Surgical and non-surgical treatment of inguinal hernia during non-elective admissions in the Nationwide Readmissions Database

Hernia - Inguinal hernia repair is one of the most common surgical operations, yet the optimal treatment strategy remains undefined. Treatment of symptomatic inguinal hernias include both surgical...     

Manual laxity tests for anterior cruciate ligament injuries

The manual laxity examination is the primary means by which clinicians evaluate ACL injuries. This paper reviews the literature and identifies the following ACL laxity tests: anterior drawer test, Lachman test. MacIntosh test, jerk test, flexion rotation drawer test, Slocum test, and the Losee test. Test technique, grading, limitations, and reliability are discussed for each test. General limitations of manual laxity tests are also presented. A review of ACL anatomy and the biomechanics of the pivot shift sign are provided to facilitate an understanding of the underlying principles of ACL laxity tests. J Orthop Sports Phys Ther 1990;11(10):474-481.     

Aorto-iliac arteriosclerotic disease in young human adults

A highly selected group of patients younger than 50 years of age operated on for isolated aorto-iliac arteriosclerotic disease over a 7 year period has been investigated. The group has a significant dominance of females, and the patients are further characterised by being apparently otherwise "healthy" individuals. The indication for surgery was intermittent claudication in 80% and rest pain/gangrene in the remainder, with a low postoperative morbidity and no mortality. The overall cumulative patency rate is 89% at 4 years. At follow-up, a large majority of the patients were free of symptoms and the long-term results were significantly better in females. The question arises whether our group of patients, especially the young females with isolated aorto-iliac arteriosclerotic lesion, represent a separate disease entity which, when properly treated, is a benign and curable condition.     

A morphometric and x-ray energy dispersive approach to monitoring pH-altered cadmium toxicity inAnabaena flos-aquae

Cadmium toxicity and uptake as influenced by different pH values have been studied in the freshwater cyanobacteriumAnabaena flos-aquae, using the techniques of morphometric analysis, x-ray energy dispersive analysis and atomic absorption spectrophotometry. A general reduction in cell dimension, thylakoid surface area, number and volume of polyhedral bodies, polyphosphate bodies, cyanophycin granules, lipid bodies, membrane limited crystalline inclusions, volume and number of wall layers and mesosomes was observed. These reductions were more pronounced in both acidic and alkaline medium than at pH 7.2. At 0.12 M Cd, the uptake increased with alkaline pH values, and uptake was greater at pH 7.2 than at either acid or alkaline pHs. Lysis of cell wall at 1.18 M Cd showed the following decreasing trend: pH 4.0 > pH 5.5 > pH 10.0 > pH 9.0 > pH 7.2. There was a total loss of lipid bodies at 1.18 M Cd at all pH values listed.It is suggested that these techniques can be successfully employed for bioassay studies of metal toxicity to algae. In particular, cell wall lysis and loss of lipids by algae are good indicators of pH effects and metal toxicity in the aquatic ecosystem.     

Structure and function of plasminogen activator inhibitor-2

Serine proteinase inhibitors (serpins) are well known regulators of extracellular proteolytic pathways. A recently identified group of intracellular serpins of mammalian and viral origin, designated ovalbumine-like serpins, modify intracellular proteolytic pathways involved in the regulation of apoptosis and inflammation. This review focuses on plasminogen activator inhibitor-2 (PAI-2) in terms of the molecular structure-function relationships and its intracellular functions, in particular in relation to apoptosis. PAI-2 inhibits apoptosis in cell lines challenged with tumor necrosis factor or certain viruses. The intracellular proteinases which PAI-2 act upon are still unknown. During myeloid apoptosis, PAI-2 proteolytically modified to a smaller but still proteinase inhibitory form. PAI-2 is unique among the serpins with respect to its large CD-domain localized between alpha-helices C and D. Recent data show that two domains in PAI-2 are required for its antiapoptotic activity, the CD-domain and the proteinase reactive site. We have shown the CD-domain is involved in covalent and reversible interactions with cytosolic proteins, e.g. the annexins. These intracellular PAI-2-reactive proteins might represent participants in signalling pathways involved in the regulation of cell survival.     

Pornographic lives

This article examines the connection between pornography and violence against women through interviews with men about pornography use. It emphasizes the value of narrative accounts as important sources of information over experimental laboratory research. The narratives described in this article give specific examples of how pornography can 1) be an important factor in shaping a male-dominant view of sexuality; 2) contribute to a user's difficulty in separating sexual fantasy and reality; 3) be used to initiate victims and break down their resistance to sexual activity; and 4) provide a training manual for abusers. The subjects in this study were divided into two groups: 11 men who responded to a classified ad that asked for male interview subjects and 13 residents of the Alpha Human Services sex offender treatment program. The interviews documented in this article focus on cases where there is a clear link between pornography use and abuse. Analysis of the interviews provides support for the feminist anti-pornography critique.     

Macrophages interact with enriched populations of distinct T lymphocyte subsets for the induction of severe destructive Lyme arthritis

Severe destructive Lyme arthritis was detected in the hind paws of hamsters infused with enriched populations of either CD4+ or CD4- T lymphocytes along with macrophages exposed in vitro to formalin-inactivated Borrelia burgdorferi and then infected with the Lyme spirochete. Swelling was detected 4 days after infection, increased rapidly, peaked on day 8 of infection, and gradually decreased. Similarly, severe destructive arthritis was induced in hamsters infused with enriched populations of unfractionated T lymphocytes and macrophages exposed to spirochetes after infection with B. burgdorferi. Histopathological examination affirmed that hamsters infused with CD4+, CD4-, or unfractionated T lymphocytes and macrophages exposed to B. burgdorferi-induced arthritis. In addition, macrophages exposed in vitro to B. burgdorferi demonstrated both conventional and coiling phagocytosis, suggesting a mechanism by which CD4+ and CD4- T lymphocytes induce arthritis, respectively. These findings demonstrate that both CD4+ and CD4- subpopulations of T lymphocytes are capable of interacting with macrophages for the induction of severe destructive Lyme arthritis.     

Frequency of alpha- and beta-haemolysin in Staphylococcus aureus of bovine and human origin. A comparison between pheno- and genotype and variation in phenotypic expression

The phenotypic expression of haemolysins and the presence of genes encoding alpha and beta-haemolysin were determined in 105 Staphylococcus aureus isolates from bovine mastitis, 100 isolates from the nostrils of healthy humans, and 60 isolates from septicaemia in humans. Furthermore, the possible change in expression of haemolysins after subcultivation in human and bovine blood and milk was studied in selected isolates. Alpha-haemolysin was expressed phenotypically in 39 (37%) of the bovine isolates, in 59 (59%) of the human carrier isolates, and in 40 (67%) of the isolates from septicaemia. Beta-haemolysin was expressed in 76 (72%) bovine, 11 (11%) carrier, and 8 (13%) septicaemia isolates. Significantly more bovine than human isolates expressed beta-haemolysin and significantly fewer expressed alpha-haemolysin. Genotypically, the gene encoding alpha-haemolysin was detected in all isolates. A significant difference in the prevalence of the gene encoding beta-haemolysin between the bovine (96%), human carrier (56%) and isolates from septicaemia (57%) was found. Of the bovine isolates, 75% of those carrying the gene encoding beta-haemolysin expressed beta-haemolysin phenotypically, whereas only 20% of the carrier isolates and 24% of the septicaemia isolates did so. No change in expression of haemolysins could be observed after subcultivation of bovine isolates in human blood and milk. After 5 to 10 subcultures in bovine blood and 1 to 4 in bovine milk, 9 of 10 human isolates originally phenotypically beta-haemolysin negative initiated the expression of beta-haemolysin. This study showed that a larger proportion of S. aureus of bovine origin carry the beta-haemolysin gene compared to isolates from humans. Furthermore, a larger number of the isolates of bovine origin carrying the beta-haemolysin gene express this gene phenotypically compared to isolates of human origin.