Total hip arthroplasty in patients with deficient bone stock and small femoral canals.

Total hip arthroplasty in patients requiring very small femoral stems is a challenge because frequently deformity and inadequate bone stock, especially of the acetabulum, are also present. An analysis of 34 consecutive cases managed with a 9-mm distal diameter noncemented stem was performed. The mean patient age was 42.

Deep brain stimulation of the subthalamic nucleus: effectiveness in advanced Parkinson's disease patients previously reliant on apomorphine.

Objectives: To assess the efficacy of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with advanced Parkinson's disease previously reliant on apomorphine as their main antiparkinsonian medication.

Methods: Seven patients with motor fluctuations despite optimal medical treatment given as predominantly apomorphine infusion (n=6), or intermittent apomorphine injections (n=1) underwent bilateral STN DBS using frameless stereotactic surgery. Standard assessments of parkinsonism and motor fluctuations, using Unified Parkinson's Disease Rating Scale (UPDRS) were performed before and six months after surgery.

A randomized, observer-blinded trial of twice vs. three times weekly narrowband ultraviolet B phototherapy for chronic plaque psoriasis.

Background: The optimum treatment frequency for narrowband (TL-01) ultraviolet B (NB-UVB) in psoriasis is not yet known. We have previously found three times weekly to be preferable to five times weekly treatment in our population.

Objectives: To compare twice weekly with three times weekly NB-UVB phototherapy in chronic plaque psoriasis.

Taking treatment to the patient: development of a home TL-01 ultraviolet B phototherapy service.

Background: While most patients requiring phototherapy can attend for hospital-based out-patient ultraviolet (UV) B therapy, a significant number cannot attend because of geographical, work, economic and other reasons.

Objectives: To determine whether there was a need for home phototherapy in the Tayside area and, if so, to establish protocols and then to assess if such a service would be workable.

Methods: Patients referred from dermatology out-patient clinics in Tayside for narrow-band UVB (TL-01) phototherapy completed a pilot questionnaire that was followed by a two-phase project.

UV-B phototherapy clears psoriasis through local effects.

Objective: To determine if UV-B phototherapy clears psoriasis through systemic effects.

Design: Randomized, within-subject comparison of change in psoriasis in 3 plaques in patients attending for whole-body UV-B therapy. Change in patients' psoriasis plaques covered during UV-B treatment was compared with plaques in an untreated control group.

The long-term success of modular proximal fixation stems in revision total hip arthroplasty.

A prospective study was carried out on the use of a proximally modular, proximal ingrowth noncemented stem in hip revision surgery. There were 109 short stems and 211 long stems. The mean follow-up was 7 years (range, 2-12 years).

Racial misclassification of American Indians in Oklahoma State surveillance data for sexually transmitted diseases.

The burden of sexually transmitted diseases (STDs) is high in American Indian/Alaska Native (AI/AN) populations. In addition, race is often misclassified in surveillance data. This study examined potential racial misclassification of American Indians in STD surveillance data in Oklahoma.

New sunscreens confer improved protection for photosensitive patients in the blue light region.

Background: Some patients with photosensitivity disorders are sensitive to visible radiation. As current commercial sunscreens do not significantly absorb in this region, there is a lack of effective topical photoprotection. To meet this need a new range of sunscreens has been developed incorporating zinc oxide and pigmentary grade titanium dioxide as active ingredients.

Evaluation of the Mycobacterium bovis restriction fragment length polymorphism probe pUCD, in combination with the direct repeat probe, for molecular typing of Mycobacterium tuberculosis strains in Ireland.

A mycobacterial restriction fragment length polymorphism probe, pUCD, has recently been described which represents an effective tool for the strain typing of Mycobacterium bovis. The present study evaluated this probe, in combination with the direct repeat probe (DR), for the molecular typing of 90 strains of Mycobacterium tuberculosis from 87 patients, looking at a group (62 isolates) of nonselected samples to assess pUCD combined with DR as a general tool and a subset of 32 isolates with a common specific IS6110 strain type in Ireland. Within the group of 62 isolates, pUCD-DR identified 42 strains and was comparable to both IS6110 (41 strains) and polymorphic guanine-cytosine-rich sequence (PGRS) (37 strains) analysis.

Dextran reduces embolic signals after carotid endarterectomy.

One hundred fifty patients undergoing carotid endarterectomy were randomly assigned to receive intravenous 10% dextran 40 or placebo. Transcranial Doppler monitoring of the ipsilateral middle cerebral artery 0 to 1 hour postoperatively detected embolic signals in 57% of placebo and 42% of dextran patients, with overall embolic signal counts 46% less for dextran (p = 0.052).

[Modular shafts in hip prosthesis revision surgery].

The introduction of a proximally modular hip stem has greatly simplified difficult hip surgery. The long-term results of revision surgery indicate that the majority of revision cases can be handled with a proximal ingrowth implant, which helps speed bone recovery and simplifies re-revision if it is required. To date no particular downside has been noted as a result of the use of a modular stem.

Adult neurogenesis produces a large pool of new granule cells in the dentate gyrus.

Knowing the rate of addition of new granule cells to the adult dentate gyrus is critical to understanding the function of adult neurogenesis. Despite the large number of studies of neurogenesis in the adult dentate gyrus, basic questions about the magnitude of this phenomenon have never been addressed. The S-phase marker bromodeoxyuridine (BrdU) has been extensively used in recent studies of adult neurogenesis, but it has been carefully tested only in the embryonic brain.

An unusual case of trisomy and triploidy in a chorion villus biopsy.

A case is reported of a 35-year-old woman who underwent a chorion villus biopsy (CVB) at 17 weeks' gestation after intrauterine growth retardation and oligohydramnios were diagnosed by ultrasound scan. Chromosome analysis of the CVB direct preparations showed a 47,XX,+6 karyotype in all cells. The pregnancy was terminated and subsequent analysis of cultured cells from both the CVB and the post-mortem placenta showed three cell lines: 46,XX, 47,XX,+6 and 69,XXX, while fetal skin and muscle were entirely 69,XXX.

Glucose-6-phosphatase mutation G188R confers an atypical glycogen storage disease type 1b phenotype.

Glycogen storage disease type 1a (GSD 1a) is caused by a deficiency in microsomal glucose-6-phosphatase (G6Pase). A variant (GSD 1b) is caused by a defect in the transport of glucose-6-phosphate (G6P) into the microsome and is associated with chronic neutropenia and neutrophil dysfunction. Mutually exclusive mutations in the G6Pase gene and the G6P transport gene establish GSD la and GSD 1b as independent molecular processes and are consistent with a multicomponent translocase catalytic model.

Glucagon-like peptide-2 enhances intestinal epithelial barrier function of both transcellular and paracellular pathways in the mouse.

Background And Aims: Glucagon-like peptide-2 (GLP-2) is a recently identified potent intestinotrophic factor. We have evaluated the effect of GLP-2 treatment on intestinal epithelial barrier function in mice.

Methods: CD-1 mice were injected subcutaneously with GLP-2 or a protease resistant analogue, h[Gly(2)]GLP-2, twice daily for up to 10 days.

Transfection of alpha(1,3)fucosyltransferase antisense sequences impairs the proliferative and tumorigenic ability of human colon carcinoma cells.

Sialyl Lewis x and sialyl Lewis a are oncodevelopmental antigens involved in the pathogenesis of colon adenocarcinoma. Biosynthesis of these glycans is controlled by alpha(1,3/1,4)fucosyltransferases. We report the disruption of sialyl Lewis x/a biosynthesis and inhibition of colon carcinoma cell proliferation by stable transfection of antisense sequences directed at the human Lewis alpha(1,3/1,4)fucosyltransferase gene, FUT3, and the plasma alpha(1,3)fucosyltransferase gene, FUT6.