had had revision of one or both components for any reason. Twenty-three acetabular components (27 percent) and six femoral components (7 percent) had been revised because of aseptic loosening. An additional two hips (2 percent) in two patients were loose according to radiographic criteria but had not been revised. Of the sixty-five all-polyethylene acetabular components that had been inserted with cement and were in patients who were alive at least seventeen years postoperatively, fifteen (23 percent) had been revised because of aseptic loosening. An additional seventeen cups (26 percent) were loose according to radiographic criteria. Thus, a total of thirty-two cups (49 percent) had been revised because of loosening or were loose but had not been revised at the time of the latest follow-up. The femoral components that had been inserted with use of second-generation cementing techniques fared better than did the acetabular components that had been inserted with these techniques during the same time-period. We found that assessment of all postoperative radiographs rather than only those that had been made immediately postoperatively increased the accuracy of the grading of the cement around the femoral component. Subsequent radiographs frequently had been made at different projections, which revealed new findings, consisting primarily of previously undetected voids, areas of thin cement, and defects in the cement mantle. Thus, we now use all available radiographs to determine the grade of the cement.     

A Python toolbox for computing solutions to canonical problems in electromagnetics

One of the most important steps in the development of any numerical code is the validation of the implementation by comparison of the results obtained for a set of test cases to the exact solution. In the context of codes developed for high-frequency electromagnetics, this usually means comparing computed results to analytical solutions. Obtaining these analytical solutions can be a nontrivial problem, although fortunately it need only be implemented once, and can then be used repeatedly to validate any new code. This paper concentrates on finding the analytical solution to eigenvalue problems for a range of standard geometries, as well as the near-field solution for plane-wave scattering from a PEC sphere. The solutions are implemented using the Python programming language and the SciPy library of scientific functions.     

Risk factors for colorectal cancer in a prospective study among U.S. white men

The mRNA expression of presenilin-1 (PS1) and beta-amyloid precursor protein (betaAPP) was investigated in the embryonic day 20 rat olfactory bulb, nasal cavity, and inner ear using in situ hybridization histochemistry. In the olfactory bulb, PS1 mRNA was strongly expressed in both olfactory bulb neuroepithelium and the differentiating olfactory bulb. In contrast, betaAPP mRNA was preferentially expressed in differentiating fields. In the nasal cavity, PS1 mRNA was strongly expressed throughout the olfactory epithelium, while betaAPP mRNA expression was concentrated in the middle part of the epithelium. In the membrane labyrinth of the inner ear, although PS1 mRNA was evenly distributed in both sensory epithelium and supporting cells, betaAPP mRNA was exclusively expressed in the sensory epithelium. These data suggest that PS1 is expressed earlier than betaAPP, and that PS1 and betaAPP co-operatively play pivotal roles in the development of the olfactory and vestibulocochlear systems.