Polyethylene wear in unicondylar knee prostheses. 106 retrieved Marmor, PCA, and St Georg tibial components compared.

106 unicondylar knee replacement tibial components were retrieved and analyzed for the amount and type of polyethylene wear. Three different designs were retrieved which had essentially the same femorotibial conformity. Each design showed a characteristic failure pattern. The polyethylene of PCA tibial components showed serious delamination after only short durations, as a result of heat pressing. St Georg sledge prostheses showed some delamination after 4 years' duration due to sub-surface cracks which were initiated by fusion defects in the polyethylene; metal backing of the components did not affect delamination of this prosthesis. The Marmor designs showed the least wear, with shiny depressions and surface pitting; no delamination was observed in the Marmor prosthesis. Molecular weight determination by gel permeation chromatography and analysis of crystallinity using Fourier transformation infra-red spectroscopy demonstrated that St George polyethylene had higher molecular weight and crystallinity than Marmor polyethylene. In some of the components investigated, crystallinity and molecular weight of the polyethylene were reduced under the wear track when compared with the unworn polyethylene. Since fusion defects may cause delamination of polyethylene we urge manufacturers to reduce the number of such defects.     

DTPA renal scan assessment of renal allograft dysfunction in rats

The precise cause of allograft dysfunction after renal transplantation often cannot be established by non-invasive means. In clinical practice, radionuclide scans form an integral part of the clinician's armamentarium in the assessment of these patients [1, 2]. Unfortunately, in the clinical setting more than one pathological process may be responsible for the impaired function, making it difficult to correlate the scan appearances with the pathology. In this study in rats we compared the renal DTPA scan appearances of the various pathological processes which may cause renal allograft dysfunction in the immediate post-transplant period.     

Fine structure of the bladder tegument of Taenia saginata metacercaria with reference to establishment in the final host

The ultrastructure of the bladder tegument of the metacestode of Taenia saginata, with considerations on the establishment in the definitive host. The tegument surface of invaginated Taenia saginata metacestodes was demonstrated by scanning electron micrograph. The tegument is folded irregularly and its surface is amplified by the presence of microtriches, 44-45 microtriches/micron 2. The microtriches are about 500 nm long and have an absorptive function. Likely, form and sensity of microtriches turn out a capillary attraction that plays an important role in contact with surface (finger, tongue and duodenum of man, instrumentarium , glass, plastics). This opinion is supported by scanning electron micrograph of the surface of finger-tips, of the tongue and the duodenum of man.     

The use of peroxidase anti-peroxidase (PAP) complexes in the detection of plant viruses by ELISA

An ELISA test system for detection of plant viruses in field samples is described, based on the unlabelled antibody method using a peroxidase-antiperoxidase (PAP) complex. Novel features of the system include the use of acid-treated naked bacteria as combined carrier-adjuvants for the production of rabbit antiviral antibodies, and the use of acid-treated chicken antibodies (IgY) for antigen trapping in the ELISA. Systems for detection of potato virus Y (PVY), potato leafroll virus (PLRV), grapevine fanleaf virus (GFV) and grapevine virus A (GVA) were developed and compared with conventional direct double antibody sandwich (DAS) systems in tests with both purified virus and field samples. The PAP systems offer improved sensitivity, no background problems in the outer rows of the microtitre plates and are much easier to visualize with the naked eye if no plate reader is available.     

Patient Satisfaction with AbobotulinumtoxinA for Aesthetic Use in the Upper Face: A Systematic Literature Review and Post-hoc Analysis of the APPEAL Study

BACKGROUND: AbobotulinumtoxinA (AboBoNT-A; Dysport^®; Ipsen, Boulogne-Billancourt, France/Azzalure^®; Galderma, Lausanne, Switzerland) is a botulinum neurotoxin type A approved for aesthetic use in the treatment of glabellar lines in adult patients under 65 years in Europe, the United States, and other countries. OBJECTIVE: We sought to analyze current literature on patient satisfaction with aboBoNT-A for upper facial aesthetic indications. METHODS: A systematic review of literature databases (PubMed/MEDLINE, Embase, the Cochrane Library, and Google Scholar) was performed to identify English-language publications reporting on patients with aesthetic indications (including glabellar lines and wrinkles) receiving aboBoNT-A, that assessed patient and/or physician satisfaction with treatment, with no restrictions on comparator studies. Structured data extraction was used to enable inter-study analysis. A post-hoc analysis was also performed to assess patient satisfaction by sex and age, using results from the noninterventional APPEAL study of patients’ satisfaction with aboBoNT-A for treating glabellar lines. RESULTS: Overall, 22 original research papers were identified. Patient satisfaction rates for aboBoNT-A treatment were significantly higher versus placebo from two weeks to between three and five months postinjection. At two to three weeks postinjection, patient satisfaction rates were 52% and 99% across studies. In studies with later time points, patient satisfaction rates were 85 to 87 percent at 5 months and between 25 and 100 percent at 6 months post-injection. Physician satisfaction was also high (97%–100%, across three treatments). No notable differences in patient satisfaction by sex or age were observed in the APPEAL study. CONCLUSION: High rates of patient satisfaction have been achieved with aboBoNT-A treatment for upper facial aesthetic indications. Despite the current recommended interval of ≥12 weeks, satisfaction with the aesthetic results of aboBoNT-A therapy is still evident up to 6 months post-injection in some patients.     

MR imaging of the male pelvis

Prostate and urinary bladder cancer are the most frequently encountered malignancies of the urinary tract. Appropriate use of the different imaging techniques is crucial for accurate assessment of prognosis and for the development of appropriate treatment planning. Especially determination of local tumor extension and detection of nodal or bone metastases is extremely important. In this regard MR imaging is the most promising imaging technique. Therefore, in this review its role in staging these malignancies is evaluated and compared with clinical staging, and other imaging techniques. Finally, future developments, such as new sequences, new contrast agents, the role of surface coils and MR-guided biopsy, are considered. Also, the preferred radiological approach is discussed.     

Idiopathic intracranial hypertension in patients with Graves' ophthalmopathy

We report two cases of idiopathic intracranial hypertension in patients with Graves' ophthalmopathy. These patients, with known Graves' ophthalmopathy, presented with new onset optic disc edema and preserved visual function. Moderate enlargement of the extraocular muscles was observed in one case and moderate expansion of the orbital fat volume was observed in the second case. Lumbar puncture revealed an elevated opening pressure and normal cerebrospinal fluid composition in both patients. Also, no intracranial abnormalities were seen with neuroimaging studies. The findings in these patients suggest idiopathic intracranial hypertension as a second concurrent diagnosis, and should be considered as a possible etiology of optic disc edema in patients with Gravest ophthalmopathy and preserved visual function.     

Multiple intracranial juvenile xanthogranulomas. Case report

The authors report on an 11-year-old boy in whom proptosis of the eye caused by a benign intraosseous xanthofibroma of the left orbital wall became clinically apparent at the age of 4 years. Two years later he developed bilateral papilledema, at which time computerized tomography and magnetic resonance studies revealed multiple enhancing intracranial lesions. The largest mass was located in the left middle fossa; other lesions were located at the tentorium cerebelli, in both lateral ventricles, near the superior sagittal sinus, and extracranially near the left jugular vein. The mass in the left middle fossa was resected and diagnosed as juvenile xanthogranuloma (JXG). Thirty months later, the patient again became symptomatic, exhibiting behavioral abnormalities and a decrease in mental powers. At that time, the two remaining lesions in both lateral ventricles had grown enough to cause trapping of the temporal horns and raised intracranial pressure. These lesions were successively resected and histopathologically confirmed to be JXGs. However, resection of the second intraventricular lesion was complicated by postoperative bilateral amaurosis, presumably caused by postdecompression optic neuropathy. According to a review of the literature, fewer than 20 patients with JXG involving the central nervous system have been reported. The patient described in this report is the first in whom multiple intracranial JXGs developed in the absence of cutaneous manifestations. Although JXGs are biologically benign lesions, the treatment of patients with multifocal and/or progressive intracranial manifestations is problematic.