bluuebunny/crossref_metadata_2025 huggingface dataset:
LVIS Jr. stent for treatment of intracranial aneurysms with parent vessel diameter of 2.5 mm or less
Authors: Santillan Alejandro , Boddu Srikanth , Schwarz Justin , Lin Ning , Gobin Y Pierre , Knopman Jared , Patsalides Athos
Published: February 2018

Background and purpose

This retrospective study evaluates the safety, effectiveness, and long-term clinical and angiographic follow-up of intracranial aneurysms treated with the Low-Profile Visualized Intraluminal Support Junior (LVIS Jr.) stent and parent vessels of diameter equal to or less than 2.5 mm.

Materials and methods

We included all patients treated with the LVIS Jr. stent in aneurysms with small parent vessel diameter between March 2015 and July 2017. Periprocedural adverse events, immediate aneurysm occlusion rates, and clinical and angiographic follow-up are reported.

Results

A total of 35 patients with 35 aneurysms were included. Ten aneurysms were ruptured (28.6%) and 25 were unruptured (71.4%). The parent arteries measured 0.9 mm to 2.5 mm in diameter (mean, 2.2 mm). Intra-procedural thromboembolic complications occurred in four patients (11.4%) and there was an intraoperative aneurysm rupture in one patient (2.8%). Immediate complete aneurysm occlusion was noted in 21 out of 35 patients (60%). Clinical follow-up ranged between one and 25 months (mean, 10.5 months) and magnetic resonance angiography follow-up ranged between four and 24 months (mean, 10.4 months). Complete aneurysm occlusion was achieved in 21 out of 29 patients (72.4%) at last angiographic follow-up (mean, 9.4 months; range four to 23 months). In-stent stenosis occurred in one out of 29 patients (3.4%), who was asymptomatic. Of the four patients with in-stent thrombosis, three patients were treated with “Y configuration” (two patients with middle cerebral artery aneurysms and one patient with an anterior communicating artery aneurysm). Mortality rate was 0%. Neurological morbidity was 2.9%.

Conclusions

Stenting with the LVIS Jr. stent allowed us to treat complex intracranial aneurysms with parent vessel diameter of 2.5 mm or less with an acceptable safety profile.
Current and future use of nucleo(s)tide prodrugs in the treatment of hepatitis C virus infection
Authors: Dousson Cyril B
Published: February 2018

This review describes the current state of discovery of past most important nucleoside and nucleotide prodrugs in the treatment of hepatitis C virus infection as well as future potential drugs currently in discovery or clinical evaluation. I highlight first generation landmark prodrug compounds which have been the foundations of incremental improvements toward the discovery and approval milestone of Sofosbuvir. Sofosbuvir is the first nucleotide prodrug marketed for hepatitis C virus treatment and the backbone of current combination therapies. Since this approval, new nucleotide prodrugs using the same design of Sofosbuvir McGuigan prodrug have emerged, some of them progressing through advanced clinical trials and may become available as new incremental alternative hepatitis C virus treatments in the future. Although since Sofosbuvir success, only minimal design efforts have been invested in finding better liver targeted prodrugs, a few novel prodrugs are being studied and their different modes of activation may prove beneficial over the heart/liver targeting ratio to reduce potential drug–drug interaction in combination therapies and yield safer treatment to patients. Prodrugs have long been avoided as much as possible in the past by development teams due to their metabolism and kinetic characterization complexity, but with their current success in hepatitis C virus treatment, and the knowledge gained in this endeavor, should become a first choice in future tissue targeting drug discovery programs beyond the particular case of nucleos(t)ide analogs.
University Students’ Perceptions of Links Between Substance Use and Mental Health
Authors: Hudson Amanda , Thompson Kara , MacNevin Parnell D. , Ivany Meredith , Teehan Michael , Stuart Heather , Stewart Sherry H.
Published: February 2018

There is a consensus among addictions researchers and clinicians that mental health concerns and substance use problems are often interrelated. It is less clear to what extent the general public, and university students in particular, understand connections between substance use and mental health. The current study aimed to understand university students’ perceived links between substance use and mental health by conducting three semistructured focus groups ( N = 24 participants, 67% female). Thematic analysis of the data yielded five themes: (1) Students use substances to cope with mental health issues, (2) substance use can lead to mental health problems, (3) links between mental health and substance use are cyclical, (4) substance use is an aspect/indicator of mental health, and (5) substance use and mental health are not always linked. Findings provide insight into the understudied area of perceived links between substance use and mental health and have implications for campus programming.
Low catalase expression confers redox hypersensitivity and identifies an indolent clinical behavior in CLL
Authors: Cavallini Chiara , Chignola Roberto , Dando Ilaria , Perbellini Omar , Mimiola Elda , Lovato Ornella , Laudanna Carlo , Pizzolo Giovanni , Donadelli Massimo , Scupoli Maria Teresa
Published: February 2018

Key Points

Low catalase expression confers hypersensitivity to external redox cues. Differential redox profiles are associated with divergent clinical behaviors in CLL.
Determinants of hematology-oncology trainees' postfellowship career pathways with a focus on nonmalignant hematology
Authors: Marshall Ariela L. , Jenkins Sarah , Mikhael Joseph , Gitlin Scott D.
Published: February 2018

Key Points

Hematology-oncology fellowship graduates spend a relatively small proportion of their time practicing nonmalignant hematology. Factors that may increase interest in nonmalignant hematology include better access to mentors and improved opportunities for career growth.
Targeted next-generation sequencing in blast phase myeloproliferative neoplasms
Authors: Lasho Terra L. , Mudireddy Mythri , Finke Christy M. , Hanson Curtis A. , Ketterling Rhett P. , Szuber Natasha , Begna Kebede H. , Patnaik Mrinal M. , Gangat Naseema , Pardanani Animesh , Tefferi Ayalew
Published: February 2018

Key Points

Mutation patterns in blast phase MPN, including paired sample analysis, point to specific mutations with potential pathogenetic relevance. RUNX1 mutations predict inferior survival in blast phase MPN, independent of specific treatment strategies.
Correction to: A holistic view of cancer bioenergetics: mitochondrial function and respiration play fundamental roles in the development and progression of diverse tumors
Authors: Alam Md Maksudul , Lal Sneha , FitzGerald Keely E. , Zhang Li
Published: February 2018

In this Correction, the authors would like to acknowledge that the original publication of the article “A holistic view of cancer bioenergetics: mitochondrial function and respiration play fundamental roles in the development and progression of diverse tumors” [1] was supported by CPRIT (Cancer Prevention & Research Institute of Texas) Grant RP160617.
Genomic Alterations and Complex Subclonal Architecture in Sporadic GH-Secreting Pituitary Adenomas
Authors: Hage Mirella , Viengchareun Say , Brunet Erika , Villa Chiara , Pineau Dominique , Bouligand Jérôme , Teglas Jean-Paul , Adam Clovis , Parker Fabrice , Lombès Marc , Tachdjian Gérard , Gaillard Stéphane , Chanson Philippe , Tosca Lucie , Kamenický Peter
Published: February 2018

Purpose

The molecular pathogenesis of growth hormone-secreting pituitary adenomas is not fully understood. Cytogenetic alterations might serve as alternative driver events in GNAS mutation–negative somatotroph tumors.

Experimental Design

We performed cytogenetic profiling of pituitary adenomas obtained from 39 patients with acromegaly and four patients with sporadic gigantism by using array comparative genomic hybridization analysis. We explored intratumor DNA copy-number heterogeneity in two tumor samples by using DNA fluorescence in situ hybridization (FISH).

Results

Based on copy-number profiles, we found two groups of adenomas: a low–copy-number alteration (CNA) group (<12% of genomic disruption, 63% of tumors) and a high-CNA group (24% to 45% of genomic disruption, 37% of tumors). Arm-level CNAs were the most common abnormalities. GNAS mutation–positive adenomas belonged exclusively to the low-CNA group, whereas a subgroup of GNAS mutation–negative adenomas had a high degree of genomic disruption. We detected chromothripsis-related CNA profiles in two adenoma samples from an AIP mutation–positive patient with acromegaly and a patient with sporadic gigantism. RNA sequencing of these two samples identified 17 fusion transcripts, most of which resulted from chromothripsis-related chromosomal rearrangements. DNA FISH analysis of these samples demonstrated a subclonal architecture with up to six distinct cell populations in each tumor.

Conclusion

Somatotroph pituitary adenomas display substantial intertumor and intratumor DNA copy-number heterogeneity, as revealed by variable CNA profiles and complex subclonal architecture. The extensive cytogenetic burden in a subgroup of GNAS mutation–negative somatotroph adenomas points to an alternative tumorigenic pathway linked to genomic instability.
Insight into Structural Demand for Cold Crystallization of a Small Molecule. A Case Study for Schiff Base Compounds that Exhibit Prototropic Tautomerization
Authors: Iwase Katsunori , Toyama Yasuhiro , Yoshikawa Isao , Yamamura Yasuhisa , Saito Kazuya , Houjou Hirohiko
Published: February 2018

To elucidate the relationship between prototropic tautomerism and the cold crystallization phenomenon, o-hydroxy aryl Schiff base compounds derived from three different toluidine isomers were examined. Comparing their thermal behavior, we confirmed that cold crystallization occurred to give a different crystalline phase compared to the initial state. To elucidate the mechanisms of the cold crystallization of the materials, their thermal, structural, and energetic properties were investigated. The DFT calculation of the molecules in their OH- and NH-forms suggested that the NH-form has higher molecular flexibility, which may prevent normal crystallization upon cooling, compared to the OH-form. Spectroscopic analyses implied that the molecules are present as a mixture of the OH- and NH-forms, and that they efficiently crystallize when a preferable OH/NH ratio is achieved. For this molecular system, we concluded that the equilibrium between NH- and OH-forms controls the supercooling of the liquid as well as nucleation and crystal growth.
Improving the biomedical research literature: insights from authors’ editors can help journal editors define and refine their core competencies
Authors: Matarese Valerie , Shashok Karen
Published: February 2018

A team of stakeholders in biomedical publishing recently proposed a set of core competencies for journal editors, as a resource that can inform training programs for editors and ultimately improve the quality of the biomedical research literature. This initiative, still in its early stages, would benefit from additional sources of expert information. Based on our experiences as authors’ editors, we offer two suggestions on how to strengthen these competencies so that they better respond to the needs of readers and authors – the main users of and contributors to research journals. First, journal editors should be able to ensure that authors are given useful feedback on the language and writing in submitted manuscripts, beyond a (possibly incorrect) blanket judgement of whether the English is “acceptable” or not. Second, journal editors should be able to deal effectively with inappropriate text re-use and plagiarism. These additional competencies would, we believe, be valued by other stakeholders in biomedical research publication as markers of editorial quality.
Human CCL3L1 copy number variation, gene expression, and the role of the CCL3L1-CCR5 axis in lung function
Authors: Adewoye Adeolu B. , Shrine Nick , Odenthal-Hesse Linda , Welsh Samantha , Malarstig Anders , Jelinsky Scott , Kilty Iain , Tobin Martin D. , Hollox Edward J. , Wain Louise V.
Published: February 2018

Background: The CCL3L1-CCR5 signaling axis is important in a number of inflammatory responses, including macrophage function, and T-cell-dependent immune responses. Small molecule CCR5 antagonists exist, including the approved antiretroviral drug maraviroc, and therapeutic monoclonal antibodies are in development. Repositioning of drugs and targets into new disease areas can accelerate the availability of new therapies and substantially reduce costs. As it has been shown that drug targets with genetic evidence supporting their involvement in the disease are more likely to be successful in clinical development, using genetic association studies to identify new target repurposing opportunities could be fruitful. Here we investigate the potential of perturbation of the CCL3L1-CCR5 axis as treatment for respiratory disease. Europeans typically carry between 0 and 5 copies of CCL3L1 and this multi-allelic variation is not detected by widely used genome-wide single nucleotide polymorphism studies. 

Methods: We directly measured the complex structural variation of CCL3L1 using the Paralogue Ratio Test and imputed (with validation) CCR5del32 genotypes in 5,000 individuals from UK Biobank, selected from the extremes of the lung function distribution, and analysed DNA and RNAseq data for CCL3L1 from the 1000 Genomes Project.

Results: We confirmed the gene dosage effect of CCL3L1 copy number on CCL3L1 mRNA expression levels.  We found no evidence for association of CCL3L1 copy number or CCR5del32 genotype with lung function.

Conclusions: These results suggest that repositioning CCR5 antagonists is unlikely to be successful for the treatment of airflow obstruction.
The quality of higher education through the eyes of the consumers of educational services
Authors: Дмитриев Николай , Dmitriev Nikolay
Published: February 2018

The article analyses the incentives of the Russian higher education institutions to provide quality education which develop as a result of the competition and signals from labor market. The mechanism of a quality assurance of training of specialists in higher education institution is the quality management system. The experience of formation of a quality management system is presented. The structure and interrelation of components of quality of education is considered. Criteria and indicators of quality of educational process, which can be applied in estimation of quality in the educational organization, are offered. Besides, backbone components of quality — satisfaction of consumers with educational services are considered.
Investment Planning: Identification of Conditions
Authors: Мелай Е. , Melay E. , Сергеева Анна , Sergeeva Anna
Published: February 2018

Financial planning is the process of developing a set of strategic and tactical planning documents that define the goals, objectives and means of their implementation in the field of investment, financial and operational policies. The initial planning stage should be an assessment of the situation in the selected planning area. When planning investments, this is an analysis of the financial condition of the organization, reflecting the conditions for investment. Planning your own investments in your business, as well as investing in other business is carried out in conditions of financial well-being. The organization will be investment attractive in the face of unfavorable financial condition, if the financial condition of the organization is not a significant factor for the investor when choosing the object of investment. To conclude on the financial well-being of the organization can be based on the definition of the financial state scoring of the organization according to the proposed methodology.
ECG of the month
Authors: Richley Dave
Published: February 2018

Dave Richley presents an ECG for you to analyse
Continuous ECG monitoring in hospital: part 1, indications
Authors: Sampson Michael
Published: February 2018

Continuous monitoring of the electrocardiogram (ECG) is a common intervention in people admitted to hospital, especially when the cause of admission has a cardiovascular origin. Although widely considered a simple, routine procedure, ECG monitoring requires expert knowledge and sound clinical judgement for it to be used safely. Incorrect use of monitoring equipment can result in sub-optimal care, and adverse patient outcomes, including death. Patient selection, correct setup of equipment, and careful alarm management are all important in ensuring that monitoring is conducted safely. In this first article in a two-part series, the indications for monitoring are discussed and evaluated. For most patients, this will be arrhythmia monitoring; however, some will have an additional requirement for ischaemia or QT interval monitoring. The practical aspects of ECG monitoring will be addressed in the second article of this short series.
RECURRENT DISLOCATION OF THE SHOULDER
Authors: Adams J. Crawford
Published: February 2018

A review of the pathology, mechanism, and operative treatment of recurrent dislocation of the shoulder, based on an analysis of 180 cases, with 159 operations, is presented. From this analysis the following conclusions have been made and appear to be substantiated:

1. The pathology comprises two important elements: (a) anterior detachment of the glenoid labrum from the bone margin of the glenoid, associated with some degree of stripping of the anterior part of the capsule from the front of the neck of the scapula, found in 87 per cent. of cases examined adequately at operation; (b) defect or flattening of the posterolateral aspect of the articular surface of the head of the humerus which engages with the glenoid cavity when the arm is in external rotation and abduction; this defect is demonstrated most readily in antero-posterior radiographs taken with the humerus in 60 to 70 degrees of internal rotation and was shown to be present in 82 per cent. of cases which had been subjected to adequate radiographic examination.

2. The frequency of the humeral head defect has been under-estimated in the past, because of the difficulty of demonstrating it, particularly when the defect is small.

3. Either type of lesion alone may predispose to recurrence of the dislocation.

4. Both types of lesion are often present in the same shoulder. When this is the case the tendency to redislocation is great.

5. The initial dislocation, which results in the development of one or both these persistent structural abnormalities, may be due to very different types of injury, the commonest of which is a fall on the outstretched hand. The factor common to all these injuries is a resultant force acting on the humeral head in the direction of the anterior glenoid margin.

6. In the treatment of recurrent dislocation of the shoulder joint the Nicola operation is unreliable, and it may be associated with a recurrence rate as high as 36 per cent. It is believed that continued instability after this operation is usually due to the presence of a defect of the humeral head.

7. Operative treatment should aim at repairing, or nullifying, the effects of both types of lesion. For anterior detachment of the labrum this involves either suturing the labrum back to the glenoid margin, or constructing some form of anterior buttress, fibrous or bony: for humeral head defects it necessitates some procedure designed to limit external rotation, thus preventing the defect from coming into engagement with the glenoid cavity. Such limitation of external rotation does not constitute a significant disability.
RECURRENT DISLOCATION OF THE SHOULDER
Authors: Eyre-Brook A. L.
Published: February 2018

1. The operative findings in seventeen cases of recurrent dislocation of the shoulder are presented and discussed. Detachment of the glenoid labrum (thirteen cases) and the formation of a posterior humeral groove (eleven cases) were the most consistent findings.

2. In one case recurrent dislocation of the shoulder was due to avulsion of the subscapularis muscle.

3. The surgical treatment of these cases is described, usually consisting of a modification of Bankart's operation.

4. The results of follow-up are given as an intermediate report. No post-operative dislocation has so far been reported.
EVOLUTION OF MOULD ARTHROPLASTY OF THE HIP JOINT
Authors: Smith-Petersen M. N.
Published: February 2018

This is the first time that the principle of the mouldâthe principle of guiding the repair of nature for the purpose of recreating a destroyed or damaged structure, has been applied to surgery. The evolution of the method to its present encouraging stage is the result of the co-operative, professional family spirit of the Massachusetts General Hospital. We all share in it. We share it with the general surgeon because of his contributions to surgical technique. We share it with the "medical man" because of his pre-operative and post-operative care of the patient; because of his guidance as to when, and when not, to operate; and because of the many friendly arguments which are productive of so much good. We share it with the anaesthetist because of his clinical judgment of the patient, his selection of anaesthetic agent, and his continuous, conscientious administration of the anaesthetic throughout the operation.

I am going to change from "we" to "I." I owe so much to my assistants, from the first to the last: Bill Rogers, Eddie Cave, George Van Gorder, Paul Norton, Milton Thompson, Otto Aufranc, and Carroll Larson. I want to thank them all for helping to carry the load, for remembering the things that I forgot, and for making helpful suggestions which often led to improvement in surgical technique or to the construction of a useful instrument. I want to pay tribute to the staff of the Orthopaedic Service of the Massachusetts General Hospital and to thank its members for kindly scepticism, constructive criticism, and neverfailing loyal support.

The subject of this lecture, "Evolution of Mould Arthroplasty of the Hip Joint," is appropriate for a Moynihan lecture. It is not the work of one man alone. It is the work of one man, supported by a co-operative, helpful, and friendly hospital staff. This is what Lord Moynihan strove so hard to bring about at a time when surgeons viewed one another as rivals. To quote Dr William Mayo: "It is to Lord Moynihan's everlasting credit that, largely as a result of his unceasing efforts, surgeons came to consider themselves as fellow-workers in a cause."
PARAPLEGIA IN HYPEREXTENSION CERVICAL INJURIES WITH NORMAL RADIOGRAPHIC APPEARANCES
Authors: Taylor Alexander R. , Blackwood William
Published: February 2018

1) A case is reported of paraplegia with normal radiographic appearances in which cervical cord damage was shown at autopsy to have been due to hyperextension injury.

2) The mechanism of such injuries is discussed, together with the differential diagnosis from acute prolapse of an intervertebral disc.

3) The grave dangers of using the fully extended position of the cervical spine in the management of these cases is noted.
CONGENITAL ABSENCE OF THE HUMERAL HEAD
Authors: Andreasen A. T.
Published: February 2018

1. Two cases of an unrecognised congenital defect of the humeral head are described and the cause is discussed.

2. Only six cases with similar radiographic appearances could be collected from the literature. In most of these cases other skeletal deformities were present, whereas in those now reported only the shoulder was affected.

3. Examination of radiographs suggests that the main deformity consists of lack of development of the capital epiphysis of the humerus.

4. Consideration of the cases, together with experimental data from the studies of Fell and Canti, suggests that the time in development at which the fault occurred was the presumptive joint stage, just when the articular rudiments had separated.

5. A "nociferous agent," acting only for a limited period, and only on certain tissues, is postulated.

6. It is suggested that the defects recorded should be recognised as a group of congenital deformities of the shoulder joint.
CONGENITAL ELEPHANTIASIS ASSOCIATED WITH CONSTRICTION BY ANOMALOUS BANDS
Authors: Farmer A. W.
Published: February 2018

Congenital anomalous bands of the extremities are variable in position, depth, and in the completeness of their encirclement. They represent one of a group of abnormalities which are often present in the same individual. Cases associated with gross lymphoedema are rare. The treatment of such a case is presented.
ARTHROPLASTY OF THE KNEE JOINT
Authors: Samson J. Edouard
Published: February 2018

These statistics show that some movement was gained, with good stability and painlessness, in thirty-five of the fifty operations (70 per cent.) and that there was failure, with reankylosis, instability, or persistent pain, in fifteen (30 per cent.).
FRACTURES OF THE PATELLA
Authors: Scott J. C.
Published: February 2018

1. A series of 196 fractures of the patella has been reviewed.

2. The treatment adopted was excision of the whole boneâl0l; excision of part of the boneâ33; open reduction and sutureâ18; suture with later excisionâ14; no operationâ30.

3. The average time of post-operative disability varied from 3Â·6 to 5Â·3 months. The time was appreciably less when operation was carried out before the fourteenth day than when it was done later.

4. An attempt was made to follow up, two to five years after injury, those patients in whom the result was not influenced by other major injuries of the limbs or by unexpected complications. Replies to questionnaires were received from 116 patients.

5. Of these, all regained a good range of movement, varying from 90 degrees of flexion to full movement, whether treatment was by excision of part or all the bone, or by open reduction and suture.

6. The late results of excision of the patella, as estimated by the patients themselves two to five years after treatment, showed that there was considerable residual disability.

7. After total excision of the bone only 5 per cent. of patients considered that the knee was normal; 90 per cent. complained of aching; 60 per cent. complained of "giving way." After excision of one fragment, about half the patients regarded the knee as normal and half complained of aching and stiffness.

8. The number of fractures in this series treated by accurate internal fixation was too small to make justifiable comparisons.

9. The indications for non-operative treatment, open reduction and accurate internal fixation, excision of one fragment, and excision of the whole bone are discussed.

10. Excision of part or all the patella is often inevitable, but some claims made in the past for the results of this operation are not substantiated.
ARTERIAL SUPPLY AT THE FEMORAL HEAD AND ITS CLINICAL IMPORTANCE
Authors: Tucker F. R.
Published: February 2018

1. The arterial supply of the upper end of the femur has been studied in twenty-four children and twenty adults.

2. The arterial system was demonstrated by injection of radio-opaque material, with Spalteholz' method of clarification, and histological section of the neck and ligamentum teres.

3. The upper end of the femur is supplied by the nutrient artery of the shaft, the retinacular vessels of the capsule, and the foveolar artery of the ligamentum teres.

4. The retinacular vessels consist of three separate groups: postero-superior, posteroinferior, and anterior. These vessels are the chief supply to the epiphysis and femoral head at all ages.

5. The foveolar artery constitutes a small and subsidiary blood supply to the femoral epiphysis. In this series, it penetrated the cartilaginous or osseous head in 33 per cent. of young specimens and 70 per cent. of adult specimens. The foveolar vessels increase in size with age.

6. The site of the vascular pathology in various lesions of the femoral head is considered.
OSTEOCLASTOMA
Authors: Windeyer B. W. , Woodyatt P. B.
Published: February 2018

1. In this series of thirty-eight cases of osteoclastoma, twenty-five occurred at the end of a long bone. Nineteen were in the lower limb and half tif these were near the knee joint; six were in the upper limb; of the remainder, nine occurred in the vertebrae or the sacrum.

2. More cases occurred in females than males, the ratio being twenty-three females to fifteen males. Just over half the cases occurred in the second and third decades.

3. In seven there was a definite history of injury preceding symptoms by several months.

4. It is often difficult to arrive at a diagnosis on clinical and radiographic findings alone. Histological information is usually necessary before a certain diagnosis can be made. A limited biopsy is safe and reliable.

5. Malignant change with the development of metastases occurs in a small proportion of cases, regardless of the particular treatment that has been employed. This is illustrated in Case 3 of this series, in the case reported by Gordon Taylor, and in the case reported by Finch and Gleave.

6. The methods of treatment used in the patients here reported included curettage or local excision, with or without radiation, and radiation alone.

7. The patients treated by curettage or excision were dealt with during an earlier period than those treated by irradiation alone, and an exact comparison of results is not possible. The follow-up of patients treated by radiotherapy alone is too short to exclude the possibility of recurrence; but the immediate results appear to show definite improvement upon those of surgical treatment.

8. In this limited series it is to be noted that malignant change occurred in a higher proportion of cases treated by curettage and radiotherapy than in those treated by radiotherapy alone.

9. It appears that, in the treatment of osteoclastoma of bone, radiotherapy alone is the treatment of choice.
FRACTURES OF THE DORSO-LUMBAR SPINE
Authors: Nicoll E. A.
Published: February 2018

1 . A series of 166 fractures and fracture-dislocations of the dorso-lumbar spine has been reviewed.

2. A new method of classifying these injuries is suggested.

3. A type of fracture with lateral wedging, previously unidentified, which has certain distinctive clinical and anatomical features is described.

4. The factors responsible for redisplacement are discussed and it is considered that in most cases this is predictable from the outset.

5. At the present time orthodox treatment is based on the assumption that a perfect anatomical result is indispensable to a perfect functional result. Analysis of the results in the series now reported shows that there are no grounds for this assumption.

6. Treatment is discussed in the light of the foregoing conclusions. This is based on a division of cases into stable and unstable types, the recognition of which is of crucial importance.
EARLY ASSESSMENT OF SUPRASPINATUS TEARS
Authors: Brown J. Tulloch
Published: February 2018

1. The end-results of conservative treatment of supraspinatus tears have been studied in a series of 109 patients graded on a clinical basis, and in a further series of twenty-seven patients assessed initially by procaine infiltration.

2. In 87 per cent. of patients with mild lesions, full function was regained in an average period of five and a half weeks. In more than 50 per cent. of patients with apparently severe lesions, there was full functional recovery in eleven to thirteen weeks.

3. Clinical assessment, other than as mild or apparently severe, is unreliable in the early stages.

4. Procaine infiltration of recent tears, by abolishing pain and spasm, allows more accurate assessment of supraspinatus function and gives a more clear indication as to the advisability of conservative or early operative treatment. If such infiltration of the torn segment of tendon fails to restore voluntary abduction power, early operative repair is indicated.

5. Six patients with negative procaine tests, in whom the shoulder cuff was subsequently explored, all showed extensive tears.
ACUTE DEPOSITION OF CALCIUM NEAR THE ELBOW
Authors: Hughes E. S. R.
Published: February 2018

1. Three cases of localised deposition of calcium salts deep to the origin of the common extensors of the forearm with acute symptoms clinically indistinguishable from "tennis elbow" are described.

2. Reports of nine similar cases have been found in the literature.

3. It is suggested that "tennis elbow" is caused by a lesion, probably an adventitial bursa, in the tissue space between the tendon of origin of the forearm extensors and the capsule of the radio-humeral joint; and that it is the sudden precipitation of calcium phosphate at this site which causes the lesion here described.

4. Acute calcification near the elbow joint is compared with the similar calcification which may occur in the insertion of the supraspinatus tendon.

5. Operative treatment is advised.
OBLIQUE DISPLACEMENT OSTEOTOMY FOR OSTEOARTHRITIS OF THE HIP JOINT
Authors: Osborne G. V. , Fahrni W. H.
Published: February 2018

1. Experimental evidence is advanced to suggest that the effect of the McMurray displacement osteotomy in osteoarthritis of the hip is to diminish the load carried by the head of the femur, firstly by correction of deformity, and secondly by a "pelvic support" action.

2. A review of seventy-five cases has revealed certain important details in selection and operative management. The end-results indicate that the operation, when correctly performed, is successful in relieving pain and diminishing disability.
THE USE OF AN ARTIFICIAL FEMORAL HEAD FOR ARTHROPLASTY OF THE HIP JOINT
Authors: Judet Jean , Judet Robert
Published: February 2018

We have endeavoured to make known the results of a simple type of arthroplasty of the hip which is well tolerated even by elderly patients. It has not been the purpose of this article to compare former operations with our own, a newcomer in the field of surgery of the hip. In particular we do not wish to compare our comparatively recent results with Smith-Petersen's well-established method of cup arthroplastyâa magnificent contribution to the surgery of the region. The results we have already obtained, however, appear sufficiently favourable to merit further study and development of the method. If the future confirms the value of our early results, we shall perhaps be able to suggest operation to patients who suffer more from loss of function than from pain.
HALLUX RIGIDUS
Authors: Bingold A. C. , Collins D. H.
Published: February 2018

1. Clinically, hallux rigidus is a painful condition of the joints of the great toe associated with loss of dorsiflexion of the first phalanx.

2. Pathologically, the morbid changes are those of a traumatic synovitis followed by an early development of osteoarthritis, the initial lesions of which are erosions of the cartilage at the centre and near the dorsal margin of the base of the proximal phalanx. There is no fundamental pathological difference between the adult and adolescent varieties of hallux ngidus. Both represent stages in the developmental cycle of osteoarthritis in the proximal joint of the great toe.

3. The radiographic density and apparent fragmentation of the phalangeal epiphysis do not represent an abnormality of the bone and have no significance in the etiology of hallux rigidus.

4. The cause of hallux rigidus is an abnormal gait developed either to protect an injured or inflamed metatarso-phalangeal joint from the pressure of weight-bearing, or to stabilise a hypermobile first metatarsal. The effects of this gait are to transfer most of the pressure from the flexor brevis tendon and the two sesamoids to the base of the first phalanx. Excessive pressure on this joint predisposes to osteoarthritis.

5. Evidence of this abnormal gait is found in the peculiarities of wear seen in old shoes.

6. There is a high correlation between unilateral hallux rigidus and the patient's footedness.
OSTEOCHONDRITIS OF THE CUBOID ASSOCIATED WITH TUBERCULOSIS OF ADJACENT TARSAL BONES
Authors: Khoo F. Y.
Published: February 2018

1. A case of osteochondritis of the cuboid, with co-existing tuberculosis of the third cuneiform bone, is reported.

2. The possible relationship between osteochondritis and tuberculosis is discussed.
THE RESULTS OF TRANSPOSITION OF THE ULNAR NERVE FOR TRAUMATIC ULNAR NEURITIS
Authors: McGowan Anna J.
Published: February 2018

1. The progress of recovery after transposition of the ulnar nerve has been studied in forty-six patients with ulnar neuritis of traumatic or mechanical origin.

2. In assessing the results, the lesions were divided into three grades according to the severity of the neurological signs: Grade I, minimal lesions with no detectable motor weakness; Grade II, intermediate lesions; Grade III, severe lesions with paralysis of one or more of the ulnar intrinsic muscles.

3. The earliest and most constant result after operation was the relief of discomfort and ulnar paraesthesiae.

4. The degree of motor recovery varied according to the severity of the lesion at the time of the operation. In Grades I and II cases, all the muscles (with one exception) were acting against gravity and resistance at the final examination. In Grade III cases, the recovery was usually far from complete. Recovery of sensibility was uniformly good.

5. In a further six patients with persistent symptoms after transposition, relief was obtained by free mobilisation and placing the nerve deep to the flexor origin.
SPONDYLOLISTHESIS WITH AN INTACT NEURAL ARCHâTHE SO-CALLED PSEUDO-SPONDYLOLISTHESIS
Authors: MacNab Ian
Published: February 2018

Spondylolisthesis without a defect in the neural arch, the "pseudo-spondylolisthesis" of Junghanns, usually affects the fourth lumbar vertebra. The essential lesion is an increase in the angle between tile inferior facets and the pedicles which allows subluxation at the inferior joints. The forward displacement averages less than one centimetre.

It commonly produces a clinical picture of backache and sciatica, but may present with. a "drop foot," and in unusual instances compression of the cauda euluina may occur.

Patients seen in the early stages without signs of nerve root compression are best treated by localised spinal fusion. Late fusion may afford no relief because of secondary changes in the spine, but these patients obtain some benefit from a corset. Laminectomy is indicated for severe symptoms in patients who show signs of nerve root compression; it should be followed by spinal fusion.
TWO CASES OF OSTEOCHONDRITIS DISSECANS AFFECTING SEVERAL JOINTS
Authors: Hay B. M.
Published: February 2018

1. Two cases of osteochondritis dissecans affecting several joints are described.

2. There is no evidence that injury, congenital anomaly or constitutional disturbance played any part in the etiology of either case.
EXPERIMENTAL RUPTURE OF THE MEDIAL COLLATERAL LIGAMENT OF THE KNEE
Authors: Jack Ewen A.
Published: February 2018

Rupture of a ligament usually occurs along a definite line, but is associated with considerable intrinsic damage to the remote parts of the ligament. In spite of this, healing occurs by regeneration of regular collagen to form a new ligament with good tensile strength, provided the ends of the torn ligament are in reasonable apposition, and provided the blood supply is adequate.

When lateral instability of the knee after a recent injury suggests that a collateral ligament has been ruptured, wide displacement of the torn ends should be suspected. Accurate replacement can be guaranteed only by surgical intervention; operative repair therefore seems to be justifiable on anatomical grounds. If operation is contemplated it should be undertaken within the first week after injury when it is easy to achieve accurate repair, which later becomes impossible because of shrinkage and friability of the tissue. In order to preserve blood supply, the areolar covering should be disturbed as little as possible, and the least possible amount of fine suture material should be used to anchor the torn ends in position. Nevertheless when the tear involves the upper attachment, ischaemia of the damaged ligament may prevent normal healing, whatever the treatment adopted.
HALF A CENTURY OF ORTHOPAEDIC PROGRESS IN GREAT BRITAIN
Authors: Osmond-Clarke H.
Published: February 2018

It has been fascinating to trace the gradual erection of the British edifice of orthopaedics, and nostalgic to recapture a memory, however fleeting, of some of the figures who built it and taught us so much of our sum of knowledge half-way through the twentieth centuryâthe remarkable spell of Robert Jones, the lofty, ascetic Tubby, the pugnacious Openshaw, the forceful and enthusiastic Hey Groves, the earnest but irascible Laming Evans, the equable and thoughtful Elmslie, the restless and exuberant Trethowan. It is always tempting to conclude: "those were the days." It is probably wise to do no more than record the events and leave judgment of progress to a later century. But we are being judged already and not always kindly or even truthfully. We are justified surely in priding ourselves on what has already been achieved, and on the service that orthopaedic surgery now gives to the community and promises for the future. In concern for this aspect of our work we have perhaps tended to neglect our capacity for basic research. But we are aware of this shortcoming, as witness our closer relationships with research departments of universities and royal colleges, and our increasing contacts with colleagues in the basic sciences. Finally, apart from the most intellectual snob and the pessimistic cynic, all must surely rejoice at the enthusiasm, industry and ability of our young colleaguesâthe orthopaedic surgeons of to-morrow.
CONGENITAL POSTERIOR BOWING OF THE TIBIA WITH TALIPES CALCANEO-VALGUS
Authors: Miller B. F.
Published: February 2018

1. The literature dealing with congenital bowing of the tibia has been reviewed, and three types of deformity have been distinguished.

2. Five examples of the third type, in which the bowing is posterior and medial, are presented.

3. The characteristic features of the clinical entity are described, and the satisfactory response to conservative treatment is illustrated.
OSTEOCHONDROMATOSIS OF THE HIP JOINT
Authors: Bloom Ross , Pattinson J. N.
Published: February 2018

1. Three cases of osteochondromatosis of the hip joint are described.

2. Attention is drawn to the diagnostic importance of erosions at the junction of head and neck of the femur, and the conical shape of the femoral neck.

3. Arthrography is of particular value in diagnosis when the loose bodies are radio-translucent.
FRACTURES OF THE UPPER END OF THE TIBIA
Authors: Palmer Ivar
Published: February 2018

1. Ninety-eight cases of fracture of the upper end of the tibia treated by operative reduction have been reviewed.

2. The true split fractures and the mildly comminuted compression fractures showed the best results. The "mosaic" cases showed the least satisfactory results.

3. Age has scarcely any effect on the end-results and is consequently no contra-indication to operation.

4. Nearly half the patients regained normal or almost normal mobility in the knee joint.

5. In no case did a meniscus left in place cause symptoms indicating internal derangement.
ACTINOMYCOSIS OF BONE WITH SPECIAL REFERENCE TO INFECTION OF THE VERTEBRAL COLUMN
Authors: Cope V. Zachary
Published: February 2018

1. The pathology of actinomycosis is briefly summarised, especially its method of invading bone by direct spread.

2. The manifestations, diagnosis and treatment of spinal involvement are considered.

3. The literature is brought up to date with a) a summary of fifteen cases published since the last collected series (forty-seven cases), and b) notes of three cases previously unreported, making, with the case reported on page 215 by Mr Brett, sixty-six cases in the literature.
TENODESIS OF SUBCLAVIUS IN THE TREATMENT OF RECURRENT DISLOCATION OF THE STERNO-CLAVICULAR JOINT
Authors: Burrows H. Jackson
Published: February 2018

1. It is suggested that replacement of the costo-clavicular ligament is mechanically an essential part of the operative treatment of recurrent sterno-clavicular dislocation.

2. Tenodesis of the subclavius appears to be the simplest and safest way of achieving such replacement.

3. Two cases are described of recurrent sterno-clavicular dislocation treated by this procedure and capsulorrhaphy.

4. Full function was restored in both cases; and there had been no recurrence at the times of follow-upâthree years and six months after operation in the first case, and twelve months after operation in the second. In this case the joint had withstood violence that had shattered the clavicle.

5. Further trial in judiciously selected cases, with report, is suggested.
ISCHAEMIC NECROSIS AND REGENERATION OF THE TIBIALIS ANTERIOR MUSCLE AFTER RUPTURE OF THE POPLITEAL ARTERY
Authors: Horn J. S. , Sevitt S.
Published: February 2018

1. A clinico-pathological study of a patient who suffered traumatic rupture of his right popliteal artery is outlined.

2. Collateral circulation from the genicular anastomosis developed within twenty hours.

3. Ischaemic necrosis of the belly of the tibialis anterior occurred, but voluntary power began to return about twenty-one weeks after injury.

4. Biopsy of the muscle nineteen, fifty-seven and seventy-six weeks after injury showed that the muscle belly was being reconstituted by new fibres and that the ischaemic tissue remained entombed in the deepest part of the muscle. The regenerating fibres arose from small numbers of subfascial fibres which either survived the ischaemic episode or had arisen by myoblastic differentiation of connective tissue cells. Sarcoplasmic outgrowths produced new contractile substance, and new fibres were formed by amitotic fission. Many of the fibres matured and the regenerative process was still active seventy-six weeks after injury.

5. Growth of new nerve bundles containing myelinated axons accompanied the development of new muscle fibres.
HAEMOSIDEROSIS AND HAEMOCHROMATOSIS OF SYNOVIAL TISSUES
Authors: Collins Douglas H.
Published: February 2018

1. Rusty staining of the synovial membrane is the gross manifestation of loading of phagocytic synovial-lining cells and of macrophages in the stratum synoviale with haemosiderin.

2. Absorption of blood effused into the joint cavities is the commonest cause of such synovial pigmentation.

3. Obvious discolouration of the synovial tissues usually follows only after repeated haemarthroses, in such conditions as haemophilia, synovial tumour and in some cases of chronic rheumatoid arthritis.

4. An identical naked-eye appearance is seen in multiple joints of patients with generalised haemochromatosis.

5. In haemochromatosis the iron-containing pigment tends to be confined to the surface layer of cells of the synovial membrane.

6. The presence of haemosiderin in synovial cells, per se, leads to no disability of the joint and is unaccompanied either by inflammatory reaction or fibrosis. Arthritis in a patient with haemochromatosis is fortuitous.
CALCINOSIS
Authors: Hamilton A. R.
Published: February 2018

1. The salient features of calcinosis universalis and calcinosis circumscripta are described.

2. The term "calcinosis localisata" is suggested to distinguish the localised type of calcinosis from the more widespread calcinosis.

3. Thirteen cases of calcinosis localisata are described: in five the lesion was situated about the greater tuberosity of the humerus; one was in the axillarv aspect of the shoulder; one on the dorsum of the foot; two in the digits of the hand; one on the dorsum of the wrist; one in the region of the flexor carpi ulnaris tendon; one on the lateral aspect of the elbow; and one at the tip of the greater trochanter.

4. The value of rest is emphasised; in some cases chemotherapy appeared to be indicated.