Silver ions in the treatment of local infections.

A study of the use of free silver ions as an antibacterial and antifungal agent administered to infected local wounds has been conducted over the past two decades. A variety of iontophoretic techniques has been employed utilizing either pure silver wires or several types of silvered nylon fabrics as anodes in a direct current electrical circuit. A new type of silver nylon has recently been evaluated for the same use without iontophoretic current.

Artificial disc technology.

After approximately 40 years of research and development, artificial disc technology may finally be coming of age. A number of devices are either at the late stage of preclinical study or in the early stage of clinical trial, and the results are promising so far. Due to the multicomponent structure of the disc, surgeons performing disc arthroplasty have the option of replacing either the entire disc or a portion of it.

Adverse clinical events during cemented long-stem femoral arthroplasty.

The occurrence and risk factors for adverse clinical events associated with cemented long-stem femoral arthroplasty were studied. The hypothesis was that patients with femoral metastatic disease and previously uninstrumented canals were at higher risk for such adverse events. Fifty-five consecutive patients requiring long-stem femoral arthroplasty at two institutions were retrospectively reviewed.

Association between administrative and ownership characteristics of hospices and their proportion of inpatient deaths.

Hospice patients are more likely to die at home than patients involved in conventional medical care, but the proportion of home deaths varies between programs. A study of the effect of hospice administrative characteristics on inpatient death rates is presented. Data from hospice programs that operated in New York State between 1993 and 1995 were obtained from the State Health Department and from publications of the National Hospice Organization.

The dependent patient in a psychiatric inpatient setting: relationship of interpersonal dependency to consultation and medication frequencies.

To examine the relationship between interpersonal dependency and medical service use in a hospital setting, the number of medical consultations and psychotropic medication prescriptions were compared in matched, mixed-sex samples of 40 dependent and 40 nondependent psychiatric inpatients. Results indicated that dependent patients received more medical consultations and a greater number of medications than did nondependent patients with similar demographic and diagnostic profiles. Implications of these results for theoretical models of interpersonal dependency and for previous research on the dependency-help-seeking relationship are discussed.

Scalp aplasia cutis congenita presenting with sagittal sinus hemorrhage.

We describe an infant with aplasia cutis congenita of the scalp complicated by sagittal sinus hemorrhage. The defect was successfully managed by primary closure with scalp flaps. The literature on aplasia cutis congenita is reviewed, including etiology, genetic transmission, associated anomalies, and options for management.

Murine animal model.

Experimental animal models are available for the development of new treatment. Murine animal models have particular advantages for comparative study to evaluate the efficacy and safety of different treatment modalities because many mice can be treated at the same time with easy handling. Among several experimental models, murine renal carcinoma (Renca), which arises spontaneously in Balb/c mice, is the most frequently used for the assessment of chemotherapy, immunotherapy, and radiotherapy.

Use of local climatic data to determine if weather precludes the operation of an air medical system.

Introduction: Weather is one of many factors that affect safety in an air medical program. Syracuse, New York, has notoriously bad weather, and some have questioned whether an air medical service is practical given central New York's climate. This study was undertaken to determine the extent to which the area's climate could be expected to limit the availability of an air medical service.

Expandable metal stents in achalasia--is there a role?

Objective: Achalasia is treated with pneumatic dilation or myotomy, and botulinum toxin injections are occasionally used. We review our community's experience with expandable metal stents in six patients who failed medical treatment or were poor surgical candidates.

Methods: Eight stents were placed in six patients between July 1995 and November 1997.

The role of arthroscopy in the evaluation and treatment of triangular fibrocartilage complex injuries in athletes.

Treating athletes with TFCC injuries can be a difficult but very rewarding undertaking. Each athlete has individual priorities and concerns, ranging from general health and fitness for the recreational athlete to earning or potentially earning a living as a professional athlete. It is crucial for the treating surgeon to understand these issues to offer the appropriate treatment options at the appropriate time.

The clinical utility of fetal cell sorting to determine prenatally fetal E/e or e/e Rh genotype from peripheral maternal blood.

Objective: This study was undertaken to determine the fetal E/e or e/e Rh genotype prenatally from peripheral maternal blood by examining sorted fetal cells from alloimmunized and nonalloimmunized pregnancies.

Study Design: Eighteen maternal peripheral venous blood samples were obtained before amniocentesis from 15 pregnant women who were homozygous for the e allele. Five were not alloimmunized and 10 were alloimmunized.

Respiratory distress secondary to both amphotericin B deoxycholate and lipid complex formulation.

A 73-y-old female with a history of adenocarcinoma of colon and refractory anemia developed febrile neutropenia following chemotherapy. Therapy with iv infusion of amphotericin B deoxycholate (AmBd) was initiated on day 8 of hospital admission. Premedications included acetaminophen, diphenhydramine and meperidine.

Pulmonary eosinophilia and production of MIP-1alpha are prominent responses to infection with pneumonia virus of mice.

Human eosinophils secrete two distinct ribonucleases that have antiviral activity against pathogens of the family Paramyxoviridae. To examine the role of eosinophils and their ribonucleases in host defense against paramyxovirus pathogens in vivo, we have developed a mouse model involving a viral pathogen that naturally targets a rodent host. In this work we describe infection of Balb/c mice with pneumonia virus of mice (PVM, strain J3666), a paramyxovirus pathogen found frequently among rodent populations.

New insights into causes and treatments of kidney stones.

Recent findings have provided insight into the molecular basis of kidney stone formation and entirely changed our approach to management of calcium stones. Understanding the role of genetic factors and the various promotors and inhibitors of stone formation should lead to more effective prophylaxis and treatment of other types of stones as well.

Chloral hydrate versus midazolam for sedation of children for neuroimaging: a randomized clinical trial.

Objective: The comparative safety and efficacy of chloral hydrate and midazolam for sedation of children has not been adequately studied.

Methods: In a double-blind randomized trial, at a single university hospital, we enrolled 40 children, ages 2 months to 8 years, in an out-patient neuroimaging study. Children judged to require sedation were enrolled during a 14-month period ending August 1995.

Switching antipsychotic therapies.

Background: Atypical antipsychotics are superior to conventional antipsychotics in improving positive and negative psychotic symptoms. Atypical antipsychotics do not exacerbate mood symptoms, and may improve mood symptoms and cognitive functioning; additionally, they have better adverse effect profiles than conventional antipsychotics.

Objective: To review the benefits of switching patients with schizophrenia or schizoaffective disorder from a conventional to an atypical antipsychotic, or from one atypical antipsychotic to another.

Do warning lights and sirens reduce ambulance response times?

Objective: To determine the time saving associated with lights and siren (L&S) use during emergency response in an urban EMS system.

Methods: This prospective study evaluated ambulance response times from the location at time of dispatch to the scene of an emergency in an urban area. A control group of responses using L&S was compared with an experimental group that did not use L&S.

Rural vs urban motor vehicle crash death rates: 20 years of FARS data.

Objectives: Historically, motor vehicle crash (MVC)-related mortality is higher in rural areas than in urban areas. The authors evaluated whether the difference in rural and urban MVC deaths is persisting, and whether the frequency of patients being found dead at the scene, particularly in rural areas, is increasing.

Methods: Fatal Accident Reporting System (FARS) data for 1977 through 1996 were reviewed.

Variation in the posterior vertebral contour line at the level of C-2 on lateral cervical roentgenograms: a method for odontoid fracture detection.

As an aid to the assessment of alignment and lordosis, four contour lines can be drawn on the lateral radiograph of the cervical spine. One of these contour lines is the posterior vertebral contour line, in which a smooth, gentle curve, convex anteriorly, is formed by a line drawn along the posterior margins of the cervical vertebral bodies. It is unknown whether discontinuity in the posterior contour line at this level represents a pathologic process of the odontoid.

Characteristics of unicortical and bicortical lateral mass screws in the cervical spine.

Study Design: A biomechanical study evaluating the safety and efficacy of unicortical versus bicortical lateral mass screws in the cervical spine.

Objectives: To analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws placed in cadaveric spines and to evaluate the influence of level of training on the positioning of these screws.

Summary Of Background Data: Lateral mass plating for posterior cervical spine fusion is an effective method for the treatment of traumatic and degenerative instability.

Characterization of paxillin LIM domain-associated serine threonine kinases: activation by angiotensin II in vascular smooth muscle cells.

Recently we reported a novel means of regulating LIM domain protein function. Paxillin LIM zinc-finger phosphorylation in response to cell adhesion regulates the subcellular localization of this cytoskeletal adaptor protein to focal adhesions, and also modulates cell adhesion to fibronectin (Brown et al. [1998] Mol.

The normal breast epithelium of women with breast cancer displays an aberrant response to estradiol.

Breast epithelial response to estradiol may play an important role in breast cancer etiology. We have examined the relationship between serum estradiol and progesterone levels and normal breast epithelial expression of estrogen receptor (ER) alpha, progesterone receptor (PgR), and epithelial proliferation (as reflected by the Ki-67 labeling index) in 121 women (50 newly diagnosed breast cancer cases and 71 benign breast disease controls). Simultaneous samples of grossly normal breast tissue and venous blood were obtained from women undergoing breast surgery.