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[Diaphyseal pseudarthroses. Epidemiology and outcome].

From 1971 to 1993, a total of 759 cases of nonunion of both the upper and lower extremities were treated. In recent years the frequency of these cases of nonunion has clearly declined. Analysis of patient data shows a positive trend particularly for nonunion in the lower arm and leg while at the same time nonunion in the upper arm and leg remained essentially constant. Moreover, the proportion of aseptic to septic manifestations has shifted towards the aseptic forms in a ratio of 1:0.5. The treatment results of a representative, randomly chosen group (n = 107 out of a total of 392) from 1981 to 1993 are satisfactory with little statistical deviation for the upper extremity. The least pleasing results were seen in nonunion of the lower leg, which differed from the somewhat better results for the upper leg on the OLERUD score, with a statistical significance of P < 0.05. This study shows a very interesting development in clinical results.

Adolescent↗

Differential regulation of angiogenic genes in diabetic wound healing.

Wound healing is a complicated biological process that involves interactions of multiple cell types, various growth factors, their mediators, and the extracellular matrix proteins. In this study, we have studied the differential regulation of angiogenic genes during wound healing in transgenic (Lepr -/-) diabetic mice and non-diabetic mice. Under aseptic conditions, 8 mm full thickness cutaneous wounds were created on either side of the mid-dorsal. Wound tissues were studied at 4, 7, and 11 days post-wounding and healing was assessed by histology. The pathway-specific gene array data demonstrated differential regulation of growth factors, transcription factors, and other related genes, such as fibroblast growth factors and their receptors. The extracellular matrix protein osteopontin (OPN), an important component of cellular immunity and inflammation, showed higher expression in non-diabetic wounds after 4 days post-wounding, whereas its expression was at basal level in diabetic wounds. OPN expression remained upregulated in non-diabetic wounds at day 7 post-wounding and was downregulated to basal level at day 11 post-wounding. However, expression of OPN was upregulated in diabetic wounds at day 7 post-wounding and remained constitutively higher at day 11 post-wounding. OPN expression was concomitant with the extent of healing as assessed by histology at the corresponding sampling point. This finding suggests that OPN might be playing a crucial role in the early events of the wound healing and its delayed expression may be in part responsible for the delayed healing of wounds in diabetic mice.

Animals↗

Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's.

Herpes simplex encephalitis (HSE) is a life-threatening consequence of herpes simplex virus (HSV) infection of the central nervous system (CNS). Although HSE is rare, mortality rates reach 70% in the absence of therapy and only a minority of individuals return to normal function. Antiviral therapy is most effective when started early, necessitating prompt diagnosis. The International Herpes Management Forum (IHMF) has issued guidelines to aid the diagnosis and treatment of HSE. Polymerase chain reaction (PCR) of the cerebrospinal fluid (CSF) is the diagnostic method of choice for HSE, but negative results need to be interpreted in the context of the patient's clinical presentation and the timing of the CSF sampling. CSF virus culture is of little value in all but patients under the age of 6 months. CSF (intrathecal) antibody measurements are not recommended for acute diagnostic purposes. However, demonstration of an intrathecal HSV antibody response may be helpful in retrospective diagnosis or in cases in which CSF is sampled only late after onset of infection and PCR is negative. Serum HSV antibody measurements are not of utility in the diagnosis of HSV encephalitis in adults. In children and young adults, HSV serology may help define whether HSE is part of a primary or a reactivated HSV infection, although the clinical features, therapy, and prognosis of these two forms of HSV encephalitis are similar. The IHMF recommends that all patients with HSE receive intravenous aciclovir 10 mg/kg every 8 h for 14-21 days. Owing to the life-threatening nature of the disease, if there is a delay in diagnostic test results therapy should not be withheld until they become available. After completion of therapy, PCR of the CSF can confirm the elimination of replicating virus, aiding further management of the patient. Clinical trials of other antiviral agents (i.e. adjunctive oral valaciclovir after intravenous aciclovir) for the treatment of HSE are underway. Herpes infection of the CNS, especially with HSV-2, can also cause both monophasic and recurrent aseptic meningitis, as well as myelitis or radiculitis. Limited evidence suggests that aciclovir may be effective in its treatment. Recurrent aseptic meningitis is predominantly caused by HSV-2 infection, and is characterized by self-limited episodes of fever, meningismus and severe headache. Many cases are indistinguishable from cases previously classified as "Mollaret's meningitis", a term that should now be reserved for idiopathic cases of recurrent aseptic meningitis.

Acyclovir↗

Root canal treatment in Denmark is most often carried out in carious vital molar teeth and retreatments are rare.

AIM: To study the reasons given by a representative sample of Danish general dental practitioners (GDPs) for undertaking root canal treatment and, to investigate their confidence in performing root canal treatment on molar teeth. METHODOLOGY: A questionnaire was sent to 600 Danish GDPs randomly selected from the roster of the Danish Dental Association. They were asked to recall various factors about their experience of the last root filling they completed, including the reason for treatment and the pulp diagnosis. Self-assessments on 100-mm visual analogue scales (VAS) were reported concerning the confidence in performing root canal treatment of a molar. End-point definitions were 'very easy' (0) and 'very difficult' (100), respectively. Time reports of molar treatments were given in categorized groups. RESULTS: The most frequent reason for performing root canal treatment was caries within the tooth involved (55%). The majority of treatments involved teeth with vital pulps (54%). Retreatments were carried out in 2% of the cases. The confidence in performing root canal treatment varied but was relatively high, expressed as VAS-values below 50. The creation of an aseptic working field was regarded as the most difficult procedure followed by root canal preparation. Fifty-six percent of the responders stated a time frame of 46-75 min to complete root filling in a molar tooth. CONCLUSIONS: Root canal treatment in Denmark was reported to be undertaken most often because of caries. Treatment was typically performed in molar teeth with vital pulp. Even though apical periodontitis was frequently noted in root filled teeth, retreatments were rare. From a subjective perspective root canal treatment was not considered to be very difficult and was carried out relatively rapidly.

Analysis of Variance↗

Evaluation of the sanitization effectiveness of a denture-cleaning product on dentures contaminated with known microbial flora. An in vitro study.

OBJECTIVES: To see if dentures contaminated with Staphylococcus aureus, Pseudomas aeruginosa, Bacillus cereus, Candida albicans, and herpes simplex virus 1 could be effectively decontaminated by using Medical Tabs for Dentures. METHOD AND MATERIALS: Ten methylmethacrylate dentures with processed soft liners (soft-liner dentures) and 10 methylmethacrylate dentures without processed soft liners (hard dentures) were aseptically fragmented and individually incubated with a target microorganism. Test denture fragments were immersed in Medical for 5 minutes, vortexed for 5 minutes, and serially diluted onto media. The control denture fragments were similarly treated in sterile water. For virus contamination, denture fragments were contaminated with 1.2 x 10(9) tissue culture infective dose (TCID)50/mL. They were treated with either Medical for 5 minutes (test fragments) or water (controls) for 5 minutes. Serial dilutions were performed and viral (TCID)50/mL titers were calculated using the Reed-Muench method. RESULTS: Medical treatments effectively eliminated C. albicans, S. aureus, and P. aeruginosa from soft-liner dentures. Treatment of hard dentures eradicated C. albicans and reduced the numbers of S. aureus and P. aeruginosa to < 10. B. cereus showed a reduction of 10 microorganisms in hard dentures while the soft-liner dentures did not show an appreciable reduction. Viral analyses found that both types of dentures retained large amounts of virus when washed with water, but no virus was recovered from any of the 40 samples treated with Medical. CONCLUSION: A single use of Medical Tabs for Dentures is effective in eliminating certain species of microorganisms, including selected viruses, in vitro.

Bacillus cereus↗

Self-care habits and disease-state understanding of diabetic patients.

Diabetic patients who had never participated in a formal diabetes education program were surveyed to assess their self-care patterns and knowledge of diabetes. A sample of 142 men was selected from the diabetes clinic of a VA hospital. Patients were interviewed, a questionnaire was given to the insulin-dependent patients, and medical records were reviewed to determine concurrent use of antidiabetic medications and other drugs. The majority of patients (91%) were aware of the effects of alcohol, glucose rich foods, and lack of medication on diabetic control. However, 42% of the patients were aware of the effects of excessive exercise, and only 52% were aware of the effects of omitting meals. The most frequently cited problems involved factors of dietary control such as the use of food measurements, exchange lists, and caloric allotments. Patient knowledge of urine testing techniques was greater than knowledge of other areas. Only 24% of the patients knew the symptoms of hyperglycemia. The importance of foot care was understood by 44% of the patients, but only 13% knew how to remove corns and calluses correctly. The results of the supplemental questionnaire showed that the lowest levels of knowledge concerned insulin measurement and conversions. The appropriate aseptic procedures were known by the majority of the patients, and the time of insulin administration was understood by 97%. Medical records revealed that 23 patients were taking thiazides concurrently with their antidiabetic medication. An inverse relationship was found between age and knowledge scores, and a direct relationship was found between educational level and knowledge scores. These results should be useful in developing educational programs for diabetic patients.

Alcohol Drinking↗

Extraosseous cement granuloma associated with total hip replacement in 6 dogs.

OBJECTIVE: To report the clinical, radiographic, and pathologic features of extraosseous cement granuloma (ECG), a low occurrence, long-term complication of total hip replacement (THR). STUDY DESIGN: Retrospective clinical study. Sample Population-Six client-owned dogs. METHODS: Medical records for 6 dogs that had a cemented modular THR and developed ECG were reviewed for the clinical, radiologic, and histopathologic findings of ECG. Morphologic and elemental analyses of retrieved particles were conducted in 2 dogs using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). RESULTS: Three golden retrievers and 3 Labrador retrievers had progressive lameness in the operated limb 4 to 7 years after THR and developed ECG. Other clinical features included an acute deterioration to non-weight bearing associated with pathologic fracture of the proximal femur in 2 dogs, and obstipation in 1 dog. In 5 dogs, there was a large caseous mass surrounding the proximal femur. Obstipation in 1 dog was caused by a similar mass adjacent to bone cement used for fixation of the acetabular cup. Radiographic changes included a multilobular soft tissue mass, containing irregular mineral densities, in the gluteal mass surrounding the proximal femur, THR interface deterioration, osteolysis, new bone formation, and implant subsidence were consistent with chronic aseptic loosening. The histopathologic diagnosis was sterile granuloma associated with a massive heterogeneous particulate burden, which was assumed to have resulted from severe wear of all prosthesis components. CONCLUSIONS: ECG is a manifestation of severe aseptic loosening of cemented total hip replacement, with the generation of wear debris probably responsible for granuloma formation. CLINICAL RELEVANCE: Because revision can offer a good prognosis in early aseptic femoral loosening, yearly radiographic monitoring of the recipients is recommended.

Animals↗

Bacterial leakage of mineral trioxide aggregate as compared with zinc-free amalgam, intermediate restorative material, and Super-EBA as a root-end filling material.

Several dye leakage studies have demonstrated the fact that mineral trioxide aggregate (MTA) leaks significantly less than other root-end filling materials. The purpose of this study was to determine the time needed for Serratia marcescens to penetrate a 3 mm thickness of zinc-free amalgam, Intermediate Restorative Material (IRM), Super-EBA, and MTA when these materials were used as root-end filling materials. Fifty-six, single-rooted extracted human teeth were cleaned and shaped with a series of .04 Taper rotary instruments (Pro-series 29 files). Once the canals were prepared in a crown down approach, the ends were resected and 48 root-end cavities were ultrasonically prepared to a 3 mm depth. The teeth were then steam sterilized. Using an aseptic technique, under a laminar air flow hood, the root-end cavities were filled with amalgam, IRM, Super-EBA, and MTA. Four root-end cavities were filled with thermoplasticized gutta-percha without a root canal sealer and served as positive controls. Another four root-end cavities were filled with sticky wax covered with two layers of nail polish and served as negative controls. The teeth were attached to presterilized (ethylene oxide gas) plastic caps, and the root ends were placed into 12-ml vials of phenol red broth. Using a micropipette, a tenth of a milliliter of S. marcescens was placed into the root canal of each tooth. To test the sterility of the apparatus set-up, the root canals of two teeth with test root-end filling materials and one tooth from the positive and negative control groups were filled with sterile saline. The number of days required for S. marcescens to penetrate the four root-end filling materials and grow in the phenol red broth was recorded and analyzed. Most of the samples filled with zinc-free amalgam leaked bacteria in 10 to 63 days. IRM began leaking 28 to 91 days. Super-EBA began leaking 42 to 101 days. MTA did not begin leaking until day 49. At the end of the study, four of the MTA samples had not exhibited any leakage. Statistical analysis of the data indicated Mineral Trioxide Aggregate to be a most effective root-end filling material against penetration of S. marcescens.

Aluminum Compounds↗

Molecular identification of mumps virus genotypes from clinical samples: standardized method of analysis.

A sensitive nested reverse transcription-PCR assay, targeting a short fragment of the gene encoding the small hydrophobic protein (SH gene), was developed to allow rapid characterization of mumps virus in clinical samples. The sensitivity and specificity of the assay were established using representative genotypes A, B, C, D, E, and F. Mumps virus RNA was characterized directly from cerebrospinal fluid (CSF) samples and in extracts of mumps virus isolates from patients with various clinical syndromes. Direct sequencing of products and subsequent phylogenetic analysis enabled genetic classification. A simple web-based system of sequence analysis was established. The study also allowed characterization of mumps virus strains from Argentina as part of a new subgenotype. This PCR assay for characterization of mumps infections coupled to a web-based analytical program provides a rapid method for identification of known and novel strains.

Amino Acid Sequence↗

Isolation and characterization of heparin and gelatin binding buffalo seminal plasma proteins and their effect on cauda epididymal spermatozoa.

Seventy semen ejaculates were obtained from 14 Murrah buffalo bulls and were subjected to plasma separation immediately after collection by centrifugation at 2000 rpm for 20 min and stored in liquid nitrogen until analysis. In the seminal plasma the total protein concentration were estimated and the heparin and gelatin binding (HB and GB) proteins were isolated using heparin and gelatin affinity column chromatography. The molecular weight of individual isolated HB and GB protein was determined by SDS-PAGE analysis. Buffalo bull spermatozoa was collected from cauda epididymis under aseptic conditions and was used for the in vitro fertility tests (i.e. bovine cervical mucus penetration test (BCMPT) and hypo-osmotic swelling test (HOST)). The heparin and gelatin binding buffalo seminal plasma proteins were used in six concentrations i.e. 10, 20, 30, 40, 50 and 60 microg/ml to test their effect on in vitro fertility assessment of cauda epididymal spermatozoa. The overall mean values of total protein, HB and GB proteins were recorded as 29+/-2.7, 2.61 and 0.2mg/ml, respectively. Eighteen total protein bands were observed in the range of 12-127 kDa. Eight major HB proteins were isolated in the range of 13-71 kDa. Seven major GB proteins were isolated in the range of 13-61 kDa in the buffalo seminal plasma. The mean penetration distance (mm) travelled by the buffalo cauda spermatozoa was maximum in HB proteins (26.9+/-0.6) followed by GB proteins (25.4+/-0.6) and control (21.2+/-1.4). The difference in BCMPT values between protein treated and control group was significant (P<0.05). Almost similar trend in the effect of protein on values of HOST percentage in both HB and GB proteins treated semen samples were recorded (66.4+/-0.65 and 66.1+/-0.6, respectively). The difference in HOST values between proteins treated and control group (50.4+/-2.0) was significant (P<0.05). The present results indicate that among the isolated proteins, 4 proteins were commonly seen in both the heparin and gelatin-sepharose affinity column chromatography, and the addition of buffalo seminal plasma proteins improved the in vitro sperm functions (40 microg/ml gave best results) of buffalo cauda spermatozoa.

Animals↗

Rapid detection of enterovirus infection by automated RNA extraction and real-time fluorescence PCR.

BACKGROUND: Molecular detection has been shown to be superior to tissue culture for the detection of enteroviruses in cerebrospinal fluid (CSF) specimens. OBJECTIVES: In this study, a qualitative molecular assay based on automated RNA extraction with the MagNA Pure LC and real-time PCR on the LightCycler (LC) instrument was evaluated and compared with an in-house molecular assay. STUDY DESIGN: A total of 109 CSF specimens were investigated for the comparative study. The detection limit of the new molecular assay was determined with 10-fold dilutions of two enterovirus strains and with the Third European Union Concerted Action Enterovirus Proficiency Panel. RESULTS: With the enterovirus strains, the detection limit of the LC assay was found to be 0.1 TCID(50) (50% tissue culture infective dose). When samples of the Third European Union Concerted Action Enterovirus Proficiency Panel were tested, both molecular assays gave identical results to the expected results, which were based upon the results of three reference laboratories using a total of four different molecular methods before distribution of the panel. When clinical specimens were tested, there was a correlation between the LC assay and the in-house assay in 105 of 109 cerebrospinal fluids. CONCLUSIONS: The new molecular assay allows rapid detection of enterovirus RNA in CSF. It was found to be labor saving and showed sufficient sensitivity.

Adult↗

Effects upon bone metabolism following total hip and total knee arthroplasty.

OBJECTIVE: In a prospective study we evaluated the course of markers for bone formation and bone resorption in patients undergoing elective total hip and total knee arthroplasty due to osteoarthritis. The aim was to evaluate which changes in bone metabolism take place in the immediate postoperative course following arthroplasty. METHODS: Serum and urine samples were obtained preoperatively and in the postoperative course from patients undergoing total arthroplasty over a 90- or 180-day period. The study included a total of 63 patients with cemented hip prostheses (n = 20), uncemented hip prostheses (n = 23) and cemented knee prostheses (n = 20). Different biochemical markers of bone metabolism were assessed including the serum markers bone-specific alkaline phosphatase, and carboxyterminal propeptide of type I procollagen, and the urine markers n-telopeptide (NTx) and deoxypyridinoline (DPD). RESULTS: For all four markers, there were changes over time which were statistically significant. Markers indicating bone formation were slightly elevated after a 3-month period. In contrast, the two markers indicating bone resorption were back to normal after a 6-month period. There were differences between the groups with cemented and uncemented total hip arthroplasty in the postoperative course with higher values of the markers indicating bone resorption in the cemented group. However, these differences were not statistically significant. CONCLUSIONS: Our results indicate that the two markers of bone resorption, NTx and DPD, are elevated during the first 6 months after hip and knee arthroplasty. Therefore, during this period they cannot be used as a marker for aseptic loosening. However, if these two markers are still elevated after this period, they may reflect an impaired bone metabolism. Further studies are required to assess the potential value of these markers for the diagnosis of aseptic loosening.

Adult↗

Humoral response in Toscana virus acute neurologic disease investigated by viral-protein-specific immunoassays.

The Toscana virus (family Bunyaviridae, genus Phlebovirus) is the only sandfly-transmitted virus that demonstrates neurotropic activity. Clinical cases ranging from aseptic meningitis to meningoencephalitis caused by Toscana virus are yearly observed in central Italy during the summer, and several cases have been reported among tourists returning from zones of endemicity (Italy, Portugal, Spain, and Cyprus). In Toscana virus patients, immunoglobulin M (IgM) antibodies, usually present at the onset of symptoms, can reveal elevated titers by enzyme-linked immunosorbent assay and can persist for at least 1 year. IgG antibodies can be absent at the onset of symptoms: titers rise in convalescent sera and persist for many years. At least five proteins have been identified in Toscana virus-infected cells: nucleoprotein N, glycoproteins G1 and G2, a large protein (L) assumed to be a component of the polymerase, and two nonstructural proteins, NSm and NSs. We report results of a study on the antibody response to individual viral proteins in patients with Toscana virus-associated acute neurologic disease. Immunoblotting and semiquantitative radioimmunoprecipitation assay (RIPA) allow identification of nucleoprotein N as the major antigen responsible for both IgM and IgG responses. Antibodies to proteins other than nucleoprotein N are detected only by RIPA. Antibodies to glycoproteins are detected in about one-third of patients, and whereas their presence always predicts neutralization, some serum samples with neutralizing activity have undetectable levels of antibodies to G1-G2. Antibodies to nonstructural proteins NSm and NSs are also identified. The results obtained raise some questions about antigenic variability and relevant neutralization epitopes of Toscana virus.

Acute Disease↗

The effects of femoral stem and neck length on cement strains in a canine total hip replacement model.

OBJECTIVE: To determine the effects of femoral prosthesis stem length and head size on cement strains in a canine hip replacement system. STUDY DESIGN: An in vitro experimental model. SAMPLE POPULATION: (1) Three standard and 3 1-cm shortened femoral implants with +3 femoral heads. (2) Two standard implants with +0, +3, and +6 femoral heads. METHODS: Femoral stems were embedded in polymethylmethacrylate cement. A uniaxial proximodistal-oriented strain gauge was applied to the cement on the medial and lateral aspects of the construct 1.5 cm, 6.0 cm and 7.0 cm distal to the collar. Each construct with a +3 femoral head was mounted in a materials testing system. An axial compressive load (0-200 N) was applied to the femoral head and cement strains were recorded. Additionally, 2 standard length constructs were also tested with +0 and +6 femoral heads. The effects of stem length and neck length on cement strains were assessed with analysis of variance. RESULTS: Strains increased at all locations with increasing loads for all constructs. Shorter implants had higher strains by 152% and 171%, lateral (P =.003) and medial (P =.0025) to the stem tip. No significant strain differences were noted, at any strain gauge location, between different neck lengths (P values ranged from.20 to.67). CONCLUSIONS: Although a shorter implant stem has a potential to improve implant fit, it led to significantly higher cement strains that may increase the risk for aseptic loosening. Changes in femoral neck length did not significantly affect cement strains under the conditions tested. CLINICAL RELEVANCE: Shortening of the femoral stem currently cannot be recommended in canine total hip replacement. The existing use of variable neck lengths likely does not increase the risk of failure of the femoral stem.

Animals↗

[A study on the perception level of nursing activities of nurses in general hospitals].

The Study was carried out for the purpose of investigating the degree of perception in nursing activities. This study reports perceptions of nurses on the choices they make among competing activities, contrasts this perception with their opinion of what tasks they would like to spend time on. A sample of 231 clinical nurses was selected to participate in this study at two general hospitals in Seoul. The data was collected from July 10th to 25th, 1990. Subjects were instructed to rate one of five points likert type scale on the 43 items of nursing activities. Analysis of data was done by means of the SPSS-X Program using frequency, t-test and ANOVA. The results of this study were as follows; 1. The characteristics of the subjects were as follows: The age group of 25-29 years was 45.9%. For religion, Christians had the highest score, 68.4% and singles in subjects were 81.4%. For academic background, 64.5% were graduated from nursing junior colleges. In the subjects, staff nurses were 86.6%. 22.5% of them had worked for less than 1 year and 20.8% had 37 months to 5 years experience at the time of the survey. 62.8% were satisfied with the job. 2. The perception level of nursing activities: 1) The mean score for perception of professional nursing functions was 4.157 point, with a maximum score set at 5 points. The mean score for perception of priorities was 3.781. Perception of spending time was 3.932. 2) In perception of professional nursing functions, more important items were Aseptic technique (4.866), Shift and exchange of information concerning patients(4.654), Observing patients (4.799). Less important items were Transporting patients(3.411), Changing linens(3.442), Giving a bed shampoo (3.506). In priorities, more important ones were Aseptic technique(4.706), Shift and exchange of information concerning patients(4.524), Observing patients(4.390), Taking vital signs(4.355). And less important ones were Changing linens (3.100), Giving bed baths(3.113), Giving back rubs(3.121). In spending time, more important ones were Aseptic technique(4.706), Observing patients (4.532), Shift and exchange of information concerning patients(4.532). And less important ones were Changing lines(3.368), Transporting patients(3.394), Giving bed baths(3.450). 3) In the role perception level, the mean distribution of perception was 3.511-4.335; the role was perceived to be in order of frequency as a facilitator, coordinator, change agent and advocator role. The most important scale of factors by nursing activities was indirect nursing activities.

Adult↗

[Experiments on new synthetic and non-absorbable surgical threads].

The aim of this work was a complex evaluation of synthetic non-absorbable surgical threads of the latest, so called 3rd generation: Novafil, Monolene and Fore-Tex. Biological tests in vivo were carried on 90 white rats of the Wistar tribe. The animals were divided into three experimental groups depending on the kind of the implanted surgical thread. Moreover, taking into account the place of implantation of the tested threads, each group was divided into two sub-groups containing 15 rats each. Operations were carried on in the conditions of surgical aseptics implanting the tested threads into the striated muscles of the back and into the liver in order to make macroscopic and microscopic tests of tissue reaction and also into the peritoneal cavity in order to carry out resistance tests after a different time of the threads stay in the tissues. The animals' sections were carried out 7, 14, 21, 90 and 180 days after the implantation of the above mentioned threads. On the basis of many year's experience of The Institute of Experimental Surgery and Biomaterial Research and review of 52 works of specialistic literature I have chosen the following additional criteria of evaluation: tests of stability of surgical knot, tests of resistance in the knot to break, tests of surgical convenience including easiness of carriage of the tested threads through the tissues, flexibility, absorbability, possibility of coiling of a loose segment of threads, electrifying and the security of the knot. Tissue reaction was based on macroscopic and microscopic tests. In macroscopic tests we paid attention to the course of healing of the threads in transversostrated muscles and in liver tissue paying attention to the behaviour of the organs of o the abdominal cavity during the section. Characteristic pictures are documented by photographs. Microscopic tests consisted on making histological samples of the threads together with the surrounding tissues. Microscopic evaluation was carried on 1080 samples using punctual of tissue reaction. The used punctual system for describing tissue reaction after implantation of non-absorbable surgical threads includes the number and degree of condensation of cells in the vicinity of the implanted thread, the width of the sphere of the inflammatory reaction and the histological analysis of the cells type. The used punctual evaluation enables objective evaluation of the tested histological samples. Variously evaluated threads Novafil, Monolene and Gore-Tex are characterised by large resistance, very good surgical convenience and minimal tissue reaction. On the basis on the carried out laboratory tests and tests on animals the following conclusions were made: 1. Non-absorbable surgical threads Novafil, Monolene, Gore-Tex do not make organism changes and heal with minimal tissue reaction what proves their high biocompatibility. 2. The used punctual evaluation of the tissues reaction after implantation of non-absorbable surgical threads allows complex and objective classification of the degree of tissues reaction. 3. Monofibrous surgical threads Novafil and Monolene do not lose resistance to break in the knot. 4. Surgical threads Novafil and Monolene are characterized by very good security of the knot while threads Gore-Tex have large flexibility and small coefficient of friction, which is the cause of weak security of the knot in case of fastening under tension. 5. Tissues reaction after implantation of synthetic non-absorbable surgical threads Novafil, Monolene and Gore-Tex is smaller in comparison with the tissues reaction which were caused by non-absorbable surgical threads tested in the former years. 6. In comparison with the non-absorbable surgical threads tested in the former years, very good surgical convenience, lack of loss of resistance to break in the knot and minimal tissues reaction give the basis to classify threads Novafil, Monolene and Gore-Tex to improved non-absorbable surgical threads of the new generation

Animals↗

Detection of enteroviral RNA by a new single-step PCR.

In this study we present a modified diagnostic routine PCR (polymerase chain reaction) technique for the detection of specific enteroviral nucleic acid sequences in human body fluids, the use of which would reduce the number of false-positive results, the costs and the concentration of reagents required in PCR. Cerebrospinal samples, pharyngeal swabs and faeces were tested. To this end, general primers, selected in the highly conserved 5' non-coding region were used, with a closed-tube RT semi-nested PCR protocol, and the PCR product was analysed using a hybridization in solid phase. A total of 32 patients with suspected enteroviral infection, 17 with suspected viral meningitis and 15 with a possible acute enteroviral infection different from meningitis were analysed, and 80% of the patients with possible acute enteroviral infection were PCR-positive. A broad range of enteroviruses can be detected and false-positive results can be reduced. The availability of results in less than 12 h and the lack of need for radiolabelled probes also increase the convenience of this protocol.

Enterovirus↗

Nested PCR for rapid detection of mumps virus in cerebrospinal fluid from patients with neurological diseases.

In this study, we have developed a reverse transcription (RT)-nested polymerase chain reaction (n-PCR) for the detection of mumps virus RNA in cerebrospinal fluid (CSF) from patients with neurological infections. A specific 112-bp fragment was amplified by this method with primers from the nucleoprotein of the mumps virus genome. The mumps virus RT-n-PCR was capable of detecting 0.001 PFU/ml and 0.005 50% tissue culture infective dose/ml. This method was found to be specific, since no PCR product was detected in each of the CSF samples from patients with proven non-mumps virus-related meningitis or encephalitis. Mumps virus RNA was detected in all 18 CSF samples confirmed by culture to be infected with mumps virus. Positive PCR results were obtained for the CSF of 26 of 28 patients that were positive for signs of mumps virus infection (i.e., cultivable virus from urine or oropharyngeal samples or positivity for anti-mumps virus immunoglobulin M) but without cultivable virus in their CSF. Overall, mumps virus RNA was detected in CSF of 96% of the patients with a clinical diagnosis of viral central nervous system (CNS) disease and confirmed mumps virus infection, while mumps virus was isolated in CSF of only 39% of the patients. Furthermore, in a retrospective study, we were able to detect mumps virus RNA in 25 of 55 (46%) CSF samples from patients with a clinical diagnosis of viral CNS disease and negative laboratory evidence of viral infection including mumps virus infection. The 25 patients represent 12% of the 236 patients who had a clinical diagnosis of viral CNS infections and whose CSF was examined at our laboratory for a 2-year period. The findings confirm the importance of mumps virus as a causative agent of CNS infections in countries with low vaccine coverage rates. In summary, our study demonstrates the usefulness of the mumps virus RT-n-PCR for the diagnosis of mumps virus CNS disease and suggests that this assay may soon become the "gold standard" test for the diagnosis of mumps virus CNS infection.

Central Nervous System Diseases↗