Folic acid, Vitamin B(12), and homocysteine in smoking and non-smoking pregnant women.

Introduction: Lower plasma levels of vitamins may result in hyperhomocysteinemia, a known risk factor in pregnancy. As smoking may alter nutrition, we were interested in its effect on folate and Vitamin B(12) in pregnancy.

Materials And Methods: A cross-sectional study of 62 smoking and 76 non-smoking healthy pregnant women.

Ankle-foot orthosis has limited effect on walking test parameters among patients with peripheral ankle dorsiflexor paresis.

The aim of this study was to determine the relationship between ankle dorsiflexor strength and performances on several walking tests and to determine the effect of ankle-foot orthosis (AFO) use on walking tests. The following tests were used: 10-metre walking test (with and without three stairs), a complex walking task (6-minute walk with cognitive loading) and a subjective evaluation (SIP68 mobility scale and questionnaire). Isometric strength of the ankle dorsiflexors was measured.

Pharmacodynamic steady state of tiotropium in patients with chronic obstructive pulmonary disease.

Tiotropium (Spiriva) is a new once-daily inhaled anticholinergic that has its effect through prolonged muscarinic (M)3 receptor antagonism. It has a clinically documented, long duration of action with once-daily dosing in chronic obstructive pulmonary disease (COPD). A single-centre, double-blind, ipratropium-controlled study was conducted in order to characterize the onset of pharmacodynamic steady state of tiotropium in patients with COPD.

Multiparameter flow cytometry as a tool for the detection of micrometastatic tumour cells in the sentinel lymph node procedure of patients with breast cancer.

Aim: To investigate whether multiparameter flow cytometry (MP-FCM) can be used for the detection of micrometastasis in sentinel lymph nodes (SLNs) in breast cancer.

Methods: Formalin fixed, paraffin wax embedded sentinel lymph nodes (n = 238) from 98 patients were analysed. For each lymph node, sections for haematoxylin and eosin (H&E) staining and immunohistochemistry (IHC) for cytokeratin (MNF116) were cut at three levels with a distance of 500 microm.

Blood supply of the posterior cerebral artery by the carotid system on angiograms.

Background And Purpose: Occipital lobe infarcts are traditionally attributed to vertebrobasilar disease. However, anatomical studies indicate that in some people the supply of the posterior cerebral artery is via the carotid system. We investigated how often such a developmental variant in the cerebral blood supply was present during life.

Survival analysis of human meniscal transplantations.

We describe a prospective survival analysis of 63 consecutive meniscal allografts transplanted into 57 patients. The lateral meniscus was transplanted in 34, the medial meniscus in 17, and both menisci (combined) in the same knee in six. For survival analysis we used persistent pain or mechanical damage as clinical criteria of failure.

Immediate and long-term effects of ankle-foot orthosis on muscle activity during walking: a randomized study of patients with unilateral foot drop.

Objectives: To determine (1) whether use of an ankle-foot orthosis (AFO) by patients with ankle dorsiflexor paresis leads to decreased muscle activity, immediately or 6 weeks after AFO use, and (2) whether this decrease (if present) differs between healthy and paretic subjects.

Design: Cross-sectional and longitudinal randomized case-control study.

Setting: Rehabilitation research center in the Netherlands.

Aretaeus on migraine and headache.

Aretaeus of Cappadocia's classification of headache has been referred to for many centuries. Several Latin translations and an English translation (1856) of his books have been published in the past. We translated the pertinent texts on headache from the Greek text as published by Hude in 1958.

Phenotypic variability of the cat eye syndrome. Case report and review of the literature.

We present a male infant with preauricular skin tags and pits, downslanting palpebral fissures, hypertelorism, ectopic anus, hypospadias, and hypoplastic left heart syndrome. The clinical features in our patient show phenotypic overlap with the cat eye syndrome, as illustrated by the review of 105 reported cases. Cytogenetic analysis revealed a supernumerary marker chromosome, which was identified by microdissection and fluorescence in situ hybridization as an isodicentric chromosome 22(pter --> q11.

Primary large cell neuroendocrine carcinoma of the presacral region.

A 7 cm diameter presacral tumour, not related to the intrapelvic organs, was found in a 51 year old woman. The needle biopsy showed a poorly differentiated large cell carcinoma. The patient died of urosepsis after chemotherapy.

Detection of lung cancer on the chest radiograph: impact of previous films, clinical information, double reading, and dual reading.

To study the impact of clinical information, previous chest radiographs, double reading (one pair of observers read the films independently) and dual reading (one pair of observers read the films simultaneously) on the sensitivity, specificity and odds ratios of observers in the detection of early lung cancer on the chest radiograph. The study was performed in 3 sessions. In the first session, 14 observers reviewed the chest radiographs of 100 cases (30 with early lung cancer, 35 with no abnormalities, 35 with other cardiopulmonary diseases).

A conservative treatment of phimosis in boys.

Objective: The aim of this study was to evaluate the efficacy of topical applications of clobetasol propionate cream in the treatment of phimosis in boys and a comparison of the results presented with an overview of the current studies.

Methods: In a prospective study, 94 boys (mean age 5.5 years) were treated with topical applications of 0.

Acetabular revision with impacted grafting and a reinforcement ring: 42 patients followed for a mean of 10 years.

We analyzed the outcome of 42 cemented cup revisions (40 patients) with morselized bone grafts and a reinforcement ring after median 10 (7-16) years. The acetabular component migrated a mean of 7 (5-8) mm in 5 hips. The migration stopped after 2 years except in 1 hip, the only one revised because of mechanical loosening.

Improved pre-operative mediastinal staging in non-small-cell lung cancer by serial sectioning and immunohistochemical staining of lymph-node biopsies.

Objective: Mediastinal staging of non-small-cell lung carcinoma (NSCLC) by mediastinoscopy suffers from a low sensitivity, leading to a number of patients with unforeseen N2 disease at thoracotomy. This study was undertaken to assess whether pre-operative staging could be improved by serial sectioning and immunohistochemical staining of mediastinoscopy biopsies.

Methods: In 183 consecutive patients with NSCLC, a thoracotomy was performed after a thorough mediastinal staging by computed tomography scan and cervical mediastinoscopy.

About medicine and the arts. Charcot and French literature at the fin-de-siècle.

The relationship between medicine and the arts, literature in particular, has many aspects. One of the most obvious relations is the use of literature as a source for historical studies. Jean-Martin Charcot and his school often appear in French literature at the end of the 19th century.

Flow cytometric DNA and phenotype analysis in pathology. A meeting report of a symposium at the annual conference of the German Society of Pathology, Kiel, Germany, 6-9 June 2000.

This meeting report summarizes the presentations of three different groups that are active in the field of flow cytometry (FCM) in relation to diagnosing and classification of proliferative disorders. The report starts with the contribution from Regensburg about the developments in DNA FCM, the progression to dual parameter determinations, and combination of immunophenotyping in combination with DNA. In the second part, the use of FCM for the detection of isolated tumor cells in the peripheral blood from patients with prostate or breast cancer is discussed in a contribution from Münster.

Stentless bioprostheses have ideal haemodynamics, even in the small aortic root.

Objective: To determine normal Doppler and 2D gradients and flow characteristics of the Freestyle stentless aortic bioprosthesis related to valve size.

Background: The Freestyle stentless aortic bioprosthesis is one of the newer aortic xenografts. Only limited data are available of the echocardiographic flow characteristics during a mid-term follow-up period of this valve.

Delivery of fenoterol via Respimat, a novel 'soft mist' inhaler. a randomised, double-blind (within device), placebo-controlled, cross-over, dose-ranging study in asthmatic patients.

Background: The phase-out of chlorofluorocarbons (CFCs) for metered dose inhalers (MDIs) has prompted the development of alternative propellants and the design of propellant-free devices for inhalation therapy.

Objective: This study was carried out to determine the dose of fenoterol inhaled from Respimat (RMT), a new propellant-free soft mist inhaler, which is equivalent in terms of efficacy and safety to 1 puff of either 100 or 200 microg fenoterol inhaled from a conventional CFC-MDI (Berotec).

Methods: Sixty-two asthmatic patients (35 male, 27 female) with a mean baseline FEV(1) of 1.

Randomized clinical trial on the use of antispasmodic drugs in barium enema: impact on radiological practice.

Purpose: To assess the willingness of radiologists to change their practice when the results of a randomized clinical trial (RCT) on the use of antispasmodic drugs in barium enema are presented.

Materials And Methods: During the years 1994 and 1995 two postal questionnaires were sent to 481 practicing radiologists who were all members of the Netherlands Society of Radiology. In the first questionnaire the respondents were asked to give the characteristics of their practices in performing daily barium enema.