Activated platelets rapidly up-regulate CD40L expression and can effectively mature and activate autologous ex vivo differentiated DC.

Background DC are a promising immunotherapeutic for treatment of infectious/malignant disease. For clinical trials, immature DC generated from precursor cells such as monocytes, using serum-free media containing GM-CSF and IL-4, can be matured with specific cytokines/factors. CD40 ligand (CD40L) plays an important role in DC activation/maturation but is not available for clinical applications.

Long-term skeletal stability after maxillary advancement with distraction osteogenesis using a rigid external distraction device in cleft maxillary deformities.

Rigid external distraction is a highly effective technique for correction of maxillary hypoplasia in patients with orofacial clefts. The clinical results after correction of sagittal maxillary deformities in both the adult and pediatric age groups have been stable. The purpose of this retrospective longitudinal cephalometric study was to review the long-term stability of the repositioned maxilla in cleft patients who underwent maxillary advancement with rigid external distraction.

Ductal lavage using medically aseptic technique in women at high risk for breast cancer.

Ductal lavage of the breast is a minimally invasive procedure used to collect epithelial cells from the lumen of the ductolobular system for cytologic analysis. The purpose of this study was to determine the safety of using an aseptic technique in performing ductal lavage. The study included 114 consecutive patients at high risk for breast cancer with clinically negative mammograms and no palpable masses.

Mannose binding lectin (MBL) and HIV.

The envelope protein (gp120/gp41) of HIV-1 is highly glycosylated with about half of the molecular mass of gp120 consisting of N-linked carbohydrates. While glycosylation of HIV gp120/gp41 provides a formidable barrier for development of strong antibody responses to the virus, it also provides a potential site of attack by the innate immune system through the C-type lectin mannose binding lectin (MBL) (also called mannan binding lectin or mannan binding protein). A number of studies have clearly shown that MBL binds to HIV.

Fine-needle aspiration of subcutaneous panniculitis-like T-cell lymphoma.

We report the fine-needle aspiration (FNA) cytology findings of Subcutaneous Panniculitis-like T-cell Lymphoma (SCPTCL) in a 66-year-old woman who presented with a four month history of asymptomatic subcutaneous nodules on her right chest wall and back. An excisional biopsy of the right chest nodules was performed, and the diagnosis of SCPTCL was rendered. On a follow-up visit, several skin lesions were noted throughout her body.

Antibiotic resistance patterns of group B streptococcal clinical isolates.

Objectives: To determine the in vitro resistance of group B streptococcus (GBS) to 12 antibiotics. To determine if there has been any decrease in sensitivity to the penicillins or other antibiotics currently used for GBS chemoprophylaxis in pregnant women. Find suitable alternative antibiotics to penicillin.

Sideroblastic anemia due to linezolid in a patient with a left ventricular assist device.

An acquired form of sideroblastic anemia has been described in association with several drugs, especially anti-microbial agents. A case of sideroblastic anemia is presented in a patient with a left ventricular assist device drive-line infection who was receiving linezolid, an antibiotic used for serious infections with gram-positive organisms. This patient's anemia resolved after discontinuation of the drug; he subsequently underwent an uncomplicated orthotopic heart transplant with no recurrence of anemia.

Clinical comparison of extended-release divalproex versus delayed-release divalproex: pooled data analyses from nine trials.

Divalproex sodium is an effective anticonvulsant, antimanic, and migraine prophylaxis agent. Recently, a new extended-release (ER) formulation of divalproex sodium has become available, which allows for once-daily dosing and provides prolonged therapeutic serum levels. Using data pooled from nine open-label trials involving 321 epilepsy and psychiatry patients, we compared the efficacy and tolerability of divalproex ER with preceding treatment with the older delayed-release (DR) formulation, based on patient reports and analysis by McNemar's test for within-subject paired data.

Characterization of the cellular origin of a tissue-engineered human phalanx model by in situ hybridization.

Tissue-engineered models of human phalanges have previously been fabricated from a combination of bovine periosteum, cartilage, tendon, and biodegradable polyglycolic acid and poly-L-lactic acid scaffolds. Resulting constructs implanted in athymic mice for more than 40 weeks developed new bone, cartilage, and tendon and became vascularized, but cell types comprising the constructs were unidentified. The origin of cells in middle phalanx models implanted for 20 weeks in nude mice has been studied by in situ hybridization analyzing species-specific gene expression.

Radiographic criteria for placement of translaminar facet screws.

Background Context: Screw fixation of the facet joint has been reported to stabilize the lumbar spine and facilitate spinal fusion. Accurate placement of translaminar facet screws (TLFSs) requires identification of the posterior spinal elements, and the facet joints in particular, which may be facilitated by intra-operative fluoroscopy.

Purpose: The purpose of this study was to define the radiographic parameters that will allow for successful placement of TLFSs.

Daily needle aspiration versus surgical lavage for the treatment of bacterial septic arthritis in adults.

Septic arthritis is a substantial public health problem, accounting for 0.2-0.7% of hospital admissions.

A quiet hand for microneurosurgery: twiddle your thumb. Technical note.

Fatigue is both the most tremor-producing factor and the constant companion of a busy neurosurgeon. Because of the difficulty in controlling tremor-generating factors, the authors sought to develop a means of manipulating surgical instruments with minimal muscle movement while allowing accurate and repeatable movements in all conditions. The "quiet hand technique" is an isolation technique that creates a stable platform by forming the four fingers into a salute that thenceforth moves as one.

IgG-associated mesangial glomerulonephritis in a patient with Down syndrome.

Background: Patients with Down syndrome have a variety of urinary tract abnormalities including obstructive hydronephrosis, dysplasia, reflux nephropathy and glomerular lesions. However, primary glomerulonephritis with prominent IgG deposits has not been reported previously in this syndrome.

Case Report: A 17-year-old girl with Down syndrome presented with proteinuria and chronic renal insufficiency.

The effect of anesthesia and surgery on CYP3A activity in rats.

The purpose of this investigation was to examine the effects of surgery and anesthesia on in vivo CYP3A activity and portal venous blood flow. Midazolam, a CYP3A probe for both rats and humans, was administered orally (2.7 mg), intravenously (0.

Fibronectin fragments elevate nitric oxide (NO) and inducible NO synthetase (iNOS) levels in bovine cartilage and iNOS inhibitors block fibronectin fragment mediated damage and promote repair.

Objective And Design: To determine whether fibronectin fragments (Fn-f) upregulate nitric oxide (NO) and inducible NO synthetase (iNOS) levels in explants and whether iNOS inhibitors block Fn-f mediated cartilage damage or promote repair.

Material: Bovine cartilage explants were studied.

Treatment: Explants were cultured with Fn-f and involvement of NO pathway investigated.

Genetic polymorphisms in Parkinson disease subjects with and without hallucinations: an analysis of the cholecystokinin system.

Background: Hallucinations in patients with Parkinson disease (PD), occurring in about one third of those receiving long-term dopaminergic therapy, contribute to morbidity and mortality. In matched Chinese PD subjects with and without hallucinations, the presence of the -45 C/T locus in the cholecystokinin (CCK) gene, particularly when combined with the CCK receptor, CCKAR (cholecystokinin A receptor), C polymorphism, was associated with increased hallucination risk. Because CCK gene polymorphisms vary across ethnic groups, the presence of similar associations in white PD subjects merits investigation.

Effect of supplemental translaminar facet screw fixation on the stability of stand-alone anterior lumbar interbody fusion cages under physiologic compressive preloads.

Study Design: A biomechanical study of lumbar threaded interbody cage construct under varying compressive preloads of similar magnitudes to those experienced in vivo during daily activities.

Objectives: To test the hypothesis that supplemental translaminar facet screws would enhance the stability (ability to reduce segmental angular motion) of threaded interbody cages in flexion-extension during activities in which the spine is subjected to low compressive preloads, and therefore the stand-alone interbody cage construct is least stable.

Summary Of Background Data: Controversy exists over whether threaded anteriorly placed interbody cages can be routinely used as "stand-alone" devices or whether they require supplemental posterior stabilization to achieve successful fusion.

Twelve-lead electrocardiogram: the advantages of an orderly frontal lead display including lead -aVR.

Background: It is possible that efforts in ECG review by both young experienced clinicians are currently discouraged-and risk to be completely dismissed-by the conventional (ie, disorderly) display of the frontal plane leads, with lead aVR at -150 degrees.

Methods: We reviewed studies on the usefulness of leads aVR and -aVR as well as on the history of the frontal leads in electrocardiography.

Results: Lead aVR and particularly, lead -aVR, provide useful information when systematically analyzed.

Z-palatoplasty (ZPP): a technique for patients without tonsils.

Objective: Patients without tonsils and with Friedman tongue position (FTP) III and IV are poor candidates for uvulopalatopharyngoplasty (UP3). Even when combined with adjunctive hyopharyngeal techniques, results are poor. We assessed a modified uvulopalatoplasty based on a bilateral Z-plasty in treating patients without tonsils who have obstructive sleep apnea/hypopnea syndrome (OSAHS).

An accessory portal for posterior cruciate ligament tibial insertion visualization.

Posterior cruciate ligament (PCL) reconstruction is infrequently performed, technically challenging, and has less predictable results compared with its anterior cruciate ligament (ACL) counterpart. Creation of a transtibial tunnel has been associated with catastrophic neurovascular complications, as well as tunnel malpositioning. This technical note reports the use of the femoral PCL tunnel to visually access the posterior slope for tibial tunnel creation.

Effect of contrast enhancement on measurement of carotid artery intimal medial thickness.

Previous studies have used standard B-mode ultrasound to quantify the aggregate mean intimal medial thickness (IMT) of the near and far wall of the common carotid artery (CCA). Many investigators have had difficulty in accurately evaluating the near wall IMT secondary to difficulty in discerning the vessel lumen and intima. The purpose of this study is to determine the effect of contrast enhanced ultrasound on IMT measurement when compared with non-enhanced images.