Unique Presentation of Microscopic Polyangiitis: Hearing and Vision Loss, Dysphagia, and Renal Dysfunction.

Microscopic polyangiitis (MPA) is an autoimmune small-vessel vasculitis often positive for perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA), or anti-myeloperoxidase (MPO), that classically affects the lungs, kidneys, and skin. Several atypical presentations of MPA involving other organs have also been reported in the literature. We report a unique case of a patient who presented with rare presentations of MPA: hearing and vision loss, dysphagia, renal dysfunction.

Ruminal Fermentation of Anti-Methanogenic Nitrate- and Nitro-Containing Forages In Vitro.

Nitrate, 3-nitro-1-propionic acid (NPA) and 3-nitro-1-propanol (NPOH) can accumulate in forages and be poisonous to animals if consumed in high enough amounts. These chemicals are also recognized as potent anti-methanogenic compounds, but plants naturally containing these chemicals have been studied little in this regard. Presently, we found that nitrate-, NPA-, or NPOH-containing forages effectively decreased methane production, by 35-87%, during in vitro fermentation by mixed cultures of ruminal microbes compared to fermentation by cultures incubated similarly with alfalfa.

Comparison of Ambulatory Blood Pressure Patterns in Patients With Intradialytic Hypertension and Hemodialysis Controls.

Background/aims: Intradialytic hypertension (IH) patients have higher mortality risk than other hemodialysis patients and have been shown to have higher ambulatory blood pressure (BP). We hypothesized that interdialytic BP patterns would differ in IH patients and hypertensive hemodialysis controls.

Methods: We consecutively screened hemodialysis patients at our university-affiliated units.

Randomized controlled trial on the impact of music therapy during cardiac catheterization on reactive hyperemia index and patient satisfaction: the Functional Change in Endothelium After Cardiac Catheterization, With and Without Music Therapy (FEAT) study.

Objectives: To determine the impact of music intervention on endothelial function, hemodynamics, and patient anxiety before, during, and after cardiac catheterization.

Background: The effect of music therapy during cardiac catheterization on endothelial function and patient satisfaction has received limited study.

Methods: Seventy patients undergoing elective cardiac catheterization were randomized to music therapy (n=36) or no music therapy (n=34).

Sealing the acetabular notch: does it improve cement penetration in the acetabulum?

Since the advent of cemented hip replacements inthe 1950s, outcomes of cementing techniques in the stem have improved significantly. These improvements have not translated as readily to the acetabulum. This article suggests further techniques of improving cementiig techniques in the acetabulum.

The ultimate Aberdeen knot.

Introduction: The Aberdeen knot has been shown to be stronger and more secure than a surgeon's knot for ending a suture line. No data exist as to the ideal configuration of the Aberdeen knot. The Royal College of Surgeons of England in their Basic Surgical Skills Course, 2002 recommended six throws.

Use of botulinum toxin in small-angle heterotropia and decompensating heterophoria: a review of the literature.

Botulinum toxin has been used extensively in strabismus management. However, less is published regarding its use in small-angled manifest deviations or decompensating heterophorias, where an alternative to surgery is required. The aim of this review is to look at the use and effectiveness of botulinum toxin in managing small-angled manifest deviations, both constant and intermittent, and decompensating heterophorias.

A new and effective tension-band braided polyester suture technique for transverse patellar fracture fixation.

Objectives: Concerning the tension-band principle of internal fixation, this study aims to establish whether any difference in interfragmentary gap exists after bone-reducing forceps are released, when a recommended suture-knot technique and a new technique are tested in vitro on a purpose built machine that features a model of a transverse fracture of the patella. In addition, a standard tension-band wiring technique has also been tested as one form of control.

Background: Satisfactory compression at a fracture site reduces the risk of failure of fixation, loss of reduction (interfragmentary gap >2mm) and subsequent risks of malunion, delayed union, and ultimately non-union from excessive movement.

Optical quality of the nasendoscope with and without the endosheath.

With the increasing use of the endosheath in clinical practice, we set out to investigate the quality of the nasendoscope image produced with and without an endosheath. It has been suggested by some users that the endosheath degrades the image. We used a spectrophotometer to assess the optical transmission of the endosheath and found no selective chromatic absorption.

The distribution of cement penetration into bovine acetabular bone utilising various pressurisation techniques.

Most mechanical failures of acetabular fixation within ten years of primary cemented hip replacement are attributable to a failure to achieve good initial fixation of bone and cement. Several studies have suggested that to achieve good fixation between bone and cement between 3 mm and 5 mm of cement penetration into bone is desirable. Whilst several acetabular cement pressurisation systems exist, little is known about the effects of cement pressurisation on the pattern of penetration of cement into cancellous bone within the pelvis.

Screening for sight-threatening diabetic retinopathy: comparison of fundus photography with automated color contrast threshold test.

Purpose: To compare tritan contrast threshold (TCT) with fundus photography in screening for sight-threatening diabetic retinopathy (STDR), before significant visual loss.

Design: Prospective, comparative study.

Methods: A total of 510 consenting diabetic patients attending a hospital-based photographic screening clinic were recruited over a 2-year period.

Orientational contrast sensitivity and chromatic contrast thresholds in multiple sclerosis.

Purpose: To investigate abnormalities of orientational contrast sensitivity (CS) and chromatic contrast threshold (CCT) in multiple sclerosis (MS).

Design: Case control study.

Methods: Nine subjects (mean age, 42 +/- 11 years; range, 20-62 years) with MS, an expanded disability status scale of 3 or less, and normal visual acuity (VA) (logarithm of the minimum angle of resolution [logMAR] VA less than.

The femoral cement mantle in three total hip replacements.

We measured the size and volume of the femoral broaches and stems supplied with three commercial total hip replacement (THR) systems (JRI Furlong, Biomet Stanmore, and Howmedica Exeter). Using an in vitro method, we created cement mantles that could be directly measured. The broaches supplied with the Biomet Stanmore and the Howmedica Exeter systems allowed the creation of significantly thicker cement mantles than the JRI broaches and stems (Stanmore mean thickness = 1.

Monocular chromatic contrast threshold and achromatic contrast sensitivity in children born prematurely.

Purpose: To study the effect of prematurity on monocular chromatic contrast thresholds (CCT) and achromatic contrast sensitivity (ACS).

Design: Case-control study.

Methods: A prospective study of 59 children born at less than 33 weeks' gestation was undertaken.

Assessment of colour vision as a screening test for sight threatening diabetic retinopathy before loss of vision.

Aim: To assess the effects of sight threatening diabetic retinopathy (STDR) on colour vision and to evaluate automated tritan contrast threshold (TCT) testing for STDR screening before significant visual loss.

Method: Patients were recruited from a hospital based photographic screening clinic. All subjects underwent best corrected Snellen visual acuity (BCVA) and those with 20/30 vision or worse were excluded.

Chromatic contrast thresholds as a prognostic test for visual improvement after macular hole surgery: color vision and macular hole surgery outcome.

Purpose: To evaluate the relationship between preoperative chromatic contrast thresholds, postoperative visual acuities (VA), and visual improvement after macular hole surgery.

Methods: A consecutive series of patients with Stage II to IV macular holes was studied before macular hole surgery. Preoperative chromatic contrast thresholds, VA, and reading acuity were analyzed in relation to the postoperative visual function.

Production, characterization, and cross-reactivity studies of monoclonal antibodies against the coccidiostat nicarbazin.

A cELISA was developed for the coccidiostat nicarbazin. On the basis of previous computer-assisted molecular modeling studies, p-nitrosuccinanilic acid (PNA-S) was selected as a hapten to produce antibodies to 4,4'-dinitrocarbanilide (DNC), the active component of the coccidiostat nicarbazin. Synthesis is described for the hapten [p-nitro-cis-1,2-cyclohexanedicarboxanilic acid (PNA-C)] used in a BSA conjugate as a plate coating antigen.

Screening for CMV retinitis using chromatic discrimination thresholds and achromatic contrast sensitivity.

Background: Many patients with cytomegalovirus retinitis (CMVR) are unaware of visual disturbance so screening is advocated for patients with HIV and low CD4 counts. Many tests of retinal function have been recommended but few are effective at detecting CMVR. We assess the potential of chromatic discrimination thresholds and achromatic contrast sensitivity as screening tests for patients with CMVR.

Predictability of mutant sequences. Relationships between mutational mechanisms and mutant specificity.

Spontaneous mutations are rare and are produced by multiple biochemical mechanisms. Nonetheless, studies of these mechanisms have revealed striking examples in which mutational specificity can be regularly related to a characteristic of the surrounding DNA sequence and/or the enzymes participating in mutagenesis. Thus, to an increasing degree the DNA sequences of mutants are "predictable.

Primer-template misalignments during leading strand DNA synthesis account for the most frequent spontaneous mutations in a quasipalindromic region in Escherichia coli.

Spontaneous mutant sequences which differ from the starting DNA sequence by the specific correction of quasipalindromic to perfect palindromic sequence are hallmarks of mutagenesis mediated by misalignments directed by palindromic complementarity. The mutant sequences are specifically predicted by templated, but ectopic, DNA polymerization on a misaligned DNA substrate. In a previous study, we characterized a spontaneous frameshift hotspot near a 17 bp quasipalindromic DNA sequence within the mutant chloramphenicol acetyl transferase (CAT) gene of plasmid pJT7.

The spectrum of acridine resistant mutants of bacteriophage T4 reveals cryptic effects of the tsL141 DNA polymerase allele on spontaneous mutagenesis.

Mutations in the ac gene of bacteriophage T4 confer resistance to acridine-inhibition of phage development. Previous studies had localized the ac gene region; we show that inactivation of T4 Open Reading Frame 52.2 confers the Acr phenotype.

Chromatic-contrast threshold impairment in diabetes.

A prospective study was carried out to investigate acquired colour-vision deficits in diabetics using an automated, computer-controlled, cathode-ray-tube based test of chromatic contrast. Chromatic-contrast thresholds estimates were measured along both a red/ green (constant S-cone) confusion axis and a tritan (constant M/L-cone) confusion axis for 305 eyes of 305 diabetics. The diabetic data were partitioned into groups based on a clinical categorisation of retinopathy.