The clinical associations of mitotic spindle autoantibodies in a South Australian cohort.

Background: The mitotic spindle apparatus (MSA) is a unique structure of microtubules and associated proteins involved in the segregation and reorganisation of chromosomes during cell division. Autoantibodies to the MSA (anti-MSA) are reported to occur rarely, but are easily identified during the immunofluorescent detection of anti-nuclear antibodies (ANA), and are generally reported as part of that investigation.

Aims: As the clinical significance of these antibodies is unknown, our aim was to identify the clinical features of subjects identified with anti-MSA, and in a subset investigate the co-association with organ specific anti-thyroid antibodies.

The effect of blood transfusion protocol on retinopathy of prematurity: A prospective, randomized study.

Objective: Controversy exists regarding the potential influence of anemia and blood transfusions on the rate of retinopathy of prematurity (ROP) in premature infants. A prospective, randomized, masked trial was performed to determine the influence of red blood cell transfusion protocol on ROP incidence and severity in a population of high-risk infants.

Methods: A total of 50 infants with birth weights <1251 g were divided randomly into two groups beginning on day of life 29.

Lifetime physical activity is associated with bone mineral density in premenopausal women.

Osteoporosis causes premature disability among millions of elderly people in the United States, particularly women. Exercise helps to maintain bone mass, yet it remains unclear what type of physical activity during what age periods is most beneficial for bone mass and density. This cross-sectional study investigated the relationship between different measures of lifetime physical activity and bone mineral density (BMD) in 25 premenopausal women (mean age 41 years, range 28-50 years).

International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA).

Antineutrophil cytoplasmic antibody (ANCA) tests are used to diagnose and monitor inflammatory activity in the primary systemic small vessel vasculitides. ANCA is best demonstrated in these diseases by using a combination of indirect immunofluorescence (IIF) of normal peripheral blood neutrophils and enzyme-linked immunosorbent assays (ELISAs) that detect ANCA specific for proteinase 3 (PR3) or myeloperoxidase (MPO). For ANCA testing in "new" patients, IIF must be performed on all serum samples.

Frequency and characteristics of lingual thyroid not detected by screening.

Four patients with lingual thyroid glands presenting beyond the neonatal period have been evaluated at the Hospital for Sick Children, Toronto since the advent of neonatal TSH screening. All were female, clinically euthyroid at diagnosis and presented with symptoms of a lingual mass. We estimate that 1.

Parathyroid adenoma after radiation in an 8-year-old boy.

We describe an 8-year-old boy who had asymptomatic hypercalcemia 4 years after radiotherapy involving the left orbit and lungs. A right parathyroid adenoma was diagnosed, and normocalcemia was achieved after its removal. Routine monitoring of serum calcium and phosphate levels is recommended for children after head and neck irradiation.

Expression and function of the leucine zipper protein Par-4 in apoptosis.

The prostate apoptosis response-4 (par-4) gene was identified by differential screening for genes that are upregulated when prostate cancer cells are induced to undergo apoptosis. The par-4 gene is induced by apoptotic signals but not by growth-arresting, necrotic, or growth-stimulatory signals. The deduced amino acid sequence of par-4 predicts a protein with a leucine zipper domain at its carboxy terminus.

The effect of substrate utilization, manipulated by nicotinic acid, on excess postexercise oxygen consumption.

Increased fat oxidation during the recovery period from exercise is thought to be a contributing factor for excess postexercise oxygen consumption (EPOC). In an attempt to study the effect of serum free fatty acid (FFA) availability during exercise and recovery on the EPOC, nicotinic acid, a potent inhibitor of FFA mobilization from adipose tissue, was administered to five trained male cyclists prior to, during, and after a bout of cycling at 65% VO2max. In the nicotinic acid trial, a 500 mg dose of nicotinic acid was ingested prior to exercise, and 100 mg doses were ingested at 15, 30, and 45 min exercise, and 30 min recovery.

Diabetes prevalence rates among First Nations adults on Saskatchewan reserves in 1990: comparison by tribal grouping, geography and with non-First Nations people.

Objective: To determine age-specific, sex-specific and total prevalence rates of diabetes mellitus among Saskatchewan First Nations adults and to compare these rates by tribal grouping, geography and with non-First Nations people.

Design: A point prevalence study of all Saskatchewan reserves in 1990.

Results: Age-adjusted rates of diabetes mellitus were higher (risk ratio 1.

Roux-en-Y jejunostomy in the pediatric population.

Surgical access for nutrition is required in a variety of pediatric disorders. In some, the presence of gastroesophageal reflux, poor gastric emptying, and risks for fundoplication favor the use of a jejunostomy. The significant problems associated with the simple loop jejunostomy can be avoided by using the Roux-en-Y configuration.

Clinical associations of anti-lamin autoantibodies.

Background: The clinical associations of anti-lamin autoantibodies were first described in 1973. Since then a number of individual case reports and two small series have been published. These have suggested an association with connective tissue disorders and autoimmune liver disease.

Maximal effort during functional capacity evaluations: an examination of psychological factors.

Background And Purpose: Patients with low back pain are often administered a Functional Capacity Evaluation (FCE) to determine levels of physical functioning at the conclusion of their rehabilitation program. The purpose of this study was to examine the relationship between psychological factors (ie, self-reported disability, anxiety, depression, self-efficacy) and maximal effort exerted during the FCE.

Subjects And Methods: Sixty-four patients with low back pain were administered the the Oswestry Low Back Disability Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, and the FCE Self-Efficacy Scales before administration of the FCE.

Bone mineral density in mother-daughter pairs: relations to lifetime exercise, lifetime milk consumption, and calcium supplements.

This study investigated associations between lifetime milk consumption, calcium intake from supplements, lifetime weight-bearing exercise, and bone mineral density (BMD) among 25 elderly women (mean age 72 y) and their premenopausal daughters (mean age 41 y). The BMD of the total, axial, and peripheral skeleton was measured by dual-energy X-ray absorptiometry. Lifetime milk consumption, supplemental calcium intake, and weight-bearing exercise were estimated retrospectively by questionnaire and interview.

Neutrophils activated by granulocyte-macrophage colony-stimulating factor express receptors for interleukin-3 which mediate class II expression.

Freshly isolated peripheral blood neutrophils, unlike monocytes and eosinophils, do not bind interleukin-3 (IL-3) or respond to IL-3). We show that neutrophils cultured for 24 hours in granulocyte-macrophage colony-stimulating factor (GM-CSF) express mRNA for the IL-3 receptor (R) alpha subunit, as shown by RNase protection assays, and IL-3R alpha chain protein, as shown by cytometric analysis using two different specific monoclonal antibodies. This effect was selective for GM-CSF, because granulocyte colony-stimulating factor, tumor necrosis factor-alpha, interferon-gamma, and IL-1 failed to induce the IL-3 receptor.

Survival in neonatal congenital hernia without extracorporeal membrane oxygenation support.

The experience with high-risk congenital diaphragmatic hernia (CDH) at an institution that does not offer extracorporeal membrane oxygenation (ECMO) was reviewed. Between January 1, 1983 and December 31, 1993, 38 children presented with Bochdalek-type CDH. Excluded were two infants with lethal cardiac anomalies and four presenting after 4 hours of age.

Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea.

Female athletes exhibit a higher prevalence of exercise-associated amenorrhea and oligomenorrhea compared with nonathletic women, and both conditions are related to reduced bone mineral density (BMD), particularly at the spine. This study investigated bone mass and oligomenorrhea and amenorrhea in two groups of competitive female athletes with different skeletal loading patterns: gymnasts and runners. Bone mineral density (g/cm2) of the femoral neck, lumbar spine (L2-4), and whole body was assessed by dual energy X-ray absorptiometry (QDR-1000/W, Hologic Inc.

Toxic epidermal necrolysis associated with Klebsiella pneumoniae sepsis.

Toxic epidermal necrolysis (TEN) is a rare condition in childhood usually attributed to drugs. We describe a 4-month-old infant who developed typical clinical and histologic findings of TEN concomitantly with Klebsiella pneumoniae sepsis. We emphasize that in cases of acute, severe exfoliative disease in infants, apart from staphylococcal infection, gram-negative bacterial sepsis must also be considered.

Screening and monitoring coeliac disease: multicentre trial of a new serum antibody test kit.

A multicentre trial was conducted to evaluate a new test for anti-gliadin antibodies (AGA) in serum (Coeliac Screening Kit, CSK, Medical Innovations Limited, Artarmon, NSW, Australia). The test showed excellent reproducibility for both anti-gliadin IgA and IgG detection. The average intraassay coefficient of variation (CV) was 3.

Thrombotic complications of saphenous central venous lines.

Authors of recent publications advocate central venous access by saphenous vein cutdown in the thigh. Even relatively inert SILASTIC catheters are recognized to convey a risk of large vein thrombosis when maintained for long periods. Thrombosis of the inferior vena cava (IVC) and tributaries place the patient at risk for a spectrum of problems not associated with superior vena cava (SVC) cannulation.

Repair of pectus excavatum using a Dacron vascular graft strut.

Long-term follow-up was obtained for 161 patients who underwent a modified Ravitch repair of pectus excavatum. In all cases, the substernal strut was fashioned from a Dacron vascular graft. Follow-up was done by telephone (most cases) and also by office visit (43 cases).