Late recurrence of varus deformity after proximal tibial osteotomy.

One hundred thirteen knees with medial gonarthrosis in 95 patients were treated by valgus-producing proximal tibial osteotomy and followed clinically and roentgenographically for a minimum of five years (mean, 6.3 years). Sixty-four knees (57%) were pain free or had only mild discomfort when walking.

Early and late results after isolated coronary artery bypass surgery in 159 patients aged 80 years and older.

We have studied 159 patients 80 years of age or older who have had isolated coronary artery bypass grafting (CABG) since 1977. Eighty-seven percent have had surgery since 1984. Two thirds of the patients were male, and the mean age was 82 years.

Dose-dependent variations in blood flow evaluation of canine nerve, nerve graft, tendon, and ligament tissue by the radiolabeled-microsphere technique.

This study evaluates the dose-dependent accuracy of the radionuclide-labeled microsphere technique for blood flow evaluation in nerve, tendon, and ligament. In eight dogs, blood flows were determined for nerve, nerve graft, tendon, and ligament tissue by simultaneous injection of high- and low-dose microspheres with different radiolabels. The results demonstrated no significant differences in blood flow as measured from the small number of microspheres (less than 400) and the high number (more than 400) for nerve and tendon tissue.

Long-term course of patients with persistent hypercalcitoninemia after apparent curative primary surgery for medullary thyroid carcinoma.

Thirty-one patients with persistent hypercalcitoninemia after seemingly adequate primary operation for medullary thyroid carcinoma (MTC) were followed for a mean period of 11.9 years after operation. Ten patients had sporadic MTC and the remaining patients were members of families with multiple endocrine neoplasia (MEN)--either MEN 2A (15 patients) or MEN 2B (six patients).

Natural history of hypertrophic cardiomyopathy in the elderly.

The prognosis of patients diagnosed as having hypertrophic cardiomyopathy at advanced age has not been well defined. This study details follow-up information obtained for 95 patients initially diagnosed as having hypertrophic cardiomyopathy at age greater than or equal to 65 years. Seventy-five percent of patients were symptomatic, as defined by the presence of chest pain, dyspnea or syncope, and the mean ventricular septal thickness was 20 mm.

Ileal pouch-anal anastomosis. Reoperation for pouch-related complications.

The aim was to assess the value of reoperative surgery for pouch-related complications after ileal pouch-anal anastomosis (IPAA) for chronic ulcerative colitis and familial adenomatous polyposis. Between January 1981 and August 1989, 114 of 982 IPAA patients (12%) seen at the Mayo Clinic had complications directly related to IPAA that required reoperation. Among the 114 patients, the complications prevented initial ileostomy closure in 33 patients (25%), occurred after ileostomy closure in 68 patients (60%), and delayed ileostomy closure in the remaining patients.

Idiopathic symptomatic osteoarthritis of the hip and knee: a population-based incidence study.

We identified all residents of Rochester, Minnesota, who sought medical assistance for the first time in 1985 because of symptomatic osteoarthritis of the hip or knee that was unrelated to a specific disease. Of these residents, 98 (59 women and 39 men) had 122 symptomatic joints (95 knees and 27 hips), for age- and sex-adjusted incidence rates of 205 new patients and 255 newly affected joints per 100,000 person-years. The incidence of osteoarthritis of the hip was greater in women than in men, whereas the sex ratio for occurrence of osteoarthritis of the knee approached unity.

Radiologic anatomy of the painful bunionette.

Radiographs were studied of 91 feet in 62 patients with the diagnosis of bunionette and no prior bunionette or hallux valgus operations. Various radiologic measurements were compared to a matched control group with no bunionette symptoms or previous forefoot operations. The bunionette group had a significantly increased metatarsophalangeal 5 angle, intermetatarsal 4-5 angle, and intermetatarsal 1-2 angle compared to the control group.

Medulloblastoma--prognostic factors and outcome of treatment: review of the Mayo Clinic experience.

From March 1965 through December 1984, 58 patients (35 male and 23 female patients; median age, 17 years) with posterior fossa (PF) medulloblastoma underwent surgical treatment and postoperative radiation therapy at our institution. Radiation fields were the craniospinal axis in 39 patients, PF plus spinal axis in 12, PF in 6, and whole brain in 1. Median radiation doses were 43 Gy (22 to 60 Gy) to the PF and 34 Gy (6.

Field strength in neuro-MR imaging: a comparison of 0.5 T and 1.5 T.

A study was undertaken comparing neurological magnetic resonance imaging at high (1.5 T) and mid (0.5 T) field strengths.

Doppler echocardiography in aortic stenosis: feasibility and clinical impact.

The clinical utility of Doppler echocardiography for the assessment of aortic stenosis was prospectively studied in 425 consecutive patients referred to the echocardiography laboratory over 1 year with the clinical diagnosis of aortic stenosis. Optimal peak Doppler velocities were obtained in 405 (95%) patients of all ages. In 108 patients, the severity of aortic stenosis as determined by subsequent cardiac catheterization was compared with that found by Doppler assessment.

Statistical methods in microbiology.

Statistical methodology is viewed by the average laboratory scientist, or physician, sometimes with fear and trepidation, occasionally with loathing, and seldom with fondness. Statistics may never be loved by the medical community, but it does not have to be hated by them. It is true that statistical science is sometimes highly mathematical, always philosophical, and occasionally obtuse, but for the majority of medical studies it can be made palatable.

Influence of referral bias on the apparent clinical spectrum of infective endocarditis.

Purpose: To assess the effect of referral bias on the clinical spectrum of infective endocarditis.

Patients And Methods: We performed a retrospective study comparing a population-based cohort of incidence cases from Olmsted County, Minnesota, with a cohort of referred cases from the practice of the Mayo Clinic during the period from 1970 to 1987.

Results: In the community cohort, age was an important risk factor for acquiring endocarditis (incidence rate ratio 8.

Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis.

Although the etiology of pouchitis after ileal pouch-anal anastomosis (IPAA) is unknown, its manifestations resemble those of nonspecific inflammatory bowel disease, including, anecdotally, the apparent ability to evoke extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD). Our aim was to determine in what manner pouchitis and EIMs were associated. The computerized records of 819 consecutive patients who underwent IPAA between January 1981 and December 1988 were reviewed.

Effect of femoral head size on wear of the polyethylene acetabular component.

A technique was developed to determine the wear of the acetabular component of a total hip replacement by examination of standardized initial and follow-up radiographs. Three hundred and eighty-five hips were followed for at least 9.5 years after replacement.

Rheumatoid pericarditis: clinical features and survival.

We describe the clinical characteristics and actuarial survival of a consecutive cohort of 41 patients with rheumatoid arthritis and clinical pericarditis who were seen at the Mayo Clinic between 1970 and 1987 and followed up until death or through 1987. The survivors were followed up for a median of 5.1 years.

Effect of inpatient psychiatry training on internal medicine residents. Results of a survey.

Forty-two residents in internal medicine completed an attitudinal survey at the beginning and end of a 2-month inpatient psychiatry rotation. Residents noted a significant increase in their confidence regarding the management of various psychiatric problems and personality problems, the conducting of supportive counseling, the making of psychiatric referrals, the usefulness of psychotherapy, and the ability to discuss emotionally difficult subjects with patients. The rotation was perceived as being worthwhile and enjoyable.

Positive predictive value of clinical suspicion of abdominal aortic aneurysm. Implications for efficient use of abdominal ultrasonography.

Although selective screening for an abdominal aortic aneurysm (AAA) by abdominal palpation aimed at detecting AAAs has engendered considerable support, no population-based data pertaining to the positive predictive value (PPV) of the clinical assessment of AAAs in routine clinical practice are available. Therefore, we used the unique resources of the Rochester (Minn) Epidemiology Project and the Mayo Clinic computerized abdominal ultrasonography database to identify all residents of Olmsted County, Minnesota,who underwent ultrasound examination for a clinically suspected AAA between November 1, 1985, and October 31, 1987. Of 116 residents who were suspected of having an AAA on abdominal palpation and were referred for an ultrasound examination for confirmation, 17 patients had a 3.

Carcinoma of the gallbladder. Does radical resection improve outcome?

The records of 111 patients with gallbladder carcinoma operatively treated between 1972 and 1984 were retrospectively reviewed. Fifty-seven percent of patients had distant metastases; another 16% had nodal metastases without distant disease. Median survival was 0.

Effect of silicone elastomer contact lens wear on endothelial cell morphology in aphakic eyes.

We prospectively evaluated the effect of extended silicone elastomer contact lens wear on the endothelial mosaic of aphakic subjects. Endothelial cell photography and central corneal thickness measurements were performed on 23 eyes of 15 aphakic subjects (mean age 60 +/- 10 years). These measurements were made before lens wear (n = 23) and were repeated after 1 year (n = 19) and again after 5 years (n = 10) of lens wear.

Sudden death after repair of double-outlet right ventricle.

The outlook for patients with double-outlet right ventricle has improved since the development of corrective operations. Late arrhythmic deaths after successful procedures have been reported; however, the magnitude remains unknown. This study was undertaken to identify the magnitude of late sudden death and the significant factors associated with it.

Effect of treatment of shell vial cell cultures with dimethyl sulfoxide and dexamethasone and age of MRC-5 monolayers for detection of cytomegalovirus.

Pretreatment of MRC-5 cell monolayers in commercially prepared shell vials with 1% dimethyl sulfoxide (DMSO) and 10(-5) mol/L dexamethasone (DEX) was evaluated. Preliminary experiments indicated enhanced infectivity of AD-169 for pretreated MRC-5 cells in shell vials of ages 9 and 16 days. Compared with untreated shell vials, DMSO-DEX increased positivity (day 9, 19 vs.

Long term clinical results after proximal gastric vagotomy.

The long term clinical results after proximal gastric vagotomy (PGV) for peptic ulcer were determined among 396 patients who underwent surgical treatment at the Mayo Medical Center between 1973 and 1981. PGV was performed for duodenal ulcer (n = 293), midgastric ulcer (n = 14), prepyloric or pyloric ulcer (n = 46) and combined gastric, pyloric, prepyloric and duodenal ulcers (n = 43). Postoperative follow-up observation ranged from five to 13 years (a mean of eight years) and was complete in 96 per cent of the patients.

Duplex and color Doppler sonographic evaluation of vasculogenic impotence.

One hundred eighty patients with suspected vasculogenic impotence were evaluated with conventional penile duplex sonography with spectral analysis and color Doppler imaging. Measurements of mean peak systolic and end-diastolic velocities were obtained from the cavernosal arteries before and after intracavernosal injections of papaverine. Sixty-one patients were examined with dynamic cavernosography and cavernosometry, and 12 patients were studied with selective internal pudendal and penile arteriography.

Charnley total hip arthroplasty with cement. Fifteen-year results.

The results of the first 333 Charnley total hip arthroplasties that were performed with cement at the Mayo Clinic were reviewed a minimum of fifteen years postoperatively. Data were available for 166 of 170 hips of patients who were still alive. One hundred and thirty patients died, and thirty-seven hips were revised.