Debridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure)

The Outerbridge-Kashiwagi (O-K) procedure has been described to treat mild to moderate osteoarthritis of the elbow. We treated a consecutive series of 15 patients (16 elbows) with the O-K procedure. All patients were reviewed after a mean follow-up of twenty months (range 3-64 months). The purpose of this study was to evaluate the results of the O-K procedure. Assessment included evaluation of elbow pain, range of motion and the Mayo elbow Performance Index (MPI). The mean arc of motion improved from 94 degrees (range, 65 degrees-120 degrees) preoperatively to 114 degrees (range 93 degrees-128 degrees) at the time of follow-up (p < 0.01). At the latest follow-up evaluation the total MPI improved from 63 (range, 50-75) to 88 (range, 45-100) (p < 0.01), eight elbows (50%) had no pain, seven (43.8%) mild pain and one (6.2%) moderate pain. The result was excellent for 8 elbows (50%), good for 6 (37.5%), fair for one (6.2%) and poor for one (6.2%). Patients' satisfaction showed that thirteen (86.6%) were much better or better and two (13.3%) were not improved compared with the preoperative situation.     

Performance characteristics of updated INNO-LiPA assays for molecular typing of human leukocyte antigen A (HLA-A), HLA-B, and HLA-DQB1 alleles

We carried out a multicenter performance evaluation of three new DNA-based human leukocyte antigen (HLA) typing assays: INNO-LiPA HLA-A Update, INNO-LiPA HLA-B Update, and INNO-LiPA HLA-DQB1 Update. After optimization, the accuracy rates were all 100%, and the final observed resolutions were 99.4, 92.4, and 85.6%, respectively. These rapid and easy-to-perform assays yielded results fully concordant with other DNA-based tissue typing tests.     

Safe and reliable sound threshold measures with direct vibration of the ossicular chain

OBJECTIVES: The aim of the study was to evaluate the safety and feasibility of piezoelectric malleus vibration audiometer (MVA), which presents micromechanical vibrations to the umbo membranae tympani. STUDY DESIGN: Phase I study performed in a tertiary referral center (University Hospital). METHODS: The coupling rod of the MVA was moved slowly through the outer ear canal toward the eardrum with a micromanipulator. Coupling was completed when the rod tip touched the umbo membranae tympani. Basic audiologic measures of sound threshold obtained with direct stimulation of the malleus are presented. We used MANOVA (multivariate repeated measures ANOVA) to investigate the repeatability of MVA thresholds from one day to the other and when decoupling and retracting the coupling rod 2 mm off the umbo. We also selected the MANOVA to test for unwanted bone-conduction threshold shifts after MVA application. We assessed normality of the data by quantile-quantile plots of the residuals. RESULTS: Twenty-eight male and 10 female subjects with normal hearing, 22.2 to 34.6 years old (median age, 27.2 yr) underwent an examination. Thirty-six subjects underwent MVA, because 2 of the 38 subjects who volunteered for the study have not undergone the procedure due to the external auditory canal anatomy preventing application of the MVA. The results show that it is possible to safely and reliably measure thresholds of direct vibration of the ossicular chain. Using pure tone audiograms, no pure tone bone- and/or air-conduction threshold shifts occurred after the procedure. None of the subjects reported any other ear-related symptoms such as vertigo, tinnitus, or dizziness. Geometric mean vibratory displacements at threshold ranged from 0.55 nm at 250 Hz to 0.03 nm at 6 kHz. MANOVA demonstrated a repeatability of MVA thresholds. CONCLUSION: Malleus vibration audiometry will not allow exact linkage of actual implantable hearing aid. But the present study demonstrates that MVA can provide an audiometric tool for assessing ossicular function and integrity prior to implantation of an electronic hearing amplifier.     

Acceptability and feasibility of an interactive computer-tailored fat intake intervention in Belgium

In order to reduce the risk of chronic diseases health authorities recommend restricting fat intake to 30% of the total energy uptake. However, fat intake in Belgium is much higher warranting interventions aimed at reducing fat intake. Tailored interventions have shown to be promising; however, studies on effectiveness of interactive computer-tailored systems are needed. We investigated the acceptability and feasibility of a recently developed interactive computer-tailored fat reduction intervention. Differences in the reported acceptability and feasibility according to demographic and stages of change were explored. Participants (n = 220) completed a computerized questionnaire, and received a personal fat intake advice, which was almost immediately displayed on screen. They also completed an evaluation questionnaire, during and after they ran the tailored program, with questions on the quality, user-friendliness and applicability of the program. Participants rated the program positively on all aspects. No significant differences in acceptability and feasibility scores were found according to sex, education levels and computer literacy. Although several significant differences were found between age groups and stages of change (oldest group, contemplators and preparators were more positive about the program), the importance of these differences is probably not great, since acceptability and feasibility scores for the different age groups and stages of change were always very high. These results suggest that the computer-tailored intervention is an acceptable and feasible tool for reducing fat intake in a general population in Belgium.     

Pharmacokinetics and tolerability of long-acting risperidone in schizophrenia

The pharmacokinetics and tolerability of long-acting risperidone (Risperdal Consta) were evaluated in a multicenter, prospective, open-label, 15-week study of 86 patients with schizophrenia. Subjects stabilized on 2, 4 or 6 mg of oral risperidone once daily for at least 4 weeks were assigned to receive i.m. injections of 25, 50 or 75 mg of risperidone, respectively, every 2 weeks for 10 weeks. The 90% confidence intervals for the i.m./oral ratios of the mean steady-state plasma-AUC, corrected for dosing interval, and of the average plasma concentration of the active moiety (risperidone plus 9-hydroxyrisperidone) were within the range of 80-125%, indicating bioequivalence of the i.m. and oral formulations. However, mean steady-state peak concentrations of the active moiety were 25-32% lower with i.m. than oral dosing (P < 0.05) and fluctuations in plasma active-moiety levels were 32-42% lower with the i.m. than oral regimen. Symptoms of schizophrenia continued to improve after switching from oral to i.m. dosing. Long-acting risperidone was well tolerated locally and systematically. Although overall bioequivalence of the two formulations was established, the differences in pharmacokinetic profiles between the two formulations indicate potential benefits for long-acting risperidone.     

Processing of affective prosody and lexical-semantics in spoken utterances as differentiated by event-related potentials

In the current study, event-related potentials (ERPs) were utilized to assess whether ERP correlates would distinguish between prosodic and lexical-semantic information processed during the comprehension of a spoken affective message. To this end, we employed a standard oddball paradigm with stimuli varying in lexical-semantic or prosodic characteristics. An N400 component was obtained in response to all stimuli and conditions (non-targets and targets). Greater negativity in the N400 amplitude was observed in response to semantic as compared to prosodic stimuli. An anterior (P3a) positive component was increased for prosodic as compared to semantic targets. We also investigated whether an N400 and/or P3a component would be present when a stimulus carried affective semantic and affective prosodic information. The ERP structure observed in response to targets of this condition showed a reduction in the amplitude of the N400 component and an explicit anterior P3a component, significantly greater than the P3a component in response to prosodic or semantic targets. Finally, a P3b component was evoked in response to targets, regardless of communicative dimension.     

Interleukin-3 promotes proliferation and differentiation of human hematopoietic stem cells but reduces their repopulation potential in NOD/SCID mice

In the present study we explored systematically the influence of human interleukin-3 (IL-3) on the cord blood (CB) cell-derived production of human hematopoietic cells in the bone marrow, blood, and spleen of chimeric nonobese/severe combined immunodeficient mice ((NOD/SCID) mice. CB mononuclear cells and MACS-enriched CB CD34(+) cells were injected into irradiated NOD/SCID mice. The mice were additionally transplanted with a stably transfected rat fibroblast cell line expressing the human IL-3 gene (Rat-IL-3) constitutively, or with the nontransfected rat fibroblast cell line as a control (Rat-1). Rat-IL-3 mice displayed a higher engraftment of human hematopoietic cells in bone marrow, spleen, and peripheral blood compared with mice with Rat-1 cotransplantation. When we transplanted their total bone marrow cell population into secondary mice, surprisingly, mice transplanted with bone marrow cells from Rat-1 mice displayed a higher proportion of human hematopoietic cells compared with Rat-IL-3 mice. As expected, bone marrow cultures (BMCs) from Rat-IL-3 mice contained a higher proportion of human cells than Rat-1 bone marrow cells. However, when BMCs were passaged to new flasks, we observed a higher proportion of human cells in BMCs from Rat-1 mice compared with BMCs from Rat-IL-3 mice. IL-3 promotes the proliferation and differentiation of hematopoietic stem cells in chimeric bone marrow. In addition, IL-3 may play a role in the depletion of hematopoietic stem cells in chimeric bone marrow. In the absence of IL-3, the hematopoietic stem cells may remain in a quiescent state and proliferation can be induced by stimuli, including secondary transplantation or cell passage.