Typing of herpes simplex virus with synthetic DNA probes.

Three single-stranded oligonucleotide probes, 22 bases long, homologous to unique regions of herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and a region common to both were chemically synthesized with use of a modified phosphochloridite protocol. For hybridization experiments each probe was labeled with use of polynucleotide kinase and [gamma-32P] ATP to a specific activity of approximately 2 X 10(9) cpm/micrograms. Two hundred one clinical isolates of HSV (96 HSV-1 and 105 HSV-2) collected from vesicles in the mucocutaneous junction of the mouth or from the genital area were analyzed.

Myocardial infarct size quantification by MR imaging early after coronary artery occlusion in dogs.

The feasibility of using magnetic resonance (MR) imaging to estimate myocardial infarct size was explored in an in vitro model using only the inherent differences in contrast between infarcted and noninfarcted myocardium. Eight dogs underwent coronary occlusion; their hearts were removed 6 hours later. Estimates of T2 for normal and infarcted myocardium were derived from MR images.

Acute subarachnoid hemorrhage: in vitro comparison of magnetic resonance and computed tomography.

The computed tomographic (CT) attenuation values and magnetic resonance (MR) signal intensities of simulated acute subarachnoid hemorrhage were compared systematically. In vitro MR and CT measurements (T1, T2, and Hounsfield units) were made of mixtures of normal human cerebrospinal fluid (CSF) and normal heparinized blood, ranging from 0% to 100% by volume. The mixtures were measured in a plexiglass phantom with a Siemens DR3 CT scanner for attenuation measurements (Hounsfield units) and in the Baylor Bruker Instruments Proton Scanner (6-MHz) using inversion-recovery and spin-echo pulse sequence techniques for T1- and T2-calculated relaxation times.

Revision total knee arthroplasty.

Careful attention to axial alignment, soft tissue balance, and stability will minimize prosthetic failure. In revision arthroplasty a prosthesis designed to replace bone loss with the least constraint possible should be used. In the current series revision of the noninfected failed total knee arthroplasty has provided satisfactory results in 50% to 60% of the patients.

A previously unreported cause of pain after total knee arthroplasty.

Total knee arthroplasty achieves consistently excellent results in most patients. The most common causes of failure are loosening and infection. This article reviews the records of five patients in whom intraarticular fibrous tissue hypertrophy was the cause of pain after total knee arthroplasty.

Computed tomography in infantile spasms: effects of hormonal therapy.

During a prospective double-blind, crossover study of ACTH versus prednisone therapy, serial computed tomography (CT) scans were performed on 16 children with infantile spasms. Pre-treatment scans revealed four findings: normal (6 patients), generalized atrophy (bilaterally enlarged ventricles and/or subarachnoid space) (2 patients), predominantly focal atrophy (3 patients), and congenital anomalies (5 patients). Within 2 weeks of initiating relatively low therapeutic dosages of ACTH or prednisone, a significant number of the infants (63%) had CT findings consistent with decreased cortical volume; in many cases (44%), these findings had not reversed 4 to 6 weeks after discontinuing therapy.

Phase alterations of spin echoes by motion along magnetic field gradients.

Using a Taylor series expansion of the phase shift of a moving isochromatic spin group in the presence of a magnetic field gradient, the refocusing effects of the Carr-Purcell-Meiboom-Gill pulse sequence on stationary nuclei and those with constant, rectilinear velocity are readily demonstrated. Continuing the analysis to higher orders of motion reveals that nuclei with a constant, rectilinear acceleration have a phase shift at the spin echoes which increases linearly with echo number. Constant, rectilinear jerk (the time rate of change of acceleration) leads to an increase in phase shift from echo to echo which is quadratic in nature with an overlying reduction of the odd-numbered echoes by a constant amount.

Long-term low-dose glucocorticoid therapy associated with remission of overt renal tubular acidosis in Sjögren's syndrome.

Renal tubular acidosis and focal interstitial inflammatory cell infiltrate secondary to Sjögren's syndrome remitted with low-dose glucocorticoid therapy over five and one half years in a patient with associated mild systemic lupus erythematosus. Such response has not been previously documented. This observation may have therapeutic applications for renal tubular acidosis associated with Sjögren's syndrome that deserve further investigation.

Hypomorphic variant of the slow allele of C3 associated with hypocomplementemia and hematuria.

This report describes the first instance of a hypomorphic variant (C3*s) of the most common C3 allele, C3 Slow, which was detected in a four-year-old Caucasian boy with hematuria. Analysis of C3 phenotypes, as determined by agarose electrophoresis, showed a hypomorphic C3 Slow in the patient and a maternal aunt. Serum C3 concentration was significantly reduced in the patient and his mother (610 and 750 micrograms/ml; normal +/- 1 SD = 1,240 +/- 240 micrograms/ml) and was at the lower limits of normal in the affected aunt (770 micrograms/ml).

Early motion with cast-brace after modified Coventry high tibial osteotomy.

The records of 31 patients who were treated by a modified Coventry high tibial osteotomy were reviewed, and the early results of postoperative management with a cylinder cast were compared with those with early motion in a cast-brace. Thirteen patients (15 knees) who had immobilization in a cylinder cast after surgery for an average of 44.3 days had lost a mean of 10 degrees of flexion at three months of follow-up study.

Magnetic resonance imaging in multiple sclerosis: results in 32 cases.

A prospective clinical study was performed in 32 patients with multiple sclerosis (MS) to evaluate the sensitivity of lesion detection and accuracy of lesion localization by neurologic examination, delayed enhanced computed tomography (CT) with a double dose of contrast material, and proton magnetic resonance (MR) imaging. After neurologic examination patients were classified by probability of MS (possible, four patients; probable, three patients; and definite, 25 patients) and by disease activity (acute, chronic with acute exacerbation, or chronic progressive). Subsequently they underwent delayed enhanced CT scanning and MR imaging with more than one spin-echo technique.

Improvements in the clinical utility of calculated T2 images of the human brain.

Magnetic Resonance Imaging (MRI) affords a considerable improvement in image contrast over other methods by virtue of the intrinsic NMR parameters spin density, T1, and T2. However, the clinical utility of routine quantification of these parameters is currently unknown. Calculated T2 images might afford additional disease specific information provided the calculation algorithm generates accurate T2 values.

Accurate T1 and spin density NMR images.

We present a method for producing accurate calculated T1 and spin density nuclear magnetic resonance images. A modified Carr-Purcell-Meiboom-Gill pulse sequence is used to obtain a series of images containing both T1 and T2 dependence. The image series is first analyzed to remove the T2 dependence.

Temporal and spatial control of flagellar and chemotaxis gene expression during Caulobacter cell differentiation.

Each Caulobacter cell division yields daughter cells that differ from one another both structurally and functionally. By focusing on the biogenesis of the polar flagellum and the proteins of the chemosensory system, several laboratories have now defined an extensive network of genes whose temporal expression is controlled in the predivisional cell. The differential turn-on of these genes contributes to the generation of asymmetry in the predivisional cell in that the products of these genes are targeted to specific cellular locations.

Iohexol cerebral angiography. Multicenter clinical trial.

Ionic contrast media currently used in cerebral angiography frequently cause discomfort due to hyperosmolality. This double-blind, multicenter trial compared two ionic media, meglumine iothalamate and meglumine-Na diatrizoate, with the new nonionic agent, iohexol, in 277 patients undergoing cerebral angiography. Vital signs, cardiovascular changes, and neurologic status were evaluated before, during, and after injection.

Androgen receptors in breast cancer.

Androgen receptor assays have been performed on 1371 specimens of histologically confirmed primary and recurrent breast cancer. Forty-two patients who had received tamoxifen as treatment for advanced disease were assessed for objective response. Another 42 patients who had received chemotherapy were similarly studied.

Polycentric total knee arthroplasty. A ten-year follow-up study.

After review of the first 209 polycentric total knee arthroplasties (in 159 patients) performed at the Mayo Clinic between July 1970 and November 1971, we found that the calculated probability of the arthroplasty remaining successful ten years postoperatively was 66 per cent. Actual results showed 42 per cent of the arthroplasties to be successful in patients who were still alive at review; another 24 per cent were successful but were in patients who had died or were lost to follow-up before ten years postoperatively. In 34 per cent failure occurred, which we defined as reoperation for any reason, unacceptable pain, or loss of function.

Neuronal effects of water-soluble contrast agents.

The in vitro rat hippocampus slice preparation has been utilized to examine the direct neurotoxicity of water-soluble contrast agents. Intraneuronal recordings were obtained from pyramidal cells in the CA1 field of rat hippocampus slices. Synaptic activity was evoked by Schaffer's collateral stimulation.

Management of the infected total joint arthroplasty.

Infection is the most severe complication of total joint arthroplasty. Prompt recognition and correct management, as well as prophylaxis against infection, are essential to minimize morbidity and maximize function. In this article, the etiology and diagnosis of prosthetic infection and the management of infected total arthroplasties of the hip, knee, ankle, shoulder, elbow, and wrist are discussed.

Fat embolism syndrome after bilateral total knee replacement.

An elderly patient who underwent bilateral total knee arthroplasty suffered the relatively uncommon complication of the fat embolism syndrome; treatment was successful.

Progesterone receptors in breast cancer.

Sixty-six women who had received hormonal therapy for advanced disease were assessed for objective response to treatment. Another 51 patients who had received chemotherapy were similarly studied. Progesterone receptor was of no value as a predictor of patients unlikely to respond to hormone therapy, though it may have a role in predicting patients likely to respond favourably.

Hormone receptors in male breast cancer.

Hormone receptor assays were performed on specimens of breast cancer from 19 male patients over a six year period. Ninety-four per cent were positive for oestrogen receptor, 93% for progesterone receptor and 57% for androgen receptor. Eight patients had hormonal treatment for advanced disease and five (62.

Neurotoxic effects of water-soluble contrast agents on rat hippocampus.

Electrical activity in cells directly exposed to water-soluble radiographic contrast agents was investigated by intracellular and extracellular recordings from neurons in in vitro rat hippocampus slices. Measurements included extracellular field potentials, intracellular resting membrane potential and membrane conductance, postsynaptic events, action potential configurations and spontaneous electrical activity. The neurons were exposed to test solutions of an ionic contrast agent, sodium diatrizoate, and a nonionic contrast agent, metrizamide, as well as control solutions.