Bilateral arthrography of the wrist

In order to determine the true significance of a positive arthrogram in the investigation of wrist pain, a prospective trial was carried out in 60 patients, using the opposite asymptomatic wrist as a control. Of the 46 patients with positive findings in the symptomatic wrist, 34 (74%), had positive arthrograms in the opposite, asymptomatic, wrist. As a result of this, we conclude that a unilateral arthrogram is of little diagnostic value and we recommend the use of the opposite, asymptomatic, wrist as a control.     

An in vivo investigation into bond failure rates with a new self-etching primer system.

Self-etching primers have recently been introduced to simplify the orthodontic bonding process. The aim of this study was to compare the effectiveness of such a product with conventional 2-stage etching and priming with 37% o-phosphoric acid and a conventional unfilled primer. Twenty consecutive patients having orthodontic bonds placed were selected to participate in this cross-mouth control study. Diagonally opposite quadrants were randomly allocated to either the self-etching primer group or the conventional etching and priming group. A total of 364 teeth were bonded with a light-cured diacrylate adhesive; bond failures were then monitored over 6 months. There were 20 bond failures (10.99%) in the self-etching primer group and 9 bond failures (4.95%) in the conventional etch and priming group over this period. The results were analyzed with the McNemar test and 95% confidence interval. The difference between the failure proportions was -0.06 with an associated 95% confidence interval of -0.121 to 0.001. This study produced weak evidence to suggest that bond failures with a self-etching primer will be higher than those with conventional etching and priming. This increased likelihood of bond failure must be weighed against the time advantage of the self-etching primer when used at the initial bonding appointment.     

Retrorenal colon: implications for percutaneous diskectomy

It has been recommended that computed tomography (CT) with the patient prone be performed in every patient undergoing percutaneous diskectomy; this would enable detection of a retrorenal location of the colon, which could interfere with the percutaneous procedure. In this evaluation of 346 prone CT studies, only one patient (0.29%) was found to have retrorenal or retropsoas bowel that would have been perforated at diskectomy. Because of this extremely low prevalence, the performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not believed to be necessary.     

肾移植受者血清巨细胞病毒IgE和IgA抗体检测

采用间接ＥＬＩＳＡ检测２３名肾移植受者血清巨细胞病毒（ＣＭＶ）抗体，共检出１８名（７８％）活动性ＣＭＶ感染，其中１０名（４４％）为原发性感染。结果证实ＣＭＶ－ＩｇＥ和－ＩｇＡ具有较好的血清学诊断价值，优于ＣＭＶ－ＩｇＭ。     

GGA1 acts as a spatial switch altering amyloid precursor protein trafficking and processing

The beta-amyloid (Abeta) precursor protein (APP) is cleaved sequentially by beta-site of APP-cleaving enzyme (BACE) and gamma-secretase to release the Abeta peptides that accumulate in plaques in Alzheimer's disease (AD). GGA1, a member of the Golgi-localized gamma-ear-containing ARF-binding (GGA) protein family, interacts with BACE and influences its subcellular distribution. We now report that overexpression of GGA1 in cells increased the APP C-terminal fragment resulting from beta-cleavage but surprisingly reduced Abeta. GGA1 confined APP to the Golgi, in which fluorescence resonance energy transfer analyses suggest that the proteins come into close proximity. GGA1 blunted only APP but not notch intracellular domain release. These results suggest that GGA1 prevented APP beta-cleavage products from becoming substrates for gamma-secretase. Direct binding of GGA1 to BACE was not required for these effects, but the integrity of the GAT (GGA1 and TOM) domain of GGA1 was. GGA1 may act as a specific spatial switch influencing APP trafficking and processing, so that APP-GGA1 interactions may have pathophysiological relevance in AD.     

Primary and secondary sexual abstinence in high school students.

PURPOSE: To assess reasons for choosing not to have sexual intercourse among two groups: virgins (primary abstainers) and already sexually experienced youth (secondary abstainers). METHODS: 73,464 Minnesota ninth- and twelfth-grade adolescents completed the 1998 Minnesota Student Survey. Respondents identified reasons for abstinence from a checklist from which they could nominate all relevant items. Reasons for each group were analyzed using Chi-square with a conservative criterion value (p <.001) owing to large sample size. Logistic regression was used to examine the associations of gender, grade, and their interactions, with reasons for abstinence. RESULTS: Sixty-six percent reported never having had intercourse (primary abstainers). Among sexually experienced youth, 7.8% reported choosing not to have intercourse (secondary abstainers). Fear of pregnancy was the reason endorsed most often, more by girls than by boys (OR = 26 for primary abstainers, 6.9 for secondary abstainers). Fear of other adverse consequences, such as sexually transmitted infections, parental disapproval, or fear of getting caught, were generally selected by more girls than boys, and by more primary than secondary abstainers. Similarly, more girls and primary abstainers than boys or secondary abstainers generally selected statements reflecting normative beliefs on youth or their friends having intercourse. CONCLUSIONS: Fear of adverse consequences and normative beliefs about the appropriateness of having sexual intercourse were most frequently endorsed as important reasons by both groups of abstainers.     

Successful treatment of periungual warts using photodynamic therapy: a pilot study

AIM: The aim of this pilot study was an investigation on photodynamic therapy (PDT) whether it is a good alternative for treating periungual and subungual warts of the hands. STUDY DESIGN: Twenty patients (mean age: 30.5 years) with a total of 40 periungual and subungual warts were treated with PDT. A photosensitizer, 20%delta-aminolevulinic acid was applied on the warts. After a mean incubation time of 4.6 h (SD: 1.2), the warts were irradiated with the VersaLight for 5-30 min (15.2 +/- 4.3 min). RESULTS: After a mean of 4.5 treatments a mean clearance of 100% was achieved in 90% of the patients. One patient (5%) showed a clearance of 50% and another showed no improvement. The subungual or periungual location of the wart had no influence on the number of treatments or end result (P > 0.05). There were two recurrences during the mean follow-up period of 5.9 months (SD: 7.6). Besides mainly pain and hyperpigmentation, most treatments had no side-effects. CONCLUSION: PDT can offer a good alternative for treating periungual warts of the hands. Larger studies are indicated.