Intercondylar notch measurements with special reference to anterior cruciate ligament surgery.

The femoral intercondylar notch width was measured in 93 patients with chronic anterior cruciate ligament (ACL) insufficiency (Group 1), in 62 patients with an acute tear of the ACL (Group 2), and in 38 fresh anatomic specimen knees (Group 3). In six of the specimen knees, further anatomic studies of the intercondylar notch were performed after tissue removal. The average intercondylar distance was 16.

Coronary atherectomy. An alternative to balloon angioplasty.

To date, physicians at our hospital have performed coronary atherectomy on 15 patients. Of these patients, four needed open heart surgery. One patient needed surgery because a vessel was dissected during the procedure, and the three other patients had unsuccessful procedures.

Myelin proteolipid protein contains thioester-linked fatty acids.

Myelin proteolipid protein (PLP) is known to contain long-chain, covalently bound fatty acids. Previous studies, including our own, have suggested the occurrence of an oxyester type of linkage between fatty acids and PLP. However, we found that protein-SH groups are required in the acylation reaction, suggesting the possible presence of thioesters.

An outbreak of hepatitis B associated with jet injections in a weight reduction clinic.

From January 1984 through November 1985, 31 clinical cases of hepatitis B occurred among attendees of a weight reduction clinic (clinic 1). Before the onset of illness, each case-patient had received a series of injections of human chorionic gonadotropin administered by jet injectors at clinic 1. Clinical history, risk factor assessment, serologic evaluation, and review of clinic injection records were obtained on 287 (84%) of 341 persons who had attended clinic 1 in the first 6 months of 1985.

Cysteine-108 is an acylation site in myelin proteolipid protein.

Myelin proteolipid protein (PLP) contains covalently bound long-chain fatty acids. A large proportion of these acyl moieties are bound in thioester linkages, as demonstrated by alkylation of newly formed SH groups upon deacylation. To identify the Cys residue(s) involved in the thioester linkage(s), reduced and carboxyamidomethylated proteolipid protein was labeled with [14C]iodoacetamide upon deacylation with neutral hydroxylamine.

Load tolerance, security, and failure modes of fixation devices for synthetic knee ligaments.

One weak link in synthetic ligament reconstruction of the knee is the fixation device-ligament-bone interface. In this study, a laboratory model using bovine calf bone was designed to evaluate six different fixation devices combined with either an unlooped ligament in different configurations or a looped ligament. Results are expressed in terms of maximum load to failure, elongation at the site of fixation, stiffness of fixation prior to failure, and mode of failure.

Surgical or non-surgical treatment of acute rupture of the anterior cruciate ligament. A randomized study with long-term follow-up.

One hundred and eleven consecutive patients who had acute injuries to the knee that included rupture of the anterior cruciate ligament, as shown by physical examination with the patient under anesthesia and by diagnostic arthroscopy, were randomized to three treatment groups: simple repair of all injured structures, repair of all injured structures and augmentation of the anterior cruciate ligament with a strip of the iliotibial band, and repair of all injured structures except the anterior cruciate ligament. In all other respects, the knees were treated in an identical fashion. Of the 111 patients, 107 were re-examined forty-five months or more after operation.

Failure of a bovine xenograft for reconstruction of the anterior cruciate ligament.

Fourteen patients with gross anterior instability had the anterior cruciate ligament reconstructed with a bovine xenograft. Major problems with swelling, pain, and synovitis were encountered in 13 patients, of whom 3 developed a synovial fistula. Histologic evidence for allergic reactions was found in 3 patients.

Precision in reconstruction of the anterior cruciate ligament. A new positioning device compared with hand drilling.

To evaluate the precision of a drill guide for use in anterior cruciate ligament reconstruction and the reproducibility of the results, the device was tested in 30 operations (Group 1); 17 operations were done freehand (Group 2); 10 cadaver knees served as anatomic controls. The internal orifices of the bony channels in Groups 1 and 2 and the central point of the anterior cruciate ligament attachments in the cadaver group were identified on lateral radiographic views. The position of the tibial ligament attachments in the cadaver group did not differ from the orifices of the drilled channels in Groups 1 and 2.

Some simple computational methods to improve the folding of large RNAs.

Computational methods are described which increase the efficiency of the RNA folding algorithm described by Zuker and Stiegler. Bit addressing has been used to reduce the memory requirements from 2NxN to NxN/2. The order in which the nucleotide sequence is examined internally has been altered, and some additional short arrays which carry temporary information have been introduced.

Identification of patients with cholesterol or pigment gallstones by discriminant analysis of radiographic features.

In a search for a way to distinguish cholesterol gallstones from pigment gallstones by oral cholecystography, we evaluated 56 patients with surgically confirmed cholelithiasis. Only buoyancy was highly predictive of gallstone composition: all 14 patients with floating stones had cholesterol stones (P less than 0.01), but only one third of the patients with cholesterol stones had stone buoyancy.

Ultrasonic properties of gallstones. Effect of stone size and composition.

In vivo and in vitro ultrasonic characteristics of gallstones were compared with stone size and composition with the aim of understanding the basis for these features. In vivo and in vitro ultrasonic features of the same stone were identical. Acoustic shadowing was not due to stone type, radiodensity, or calcium content.

Mediastinal pancreatic pseudocyst. An ultrasonic diagnosis.

Mediastinal extension of pancreatic pseudocysts is uncommon. Frequent presenting complaints include chest pain and shortness of breath. Dysphagia is rare.

Hepatic hemangiomas: pitfalls in scintigraphic detection.

The evaluation of solitary hepatic lesions detected on scintiscans is a common clinical problem. It is usually assumed that radionuclide rapid sequence flow studies and blood pool images are reliable and accurate methods of demonstrating the vascularity of hepatic lesions. Our recent experience with 3 patients with angiographically proven hepatic hemangiomas indicates that radionuclide techniques may fail to detect the vascularity of hemangiomas.

Designing a mental health center to replace a county hospital.

An architectural team worked closely with a county building committee and the administrative staff of a Wisconsin county hospital to design a new active-treatment facility. The goals included changing the hospital's negative image in the community, fostering a close relationship between all programs and all groups of users, and encouraging inpatients to make the best possible use of various treatment areas. Planning was interrupted by a community-wide controversy over the location, and the facility was eventually built on a compromise site.