bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical treatment of spontaneous posterior interosseous nerve palsy
Authors: Ochi K. , Horiuchi Y. , Tazaki K. , Takayama S. , Nakamura T. , Ikegami H. , Matsumura T. , Toyama Y.
Published: February 2011

We have reviewed 38 surgically treated cases of spontaneous posterior interosseous nerve palsy in 38 patients with a mean age of 43 years (13 to 68) in order to identify clinical factors associated with its prognosis. Interfascicular neurolysis was performed at a mean of 13 months (1 to 187) after the onset of symptoms. The mean follow-up was 21 months (5.5 to 221). Medical Research Council muscle power of more than grade 4 was considered to be a good result. A further 12 cases in ten patients were treated conservatively and assessed similarly.

Of the 30 cases treated surgically with available outcome data, the result of interfascicular neurolysis was significantly better in patients < 50 years old (younger group (18 nerves); good: 13 nerves (72%), poor: five nerves (28%)) than in cases > 50 years old (older group (12 nerves); good: one nerve (8%), poor: 11 nerves (92%)) (p < 0.001). A pre-operative period of less than seven months was also associated with a good result in the younger group (p = 0.01). The older group had a poor result regardless of the pre-operative delay.

Our recommended therapeutic approach therefore is to perform interfascicular neurolysis if the patient is < 50 years of age, and the pre-operative delay is < seven months. If the patient is > 50 years of age with no sign of recovery for seven months, or in the younger group with a pre-operative delay of more than a year, we advise interfascicular neurolysis together with tendon transfer as the primary surgical procedure.
The effect of surface finish and interstitial fluid on the cement-in-cement interface in revision surgery of the hip
Authors: Rudol G. , Wilcox R. , Jin Z. , Tsiridis E.
Published: February 2011

The mechanical performance of the cement-in-cement interface in revision surgery has not been fully investigated. The quantitative effect posed by interstitial fluids and roughening of the primary mantle remains unclear. We have analysed the strength of the bilaminar cement-bone interface after exposure of the surface of the primary mantle to roughening and fluid interference. The end surfaces of cylindrical blocks of cement were machined smooth (Ra = 200 nm) or rough (Ra = 5 μm) and exposed to either different volumes of water and carboxymethylcellulose (a bone-marrow equivalent) or left dry. Secondary blocks were cast against the modelled surface. Monoblocks of cement were used as a control group. The porosity of the samples was investigated using micro-CT. Samples were exposed to a single shearing force to failure.

The mean failure load of the monoblock control was 5.63 kN (95% confidence interval (CI) 5.17 to 6.08) with an estimated shear strength of 36 MPa. When small volumes of any fluid or large volumes were used, the respective values fell between 4.66 kN and 4.84 kN with no significant difference irrespective of roughening (p > 0.05). Large volumes of carboxymethylcellulose significantly weakened the interface. Roughening in this group significantly increased the strength with failure loads of 2.80 kN (95% CI 2.37 to 3.21) compared with 0.86 kN (95% CI 0.43 to 1.27) in the smooth variant. Roughening of the primary mantle may not therefore be as crucial as has been previously thought in clinically relevant circumstances.
Adverse reaction to metal debris following hip resurfacing
Authors: Langton D. J. , Joyce T. J. , Jameson S. S. , Lord J. , Van Orsouw M. , Holland J. P. , Nargol A. V. F. , De Smet K. A.
Published: February 2011

We sought to establish the incidence of joint failure secondary to adverse reaction to metal debris (ARMD) following metal-on-metal hip resurfacing in a large, three surgeon, multicentre study involving 4226 hips with a follow-up of 10 to 142 months. Three implants were studied: the Articular Surface Replacement; the Birmingham Hip Resurfacing; and the Conserve Plus. Retrieved implants underwent analysis using a co-ordinate measuring machine to determine volumetric wear. There were 58 failures associated with ARMD. The median chromium and cobalt concentrations in the failed group were significantly higher than in the control group (p < 0.001). Survival analysis showed a failure rate in the patients with Articular Surface Replacement of 9.8% at five years, compared with < 1% at five years for the Conserve Plus and 1.5% at ten years for the Birmingham Hip Resurfacing. Two ARMD patients had relatively low wear of the retrieved components. Increased wear from the metal-on-metal bearing surface was associated with an increased rate of failure secondary to ARMD. However, the extent of tissue destruction at revision surgery did not appear to be dose-related to the volumetric wear.
Nitroxides and nucleic acids: Chemistry and electron paramagnetic resonance (EPR) spectroscopy
Authors: Sigurdsson Snorri Th.
Published: February 2011

Electron paramagnetic resonance (EPR) spectroscopy has increasingly been applied for the study of nucleic acid structure and dynamics. Such studies require incorporation of free radicals (spin labels) into the biopolymer. The labels can be incorporated during chemical synthesis of the oligomer (phosphoramidite approach) or postsynthetically, by reaction of a spin-labeling reagent with a reactive functional group on the oligonucleotide. Incorporation of the rigid nitroxide spin label Ç is an example of the phosphoramidite method, and reaction of a spin-labeled azide with an alkyne-modified oligomer to yield a triazole-derived, spin-labeled nucleotide illustrates the postsynthetic spin-labeling strategy. Characterization and application of these labels to study structural features of DNA by EPR spectroscopy is discussed. Finally, a new spin-labeling strategy is described for nucleic acids that relies on noncovalent interactions between a spin-labeled nucleobase and an abasic site in duplex DNA.
Serum vaspin levels in normal pregnancy in comparison with non-pregnant women
Authors: Giomisi Athina , Kourtis Anargyros , Toulis Konstantinos A , Anastasilakis Athanasios D , Makedou Kali G , Mouzaki Maria , Gerou Spyridon , Gavana Elpida , Agorastos Theodoros , Giannoulis Charalambos
Published: February 2011

Objective

Pregnancy represents a state of insulin resistance (IR). Vaspin (SERPINA12) is a novel insulin-sensitizing adipokine that might be implicated in endogenous glucose regulation. However, its role in pregnancy and its circulating levels have not been adequately studied. We aimed to evaluate serum vaspin levels in pregnancy and their correlation with known markers of IR.

Design

A group of 106 women (age 27.9±0.4 years) at the 24–30th week of gestation (pregnancy group) and another 106 age-matched healthy non-pregnant controls (control group) were included in the study.

Methods

Serum glucose, insulin, vaspin, adiponectin, and lipid parameters were measured. The quantitative insulin sensitivity check index (QUICKI) was used as an insulin sensitivity index.

Results

Pregnant women had significantly higher body mass index (BMI), lipids, and serum insulin and lower serum glucose and vaspin levels than controls. Vaspin was positively correlated to adiponectin in both groups (P<0.001 and P<0.004 respectively) but was not correlated to BMI, serum insulin levels, or the QUICKI index in either group. Furthermore, vaspin was negatively correlated to lipid parameters (total cholesterol, triglycerides, and low-density lipoproteins) in the pregnant but not in the non-pregnant women.

Conclusions

Vaspin cannot serve as a marker of IR in either pregnant or non-pregnant women, although it is significantly correlated with adiponectin. On the other hand, vaspin might be useful as a surrogate marker of lipid metabolism in pregnancy if confirmed by subsequent studies.
Excess of glucocorticoid induces myocardial remodeling and alteration of calcium signaling in cardiomyocytes
Authors: De Priyanka , Ghose Roy Sreerupa , Kar Dipak , Bandyopadhyay Arun
Published: February 2011

Ventricular dysfunction is one of the important side effects of the anti-inflammatory agent, glucocorticoid (GC). The present study was undertaken to examine whether abnormal calcium signaling is responsible for cardiac dysfunction due to an excess of GC hormone. The synthetic GC drug, dexamethasone (DEX), significantly (P<0.001, n=20) increased heart weight to body weight ratio, left ventricular remodeling, and fibrosis. The microarray analysis showed altered expression of several genes encoding calcium cycling/ion channel proteins in DEX-treated rat heart. The altered expression of some of the genes was validated by real-time PCR and western blotting analyses. The expression of the L-type calcium channels and calsequestrin was increased, whereas sarcoendoplasmic reticulum calcium transport ATPase 2a (SERCA2a) and junctin mRNAs were significantly reduced in DEX-treated rat left ventricular tissues. In neonatal rat ventricular cardiomyocytes, DEX also increased the level of mRNAs of atrial- and brain natriuretic peptides, L-type calcium channels, and calsequestrin after 24 h of treatment, which were mostly restored by mifepristone. The caffeine-induced calcium release was prolonged by DEX compared to the sharp release in control cardiomyocytes. Taken together, these data show that impaired calcium kinetics may be responsible for cardiac malfunction by DEX. The results are important in understanding the pathophysiology of the heart in patients treated with excess GC.
Educational Perspectives
Authors: Dadiz Rita , Guillet Ronnie
Published: February 2011

Interdisciplinary education for pediatric and obstetric practitioners promotes collaboration, communication, and teamwork. Educational methods that use team training and encourage self-reflection and group discussion have been shown to improve team dynamics and neonatal outcomes. This article introduces several educational techniques that, when successfully implemented, can provide opportunities for better collaboration among pediatric and obstetric practitioners during deliveries.
Economic Evaluation With Clinical Trials in Neonatology
Authors: Dukhovny Dmitry , Zupancic John A.F.
Published: February 2011

With the current economic climate, the budget crisis within the health-care system, and the rapid development of health-care technologies in the field of neonatology, it is essential for decision makers at every level to understand how to interpret published economic evaluations to help guide both practice and budget decisions. The objective of this article is to provide a stepwise approach to interpreting economic evaluations conducted alongside randomized, controlled trials (RCTs). The emphasis in assessing the validity of such an analysis is to ensure that the authors are transparent in their approach with respect to factors such as the intervention and comparator, time horizon, study perspective, sources for costs and effects, appropriate combining of costs and effects into a single metric, and assessment of uncertainty and time preference.
Periventricular Leukomalacia
Authors: Bass W. Thomas
Published: February 2011

The most common form of brain injury in preterm infants is focal necrosis and gliosis of the periventricular white matter, generally referred to as periventricular leukomalacia (PVL). PVL is also the most common cause of cerebral palsy in preterm infants. Although the incidence of the most severe cystic form of PVL is decreasing, a more subtle diffuse form has emerged as the much more common lesion, possibly related to the increased survival of the smallest, most vulnerable infants. Experimental data suggest the central theme of pathogenesis is the effect of hypoxia, ischemia, and inflammation on the oligodendrocyte progenitor cell, the primary cellular target of PVL. Innovative experimental models and clinical trials using magnetic resonance imaging continue to shed light on the mechanisms of brain injury involved in PVL and provide the basis for future neuroprotective strategies. This review presents the neuropathology, pathogenesis, clinical presentation, diagnosis, and outcome of PVL.
Pain and Pleasure in Short Essay Writing: Factors Predicting University Students' Writing Anxiety and Writing Self‐Efficacy
Authors: Martinez Christy Teranishi , Kock Ned , Cass Jeffrey
Published: February 2011

Since the inception of the Writing Across the Curriculum movement more than 30 years ago, scholars have explored ways of enhancing students' writing performance. Faculty members across disciplines are often challenged by students' resistance to writing; resistance that may stem from anxiety, poor academic performance, and lack of recognition that writing is important in their lives. To examine predictors of students' writing anxiety and writing self‐efficacy, 127 college students completed a pre‐ and post‐assessment survey. Findings indicated that GPA and gender significantly affected writing anxiety, and leisure writing and writing anxiety were significant predictors of writing self‐efficacy. Suggestions for future research and possible interventions for alleviating students' writing anxiety and enhancing their writing self‐efficacy and performance are provided.
Web 3.0, Litbots, and TPWSGWTAU
Authors: McEneaney John E.
Published: February 2011

Digital literacies are typically distinguished from traditional literacy either in terms of content (media vs. print) or practice (page turning vs. keyboarding and clicking). This article presents a case for an approach that emphasizes the “who” of reading by contrasting traditional and digital literacies in terms of who counts as a reader. Whereas traditional literacy views reading as a uniquely human act, digital literacies are introducing meaning‐making technologies that open the door to machine readers. Furthermore, these meaning‐making technologies will drive the next iteration of the Web (Web 3.0), forcing reading educators, reading teachers, and researchers to rethink some of our most basic assumptions about readers and texts.
Beyond carbon and nitrogen: how the microbial energy economy couples elemental cycles in diverse ecosystems
Authors: Burgin Amy J , Yang Wendy H , Hamilton Stephen K , Silver Whendee L
Published: February 2011

Microbial metabolism couples elemental reactions, driving biogeochemical cycles. Assimilatory coupling of elemental cycles, such as the carbon (C), nitrogen (N), and phosphorus cycles, occurs when these elements are incorporated into biomass or released through its decomposition. In addition, many microbes are capable of dissimilatory coupling, catalyzing energy‐releasing reactions linked to transformations in the oxidation state of elements, and releasing the transformed elements to the environment. Different inorganic elements provide varying amounts of energy yield, and the interaction of these processes creates a microbial energy economy. Dissimilatory reactions involving C, N, iron, and sulfur provide particularly important examples where microbially mediated oxidation–reduction (redox) transformations affect nutrient availability for net primary production, greenhouse‐gas emissions, levels of contaminants and natural toxic factors, and other ecosystem dynamics. Recent discoveries of previously unrecognized microbial dissimilatory processes are leading to reevaluation of traditional perceptions of biogeochemical cycles.
Introduction to coupled biogeochemical cycles
Authors: Schlesinger William H , Cole Jonathan J , Finzi Adrien C , Holland Elisabeth A
Published: February 2011

At the 2009 Annual Meeting of the Ecological Society of America, investigators of ecosystem science and biogeochemistry gathered in a series of sessions sponsored by the National Science Foundation to examine what is known about the coupling of chemical elements in biochemistry and thus in global biogeochemical cycles. As an introduction to the topic, this paper offers some philosophical thoughts about the origins and implications of coupled biogeochemical cycles on Earth. The chemical characteristics of Earth have carried the imprint of biology since the first appearance of life more than 3.5 billion years ago. Movements of about 30 chemical elements essential to life are coupled, so that the behavior of one element can often be used to predict the behavior of other elements – in both the natural and human‐perturbed settings of the world. The coupling of biochemical elements stems from basic stoichiometry (the relative quantities of chemical elements in living biomass), the oxidation–reduction or “redox” reactions (in which one substance is oxidized [loses electrons] and another is reduced [gains electrons]) of metabolic activity, and chelation (in which a metal ion binds to an organic compound). Many anthropogenic environmental problems – climate change, eutrophication, acid precipitation, metal pollution – originate from the release of non‐stoichiometric and toxic quantities of chemical elements to the environment. Geoengineering proposals as solutions to certain global environmental problems must be consistent with the underlying constraints of coupled biogeochemical cycles. Biogeochemistry has much to offer to policy makers, and biogeochemists must contribute to current deliberations about how to solve environmental problems.
Improving biogeochemical knowledge through technological innovation
Authors: Melack John M , Finzi Adrien C , Siegel David , MacIntyre Sally , Nelson Craig E , Aufdenkampe Anthony K , Pace Michael L
Published: February 2011

The understanding of biogeochemical cycles has benefited from technological advances facilitating new kinds of measurements and observations. Satellite‐borne ocean‐color sensors that assess the physiological status of phytoplankton have led to improved estimates of oceanic productivity, as have micrometeorological approaches measuring terrestrial photosynthesis and respiration. The advent of satellites fitted with synthetic aperture radar (a specialized sensor used to determine inundation extent and vegetation types in wetlands) has revealed large fluxes of carbon dioxide and methane from these areas. Advances in the measurement of chemical constituents and turbulence have allowed the detection of high‐resolution coupling between physical and biogeochemical processes. Genomics and proteomics – the study of genes and of an organism's complement of proteins, respectively – have revolutionized our understanding of the types of cells present in the environment and their ability to transform elements by allowing direct assessment of gene and protein sequences.
Multi‐element regulation of the tropical forest carbon cycle
Authors: Townsend Alan R , Cleveland Cory C , Houlton Benjamin Z , Alden Caroline B , White James WC
Published: February 2011

Tropical ecosystems dominate the exchange of carbon dioxide between the atmosphere and terrestrial biosphere, yet our understanding of how nutrients control the tropical carbon (C) cycle remains far from complete. In part, this knowledge gap arises from the marked complexity of the tropical forest biome, in which nitrogen, phosphorus, and perhaps several other elements may play roles in determining rates of C gain and loss. As studies from other ecosystems show, failing to account for nutrient–C interactions can lead to substantial errors in predicting how ecosystems will respond to climate and other environmental changes. Thus, although resolving the complex nature of tropical forest nutrient limitation – and then incorporating such knowledge into predictive models – will be difficult, it is a challenge that the global change community must address.
Increased Expression of Macrophage-Inducible C-type Lectin in Adipose Tissue of Obese Mice and Humans
Authors: Ichioka Masayuki , Suganami Takayoshi , Tsuda Naoto , Shirakawa Ibuki , Hirata Yoichiro , Satoh-Asahara Noriko , Shimoda Yuri , Tanaka Miyako , Kim-Saijo Misa , Miyamoto Yoshihiro , Kamei Yasutomi , Sata Masataka , Ogawa Yoshihiro
Published: February 2011

OBJECTIVE

We have provided evidence that saturated fatty acids, which are released from adipocytes via macrophage-induced adipocyte lipolysis, serve as a naturally occurring ligand for the Toll-like receptor (TLR) 4 complex in macrophages, thereby aggravating obesity-induced adipose tissue inflammation. The aim of this study was to identify the molecule(s) activated in adipose tissue macrophages in obesity.

RESEARCH DESIGN AND METHODS

We performed a cDNA microarray analysis of coculture of 3T3-L1 adipocytes and RAW264 macrophages. Cultured adipocytes and macrophages and the adipose tissue of obese mice and humans were used to examine mRNA and protein expression.

RESULTS

We found that macrophage-inducible C-type lectin (Mincle; also called Clec4e and Clecsf9), a type II transmembrane C-type lectin, is induced selectively in macrophages during the interaction between adipocytes and macrophages. Treatment with palmitate, a major saturated fatty acid released from 3T3-L1 adipocytes, induced Mincle mRNA expression in macrophages at least partly through the TLR4/nuclear factor (NF)-κB pathway. Mincle mRNA expression was increased in parallel with macrophage markers in the adipose tissue of obese mice and humans. The obesity-induced increase in Mincle mRNA expression was markedly attenuated in C3H/HeJ mice with defective TLR4 signaling relative to control C3H/HeN mice. Notably, Mincle mRNA was expressed in bone-marrow cell (BMC)-derived proinflammatory M1 macrophages rather than in BMC-derived anti-inflammatory M2 macrophages in vitro.

CONCLUSIONS

Our data suggest that Mincle is induced in adipose tissue macrophages in obesity at least partly through the saturated fatty acid/TLR4/NF-κB pathway, thereby suggesting its pathophysiologic role in obesity-induced adipose tissue inflammation.
Mendelian Randomization Studies Do Not Support a Role for Raised Circulating Triglyceride Levels Influencing Type 2 Diabetes, Glucose Levels, or Insulin Resistance
Authors: De Silva N. Maneka G. , Freathy Rachel M. , Palmer Tom M. , Donnelly Louise A. , Luan Jian'an , Gaunt Tom , Langenberg Claudia , Weedon Michael N. , Shields Beverley , Knight Beatrice A. , Ward Kirsten J. , Sandhu Manjinder S. , Harbord Roger M. , McCarthy Mark I. , Smith George Davey , Ebrahim Shah , Hattersley Andrew T. , Wareham Nicholas , Lawlor Debbie A. , Morris Andrew D. , Palmer Colin N.A. , Frayling Timothy M.
Published: February 2011

OBJECTIVE

The causal nature of associations between circulating triglycerides, insulin resistance, and type 2 diabetes is unclear. We aimed to use Mendelian randomization to test the hypothesis that raised circulating triglyceride levels causally influence the risk of type 2 diabetes and raise normal fasting glucose levels and hepatic insulin resistance.

RESEARCH DESIGN AND METHODS

We tested 10 common genetic variants robustly associated with circulating triglyceride levels against the type 2 diabetes status in 5,637 case and 6,860 control subjects and four continuous outcomes (reflecting glycemia and hepatic insulin resistance) in 8,271 nondiabetic individuals from four studies.

RESULTS

Individuals carrying greater numbers of triglyceride-raising alleles had increased circulating triglyceride levels (SD 0.59 [95% CI 0.52–0.65] difference between the 20% of individuals with the most alleles and the 20% with the fewest alleles). There was no evidence that the carriers of greater numbers of triglyceride-raising alleles were at increased risk of type 2 diabetes (per weighted allele odds ratio [OR] 0.99 [95% CI 0.97–1.01]; P = 0.26). In nondiabetic individuals, there was no evidence that carriers of greater numbers of triglyceride-raising alleles had increased fasting insulin levels (SD 0.00 per weighted allele [95% CI −0.01 to 0.02]; P = 0.72) or increased fasting glucose levels (0.00 [−0.01 to 0.01]; P = 0.88). Instrumental variable analyses confirmed that genetically raised circulating triglyceride levels were not associated with increased diabetes risk, fasting glucose, or fasting insulin and, for diabetes, showed a trend toward a protective association (OR per 1-SD increase in log10 triglycerides: 0.61 [95% CI 0.45–0.83]; P = 0.002).

CONCLUSIONS

Genetically raised circulating triglyceride levels do not increase the risk of type 2 diabetes or raise fasting glucose or fasting insulin levels in nondiabetic individuals. One explanation for our results is that raised circulating triglycerides are predominantly secondary to the diabetes disease process rather than causal.
Glucose Monitoring After Fruit Peeling: Pseudohyperglycemia When Neglecting Hand Washing Before Fingertip Blood Sampling
Authors: Hirose Takahisa , Mita Tomoya , Fujitani Yoshio , Kawamori Ryuzo , Watada Hirotaka
Published: February 2011

OBJECTIVE

To examine whether hand contamination with fruit results in a false blood glucose (BG) reading using capillary fingertip blood sample.

RESEARCH DESIGN AND METHODS

The study subjects were healthy volunteers with normal glucose tolerance test. Capillary BG samples were collected from the fingertip after peeling orange, grape, or kiwi fruit, followed by no action, washing hands with tap water, or rubbing the fingertip with an alcohol swab, then analyzed with glucose monitors.

RESULTS

The BG levels measured after peeling any of the fruits, followed by washing hands, were similar to the control subjects (no fruit handling), but the levels after fruit peeling, followed by no washing, were abnormally and significantly high, even when the fingertip was cleaned once or five times with an alcohol swab before blood sampling.

CONCLUSIONS

To avoid overestimation of blood glucose using portable monitors, the hands should be washed before monitoring capillary BG, especially after fruit has been handled.
Effects of Bilio-Pancreatic Diversion on Diabetic Complications
Authors: Iaconelli Amerigo , Panunzi Simona , De Gaetano Andrea , Manco Melania , Guidone Caterina , Leccesi Laura , Gniuli Donatella , Nanni Giuseppe , Castagneto Marco , Ghirlanda Giovanni , Mingrone Geltrude
Published: February 2011

OBJECTIVE

The surgical option could represent a valid alternative to medical therapy in some diabetic patients. However, no data are available on long-term effects of metabolic surgery on diabetic complications. We aimed to determine whether patients with newly diagnosed type 2 diabetes who underwent bilio-pancreatic diversion (BPD) had less micro- and macrovascular complications than those who received conventional therapy.

RESEARCH DESIGN AND METHODS

This was an unblinded, case-controlled trial with 10-years’ follow-up, conducted from July 1998 through October 2009 at the Day Hospital of Metabolic Diseases, Catholic University, Rome, Italy. A consecutive sample of 110 obese patients (BMI >35 kg/m2) with newly diagnosed type 2 diabetes was enrolled. The study was completed by 50 subjects. The main outcome measure was long-term effects (10 years) of BPD versus those associated with conventional therapy on microvascular outcome, micro- and macroalbuminuria, and glomerular filtration rate (GFR). Secondary measures included macrovascular outcomes, type 2 diabetes remission, glycated hemoglobin, and hyperlipidemia.

RESULTS

Ten-year GFR variation was −45.7 ± 18.8% in the medical arm and 13.6 ± 24.5% in the surgical arm (P < 0.001). Ten-year hypercreatininemia prevalence was 39.3% in control subjects and 9% in BPD subjects (P = 0.001). After 10 years, all BPD subjects recovered from microalbuminuria, whereas microalbuminuria appeared or progressed to macroalbuminuria in control subjects. Three myocardial infarctions, determined by electrocardiogram, and one stroke occurred in control subjects. After the 10-year follow-up, coronary heart disease (CHD) probability was 0.22 ± 0.10 and 0.05 ± 0.04 in the medical and surgical groups, respectively (P < 0.001). Remission from type 2 diabetes was observed in all patients within 1 year of surgery. Surgical and medical subjects had lost 34.60 ± 10.25 and 0.38 ± 6.10% of initial weight at the 10-year follow-up (P < 0.001).

CONCLUSIONS

Renal and cardiovascular complications were dramatically reduced in the surgical arm, indicating long-term benefits of BPD on diabetic complications, at least in the case of morbid obesity with decompensated type 2 diabetes.
Estimation of intrathoracic arterial diameter by means of computed tomographic angiography in Hispaniolan Amazon parrots
Authors: Beaufrère Hugues , Rodriguez Daniel , Pariaut Romain , Gaschen DVM Lorrie , Schnellbacher Rodney , Nevarez Javier G. , Tully Thomas N.
Published: February 2011

Objective—To establish a computed tomography (CT)-angiography protocol and measure the diameters of major arteries in parrots.

Animals—13 Hispaniolan Amazon parrots (Amazona ventralis).

Procedures—16-slice CT scanning was used to measure the apparent diameter of the ascending aorta, abdominal aorta, pulmonary arteries, and brachiocephalic trunk. Before scanning, all birds underwent ECG and echocardiographic assessment and were considered free of detectable cardiovascular diseases. Each bird was anesthetized, and a precontrast helical CT scan was performed. Peak aortic enhancement was established with a test bolus technique via dynamic axial CT scan over a predetermined single slice. An additional bolus of contrast medium was then injected, and a helical CT-angiography scan was performed immediately afterward. Arterial diameter measurements were obtained by 2 observers via various windows before and after injection, and intra- and interobserver agreement was assessed.

Results—Reference limits were determined for arterial diameter measurements before and after contrast medium administration in pulmonary, mediastinal, and manual angiography windows. Ratios of vertebral body diameter to keel length were also calculated. Intraobserver agreement was high (concordance correlation coefficients ≥ 0.95); interobserver agreement was medium to high (intraclass correlation coefficients ≥ 0.65).

Conclusions and Clinical Relevance—CT-angiography was safe and is of potential diagnostic value in parrots. We recommend performing the angiography immediately after IV injection of 3 mL of iohexol/kg. Arterial diameter measurements at the described locations were reliable.
Evaluation of the effects of a commercially available Salmonella Newport siderophore receptor and porin protein vaccine on fecal shedding of Salmonella bacteria and health and performance of feedlot cattle
Authors: Dodd Charles C. , Renter David G. , Thomson Daniel U. , Nagaraja T. G.
Published: February 2011

Objective—To evaluate effects of a Salmonella Newport siderophore receptor and porin protein (SRP) vaccine on cattle health and performance and on prevalence of fecal shedding of Salmonella bacteria in feedlot cattle.

Animals—1,591 beef cattle.

Procedures—Cattle were randomly allocated within a replicate (n = 10 replicates [20 total pens]), administered 2 mL of a Salmonella Newport SRP vaccine (n = 795 cattle) or a placebo (796), and revaccinated approximately 21 days after the first administration. Health and performance data were recorded by trained feedlot personnel who were blinded to treatment. Fresh fecal samples (n = 25) were collected from pen floors on days 0, 60, and 120 and within 24 hours of cattle harvest and were subjected to selective Salmonella culture and serotyping by laboratory personnel who were blinded to treatment. Pen-level mixed models were used to analyze data.

Results—Significant differences in fecal prevalence of Salmonella bacteria or health and performance variables were not detected between vaccinated and control cattle. Salmonella bacteria were recovered from all 10 replicates, and cumulative prevalence estimates ranged from 1.5% to 22%. Overall prevalence of fecal shedding of Salmonella bacteria was 10.2% and 10.9% in vaccinated and control cattle, respectively. Overall morbidity risk was 34.8% for both vaccinated and control cattle. Overall mortality risks were 1.9% and 1.1% for vaccinated and control cattle, respectively.

Conclusions and Clinical Relevance—In this setting, administration of the Salmonella Newport SRP vaccine in feedlot cattle had no effect on fecal prevalence of Salmonella bacteria or cattle health and performance.
Evaluation of an extractionless high-performance liquid chromatography-tandem mass spectrometry method for detection and quantitation of rosiglitazone in canine plasma
Authors: Frazier Sara Allstadt , McKemie Daniel S. , Guerrero Teri A. , Skorupski Katherine A. , Rodriguez Carlos O.
Published: February 2011

Objective—To develop a simple extractionless method for detection of rosiglitazone in canine plasma and test the method in a pharmacokinetic study after oral administration of rosiglitazone in dogs.

Animals—3 client-owned dogs with cancer.

Procedures—High-performance liquid chromatography-tandem mass spectrometry was performed on canine plasma. The 3 dogs with cancer in the pharmacokinetic study were assessed via physical examination and clinicopathologic evaluation and considered otherwise healthy. Food was withheld for 12 hours, and dogs were administered a single dose (4 mg/m2) of rosiglitazone. Plasma was collected at various times, processed, and analyzed for rosiglitazone.

Results—The developed method was robust and detected a minimum of 0.3 ng of rosiglitazone/mL. Mean ± SD maximum plasma concentration was 205.2 ± 79.1 ng/mL, which occurred at 3 ± 1 hours, and mean ± SD elimination half-life was 1.4 ± 0.4 hours. The area under the plasma rosiglitazone concentration-versus-time curve varied widely among the 3 dogs (mean ± SD, 652.2 ± 351.3 ng/h/mL).

Conclusions and Clinical Relevance—A simple extractionless method for detection of rosiglitazone in canine plasma was developed and was validated with excellent sensitivity, accuracy, precision, and recovery. The method enabled unambiguous evaluation and quantitation of rosiglitazone in canine plasma. This method will be useful for pharmacokinetic, bioavailability, or drug-drug interaction studies. Oral rosiglitazone administration was well tolerated in the dogs.
Effects of preparation method, shear force, and exposure to collagen on release of growth factors from equine platelet-rich plasma
Authors: Textor Jamie A. , Norris Jeffrey W. , Tablin Fern
Published: February 2011

Objective—To test the hypotheses that preparation method, exposure to shear force, and exposure to collagen affect the release of growth factors from equine platelet-rich plasma (PRP).

Sample Population—PRP obtained from 6 horses.

Procedures—PRP was prepared via 2 preparation methods (tube and automated) and subjected to 6 treatment conditions (resting, detergent, exposure to shear via 21- and 25-gauge needles, and exposure to collagen [10 and 20 μg/mL]). Concentrations of platelet-derived growth factor, isoform BB (PDGF-BB); transforming growth factor β, isoform 1 (TGFβ1); and insulin-like growth factor, isoform 1 (IGF-1) were quantified by use of ELISAs. Statistical analysis was conducted via repeated-measures ANOVA.

Results—Platelet numbers were significantly higher in tube-prepared PRP than in automated-prepared PRP Growth factor concentrations did not differ significantly between preparation methods. Mean PDGF-BB concentration ranged from 134 to 7,157 pg/mL, mean TGFβ1 concentration ranged from 1,153 to 22,677 pg/mL, and mean IGF-1 concentration ranged from 150 to 280 ng/mL. Shear force did not affect growth factor concentrations. Dose-dependent increases in PDGF-BB and TGFβ1 were detected in response to collagen, but equalled only 10% of the estimated total platelet content. Concentrations of IGF-1 were not significantly different among treatments and negative or positive control treatments. Serum concentrations of PDGF-BB and TGFβ1 exceeded concentrations in PRP for most treatment conditions.

Conclusions and Clinical Relevance—Release of growth factors from equine PRP was negligible as a result of the injection process alone. Investigation of platelet-activation protocols is warranted to potentially enhance PRP treatment efficacy in horses.
Suspected phenobarbital-induced pseudolymphoma in a cat
Authors: Baho Meg J. , Hostutler Roger , Fenner William , Corn Stephanie
Published: February 2011

Case Description—A 4.5-year-old spayed female domestic shorthair cat was evaluated because of a generalized seizure disorder that developed after an anesthesia-related hypoxic event.

Clinical Findings—Following administration of phenobarbital, the seizures stopped but the cat developed severe generalized lymphadenopathy. Results of a CBC and serum biochemical analysis were unremarkable. Cytologic examination of the lymph nodes revealed a reactive lymphocyte population. Differential diagnoses included neoplasia and infection, but results of related diagnostic tests were all negative.

Treatment and Outcome—Treatment was changed from phenobarbital to levetiracetam. Ten days following discontinuation of phenobarbital, the lymph node enlargement resolved, and the cat remained free of seizures with levetiracetam as treatment.

Clinical Relevance—Pseudolymphoma and anticonvulsant hypersensitivity syndrome are recognized potential sequelae to anticonvulsant administration in humans. However, a pseudolymphoma-like reaction to anticonvulsants in veterinary species has not previously been reported. This case highlighted a potentially serious yet reversible sequela to phenobarbital treatment that may have been mistaken for more severe illness such as neoplasia.
Achilles Tendon Ruptures in Elite Athletes
Authors: Maffulli Nicola , Longo Umile Giuseppe , Maffulli Gayle D. , Khanna Anil , Denaro Vincenzo
Published: February 2011

Background: The management of Achilles tendon (AT) ruptures in elite athletes can be challenging. We performed a retrospective review of prospectively collected data study to evaluate the results of percutaneous repair of an acute AT rupture in elite athletes. Materials and Methods: Seventeen elite athletes with prodromal tendinous problems sustained an acute tear of the AT and underwent percutaneous surgical repair. We performed preoperative evaluations the day of surgery, and report the results of postoperative evaluation at a final followup at an average of 72 months from the procedure. Each patient was evaluated for limb dominance, trauma history, duration and type of preoperative symptoms, and postoperative AT Total Rupture Score (ATRS). Results: All patients were able to fully weightbear on the operated limb by the end of the 8th postoperative week. The average time to return to full sport participation was 4.8 ± 0.9 months. Two of the 15 elite athletes on whom we have full data suffered from a superficial infection of the surgical wound. Conclusion: Our study suggests that percutaneous repair of the AT is a good option for elite athletes, allowing a safe and prompt return to sport activities.

Level of Evidence: IV, Retrospective Case Series
Epidemiology of Metatarsal Stress Fractures Versus Tibial and Femoral Stress Fractures During Elite Training
Authors: Finestone Aharon , Milgrom Charles , Wolf Omer , Petrov Kaloyan , Evans Rachel , Moran Daniel
Published: February 2011

Background: The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Materials and Methods: Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. Results: The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 ( p = 0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports ( p = 0.02) and greater tibial length ( p = 0.05) were protective factors for stress fracture. Conclusion: The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures should be aware of this pattern.

Level of Evidence: IV, Case Series
Short-Term Outcome of Retrograde Tibiotalocalcaneal Arthrodesis with a Curved Intramedullary Nail
Authors: Mückley Thomas , Klos Kajetan , Drechsel Thomas , Beimel Claudia , Gras Florian , Hofmann Gunther O.
Published: February 2011

Background: The aim of this study was to investigate the potential clinical benefit of tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary nail with a valgus curve, two compression options, and angle-stable locking. Material and Methods: Patients who had undergone TTCA at two tertiary hospitals were eligible. Patients who had undergone TTCA before the beginning of the study were evaluated retrospectively, then all following patients were examined prospectively. There were 59 TTCAs; 55 patients were available for analysis. Twenty-eight were evaluated retrospectively, 27 prospectively. Main Outcome Measures were an SF-36, Mazur-, and AOFAS ankle-hindfoot rating scores and radiographic examination. Results: Bony union was obtained in 53 patients. Fifty-one patients were satisfied with the outcome. Fifty-one patients had marked subjective improvement in mobility. The mean AOFAS score of the 55 patients at the latest followup was 66.8 (range, 38 to 86). The mean Mazzur score was 68.0 (range, 30 to 83). In the prospective group, the scores were significantly improved: AOFAS score by an average of 39.6 points ( p < 0.001); Mazur score by an average of 43 points ( p < 0.001); SF-36 physical component summary score ( p < 0.001) and mental component summary score also improved ( p < 0.048). Radiology showed good hind-foot alignment. The complication rate was 25%. Conclusion: Compared with the literature, the data obtained in this study show a good outcome and a high rate of bony union, with comparable complication rates. Patient satisfaction was good. However, the patients still had limitations. The clinical benefit of the nail used was confirmed.

Level of Evidence: IV, Case Series
Plantar Pressure with and without Custom Insoles in Patients with Common Foot Complaints
Authors: Stolwijk Niki M. , Louwerens Jan Willem K. , Nienhuis Bart , Duysens Jacques , Keijsers Noël L. W.
Published: February 2011

Background: Although many patients with foot complaints receive customized insoles, the choice for an insole design can vary largely among foot experts. To investigate the variety of insole designs used in daily practice, the insole design and its effect on plantar pressure distribution were investigated in a large group of patients. Materials and Methods: Mean, peak, and pressure-time-integral per sensor for 204 subjects with common foot complaints for walking with and without insoles was measured with the footscan® insole system (RSscan International). Each insole was scanned twice (precision3D), after which the insole height along the longitudinal and transversal cross section was calculated. Subjects were assigned to subgroups based on complaint and medial arch height. Data were analyzed for the total group and for the separate subgroups (forefoot or heel pain group and flat, normal or high medial arch group). Results: The mean pressure significantly decreased under the metatarsal heads II-V and the calcaneus and significantly increased under the metatarsal bones and the lateral foot ( p < 0.0045) due to the insoles. However, similar redistribution patterns were found for the different foot complaints and arch heights. There was a slight difference in insole design between the subgroups; the heel cup was significantly higher and the midfoot support lower for the heel pain group compared to the forefoot pain group. The midfoot support was lowest in the flat arch group compared to the high and normal arch group ( p < 0.05). Conclusion: Although the insole shape was specific for the kind of foot complaint and arch height, the differences in shape were very small and the plantar pressure redistribution was similar for all groups. Clinical Relevance: This study indicates that it might be sufficient to create basic insoles for particular patient groups.
Comparison of Initial Compression of the Medial, Lateral, and Posterior Screws in an Ankle Fusion Construct
Authors: Jeng Clifford L. , Baumbach Sebastian F. , Campbell John , Kalesan Bindu , Myerson Mark S.
Published: February 2011

Background: One of the requirements for successful ankle arthrodesis is adequate compression by the fixation across the fusion surfaces. A common screw construct for ankle fusion is three crossed screws from proximal-to-distal. Because the screws are inserted nearly orthogonal to each other, it is possible minimal additional compression is obtainable once the first screw is inserted. The aim of this study was to determine which of the three screws gave the greatest initial compression and theoretically should be inserted first. Materials and Methods: Seventeen cadaver limbs were dissected to expose the anterior and posterior aspects of the tibiotalar joint. Three Fuji film templates were created for each ankle joint with a hole to accommodate a 7.0-mm cannulated screw. Each film was tested with a single medial, lateral, or posterior screw. The Fuji films were then analyzed for contact area, percent contact area, and pressure. Results: There was no difference in the total contact area, percent contact area, or pressure generated between the three screws. The mean contact area for all screws was 11% of the joint surface. All three screws had greater contact area and percent contact area over the anterior half of the ankle joint. Conclusion: The medial, lateral, and posterior screws were equivalent with respect to contact area, percent contact area, and pressure generated across the tibiotalar joint. All three screws had greater contact area over the anterior half of the joint. Only 11% of the tibiotalar joint surface came in contact following the insertion of a single partially threaded screw. Clinical Relevance: In a neutrally aligned ankle arthrodesis the order of screw insertion does not affect the amount of compression ultimately achieved at the fusion site.
Stress Fracture of the Anterior Process of the Calcaneus Associated With a Calcaneonavicular Coalition: A Case Report
Authors: Pearce Christopher J. , Zaw Htwe , Calder James DF
Published: February 2011

Level of Evidence: V, Expert Opinion