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.     

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.     

Surface coat of sheep pulmonary intravascular macrophages: Reconstitution,and implication of a glycosyl-phosphatidylinositol anchor

Background: Pulmonary intravascular macrophages (PIMs) of sheep have a globular surface coat that facilitates endocytosis of tracer particles and Escherichia coli lipopolysaccharide, and is disrupted by the heparin and Brefeldin A treatments. The present study investigated the in vivo dynamics of the coat globules following heparin-mediated removal, and the mechanism of globule organization on the plasma membrane of PIMs in vitro. Methods: Sheep were administered heparin at a dose of 50 IU/kg body weight IV, and euthanised at 30 min, 3, 6, 12, 48, and 120 hr (n = 2 for each treatment) after the treatment. Control sheep (n = 2) were injected with normal saline solution. The tissues were processed for an ultrastructural examination and acid phosphatase (ACPase) cytochemistry. Heparintreated lungs were subjected to morphometric analysis of the coat globules. Lung tissues from normal sheep (n = 2) were incubated with phosphatidylinositol-specific-phospholipase C (PIPLC; 2 IU/ml PBS) in vitro for 30 and 75 min. Results: Heparin study: The ultrastructural and morphometric data showed that the coat globules were removed at 30 min and reconstituted within 48 hr of the treatment. The PIMs showed priminent Golgi complexes associated with secretory vesicles, microtubules, and centriole between 3–12 hr of heparin treatment. Acid phosphatase cytochemistry also demonstrated secretory activity in the Golgi complexes of PIMs during the coat reconstitution. PIPLC study: The coat globules of PIMs were removed in a time-dependent mode by the PIPLC treatment without damage to other cell organelles. Conclusions: This study demonstrates a time-dependent reconstitution of the coat of PIMs in conjunction with secretory activity following heparinmediated removal, probably through sequenstration of the globules from blood. This ability is of functional significance as the coat mediates particle endocytosis by the PIMs. The results also suggest the presence of a glycosyl-phosphatidylinositol (GPI) anchor in tethering of globules on the plasma membrane of PIMs to offer a structural basis for their integrity in pulmonary vascular flow. © 1995 Wiley-Liss, Inc.     

Convergent effects from vestibulospinal tract and primary cutaneous afferent fibers on motoneurons to ankle extensor and flexor muscles in humans

The latency and magnitude of cutaneomuscular reflexes, evoked by stimulation of the sural nerve in the contralateral and ipsilateral tibialis anterior and soleus, were investigated in normal human subjects during static tilts in the pitch axis. For all subjects the test reflex consisted of oscillating sequences of excitation and inhibition, each muscle exhibiting a characteristic pattern defined by its latency and sign of the initial phase. The latency of the various components and the sign of the initial phase did not vary with angle of tilt. However, the results of an ANOVA demonstrate a highly significant tilt-dependent modulation of the amplitude of the test reflex for the initial inhibitory phase of the contralateral tibialis anterior. We propose that this tilt-dependent effect on the crossed cutaneomuscular reflex originates from activity in the otolith organ receptors.     

Clinical importance of Campylobacter pyloridis and associated serum IgG and IgA antibody responses in patients undergoing upper gastrointestinal endoscopy.

Campylobacter pyloridis was isolated from 77% of 220 (35%) unselected adults undergoing gastroscopy. Isolation was significantly associated with histological gastritis (p less than 0.0001), duodenal ulcer (p less than 0.0001), and to a much lesser extent, with gastric ulcer (p less than 0.05). The relation between the isolation of C pyloridis and peptic ulcer seemed to be independent of coexisting gastritis. In those with no endoscopic or histological evidence of disease there was no relation between isolation and increasing age. Antibody responses to a whole cell sonicate of a strain of C pyloridis were measured by means of an enzyme linked immunosorbent assay (ELISA). Increased IgA (p less than 0.0001) and IgG (p less than 0.0001) antibody titres were found in patients with C pyloridis. Peptic ulceration or gastritis were present in 78% and 100% of patients with a high concentration of IgG and IgA, respectively, but in only 9% and 18% of those with low titres. These results provide further evidence for a possible pathogenic role of these organisms in gastric disease and suggest that immunological markers of their presence might be useful non-invasive indicators of disease.     

Lack of shared lymphocyte-stimulating determinants between H-2I and HLA-D/DR using mouse primed lymphocyte typing cells

A number of anti-H-2 alloantisera containing antibody reactive with I region gene products (Ia) of the major histocompatibility complex cross-react with determinants expressed by human peripheral blood B lymphocytes. Such data have led to the conclusion that Ia and DR antigens share cross-reacting determinants. We have attempted to generate mouse primed T lymphocyte populations specific for defined I region gene product determinants which concomitantly recognize DR determinants on human peripheral blood leukocytes in primed lymphocyte typing (PLT) analysis. Mouse PLT cells were generated in primary MLC using strain combinations identical to those in which positive mouse/human cross-reacting antisera have been obtained. The resulting PLT cells exhibited strong, yet specific, secondary MLC responses against mouse cells expressing the Ia determinants used as the primary stimulus. In contrast, when examined on panels of human peripheral blood leukocytes, no reactivity was detected. This lack of cross-reactivity suggests that mouse T cells primed toward Ia determinants do not regularly recognize cross-reacting determinants of DR or D-associated antigens expressed on human PBLs. Consequently, mPLT cells are not a useful reagent in defining HLA-D region polymorphism.     

Chondral separation in the trochlear groove - a definite clinical entity

Four patients with unusual femoro-patellar chondral defects are presented. We were unable to find their particular lesion described adequately in the literature. The patients all gave a history of relatively minor non-contact injury and presented with anterior knee pain and persistent swelling. The main features on clinical examination were moderate effusion and marked patello-femoral crepitus. Plain X-rays of the knee were unhelpful. At arthroscopy large full thickness chondral defects were seen on the femoral side of the patello-femoral articulation at the site of patellar contact with the knee in about 60° of flexion. The synovium was found to be prolific and vascular. Multiple 1.6-mm drill holes were made in the defect and chondral debris was washed out. Two patients underwent associated lateral patellar release. When a clear cut mechanical patello-femoral disorder presents unexpectedly with associated effusion and a normal radiograph, we suggest that arthroscopy be advised with particular attention to the femoral trochlea.