Role of platelet rich plasma in fracture non-union of scaphoid - Case series

This case series of 4 patients was studied at Queen Mary Hospital, Hong Kong from 2007 to 2011 to evaluate the clinical and radiological outcome of scaphoid fracture non-union treated with Open reduction and internal fixation ORIF supplemented with Bone Graft (BG) from iliac crest and Platelet Rich Plasma PRP. The purpose was to achieve union with pain free adequate range of movement. Patients presenting with scaphoid fracture non-union were included in our study. Total 4 patients with an average age of 35±7.7 years (range 31 to 47 years) and mean follow-up of 21.75±14.97 months, (range 05 months to 3.5 years) were included. All patients achieved union with pain free Range of motion of wrist as well as thumb. We recommend open reduction and internal fixation with bone graft along with platelets rich plasma for non-union of scaphoid.

Effectiveness of Pelvic Floor Muscle Training Alone and in Combination With Biofeedback, Electrical Stimulation, or Both Compared to Control for Urinary Incontinence in Men Following Prostatectomy: Systematic Review and Meta-Analysis

BACKGROUND

The efficacy of pelvic floor muscle training (PFMT) alone and in combination with biofeedback (BFB), electrical stimulation (ES), or both for urinary incontinence in men following prostatectomy is inconclusive.

PURPOSE

The purpose of this study was to determine whether PFMT works well alone or in combination with BFB, ES, or both in comparison with a control.

DATA SOURCES

The databases Ovid Medline, EMBASE, CENTRAL, Scopus, and Web of Science, and the specialized register of the Citroen Incontinence Review Group were searched from study inception to August 2017. Abstract proceedings from urological meetings, including the European Association of Urology and the American Urological Association, were also searched.

STUDY SELECTION

Randomized controlled trials that compared PFMT alone and PFMT with ES, BFB, or both and no treatment, placebo, or sham were included in the review.

DATA EXTRACTION, SYNTHESIS, AND QUALITY

Two independent reviewers completed data extraction and quality appraisal. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used for quality appraisal. Meta-analysis was done with software used for preparing and maintaining Cochrane reviews.

LIMITATIONS

Methodological flaws in the included studies limited internal validity.

CONCLUSIONS

PFMT alone, PFMT plus BFB and ES, and PFMT plus ES were more effective than the control for urinary incontinence following prostatectomy. The effect of PFMT plus BFB on postprostatectomy incontinence remains uncertain.

New technique: tendon interposition arthroplasty in Distal Interphalangeal Joint arthritis in Chinese population - New horizon for treatment

OBJECTIVE

To evaluate the clinical outcome of managing distal inter-phalangeal joint arthritis by using excisional arthroplasties with soft-tissue interposition to provide pain-free joint with adequate range of motion and preserving the bone stock.

METHODS

The case series was conducted at Queen Mary Hospital, Hong Kong from 2013 to 2015 and comprised patients with distal inter-phalangeal joint arthritis. Excisional arthroplasty was performed for all patients. Interposition was performed using extensor retinaculum/ palmaris longus. An axial K wire for 3-4 weeks was applied to maintain the reconstructed part in satisfactory alignment. Mallet splint was applied for another 3 weeks. Free active mobilisation was allowed afterward. Clinical assessment was done at least at 3, 6 and 12 months.

RESULTS

There were three patients in the series, and all the 5 fingers, including one thumb, achieved good range of motion with no complication except in 1(33.3%) patient who needed re-exploration of index finger for retained suture with no documentary infection. All patients (100%) had significant pain relieved with mean visual analogue scale score of 3/10±SD at 3 months and 0/10 at 1-year follow-up. All achieved good range of motion. All (100%) were satisfied with postoperative surgical outcome.

CONCLUSIONS

Interposition arthroplasty gave the patients adequate range of motion with preservation of bone stock.

Current management of hand enchondroma: a review

Enchondromas are benign bone tumours originating from cartilages. It is mainly discovered incidentally in radiographs or due to symptoms like pathological fracture or pain. Conservative treatment through regular check-up and surgical excision using curettage are the two major treatment methods for enchondromas. This review concludes that small localized asymptomatic lesions can be treated conservatively while most expanding or symptomatic lesions should be treated with simple curettage. Adjuvant treatments like high-speed burring or alcohol instillation are not recommended.

A rare combination: locked volar distal radio-ulnar joint dislocation with isolated volar capsule rupture

Distal Radioulnar Joint (DRUJ) dislocation is a commonly missed injury. A high clinical suspicion is required as the dislocation may not be obvious in the conventional views of radiographs. Volar DRUJ dislocations are far less common than the dorsal ones. Since triangular fibrocartilage complex (TFCC) is the major stabilizer of DRUJ, it is common that the irreducible DRUJ dislocation is associated with TFCC tear. We report a patient who had irreducible volar DRUJ dislocation blocked by the volar lip of sigmoid notch, with only isolated volar capsule rupture.

A new building block: costo-osteochondral graft for intra-articular incongruity after distal radius fracture

Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature. At nine-year follow-up, he was pain free and had full range of movement of the wrist. The authors suggest that costo-osteochondral graft could be an option with satisfactory result.

Peak load resistance of the JuggerKnot™ soft anchor technique compared with other common fixation techniques for large mallet finger fractures

INTRODUCTION

To identify the strongest peak load resistance among four mallet finger fracture fixation methods (Kirschner wire, pull-out wire, tension-band wiring and the JuggerKnot™ (Biomet) soft anchor fixation).

METHODS

Fixation techniques were assigned among 24 specimens from six cadaveric human hands in a randomized block fashion. Peak load resistance was tested at 30°, 45° and 60° of flexion of the distal interphalangeal joint.

RESULTS

The mean peak load of tension-band wiring was 67.8 N at 60° of flexion which was most superior. The JuggerKnot™ fixation had mean peak loads of 13.35 N (30°), 22.51 N (45°) and 32.96 N (60°). No complications of implant failure or fragmentation of the dorsal fragment was noted.

CONCLUSIONS

Tension-band wiring was the strongest fixation method but was most prominent on the skin surface as seen in three specimens. The JuggerKnot™ soft anchor fixation had similar peak load resistance as k-wire fixation and pull-out wiring.

THE BEAUTY OF STABILITY: DISTAL RADIOULNAR JOINT STABILITY IN ARTHROSCOPIC TRIANGULAR FIBROCARTILAGE COMPLEX REPAIR

The triangular fibrocartilage complex (TFCC) has an important role in the stability of the distal radioulnar joint (DRUJ) stability. We designed a new method of TFCC tear repair that has satisfactory post-operative DRUJ stability. From May 2004 to August 2010, 14 patients who underwent this operation were reviewed. The average post-operative follow-up period was 8.2 months; 66.7% of the patients with TFCC tear in sigmoid notch had clinical DRUJ instability, while only 50% of tear in fovea and 16.7% of tear in base of ulnar styloid had clinical DRUJ instability. Transosseous suture via inside-outside technique was used for repair. At the final follow-up, all 14 patients have soft end point with < 5 mm translations of the DRUJ shown by the stress test. Based on this small sample with satisfactory outcome assessed by the Mayo modified wrist score and DRUJ stability, we recommend TFCC tear in sigmoid notch, which has a higher chance of DRUJ instability, to be repaired by transosseous suture.

REVIEW ON MALLET FINGER TREATMENT

Mallet finger is a common injury involving either an extensor tendon rupture at its insertion or an avulsion fracture involving the insertion of the terminal extensor tendon. It is usually caused by a forceful blow to the tip of the finger causing sudden flexion or a hyperextension injury. Fracture at the dorsal aspect of the base of the distal phalanx is commonly associated with palmar subluxation of the distal phalanx. Most mallet finger injuries are recommended to be treated with immobilisation of the distal interphalangeal joint in extension by splints. There is no consensus on the type of splint and the duration of use. Most studies have shown comparable results with different splints. Surgical fixation is still indicated in certain conditions such as open injuries, avulsion fracture involving at least one third of the articular surface with or without palmar subluxation of the distal phalanx and also failed splinting treatment.

Mycobacterium marinum infection of the hand and wrist

PURPOSE

To review records of 166 patients who underwent treatment for Mycobacterium marinum tenosynovitis of the hand and wrist to identify factors associated with functional outcome.

METHODS

Records of 97 men and 69 women aged 13 to 85 (mean, 50) years who underwent treatment for suspected M marinum tenosynovitis of the hand and wrist were retrospectively reviewed. All underwent open biopsy; synovectomy was performed when florid synovitis was present. Rifampicin and ethambutol were usually prescribed. Clarithromycin, minocycline and/or levofloxacin were used as adjuvants if there was drug intolerance, allergy, or relapse. The duration of antibiotic treatment depended on the clinical recovery. Patients were followed up for one year after completion of drug treatment. Functional outcome was considered excellent for those with >195º total active motion (TAM) and >75% return of motion, good for those with 130º to 195º TAM and 50 to 75% return of motion, fair for those with 65º to 129º TAM and 25 to 49% return of motion, and poor for those with<65º TAM and <25% return of motion.

RESULTS

The mean delay in presentation was 4.9 (0.3-120) months. 93 of the patients presented with disabilities (flexion deformity or reduced range of motion), 64 of whom presented one month after injury. 37 (22%) of the patients had received intralesional steroids prior to admission, 30 of whom presented one month after injury. 32 (19%) patients were treated with antibiotics alone, whereas 134 (81%) patients underwent debridement in addition to antibiotic treatment. The mean duration of antibiotic treatment was 7.2 (range, 0-29) months. Of the 156 patients who completed the follow-up, functional outcome was satisfactory in 128 (82%) and unsatisfactory in 28 (17%). Steroid injections and late presentation led to worse functional outcome. Patients with unsatisfactory outcome were more likely to have received intralesional steroid injections (43% [16/37] vs. 10% [12/118], p<0.001, Pearson Chi squared test), have presented >2 months after injury (27% [21/79] vs. 9% [7/77], p=0.004, Pearson Chi squared test), and have undergone synovectomy (23% [28/124]) vs. 0% [0/32], p=0.001, Fisher's exact test). Worse functional outcome correlated with late presentation (r=0.218) and the greater number of debridement procedures (r=0.453).

CONCLUSION

Delayed antibiotic treatment of M marinum infections and steroid injections were associated with unsatisfactory outcome. Clinicians must have a high index of suspicion for this condition and avoid inappropriate management such as intralesional steroid injections. Public awareness to this condition should be raised.

Another light in the dark: review of a new method for the arthroscopic repair of triangular fibrocartilage complex

The triangular fibrocartilage complex (TFCC) is an anatomically and biomechanically important structure. Repair of radial-sided TFCC tear has previously been challenging. We designed a new method of radial-sided TFCC tear repair and found that it was also applicable for ulnar-sided TFCC tear repair. From October 2006 to December 2010, 10 patients underwent this operation and were reviewed: 9 men and 1 woman, with a mean age of 33.9 years. Average postoperative follow-up was 8 months. We graded results according to the Mayo modified wrist score. We rated 2 of the 10 patients (20%) as "excellent," 3 (30%) as "good," and 5 (50%) as "fair." The 5 patients who were rated as "fair" returned to regular jobs or had restricted employment. Based on this small sample, we recommend that this technique be considered an alternative method for TFCC repair.

The last defence? Surgical aspects of gouty arthritis of hand and wrist

OBJECTIVE

To review the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of gouty arthritis of the hand and wrist, with a focus on the surgical aspects.

DATA SOURCES AND EXTRACTION

Electronic databases including MEDLINE, PubMed, and the Cochrane library were searched with the key words of "gouty arthritis", "hand", "wrist", and "surgical".

STUDY SELECTION

A total of 55 articles were selected for inclusion in this review.

DATA SYNTHESIS

There is no existing study for the overall prevalence of gout in Asia, though one study showed that it was 3.1% in Taiwan. Its pathophysiology entails hyperuricaemia, trauma, lower temperatures, and previous diseases. Gouty arthritis of hand and wrist presents as acute wrist pain, subcutaneous or peritendinous tophi, tenosynovitis, entrapment neuropathy, tendon rupture, or even bone destruction. Demonstration of negatively birefringent crystals in the absence of organisms and a normal white cell count in synovial fluid confirm the diagnosis. Medical treatment including non-steroidal anti-inflammatory drugs, colchicines, allopurinol, uricosuric agents, and lifestyle modifications remain the mainstay of treatment. Surgical treatment options for tophaceous gout involve decompression by aspiration, incision and drainage, tenosynovectomy, shaving procedures, and complex surgical approach. CONCLUSION. While medical treatment remains the mainstay of treatment for gouty arthritis of the hand and wrist, 5% of patients may not respond. In this group, surgery is often performed in advanced stages, but yields less-than-satisfactory outcomes. Gouty arthritis is difficult to treat when it starts to cause stiffness and deformities. Although more studies are needed to evaluate the outcomes, the authors suggest that one possible solution is pre-emptive surgery.

BIOMECHANICAL EVALUATION OF PLATE OSTEOSYNTHESIS FOR AO TYPE C2 FRACTURE OF THE DISTAL RADIUS — A CADAVER STUDY

An AO type C2 distal radius fracture was simulated in a cadaver model by creating a metaphyseal defect of 5 mm and an intra-articular defect of 2 mm. Five different methods of plate osteosynthesis were tested biomechanically in each of six fresh cadaveric hands. Biomechanical testing suggested that cement augmented plating plus screws in the distal fragment was the strongest. Dorsal and volar plating plus screws on both sides of the distal fragment had the same effect of restoring stiffness and load transmission pattern as fixation with double plating plus volar screws alone. Fixation with plating plus dorsal screws was significantly weaker than these three methods, and double buttress plating with no screws in the distal fragments was the weakest.

Review article: Mycobacterium marinum infection of the hand and wrist

Misdiagnosis and delayed treatment of Mycobacterium marinum infection is common because of its diverse manifestations. This leads to inappropriate use of antimicrobials, extension of the infection from the skin to the tenosynovium, and a poor prognosis (loss of tendons and prolonged immobilisation, secondary to multiple debridements and joint contractures). Clinicians should be aware of this type of infection, especially in subjects at risk (fishermen and aquarium enthusiasts), and those with a history of trauma coupled with exposure to water or marine life. A proactive approach to obtain a biopsy for histopathological and microbiological diagnosis is advised. Anti-mycobacterial treatment should be started promptly. The combined use of rifampicin, ethambutol, and clarithromycin appears to be effective, and debridement is indicated in patients with deep-seated infections.

A review of necrotising fasciitis in the extremities

OBJECTIVE

To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong.

DATA SOURCES AND STUDY SELECTION

Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'.

DATA EXTRACTION

All articles involving necrotising fasciitis in Hong Kong were included in the review.

DATA SYNTHESIS

The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis.

CONCLUSION

Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival.

Occupational repetitive strain injuries in Hong Kong

OBJECTIVE

To review currently available evidence on the epidemiology and management of occupational repetitive strain injuries with particular reference to Hong Kong.

DATA SOURCES AND STUDY SELECTION

Medline, PubMed and Cochrane Library searches of local and internationally published English journals from 1990 to 2007 regarding repetitive strain injuries.

DATA EXTRACTION

All articles involving occupational repetitive strain injuries in Hong Kong were included in this review.

DATA SYNTHESIS

There were 16 articles contributing data on the impact of repetitive strain injuries both in Hong Kong and around the world. There were seven articles dealing with the problem of computer station set-ups and methods for improving the workstation environments.

CONCLUSION

Currently there were significant data on the impact of repetitive strain injuries in Hong Kong. The data took the form of compensation claims, days away from work, and cost of medical consultations. Other articles described proper workplace adjustments to help prevent repetitive strain injuries. However, there were no figures in the current literature showing the impact of these adjustments in reducing the incidence of repetitive strain injuries. More research could help to delineate the relationship between different types of interventions and occupational repetitive strain injuries.

Efficacy of multidisciplinary approach in treatment of constipation: a pilot study

OBJECTIVE

To evaluate a multidisciplinary Hong Kong treatment programme for patients with constipation.

DESIGN

Pilot study.

SETTING

A joint collaboration among the departments of surgery, physiotherapy, and dietetics in a regional hospital in Hong Kong.

PATIENTS

Thirty-one constipated patients with normal colonic transit and pelvic floor dyssynergia.

INTERVENTION

Multidisciplinary treatment including dietary modification, bowel habit adjustment, and physiotherapy.

MAIN OUTCOME MEASURES

Anorectal manometry, fibre intake, subjective improvement, bowel frequency, Bristol score, and straining time and effort.

RESULTS

Significant improvement was found in mean fibre intake, straining time and effort, but not in anal manometric results. A total of 78% of patients demonstrated more than 50% improvement in subjective symptoms, whereas 70% of the patients enjoyed objective improvement in pelvic floor dyssynergia documented by electromyography and anal pressure during a push effort.

CONCLUSION

The multidisciplinary rehabilitative programme for constipated patients significantly improved symptoms. Electromyography and anal pressure during a push effort are useful tools for objective assessment of the treatment effect.

Isolation and expression of PASK, a serine/threonine kinase, during rat embryonic development, with special emphasis on the pancreas

We report the isolation and characterization of a serine/threonine kinase expressed during rat pancreas development. This kinase was cloned as part of a general screen using degenerate oligonucleotides to map expression of kinases and receptors during the course of pancreatic development. Sequence analysis showed it to be a member of the ste20-like serine/threonine kinase family. Northern blotting analysis against both fetal and adult tissues showed two transcripts, one of 2 kb and the other of 4 kb. The ratio of transcript expression varied with the tissue. In situ hybridization analysis showed that this gene is expressed in the early gut and pancreatic epithelium. By embryonic Day 15, the transcript is localized to cells that will eventually become exocrine in nature. In situ hybridization analysis also demonstrated high levels of expression in the choroid plexus, the developing myocardium, kidney, CNS, dorsal root ganglia, and testes. In addition, a search of the EST database revealed a related human kinase not previously described.

Phase I trial of sequential high-dose chemotherapy with escalating dose paclitaxel, melphalan, and cyclophosphamide, thiotepa, and carboplatin with peripheral blood progenitor support in women with responding metastatic breast cancer

A single high-dose cycle of chemotherapy with stem cell support can produce disease-free survival of 15-20% for at least 3 years in women with responding stage IV breast cancer. North American Autologous Bone Marrow Transplant Registry data suggest that a complete response (CR) is the single most important prognostic factor associated with prolonged disease-free survival. Therefore, if sequential high-dose chemotherapy can increase the CR rate, then perhaps an increased proportion of patients will remain disease free. Women with at least a partial response (PR) to induction chemotherapy received three separate high-dose cycles of chemotherapy with peripheral blood progenitor support and granulocyte colony-stimulating factor. The first intensification was a dose escalation of paclitaxel (400-825 mg/ m2), the second intensification was melphalan (180 mg/m2), and the third intensification consisted of 6000 mg/m2 cyclophosphamide (1500 mg/m2/day), 500 mg/m2 thiotepa (125 mg/m2/day), and 800 mg/m2 carboplatin (200 mg/m2/day; CTCb). Thirty-six women were enrolled and 31 completed all three cycles. After the paclitaxel infusion most patients developed reversible predominantly sensory neuropathy. Of the 19 patients with measurable disease, 6 converted to CR, 7 converted to a PR* (the complete resolution of all soft tissue or visceral disease with sclerosis of prior lytic bone lesions), and 2 had a further PR for an overall response rate of 79%. Two patients had no further response and disease in two patients progressed, and thus they were taken off the study before CTCb. Seventy-eight percent are progression-free at a median follow-up of 14 months (range, 3-24+). Three sequential cycles of high-dose chemotherapy are feasible and were administered in this study with no mortality. Single agent paclitaxel at doses up to 825 mg/m2 were well tolerated with moderate reversible toxicity.

Comparative protection against oxyradicals by three flavonoids on cultured endothelial cells

Oxygen-derived free radicals are known to injure the endothelium of aorta in diverse disorders. In this study we compared the cytoprotective effects of three flavonoids against oxyradical damage to porcine aortic endothelial cells in vitro. Cultured porcine aortic endothelial cells were exposed to oxyradicals generated by xanthine oxidase--hypoxanthine (XO-HP). The cytoprotective activities of morin, quercetin, and catechin on these systems were compared using established morphologic criteria. The results in the XO-HP system showed that morin at 0.125, 0.25, and 0.5 mM delayed cell necrosis to 27.4 +/- 1.3, 46.8 +/- 1.8, and longer than 70 min, respectively, compared with 12.0 +/- 1.3 min in the control group. These degrees of protection were significantly stronger than those provided by quercetin and catechin at corresponding concentrations (p < 0.01). Morin and quercetin were moderate inhibitors of xanthine oxidase on the basis of the oxygen consumption rate, whereas catechin at the same concentrations had little inhibitory effect. The data from uric acid formation and cytochrome c reduction were consistent with the oxygen consumption measurement for the three flavonoids.

Plastic adhesive drapes and wound infection after hip fracture surgery

One hundred and twenty patients with acute hip fractures treated operatively were randomized into two groups. In the 'drape' group (n = 65) the operation site was covered with plastic adhesive drape after preparation. In the 'no drape' group (n = 55) the operation site was left uncovered. The two groups were otherwise matched. Swabs for culture were taken from skin adjacent to the wound before closure. The drape group had four positive wound swabs. There was only one positive wound swab for the no-drape group. There was no difference in the post-operative wound infection rates.

5' flanking DNA sequences direct cell-specific expression of rat tyrosine hydroxylase

Tyrosine hydroxylase (TH) is selectively expressed in catecholaminergic neurons and in chromaffin cells of the adrenal medulla. Constructs in which 5' flanking sequences of the rat TH gene directed expression of bacterial chloramphenicol acetyltransferase (CAT) were transfected into cell lines and assayed for transient expression of CAT. In most nonexpressing cell lines, CAT levels were less than 5% of that found in a TH-positive pheochromocytoma line (PC8b). In two lines described here, a rat anterior pituitary cell line (GH4) and a rat fibroblast line (Fr3T3), CAT expression reached 12 and 20%, respectively, of the PC8b level. Greater than 90% of the PC8b activity was lost when sequences between -212 and -187 (in relation to the transcriptional initiation site) were deleted. Further deletions that removed the cyclic AMP response element (CRE) (-45) and the TATA box at -29 reduced transcriptional activity to background in all three lines. These data suggest that 212 nucleotides of the 5' sequence are sufficient for pheochromocytoma expression and that information between -212 and -187, which includes an AP1 site (-206 to -200), is essential for full transcriptional activity. In addition, sites for other protein transcription factors (AP2, POU/Oct, SP1, and CRE) reside between -221 and -38 and are largely conserved between the human and rat gene.

Identification of antigenically related polypeptides at centrioles and basal bodies

An antigen localized at the centriolar region has been identified by indirect immunofluorescence studies in African green monkey kidney, human, hamster, rat, and mouse cells. The antigen consists of two polypeptides of 14,000 and 17,000 daltons. A related antigen is also present at the basal body region in ciliated cells from chicken, cat, mouse, pig, steer, and rabbit trachea and from rabbit fimbria. Immunoelectron microscopy shows that the immunoreactive antigen is indeed located in the region around the basal bodies of ciliated cat tracheal cells. Thus, we have found an antigen that is common to a variety of cell types from many different animal sources and is specifically associated with both centrioles and basal bodies. The possible role of the antigen in differentiation is discussed.