AIM: Review and critical evaluation of 181 shoulder arthroplasties performed on 171 patients between December 1992 and January 1997. METHOD: We performed 118 hemiarthroplasties and 63 total shoulder replacements in 171 patients with an average age of 56.5 years. The patients were examined clinically and radiologically before surgery and followed-up for an average of two years. The Constant score was used for postoperative functional assessment. RESULTS: 46 % of the patients were very satisfied and 31 % were satisfied with the outcome. We found a significant pain reduction and an improvement of active joint function. The average Constant score was 34.9 preoperatively and 65.2 postoperatively. Overall, we found the best results after joint replacement in patients treated for avascular necrosis or fracture sequelae of the humeral head. A revision surgery had to be performed in 16 patients (8.8 %). CONCLUSION: The results of this study are encouraging and underline the growing importance of shoulder arthroplasty. The preoperative limited range of motion, previous surgeries, and the status of the rotator cuff are preoperative indicators for a favourable postoperative outcome. Preoperative planning, anatomical reconstruction, and an optimal rehabilitation programme are the keys for successful shoulder arthroplasty.

Adult↗

PubMedDate not supplied

Utero-ovarian interaction in the regulation of reproductive function.

The physiological regulation of fertile reproductive cycle in mammals depends on interactions between hypothalamus-pituitary, ovarian and uterine stimuli. Over the past 20 years, much has been learned about the interrelation between the affluent and effluent lymph and vascular drainage in and around both ovarian and uterine tissues. An essential feature in the regulation of the fertile cycle is the functional status of the ovary, particularly the corpus luteum. During the time of implantation and the early pregnancy, an active corpus luteum is essential. As human chorionic gonadotrophin (HCG) is important in the maintenance of the corpus luteum, we investigated if it was produced by the cyclic endometrium. Immunohistochemical and in-situ hybridization reactions were performed but neither identified the presence of HCG during the proliferative phase. Positive staining and beta-human chorionic gonadotrophin (beta-HCG) mRNA were observed during the secretory phase in the glandular cells of the endometrium. The results were confirmed by Western blotting of secretory phase endometrium extracts and assessment of the functional secretory capacity of primary endometrial cultures. Polymerase chain reaction (PCR) investigations showed a positive result in the secretory phase. We postulate that, based on the very close morphological interrelation between the uterus and the ovary, the beta-HCG of the endometrium is the primary factor for the maintenance of the corpus luteum and early pregnancy.

Animals↗

PubMedDate not supplied

S-100 protein immunoreactivity in bovine testis.

The present study deals with immunohistochemical localization of S-100 protein in the bovine testis. Immunoreactivity for the protein was seen in Sertoli cells of the seminiferous tubules and as a particularly intense staining in the terminal tubular segment (transitional region, middle portion, and terminal plug), which is mainly composed of modified Sertoli cells. Immunoreactivity was also found in epithelial cells of the straight testicular tubules and rete testis, and in the endothelium of capillaries, veins and lymphatic vessels. Although the functional significance of S-100 protein immunoreactivity in the Sertoli cells remains unclear, the present results suggest that it may be involved in the microtubule assembly-disassembly system. The specificity of the immunolabelling observed should enable the antigen and/or antibody to S-100 to be used as an investigative and diagnostic tool in the study of bovine Sertoli cell function.

Animals↗

PubMedDate not supplied

Identification of cognitive impairment in the elderly: homocysteine is an early marker.

In 336 consecutive patients attending a university-affiliated memory unit, clinical and psychological findings, neuroimaging and laboratory tests were analyzed. The patients were diagnosed with early Alzheimer's disease 3%, senile dementia (SDAT) 16%, vascular dementia (VAD) 20%, other dementias 9%, minor cognitive impairment (dysmentia) 32% and subjective symptoms only 21%. Increases in vascular risk factors, serum homocysteine, ApoE4 load and neuroimaging pathology were found in dementia but also in dysmentia and in patients with subjective symptoms only. The homocysteine levels correlated inversely with cognitive performance. The increases in serum homocysteine, which were pathological in VAD, Dysmentia and SDAT, may be indicative of a disturbed cerebral one-carbon metabolism and signal-accelerated development of cognitive disease.

Aged↗

PubMedDate not supplied

Aerobic capacity and functional classification of patients with severe left-ventricular dysfunction.

Classes I/II and III of the classification systems of the New York Heart Association (NYHA), Canadian Cardiovascular Society (CCS) and American Medical Association (AMA) were compared with each other and with the Weber classification (O2 uptake, VO2/kg during treadmill walking) in 35 male patients with severe left ventricular dysfunction. Measured end points were ventilatory threshold (VT) and peak exercise. Also investigated was whether the CCS and AMA scales, due to their more stringent differentiation, are more precise than the NYHA system in determining a limited physical capacity and whether there are other differentiating factors useful in classification which may be derived from cardiopulmonary exercise testing. At the VT, the mean VO2/kg did not differ significantly in any classification system between classes I/II and III (12.8 +/- 2.5 vs. 11.1 +/- 2.3 ml/kg/min) and corresponded to Weber class B. At peak exercise, the mean VO2/kg only differed significantly within the NYHA classification; classes I/II (16.3 +/- 3.1 ml/kg/min) corresponded to Weber class B, and class III (13 +/- 3 ml/kg/min) to Weber class C. The individual values displayed a large scatter. Factors differing in classes I/II and III of all three systems at peak exercise were the ventilatory equivalent of O2 and CO2 as well as end-tidal partial pressure for O2 and CO2. At VT these factors showed a separating character only in the AMA classification. It is not possible to determine objective functional impairment by use of the NYHA, CCS and AMA systems because they are not analogous to the Weber system. Nevertheless, these classification systems can be used for clinical assessment and follow-up.

Exercise Test↗

PubMedDate not supplied

Pharmaceutical container/closure integrity. V: An evaluation of the WILCO "LFC" method for leak testing pharmaceutical glass-stoppered vials.

The sensitivity, reliability, reproducibility and ease of use of the WILCO LFC package integrity test method was evaluated by preparing and testing a series of rubber-stoppered glass vials which were modified by affixing a glass micropipette through the vial side wall. The test units contained water, 50% aqueous ethanol, 20% lithium chloride or 20% aqueous glycerol. Leakage measurement obtained by LFC testing were compared to helium leak rate measurements. The LFC methods detected all leak > 0.0014 standard cubic centimeters per second (sccs), which represents a sensitivity about fourteen-fold greater than standard vacuum decay methods. The minimum detectable leak corresponded to a nominal micropipette internal diameter of between 1 and 2 microns. The effective detection range corresponded to a leak size associated with a 40 to 100% probability of microbial ingress based on a previously reported logistical regression model between helium leak rate and microbial immersion. The sensitivity did not vary with solvent or testing duration in range of 5 to 10 seconds. The coefficient of variation was about 3%. The LFC operation was rapid and without apparent mechanical or electronic problems over the two day testing period used in these studies.

Drug Packaging↗

PubMedDate not supplied

[Thrombocytopenia probably induced by norfloxacin. Apropos of a case].

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

[Treatment of behavioral and affective disorder in alcoholic and geriatric patients (author's transl)].

Tiapride, a new drug of the anisamides' family, offers not only a major effectiveness on physical disease in alcoholism, but also on behavioral or affective disorder such agitation, hostility, impulsivity in alcoholic or in geriatric patients; this particular effectiveness is presented through the study of a sample of 15 alcoholic and geriatric patients.

Adult↗

PubMedDate not supplied

Cytoimmunological monitoring in acute rejection and viral, bacterial or fungal infection following transplantation.

This study assessed the ability of immunomonitoring to differentiate between acute cardiac rejection and viral, bacterial or fungal infections, using data of thirty-five cyclosporine treated heart and heart-lung transplant recipients. Peripheral blood samples were analyzed daily for 20 days, then three times weekly until the patient's discharge. Later, peripheral blood was examined every fourteen days on an outpatient basis. White blood cells were counted and differentiated. A mononuclear concentrate was obtained by the Ficoll-Hypaque gradient and centrifugation method, and cytocentrifuged onto slides. The cells were stained by a five minute method. Percentages of lymphocytes, prelymphoblasts, lymphoblasts, large granular lymphocytes and monocytes were calculated. When activated cells were detected, aliquots of the mononuclear concentrate were labeled using monoclonal antibodies. In these thirty-five patients, more than 60 acute rejection episodes were diagnosed by the cytoimmunological method. Acute rejection was characterized by a significant rise of the number of leukocytes, lymphocytes, prelymphoblasts and lymphoblasts. The T-lymphocyte population increased while the B-cells remained normal. Ninety-five percent of all acute rejection episodes were diagnosed using cytoimmunological parameters. During viral infection more than 20% of the mononuclear cells were large granular lymphocytes and the OKT4/OKT8 ratio was less than one. During bacterial and fungal infections the B-lymphocytes increased to 40% of the mononuclear cells. In addition, juvenile polymorphs appeared in the mononuclear concentrate and the OKT4/OKT8 ratio was within normal limits (1.5 to 2.5).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗

PubMedDate not supplied

[Premature rupture of membranes at term. Retrospective study of 88 cases].

A retrospective study enabled us to evaluate the "wait-and-see" attitude adopted in our department in case of premature rupture of the membranes at term. The series included 88 patients (9.74%) who delivered spontaneously or after induction. The following maternal parameters were studied:time between rupture and delivery, pyrexia and chorioamnionitis number of vaginal digital examinations, histology and placental bacteriology. Neonatal criteria were based upon an infection assessment. Our results showed that approximately 80% of patients were in labor within 24 hours following rupture. Cesarean section rate remained stable (13%) in comparison with the overall rate for the department. Neonatal infectious morbidity (5.7%) showed no increase. The incidence of chorioamniotitis did not vary (7 cases) but appeared to be related to the number of vaginal examinations before labor. In conclusion, our attitude of temporization did not result in any increase in the number of cesarean sections nor of neonatal infections in comparison with the general population in the department. Prostaglandins might be useful in unfavorable obstetric situations.

Adult↗

PubMedDate not supplied

[Standards, options and diagnostic and therapeutic recommendations in oncology. Fédération Nationale des Centres de Lutte contre le Cancer].

From 1992 onwards, the various French institutions working on cancerology launched a program for establishing standards and options in view of assisting practitioners. The program is basically oriented towards diagnostics and care, but economic, social or ethical aspects are not neglected. A first edition of the recommended standards and options was published in 1995 on paper and CD-ROM. Dissemination through Internet is planned.

Humans↗