The Littler line method and the area under a Gaussian curve: a new method of assessing digital range of motion.

A new method of measuring digital range of motion (the Littler line method) is presented. When a Gaussian curve is centered over the Littler line and the appropriate area under the curve is computed, this area can provide a measure of the functional range of motion regained by an injured digit. Seventeen children (24 digits) with flexor tendon injuries were evaluated at an average follow-up period of 58 months (range, 12-121 months). The Littler line/Gaussian curve method was found to be more reproducible than total active motion, particularly in zone I and II injuries. This method can serve as a more meaningful functional assessment tool than a linear measurement such as total active motion, because it emphasizes digital motion in the mid-ranges of digital motion. (J Hand Surg 2001;26A:23-30.

Displaced intra-articular fractures of the distal aspect of the radius. Long-term results in young adults after open reduction and internal fixation.

The purpose of this retrospective study was to determine the long-term functional and radiographic outcomes in a series of young adults (less than forty-five years old) in whom an acute displaced intra-articular fracture of the distal aspect of the radius had been treated with operative reduction and stabilization. Twenty-six fractures in twenty-six patients met the initial inclusion criteria for the study. Twenty-one patients returned for a physical examination, imaging (plain radiographs and computerized tomography scans), and completion of a validated musculoskeletal function assessment questionnaire at a minimum of 5.5 years. The physical examinations were performed by the same observer, who was not involved in the initial care of the patients. The plain radiographs and computerized tomography scans were assessed in a blinded fashion by two independent observers who measured the radiographic parameters with standardized methods. At an average of 7.1 years, osteoarthrosis of the radiocarpal joint was evident on the plain radiographs and computerized tomography scans of sixteen (76 per cent) of the twenty-one wrists. A strong association was found between the development of osteoarthrosis of the radiocarpal joint and residual displacement of articular fragments at the time of osseous union (p < 0.01). However, the functional status at the time of the most recent follow-up, as determined by physical examination and on the basis of the responses on the questionnaire, did not correlate with the magnitude of the residual step and gap displacement at the time of fracture-healing. All patients had a good or excellent functional outcome irrespective of radiographic evidence of osteoarthrosis of the radiocarpal or the distal radio-ulnar joint or non-union of the ulnar styloid process. It appears prudent therefore to base the indications for salvage operative procedures on the presence of severe symptoms or a loss of function rather than on radiographic evidence of osteoarthrosis of the radiocarpal joint.

Elevation of serum immunoglobulin M (IgM) level in patients with brain tumors.

Sera of 43 brain tumor patients were analyzed along with various other control groups for serum immunoglobulin, cold and sheep cell hemagglutinin and a heterophile type antibody. Serum IgM and heterophile antibody (non-Forssman type) were found elevated in brain tumor and various acute viral meningoencephalitis groups. Serum IgA and IgG levels were essentially unchanged. IgM levels appear to be particularly stimulated by the meningioma class because the removal of tumor from the host was accompanied by its return to normal range. This system of IgM measurement may prove to be a valuable tool in preliminary diagnosis of brain tumors.

Common antigen in meningioma-derived cell cultures.

Serums of patients with intracranial meningiomas reacted in immunofluorescence assays with cell cultures and tumor imprints prepared from human meningiomas. Antibody in these serums appears to be specific for antigens in meningioma tissue and shows some cross-reactivity with neoplastic tissue of glial origin.

Genital herpesvirus hominis type 2 infection: an experimental model in cebus monkeys.

Genital infection with herpesvirus hominis type 2 was established in ten female cebus monkeys. Clinical and laboratory findings in the cebus mimic closely those observed in humans, thus providing an experimental model which may be used in the study of the possible role of genital herpetic infection in cervical cancer and in perinatal and chronic neurological diseases.