bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint Influence of SNPs and DNA Methylation on Lipids in African Americans From Hypertensive Sibships
Authors: Wright Michelle L. , Ware Erin B. , Smith Jennifer A. , Kardia Sharon L. R. , Taylor Jacquelyn Y.
Published: February 2018

Introduction:

Plasma concentrations of lipids (i.e., total cholesterol, high-density cholesterol, low-density cholesterol, and triglycerides) are amenable to therapeutic intervention and remain important factors for assessing risk of cardiovascular diseases. Some of the observed variability in serum lipid concentrations has been associated with genetic and epigenetic variants among cohorts with European ancestry (EA). Serum lipid levels have also been associated with genetic variants in multiethnic populations.

Methods:

The purpose of this study was to determine whether single-nucleotide polymorphisms (SNPs) and DNA methylation (DNAm) differences contribute to lipid variation among African Americans ([AAs], N = 739) in the Genetic Epidemiology Network of Arteriopathy (GENOA) study.

Results:

Previous meta-analyses identified 161 SNPs that are associated with lipid traits in populations of EA. We evaluated these SNPs and 66 DNAm sites within the genes containing the SNPs in the GENOA cohort using linear mixed-effects modeling. We did not identify any significant associations of SNPs or DNAm with serum lipid levels. These results suggest that the SNPs identified as being significant for lipid levels through the EA genome-wide association studies may not be significant across AA populations.

Conclusions:

Reductions in morbidity and mortality due to variation in lipids among AAs may be achieved through a better understanding of the genetic and epigenetic factors associated with serum lipid levels for early and appropriate screening. Further large-scale studies specifically within AA and other non-EA populations are warranted.
Does Brexit mean the end for Critical Management Studies in Britain?
Authors: Grey Christopher
Published: February 2018

My argument in the Speaking Out essay is, first, that in the European Union Referendum vote, Critical Management Studies found itself on the same, anti-Brexit, side as big business and mainstream management studies, making it hard to sustain itself as something separate from these. Second, I argue that this reflects a wider set of issues about the liberal-left and the European Union, which, third, means that British Critical Management Studies now finds itself located within what is regarded on the pro-Brexit side as ‘the establishment elite’, and that to work effectively against Brexit, British Critical Management Studies will need to work as part of that establishment elite. My conclusion is that this may mark the end of British Critical Management Studies as it has hitherto existed.
Re-orientation: Marriage, heteronormativity and heterodox paths
Authors: Brook Heather
Published: February 2018

‘Hetero’ (from the Greek, ‘different’) is most familiar to us in its attachment as a prefix to ‘sexuality’. In gender studies, sexuality studies and feminist scholarship, heterosexuality is routinely contrasted with homosexuality, and this contrast is often mapped over the opposition of heteronormative versus queer (ideas, practices, effects). These word-pairs (heterosexual and homosexual; heteronormative and queer) tend to operate dichotomously – that is, in exclusive, exhaustive and hierarchically ordered ways. Taking up Sara Ahmed’s work on orientation, this article experiments with an alternative pairing, exploring the potential for admixture or subversion in those dichotomies. ‘Heterodoxy’ is introduced as a concept that might be usefully contrasted with ‘orthodoxy’ in sexuality/gender studies – particularly in relation to current debates on marriage. The larger aim of this endeavour is to theorise heterosexuality in more accurate ways, and to seek out understandings of heterosexuality (including its historical relationship with heteronormative marriage) which acknowledge its horrors without foreclosing hope for its future.
The Southern Accent as a Heuristic in American Campaigns and Elections
Authors: Amira Karyn , Cooper Christopher A. , Knotts H. Gibbs , Wofford Claire
Published: February 2018

Are political candidates perceived differently based on the presence or absence of a southern accent? To address this question, we employ an experimental design that explores reactions to political candidates with a southern accent and a regionally neutral accent. We focus on perceptions of three general categories of candidate characteristics: candidate traits, candidate affect, and candidate issue positions. Overall, we discover that candidates with a southern accent are viewed more negatively, and they are thought to hold more conservative policy positions, than candidates with no discernible accent. Our findings suggest that the southern accent provides a heuristic that affects how voters perceive candidates.
Identity Processes in Ladakhi Emerging Adults: Testing the Dimensions of Identity Development Scale in an Indigenous Himalayan Population
Authors: Ozer Simon , Meca Alan , Schwartz Seth J.
Published: February 2018

Identity research has flourished in recent years based on the theoretical foundation proposed by Erikson. Identity development is generally conceptualized as a process occurring through an interplay between the individual and her or his social context. Consequently, one of the challenges facing identity research is to become more culturally sensitive—that is, to examine whether models and theories of identity work as expected in various cultural contexts. Luyckx et al.’s (2008) identity model proposes five identity exploration and commitment processes, and a survey instrument was developed to assess these processes. The current study tests this Dimensions of Identity Development Scale (DIDS) in an indigenous population of emerging adults from Ladakh. Results confirm the central dimensions of identity exploration and commitment. However, the original DIDS structure was not identically replicated in this population, suggesting that identity models should be developed or adapted to the specific sociocultural context.
Incorporating Multiple Perspectives Into the Development of an Electronic Survivorship Platform for Head and Neck Cancer
Authors: Salz Talya , Schnall Rebecca B. , McCabe Mary S. , Oeffinger Kevin C. , Corcoran Stacie , Vickers Andrew J. , Salner Andrew L. , Dornelas Ellen , Raghunathan Nirupa J. , Fortier Elizabeth , McKiernan Janet , Finitsis David J. , Chimonas Susan , Baxi Shrujal
Published: February 2018

Purpose

To improve the care of survivors of head and neck cancer, we developed the Head and Neck Survivorship Tool: Assessment and Recommendations (HN-STAR). HN-STAR is an electronic platform that incorporates patient-reported outcomes into a clinical decision support tool for use at a survivorship visit. Selections in the clinical decision support tool automatically populate a survivorship care plan (SCP). We aimed to refine HN-STAR by eliciting and incorporating feedback on its ease of use and usefulness.

Methods

Human-computer interaction (HCI) experts reviewed HN-STAR using think-aloud testing and the Nielsen Heuristic Checklist. Nurse practitioners (NPs) thought aloud while reviewing the clinical decision support tool and SCP and responded to an interview. Survivors used HN-STAR as part of a routine visit and were interviewed afterward. We analyzed themes from the feedback. We described how we addressed each theme to improve the usability of HN-STAR.

Results

Five HCI experts, 10 NPs, and 10 cancer survivors provided complementary usability insight that we categorized into themes of improvements. For ease of use, themes included technical design considerations to enhance user interface, ease of completion of a self-assessment, streamlining text, disruption of the clinic visit, and threshold for symptoms to appear on the SCP. The theme addressing usefulness was efficiency and comprehensiveness of the clinic visit. For each theme, we report revisions to HN-STAR in response to the feedback.

Conclusion

HCI experts provided key technical design insights into HN-STAR, whereas NPs and survivors provided usability feedback and clinical perspectives. We incorporated the feedback into the preparation for additional testing of HN-STAR. This method can inform and improve the ease of use and usefulness of the survivorship applications.
The Problem of Productivity Factors in the Economy of Modern Russia
Authors: Басовская Елена , Basovskaya Elena , Басовский Леонид , Basovskiy Leonid
Published: February 2018

The econometric models constructed in the work allowed us to establish the main production factors that streamline the productivity level — per capita GRP in modern Russia. The most significant positive impact on productivity is exerted by capital, which estimated by the labor funds. The level of education of the employed population has a significant positive impact on productivity. In most regions of the country, new technologies, embodied in new fixed assets, have a positive impact on productivity. In most regions of the country, the number of officials has a significant negative impact on productivity.
EXCISION OF PATELLA FOR RECURRENT DISLOCATION
Authors: McFarland Bryan
Published: February 2018

Patellectomy is at present the best operation for recurrent dislocation, not only because the immediate result is excellent, but because it avoids the later arthritis which must inevitably arise if a patella so damaged is retained.
PRESSURE AT THE CERVICO-BRACHIAL JUNCTION
Authors: Telford E. D. , Mottershead S.
Published: February 2018

1. The causes of pressure on the neuro-vascular bundle of the upper limb are many and varied. No one cause such as clavicular pressure can explain all cases.

2. Costo-clavicular pressure is not possible when there is a normal first rib and a normal thoracic outlet, but it is certainly a factor when the costo-clavicular interval is narrowed by the presence of a large cervical rib or an abnormal first thoracic rib. Clavicular pressure can act only during retraction and abduction, not in depression of the shoulder.

3. Temporary alterations in the radial pulse on movements of the shoulder in normal individuals are due to causes distal to the clavicle and have no relation to costo-clavicular pressure.

4. While irritation of sympathetic nerve fibres may explain the majority of cases of thrombosis, there are others in which clotting occurs in an aneurismal dilatation produced by pressure between the clavicle and the abnormal costal element. It is likely that the thrombosis occurs in an aneurism which has been present for some length of time. The cause of the aneurismal dilatation may be vaso-motor paralysis of a segment of the artery, ending distally at a point where a fresh intact leash of nerves is relayed to the vessel.

5. The importance of the scalenus anterior syndrome has been over-emphasised. If operative treatment is limited in all cases to anterior scalenotomy the results will be disappointing.

6. If operation is advised it should be performed without rigid and preconceived ideas, through an adequate incision, and with exploration wide enough to allow thorough investigation of the cause of pressure.
THE MOVEMENTS OF BONES AND JOINTS
Authors: MacConaill M. A.
Published: February 2018

1. Muscles acting upon any joint can be divided into two principal groups: muscles of displacement or spurt muscles, and muscles of stabilisation or shunt muscles.

2. Muscles which arise far from the joint are spurt muscles; those which arise near it are shunt muscles.

3. The fibrous tendon sheaths are joint-stabiising mechanisms.

4. The lumbrical and interosseous muscles are muscles of stabilisation of the digits.

5. The arrangement of the musculature is such as to ensure a constant pressure across the joint cavity during rest or uniform movement. The necessary centripetal force during movement is supplied mainly by the shunt muscles.

6. Experiments are described to illustrate these observations.
INTERMITTENT CLAUDICATION
Authors: Boyd A. M. , Ratcliffe A. Hall , Jepson R. P. , James G. W. H.
Published: February 2018

1. A description is given of historical discoveries relating to intermittent claudication. Various theories that have been advanced are discussed. A hypothesis, based on the work of Lewis, is elaborated.

2. A classification of obliterative arterial disease is outlined. The three groups that are distinguished are: primary thrombosis of the popliteal artery; juvenile obliterative arteritis; and senile obliterative arteritis.

3. The methods adopted for assessment of the severity of disease, including study of the clinical features, arteriographic findings, results of novocain infiltration and examination of the patient on a walking machine, are reported.

4. Methods of treatment by Buerger's exercises, contrast baths, intermittent venous occlusion and suction pressure; by lumbar ganglionectomy ant paravertebral block with phenol; by vitamin E (Î±-tocopherol) therapy; by treatment with thiouracil antistin; by internal popliteal myoneurectomy and division of the external popliteal and posterior tibial nerves; and by tenotomy of the tendo Achillis, are discussed.

5. It is concluded that tenotomy of the tendo Achillis should replace myoneurectomy in Type 3 cases where the blood supply is so far reduced that vascular stability cannot be achieved, and that it might apply in Type 2 cases in which there is persistent pain at a steady level.

6. The results of treatment in 276 patients with intermittent claudication are recorded.
THE PAINFUL SHOULDER Review of One Hundred Personal Cases with Remarks on the Pathology
Authors: Withers R. J. W.
Published: February 2018

1. In a series of one hundred personal cases of "painful shoulder" rupture of the musculotendinous cuff was proved by operation in eighteen cases and was presumed in eight further cases, namely, in about one quarter of the series.

2. Of the eighteen cases treated by operation through the transacromial approach, perfect results were obtained only in four. The other results were unsatisfactory. In five, movement was good but there was pain or weakness of the limb. In nine the condition was unaltered or made worse.

3. Conservative treatment of traumatic lesions of the supraspinatus tendon is therefore advocated. The advisability of rest of the shoulder joint in an abduction splint for five or six weeks is stressed. Operative exposure, through a transacromial approach, is recommended only when conservative measures have failed.

4. When there is rupture of the cuff there is evidence that simple longitudinal suture of the gap after freshening of the margins is likely to give better results than attempts to suture the medial end of the rupture to the greater tuberosity. Most ruptures have a longitudinal extension of the initial transverse tear, and direct suture of the medial edge of the gap to the greater tuberosity may lead to shortening of the tendon and interference with its function.

5. Ruptures of the supraspinatus tendon may cause no symptoms, lead to complete loss of function, or cause a painful arc of movement during mid-elevation. The clinical state depends upon whether or not the condition of the ruptured tendon is causing pain, and whether the other short rotator muscles of the shoulder can compensate in tensor and fixator actions for the loss of action of the supraspinatus.

6. Capsulitis is a convenient term by which to describe inflammatory lesions of the capsule and bursae around the shoulder joint. The initial stage of irritative capsulitis may develop to the later stage of adhesive capsulitis. Differentiation is important because treatment in the first stage is by rest, and in the second by manipulation and exercise.

7. The subdeltoid bursa is the "peritoneum" of the spinatus tendons; like the peritoneum it shares the pathology of the organs it protects and is itself seldom the site of primary pathological processes.

8. The management of the "frozen shoulder," whether loss of movement is protective or adhesive, calls for time and patience but the ultimate outlook is good.
SHOULDER PAIN With Particular Reference to the "Frozen" Shoulder
Authors: Simmonds F. A.
Published: February 2018

1. The "frozen" shoulder syndrome is due to an inflammatory lesion in the musculotendinous cuff invoked by a local area of degeneration.

2. The available evidence suggests that the primary site of the degenerative lesion is in the supraspinatus tendon.

3. Other causes of shoulder pain which must be differentiated from "frozen" shoulder are peritendinitis of the long head of biceps, degeneration or tears of the supraspinatus, and calcified deposits in the supraspinatus.

4. An explanation of the pathogenesis of lesions of the musculo-tendinous cuff is submitted in which the different types of clinico-pathological syndrome are correlated. This hypothesis is in accord with the experimental, clinical and operative findings.
PAINFUL SHOULDER Calcification of the Supraspinatus Tendon
Authors: Jones G. Blundell
Published: February 2018

1. The explosive type of painful shoulder due to rupture of a calcified deposit into the sub-deltoid bursa is described.

2. A brief report of six cases is presented.

3. No treatment other than rest and sedation is needed.
ARTERIOGRAPHY IN BONE TUMOURS
Authors: Dos Santos Reynaldo
Published: February 2018

1. Serial arteriograms show not only the anatomical distribution of blood vessels but also the functional state and activity of the peripheral circulation. The technique is of value in the diagnosis of tumours of soft tissues and bone, and particularly in the differential diagnosis of bone tumours from chronic osteomyelitis. It may be used to assess the response of malignant bone tumours to treatment by irradiation.

2. In malignant bone tumours, serial arteriograms show irregular formation of new vessels of uniform diameter, "blood pools," and increased rapidity of flow from the arterial to the venous systems.

3. In osteoclastomas there is new vessel formation and an appearance of "blood pools," but less rapid filling of the veins. In simple tumours there is no new formation of vessels. The tumour itself is often relatively avascular.

4. In osteomyelitis there is no new formation of vessels but only dilatation of existing vessels. The vessels retain their orderly and regular arrangement of successive branches of gradually decreasing diameter.
PLEOMORPHIC SWEAT-GLAND ADENOMA OF THE FOOT
Authors: Nangle E. J. , Symmers W. St. C.
Published: February 2018

The clinical and pathological features of a pedunculated tumour of the left foot in a woman aged eighty-three years are recorded. The tumour had been present for forty years. Histologically, its pleomorphic structure was that of the "mixed tumour" of salivary gland with predominance of the myo-epithelial element. Its origin from sweat-gland tissue is presumed.
TRANSITORY EOSINOPHILIA LOCALISED IN THE NEE JOINT AFTER PNEUMARTHROGRAPHY
Authors: Murray R. C. , Forrai ElemeÌr
Published: February 2018

1. Study of 200 cases investigated by pneumarthrography has shown that the introduction of air or oxygen into the knee joint is followed by a specific reaction characterised by transient localised eosinophilia in synovial membrane and synovial fluid.

2. Complications after meniscectomy seem to be more frequent when operation is performed during the phase of eosinophil reaction.

3. The significance of these observations has been discussed in relation to other causes ofeosinophilia and it is suggested that this method of local production of eosinophils may be of experimental importance.
ORTHOPAEDIC SURGERY IN THE UNITED STATES OF AMERICA
Authors: Mayer Leo
Published: February 2018

In the welter of details contained in the preceding pages the reader has, I trust, perceived certain broad shining pathways leading towards our orthopaedic lode-star, the adequate treatment of all the crippled and disabled of our communityâadults and children, rich and poor. These are, as I see them, four in number: first, the emergence of our speciality from a tiny beginning, against the opposition of general surgery, to the position of an accepted branch of surgery secure in the support of all the branches of medical science. Second, the development not only of technical skill but of a humanitarian spirit which has resulted in the adequate care of the crippled child and, to a lesser degree, of the crippled adult. Third, the growth of educational facilities for undergraduate and postgraduate instruction and for research. Finally, the integration of orthopaedic surgery with all those progressive elements in the community which aim to democratize our efforts on behalf of the disabled.
MEDULLARY NAILING OF FRACTURES AFTER FIFTY YEARS
Authors: Watson-Jones Reginald , Adams J. Crawford , Bonnin J. G. , Burrows H. Jackson , King Thomas , Nicoll E. A. , Palmer Ivar , vom Saal Frederick , Smith Hugh , Trevor David , Vaughan-Jackson O. J. , Le Vay A. D.
Published: February 2018

One hundred and sixty-four cases of intramedullary nailing of the long bones have been studied with special reference to the difficulties and complications encountered.

There was one death not attributable to the method.

Two cases of pulmonal fat embolism and one case of thrombosis occurred, all in fractures of the femur.

The lessons we have learned from our mistakes can be summarised as follows:

1 . The method requires technical experience and knowledge and is not suited to inexperienced surgeons or surgeons with little fracture material at their disposal.

2. Intramedullary nailing should only be used in fractures to which the method is suited. In general, comminuted fractures or fractures near a joint are unsuitable.

3. Open reduction is preferable to closed methods.

4. The nail should never be driven in with violence. It should be removed and replaced with a new one if difficulty is encountered when inserting it.

5. In fractures of the femur the nail should be driven in from the tip of the trochanter after careful determination of the direction.

6. The nail should be introduced only to the level of the fracture before exploring and reducing the fracture.

7. Distraction of the fragments must be avoided.

8. If the nail bends it should be replaced by a new one, at least in femoral fractures.

9. If union is delayed, the fracture should be explored and chip grafts of cancellous bone placed around it.

10. Improvised nails or nails which are not made of absolutely reliable material should never be used.

11 . Make sure that the nail is equipped with an extraction hole for removal.
THE MONTEGGIA FRACTURE WITH POSTERIOR DISLOCATION OF THE RADIAL HEAD
Authors: Penrose J. H.
Published: February 2018

1. The posterior Monteggia fracture usually conforms to a typical pattern.

2. Its incidence is greatest among middle-aged women.

3. The mechanism of the injury is probably similar to that of the dislocated elbow. Excessive rotation of the forearm plays no part in its production.

4. Internal fixation of the ulna combined with excision of the whole radial head, or of its detached segment, is suggested as the treatment of choice.

5. The functional results after operation are excellent, but some slight permanent restriction of movement is to be expected.
STUDIES OF PAGET'S DISEASE (OSTEITIS DEFORMANS)
Authors: Lake Max
Published: February 2018

Sarcoma complicating Paget's disease is uncommon; ninety-five cases have been collected and seven further cases are now reported. Sarcoma probably complicates less than 2 per cent of all cases of Paget's disease. There is a relatively high incidence in males, especially in the sixth decade, whereas bone sarcoma over the age of fifty years without osteitis deformans is rare. Injury is prominent in the history of many cases.

Comparison of Paget's sarcoma, "ordinary" bone sarcoma and the bones affected by uncomplicated osteitis deformans reveals some important differences. As to the type of tumour, osteogenic sarcoma is the commonest, but fibrosarcoma and round-cell sarcoma are also frequent.

The serum phosphatase is a most useful prognostic guide in a disease with a generally poor prognosis. Magnesium metabolism in relation to bone sarcoma requires further study.

Prophvlaxis is based on a clinical suspicion of this complication in Paget's disease, and measures are outlined which may be of assistance.

Sarcoma in Paget's bone is highly lethal, but Nature in striking down these old people may have provided us with facts which will ultimately solve problems common to all sarcomas of bone.
THE TREATMENT OF ESTABLISHED VOLKMANN'S CONTRACTURE BY TENDON TRANSPLANTATION
Authors: Parkes Athol
Published: February 2018

A method of treatment of Volkmann's ischaemic contracture is described which retains wrist movement and restores reasonably good function to the hand in suitable cases.
THE MECHANISM OF INJURY TO THE SPINAL CORD IN THE NECK WITHOUT DAMAGE TO THE VERTEBRAL COLUMN
Authors: Taylor A. R.
Published: February 2018

A case of cervical traumatic paraplegia is described in which there was no evidence of damage to vertebrae, discs or ligaments. Experimental evidence suggests that such injuries may be caused by inward bulging of the ligamentum flavum during hyperextension. The reasons why this inward bulging may occur, despite the elasticity of the ligamentum flavum, are discussed. Treatment of such cases is considered and the importance of avoiding extension emphasised.
EXPERIMENTAL INVESTIGATIONS INTO THE PHYSICAL PROPERTIES OF THE INTERVERTEBRAL DISC
Authors: Virgin W. J.
Published: February 2018

1. The intervertebral disc is an organic viscous elastic structure capable of maintaining very great loads without disintegration.

2. Recovery of the disc after deformation depends upon: a) the imbibition of tissue fluid by the disc, b) the removal of the deforming force. Complete recovery is modified by the duration of the force.

3. Factors that interfere with the elasticity of the disc are: extreme youth (immaturity of the disc), chronic wasting diseases (general nutritional disturbance), and local pathological changes in the bodies of the vertebrae which interrupt or damage its blood supply. The intervertebral disc reaches its greatest state of efficiency in adult lifeâthat is, when the nucleus pulposus has disappeared as an entity. The function of the disc appears not to depend upon the presence of the nucleus : rather does the presence of the nucleus indicate immaturity of the disc.

4. The highly resilient elastic nature of the vertebral column is provided by the intervertebral discs, which constitute one-third of the whole length of the column.

5. The imbibition of fluid requires further investigation. It appears that from lacunae in the adjacent bodies finger-like pockets dip into the discs and that fluid passes through the lining membrane of these pockets.
EXPERIMENTAL INCISION OF THE INTERVERTEBRAL DISC
Authors: Smith J. W. , Walmsley R.
Published: February 2018

1. The normal anatomy of the intervertebral disc of immature rabbits is described.

2. An account is given of the changes that occur after an operative incision in the ventral part of the intervertebral discs of rabbits which allowed the escape of the nucleus pulposus. The account is based on observations made on fifty-five young animals killed at intervals during the twenty-five months after operation.

3. The superficial part of the wound in the annulus heals rapidly by active fibrosis. Thereafter there is a chondrification of the ventral region of the disc, followed by ossification. A prominent bony ridge ultimately ankyloses the vertebrae adjoining the disc.

4. The site of the nucleus pulposus is eventually occupied by a dense pad of fibrocartilage. A tongue of this tissue projects into the deep median part of the wound which remains unhealed.

5. A hypothesis is submitted regarding the mechanism of rupture of the annulus fibrosus and prolapse of the nucleus pulposus in man; this hypothesis is based in part on the observations of lesions in discs not subjected to operation.
REPOSITION WITH ARTHROPLASTY FOR CONGENITAL DISLOCATION OF THE HIP IN ADULTS
Authors: D'AubigneÌ R. Merle
Published: February 2018

Arthroplasty, with normal or nearly normal reposition, is possible in most old congenital dislocations of the hip in young adults. Reposition is possible even in very high dislocation, but it is difficult or impossible in aged patients and when arthritic changes have taken place. The reduction equalises the length of the extremities in unilateral cases, but makes operation on both sides necessary in bilateral cases. Post-operative complications may be largely avoided by a good technique and careful post-operative treatment. Stability is good, and consequently the limp is generally reduced. Mobility is as a rule sufficient, though often less than before operation when the hip was normally or excessively mobile. Pain is very often relieved or greatly reduced, but walking is generally limited. Even if the radiographic appearance of the hip is almost normal, the functional result may be imperfect.

This assessment is probably pessimistic, for two reasons: first, patients operated on are still improving; second, the improved technique of the later operations should give better results. Nevertheless, arthroplasty with reduction should be proposed to patients only suffering severe functional disability.
SPRUNG BACK
Authors: Newman P. H.
Published: February 2018

Sprung back is one of the commonest causes of low back pain. Its characteristic features are described. It is caused by rupture of the posterior ligaments of the spine, including sometimes the posterior longitudinal ligament and annulus fibrosus. The manner in which it is produced and its mechanical effects are discussed in detail.
CHONDRO-OSTEO-DYSTROPHY
Authors: Brailsford James F.
Published: February 2018

1. The evolution of the skeletal changes in chondro-osteo-dystrophy is described, and typical radiographs of patients observed into late adolescence are shown.

2. The etiology of the condition is discussed.
TRAUMATIC CHYLOTHORAX
Authors: Wright P. R. , Gardner A. M. N.
Published: February 2018

A case is described of bilateral traumatic chylothorax after complete dislocation of the thoracic spine. An explanation is advanced for the delayed, sudden onset of symptoms due to the chylothorax in this and other cases.
DEPOSITION OF CALCIUM SALTS IN THE MEDIAL LIGAMENT OF THE KNEE
Authors: Lamb Douglas W.
Published: February 2018

1. Two cases of deposition of calcium in the medial ligament of the knee are described. Pain was a prominent feature in both.

2. A review of the literature suggests this is an uncommon condition.

3. The condition closely resembles supraspinatus calcification, and the etiology is probably similar.

4. Both cases were treated by operation, with complete relief of symptoms.
OSTEOPOROSIS AND EPIPHYSIAL ARREST IN JOINT TUBERCULOSIS
Authors: Sissons H. A.
Published: February 2018

Amputation or post-mortem specimens from eight cases of joint tuberculosis, with immobilisation changes in bone, have been studied by fine-detail slab radiographs and subsequent histological examination. The findings in three of these cases are presented in detail.

The immobilisation changes take the form of a true osteoporosis, which is strikingly focal in nature. In the adult the sites of most marked involvement include the subcortical bone adjacent to articular surfaces and the bone in the neighbourhood of the obliterated epiphysial plates.

Areas of permanent change in bone structure may result, although commencing "repair" is seen in the form of newly developed bone trabeculae in the osteoporotic areas.

In one case, where immobilisation occurred at an early age, changes in the growing epiphysial plates were produced in addition to osteoporosis. This is correlated with the known susceptibility of growing epiphysial cartilage to a wide variety of damaging agents.

Radiologically, it is important to discriminate between these immobilisation changes and the bone destruction which might be produced by extension of the tuberculous lesion itself.
ROTATIONAL LORDOSIS: THE DEVELOPMENT OF THE SINGLE CURVE
Authors: Somerville E. W.
Published: February 2018

This paper is a theoretical and experimental study of the processes involved in the development of curvature of the spine which we have come to call scoliosis. Reasons are advanced why the term scoliosis in its modern meaning may be misleading and an alternative title of Rotational Lordosis is suggested. It is admitted that it is more cumbersome, but I maintain that it is more accurately descriptive of the deformity under discussion and differentiates it from other curvatures which are produced differently but at present all of which come under the heading of scoliosis. I am conscious that many gaps still remain unfilled, especially the important but unexplained problem of the nature of the growth disturbance. If we could solve this we would be near to a solution of one of the most bizarre, mysterious and crippling deformities with which we are faced.
RESULTS OF TREATMENT OF INFECTIONS OF THE HAND
Authors: Scott J. C. , Jones B. V.
Published: February 2018

1. A series of 1,211 cases of infection of the hand and fingers is reviewed. Of the 1,066 which required operation about two-thirds were treated by excision and suture, and the results in these cases are analysed.

2. The criterion of success was per primam healing in seventeen days or less, and 54 per cent of the cases treated by this method (excluding paronychiae) fulfilled this criterion.

3. The causes of failure are discussed.

4. It is concluded that excision and suture is the method of choice in well localised infections, but that it should be avoided in diffuse infections and in some cases with sinuses. Its use is unnecessary in trivial infections.
AN UNUSUAL BONE TUMOUR COMPLICATING PAGET'S DISEASE
Authors: Cones D. M. T.
Published: February 2018

An unusual bone tumour complicating Paget's disease of the mandible is described. At the time of local excision the histological appearances were those of a malignant osteoclastoma, but the tumour rapidly recurred as a chondrosarcoma, which spread locally and by metastasis, and caused death within six months.
FAMILIAL PAGET'S DISEASE WITH EARLY ONSET
Authors: Irvine R. E.
Published: February 2018

1. A father and two daughters suffering from Paget's disease are described.

2. The father's case is of special interest because he developed a malignant osteoclastoma of the mandible.

3. In the two daughters the condition was notable for the fact that in each case it began at the age of eighteen in the jaws, and led to the development of osteoporosis circumscripta of the skull.

4. The relationship between Paget's disease and osteoporosis circumscripta, and the age incidence and familial incidence of Paget's disease, are discussed.
OSTEOPATHIA STRIATAâVOORHOEVE'S DISEASE
Authors: Hurt R. L.
Published: February 2018

1. A case is reported which shows the typical features of osteopathia striata in all the long bones and probably in the pelvis, with the features of osteopetrosis in the skull and ribs.

2. The occurrence of longitudinal striation in osteopoikilosis and osteopetrosis is described, and the possible relationship between these two diseases and osteopathia striata is discussed.

3. The differential diagnosis is indicated.
THE ROLE OF SYMPATHECTOMY IN THE TREATMENT OF CAUSALGIA
Authors: Barnes Roland
Published: February 2018

1. Forty-eight cases of causalgia are reviewed and the clinical features are briefly described.

2. Multiple nerve injuries are common and the pain is often associated with all the injured nerves. In the upper limb there was always an incomplete lesion of the lower trunk or medial cord of the brachial plexus, or of the median nerve. In the lower limb there was always an incomplete lesion of the medial popliteal division of the sciatic, the medial popliteal, or the posterior tibial nerve. These nerves carry most of the sympathetic fibres to the hand and foot. With two exceptions all the nerve lesions were at or above the level of the knee or elbow.

3. Sympathectomy gives marked relief of pain in most cases of causalgia. Prompt treatment is essential to prevent the crippling deformities which follow prolonged voluntary immobilisation of the painful limb. The results of preganglionic are superior to those of postganglionic sympathectomy.

4. The possible pain pathways are discussed, and an explanation is offered for the successful results of sympathectomy in the treatment of causalgia.
THE TREATMENT OF SUBCAPITAL FRACTURES OF THE NECK OF THE FEMUR WITH A NAIL-PLATE AND WEDGE OSTEOTOMY
Authors: McNeur J. C.
Published: February 2018

1. Ten cases are reported of subcapital fractures of the femoral neck with low fracture-shaft angles treated by wedge osteotomy and fixation by nail-plate.

2. A simple method of osteotomy to increase the fracture-shaft angle is described.

3. In eight fresh fractures bony union was obtained when nailing was followed by immediate osteotomy.

4. The alteration of the bony anatomy does not prejudice further reconstructive surgery should it become necessary.
OPEN REDUCTION IN CONGENITAL DISLOCATION OF THE HIP
Authors: Somerville E. W.
Published: February 2018

1. It is suggested that the obstruction causing delayed reduction of the congenitally dislocated hip is the infolded limbus.

2. An operation is described by which the infolding limbus may be easily and safely removed.

3. The early results of the operation are reported.

4. The evidence for the original assumption is discussed.
REMODELLING OF THE HUMERUS AFTER SUPRACONDYLAR FRACTURES IN CHILDHOOD
Authors: Attenborough C. G.
Published: February 2018

Four cases are shown to illustrate remodelling of the lower end of the humerus after supracondylar fractures with displacement in childhood. Remodelling is rapid and will restore almost normal anatomy and good function even with severely displaced fractures. The results are much better than in many cases treated by open reduction.
NOTE ON THE NERVE ENDINGS IN A SUBJECT WITH ARTHROPATHY AND CONGENITAL ABSENCE OF PAIN
Authors: Feindel William
Published: February 2018

1. A patient wholly insensitive to painful stimuli as judged by psychical, physical, reflex and autonomic responses, showed multiple arthropathies.

2. Biopsy specimens of skin and periosteum from the region of the hip joint showed free nerve terminals similar in morphology to endings considered to subserve pain in normal subjects. The abnormality related to defective pain sensation therefore appears not to be due to a defect in the peripheral nerve endings for pain, but to be located more centrally in the nervous system.

3. In this patient, and in some patients with syringomyelia, arthropathy is associated with selective impairment of pain sensibility of the involved joints. It appears that tissue damage from the wear and tear of normal activity of a joint, if this damage is unheralded because of impairment of pain sense, can lead to arthropathy.

4. It is noted that further experimental evidence is still required to elucidate the role of various modalities of innervation in the maintenance of normal structure and function of joints.
AN INVESTIGATION INTO THE CORRELATION BETWEEN THE ELECTRICAL POTENTIALS OF METALS AND THEIR BEHAVIOUR IN BIOLOGICAL FLUIDS
Authors: Clarke E. G. C. , Hickman J.
Published: February 2018

1. The literature dealing with the reaction of tissues to metals has been briefly reviewed and discussed.

2. It is suggested that the "anodic back EMF" of metals, under the conditions of the experiment, is a measurable electrical quantity which can be correlated with their behaviour in tissues.

3. Details of the method for obtaining this "anodic back EMF" are given.

4. A correlation between the "anodic back EMF" and the loss of weight due to corrosion in vitro has been demonstrated.

5. The inertness of eighty-seven metals has been classified by this method.

6. It must be emphasised that these results are based on in vitro experiments only. In vivo experiments are in progress and the results will be published in due course. Preliminary work suggests that there is some correlation between the ABE and the behaviour of metals in tissue (Hickman 1953).
REST AND MOVEMENT
Authors: Perkins George
Published: February 2018

I have tried to stimulate interest in movement as a method of treatment. It is too much to expect that I shall have won over to my way of thinking doctors who are addicts of rest. I shall be content if they will occasionally ask: "Is my splint really necessary?"
DEVELOPMENT OF CONGENITAL DISLOCATION OF THE HIP
Authors: Somerville E. W.
Published: February 2018

Based on the constancy with which the limbus is inverted into the joint in a typical congenital dislocation of the hip, a hypothesis is presented which suggests that the sequence of events leading to established dislocation is: 1) lateral rotation aided and abetted by anteversion; 2) extension of the hips causing subluxation; 3) dislocation and inversion of the limbus; 4) secondary changes in the upper end of the femur, pelvis and acetabulum which will also develop if the deformity does not progress beyond a subluxation.

A pen picture is drawn showing how anteversion is either moulded away during growth to produce a normal hip, or persists with or without dislocation. The fate of the persistently inverted limbus is discussed and a line of treatment based on these findings is briefly considered.
RADIOGRAPHIC BONE CHANGES AT THE HIP AFTER INSERTION OF AN ACRYLIC PROSTHESIS
Authors: Buxton St J. D. , Waugh W.
Published: February 2018

1. Radiographic changes in bone structure which follow the insertion of an unplasticised acrylic prosthesis of the Judet type are described.

2. Technical details of the operation and their relation to these changes are discussed.

3. Although the period of observation is short it is suggested that after initial loosening the prosthesis becomes stabilised owing to local bone reaction.
INJURIES TO THE LATERAL CONDYLE EPIPHYSIS OF THE HUMERUS IN CHILDREN
Authors: McLearie M. , Merson R. D.
Published: February 2018

1. The mechanism of production of injury to the lateral condyle epiphysis is discussed.

2. A technique of closed reduction of rotational displacements of the epiphysis is described. Nine cases in which the method was successful are noted.

3. It is suggested that the injury should be classified with dislocation of the elbow.
FIBROUS DYSPLASIA OF BONE WITH SKELETAL LIPOID GRANULOMATOSIS
Authors: Harriman D. G. F. , Millar J. H. D.
Published: February 2018

1. A case of fibrous dysplasia in a woman aged fifty, with unilateral skeletal lesions, cutaneous pigmentation and possibly accelerated skeletal growth, is described.

2. At necropsy, the bony changes were found to be complicated by many of the changes of lipoid granulomatosis. Disseminated plaques of demyelinisation were found in the central nervous system.

3. The implications of the case are discussed.
CONGENITAL DYSPLASIA OF THE HIP
Authors: Weissman S. L.
Published: February 2018

1. The examination of fifty-one infants presenting signs of unilateral dysplasia (preluxation) of the hip disclosed the existence of an abduction-contracture in the opposite "normal" hip.

2. The abduction-contracture was not infrequently found in the newborn, but seemed to attract attention mostly between the second and fifth month of life. It was seldom found after the sixth month.

3. The dysplasia in the contralateral hip showed the usual features.

4. The relationship between the degree of abduction-contracture and the degree of dysplasia was a direct one only occasionally; in most cases they seemed unrelated to each other.

5. Observation of these patients showed that the abduction-contracture followed a constant course towards gradual and spontaneous regression. The dysplasia progressed in one of the following directions: spontaneous recovery, rapid or slow recovery with treatment by abduction splint, subluxation, or true dislocation.

6. It is submitted that the coexistence of unilateral dysplasia of the hip and abduction-contracture in the opposite hip is not fortuitous. It is believed that the abduction-contracture determines the development of the dysplasia in the opposite hip through the faulty mechanics caused by "fixed pelvic obliquity."

7. The discovery of unilateral abduction-contracture soon after birth should be a warning that dysplasia may develop in the opposite hip. A careful watch should therefore be kept for signs of abduction-contracture and for the later development of dysplasia.
INJURIES OF THE ATLAS AND AXIS
Authors: Grogono B. J. S.
Published: February 2018

1. Injuries to the atlas and axis may occur at any age. They are usually not fatal.

2. In children spontaneous rotatory dislocation is the commonest type of lesion. In adults fracture of the odontoid process is more likely.

3. The spinal cord is often undamaged. In some cases complicated by cord damage the neurological disturbance is caused by an associated injury to the lower cervical spine.

4. Spinal cord damage may be immediate or delayed.

5. In cases of incomplete cord lesion there may be recovery of function after reduction of the displacement or without such reduction.

6. Diagnosis rests on the history and physical signs, and radiographic findings. Radiographs of this area require careful interpretation, and special radiographic techniques may he necessary. A normal radiograph does not necessarily exclude the possibility of atlanto-axial injury.

7. Though many patients would survive without treatment the initial discomfort and danger of complications demand that adequate protection be provided. In relatively minor injuries and in old people protection by a plaster collar may be sufficient. In some cases it is justifiable to undertake manipulation and apply a plaster. Cases with severe displacement require traction, preferably by skull calipers. Recurrent displacement, instability, and cord signs demand operative reduction and fusion. Satisfactory fusion of the atlas and axis alone is feasible, and good function is preserved. More extensive fusion of the cervical spine is seldom necessary.
MYOSITIS OSSIFICANS PROGRESSIVA
Authors: Dixon Theodore F. , Mulligan Lily , Nassim Reginald , Stevenson F. Harwood
Published: February 2018

1. A metabolic study in a case of myositis ossificans progressiva is reported.

2. The serum showed an increased power of calcification of rachitic rat cartilage.

3. Estimations of alkaline phosphatase showed slightly raised values.

4. Surgical removal of a bony bar was followed by prolonged administration of ACTH and cortisone, but no effect on the calcium-phosphorus balance or on the re-ossification within the area of operation was observed.
OSTEOARTHRITIS OF THE HIP
Authors: Lloyd-Roberts G. C.
Published: February 2018

1. The capsular changes in osteoarthritis of the hip and their pathogenesis are described, and it is concluded that symptoms are due mainly to this abnormality.

2. The clinical significance and pathogenesis of subchondral sclerosis, cysts, osteophytes, secondary subluxation and new bone formation on the lower border of the femoral neck are discussed.

3. These bony features which can be seen in the radiograph may, under certain circumstances, be correlated with the symptoms.

4. The influence of joint debris and capsular fibrosis upon the symptoms arising in other osteoarthritic joints is considered.

5. The mechanism by which osteoarthritis develops in hip joints with an anatomical abnormality is discussed in relation to the normal functional anatomy of the hip.

6. The evolution of osteoarthritis in dysplasia of the hip is considered with special reference to its diagnosis, prognosis and early treatment.

7. The supposition that osteoarthritis is commonly due to progressive ischaemia in the femoral head has been investigated and is rejected.

8. The cause of idiopathic osteoarthritis remains obscure but the evidence suggests that constitutional rather than local conditions in the joint account for many of these cases.