[Modified treatment of DNA preparation for cultured amniotic fluid cells and chorionic tissue].
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Biomedical subjects
Publications and source records attributed to K Wulff.
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In 90 patients with calcium oxalate urolithiasis an oral tryptophan-loading test with 5 g L-tryptophan was performed and the 24-hour urinary excretion of xanthurenic acid and kynurenine was measured. In 10 cases pathological deviations and an excretion pattern of tryptophan metabolites via kynurenine similar as in the hereditary vitamin-B6-dependent xanthurenic aciduria in homozygous or heterozygous from were found. Correlations between the oxalate excretion and the tryptophan metabolism do not exist. A 2-year therapy with 60 mg vitamin B6 was favourable in patients with an excretion of more than 300 mumol XA after a tryptophan load.
A well-established belief is that with crushed and contaminated wounds closure should be delayed. However, an emergency procedure involving very thorough debridement, complete reconstruction of all injured tissues, and cover by a latissimus dorsi free flap in the same operation is evaluated in 15 children presenting with severe injuries to the lower limb. It is felt that the procedure is superior to the established method because it is a one-stage procedure that minimizes the danger of infection, prevents growth impairment, shortens hospitalization, and allows early mobilization, thus being, in some cases, a limb-saving procedure.
Our monoclonal antibody 88E8 specifically binds to and inhibits human salivary alpha-amylase (EC 3.2.1.1) and cross reacts negligibly with the pancreatic isoenzyme, inhibiting it by less than 1%, as compared with about 90% for the salivary isoenzyme. The antibody binds the S1 and S2 types of salivary alpha-amylase, but no pancreatic alpha-amylase isoenzyme forms. A pancreatic alpha-amylase assay involving 88E8 is under development, with alpha-glucosidase as auxiliary enzyme and p-nitrophenyl-maltoheptaoside as substrate; we give preliminary data on this assay. The assay has to be done by substrate start, because the antibody interacts very slowly with the enzyme in the presence of substrate. Assay results for pancreatic alpha-amylase correlate well with those for isoamylase assayed with use of an inhibitor from wheat-germ.
The method of nucleic acid hybridization opens up new possibilities in laboratory diagnosis. This method, which enables us to assay for definite nucleic acid sequences in the specimen, has the advantage of high specificity and a strong binding force between the analyte nucleic acid and the nucleic acid probe. So far this method primarily works with radioactive labels. The development of non-radioactive detection systems suited for routine laboratories with sufficient sensitivity is still at its origin. One broad field of application for nucleic acid hybridization is the detection of the genome of certain viruses or bacteria in the specimen. Another more future oriented potential of these methods lies in the investigation and diagnosis of inborn errors of metabolism.
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Acute ischaemia in the tibial compartments is a recognized complication of fractures, vascular injury, vascular surgery, crush injuries and burns. The tissue pressure was measured in the first week after injury and the effect of diuretics has been evaluated in a double-blind randomized manner. The pressure in the anterior tibial compartment was measured in the first week after injury in a double-blind randomized manner in 40 patients who had sustained either accidental or surgical injury of the leg. The pressure in the group treated with placebos increased by 20 per cent in the first 24 hours, whereas the pressure fell by 25 per cent in those treated with diuretics. Diuretic treatment is recommended for patients with injury of the lower limbs.
Prevalence of progressive muscular dystrophy in 1965 and incidence in Denmark for the period 1965 to 1975 was studied by collection of data from hospital departments, nursery homes and general practitioners. This material was supplemented with information from death certificates and disablement pension records. Total patient group included 445 patients with progressive muscular dystrophy alive January 1st 1965. Prevalence was 69.4 per 10(6) male inhabitants in the Duchenne type, whereas the prevalences in the limb-girdle and facioscapulohumeral types were 36.5 and 18.6 per 10(6) inhabitants, respectively. Incidence was 222 per 10(6) male newborns in the Duchenne type, 66 and 26 per 10(6) newborns for the limb-girdle and the facioscapulohumeral types, respectively. Figures for the Duchenne type are in agreement with previous results. Both prevalence and incidence rates for the limb-girdle and the facioscapulohumeral types exceed published figures by a factor 3 to 6. These high Danish rates seem to reflect the true prevalence and incidence in the less serious types of progressive muscular dystrophy, probably because the Danish health system with free medical care and easy access to specialized hospital departments makes it possible to identify all cases of progressive muscular dystrophy.
The normal sectional anatomy of the calcaneus was studied as the background for interpretation of computed tomography (CT) of fractures. Multiplanar CT examination of the normal calcaneus was obtained, and sections were matched with a simplified anatomic model. Sectional anatomy in the four most important planes is described. This facilitates three-dimensional understanding of the calcaneus from sections and interpretation of CT sections obtained in any atypical plane.
Computed tomography (CT) of 25 fractured calcanei was performed to investigate the potential of CT in evaluating the pattern and biomechanics of these fractures. The characteristic findings of typical fractures are presented, including the number and type of principal fragments, size and dislocation of the sustentacular fragment, and involvement of the anterior and posterior facets of the subtalar joint. In 17 cases, the calcaneus consisted of four or more fragments. Furthermore, in 17 cases the sustentacular fragment included all or part of the posterior facet joint. In 18 of the 25 cases, the sustentacular fragment was displaced. It is concluded that well performed CT is an invaluable adjunct in understanding the fracture mechanism and in detecting pain-provoking impingement between the fibular malleolus and the tuberosity fragment. CT analysis can provide the orthopedic surgeon with comprehensive information on which to base decisions regarding surgical/nonsurgical treatment as well as surgical approach and technique.
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A monoclonal antibody (66C7) was prepared that specifically binds human salivary amylase (EC 3.2.1.1); it cross reacts with human pancreatic amylase by less than 1%. Two procedures are described for determination of isoamylases in human serum with this antibody: an enzyme immunoassay for determining amylase of salivary origin, and a routine method in which this amylase is immunoprecipitated and the remaining (pancreatic) amylase activity is assayed. Results by the two methods correlate well.
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Intracranial hemorrhage (ICH) remains a serious problem in hemophilia. Consecutive episodes of ICH or reports of head trauma were prospectively recorded in 140 patients with hemophilia seen during a two-year period. Forty of 48 consecutive episodes of ICH or trauma occurred in 37 patients with severe disease (less than 1% factor VIII or IX). Five injured patients had inhibitors to factor VIII. Two fatalities occurred following injury and one patient died following a spontaneous bleed. Injury in 40 instances warranted replacement therapy. No patient given coagulation factor within six hours of injury experienced ICH. The risk of ICH following head trauma (13% in this series) warrants aggressive use of coagulation factor replacement. Watchfulness in dealing with such patients and early therapy may be more necessary than often realized.
In five middle-aged men with calf pain during jogging or fast walking, chronic compartment syndrome of the calf or anterior tibial muscles was revealed by circulatory studies which included measurement of compartment tissue pressure. After two to three weeks of diuretic medication the men were re-examined. Initially elevated compartment tissue pressures at rest and after exercise were significantly decreased following diuretic treatment. The study indicates that calf pain similar to that of arterial insufficiency may be caused by compartment syndrome even in elderly persons and may be relieved with diuretic medication.
Fractures of the distal femur comprise 4 per cent of all femoral fractures. The records of a consecutive series, from 1969 to 1976, of 135 adult patients with 137 fractures, not caused by malignant disease, were reviewed for age, sex, previous disease, type of fracture, treatment and end-result. Eighty-four per cent of the patients were over 50 years of age, 19 per cent had other general factors predisposing them to fracture, and 42 per cent had previous or current disease of the fractured leg. Eight-three fractures were caused by moderate and 52 by severe trauma. Unicondylar fractures were separated into lateral or medial type. Ten fractures were open and 45 were operated on primarily, mostly using condylar plates, screws or Rush pins. Satisfactory results (pain-free knee without angular deformity and at least 90 degrees of motion) were achieved in two-thirds of the fractures following both non-surgical and surgical treatment. However, the surgical group was an average of 8 years younger and contained a higher proportion of bicondylar fractures than the nonsurgical group. Treatment in traction involved a mean period of 7 weeks for 47 patients. This expensive treatment is no longer used for femoral neck, trochanteric or shaft fractures. In distal femoral fractures the goal should also be early mobilization, if necessary using surgical treatment.