Tumour rejection antigens associated with carcinogen-induced tumours

Summary The most important immunological characteristic of tumours induced with chemical carcinogens is the expression of highly polymorphic tumour specific antigens. These cell surface components are primarily concerned with immune rejection reactions to these types of tumour, and current evidence strongly suggests that they are related to normal alloantigen.     

Influence of reagent quality and reaction conditions on the determination of serum albumin by the bromcresol green dye-binding method.

In an age of reference methodologies and sophisticated quality control techniques it is surprising that so little attention is paid to the quality of the reagents that are used. This paper reports on an investigation of the bromcresol green dye-binding procedure for the estimation of serum albumin in which particular attention has been paid to changes in the reagent components that contribute to the performance of the method. It has been shown that detailed attention to the quality control of the reagents can improve the precision and interlaboratory comparison in the estimation of serum albumin.     

Kinetic immunoturbidimetry: the estimation of albumin.

The applicability of commercially available antisera for use in kinetic immunoturbidimetry has been studied using the protein albumin as a simple model. The sensitivity of the kinetic immunoturbidimetric approach has been found to be comparable to published data for nephelometric systems, being able to detect concentrations of protein as low as 1 mg/l. The technique has shown to be as precise as most dye binding techniques for the measurement of albumin, producing a within batch C.V. of 1.0% and a between batch C.V. of 1.5%. The technique was found to be comparable to another immunological technique (RID). The fast assay time (30--60 sec), cost and good precision makes this the method of choice for routine albumin measurement. The extreme sensitivity of the technique of kinetic immunoturbidimetry makes the technique applicable to the estimation of a wide range of proteins in blood, urine and CSF.     

A clinical project to evaluate reuse of a CAPD disconnect system minicap as a safe, effective practice

The current health care environment is being driven by approaches to health care services that focus on quality and at the same time cost-effectiveness. With this in mind, a clinical project was designed to investigate the possibility of reusing the disconnect minicap as a safe, effective clinical practice. During a two-phase project, continuous ambulatory peritoneal dialysis (CAPD) disconnect caps were purposely touch contaminated and cultured before and after povodine iodine was instilled in the minicap. During the second phase of the project a simulated peritoneal effluent system was constructed and fluid cultures obtained. The specimen analyses demonstrated negative reports of the minicap after dwelling in povidine iodine and fluids after reuse of the minicap. The pilot project opens an area of research for nephrology nurses that could potentially lead to cost savings in the provision of care for patients with chronic renal failure.     

Assessing study-specific regional variations in fMRI signal

In this paper, we present a post hoc method for identifying regions where functional MRI data are subject to signal reduction that may compromise sensitivity to activations. The motivation for developing this technique derives from recent language studies that showed responses in the inferior temporal lobe that could be detected by PET but not by fMRI. Reduced signal is due mostly to susceptibility artifacts and can be identified by comparing the T2* images (which are subject to susceptibility artifacts) with T2 images (which are not). However, T2 images are not usually acquired in fMRI studies. Therefore, we propose that areas with reduced signal can be identified by comparing T2* images that are corrected for nonuniformity with the original uncorrected images. The technique provides a voxel-wise characterization of signal reduction that pertains to the particular data that enter into a statistical model. It requires only the functional data and can thus be applied post hoc and without any additional scans.     

The mechanism in junctional failure of thoraco-lumbar fusions. Part II: Analysis of a series of PJK after thoraco-lumbar fusion to determine parameters allowing to predict the risk of junctional breakdown

Purpose

To identify risk factors, in 12 patients with junctional breakdown (JBD) after thoraco-sacral fusions and to test a software locating maximal bending moment on full spine EOS images.

Methods

Twelve patients underwent long fusions for lumbar degenerative pathologies. Preop EOS images were compared to first postop EOS showing JBD. Parameters analyzed were: spinopelvic parameters [pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA), spinosacral angle (SSA), lordosis, and kyphosis], proximal junctional angle (PJA), odontoid-hip axis angle (ODHA), and CIA. A new software estimated the location of maximum bending moment (M _max) before and after JBD.

Results

All patients except one had a JBD located between T10 and L1, diagnosed at average follow-up of 18.58 months. JBD was a fracture in six patients, severe adjacent disc degeneration in the remaining. Average PI was 52°. PT increased, SS decreased after JBD versus preop (p > 0.05). Average PJA was 34.5°. Global lordosis (GLL), upper lordosis (ULL), L4–S1 lordosis, and thoracic kyphosis (TK) were increased (p < 0.05). Lower lumbar lordosis (LLL), was not increased postJBD (p = 0.6). SVA, SSA, ODHA, and C7 slope were not modified (p > 0.05). CIA average value decreased by 7.5% after JBD. T1–T5 alignment was correlated to C7 slope before (R ² = 0.77075) and after JBD (R ² = 0.85409). ODHA decreased after JBD (p > 0.05). Most JBD occurred at or one level away from preoperative M _max location.

Conclusion

This study confirms the importance of harmonious distribution of lumbar (GLL, ULL, and ILL) and thoracic curves (TK, T1–T5 segment) in thoraco-sacral fusions. All patients showed an exaggerated ULL, resulting in a posterior shift and increased lever arm at the thoraco-lumbar junction, leading to JBD.

     

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Objectives

Knee osteoarthritis (OA) is a prevalent disease in the elderly, causing pain and contributing to poor quality of life. Surgical intervention, such as knee arthroplasty, can be used in those with end‐stage knee OA. Total knee arthroplasty (TKA) is one of the most common surgical procedures for end‐stage knee OA, with promising clinical outcomes. However, a large proportion of patients with isolated compartment OA can be treated with unicompartmental knee arthroplasty (UKA) instead. UKA has shown better patient‐reported functional outcomes, and lower mortality and major complication rates than TKA. The percentage of UKA in knee arthroplasty varied in different orthopedic centers, and we believed that the requirement for UKA was underestimated in many centers. A retrospective study was carried out on our Chinese patient population presenting for knee arthroplasty; it aimed to identify the proportion of patients that might be suitable for UKA.

Methods

A retrospective cross‐sectional study of 155 consecutive patients (168 knees) awaiting TKA for end‐stage primary OA was performed. The pattern and grade of OA was recorded from preoperative weight‐bearing anteroposterior and non‐weight‐bearing lateral radiographs. The medial, lateral, patellofemoral compartment was given an individual Kellgren–Lawrence grade on the radiographs, and those grade ≥3 were defined as end‐stage OA. The compartments involvement was established then. The integrity of the anterior cruciate ligament (ACL) was determined by the modified Keyes classification on lateral radiographs. The applicability for total or partial knee arthroplasty was determined according to the compartments involvement.

Results

Medial compartment involvement was found in 154 (91.7%) knees, while the involvement of the lateral compartment and patellofemoral joint was found in 54 (32.1%) and 57 (33.9%) knees, respectively. Eighty‐one (48.2%) of the knees showed medial compartment OA with or without patellofemoral joint involvement, and modified Keyes classification grade 1, indicating an intact ACL, and, hence, potential suitability for medial UKA. Isolated lateral OA indicating possible suitability for lateral UKA was identified in 11 knees (6.5%). No patients showed isolated patellofemoral joint OA. The other 76 (45.2%) knees could be treated by TKA.

Conclusions

The medial compartment was the most commonly affected in our Chinese patients indicated for knee arthroplasty. More than half of the patients in this group could be treated by either medial or lateral UKA.