Suspected gonadal mosaicism for isochromosomes 18p and 18q unsubstantiated by fluorescence in situ hybridization analysis of sperm.

Purpose: A father had two children, one with isochromosome 18p, and another with isochromosome 18q. The father was counseled that he might have gonadal mosaicism for isochromosomes 18p and 18q, which could confer a high recurrence risk.

Methods: A sperm sample from the father was analyzed with fluorescence in situ hybridization probes for 18p and 18q.

Multiloculated peritoneal inclusion cysts with splenic involvement: a case report.

Multilocular peritoneal inclusion cysts (MPICs) are most commonly found in women of reproductive years and involve the abdomen, pelvis, and retroperitoneum. It is commonly thought that these cysts are due to an inflammatory reaction. Patients usually present with chronic abdominal or pelvic pain and are diagnosed by ultrasound or CT scan.

Clinical features of clostridial bacteremia: a review from a rural area.

Blood samples, which were obtained from patients who lived in a rural area with approximately 500 acute-care hospital beds, were cultured from 1990 through 1997. We retrospectively reviewed the blood cultures that yielded Clostridium species (74 [0.12%] of 63,296 cultures).

Klippel-Feil anomaly with Sprengel anomaly, omovertebral bone, thumb abnormalities, and flexion-crease changes: novel association or syndrome?

We report on a family with Klippel-Feil anomaly (KF), Sprengel anomaly, omovertebral bone, thumb abnormalities, and flexion-crease abnormalities. This combination of abnormalities does not fit into Holt-Oram syndrome, Wildervanck syndrome, oculo-auriculo-vertebral (Goldenhar) anomaly, or the VATER complex. Clinical aspects of a KF classification are discussed.

Stage I surgical indexing: clinical and laboratory procedures.

This article will describe the clinical and laboratory procedures used to treat a patient with implant retained crowns including Stage I indexing, fabrication of fixed provisional crowns to be inserted at the time the implants were uncovered (Stage II surgery), and the insertion of the definitive cement-retained crowns after the soft tissues had healed. All of the components described in this article were made by Implant Innovations, Inc., Palm Beach Gardens, FL.

Comparison of 5-fluorouracil alone, 5-fluorouracil with levamisole, and 5-fluorouracil with hepatic irradiation in the treatment of patients with residual, nonmeasurable, intra-abdominal metastasis after undergoing resection for colorectal carcinoma.

Background: The authors conducted a randomized Phase III trial of three treatment regimens for patients with residual, nonmeasurable, intra-abdominal metastatic disease after undergoing resection for primary colorectal carcinoma.

Methods: To be eligible for this study, patients had to be both free of other malignancies and capable of starting their therapy within 3-6 weeks after surgery. They were required to have an Eastern Cooperative Oncology Group performance status < 3; to be chemotherapy, radiation, and immunotherapy naïve; to have adequate bone marrow, renal, and hepatic function; and to provide written, informed consent.

Efficient evaluation of thyroid nodules by primary care providers and thyroid specialists.

Objective: To determine whether primary care providers and thyroid specialists at Gundersen Lutheran Medical Center are evaluating thyroid nodules efficiently by following recently published clinical guidelines.

Study Design: One-year retrospective chart review.

Patients And Methods: We reviewed patient records from 1996 and tabulated the use of fine-needle aspiration cytology, radionuclide scanning, and thyroid ultrasonography by 49 primary care physicians evaluating 81 thyroid nodules and by 5 thyroid specialists evaluating 29 thyroid nodules.

Successful treatment of retrograde ejaculation with sperm recovered from bladder washings. A report of two cases.

Background: Retrograde ejaculation causes < 2% of male infertility but is the leading cause of aspermia. The incidence of retrograde ejaculation is increasing due to the aggressiveness of modern urologic cancer surgery and an increase in diabetes mellitus. Generally, the only adverse effect is on fertility.

The Doppler probe for planning septofasciocutaneous advancement flaps on the plantar aspect of the foot: anatomical study and clinical applications.

A 5-MHz Doppler probe was utilized to identify the perforating septofasciocutaneous vessels on the plantar aspect of the right and left feet of 10 healthy subjects. Each audible perforator was marked, and each foot was photographed, scanned into a personal computer, and standardized to 8 inches high by 4 inches wide. All 20 feet were then stacked together to create a composite average of all markings.

Detection of borreliacidal antibodies in dogs after challenge with Borrelia burgdorferi-infected ixodes scapularis ticks.

Detection of borreliacidal antibodies is an accurate serodiagnostic test for confirmation of Lyme disease in humans. In this study, 13 pathogen-free beagles, 12 to 26 weeks old, were infected with Borrelia burgdorferi by tick challenge. Dogs were monitored for clinical signs and symptoms of Lyme disease along with borreliacidal antibody production against B.

Preparing for a decision support system.

The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments.

Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas.

This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National Science Foundation research grants; all sought medical evaluation and treatment voluntarily.

A prospective study to assess osseointegration of dental endosseous implants with the Periotest instrument.

Long-term studies have documented the successful treatment of edentulous and partially edentulous patients with titanium implants. However, the inability to identify some non-osseointegrated implants before occlusal loading is costly to practitioners and patients. This study followed all patients (n = 40) who had implants placed over a 6-month period.

Parent training for attention-deficit hyperactivity disorder: parental and child outcome.

Thirty-four patients who had children with Attention-Deficit Hyperactivity Disorder (ADHD) participated in a group parent training program (PT) that taught them about ADHD and behavior management. All parents completed pre- and postparticipation questionnaires measuring parental knowledge of ADHD and behavior management, parental stress in managing their youngsters, and the severity of their child's problem behaviors. Main effects were found indicating an increase in parental knowledge and a modest decrease in parental stress.

Domestic violence: the role of the orthopaedic surgeon in identification and treatment.

Domestic violence is a major public health problem in the United States. As many as 35% of women visiting hospital emergency departments for trauma care are there because of injuries caused by intimate partner violence. The practicing orthopaedic surgeon may come in contact with these women in the emergency department as well as in the office setting.

Nonoperative management of blunt liver trauma: the value of follow-up abdominal computed tomography scans.

Our hypothesis was that follow-up abdominal CT scans are not routinely necessary in patients with blunt liver injury treated nonoperatively. We conducted an 8-year retrospective review of hospital chart and outpatient clinic records. We reviewed all admission and follow-up CT scans.

Mild hypercholesterolemia and premature heart disease: do the national criteria underestimate disease risk?

Objectives: To determine the frequency of hospital admissions for acute coronary syndrome in young adults and to examine the risk factors that predispose to the development of premature heart disease.

Background: Significant coronary heart disease (CHD) is considered rare in the young adult. Current guidelines do not recommend treatment of mild cholesterol abnormalities for primary prevention of CHD in the young.

Evaluation of whole-cell and OspC enzyme-linked immunosorbent assays for discrimination of early lyme borreliosis from OspA vaccination.

A recombinant Lyme borreliosis vaccine consisting of outer surface protein A (OspA) is commercially available for vaccination of humans against infection with Borrelia burgdorferi. Vaccination with OspA induces an antibody response that makes serologic interpretation of infection with B. burgdorferi difficult, especially by screening tests based on whole-cell preparations of B.

Use of osseointegrated implants in adult orthodontic treatment: a clinical report.

This article describes the complex dental treatment of an adult patient with multiple missing teeth, mild periodontitis, and a malocclusion. Titanium implants were placed in the posterior mandibular edentulous segments and became osseointegrated. The placement of the mandibular implants was originally designed for orthodontic anchorage.

Detection of borreliacidal antibodies in Lyme borreliosis patient sera containing antimicrobial agents.

The borreliacidal-antibody test has been used for the serological detection and confirmation of Lyme borreliosis. However, the presence of antimicrobial agents in serum can confound the accurate detection of borreliacidal antibodies. In this study, we developed a Bacillus subtilis agar diffusion bioassay to detect small concentrations of antimicrobial agents in serum.

Filippi syndrome: report of three additional cases.

Filippi syndrome is an autosomal recessive condition characterized by variable soft tissue syndactyly of the fingers and toes, microcephaly, pre- and postnatal growth retardation, mildly abnormal craniofacial appearance, and mental retardation. We report on three unrelated individuals with Filippi syndrome. All have microcephaly, minor facial anomalies, variable syndactyly of digits, growth impairment, and developmental delay.

Effective use of percutaneous cholecystostomy in high-risk surgical patients: techniques, tube management, and results.

Hypothesis: Percutaneous cholecystostomy (PC) is an effective, safe treatment in patients with suspected acute cholecystitis and severe concomitant comorbidity.

Design: Retrospective medical record review from March 1989 to March 1998.

Setting: Referral community teaching hospital (450 beds) in rural Wisconsin.