Optical coherence tomography: its clinical use for the diagnosis, pathogenesis, and management of macular conditions.

Background: Optical coherence tomography (OCT) is a noninvasive, noncontact transpupillary imaging technology that can image retinal structures in vive with a resolution of up to 10 microns. Anatomic layers within the retina can be differentiated and retinal thickness measured. The objective is to demonstrate clinical viability and useful interpretation of macular images derived from a commercially available OCT instrument.

Polypoidal choroidal vasculopathy.

Background: Polypoidal choroidal vasculopathy (PCV) is a unique form of occult choroidal neovascular membrane. The clinical presentation and angiographic findings distinguish idiopathic PCV from other known neovascular and choroidal degenerative disorders. The characteristic morphology of PCV includes the presence of a branching network of inner choroidal vessels with terminal aneurysmal dilations.

Retinal angiomatous proliferation: clinical characteristics and treatment options.

Background: A new form of exudative age-related macular degeneration (ARMD), retinal angiomatous proliferation (RAP), has been described in which neovascularization begins in the deep retina, extends through the subretinal space, and eventually communicates with choroidal neovascularization.

Methods: Case series.

Results: Common clinical features of RAP include small multiple intra-retinal hemorrhages, intra-retinal edema, vascularized pigment epithelial detachments (PEDs), and retinal choroidal anastomosis (RCA).

Early age of first sex: a risk factor for HIV infection among women in Zimbabwe.

Objective: To explore the relationship between early age of coital debut (15 years of age or younger) and risk for HIV infection among sexually active urbanized Zimbabwean women.

Design: Cross-sectional analysis of screening data from a cohort study.

Methods: Sexually active women aged 18-35 years were recruited from public sector family planning clinics in and around Harare, Zimbabwe between November 1999 and September 2002.

What's all that noise? The effect of co-morbidity on health outcome questionnaire results after knee arthroplasty.

Background: We modified the Charnley Classification for hips to facilitate its use with knee arthroplasty patients and investigated what affect the different classes of co-morbidity had on the results of a spectrum of outcome questionnaires.

Patients And Methods: 3600 patients from the Swedish Knee Arthroplasty Registry were surveyed by post with a variety of questionnaires ranging from multiple-item general health, to a single-item knee arthroplasty specific questionnaire. All patients also completed a co-morbidity questionnaire, from which a modified Charnley Classification was generated for each patient.

Atypical presentation and review of the ICE syndrome.

Background: The different variants of the iridocorneal endothelial (ICE) syndrome were separately described in the early to mid-1900's and were eventually linked to a common etiology of an abnormal corneal endothelium. The ICE syndrome typically manifests in early to middle adulthood, usually occurs in women, and is almost always unilateral. Management of patients with any variant of the ICE syndrome challenges even the best clinicians.

Efficacy of a commercial produce wash on bacterial contamination of lettuce in a food service setting.

Many microorganisms (including a number of important foodborne pathogens) can be present on raw fruits and vegetables. Since these products are frequently eaten raw, any pathogens present represent a potential risk to the consumer. The objective of this study was to compare the efficacy of a commercial produce wash with that of water for reducing the total bacterial population on lettuce when used by food service employees in university dining halls.

Extensor mechanism failure associated with total knee arthroplasty: prevention and management.

Extensor mechanism complications are the most commonly reported reasons for revision surgery after total knee arthroplasty and are a frequent source of postoperative morbidity. Patellofemoral instability is the most commonly reported extensor mechanism complication and has multiple etiologies, including prosthetic malalignment and soft-tissue imbabalce. Patellar fracture or rupture of either the quadriceps or patellar tendon can cause catastrophic disruption of the extensor mechanism.

Hair-cycle-dependent expression of parathyroid hormone-related protein and its type I receptor: evidence for regulation at the anagen to catagen transition.

The humoral hypercalcemia factor parathyroid hormone-related protein is a paracrine-signaling molecule that regulates the development of several organ systems, including the skin. In pathologic circumstances such as hypercalcemia and in development, parathyroid hormone-related protein signaling appears to be mediated by the type I parathyroid hormone/parathyroid hormone-related protein receptor. In order to clarify the role of the ligand and receptor pair in cutaneous biology, gene expression was monitored in a series of murine skin samples ranging from embryonic day 14 to 2 y with in situ hybridization and RNase protection.

Blood parasites in sage-grouse from Nevada and Oregon.

Peripheral blood smears from 196 adult and yearling female greater sage-grouse (Centrocercus urophasianus) were examined for blood parasites (167 from the breeding and 29 from the brood-rearing season) to determine prevalence of blood parasites, to attempt to correlate infection with chick survival, and to establish base-line values of prevalence in sage-grouse from Nevada and Oregon (USA). Birds were captured and released on two study areas during 1999-2001; Sheldon National Wildlife Refuge (SNWR) in northwestern Nevada, and Hart Mountain National Antelope Refuge (HMNAR) in southeastern Oregon. Birds from a third study area, Beaty's Butte grazing allotment (BB) in southeastern Oregon, were sampled in 2000 and 2001.

The 677 C-T methylenetetrahydrofolate reductase mutation does not predict increased maternal homocysteine during pregnancy.

Objective: To test the hypothesis that, regardless of the presence of the 677 C-T methylenetetrahydrofolate reductase (MTHFR) mutation, maternal homocysteine concentrations will not be significantly different in women who are taking prenatal vitamins containing folic acid, and to test this relationship in preeclampsia because homocysteine concentrations are higher in preeclamptic pregnancies.

Methods: Fifty-seven pregnant white women (control and preeclamptic) with and without the 677 C-T MTHFR mutation were studied. Total plasma homocysteine and plasma folic acid were analyzed.

A cost analysis of the prostaglandin analogs.

Background: The efficacy, ease of use, and favorable side effect profile has increased the popularity of the prostaglandin analogs for topical treatment of a variety of glaucoma types. We undertook a cost analysis study of all the prostaglandin analogs.

Methods: Mean number of drops per bottle, mean drop volume, total bottle volume, percent overfill per bottle, mean national bottle cost, daily cost of therapy, and yearly cost of therapy were calculated for all four of the prostaglandin analogs.

Overexpression of parathyroid hormone-related protein causes hypercalcemia but not bone metastases in a murine model of mammary tumorigenesis.

Several lines of evidence suggest that production of parathyroid hormone-related protein (PTHrP) by breast cancer cells contributes to the formation of bone metastases. However, it is not clear if PTHrP promotes access of cancer cells to the skeleton or if it simply promotes bone resorption around cells already within bone. To study the effects of PTHrP on the development of bone metastases, we treated mice overexpressing PTHrP in their mammary glands (K14-PTHrP transgenic mice) with 9,10-dimethyl-1,2-benz-anthracene (DMBA), a known mammary carcinogen.

Press-fit versus cemented all-polyethylene patellar component: midterm results.

This study compared the midterm results between press-fit and cemented implantation of a highly congruent, all-polyethylene patellar component. We followed prospectively 172 implants (cemented, n = 133; press-fit, n = 39). Average follow up was 6 years (range, 5-8 years).

The John Charnley Award: Three-dimensional analysis of the cement mantle in total hip arthroplasty.

Cemented fixation of the femoral stem is the gold standard for patients older than 60 years. The importance of reliably achieving an adequate cement mantle has been shown in many studies. Currently, inspection and grading of plain radiographs is the accepted method for study of the cement mantle.

Polyethylene wear of the porous-coated anatomic total hip arthroplasty with an average 11-year follow-up.

The purpose of this study was to identify the factors that affect polyethylene wear of 55 porous-coated anatomic total hip arthroplasties after 9 to 14 years selected from a study population of 311 implants. The average three-dimensional linear, two-dimensional linear, and volumetric wear rates were 0.096 mm/y, 0.

Temporally regulated overexpression of parathyroid hormone-related protein in the mammary gland reveals distinct fetal and pubertal phenotypes.

We have previously demonstrated that overexpression of parathyroid hormone-related protein (PTHrP) in the mammary glands of transgenic mice results in defects in ductal elongation and branching during puberty and in lobuloalveolar development during pregnancy. In addition, we have shown that PTHrP is necessary for the formation of the initial ductal tree during embryonic mammary development. In order to examine the effect of varying the timing of PTHrP overexpression on mammary development, we created tetracycline-regulated, K14-tTA/Tet(O)-PTHrP double transgenic mice.

The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty.

Background: We previously reported our two and five-year results of arthroplasty with the Porous Coated Anatomic total hip prosthesis. We now report on the performance of this prosthesis at ten to fourteen years.

Methods: The results of 311 total hip replacements in which a Porous Coated Anatomic prosthesis was inserted without cement in 279 patients were analyzed prospectively.

Patient satisfaction compared with general health and disease-specific questionnaires in knee arthroplasty patients.

When assessing the health status of patients after orthopaedic surgery, such as knee arthroplasty, general health and disease-specific questionnaires are gaining in popularity because of their precision in detecting subtle differences. Self-administered postal surveys using extensive questionnaires have associated patient burden, however, which may have an impact on response rate and completeness. When a high response rate is important or when the use of comprehensive questionnaires is not practical, it may be possible to gain useful outcome data after a surgical procedure by simpler means.

Osteolysis of the femur: principles of management.

Femoral osteolysis is and will remain an important cause of THA failures. The presentation is initially radiographic and patients may or may not become symptomatic. If so, pain is the most common symptom.

Appropriate questionnaires for knee arthroplasty. Results of a survey of 3600 patients from The Swedish Knee Arthroplasty Registry.

The Swedish Knee Arthroplasty Registry (SKAR) has recorded knee arthroplasties prospectively in Sweden since 1975. The only outcome measure available to date has been revision status. While questionnaires on health outcome may function as more comprehensive endpoints, it is unclear which are the most appropriate.

Effects of cocaine on fixed-interval responding reinforced by the opportunity to run.

Rate-dependent drug effects have been observed for operant responding maintained by food, water, heat, light onset, electrical brain stimulation, shock-stimulus termination, and shock presentation. The present study sought to determine if the effects of cocaine on lever pressing maintained by the opportunity to run could also be described as rate dependent. Seven male Wistar rats were trained to respond on levers for the opportunity to run in a wheel.

Parathyroid hormone-related protein maintains mammary epithelial fate and triggers nipple skin differentiation during embryonic breast development.

Prior reports have demonstrated that both parathyroid hormone-related protein (PTHrP) and the type I PTH/PTHrP receptor are necessary for the proper development of the embryonic mammary gland in mice. Using a combination of loss-of-function and gain-of-function models, we now report that PTHrP regulates a series of cell fate decisions that are central to the survival and morphogenesis of the mammary epithelium and the formation of the nipple. PTHrP is made in the epithelial cells of the mammary bud and, during embryonic mammary development, it interacts with the surrounding mesenchymal cells to induce the formation of the dense mammary mesenchyme.