Gait function improvements, using Cardiff Classifier, are related to patient-reported function and pain following hip arthroplasty

Summarizing results of three-dimensional (3D) gait analysis into a comprehensive measure of overall gait function is valuable to discern to what extent gait function is affected, and later recovered after surgery and rehabilitation. This study aimed to investigate whether preoperative gait function, quantified and summarized using the Cardiff Classifier, can predict improvements in postoperative patient-reported activities of daily living, and overall gait function 1 year after total hip arthroplasty (THA). Secondly, to explore relationships between pre-to-post surgical change in gait function versus changes in patient-reported and performance-based function. Thirty-two patients scheduled for THA and 25 nonpathological individuals were included in this prospective cohort study. Patients were evaluated before THA and 1 year postoperatively using 3D gait analysis, patient-reported outcomes, and performance-based tests. Kinematic and kinetic gait parameters, derived from 3D gait analysis, were quantified using the Cardiff Classifier. Linear regressions investigated the predictive value of preoperative gait function on postoperative outcomes of function, and univariate correlations explored relationships between pre-to-post surgical changes in outcome measures. Preoperative gait function, by means of Cardiff Classifier, explained 35% and 30% of the total variance in change in patient-reported activities of daily living, and in gait function, respectively. Moderate-to-strong correlations were found between change in gait function and change in patient-reported function and pain, while no correlations were found between change in gait function and performance-based function. Clinical significance: Preoperative gait function predicts postsurgical function to a moderate degree, while improvements in gait function after surgery are more closely related to how patients perceive function than their maximal performance of functional tests.

Comparison of gait, functional activities, and patient-reported outcome measures in patients with knee osteoarthritis and healthy adults using 3D motion analysis and activity monitoring: an exploratory case-control analysis

Objective

To examine functional performance differences using kinematic and kinetic analysis between participants with and without knee osteoarthritis (OA) to determine which outcomes best characterize persons with and without knee OA.

Methods

Participants with unilateral moderate knee OA (Kellgren–Lawrence grades 2 or 3) and controls without knee pain were matched for age, gender, and body mass index. Primary outcomes included temporal parameters, joint rotations and moments, and ground reaction forces assessed via 3D motion capture during walking and ascending/descending stairs. Secondary outcomes included timed functional activities (sit to stand; tying shoelaces), 48 hrs lower limb activity monitoring, and patient-reported outcome measures (Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, European Quality of Life–5 Dimensions).

Results

Eight matched pairs were analyzed. Compared with controls, OA participants exhibited significant reductions in peak frontal hip and sagittal knee moments, and decreased peak anterior ground reaction force with the affected limb while walking. Ascending stairs, OA participants had slower speed, fewer strides per minute, longer cycle and stance times, and increased trunk range of motion (ROM) in assessments of both limbs; longer swing time and reduced ankle ROM in the affected limb; and increased knee frontal ROM in the unaffected limb. Descending stairs, OA participants had fewer strides per minute and decreased trunk transverse ROM in assessments of both limbs; increased knee frontal ROM in the affected limb; and longer strides, shorter stance and cycle times, increased trunk sagittal and decreased knee transverse ROMs in the unaffected limbs vs controls. Compared with controls, OA participants had slower walking cadence (120–130 vs 100–110 steps/min, respectively), took significantly longer on timed functional measures, and had significantly worse scores in patient-reported outcomes.

Conclusion

Several objectives and patient-reported measures examined in this study could potentially be considered as outcomes in pharmacologic or physical therapy OA trials.

Does Gait Retraining Have the Potential to Reduce Medial Compartmental Loading in Individuals With Knee Osteoarthritis While Not Adversely Affecting the Other Lower Limb Joints? A Systematic Review

Objectives

To review the literature regarding gait retraining to reduce knee adduction moments and their effects on hip and ankle biomechanics.

Data Sources

Twelve academic databases were searched from inception to January 2019. Key words “walk*” OR “gait,” “knee” OR “adduction moment,” “osteoarthriti*” OR “arthriti*” OR “osteo arthriti*” OR “OA,” and “hip” OR “ankle” were combined with conjunction “and” in all fields.

Study Selection

Abstracts and full-text articles were assessed by 2 individuals against a predefined criterion.

Data Synthesis

Of the 11 studies, sample sizes varied from 8-40 participants. Eight different gait retraining styles were evaluated: hip internal rotation, lateral trunk lean, toe-in, toe-out, increased step width, medial thrust, contralateral pelvic drop, and medial foot weight transfer. Using the Black and Downs tool, the methodological quality of the included studies was fair to moderate ranging between 12 of 25 to 18 of 28. Trunk lean and medial thrust produced the biggest reductions in first peak knee adduction moment. Studies lacked collective sagittal and frontal plane hip and ankle joint biomechanics. Generally, studies had a low sample size of healthy participants with no osteoarthritis and assessed gait retraining during 1 laboratory visit while not documenting the difficulty of the gait retraining style.

Conclusions

Gait retraining techniques may reduce knee joint loading; however, the biomechanical effects to the pelvis, hip, and ankle is unknown, and there is a lack of understanding for the ease of application of the gait retraining styles.

Severe reaction to radiotherapy for breast cancer as the presenting feature of ataxia telangiectasia

Background:

Severe early and late radiation reaction to radiotherapy is extremely rare in breast cancer patients. Such a reaction prompted an investigation into a 44-year-old mother (patient A-T213).

Methods:

A neurological examination was performed and blood lymphocytes and skin fibroblasts were assessed for radiosensitivity chromosomally and by colony-forming assay. The ATM gene was sequenced and ATM mutations modelled by site-directed mutagenesis. The ATM kinase activity was also assessed.

Results:

Patient A-T213 was normally ambulant with no ataxia and minimal other neurological features. T lymphocytes and skin fibroblasts were unusually radiosensitive, although less sensitive than in classical ataxia telangiectasia (A-T). A lymphoblastoid cell line and skin fibroblasts expressed ATM protein with some retained kinase activity. One missense ATM mutation c.8672G>A (p.Gly2891Asp) and a c.1A>G substitution were identified. In the modelling system, the p.Gly2891Asp mutant protein was expressed and shown to have residual ATM kinase activity.

Conclusion:

Patient A-T213 has a milder form of A-T with biallelic ATM mutations, which may have contributed to breast cancer development, and certainly caused the severe radiation reaction. Ataxia telangiectasia should be investigated as a potential cause of untoward severe early and late radiation reactions in breast cancer patients.

The effects of whole grains on nutrient digestibilities, growth performance, and cecal short-chain fatty acid concentrations in young chicks fed ground corn-soybean meal diets

Five experiments were conducted to evaluate the effects of whole wheat, whole sorghum, or whole barley on nutrient digestibility, growth performance, and cecal short-chain fatty acid concentrations when supplemented primarily at the expense of corn in ground corn-soybean meal control diets. The first 4 experiments utilized New Hampshire x Columbian male chicks. In the first 2 experiments, feeding 5, 10, 15, or 20% whole wheat had no effect on growth performance at 21 d when compared with chicks fed the control diet. The third experiment tested 20, 35, and 50% whole wheat fed from 0 to 21 d of age and showed that a 50% whole wheat diet decreased (P<0.05) 21-d growth and feed efficiency when compared with chicks fed the control diet. In experiment 4, 10 and 20% whole sorghum reduced (P<0.05) growth at 21 d, whereas chicks fed 10 and 20% whole barley had similar weight gains to chicks fed a ground corn-soybean meal diet. The fifth experiment with commercial Ross x Ross male broiler chicks evaluated 10 and 20% whole sorghum or whole barley and 20 and 35% whole wheat. Growth at 21 d was unaffected by any dietary treatment. Feed efficiency was decreased (P<0.05) at 21 d with 20% whole wheat and improved (P<0.05) with 10% whole barley. Feeding whole grains to chicks resulted in an increase in gizzard weight, even as early as 7 d, in all experiments. Chicks fed diets containing 10 to 20% whole wheat generally had increased MEn values at 3 to 4, 7, 14, and 21 d and also had increased amino acid digestibility at 21 d in one experiment. At 21 d, cecal pH and short-chain fatty acid concentrations in all experiments were unaffected by feeding whole grains to chicks. The results of this study indicated that feeding whole wheat, sorghum, or barley increased gizzard weight, and feeding 10 to 20% whole wheat may increase ME and amino acid digestibility.

The effects of several organic acids on growth performance, nutrient digestibilities, and cecal microbial populations in young chicks

Four experiments were conducted to evaluate the effects of citric, gluconic, fumaric, and malic acids on growth and nutrient digestibility in New Hampshire x Columbian male chicks from hatch to 21 d. For growth performance, chicks fed 1 to 4% gluconic acid, 4% citric acid, or 4% malic acid in a corn-soybean meal diet generally showed reductions (P < 0.05) in growth to 21 d, whereas 3% citric acid, 2% malic acid, or 1.5 to 4.5% fumaric acid had no significant effect. In the first experiment, 2, 4, and 6% gluconic acid increased ME(n) values at 7, 14, and 21 d, but in experiment 2, 1 and 2% gluconic acid decreased ME(n) at 4 and 7 d, but had no effect at 14 and 21 d. The 4% level of citric acid increased ME(n) at 4 d. Digestibility of most amino acids (AA) was reduced by gluconic acid in some treatments, whereas citric acid (3%) increased AA digestibility at 4 d but not at 21 d. For cecal microbial populations at 21 d, bifidobacteria were reduced when 2% gluconic acid and 3% citric acid were fed to chicks in a corn-soybean meal diet, whereas 4% gluconic acid had no effect when fed in a dextrose-casein diet to chicks. In a dextrose-isolated soy protein diet, 4% gluconic acid reduced the cecal populations of Lactobacillus, Escherichia coli, and Clostridium perfringens. The results of this study indicated that feeding organic acids did not have any consistent effects on growth performance, ME(n), AA digestibility, or cecal microbial numbers.

The effects of several oligosaccharides on true amino acid digestibility and true metabolizable energy in cecectomized and conventional roosters

Prebiotics, such as indigestible oligosaccharides, are considered to be possible dietary alternatives to antibiotic growth promoters in poultry. The effects of indigestible oligosaccharides on nutrient digestibility in poultry are largely unknown. Therefore, an experiment was conducted to evaluate the effects of several oligosaccharides on amino acid digestibility and TMEn in roosters. The dietary treatments consisted of a corn-isolated soy protein control diet or that diet supplemented with 4 or 8 g/kg of inulin, oligofructose, mannanoligosaccharide (MOS), short-chain fructooligosaccharide, or transgalactooligosaccharide (TOS). Each of the 11 diets was tube-fed (30 g) to 4 cecectomized and 4 intact Single Comb White Leghorn roosters that had been fasted for 24 h. Excreta were then collected for the following 48 h, freeze-dried, and analyzed for amino acid content. The true digestibility of lysine and valine was increased (P<0.05) in cecectomized roosters fed 8 g/kg of MOS or TOS when compared with roosters fed the control diet. In addition, methionine digestibility was improved (P<0.05) in cecectomized roosters fed 4 g/kg of MOS or short-chain fructooligosaccharide and by 8 g/kg of oligofructose or TOS. The true digestibility of isoleucine was increased (P<0.05) in cecectomized roosters fed 8 g/kg of MOS or 4 or 8 g/kg of TOS. The magnitude of the increases in amino acid digestibility coefficients for cecectomized roosters ranged from 3 to 9 percentage units. Feeding either 4 or 8 g/kg of inulin to intact roosters decreased (P<0.05) the true digestibility of methionine. The oligosaccharides generally had no significant effect on TMEn. The results of this study indicated that the indigestible oligosaccharides had no significant effect on the digestibility of most amino acids in a corn-isolated soy protein diet. The digestibility of a few amino acids, however, was increased by some oligosaccharides in cecectomized roosters but not in intact roosters.

Ataxia telangiectasia mutated-deficient B-cell chronic lymphocytic leukemia occurs in pregerminal center cells and results in defective damage response and unrepaired chromosome damage

B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous disease involving more than one molecular mechanism that leads to the transformation of CD5(+) B cells at either the pregerminal or postgerminal center stage of differentiation. It was previously demonstrated that ataxia telangiectasia mutated (ATM) gene mutations can occur in B-CLL and cause a defect in the p53 pathway. Here the role of ATM mutations in the pathogenesis of B-CLL is addressed. Of 50 B-CLL tumors with fully analyzed ATM and TP53, 16 had ATM mutations. Six of 50 B-CLLs showed mutations in TP53 and the remaining 28 tumors had wild-type ATM or TP53. No tumor had both ATM and TP53 mutations. Remarkably, all 16 ATM mutant B-CLLs showed the absence of somatic variable region heavy chain hypermutation indicating a pregerminal center cell origin and a common pathogenesis for these tumors. Furthermore, in 5 of the 16 B-CLLs, ATM mutation preceded the transformation stage of differentiation. At the cellular level, ATM mutant tumors exhibited a deficient ATM-dependent p53 response to gamma irradiation, failure to up-regulate TRAIL-R2, a downstream target that links irradiation-induced p53 response with apoptosis, and an inability to repair induced chromosome breaks. Mantle cell lymphoma (MCL) is also of pregerminal center origin and ATM mutations are frequent in this malignancy. It is concluded that ATM is likely to play an important role at the pregerminal center stage and a model is proposed where loss of ATM function during B-cell ontogeny drives B-CLL tumorigenesis in pregerminal B cells by a dual defect in p53 damage response and repair of chromosome breaks.

An evaluation of blood creatinine measurement by creatinase on the NOVA M7 blood gas analyzer

This study compared a creatininase method for the analysis at the bedside of creatinine (CR) in whole blood on a NOVA Biomedical M7 analyser, with rate-Jaffe and creatininase-based laboratory methods. Correlation and precision data were obtained and the effect of increased bilirubin concentration was assessed.

Localization to Xq27 of a susceptibility gene for testicular germ-cell tumours

Testicular germ-cell tumours (TGCT) affect 1 in 500 men and are the most common cancer in males aged 15-40 in Western European populations. The incidence of TGCT has risen dramatically over the last century. Known risk factors for TGCT include a history of undescended testis (UDT), testicular dysgenesis, infertility, previously diagnosed TGCT (ref. 7) and a family history of the disease. Brothers of men with TGCT have an 8-10-fold risk of developing TGCT (refs 8,9), whereas the relative risk to fathers and sons is fourfold (ref. 9). This familial relative risk is much higher than that for most other types of cancer. We have collected samples from 134 families with two or more cases of TGCT, 87 of which are affected sibpairs. A genome-wide linkage search yielded a heterogeneity lod (hlod) score of 2.01 on chromosome Xq27 using all families compatible with X inheritance. We obtained a hlod score of 4.7 from families with at least one bilateral case, corresponding to a genome-wide significance level of P=0.034. The proportion of families with UDT linked to this locus was 73% compared with 26% of families without UDT (P=0.03). Our results provide evidence for a TGCT susceptibility gene on chromosome Xq27 that may also predispose to UDT.

Scatter and attenuation measurements at distances greater than 10 cm from an 192Ir source

Most algorithms developed by various investigators for use in brachytherapy treatment planning have typically been designed to calculate the dose within a 10 cm range of a radiation source. These algorithms predict the dose well at distances < 10 cm from the source but were not developed and should not be utilized to predict the dose at distances > 10 cm. On the contrary, treatment planning systems and manual calculations will produce erroneous results when dose points > 10 cm are calculated using these algorithms. The spread in the data generated by the above algorithms is 16% at 15 cm and 42% at 20 cm. Physical measurements were performed at distances between 5 and 50 cm from a high activity 192Ir source in water. The measured data correlated well with the predicted data from 5 to 10 cm, which had a 5% spread. Beyond 10 cm the measured data fell central to the range of the predicted data, with the spread of the predicted data increasing from 5% to 80% with increasing distance from the source. The measured data was fitted with a model incorporating a buildup factor and an attenuation factor. The best fit values are in reasonable agreement with those obtained by two of the investigators, Thomason and Tripathi.

Linkage analysis of chromosome 1q markers in 136 prostate cancer families. The Cancer Research Campaign/British Prostate Group U.K. Familial Prostate Cancer Study Collaborators

Prostate cancer shows evidence of familial aggregation, particularly at young ages at diagnosis, but the inherited basis of familial prostate cancer is poorly understood. Smith et al. recently found evidence of linkage to markers on 1q, at a locus designated "HPC1," in 91 families with multiple cases of early-onset prostate cancer. Using both parametric and nonparametric methods, we attempted to confirm this finding, in 60 affected related pairs and in 76 families with three or more cases of prostate cancer, but we found no significant evidence of linkage. The estimated proportion of linked families, under a standard autosomal dominant model, was 4%, with an upper 95% confidence limit of 31%. We conclude that the HPC1 locus is responsible for only a minority of familial prostate cancer cases and that it is likely to be most important in families with at least four cases of the disease.

Familial nontoxic multinodular thyroid goiter locus maps to chromosome 14q but does not account for familial nonmedullary thyroid cancer

Thyroid goiter is a common condition that is often associated with iodine deficiency. Familial forms of goiter in areas not known to feature iodine deficiency are much less common. We have performed a genomic search on a single large Canadian family with 18 cases of nontoxic multinodular goiter in which 2 individuals also had papillary lesions highly suggestive of papillary carcinoma. A locus on chromosome 14q (MNG1 [multinodular goiter 1]) has been identified, with a maximal two-point LOD score of 3.8 at D14S1030 and a multipoint LOD score of 4.88 at the same marker, defined by D14S1062 (upper boundary) and D14S267 (lower boundary). The gene encoding thyroid-stimulating hormone receptor (TSHR), which is located on chromosome 14q, is outside the linked region. To determine the role of this gene in familial nonmedullary thyroid cancer (NMTC), we studied 37 smaller pedigrees each containing at least two cases of NMTC. Analysis by both parametric and nonparametric methods indicates that only a very small proportion of familial NMTC (point estimate 0.001, support intervals 0-.6 under a dominant model) is attributable to MNG1.

Dosimetric results from a feasibility study of a novel radiosurgical source for irradiation of intracranial metastases

PURPOSE

A feasibility study addressing the role of a new miniature x-ray device, the Photon Radiosurgery System (PRS), for interstitial radiosurgical treatment of intracranial metastatic neoplasms, was conducted at our institution. To gain insight into the role of PRS vis-à-vis other currently available radiosurgical treatment modalities, dosimetric comparisons of Linac Radiosurgery and proton beam therapy were performed in the treatment of a small approximately spherical metastasis.

METHODS AND MATERIALS

The photon radiosurgery system is a miniature, battery operated, high-voltage x-ray generator that produces low-energy x-rays with an effective energy of 10-20 keV emanating from the tip of a probe stereotactically inserted into small tumors (< 3 cm in diameter) in humans. Patients, 18 years or older, with supratentorial mass lesions less than 3 cm in diameter were eligible if they were likely to survive their systemic cancer and be capable of self-care for more than 4 months. Patients were ineligible if presenting with infratentorial lesions, contraindications for biopsy, or receipt of chemotherapy or radiotherapy within 4 weeks were ineligible.

RESULTS

Fourteen patients with metastatic supratentorial lesions were treated from December 1992 to December 1993 for metastatic tumors to the brain. Single doses of 10-20 Gy were delivered to spherical targets of 10 to 35 mm in diameter. Treatment, including biopsy, pathologic review and radiation treatment, generally took less than 3 h. One patient, later found to have an ischemic stroke, developed a small hemorrhage from the biopsy that preceded interstitial irradiation. There were no other complications. Median survival was 10 months. Three locally recurrent lesions failed at 3.5, 4, and 10 months after treatment. All patients had stable or improved Karnofsky status for 2 weeks to 21 months after treatment. The PRS dosimetry appears at least as good as that obtained using 6 MV Linac or 160 MeV protons. Analyses of dose-volume histograms comparing the volumes of normal CNS tissue irradiated employing each of the respective modalities suggest a small sparing of normal tissue with PRS, as opposed to linac or protons, in this patient population with small, approximately spherical tumors.

CONCLUSIONS

The PRS device provides a unique cost and time efficient procedure for providing interstitial radiation therapy immediately following histologic confirmation of malignancy in patients undergoing biopsy of intracranial lesions. The PRS treatment appears safe, and preliminary data suggest no evidence of treatment-related morbidity within the life span of the selected patient population. When treating small, spherical lesions, PRS appears to offer a modest dosimetric advantage over Linac or proton beam therapy in sparing normal tissue. These encouraging results have prompted a Phase II trial that is currently underway. Further efforts are necessary in the design of a clinically relevant trial addressing the role of fractionated external beam radiation therapy with boost vs. PRS treatment with WBRT in the treatment of single metastases.

Accelerated telomere shortening in ataxia telangiectasia

Ataxia telangiectasia (AT) is characterized by neurological deterioration, immunodeficiency, spontaneous chromosomal instability, hypersensitivity to ionizing radiation, predisposition to cancer, particularly T cell leukaemia and lymphoma, and premature ageing. The most commonly observed defect affecting telomeres in humans is telomeric fusions, particularly in T lymphocytes in AT patients. Rarely, some tumour cells, like senescent cells, have dicentric chromosomes that may arise as a result of telomeric sequence loss. We show that the AT mutation in the homozygous state confers a predisposition to accelerated telomere shortening with increasing age in peripheral blood lymphocytes (PBLs), which may be linked to premature senescence. We also show that telomeric fusions are associated with large (> 90%) preleukaemic translocation clones in T cells. We propose that these fusions may result from a compound effect of accelerated telomere shortening, together with a growth advantage of cells in large clones which leads to further telomere loss. Fusions are not observed in leukaemic cells in these patients. There is no evidence that either accelerated telomere loss per se or telomeric fusions are important in tumourigenesis. Telomerase is present in both normal and AT lymphocytes and so neither telomere shortening nor telomeric fusions can be explained by the absence of telomerase.

Severe microcephaly with normal intellectual development: the Nijmegen breakage syndrome

A brother and sister are described with severe microcephaly of prenatal onset, normal intellectual and motor development, chromosomal breakage and cellular immunodeficiency, which is characteristic of the autosomal recessive condition, Nijmegen breakage syndrome. The proband was a girl who presented at 15 months, with normal developmental milestones and an extremely small head circumference of 36 cm. Twenty per cent of her lymphocytes showed spontaneous translocations involving chromosome 7p13, 7q35, 14q11, and 14q32. The lymphocytes also showed excessive x ray induced chromosome damage. She had T cell lymphopenia, but normal immunoglobulins, and a normal alpha fetoprotein. A brother was born shortly after her diagnosis was made. He also had extreme microcephaly of 28 cm, with similar spontaneous and x ray induced chromosomal breakage, and T cell lymphopenia. Neither child has clinical evidence of immunodeficiency. To test the hypothesis that Nijmegen breakage syndrome and ataxia telangiectasia are allelic disorders, haplotype analysis was carried out in the family using DNA markers spanning the AT locus on chromosome 11q22. The affected boy had a different haplotype from his affected sister. Thus in this family, the Nijmegen breakage syndrome is not allelic to the ataxia telangiectasia locus on chromosome 11q, and the two conditions are genetically distinct. The normal intellect in these children raises questions about normal brain development in the presence of severe microcephaly.

Development of T-cell leukaemia in an ataxia telangiectasia patient following clonal selection in t(X;14)-containing lymphocytes

Ataxia telangiectasia is a rare inherited and progressive neurological disorder in which patients show an unusual predisposition to T-cell leukaemia. We report here observations on a patient with a large cytogenetically abnormal clone showing a single t(X;14)(q28;q11) translocation which conferred a proliferative advantage on the cells. The further evolution of this clone to cytogenetically more complex clones of lymphocytes was seen in the patient. She subsequently developed a rapidly progressing T-cell leukaemia, with a CD4+CD8+ T-cell phenotype, about five years after the first appearance of additional chromosome translocations in the clone cells.

Comparison of the penumbra between focused and nondivergent blocks--implications for multileaf collimators

The penumbra from a 10-MV x-ray beam has been measured using various field-shaping blocks located in the normal blocking tray position and compared to the penumbra of the adjustable photon jaws of the machine. The results showed that the penumbra was substantially degraded by these blocks only for field sizes greater than 15 x 15 cm2 and at the depth of maximum dose, dmax. At depths of 11 cm or greater, there was a significant difference only for the same range of field sizes in the 80% to 50% dose region. There was no significant difference at these depths for either the 95%-50% or the 90%-50% dose regions. No significant difference was observed between the use of lead and tungsten blocks and also between lead blocks with a straight edge and those with either an 0.5-mm or a 1-mm step in the face. Since the width of the 95% dose relative to the 50% dose is of greatest interest clinically, straight-edged blocks are as effective as divergent blocks in most situations. These results imply that the design and complexity of a multileaf collimator can be greatly simplified from a double focusing device to one that is single focusing in the plane orthogonal to the leaves.

Integrated HPV 1 genomes in a human keratinocyte cell line can be transactivated by a SV40/BPV1 recombinant virus which expresses BPV1 E2 proteins

This paper describes studies carried out on an HPV 1 carrying human keratinocyte cell line (SVD2) and two subclones of it. Although these lines contain multiple copies of HPV 1 genomes, in situ hybridization revealed that integration was restricted to band q33 on the long arms of chromosome 2. An E4 1.25-kb mRNA was specifically identified by Northern blotting and a PCR generated cDNA confirmed the presence of the E1/E4 spliced mRNA which is abundant in HPV 1 containing papillomas. Infection of an SVD2 subclone (SVD2 (cyst) sp) with a SV40/BPV1 recombinant virus which expresses the BPV1 E2 48-kb transactivator protein enhanced HPV 1 transcription at least 20-fold.

Failure to culture bacteria in groin lymph nodes during arterial reconstruction

A prospective trial was undertaken to establish if infection of groin lymph nodes was a significant risk factor in postoperative wound infection in patients undergoing groin dissection for arterial reconstruction surgery. In a series of 32 patients there was no growth on culture of any lymph nodes biopsied. None of the cases developed a post-operative infection discharging pus. In five cases minor superficial infections occurred from which bacteria were cultured. All resolved rapidly. All patients received prophylactic systemic antibiotics. We conclude that our present direct approach via a short vertical incision carries no increased risk of infection and has the advantage of speed and simplicity. It is unnecessary to make any special more complicated incision designed to avoid lymphatics.

Human adenovirus type 2 but not adenovirus type 12 is mutagenic at the hypoxanthine phosphoribosyltransferase locus of cloned rat liver epithelial cells

Using resistance to the base analog 8-azaguanine as a genetic marker, we showed that adenovirus type 2, but not adenovirus type 12, is mutagenic at the hypoxanthine phosphoribosyltransferase locus of cloned diploid rat liver epithelial cells. Adenovirus type 2 increased the frequency of 8-azaguanine-resistant colonies by up to ninefold over the spontaneous frequency, depending on expression time and virus dose.

Effects of growth hormone, prolactin and thyroxine on body wegith, somatomedin-like activity and in-vivo sulphation of cartilage in hypopituitary dwarf mice

Hypopituitary dwarf mice were found to have reduced levels of serum somatomedin-like activity compared with normal mice of the Snell strain. Treatment with bovine growth hormone for 3 and 7 days resulted in growth without significantly increased levels of serum somatomedin-like activity, as detected by in-vitro uptake of 35SO4(2-) into normal rat cartilage; only after treatment for 14 days was somatomedin activity significantly raised. However, treatment for 2 days with bovine growth hormone, bovine prolactin or thyroxine resulted in a dose-dependent increase in in-vivo uptake of 35SO4(2-) into dwarf mouse costal cartilage; growth hormone and thyroxine did not act synergistically. Ten days of treatment with growth hormone promoted a dose-dependent increase in both growth (increased weight gain and tail length) and in-vivo of 35SO4(2-). Increase in tail length was correlated with uptake of 35S04(2-). Thus, in-vivo uptake of 35SO4(2-) into dwarf mouse costal cartilage provides a sensitive method for detecting a dose-related effect of growth hormone.