Flexor digitorum longus tendon transfer.

A retrospective evaluation consisting of a written survey and physical examination was completed on flexor digitorum longus tendon transfer patients. The tendon transfer is used to alleviate symptoms and address imbalance of extrinsic and intrinsic muscles. The authors present an evaluation of 110 procedures with an average follow-up period of 65.7 months (range 7 to 198 months). A literature review, discussion of a new theory as to the etiology of hammer toes, and criteria for using the procedure are included.

Subtalar joint arthroereisis with SILASTIC silicone sphere: a retrospective study.

Many authors have discussed the various surgical techniques of subtalar joint arthroereisis in the treatment of flexible flatfoot. Some authors advocate the use of bone grafts in the sinus tarsi to limit excessive subtalar joint pronation, while others advocate the use of endoprosthetic devices. These authors will present a retrospective study of subtalar joint arthroereisis utilizing a SILASTIC silicone sphere technique devised by the senior authors.

DNA quantification in colorectal carcinoma using flow and image analysis cytometry.

Numerous studies using flow cytometry (FCM) have shown that DNA quantification and ploidy classification can provide information of prognostic significance for patients with colorectal carcinoma; recent advances in image analysis cytometry (image cytometry, ICM) provide a new, alternative technique for DNA quantification. This study investigated whether (1) patients with colorectal carcinomas that exhibit a diploid pattern of DNA distribution have improved five-year survival statistics as compared to their non-diploid counterparts and (2) ICM provides quantitative data comparable to that obtained by FCM. DNA quantification and ploidy classification of 27 cases of primary colorectal carcinoma was performed on archival paraffin-embedded tissue by both FCM and ICM; 70% (19) of the tumors were classified as nondiploid by ICM while 56% (15) were similarly classified by FCM. Diploid tumors were associated with Dukes' stage A while nondiploid tumors were associated with Dukes' stage D. The overall five-year survival rate was 75% for patients with ICM diploid tumors and 67% for patients with FCM diploid tumors. The five-year survival was only 53% for patients with nondiploid tumors identified by both techniques. This study confirmed that DNA quantification is an important prognostic indicator for patients with colorectal carcinoma. It also showed that ICM provides data comparable to that of FCM and may be more sensitive.

Elevation of IgA levels in the non-insulin-dependent (type II) diabetic patient.

Serum immunoglobulin (G, A, M) levels were performed on 66 patients with non-insulin-dependent (type II) diabetes mellitus (NIDDM). When compared with 30 age-matched normal controls and 32 hospitalized controls there was no significant difference between the mean IgG and IgM levels. The IgA levels were significantly higher (P less than 0.005) in the diabetic group when compared with both control groups. This is true regardless of age, sex, duration of disease, and type of treatment (insulin/diet or oral hypoglycemic agents and/or diet). Thirty-six percent of the diabetic patients' IgA levels exceeded the mean +/- 2 SD of the normal control group. There were no significant differences in immunoglobulin levels between insulin-treated and non-insulin-treated diabetic groups. Since diabetic patients may have a number of secondary diseases, attempts were made to correlate the most common of these (acute and/or chronic bacterial infections, hypertension, arteriosclerotic heart disease, and diabetic neuropathy) with elevated IgA levels. Only IgA levels of diabetic patients with infections versus diabetic patients without infections were significantly different (P less than 0.05). However, IgA levels of uninfected diabetic patients remained significantly higher than those of normal controls (P less than 0.005), hospitalized controls (P less than 0.01), and hospitalized controls with bacterial infections (P less than 0.005). Possible reasons for the isolated elevations of IgA are discussed.

An evaluation of a C-reactive protein assay using a rate immunonephelometric procedure.

By using 20 repetitive assays at three levels of C-reactive protein control serum, within-run and day-to-day precision of a rate immunonephelometric system was established. The precision was excellent in each case. Linearity of the system between 1.8 and 20 mg/dl was established at a coefficient of correlation of 0.999 by using serial dilutions of C-reactive protein control serum. When the immunonephelometric assay was compared with electroimmunodiffusion and radial immunodiffusion assays, coefficients of correlation of 0.986 and 0.993, respectively, were obtained. The lower limit of sensitivity of the immunonephelometric assay was 1.8 mg/dl. The relationship of clinical significance to the performance of the C-reactive protein test system using rate immunonephelometry is discussed.