Flare up of joint inflammations induced by cloned helper T cells. Retention of the helper T cells

Joint inflammations were induced in mice by intra articular (ia) injection of cloned helper T cells specific for methylated bovine serum albumin (mBSA) together with mBSA. Local injection of mBSA several weeks after waning of a joint inflammation induced by cloned helper T cells caused a flare up reaction. This indicates that the helper T cells persisted in the joint after the primary inflammation. In the present paper we show that the helper T cells can also persist for some time in a knee joint in the absence of the specific antigen and/or an inflammatory reaction.     

K-wire fixation for redislocated Colles' fractures Malunion in 8/21 cases

One therapeutic alternative for redislocation of Colles' fractures is closed reduction and transstyloid Kirschner-wire fixation. We describe our results concerning 21 redislocations treated in this way. According to Older's classification, 8 fractures were type 3 and 13 fractures type 4. After a median follow-up period of 2 years, most patients had regained normal volar tilt, but significant loss of radial tilt and radial length was found in 11 patients. Malunion occurred in 8 wrists due to either fracture comminution or insufficient K-wire fixation. According to Gartland and Werley's point system, the end-results were poor in 2, fair in 11, good in 4, and excellent in 4 wrists. There was no statistically significant difference in secondary displacement and functional end-result between Older's type 3 and type 4 fractures. We conclude that K-wire fixation is frequently not firm enough and external fixation might be a better alternative for stabilizing redislocated distal radial fractures.     

alpha 1-Antitrypsin-levels and phenotypes in Crohn's disease in the Netherlands.

A group of 310 unrelated patients suffering from Crohn's disease has been screened for quantitative and electrophoretic variations of alpha 1-antitrypsin (alpha 1AT). A comparison was made betweeen patients and healthy controls. The distribution of electrophoretic alpha 1AT variants in the patients showed no significant deviation from the controls. The alpha 1AT quantities are significantly higher in the Crohn's disease population than in the controls.     

Attempted suicide by means of burns

A study was made of the results of treatment of 57 patients who made 68 suicide attempts by means of burns in the period between 1979 and 1987. They formed 14 per cent of the total patient population older than 16 years of age. Attempted suicide was observed most frequently in patients between 20 and 39 years of age. The sex incidence was equal. Most patients were in contact with or had been in contact with mental health care institutions at the time of their attempt, half of the attempts took place in a psychiatric hospital. Twelve patients died, in nine the prognosis was considered to be so poor that in view of the seriousness of the burns or the accompanying injuries no treatment was initiated. Follow-up took place after an average 3.8 years (1-8.25 years). Information was obtained on all 45 surviving patients. Eight patients had died, six of natural causes and two had committed suicide. Eighteen patients were living at home, 13 were residents at a psychiatric hospital, three were living in a protective commune, two were being detained during Her Majesty's pleasure and one was in prison. It appeared to be difficult to incorporate these patients in a closed follow-up regimen.     

Research proposals submitted to the Dutch Investigative Medicine Fund; evaluation of the scientific quality by the Council for Scientific Research (NWO)

The Council for Medical and Health Research (MW-NWO) assessed the scientific quality of research proposals submitted to the Dutch Investigative Medicine Fund, and analysed if there had been changes over time in the proportion of proposals which the MW-NWO advised to reject, the role of reports of external reviewers and the most important methodological flaws. In the period 1995-1999 'reject' had been advised for an average of 50% of the proposals, with a tendency to a smaller proportion in recent years. In nearly half of the proposals the judgements of external reviewers were not in agreement with each other. There was only a weak correlation between the judgements of the reviewers and the final advice of NWO. Among the most important flaws mentioned in the NWO advice were: efficacy not proven (a prerequisite for the Fund), proposed study not needed to solve the policy problem and methodological flaws, e.g. design and power calculation not adequate, deficiencies of inclusion and exclusion criteria.     

Femoral shaft fracture with injury of the superficial femoral artery in civilian accidents.

Eight patients with a fracture of the shaft of the femur and a concomitant lesion of the superficial femoral artery are presented. Six patients had a viable leg; one patient, a below knee amputation, and one, an above knee amputation. Early recognition of this relatively rare combination is of paramount importance. In our experience, internal fixation of the fracture followed by grafting of the artery through separate incision works best.