Total hip arthroplasty in patients with Down's syndrome.

Hip disease occurs in between 8% and 28% of patients with Down's syndrome, many of whom develop disabling pain. We have carried out total hip replacement in six adult patients (9 hips) with severe arthritis of the hip. The mean follow-up was 7.75 years (2 to 14). At the latest review, all had relief of pain and full hip function. Increasing longevity and a high incidence of hip disease in these patients suggest a greater role for total hip arthroplasty in the future.

Carbofuran-degrading bacteria from previously treated field soils.

Laboratory incubation studies were made on soils collected from five field sites with different histories of treatment with carbofuran. All soils treated earlier with carbofuran degraded the compound more rapidly than untreated samples of the same soils. Reduced rates of degradation in the presence of chloramphenicol imply that soil bacteria are primarily responsible for the breakdown of carbofuran in these soils. Sixty-eight bacteria, capable of degrading carbofuran as the sole source of carbon and nitrogen, were isolated from liquid cultures of treated soils. The concentration of carbofuran in the liquid medium used for isolation and subsequent culture of carbofuran-degrading isolates appeared to affect the stability of their ability to degrade. Similar types of carbofuran-degrading bacteria were isolated from different soils and several different types were isolated from one soil. All carbofuran-degrading isolates were Gram-negative, aerobic rods which hydrolysed the insecticide to carbofuran phenol. They were separated into four groups on the basis of a limited number of phenotypic characters. There was a good correlation between the phenotype of carbofuran-degrading isolates and the stability of their ability to degrade. Fourteen isolates were placed in phenotypic group I and 13 of these did not degrade carbofuran after one subculture in liquid medium. Phenotypic groups II, III and IV consisted of 54 isolates in total (3, 46 and 5 isolates respectively) and 52 of these retained their ability to degrade carbofuran when subcultured.

Neuropsychologic effects of lithium discontinuation.

This study investigated the effects of blind lithium discontinuation and resumption on measures of cognition, creativity, and fine motor performance in 46 lithium-maintained euthymic outpatients. Scores on memory measures, tests of tapping speed, and associative productivity all improved significantly during the time off of lithium. In an effort to further explain these results, analyses were undertaken with six possible intervening variables: age, sex, lithium concentration in plasma, thyroid function, duration of lithium maintenance, and depressive symptoms. Significant group and interactive effects are reported and discussed. A multiple regression analysis suggested that lithium has a greater neuropsychologic effect in younger, less-depressed patients having higher lithium concentrations in plasma.

The hip joint in Down's syndrome. A study of its structure and associated disease.

Clinical and roentgenographic examination of the hip was performed in 114 patients with Down's syndrome to study range of motion, roentgenographic anatomy, and incidence of hip pathology. The study found increased external rotation of the hip. Roentgenographic studies demonstrate that, in comparison with a normal acetabulum, the acetabulum of a patient with Down's syndrome is deep, more horizontally placed, and has increased anteversion. The proximal femur of a patient with Down's syndrome has a normal neck-shaft angle and a moderate increase in anteversion. Of the patients, 7.9% had some hip abnormality, including dysplasia, dislocation, avascular necrosis, or slipped capital femoral epiphysis.

Effects of lithium carbonate on associative productivity and idiosyncrasy in bipolar outpatients.

To determine the effect of lithium carbonate on the productivity and idiosyncrasy of written associations of euthymic outpatients with affective disorder, the authors assessed 22 patients at weekly intervals during lithium treatment, 2 consecutive weeks of placebo, and 2 consecutive weeks after lithium was resumed. Lithium discontinuation produced a significant increase in associational productivity and a demonstrable increase in associative idiosyncrasy, and restoration of lithium dose significantly reversed both effects. The results suggest that lithium may affect the underlying neuropsychological functions critical to the ability to generate associations and indicate the need for further study of lithium's effects on these and other functions that may relate to neuropsychological and creative processes.

Clinical studies of a new latex particle agglutination test for detection of Haemophilus influenzae type b polyribose phosphate antigen in serum, cerebrospinal fluid, and urine.

A new latex particle agglutination test for direct detection of Haemophilus influenzae type b polyribose phosphate antigen in serum, cerebrospinal fluid, or urine was evaluated from studies at four clinical centers. Although use of a serum buffer significantly reduced inconclusive agglutination of the latex particles, the retesting of serum samples, after heat inactivation and dilution, resolved all serum samples, with one exception, as reactive or nonreactive for the presence of the polyribose phosphate antigen. A clinical accuracy of 100% was obtained for the latex particle agglutination method in respect to its capability for detection of polyribose phosphate antigen in all patients with confirmed infection by H. influenzae type b.

Induction of hepatitis B antibody in experimental animals by immunization with A-2 plaque virus.

A sero-conversion for hepatitis B antibody has resulted from immunization of patas monkeys, guinea pigs, and rabbits with the A-2 plaque virus. This agent was isolated in tissue culture from patient sera that were positive for hepatitis B antigen. The immune response was assayed with techniques of direct and indirect counter-immunoelectrophoresis, and immune electron microscopy.