De Quervain tendinitis after total trapeziometacarpal joint arthroplasty: Biomechanical evaluation of tendon excursion in the first extensor tendon compartment.

De Quervain's tenosynovitis is the most common complication after total trapeziometacarpal joint replacement. Etiology is unclear. Implantation of a ball-in-socket implant changes the biomechanics of the normal trapeziometacarpal saddle joint and increases its range of motion. The present study demonstrates that this procedure also significantly increases excursion of the abductor pollicis longus and extensor pollicis brevis tendons during thumb flexion-extension, and not during thumb abduction-adduction. Increased tendon gliding under the retinaculum of the first extensor tendon compartment could predispose to the development frictional tenosynovitis and play a role in the development of de Quervain's syndrome after total trapeziometacarpal joint replacement. LEVEL OF EVIDENCE: Not applicable (laboratory study).

A rich and diverse fauna: an illustrated guide to the cetoniines of Ghana with comparisons to Ivory Coast and Benin (Coleoptera: Scarabaeidae: Cetoniinae).

The currently known cetoniine fauna of Ghana is discussed and illustrated. It now includes 60 genera and 148 taxa, including 9 subspecies. Comparison to the adjacent countries of Ivory Coast and nearby Benin gives evidence that the faunas of all three countries surprisingly may still be grossly under-sampled and hence poorly known for what is considered a relatively well-known group of beetles. At least 22 species known from both Ivory Coast and Benin are expected to be found in Ghana but still have yet to be reported. Notes on several species concepts and the alternate use of names are also given to clarify the taxonomy of the taxa known from this area.

Spontaneous index finger extensor tendon rupture in a SNAC wrist.

We present two recent cases of spontaneous rupture of both index finger extensor digitorum communis and extensor indices proprius tendons caused by a dorsal carpus osteophyte. Both patients had a history of scaphoid fracture non-union with evolution to scaphoid non-union advanced collapse (SNAC) of the wrist. These two cases were treated surgically with a 3-corner arthrodesis, and an interposition of a fragment of one of both ruptured tendons together with a tendon transfer of a supernumerary extensor digitorum communis of the third finger. The interposed tendon fragment was sutured with a Pulvertaft weave proximally and end-to-end distally. The supernumerary tendon was added as reinforcement to this construction. At 6-month and 14-month follow-up, the patients had a slight decrease in range of motion and functionality without hindering the activities of daily living and a great improvement in strength. Isolated extension of the index finger was possible minimum 6 months postoperatively. Spontaneous tendon ruptures of the finger extensors are not common but were described earlier in literature. Recent literature described that underlying cause of a spontaneous tendon rupture should always be corrected in order to prevent or at least delay future ruptures. To our knowledge, this is a rare type of complication and this kind of treatment has never been reported in literature.

A new genus of spider beetle (Coleoptera, Ptinidae) from western Peru.

A new genus of flightless spider beetle from Peru with two new species is described. It is characterized by unique heart-shaped fused elytra and a broad pronotum with five basal depressions. The characters of this new genus and species are illustrated and discussed and the possible phylogenetic placement of this taxon is also included.

Elevational and Possible Bushmeat Exploitation Effects on Dung Beetle (Scarabaeidae: Scarabaeinae) Communities on Mount Cameroon, West Central Africa.

Dung beetle species richness and abundance on Mt Cameroon were investigated to evaluate the effects of elevation. Surveys were done at five different elevations on the southwest facing slope from 216 to 2,102 m above sea level near the tree line at intervals of ~500 m. In total, 27 species and 1,886 specimens were collected during the study. No linear relationship between either species richness or beetle abundance and elevation was found with an expected highest diversity and abundance at low elevation and the lowest diversity and abundance at high elevation. Instead, both the highest diversity and abundance were discovered at the middle elevation (914-1,012 m) with 22 species and 48% of the total catch. The highest diversity indices (Shannon and Simpson) were found at the second lowest elevation (522-625 m). The lowest diversity found at the highest elevation (1,974-2,101 m) included only two species and represented only 4% of the beetles sampled. Unexpected low diversity and abundance at the lowest elevation are hypothesized to be due at least in part to the effects of bushmeat hunting in the more accessible lower elevations and the concomitant effects on dung beetles that mainly utilize mammal dung. The most similar faunas based on Morisita-Horn paired comparisons were those at the two highest and the two lowest elevations while the most dissimilar were the middle compared with the highest elevation. Faunas appear to be divided into high and low elevation communities with a boundary or division at c.1,500-1,750 m elevation.

Effects of Exyra ridingsii (Lepidoptera: Noctuidae) on Sarracenia flava (Nepenthales: Sarraceniaceae).

Exyra ridingsii (Riley) (Lepidoptera: Noctuidae) is a moth whose obligate host is the pitcher plant Sarracenia flava (L.) (Nepenthales: Sarraceniaceae). The entire life cycle of the moth is completed in the trumpets of this fire-dependent plant that is found throughout the southeastern United States in bogs, long-leaf pine savannas, and pocosins. The purpose of this study was to determine the effects of E. ridingsii on S. flava, including the effect of herbivory on trumpet height in the year subsequent to feeding and whether moths select trumpets for oviposition based on height. Although most forms of herbivory by insects might be expected to have negative effects on plants by reducing photosynthetic abilities, it would be counterproductive for herbivory by E. ridingsii to negatively affect S. flava as this plant is the only possible habitat for E. ridingsii. At each site in selected quadrats, the number of trumpets, trumpet height, trumpet status, number of trumpets in a clump, and number of clumps were recorded. The relationship between height and herbivory was analyzed using a linear model, and a positive correlation was found between height and herbivory. E. ridingsii herbivory had no effect on the next year's growth of S. flava based on a Spearman's correlation. Therefore, we concluded that E. ridingsii has little effect on S. flava populations and has likely evolved to selectively avoid herbivory on more vulnerable, smaller plants.

Phylogeny of the Oniticellini and Onthophagini dung beetles (Scarabaeidae, Scarabaeinae) from morphological evidence.

A phylogenetic study was conducted to hypothesize relationships of most of the genera of the Oniticellini and Onthophagini for the first time using morphological characters from a diverse array of external and internal sclerites. The monophyly and sister relationship of both tribes was found using Bayesian and parsimony analyses with heavily to moderately weighted data. An alternative hypothesis based on parsimony analyses of unweighted or slightly weighted data show a paraphyletic Oniticellini without the Onthophagini, although recognition of the subtribe Helictopleurina as a tribe would eliminate non-monophyly. Of the three Oniticellini subtribes, the Helictopleurina and Drepanocerina are monophyletic. There is no support for the monophyly of the Oniticellina or the Onthophagini subtribe Alloscelina, as currently defined. The genus Liatongus is paraphyletic, while strong support was found for monophyly of the Madagascan genus, Helictopleurus. The genus Onthophagus is never monophyletic in any analysis performed. Two new subtribes are also proposed: Liatongina subtr. n. including the genus Liatongus and Attavicina subtr. n. including the genera Attavicinus and Paroniticellus. Topological evidence shows that the ancestral oniticellines and onthophagines were all coprophagous with alternative food sources evolving relatively recently. Both myrmecophily and termitophily probably evolved only once in the onthophagines. The phylogenetic analysis supports an African origin for the two tribes, with a relatively early age for the split of the Madagascar helictopleurines from the remaining oniticellines via dispersal. Furthermore, the presence of the oniticellines in the New World is hypothesized to be due to two relatively old dispersal events via Beringia and two relatively recent trans-Atlantic invasions of the Caribbean.

Glial cells in amyotrophic lateral sclerosis.

For more than twenty years glial cells have been implicated in the pathogenetic cascades for genetic and sporadic forms of ALS. The biological role of glia, including the principal CNS glia, astroglia and oligodendroglia, as well as the myeloid derived microglia, has uniformly led to converging data sets that implicate these diverse cells in the degeneration of neurons in ALS. Originating as studies in postmortem human brain implicating astroglia, the research progressed to strongly implicate microglia and contributors to CNS injury in all forms of ALS. Most recently and unexpectedly, oligodendroglia have also been shown in animal model systems and human brain to play an early role in the dysfunction and death of ALS neurons. These studies have identified a number of diverse cellular cascades that could be, or have already been, the target of therapeutic interventions. Understanding the temporal and regional role of these cells and the magnitude of their contribution will be important for future interventions. Employing markers of these cell types may also allow for future important patient subgrouping and pharmacodynamic drug development tools.

Cerebral leukoaraiosis in patients with stroke or TIA: clinical correlates and 1-year outcome.

BACKGROUND AND PURPOSE: Cerebral leukoaraiosis is frequently observed in patients with acute stroke, but its clinical consequences on functional recovery remain incompletely defined. We evaluated the clinical correlates of leukoaraiosis, and its association with stroke-outcome in a cohort of consecutively hospitalized patients. METHODS: One-thousand twenty-four consecutive patients with acute stroke or transient ischemic attack (TIA) undergoing brain CT were included in this single-center study. Patients were systematically evaluated at hospitalization and followed-up for 1 year. Mortality, functional outcome, quality of life (QoL), psychological distress, community integration, and patient perception of recovery were evaluated by leukoaraiosis severity. Adjusted ORs (95%CI) were calculated. RESULTS: Moderate/severe leukoaraiosis was diagnosed in 177 patients (17.3%) and mild leukoaraiosis in 362 patients (35.3%). After 1 year, adjusted ORs for moderate/severe leukoaraiosis compared with no leukoaraiosis were 2.0 (95%CI 1.1-4.0) for Barthel Index

Solution structure of the C-terminal SH2 domain of the human tyrosine kinase Syk complexed with a phosphotyrosine pentapeptide.

BACKGROUND: Recruitment of the intracellular tyrosine kinase Syk to activated immune-response receptors is a critical early step in intracellular signaling. In mast cells, Syk specifically associates with doubly phosphorylated immunoreceptor tyrosine-based activation motifs (ITAMs) that are found within the IgE receptor. The mechanism by which Syk recognizes these motifs is not fully understood. Both Syk SH2 (Src homology 2) domains are required for high-affinity binding to these motifs, but the C-terminal SH2 domain (Syk-C) can function independently and can bind, in isolation, to the tyrosine-phosphorylated IgE receptor in vitro. In order to improve understanding of the cellular function of Syk, we have determined the solution structure of Syk-C complexed with a phosphotyrosine peptide derived from the gamma subunit of the IgE receptor. RESULTS: The Syk-C:peptide structure is compared with liganded structures of both the SH2 domain of Src and the C-terminal SH2 domain of ZAP-70 (the 70 kDa zeta-associated protein). The topologies of these domains are similar, although significant differences occur in the loop regions. In the Syk-C structure, the phosphotyrosine and leucine residues of the peptide ligand interact with pockets on the protein, and the intervening residues are extended. CONCLUSIONS: Syk-C resembles other SH2 domains in its peptide-binding interactions and overall topology, a result that is consistent with its ability to function as an independent SH2 domain in vitro. This result suggests that Syk-C plays a unique role in the intact Syk protein. The determinants of the binding affinity and selectivity of Syk-C may reside in the least-conserved structural elements that comprise the phosphotyrosine- and leucine-binding sites. These structural features can be exploited for the design of Syk-selective SH2 antagonists for the treatment of allergic disorders and asthma.

Influence of ochratoxin A and T-2 toxin singly and in combination on broiler chickens.

Effects of feeding diets containing ochratoxin A (OA) at 2.0 mg/kg and T-2 toxin at 4.0 mg/kg singly and in combination were characterized in male broiler chicks from 1 day to 3 wk of age. Body weights were depressed by feeding OA singly, T-2 singly, and the OA/T-2 combination. The efficiency of feed utilization was reduced in the OA and OA/T-2 combination-fed groups. The T-2 toxin caused oral lesions, anemia, and changes in some serum biochemical values. Feeding OA resulted in increases in relative liver, kidney, gizzard, and pancreas weights, a microcytic hypochromic anemia, and changed serum chemistries. The OA/T-2 combination caused increases in relative liver, kidney, proventriculus, and gizzard weights and variable serum biochemistries. The effects of OA and T-2 were additive for reduced body weight gains, mean corpuscular volume, and for reduced serum levels of total protein, and for reduced lactate dehydrogenase activity. A significant interaction occurred between OA and T-2 causing elevated serum triglyceride levels and decreased gamma glutamyl transferase activity and calcium levels. Degenerative renal tubular changes were observed in some OA and OA/T-2 combination-fed chicks. These data indicate that OA and T-2 in combination may be more toxic for some parameters than the individual mycotoxins, and may pose a greater problem for the poultry industry than either of the mycotoxins individually.

A technique for controlling injuries of the iliac vein in the patient with trauma.

This has become our preferred way to control deep pelvic hypogastric vein injuries and we have found it to be particularly useful in the patient with multiple nonvascular injuries. It is rapid, entails little ongoing blood and allows for direct exposure of the injury. It minimizes the chances of creating additional iatrogenic injuries from blind clamping or dissection. Thus, this technique should not be used routinely but should be reserved for situations when attempts to obtain proximal and distal control are unsuccessful.

Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources.

The authors report survival data for the first 41 patients treated for recurrent malignant gliomas with interstitial brachytherapy at the University of California, San Francisco (1980-1984). Iodine-125 (125I) sources were temporarily implanted using stereotaxic techniques. The median survival period for 18 patients with recurrent glioblastomas was 52 weeks after brachytherapy; two patients are alive more than 5 years after brachytherapy. The median survival period for 23 patients with recurrent anaplastic astrocytomas is 153 weeks after brachytherapy, with 10 patients alive more than 3 years and four patients alive more than 4 years after brachytherapy. Both groups did significantly better (p less than 0.01) than groups of patients with the same diagnoses and similar general characteristics who were treated at recurrence with chemotherapy alone. Because of deterioration of their clinical condition and evidence of recurrence from computerized tomographic scans, 17 (41%) of 41 patients required reoperation 20 to 72 weeks after brachytherapy. Despite the invariable presence of apparently viable tumor cells mixed with necrotic tissue in the resected specimen, nine patients have survived more than 2 years after reoperation and two of the nine are still alive 4 years after reoperation. The authors conclude that brachytherapy with temporarily implanted 125I sources for well-circumscribed, hemispheric, recurrent malignant gliomas is effective and offers a chance for long-term survival even though focal radiation necrosis can seriously degrade the quality of survival in a minority of patients.

Circulating coagulation inhibitors in the acquired immunodeficiency syndrome.

Abnormal coagulation profiles were identified in ten patients with the acquired immunodeficiency syndrome (AIDS) associated with opportunistic infections and malignancies. Activated partial thromboplastin times were elevated in all patients; three of seven had elevated prothrombin times. All patients had lupus-type anticoagulants characterized by rapid prolongations of the partial thromboplastin time in mixing studies, prolonged dilute thromboplastin inhibition assays, and increased Russell viper venom clotting times. Ivy bleeding times were prolonged in three patients with defective platelet aggregation. The lupus anticoagulant was isolated from the sera of healthy heterosexual men and from patients with AIDS with and without the lupus anticoagulant, and in the presence and absence of opportunistic infections. Both polyclonal IgM and IgG lambda from plasma with lupus anticoagulant interfered with clotting studies and platelet aggregation. The inhibitors usually accompanied active opportunistic infections and tended to disappear with successful resolution of infection.

Is small beautiful if it isn't viable? The case of nursing homes.

The optimal size of nursing home is examined in the light of overseas and Australian research evidence. The economic optimal size nursing home was found to be in the range of 45-55 beds for a sample of proprietary New South Wales homes in 1978-9 where average weekly expenditure per bed was minimised. However, this did not take into account a number of other important social and environmental factors as well as costs of travel and the quality of care provided or the characteristics of patients. When these factors are considered, evidence suggests that larger than average homes have the economic advantage. Smaller adapted residences, or those incorporating group living design, may be more homelike for residents but at slightly higher cost. Thus there is unlikely to be one single optimal size of home but rather a range. The final selection of scale is therefore a matter of striking a compromise between these and other factors in each situation.

Malignant melanoma with renal dense deposits containing tumor antigens.

A patient with disseminated malignant melanoma developed mild renal failure with proteinuria four months following the diagnosis of his neoplasm. Renal biopsy showed a membranoproliferative glomerulonephritis. Electron microscopy revealed intramembranous dense deposits in the glomeruli as well as in tubular basement membranes and Bowman's capsule. Immunofluorescence microscopy demonstrated granular staining for C3 in these same locations and granular deposits of immunoglobulins in the glomerular capillary loops. Light and electron microscopy of the autopsy kidney obtained 5 months later revealed progression of the number, size and density of the deposits. Eluates from both autopsy and biopsy kidney contained melanoma antigen and anti-melanoma antibodies. This case illustrates the association between the dense deposits and neoplasia with the dense deposits representing immune complexes with the tumor as antigen.

Melanoacanthoma. Ultrastructural and immunological studies.

Electronmicroscopic studies confirmed that melanoacanthoma is a non-nevoid elevated epithelial tumor composed of keratinocytes of both basaloid and spinous differentiation and of large dentritic melanocytes. The block in transfer of pigment from melanocytes to keratinocytes was found not to be complete. Langerhans cells, present in the malpighian layers were normal in morphology. Immunofluorescent studies and an immunoprecipitin assay also showed our patient's melanoacanthoma not to be related to malignant melanoma.