Transverse tripolar spinal cord stimulation: results of an international multicenter study.

Experienced neurosurgeons at eight spinal cord stimulation centers in the United States, Canada, and Europe participated in a study from 1997 to 2000 investigating the safety, performance, and efficacy of a Transverse Tripolar Stimulation (TTS) system invented at the University of Twente, the Netherlands. This device was proposed to improve the ability of spinal cord stimulation to adequately overlap paresthesia to perceived areas of pain. Fifty-six patients with chronic, intractable neuropathic pain of the trunk and/or limbs more than three months' duration (average 105 months) were enrolled with follow-up periods at 4, 12, 26, and 52 weeks.

Hydroxyapatite-coated acetabular components. Histological and histomorphometric analysis of six cups retrieved at autopsy between three and seven years after successful implantation.

Background: Important questions remain regarding the use of hydroxyapatite-coated acetabular components in total hip arthroplasty. What is the relation of resorption of the hydroxyapatite coating to enduring fixation? Will unresorbed or dislodged hydroxyapatite particles cause adverse tissue reactions? Retrieval studies of clinically well-functioning acetabular components should help to answer these questions.

Methods: We examined six clinically successful hydroxyapatite-coated cementless acetabular components that were retrieved at autopsy between 3.

The hydroxyapatite-ABG hip system: 5- to 7-year results from an international multicentre study. The International ABG Study Group.

A proximally hydroxyapatite (HA)-coated hip prosthesis designed for proximal stem bonding and stress transfer was studied in a consecutive series of 398 patients in an ongoing, prospective multicenter study. Follow-up was 5 to 7 years. The clinical results were excellent with a mean preoperative Merle d'Aubigné score of 8.

Immunohistochemical characterization of 53 monoclonal antibodies to prostate-specific antigen.

Fifty-three antibodies submitted to the ISOBM TD-3 Workshop on the prostate specific antigen (PSA) were evaluated for their reactivity in frozen and formalin fixed tissue from benign hyperplastic prostate and salivary gland tissue. Only 13/53 antibodies showed clear reactivity in both frozen and paraffin sections, while some antibodies appeared to react only in formalin-fixed paraffin sections. Many antibodies showed extensive nonspecific reactivity in tissue sections.

Squamous cell carcinoma of suprapubic cystostomy tract without bladder involvement.

This report describes a third case of squamous cell carcinoma of the suprapubic cystostomy tract. The first case reported in 1993 concerned a squamous cell carcinoma arising adjacent to the suprapubic cystostomy site and extending anteriorly to the abdominal wall in a 80-year-old man, 5 years after suprapubic urinary diversion for urethral stricture. A second case published in 1995 described a 50-year-old paraplegic man (T11-T12 spinal cord injury) in whom a suprapubic cystostomy tract squamous cell carcinoma developed after 25 years of urinary diversion.

Indiana pouch in female patients with spinal cord injury.

Objective: We assessed the results of a continent urinary diversion (Indiana pouch) in seven women with severe neurogenic urinary incontinence.

Patients And Methods: There were seven patients (mean follow-up 28 months), in five of whom a complete Indiana pouch was created. In two the bladder was augmented with the Indiana pouch, the bladder neck was closed and an umbilical stoma was created.

A comparison of the onset of action of salbutamol and formoterol in reversing methacholine-induced bronchoconstriction.

This single-centre, randomized, double-blind, double-dummy four-way cross-over study in 24 moderately severe asthmatic patients compared the speed of onset of recommended doses of salbutamol (200 micrograms) and formoterol (12 micrograms) delivered by metered-dose inhaler in reversing the bronchoconstriction induced by a cumulative dose of methacholine to produce a 20% decrease (PD20) in forced expiratory volume in 1 s (FEV1). Specific airway conductance (SGAW) and airway resistance (RAW) were measured in baseline condition, immediately after challenge and 0.5, 1.

Spontaneous or traumatic premature closure of the tibial tubercle.

A premature closure of the physis of the tibial tubercle in a young man has given rise to a shortening of the tibia, a patella alta and a reversed tibial slope of 20 degrees with clinical genu recurvatum. After a proximal open wedge tibial osteotomy all three postural deformities could be restored. The etiology of this complex deformity is discussed.

Hydroxyapatite-coated femoral stems. Histology and histomorphometry around five components retrieved at post mortem.

We performed a histological and histomorphometric examination in five cadaver specimens of the femoral and acetabular components and the associated tissue which had been recovered between 3.3 and 6.2 years after primary total hip arthroplasty (THA) using a proximal hydroxyapatite (HA)-coated titanium alloy implant.

A century of Dutch neurology.

The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal.

Treatment of elderly patients with isolated systolic hypertension with isosorbide dinitrate in an asymmetric dosing schedule.

Nitrates decrease pulse pressure more than mean arterial pressure (MAP) and are advocated for the treatment of isolated systolic hypertension (ISH). Nitrates show drug tolerance during chronic treatment so an asymmetric dosing regimen may prevent loss of effect of nitrates. This study investigates the anti-hypertensive effect of isosorbide dinitrate (ISDN) given in a twice daily asymmetric dosing regimen in elderly patients with ISH.

Clinical aspects of pregnancy after the age of 35 years: a review of the literature.

The objective of this report is to provide an update of our current knowledge about the impact of maternal age on pregnancy outcome. Pregnancy in women > or =35 years old is associated with a higher maternal and perinatal mortality. The older gravida also has a higher chance of being delivered by Caesarean section.

E-cadherin and calretinin: a useful combination of immunochemical markers for differentiation between mesothelioma and metastatic adenocarcinoma.

Aims: To assess the diagnostic accuracy of combinations of antibodies in the differential diagnosis of metastatic carcinomas and mesotheliomas in pleural lesions.

Methods And Results: The specificity and sensitivity of the commercially available antibodies Ber-EP4, MOC-31, CEA, B72.3, CD15, E-cadherin and calretinin were evaluated using an indirect immunoperoxidase staining technique.

Reduced E-cadherin expression is associated with increased lymph node metastasis and unfavorable prognosis in non-small cell lung cancer.

E-cadherin is a calcium-dependent, epithelial cell adhesion molecule whose reduced expression has been associated with tumor dedifferentiation and increased lymph node metastasis in clinical studies involving several carcinomas. In this study, 111 patients who had previously undergone complete resection and systematic mediastinal lymph node dissection for non-small cell lung cancer (NSCLC) were studied retrospectively. In the primary tumor, as well as in the lymph node metastases, E-cadherin expression was detected by immunohistochemistry using a monoclonal antibody (HECD-1; Takara, Otsu, Japan).

Inverted papilloma of the ureter with subsequent invasive bladder cancer.

A 63-year old man presented with urinary frequency and urge. An IVU showed a tumour in the lower right ureter. Partial ureterectomy was done with a uretero-ureterostomy.

Nerve injury after hip arthroplasty. 5/600 cases after uncemented hip replacement, anterolateral approach versus direct lateral approach.

In 600 consecutive uncemented total hip replacements, 2 surgical approaches were used: the direct lateral Hardinge approach in supine position (group I: 241 cases) or in a lateral position (group II: 280 cases) and the anterolateral Watson-Jones approach in supine position (group III: 79 cases). 5 patients had clinically evident peripheral nerve injuries confirmed with EMG: none in group I, 1 lesion of the nervus ischiadicus and nervus femoralis in group II and 4 nervus femoralis lesions in group III, of which 1 was combined with an obturator nerve injury. The nerve injuries were evaluated with EMG.

Tremor in Latin texts of Dutch physicians: 16th-18th centuries.

In his monograph An essay on the shaking palsy (1817), James Parkinson mentioned tremor and propulsion to be the most important signs of the disease that he was describing. In this article, we study aspects of the history of one of the signs that he mentioned, that is, tremor, and see how the meaning of this term evolved since its description by Galen, particularly in the period from the 16th to the 18th centuries. We'll pay attention to the development of a distinction made between action tremor and rest tremor.

A double-blind, randomized trial to compare meloxicam 15 mg with diclofenac 100 mg in the treatment of osteoarthritis of the knee.

Meloxicam is a new nonsteroidal anti-inflammatory drug (NSAID), which, in animal tests, displays a high potency for anti-inflammatory and analgesic action. The aim of this study was to investigate the efficacy and tolerability of 15 mg meloxicam in comparison with 100 mg slow-release diclofenac in patients with osteoarthritis of the knee. Two hundred and fifty-eight patients were included in the intent-to-treat analysis; these were randomized into two groups to receive either 15 mg meloxicam (N = 128) or 100 mg diclofenac (N = 130) for a period of 6 weeks.

Results and complications after posterior lumbar spondylodesis with the "Variable Screw Placement Spinal Fixation System".

Between March 1988 and March 1990, 45 patients underwent a spondylodesis using transpedicular screws and plates of the "Variable Screw Placement Spinal Fixation System". The indications for operation were spondylolisthesis (13), spondylolisthesis plus discopathy at the adjacent level (4), degenerative discopathy (13), pseudarthrosis after interbody fusion (7), disc herniations (4) and disc herniations plus degenerative discopathy of the adjacent segment (4). In 1992, 43 patients were available for follow-up.

The behavior of amidolytic factor VII in smoking and non-smoking pregnant women in relation to their gestational age.

Objective: Aim of the study was to assess the behavior of factor VII by commercial amidolytic assay in smoking and non-smoking pregnant women, and to compare this with the earlier reported factor VII:C levels during pregnancy and to discuss the role of F VII:Am with regard to thromboembolic complication in smoking pregnant women.

Methods: Blood samples were obtained for 75 non-smoking pregnant women and 109 smoking pregnant women. For the chromogenic determination of F VII:Am a COA-Set F VII test kit from Kabi Vitrum was used.

Hemostasis in newborns of smoking and nonsmoking mothers.

Objective: Our purpose was to determine the effect of smoking during pregnancy on neonatal hemostasis.

Study Design: Venous blood samples of 26 newborns of smoking and 25 newborns of nonsmoking mothers were obtained from the clamped umbilical cord immediately after birth. Prothrombin fragment 1+2, thrombin-antithrombin III complex, plasmin-alpha2-antiplasmin complex, and D-dimer levels were determined to assess activation of coagulation and fibrinolysis.

Whole blood cell counts and leucocyte differentials in patients with benign or malignant ovarian tumours.

Objective: The purpose of the study was to determine whether ovarian cancer patients had haematological anomalies compared to patients with benign ovarian tumours.

Study Design: Whole blood cell counts and leucocyte differentials were measured in 70 patients suspected of having ovarian tumours. Postoperatively, 20 patients had metastatic ovarian cancer and 50 patients had benign ovarian tumours.

Multi-parameter flow cytometric analysis with detection of the Ki67-Ag in paraffin embedded mammary carcinomas.

In the present study we describe a novel multiparameter flow cytometric (FCM) assay to estimate the fraction of cycling cells in epithelial tumors derived from fresh frozen as well as archival material. To this end, MCF-7 cells as well as a series of breast carcinomas (n = 10; fresh frozen as well as formalin fixed and paraffin embedded) were stained using a panel of different antibodies directed against the Ki67-Ag (DAKO/PC, MIB-1, Ki-S5, and poly-Ki67) for a 3-parameter cytokeratin/Ki67-Ag/DNA FCM analysis. Whereas all Ki67-Ag antibodies work equally well in the methanol fixed cell line, MIB-1 and Ki-S5 epitopes are retained in cell suspensions mechanically derived from fresh frozen tissue.

Coagulation and fibrinolysis activation markers in prostatic carcinoma patients.

In 49 patients with benign prostatic hyperplasia, 24 metastatic prostatic carcinoma patients all under palliative hormonal treatment, 17 untreated prostatic carcinoma patients without metastases and 14 untreated prostatic carcinoma patients with metastases, plasma levels of thrombin-antithrombin III complex, D-dimer and plasmin-alpha2-antiplasmin were determined. The coagulation activation marker thrombin-antithrombin III complex did not show any significant difference between the different patient groups. Of the fibrinolysis markers, D-dimer levels were elevated in both metastatic groups compared to the non-metastatic group and the benign prostatic hyperplasia group.

Trivariate flow cytometric analysis of paraffin-embedded lung cancer specimens: application of cytokeratin subtype specific antibodies to distinguish between differentiation pathways.

The aim of the present study was to investigate whether trivariate FCM analysis, for the simultaneous detection of two different CK subtypes in combination with DNA content, can be applied to paraffin embedded samples of different types of non-small cell lung cancer in order to evaluate the cell cycle of individual sublines. Single cell suspensions were prepared from 50 microm thick paraffin sections of 22 lung carcinomas by pepsin digestion and immunostained with CK-antibodies which were chosen to distinguish glandular differentiation (adenocarcinomas) and squamous differentiation. There was a good correlation between the immunocytochemical results of the different CK antibodies in tissue sections and in the corresponding single cell suspensions.