bluuebunny/crossref_metadata_2025 huggingface dataset:
Habitat Structure Influences the Diversity, Richness and Composition of Bird Assemblages in Successional Atlantic Rain Forests
Authors: Casas Grasiela , Darski Bianca , Ferreira Pedro M. A. , Kindel Andreas , Müller Sandra C.
Published: October 2016

This study evaluated the influence of vegetation structure on bird diversity, guilds, and the richness and composition of species in different successional stages of the subtropical Atlantic rain forest. Much of the land that was formerly agricultural in the Brazilian Atlantic rain forest region is now given over to secondary forests. The habitat structure of these successional forests vary and are influenced by time, historical use and local variables, all of which affect bird assemblies. Sampling of bird species was carried out through audio-visual point counts conducted in forests varying from six years after abandonment to old-growth areas. Forests in which the point counts were conducted were further classified into initial, intermediate and advanced stages according to 11 vegetation structural variables, through cluster analyses. The study found that bird richness and diversity were similar between initial and intermediate stages, but higher in advanced areas. Bird species composition differed between the initial and advanced stages, whereas the guild composition of initial forests differed in both intermediate and advanced stages. Late successional forests had more heterogeneous habitats, and some species and guilds were found only in this stage. However, bird diversity and species and guild composition were similar in intermediate and advanced forests, emphasizing the importance of successional forests for conservation efforts, especially when they are located near old-growth forests and conservation units. The recovery patterns of the successional forests studied indicate a great potential for the natural regeneration of the Atlantic rain forest, at least in areas where slash-and-burn agriculture was the previous landuse.
Forest Cover and Bird Diversity: Drivers of Fruit Consumption in Forest Interiors in the Atlantic Forest of Southern Bahia, Brazil
Authors: Menezes Icaro , Cazetta Eliana , Morante-Filho José Carlos , Faria Deborah
Published: October 2016

Forest loss and fragmentation change the dynamics and structure of remnant populations, ultimately affecting key processes with implications for ecosystem functioning. Fruit consumption has important consequences for seed dispersal, maintaining the plant demography, which is also critical to the populations of animals that utilize them for resources. Therefore, understanding how forest cover reduction affects fruit consumption and, consequently, seed dispersal is essential to informing conservation policy for the remaining forest patches. This study was conducted in 20 forest sites with varying amounts of forest cover (from 6% - 85%) located in the Atlantic forest of southern Bahia, Brazil. We investigated whether forest loss and local bird diversity affected fruit consumption rates in the forest edge and interior. We used artificial fruit to estimate fruit consumption by birds. At each site, we set up 14 experimental stations, one located on the forest edge (∼3m) and the others in the forest interior (75 m), each one composed of 15 artificial fruits fixed to a plant. Our results showed that forest loss and the reduction of bird abundance led to a decrease in fruit consumption in the forest interiors, but not on the forest edges. This verifies that forest cover loss results in changes in fruit consumption, and has important consequences for seed dispersal by birds in forest remnants.
How Diverse are Epiphyte Assemblages in Plantations and Secondary Forests in Tropical Lowlands?
Authors: Einzmann Helena Julia Regina , Zotz Gerhard
Published: October 2016

The on-going destruction of old-growth forests puts tropical forest species under great pressure because of the resulting loss of habitat. An important biotic component of these forests are vascular epiphytes, which structurally depend on trees. In human-modified landscapes potential hosts may still be present, e.g. in the form of isolated remnant trees, small groups of planted trees, in patches of secondary forests, or in plantations. For this study, we assessed the potential of timber monocultures and secondary forest patches to function as refuges for vascular epiphytes. We studied epiphyte assemblages in teak and pine plantations and secondary forest patches of unknown age along a rainfall gradient (1100 – 4200 mm) at the Pacific coast of western Panama and also in a few oil palm plantations. Invariably, rainfall had the expected positive influence on epiphyte diversity and abundance. Individual-based rarefaction curves showed that species richness was significantly lower in timber and oil palm plantations compared to secondary forest patches, which in turn hosted less species-rich epiphyte assemblages than (cultivated and wild grown) pasture trees from the same study region. Our results suggest that the value of timber and oil palm plantations as refuges for vascular epiphytes in human-modified landscapes is limited. Secondary forest patches were more promising in that regard.
Coastal Zone Habitat-Use by Birds in Qatar: Insights from a Rapid Assessment Method During Spring Migration
Authors: Zogaris Stamatis , Kallimanis Athanasios
Published: October 2016

In the western part of the Arabian/Persian Gulf, coastal habitats such as intertidal wetlands and mangroves are scarce and poorly studied. We conducted a rapid assessment survey of bird species richness and abundance at the Fuwairit khor lagoon in northern Qatar, using a line transect count scheme to collect data from six different generic habitat types, repeated during five consecutive days in late April 2013. To further analyze the ecological requirements of the surveyed bird assemblage per habitat type, we assigned ecological guild categories to each species and distinguished among migrants, local, and regional breeders. Mangrove and intertidal mudflats hosted the highest bird densities and the most distinctive assemblages, while the beach habitat had high concentrations of birds but relatively few species. In contrast to the wetland habitats, near-shore marine areas and dune habitats had very limited numbers of birds and a relatively depauperate species assemblage. Employing a habitat perspective in a quantitative bird survey method shows that birds are effective biodiversity indicators for a rapid survey of coastal features in a poorly-studied region of the Arabian/Persian Gulf.
Evaluating Landscape Suitability for Golden-Headed Lion Tamarins (Leontopithecus Chrysomelas) and Wied's Black Tufted-Ear Marmosets (Callithrix Kuhlii) in the Bahian Atlantic Forest
Authors: Guy Cylita , Cassano Camila R. , Cazarre Leticia , Vleeschouwer De Kristel M. , Kierulff Maria Cecília Martins , Neves Leonardo G. , Oliveira Leonardo C. , Tardio Bruno Marchena R. , Zeigler Sara L. , Raboy Becky E.
Published: October 2016

In southern Bahia, Brazil, rapid deforestation of the Atlantic Forest threatens a variety of endemic wildlife, including the Endangered golden-headed lion tamarin (GHLT; Leontopithecus chrysomelas) and the Near Threatened Wied's black-tufted-ear marmoset (Wied's marmoset; Callithrix kuhlii). Identifying high quality areas in the landscape is critical for mounting efficient conservation programs for these primates. We constructed ecological niche models (ENMs) for GHLTs and Wied's marmosets using the presence-only algorithm Maxent to (1) locate suitable areas for each species, (2) examine the overlap in these areas, and (3) determine the amount of suitable habitat in protected areas. Our models indicate that 36% (10, 659 km2) of the study area is suitable for GHLTs and 53% (15, 642 km2) for Wied's marmosets. Suitable areas were strongly defined by presence of neighboring forest cover for both species, as well as annual temperature range for GHLTs and distance from urban areas for Wied's marmosets. Thirty-three percent of the landscape (9,809 km2) is overlapping suitable habitat. Given that the focal species form mixed-species groups, these areas of shared suitability may be key locations for preserving this important behavioral interaction. Protected areas contained 6% (651 km2) of all suitable habitat for GHLTs and 4% (682 km2) for Wied's marmosets. All protected areas were suitable for the focal species, excepting Serra do Conduru, which had low suitability for GHLTs. Our results highlight that suitable habitat for GHLTs and Wied's marmosets is limited and largely unprotected. Conservation action to protect additional suitable areas will be critical for their persistence.
Conservation Value, History and Legal Status of Non-Native White-Tailed Deer (Odocoileus Virginianus) on the Caribbean Island of St. Kitts
Authors: Keehner Jon R. , Cruz-Martinez Luis , Knobel Darryn
Published: October 2016

White-tailed deer (Odocoileus virginianus) have been introduced from North America to a variety of habitats throughout the world, including the Caribbean island of St. Kitts. Often, non-native species are considered detrimental to the environment; however, the social acceptance of non-native species appears to be resulting in a shift of the perceived conservation value of non-native animals, to the extent that they are sometimes viewed as normal or desirable in natural systems. White-tailed deer were protected by the government of St. Kitts and Nevis in 1987 but difficulties in administering and enforcing the laws have hampered conservation and research efforts. Recent progress in funding the implementation and enforcement of conservation laws provides an opportunity to explore the socio-political value of conserving the population of white-tailed deer before threats to their persistence cause their extirpation.
Artificial Perches and Solarization for Forest Restoration: Assessment of Their Value
Authors: Tomazi Aline Luiza , Castellani Tânia Tarabini
Published: October 2016

Artificial perches have been considered an effective way to increase the influx of zoochoric seeds on degraded areas. A main barrier to seedling recruitment beneath perches is competition with other plants, including non-native or invasive species. We therefore believed that the seedling recruitment would increase with invasive species management through solarization. We assessed the use of artificial perches combined with solarization as a management technique for forest restoration. An outline of subdivided plots was installed in an abandoned pasture originally covered by subtropical Atlantic forest in southern Brazil. The invasive species were Nutgrass ( Cyperus rotundus - Cyperaceae) and African Liverseed Grass ( Urochloa arrecta - Poaceae). Solarization was achieved using a black polyethylene cover. Artificial perches were installed after solarization was complete. Seed rain and established plant community species were assessed. Solarization initially eliminated previously existing vegetation, but the effects were not long lasting. Invasive species grew aggressively by vegetative means from the borders of solarized areas. Artificial perches increased the influx of zoochoric seeds, but the seeds were unable to germinate and establish due to competition by the fast growing invasive species. The combined use of artificial perches and solarization for forest restoration seems to have limited effectiveness.
Scaling-Up the Use of Chili Fences for Reducing Human-Elephant Conflict Across Landscapes in Tanzania
Authors: Chang'a Alex , Souza de Nick , Muya John , Keyyu Julius , Mwakatobe Angela , Malugu Lucas , Ndossi Humphrey Peter , Konuche Jonathan , Omondi Raphael , Mpinge Aloyce , Hahn Nathan , Palminteri Suzanne , Olson David
Published: October 2016

Elephants ( Loxodonta africana) raiding crops around Tanzanian national parks threaten farmers' lives and livelihoods, thus contributing to negative local attitudes towards wildlife. As a result, there is often tacit support for poaching among local communities, and elephants suffer through reprisal poisoning or wounding or through being shot as ‘problem animals’ by game wardens. Human-elephant conflict (HEC) is growing as the wildlands that still have elephants, especially around national parks, reserves, and wildlife corridors, are increasingly being settled. Sisal string fences soaked in engine oil mixed with ground chili ( Capsicum spp.) can dissuade elephants from entering fenced fields. For the last nine years, farmers around Mikumi National Park in Tanzania have been constructing these fences around ripening crops, and there have been no incidents of fences being broken by elephants. Community-based organizations (CBOs) that manage members' savings through village micro-credit associations help ensure the costs of materials and fence construction are met. Chili fences are rapidly becoming widespread, facilitated through farmer-to-farmer exchanges where teams of farmers demonstrate both the fences and the CBOs needed to support the project. We argue that promoting the use of chili fences, coupled with supporting CBOs, as a best practice within communities and government programs and budgets, will help reduce the need for HEC compensation, protect livelihoods, empower rural women, increase the food security of rural farmers, and help conserve elephants.
Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion
Authors: Stone Sarah , Lee Bobby , Garrison J. Craig , Blueitt Damond , Creed Kalyssa
Published: October 2016

Background:

Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC.

Hypothesis:

After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes.

Study Design:

Retrospective cohort study.

Level of Evidence:

Level 3.

Methods:

A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non–sport-related activity were excluded.

Results:

Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002).

Conclusion:

On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC.

Clinical Relevance:

Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population.
Speaker-Sex Discrimination for Voiced and Whispered Vowels at Short Durations
Authors: Smith David R. R.
Published: October 2016

Whispered vowels, produced with no vocal fold vibration, lack the periodic temporal fine structure which in voiced vowels underlies the perceptual attribute of pitch (a salient auditory cue to speaker sex). Voiced vowels possess no temporal fine structure at very short durations (below two glottal cycles). The prediction was that speaker-sex discrimination performance for whispered and voiced vowels would be similar for very short durations but, as stimulus duration increases, voiced vowel performance would improve relative to whispered vowel performance as pitch information becomes available. This pattern of results was shown for women’s but not for men’s voices. A whispered vowel needs to have a duration three times longer than a voiced vowel before listeners can reliably tell whether it’s spoken by a man or woman (∼30 ms vs. ∼10 ms). Listeners were half as sensitive to information about speaker-sex when it is carried by whispered compared with voiced vowels.
Matching Faces Against the Clock
Authors: Bindemann Markus , Fysh Matthew , Cross Katie , Watts Rebecca
Published: October 2016

This study examined the effect of time pressure on face-matching accuracy. Across two experiments, observers decided whether pairs of faces depict one person or different people. Time pressure was exerted via two additional displays, which were constantly updated to inform observers on whether they were on track to meet or miss a time target. In this paradigm, faces were matched under increasing or decreasing (Experiment 1) and constant time pressure (Experiment 2), which varied from 10 to 2 seconds. In both experiments, time pressure reduced accuracy, but the point at which this declined varied from 8 to 2 seconds. A separate match response bias was found, which developed over the course of the experiments. These results indicate that both time pressure and the repetitive nature of face matching are detrimental to performance.
Chronic Triangular Fibrocartilage Complex Tears with Distal Radioulna Joint Instability: A New Method of Triangular Fibrocartilage Complex Reconstruction
Authors: Jui-Tien Shih , Yao-Tung Hou , Hung-Maan Lee , Chuan-Ming Tan , Ming-Chun Chang
Published: October 2016

From September 1996 to September 1997, 27 adult patients were diagnosed with chronic triangular fibrocartilage complex (TFCC) tears with distal radioulna joint (DRUJ) instability in our clinic. They all received the procedure of TFCC reconstruction with partial extensor carpi ulnaris (ECU) tendon combined with or without ulnar shortening. There were 26 males and one female in the study with a mean age of 22.4 years. The follow-up period ranged from 22 to 28 months with a mean of 26.2 months. 24 patients who had positive or zero ulnar variance received the procedure of ulnar shortening. Three patients who had minus ulnar variance only received TFCC reconstruction. After the operation, the DRUJ was fixed by a 2.0 mm K-wire for 4 weeks. All patients underwent a rehabilitation program and they were reexamined at our outpatient department (OPD). The results were graded according to the Mayo Modified Wrist Score. Five of the 27 patients rated their wrists ‘excellent’, 18 rated ‘good’, and 4 rated ‘fair’. Overall, a total of 23 patients (85%) rated satisfactorily and returned to work or sport activities. In the 4 patients rated ‘fair’, mild pain at work and/or exercise, and mildly limited supination were found; however their grip strength was improved at least by 65% compared to the opposite hand. Therefore, as suggested by this study, TFCC reconstruction with partial ECU tendon combined with the ulnar shortening procedure is an alternative method for chronic TFCC tears with DRUJ instability.
Unusual Arterial Injury following a Fracture of the Forearm Bones: A Case Report
Authors: Pai VS
Published: October 2016

The author describes a case of a 10-year-old boy with fracture of both forearm bones and a concomitant partial rupture of the ulnar artery. The damage to the ulnar artery was repaired at the time of fasciotomy with a good functional outcome.
Evaluation of Letournel and Judet Classification of Acetabular Fracture with Plain Radiographs and Three-Dimensional Computerized Tomographic Scan
Authors: Visutipol Boonyarak , Chobtangsin Pornchai , Ketmalasiri Bunyat , Pattarabanjird Narongchai , Varodompun Namchai
Published: October 2016

Letournal and Judet classification of acetabular fracture is widely used. The classification is based on the identification of fracture lines on plain radiographs. Three-dimensional CT scan was claimed to give a better view of the fracture line.

Our study showed that intraobserver reproducibility and interobserver reliability were almost the same when classification was done by using plain radiographs and 3D-CT scan. And 3D-CT scan did not increase either the interobserver reliability or the intraobserver reproducibility in classifying the fracture.
Epidural Steroid Injection for Sciatica: An Analysis of 526 Consecutive Cases with Measurements and the Whistle Test
Authors: Loy Tony TT
Published: October 2016

The effects of epidural injections of triamcinolone acetonide and bupivacaine in the treatment of sciatica were analyzed in a retrospective series of 526 consecutive cases with measurements. A new test (the whistle test) is described. There is a paucity of measureable parameters in reports on the subject in the literature, and many are not specific or symptom-oriented to sciatica. The procedure was performed by the same operator and reviewed one week postoperatively with measurements. 491 patients (93.35%) achieved excellent to good pain relief, backed by appropriate increases of straight-leg-raise measurements. But 17 patients (3.46%) of this group required surgery later. It is concluded that epidural steroid injection is a simple, cost-effective and minimally invasive treatment for sciatica, especially in the acute. It also serves as a method for crisis intervention and as a prognosticator.
In Vitro Study of Immune Tolerance Induced by CTLA4–Ig in Bone Transplantation: The Effect on Cell Proliferation Stimulated by Lymphocytes and Bone Supernatant
Authors: Chuanyou Guo , Kerong Dai , Tingting Tang
Published: October 2016

To clarify the effect of CTLA4–lg on immune rejection of bone grafts, we observed the effect of CTLA4–Ig on lymphocyte proliferation of BALB/C mice stimulated by lymphocytes and bone supernatant of C57BL/6 mice. The splenic lymphocytes and bone supernatant of C57BL/6 mice, as the stimulator cells and stimulator antigens, were cultured in vitro with the splenic lymphocyte of BALB/C mice. At the same time, CTLA4–Ig at a dose of 5,10 or 20 μg/ml and L6 (as control) at 20 μg/ml were added. Six days later, the incorporation of 3H-TdR was determined. Results indicated that CTLA4–Ig at a dose of 5, 10 or 20 μg/ml significantly inhibited the cell proliferation stimulated by lymphocytes and bone supernatant of C57BL/6 mice. The effect was non-cytotoxic. L6 showed no significant inhibition of cell proliferation. CTLA4–Ig can efficiently block the proliferation of alloresponsive T cell stimulated by lymphocytes and bone supernatant of C57BL/6 mice. This study provides a basis for further study of CTLA4-induced immune tolerance of bone grafts.
Clinical Study of Surgical Treatment of Carpal Tunnel Syndrome: Open versus Endoscopic Technique
Authors: Okada Masato , Tsubata Osamu , Yasumoto Sadayuki , Toda Norihiko , Matsumoto Tadami
Published: October 2016

Twenty-six patients (30 hands) who underwent endoscopic carpal tunnel release were physically examined and asked to complete questionnaires on their symptoms, functional limitations and satisfaction. Their mean grip strength improved considerably from 17.5 kg before the operation to 31.3 kg at the final follow-up. Symptoms at the final follow-up were hypesthesia in 9 hands, muscle atrophy in 10, positive Tinel sign in 3, and positive Phalen sign in 1. The mean symptom severity score improved from 3.01 before the operation to 1.44 at the final follow-up and the mean functional status score improved from 3.20 to 1.54. The average times to return to activities of daily living and work were 7.3 days and 18.4 days respectively. Twenty-two of the 26 patients (85%) were satisfied. There was no injury to neurovascular structures. Arterial injuries were prevented by marking the superficial palmar arch and ulnar artery with a Doppler ultrasonic hemodrometer before surgery.
Clinical Results of the New Cervico-Thoracic Orthosis ‘Neck-Chest Brace’
Authors: Hijioka Akihiko , Narusawa Kennichiro , Nakamura Toshitaka
Published: October 2016

The efficacy of a new cervico-thoracic Neck-Chest brace (N-C brace) prepared for post-operative patients of cervical canal expansive laminoplasty was assessed. The orthosis is light in weight (300 g) and easy to fit. The effect of the orthosis to restrict the neck motion was studied in 10 normal young males by using lateral view radiographs in extension and flexion positions. The average range of the neck motion for the N-C brace was 24.4% of the values obtained without the orthosis. The restriction of the motion was significantly better than that without orthosis. Then, the clinical efficacy of the N-C brace was assessed in 40 patients of cervical spondylotic myelopathy who underwent expansive laminoplasty. Alignment changes of the postoperative cervical spine was found only in 10% of the patients who had a straight and kyphotic curvature pattern in the cervical spine before operation. The cervical alignments in the other 90% of patients were not changed post-operatively. These data clearly demonstrated that the N-C brace effectively controls the neck motion and is recommended for patients who have a lordotic curvature pattern in the cervical spine to prevent the post-surgical changes in the alignment after expansive laminoplasty.
Natural History of Lumbar Disc Hernia with Radicular Leg Pain: Spontaneous MRI Changes of the Herniated Mass and Correlation with Clinical Outcome
Authors: Takada Eiichi , Takahashi Masaya , Shimada Kimio
Published: October 2016

A prospective sequential MRI study was done to investigate the morphologic changes of the lumbar disc hernia (LDH). We also studied the relationship between the MRI changes and the type of LDH and the clinical outcome.

MRI was performed every 3 months from the onset for a maximum of 24 months in 42 patients with radicular leg pain and symptoms definitely diagnosed as caused by LDH. The size of the herniated mass was determined by the ratio of the anteroposterior diameter of the spinal canal to the maximum diameter of the LDH mass on T2-weighted axial images.

The clinical outcome was evaluated as excellent, good, or poor depending on leg pain and physical findings. The JOA (Japanese Orthopaedic Association) score for LDH was also used to assess the outcome. Thirty-seven (88%) of the 42 patients showed >50% reduction of the hernia on MRI 3–12 months after onset, and the morphologic changes of the herniated mass were well correlated with the clinical outcome.
The Use of Arm Span as a Predictor of Height: A Study of South Indian Women
Authors: Mohanty SP , Babu S Suresh , Nair N Sreekumaran
Published: October 2016

This study was undertaken to find out the relationship between various body parameters to identify the measurement that correlates most closely to stature. Sitting height, standing height, arm span and leg lengths of 505 healthy women between the ages of 20 and 29 were measured. The relationship between the parameters was determined by computing correlation coefficients and 95% confidence intervals. The correlation between sitting height, arm span and leg length were poor (r=0.56 and 0.29 respectively), while the correlation of arm span and leg length with standing height were good (r=0.82 and 0.84 respectively). These estimations can be of use in quantifying the age related loss in stature and in identifying individuals with disproportionate growth abnormalities and skeletal dysplasias. It can also be useful to find out the alterations in the height of an individual that may occur due to progressive deformities of the spine. The adequacy of the correction of spinal deformities may also be facilitated by computing the ratio of arm span to standing height.
Unusual Presentation of Shoulder Joint Tuberculosis: A Case Report
Authors: Mangwani Jitendra , Gupta Anil Kumar , Yadav CS , Rao KS
Published: October 2016

Tuberculosis of the shoulder joint is uncommon. In adults the classical dry type of shoulder tuberculosis ( caries sicca) has been described, while the fulminating variety has not been reported. We treated a case of fulminating variety of tuberculosis of the shoulder joint with anti-tubercular therapy and a shoulder immobilizer sling. At 18 months of follow up, the patient was disease free and had a good functional range of motion.
Trapezius Interposition of a Distal Third Clavicular Fracture in a Child: A Case Report
Authors: Itokazu M , Yoshida M , Itoh Y , Hukuta M , Kikuike K
Published: October 2016

We report an 11-year-old child with fracture of the distal clavicle who was denied conservative treatment because the medial end of the clavicle was anchored into the trapezius muscle fiber by an extreme posterior displacement. Surgical reduction was indicated.
Review Article: Polyethylene Wear and Osteolysis in Total Hip Arthroplasty
Authors: Zhu YH , Chiu KY , Tang WM
Published: October 2016

Polyethylene wear has been accepted as a major cause of osteolysis in total hip arthroplasty. Submicron particles, which are secondary to abrasive wear, migrate into the effective joint space and stimulate a foreign-body response resulting in bone loss which is mainly mediated by macrophages. Diagnosis depends on serial radiographic evaluation and frequent follow-up. Polyethylene wear and osteolysis can be prevented by reducing the wear such as using a small femoral head, adaptive polyethylene thickness, suitable surgical techniques, non-polyethylene articulation, etc. The presence of cement or circumferential coatings may also retard the distal migration of particles. Medicines such as NSAIDs and bisphosphonate appear to inhibit the progress of osteolysis. As far as treatment, revision surgery is able to reconstruct the joint by replacing partial or total prosthesis and repair the defect by bone grafting according to intraoperative assessment.
Role of Femoral Ring Allograft in Anterior Interbody Fusion of the Spine
Authors: Chotivichit Areesak , Fujita Takuya , Wong Tze-Hong , Kostuik John P , Sieber Ann N
Published: October 2016

A review was carried out on 59 patients (10 males and 49 females) who had anterior interbody fusion performed with femoral ring allograft packed with autograft bone chips with a minimum follow up of 2 years. The average age at the time of surgery was 49.1 year old (26 to 75). The total number of levels grafted was 141. The diagnosis consisted of multiple degenerative disease in 6, degenerative change below the long segment of fusion for scoliosis in 9, osteoporosis with collapsed fracture in 3, pseudarthrosis after posterior laminectomy and fusion in 35, congenital scoliosis in 3, scoliosis in 2 and paralytic scoliosis due to multiple sclerosis in one. The distribution of levels fused was T12-L1 in 6, L1–2 in 12, L2–3 in 17, L3–4 in 22, L4–5 in 35 and L5-S1 in 39. The remaining 10 levels were in the lower thoracic areas (T7-T12). The operations were performed as anterior fusion alone in 13 patients, one-stage anterior and posterior fusion in 26 patients and two-stage surgery in 20 patients. Anterior instrumentation was used in all 141 levels. At average follow-up (33.7 months) there was no significant change in allograft angles (average = 1.6o). Fusion of the allograft was classified by Bridwell's grading system. At 24 months of the follow up, 97 % of the allografts were in grade I (fully incorporated) and 3% were in grade II (partially incorporated). Compared to 12 months follow-up only 76.2% of the grafts were in grade I, 28 % were in grade II and 0.8% were in grade III. Two patients had deep posterior infections which required further surgery (without resorption of the allograft anteriorly). One patient had a screw migration anteriorly which required removal. Three patients had persistence of radiolucent line at one of the vertebral end plates – graft interfaces but no subsidence of the graft or pain. In conclusion, the femoral ring allograft appeared to benefit the anterior interbody fusion in complex spinal surgery.
Enhanced Apoptosis of Soft Tissue Sarcoma Cells with Chemotherapy: A Potential New Approach Using Trail
Authors: Clayer M , Bouralexis S , Evdokiou A , Hay S , Atkins GJ , Findlay DM
Published: October 2016

Soft tissue sarcomas are less responsive to conventional chemotherapy when compared to bone sarcomas. We investigated the possibility of enhancing the efficacy of chemotherapy by utilising the recently identified cytokine, tumour necrosis factor-related apoptosis-inducing ligand (TRAIL/Apo2L) in combination with standard chemotherapeutic agents. Fresh human soft tissue sarcomas (rhabdomyosarcoma, fibrosarcoma, malignant fibrous histiocytoma) were obtained at biopsy and dispersed tumour cells were incubated in cell culture with standard cytotoxic agents, either as single agents or in combination with TRAIL. The chemotherapeutic agents were, at best, moderately effective, in terms of induction of cellular apoptosis, although the fibrosarcoma was completely unresponsive to all single agents. TRAIL alone had no effect on any sarcoma cell culture. In contrast, the addition of TRAIL and drug together produced a significant increase in sarcoma cell apoptosis, with TRAIL and doxorubicin the most effective combination.
Polyethylene Particles from a Hip Simulator Cause 45Ca Release from Cultured Bone
Authors: Wang Kate Y , Horne J Geoffrey , Devane Peter A , Miller John H
Published: October 2016

Periprosthetic osteolysis is a dominant factor in the success or failure of total hip prostheses. Polyethylene wear debris has been implicated in the process of bone resorption and subsequent implant loosening. The present study is the first to examine the effect of ultra high molecular weight polyethylene (UHMWPE) wear debris produced by a hip simulator on calvarial bone resorption in vitro. 45Ca release was measured in cultured mouse calvarial bone samples. Although short-term exposure to UHMWPE particles (2 h) decreased 45Ca release, longer-term exposure for 1–2 days increased release in a dose-dependent manner. After one-day exposure to 7.5 × 106 particles per mL, 18% more 45Ca was released from cultured calvarial bone than from control samples. It was concluded that UHMWPE wear particles either directly or indirectly stimulated osteoclasts to activate bone resorption. Polyethylene wear debris contributes to the osteolytic process at the bone-implant interface.
Knee Stability after Repair of Isolated Midsubstance Tears of the Posterior Cruciate Ligament
Authors: Shirakura K , Terauchi M , Higuchi H , Takagishi K , Kobayashi Y , Kimura M
Published: October 2016

This study was made to compare the results after operative versus non-operative management for tears in the substance of posterior cruciate ligament. The subjects were 40 patients, half of whom were managed operatively and the other half non-operatively. End-to-end suture was performed on the operated group. The procedure was followed by cast immobilization for 4 weeks. Non-operative management consisted of immobilization in a cast for 4 weeks after arthroscopy. The average follow-up periods were 6 years 7 months and 4 years 3 months. The operated knees were significantly more stable than those of the non-operated group on stress radiographs (p<0.0001), but not to the extent of an age-matched control group (p<0.0001). The knee rating scores did not indicate any improvement of the functional outcome in the operated group. Surgery resulted in better posterior laxity than non-operative management; the achieved stability, however, was clearly less than in controls.
Septic Arthritis of the Hip Joint in Cervical Cancer Patients after Radiotherapy: Three Case Reports
Authors: Yang Shu-Hua , Yang Rong-Sen , Tsai Chin-Lin
Published: October 2016

Cervical cancer patients may experience hip problems related to the cancer itself or therapeutic management for the cancer. Septic arthritis should be one of the possibilities but there have been no reports on this. Here we present three patients who developed hip problems more than two years after radiotherapy with or without a radical operation. One patient was managed as septic arthritis because of significant inflammatory signs around the affected hip joint even though the causative organism was not confirmed. Succeeding total hip arthroplasty functioned well and had no recurrence of infection. The hip problems of the other two patients were diagnosed as radiation osteonecrosis of the femoral head initially. However, Bacteroides fragilis infection was found several months after total hip arthroplasties. Radiotherapy to the pelvis may damage the hip joint and compromise host-defense mechanisms of the pelvic region. Both factors may increase the possibility of infection of hip joints. Further clinical evidence is needed to understand whether subacute or chronic anaerobic infection could also be one of the causes leading to progressive destruction of the femoral head.
Fractures of the Distal End of Radius in Elderly Patients: A Comparative Study of Anatomical and Functional Results
Authors: Fujii Koji , Henmi Tatsuhiko , Kanematsu Yoshiji , Mishiro Takuya , Sakai Toshinori , Terai Tomoya
Published: October 2016

The functional and anatomical results of distal end of radius fractures with severe displacement in 22 elderly patients are reviewed in this retrospective study. The mean age of the patients was 69.4 years (range, 60–88 years) and the mean follow-up period was 24 months (range, 12–53 months). According to the sum of demerit points (Saito, 1983), the latest follow-up functional end results were ‘excellent’ in 64% of fractures and ‘good’ in 36%. As for the anatomical results at follow-up, the average radial tilt was 20.7°, ulnar variance was 4.0 mm, and palmar tilt was −2.7° respectively. Though most of the patients had satisfactory outcome and the functional results did not correlate with the radiographic evidence of minor deformities, the functional results of the patients with radial shortening of 6 mm or over were poor. Furthermore, the grip power was the most significant factor related to subjective evaluation and did not improve significantly in patients with the nondominant hand injured.
Clinical Evaluation of Aged Patients Who Underwent Surgery for Femoral Neck Fractures — Comparative Study of Clinical Results According to Age
Authors: Terai Tomoya , Henmi Tatsuhiko , Kanematsu Yoshiji , Fujii Koji , Mishiro Takuya , Sakai Toshinori
Published: October 2016

The objective was to assess mortality and ambulatory ability for elderly patients over 90 years of age with femoral neck fractures treated surgically. From January 1998 to March 1999, 60 patients aged over 80 years were chosen for the study. The patients had a mean age of 87.1 years. The mean follow-up period was 12.9 months. The patients were classified into three groups according to age: group A (80–84 years old), group B (85–89 years old) and group C (over 90 years old). The rates of recovered postoperative walking ability were 72.2% (13/18) of group A, 65.2% (15/23) of group B and 84.2% (16/19) of group C. These patients were followed up until death or for at least one year. The overall mortality rates were 11.1% (2/18) of group A, 17.4% (4/23) of group B and 10.5% (2/19) of group C.
Profile of Congenital Transverse Deficiencies among Cases of Congenital Orthopaedic Anomalies
Authors: Jain Sanjay , Lakhtakia P. K.
Published: October 2016

The authors showed the data of congenital amputation in 36 cases among the physically handicapped individuals (who attended a district level hospital for the purpose of obtaining a handicap certificate) during the period from 1 January 1999 to 31 December 2000.

Out of 3,550 individuals, we found 612 with congenital orthopaedic anomalies, which accounted for 17.2%. Of these 612 individuals, we noted 36 cases with congenital amputation (amputation through digits and toes were not included). Both unilateral and bilateral congenital amputations were much more common in the upper extremity as compared to lower extremity. Not a single case of simultaneous upper and lower extremity involvement was seen. The most common transverse deficiency in the upper limb was through the forearm, and in the lower limb it was through the foot. Congenital amputation was common in males with a gender ratio of 3.5:1. Left limb involvement was twice as much as right limb involvement, and it was common in both sexes. Bilateral limb involvement was seen only in males.
Skeletal Angiomatosis in Association with Gastro-Intestinal Angiodysplasia and Paraproteinemia: A Case Report
Authors: Clayer Mark
Published: October 2016

Skeletal-extraskeletal angiomatosis is defined as a benign vascular proliferation involving the medullary cavity of bone and at least one other type of tissue. It has also been known as cystic angiomatosis in which multiple cystic lesions are scattered diffusely throughout the skeleton often with similar angiomatous changes in other tissues, usually the spleen.

A case of skeletal angiomatosis in association with gastro-intestinal angiodysplasia and paraproteinemia is reported.
Traumatic Cervical Cord Injury at C3–4 without Radiographic Abnormalities: Correlation of Magnetic Resonance Findings with Clinical Features and Outcome
Authors: Takahashi M , Harada Y , Inoue H , Shimada K
Published: October 2016

Purpose.

Clinical features and outcomes of 43 patients at the Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama, were studied prospectively. These patients were not found to have radiographic abnormalities but magnetic resonance images showed acute cervical spinal cord trauma at the C3–4 disc level.

Methods.

Magnetic resonance images were analysed at presentation (immediately after the injury) and subsequent follow-up visits (at subacute and chronic stages, respectively) in an attempt to correlate imaging findings to clinical features and outcomes, respectively.

Results.

The injury mechanism was usually a yper-extension of the cervical spine. The level of neurological involvement was assessed in 9 patients with complete tetraplegia: the motor level was C5 in 6 patients and C4 in 3, whereas the sensory level was C5 in 7 patients, C4 in one, and C3 in one. Respiratory dysfunction in patients with severe paralysis, or numb and clumsy hands in patients with incomplete paralysis were the characteristic clinical features of cervical spinal cord injury at these lesions. Three patterns of signal change on magnetic resonance images were observed in patients with spinal cord injury at C3–4. A low-intensity area on T2-weighted images in the acute stage indicated a poor prognosis, while a high-intensity area at 2 to 3 weeks after injury indicated some degree of permanent paralysis.

Conclusion.

The serial signal changes of magnetic resonance images and the clinical severity or outcome seemed to be well correlated.
Postoperative Outcome of Lumbar Spinal Canal Stenosis after Fenestration: Correlation with Changes in Intradural and Extradural Tube on Magnetic Resonance Imaging
Authors: Yamazaki K , Yosida S , Ito T , Toba T , Kato S , Shimamura T
Published: October 2016

Purpose.

To evaluate the serial changes in clinical results and the intradural and extradural spaces on magnetic resonance imaging (MRI) after bilateral fenestration in 48 patients with lumbar spinal canal stenosis (LSCS).

Methods.

A prospective interventional study was performed to study the clinical results, magnetic resonance imaging scans among patients who were followed up for more than 3 years.

Results.

All patients showed improvement in clinical symptoms after operation, but clinical results deteriorated in 9 (19%) patients. Postoperative MRI scans showed that poor dural tube expansion, grouping of the cauda equina, and decrease in the cross-sectional area of the dural tube were factors associated with poor outcomes. The cross-sectional area of the dural tube and images of the cauda equina observed by MRI, before and after fenestration and during follow-up, reflected changes in clinical symptoms involving decompressed segments.

Conclusion.

Serial changes in the cross-sectional area of the dural tube and images of the cauda equina observed preoperatively, postoperatively, and on follow-up by MRI may be useful when evaluating patients' condition before and after operation. It is also useful for predicting outcomes.
Early Experience of Endoscopy-Assisted Anterior Spinal Surgery
Authors: Adulkasem W , Surangsrirat W
Published: October 2016

Purpose.

Endoscopy-assisted anterior spinal surgery is less invasive, resulting in less tissue trauma. It has a shorter recovery period, leads to less morbidity, and is more cost-efficient than conventional surgery. We report our early experience of endoscopic anterior spinal surgery in Thailand, which was performed with a basic laparoscopic instrument set and self-developed instruments for spinal surgery.

Methods.

All patients who underwent endoscopic anterior spinal surgery from July 2000 to May 2001 at the Orthopaedic Department, Nakhonpathom Hospital, Nakhonpathom were prospectively documented. The two-portal technique was applied on these patients: the first portal, a 4-cm skin incision, was made as the portal for the surgical instruments; the second portal, a one-cm skin incision, was made as the portal for the endoscope.

Results.

Nine patients underwent anterior spinal surgery with the minimally invasive technique. The mean patient age was 51.5 years (range, 17–72 years); 3 patients were females and 6 were males. The procedures included thoracoscopy, retroperitoneoscopy, diaphragmatic crus detachment, discectomy, corpectomy, fusion, and instrumentation. The mean operating time was one hour 58 minutes, and the mean estimated blood loss was 372ml; there were no serious complications.

Conclusion.

Endoscopy-assisted anterior spinal surgery can be performed without spending a high budget; the procedure is not difficult if the surgeon can develop some instruments and has experiences with arthroscopic surgery and anterior spinal surgery.
Brooks' Posterior Stabilisation Surgery for Atlantoaxial Instability: Review of 54 Cases
Authors: Moon MS , Choi WT , Moon YW , Moon JL , Kim SS
Published: October 2016

Purpose.

To assess the effectiveness of Brooks' posterior stabilisation and fusion for the unstable atlantoaxial joint due to congenital dysplastic dens and trauma.

Methods.

We retrospectively studied records of 54 patients (36 males and 18 females; age range, 3–58 years) who underwent Brooks' posterior stabilisation procedure between March 1975 and December 1999, at the Catholic University of Korea Medical Center and Dong-Shin General Hospital, Seoul. A single-stranded Kirschner wire was used to stabilise the first 19 cases (thin wires in 12 cases and thick wires in 7), and double-stranded wires were used in the next 35 cases (thin wires in 4 cases and thick wires in 31). After surgery, patients were immobilised in bed with light Halter traction of the head, followed by cervical bracing.

Results.

Fusion was observed by X-ray postoperatively at 15 weeks in 48 patients. Reduction was achieved in 3 luxation cases (including the single case of rotatory fixation). Brooks' fusion failed in 4 patients with dens fractures and 2 with dens anomaly. Four dens fractures in cases of successful Brooks' fusion in Brooks' fusion did not unite. Wire failure occurred in 4 cases of thin single-stranded wire fixation, namely, 2 cases of dens fractures and 2 of dens anomaly.

Conclusion.

Brooks' procedure is safe and has a high fusion rate when double-stranded strong wire fixation of the atlantoaxial joint is combined with meticulous bone grafting and subsequent cervical bracing.