bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrophilic Treatment of Carbon-coated Metal by Plasma Fluorination
Authors: Fukutsuka Tomokazu , Miyano Shin-ichi , Matsuo Yoshiaki , Sugie Yosohiro
Published: November 2007

Surface modification of a carbon-coated stainless steel (SUS304) was carried out by nitrogen trifluoride (NF3) plasma irradiation. NF3 plasma irradiation changed the surface wettability of the carbon-coated SUS304 from hydrophobic to hydrophilic.
Asymmetric 1,4-Addition of Arylboronic Acids to α,β-Unsaturated N-Acylamides Catalyzed by Dicationic Palladium(II)–(S,S)-Chiraphos Complex
Authors: Nishikata Takashi , Yamamoto Yasunori , Miyaura Norio
Published: November 2007

Palladium-catalyzed 1,4-addition of arylboronic acids to unsaturated carbonyl compounds has been limitedly used for ketone and aldehyde derivatives. It was found that reaction with N-acylamides exceptionally proceeds with high yields and high enantioselectivities. A dicationic palladium–chiraphos catalyst 3 gave optically active β-arylamides of up to 98% ee.
Immobilization and Hybridization Behavior of DNA on Poly(ethylene glycol)-block-Poly[2-(N,N-dimethylamino)ethyl methacrylate]-modified Gold Surfaces
Authors: Yoshimoto Keitaro , Matsumoto Shinya , Asakawa Ryosuke , Uchida Katsumi , Ishii Takehiko , Nagasaki Yukio
Published: November 2007

Single-stranded DNA (ssDNA) immobilization in a highly oriented manner with controlled ssDNA density on a gold surface was accomplished by surface modification with our original poly(ethylene glycol) (PEG)-block-oligoamine copolymer, followed by immobilization of thiol-ended ssDNA (ssDNA-SH) on the PEG tethered chain surface. As the length of the polyamine segment in the block copolymer increased, the immobilization amount of ssDNA-SH on the gold surface increased. The constructed surface improved the signal of the hybridization of ssDNA-SH with its target ssDNA, as found by surface plasmon resonance (SPR) measurements.
An Effective Process for Cutting Carbon Nanotubes via Fenton Reaction
Authors: Liao Qiu , Sun Jing , Gao Lian
Published: November 2007

An effective process via Fenton reaction combined with acid treatment was firstly used to cut carbon nanotubes (CNTs) into shorter ones.
Synthesis of 1,2,3-Triazole-containing Bile Acid Dimers and Properties of Inverse Micellar Mimic
Authors: Zhang Zhen , Ju Yong , Zhao Yufen
Published: November 2007

Six new 1,2,3-triazole-containing bile acid dimers, involving head-to-tail, head-to-head, and tail-to-tail three types of steroidal derivatives, have been synthesized via CuI-catalyzed 1,3-dipolar cycloaddition reaction “click chemistry” in high yields. The inverse micellar properties of these compounds were also investigated through hydrophilic dye solubilization studies in nonpolar media.
One-dimensional Structure Consisting of Pin-wheel Cu4Gd Core and Na+ as Connector
Authors: Yabe Kazuya , Maruno Yuji , Towatari Masaaki , Hamamatsu Takefumi , Matsumoto Naohide , Re Nazzareno , Pochaba Andrzej , Mrozinski Jerzy
Published: November 2007

A 3d–4f complex with the formula of {Na[(CuL)4Gd]}1∞ was prepared, where (CuL)− is a “ligand-complex,” [N-(4-methyl-6-oxo-3-azahept-4-enyl)oxamato]copper(II). The structure consists of a pin-wheel-like Cu4Gd core and Na+ ion as a connector to give a one-dimensional chain. The magnetic data and their analyses demonstrated an intramolecular ferromagnetic interaction within a Cu4Gd core and an intercore antiferromagnetic interaction operating through Na+ ion with the coupling parameters of J=+1.09 cm−1, zJ′=−0.07 cm−1; SCu=1⁄2, SGd=7⁄2).
Highly Efficient Method for the Synthesis of Carboxamides from Carboxylic Acids and Amines Using Benzenesulfonic Anhydride (BSA)
Authors: Funasaka Setsuo , Kato Koji , Mukaiyama Teruaki
Published: November 2007

A highly efficient method by using benzenesulfonic anhydride (BSA) in the presence of 4-(dimethylamino)pyridine (DMAP) to synthesize carboxamides from various carboxylic acids and amines including sterically hindered ones is established. This reaction proceeds smoothly to provide the desired product in high yield.
Fabrication of Fluorescent and Magnetic Multifunctional Polystyrene Microbeads with Carboxyl Ends
Authors: Zhang Pengfei , Dou Hongjing , Li Wanwan , Tao Ke , Xing Bin , Sun Kang
Published: November 2007

Here, we present a strategy to fabricate multifunctional polystyrene (PS) microbeads with carboxyl ends which exhibit magnetism and fluorescence. The strategy includes two steps: the preparation of porous PS microbeads with carboxyl-ends by combination of dispersion polymerization and seeded polymerization, and the facile process of embedding quantum dots (QDs) and magnetic nanoparticles (MNPs) into microbeads. The results indicate that the multifunctional PS microbeads (MFMs) can be dispersed in water stably and are well suitable for target encoding, capturing, and enrichment.
A New Route for Preparation of High-density Organic Phase to High Selective HPLC for Polycyclic Aromatic Hydrocarbons by Atom-transfer Radical Polymerization of Octadecyl Acrylate on Silica
Authors: Mallik Abul K , Rahman M Mizanur , Czaun Miklós , Takafuji Makoto , Ihara Hirotaka
Published: November 2007

We have previously reported that poly(octadecyl acrylate) as an organic stationary phase in HPLC shows high molecular-shape selectivity through carbonyl–π interaction on highly ordered structures of long alkyl chains. In this communication, a new “grafting-from” strategy based on surface-initiated atom-transfer radical polymerization is applied for ordering of poly(octadecyl acrylate) on silica to lead to remarkable selectivity increase.
Facile Preparation of Magnesium Ferrite Film via a Single-source Precursor Route
Authors: Yang Lan , Yin Lie , Zhang Yingchao , Lu Yanluo , Li Feng
Published: November 2007

A magnesium ferrite film has successfully been fabricated by sintering a single-source Mg–FeII–FeIII layered double hydroxide (LDH) precursor at 900 °C. It is shown that the obtained ferrite film exhibits a promising superparamagnetic behavior.
Porous Magnets Based on Copper–Octacyanotungsten Containing Noncoordinated Alcohol Molecules
Authors: Tsunobuchi Yoshihide , Hashimoto Kazuhito , Shiro Motoo , Hozumi Toshiya , Ohkoshi Shin-ichi
Published: November 2007

Two types of molecule-based magnets CuII3[WV(CN)8]2(pyrimidine)2·2-propanol·6H2O (1) and CuII3[WV(CN)8]2(pyrimidine)2·1-butanol·5H2O (2) are prepared. These compounds have a 3-dimensional porous structure, in which a noncoordinated 2-propanol or 1-butanol molecule is penetrated. These compounds show long-range magnetic ordering with Curie temperatures of 8.2 K (1) and 8.4 K (2) although large organic molecules are packed.
A New Water-soluble and Acid-stable Dinuclear Organoiridium Dinitrate Complex
Authors: Kure Bunsho , Fukuzumi Shunichi , Ogo Seiji
Published: November 2007

A new water-soluble and acid-stable dinuclear organoiridium(III) dinitrate complex [{Cp∗Ir(NO3)}2(μ-Cl)2] (1, Cp∗ = η5-C5Me5) was synthesized by the reaction of a water-insoluble organoiridium(III) complex [(Cp∗IrCl)2(μ-Cl)2] (2) with two equivalents of AgBF4 in aqueous nitric acid (1 M HNO3/H2O) at 23 °C for 12 h. The structure of 1 with two monodentate NO3− ligands is discussed in comparison with structure of a mononuclear organoiridium(III) complex with one monodentate and one bidentate NO3− ligands, [Cp∗Ir(NO3)2] (3).
Hydrocracking of Fischer–Tropsch Wax to Diesel-range Hydrocarbons over Bifunctional Catalysts Containing Pt and Polyoxocation-pillared Montmorillonite
Authors: Liu Yanyong , Hanaoka Toshiaki , Murata Kazuhisa , Okabe Kiyomi , Inaba Megumu , Takahara Isao , Sakanishi Kinya
Published: November 2007

Bifunctional catalysts containing Pt and polyoxocation-pillared montmorillonite showed high yields of diesel-range hydrocarbons (>70%) in the hydrocracking of Fischer–Tropsch wax due to their weak acid strength, high thermal stability, large surface area, and large pore size.
Decision-Tree-Based Knowledge Discovery: Single- vs. Multi-Decision-Tree Induction
Authors: Chang Namsik , Sheng Olivia R. Liu
Published: November 2007

One widely used knowledge-discovery technique is a decision-tree inducer that generates classifiers in the form of a single decision tree. As the number of prespecified decision-outcome classes increases, however, the trees so generated often become overly complex with regard to the number of leaves and nodes, and the classification accuracy consequently drops. In contrast, the multi-decision-tree induction (MDTI) approach, which constructs different decision trees for different decision-outcome classes, may reduce rule cardinality, and improve both rule conciseness and classification accuracy over a traditional single-decision tree inducer. This paper analytically and empirically compares the two techniques based on these measures. The analysis and results show that, in some situations, MDTI outperforms the traditional approach in terms of cardinality, conciseness, and classification accuracy of the acquired knowledge structures.
Novel Local-Search-Based Approaches to University Examination Timetabling
Authors: Caramia Massimiliano , Dell'Olmo Paolo , Italiano Giuseppe F.
Published: November 2007

Examination timetabling assigns examinations to a given number of time slots so that there are no conflicts. A conflict occurs if a student has to take more than one examination at the same time, or when the number of students that must take an exam exceeds the capacity of the classroom assigned. The objective is to minimize penalties from proximity constraints. We present new algorithms based on local search and report on an extensive experimental study. We consider also a variant where the concern is to produce conflict-free timetables minimizing the number of time slots, regardless of how close exams appear in the schedule. The algorithms proposed also manage the trade-off between the two objective functions and produce the best results on several standard benchmark instances, compared to the best existing algorithms.
Consumers' Price Sensitivities Across Complementary Categories
Authors: Duvvuri Sri Devi , Ansari Asim , Gupta Sunil
Published: November 2007

In this paper, we examine the pattern of correlation among consumer price sensitivities for customer purchase incidence decisions across complementary product categories. We use a hierarchical Bayesian multivariate probit model to uncover this pattern. We estimated this model using purchase incidence data for six categories involving three pairs of complementary products.

Our results show a new and interesting pattern of correlation among price parameters of complementary products. For example, we find that the correlation of own-price sensitivities of complementary products is negative. These results are consistent across the three complementary pairs of products. We also investigate the reason for this counterintuitive result.

Finally, we present some managerial implications of our model. We show how our model can be used for cross-category targeting decisions by retailers. We find that compared to nontargeted discounting, the average profitability gain from customized discounting across the three category pairs is only 1.29% when complementarity is ignored, but this gain improves to 8.26% when full complementarity is taken into account. We also investigate whether ignoring the complex pattern of correlation has implications for managerial actions regarding targeting and optimal discounting. We find that retailers can make misleading inferences about the impact of targeted discounts when they ignore cross-category effects in modeling.
Code Reuse in Open Source Software
Authors: Haefliger Stefan , von Krogh Georg , Spaeth Sebastian
Published: November 2007

Code reuse is a form of knowledge reuse in software development that is fundamental to innovation in many fields. However, to date there has been no systematic investigation of code reuse in open source software projects. This study uses quantitative and qualitative data gathered from a sample of six open source software projects to explore two sets of research questions derived from the literature on software reuse in firms and open source software development. We find that code reuse is extensive across the sample and that open source software developers, much like developers in firms, apply tools that lower their search costs for knowledge and code, assess the quality of software components, and have incentives to reuse code. Open source software developers reuse code because they want to integrate functionality quickly, because they want to write preferred code, because they operate under limited resources in terms of time and skills, and because they can mitigate development costs through code reuse.
Supply Function Equilibrium in a Constrained Transmission System
Authors: Wilson Robert
Published: November 2007

This paper characterizes a supply function equilibrium in an auction market constrained by limited capacities of links in a transportation network and limited input/output capacities of participants. The formulation is adapted to a wholesale spot market for electricity managed by the operator of the transmission system. The results are derived using the calculus of variations to obtain the Euler conditions and the transversality conditions that characterize a Nash equilibrium in an auction in which bids are as supply functions, and quantities and payments are based either on nodal prices or pay-as-bid.
Anatomical variations in vastus medialis obliquus and its implications in minimally-invasive total knee replacement
Authors: Roberts V. I. , Mereddy P. K. R. , Donnachie N. J. , Hakkalamani S.
Published: November 2007

The emergence of minimally-invasive total knee replacement (TKR) has led to the refinement of several surgical approaches, including the quadriceps-sparing and sub-vastus. There is some disagreement as to the precise definition of the term ‘minimally-invasive’, especially in regard to the preservation of vastus medialis obliquus (VMO). It is known that the termination of VMO is variable and may make these approaches difficult. We have attempted to assess the factors influencing the insertion of VMO and the impact which they have on the approach for TKR.

The MR scans of 198 knees were examined to assess the variation in the insertion of VMO in relation to the patella and the effect of variables such as age, gender and the presence of concurrent osteoarthritis of the knee on the insertion.

Our findings showed that both age and the presence of osteoarthritis were contributing factors to changes in the level of insertion of VMO. Therefore, not all capsular incisions which extend proximal to the midpole of the patella will violate the quadriceps tendon.
The variation in medial and lateral collateral ligament strain and tibiofemoral forces following changes in the flexion and extension gaps in total knee replacement
Authors: Jeffcote B. , Nicholls R. , Schirm A. , Kuster M. S.
Published: November 2007

Achieving deep flexion after total knee replacement remains a challenge. In this study we compared the soft-tissue tension and tibiofemoral force in a mobile-bearing posterior cruciate ligament-sacrificing total knee replacement, using equal flexion and extension gaps, and with the gaps increased by 2 mm each. The tests were conducted during passive movement in five cadaver knees, and measurements of strain were made simultaneously in the collateral ligaments. The tibiofemoral force was measured using a customised mini-force plate in the tibial tray. Measurements of collateral ligament strain were not very sensitive to changes in the gap ratio, but tibiofemoral force measurements were. Tibiofemoral force was decreased by a mean of 40% (sd 10.7) after 90° of knee flexion when the flexion gap was increased by 2 mm. Increasing the extension gap by 2 mm affected the force only in full extension. Because increasing the range of flexion after total knee replacement beyond 110° is a widely-held goal, small increases in the flexion gap warrant further investigation.
Copeland surface replacement of the shoulder
Authors: Mullett H. , Levy O. , Raj D. , Even T. , Abraham R. , Copeland S. A.
Published: November 2007

We describe the results of Copeland surface replacement shoulder arthroplasty using the mark III prosthesis in patients over 80 years of age. End-stage arthritis of the shoulder is a source of significant pain and debilitating functional loss in the elderly. An arthroplasty offers good relief of pain and may allow the patient to maintain independence. The risk-benefit ratio of shoulder replacement may be felt to be too high in an elderly age group, but there is no published evidence to support this theory. We have assessed whether the procedure was as reliable and safe as previously seen in a younger cohort of patients. Between 1993 and 2003, 213 Copeland surface replacement arthroplasty procedures were performed in our unit, of which 29 (13.6%) were undertaken in patients over the age of 80. This group of patients was followed up for a mean of 4.5 years (2.1 to 9.3). Their mean age was 84.3 years (81 to 93), the mean operating time was 40 minutes (30 to 45) and the mean in-patient stay was five days (2 to 21). There were no peri-operative deaths or significant complications. The mean Constant score adjusted for age and gender, improved from 15.1% to 77%. Copeland surface replacement shoulder arthroplasty may be performed with minimal morbidity and rapid rehabilitation in the elderly.
The instability severity index score
Authors: Balg F. , Boileau P.
Published: November 2007

There is no simple method available to identify patients who will develop recurrent instability after an arthroscopic Bankart procedure and who would be better served by an open operation.

We carried out a prospective case-control study of 131 consecutive unselected patients with recurrent anterior shoulder instability who underwent this procedure using suture anchors. At follow-up after a mean of 31.2 months (24 to 52) 19 (14.5%) had recurrent instability. The following risk factors were identified: patient age under 20 years at the time of surgery; involvement in competitive or contact sports or those involving forced overhead activity; shoulder hyperlaxity; a Hill-Sachs lesion present on an anteroposterior radiograph of the shoulder in external rotation and/or loss of the sclerotic inferior glenoid contour.

These factors were integrated in a 10-point pre-operative instability severity index score and tested retrospectively on the same population. Patients with a score over 6 points had an unacceptable recurrence risk of 70% (p < 0.001). On this basis we believe that an arthroscopic Bankart repair is contraindicated in these patients, to whom we now suggest a Bristow-Latarjet procedure instead.
Primary tumours of the synovium
Authors: Bhadra A. K. , Pollock R. , Tirabosco R. P. , Skinner J. A. M. , Cannon S. R. , Briggs T. W. R. , Flanagan A. M.
Published: November 2007

Four patients who developed malignant synovial tumours are described; one with chondromatosis developed a synovial chondrosarcoma and three with pigmented villonodular synovitis developed malignant change. The relevant literature is discussed.
Effect of re-implanted particles from intramedullary reaming on mechanical properties and callus formation
Authors: Hammer T. O. , Wieling R. , Green J. M. , Südkamp N. P. , Schneider E. , Müller C. A.
Published: November 2007

This study investigated the quality and quantity of healing of a bone defect following intramedullary reaming undertaken by two fundamentally different systems; conventional, using non-irrigated, multiple passes; or suction/irrigation, using one pass. The result of a measured re-implantation of the product of reaming was examined in one additional group. We used 24 Swiss mountain sheep with a mean tibial medullary canal diameter between 8 mm and 9 mm. An 8 mm ‘napkin ring’ defect was created at the mid-diaphysis. The wound was either surgically closed or occluded. The medullary cavity was then reamed to 11 mm. The Reamer/Irrigator/Aspirator (RIA) System was used for the reaming procedure in groups A (RIA and autofilling) and B (RIA, collected reamings filled up), whereas reaming in group C (Synream and autofilling) was performed with the Synream System. The defect was allowed to auto-fill with reamings in groups A and C, but in group B, the defect was surgically filled with collected reamings. The tibia was then stabilised with a solid locking Unreamed Humerus Nail (UHN), 9.5 mm in diameter. The animals were killed after six weeks. After the implants were removed, measurements were taken to assess the stiffness, strength and callus formation at the site of the defect.

There was no significant difference between healing after conventional reaming or suction/irrigation reaming. A significant improvement in the quality of the callus was demonstrated by surgically placing captured reamings into the defect using a graft harvesting system attached to the aspirator device. This was confirmed by biomechanical testing of stiffness and strength. This study suggests it could be beneficial to fill cortical defects with reaming particles in clinical practice, if feasible.
Callus distraction for the treatment of acquired radial club-hand deformity after osteomyelitis
Authors: Zhang X. , Duan L. , Li Z. , Chen X.
Published: November 2007

We report our experience of the use of callus distraction with a monolateral fixator for the treatment of acquired radial club-hand deformity after osteomyelitis. Between 1994 and 2004, 13 patients with a mean age of eight years (4 to 15) were treated by callus distraction with a monolateral fixator after a preliminary period of at least four weeks in a corrective short-arm cast.

All patients achieved bony union and were satisfied with the functional and cosmetic outcome. There were no major complications, but three patients required cancellous bone grafting at the docking site for delayed union. Local treatment and oral antibiotics were required for pin-site infection in six patients. There were no deep infection or recurrence of osteomyelitis.
Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing
Authors: Jones B. G. , Mehin R. , Young D.
Published: November 2007

Intramedullary tibial nailing was performed in ten paired cadavers and the insertion of a medial-to-lateral proximal oblique locking screw was simulated in each specimen. Anatomical dissection was undertaken to determine the relationship of the common peroneal nerve to the cross-screw.

The common peroneal nerve was contacted directly in four tibiae and the cross-screw was a mean of 2.6 mm (1.0 to 10.7) away from the nerve in the remaining 16. Iatrogenic injury to the common peroneal nerve by medial-to-lateral proximal oblique locking screws is therefore a significant risk during tibial nailing.
Reconstruction with callus distraction for nonunion with bone loss and leg shortening caused by suppurative osteomyelitis of the femur
Authors: Zhang X. , Liu T. , Li Z. , Peng W.
Published: November 2007

We present a retrospective study of 27 patients treated by callus distraction using a unilateral external fixator of our own design for nonunion with bone loss and shortening of the femur caused by suppurative osteomyelitis. The unilateral external fixator was used either alone or in combination with an intramedullary nail. The mean age of the patients was 13.6 years (8 to 18). The fixator was used alone in 13 patients and with an intramedullary nail in 14. The bone results at a mean follow-up of 88 months (37 to 144) were excellent in 16 patients and good in 11.

The functional results were excellent in 18 patients and good in nine. However, four patients still had draining sinuses at the latest follow-up. A residual deformity greater than 7° was present in seven femora, but this did not adversely affect function or require further treatment.
Injury to the axillary artery, a complication of fixation using a locking plate
Authors: Khunda A. , Stirrat A. N. , Dunlop P.
Published: November 2007

The proximal humerus internal locking system is an internal fixation device consisting of a low-profile plate and locking screws, which is used for the fixation of three- and four-part fractures of the proximal humerus. We describe a case in which the screws cut out of the humeral head causing injury to the axillary artery necessitating urgent removal of the implant.
The management of ununited fractures of the femoral neck using internal fixation and muscle pedicle periosteal grafting
Authors: Gupta A.
Published: November 2007

We describe a series of 20 patients with ununited fractures of the femoral neck following neglected trauma or failed primary internal fixation who were seen at a mean of 7.5 months (2 to 18) following injury. Open reduction and internal fixation of the fracture was performed in all patients, together with a myoperiosteal flap on the quadratus femoris muscle pedicle.

Union occurred at a mean of 4.9 months (2 to 10) in all patients. The mean follow-up was for 70 months (14 to 144). There was no further progression in six of seven patients with pre-operative radiological evidence of osteonecrosis of the femoral head. One patient had delayed collapse and flattening of the femoral head ten years after union of the fracture, but remained asymptomatic.

This study demonstrates the orthopaedic application of myoperiosteal grafting for inducing osteogenesis in a difficult clinical situation.
The results of primary Birmingham hip resurfacings at a mean of five years
Authors: Hing C. B. , Back D. L. , Bailey M. , Young D. A. , Dalziel R. E. , Shimmin A. J.
Published: November 2007

We report an independent prospective review of the first 230 Birmingham hip resurfacings in 212 patients at a mean follow-up of five years (4 to 6).

Two patients, one with a loose acetabular component and the other with suspected avascular necrosis of the femoral head, underwent revision. There were two deaths from unrelated causes and one patient was lost to follow-up. The survivorship with the worst-case scenario was 97.8% (95% confidence interval 95.8 to 99.5). The mean Harris hip score improved significantly (paired t-test, p < 0.05) from 62.54 (8 to 92) pre-operatively to 97.7 (61 to 100) at a mean of three years (2.1 to 4.3), then deteriorated slightly to a mean of 95.2 (47 to 100) at a mean of five years. The mean flexion improved from 91.5° (25° to 140°) to 110.4° (80° to 145°) at a mean of three years with no further improvement at five years (111.2°; 70° to 160°).

On radiological review at five years, one patient had a progressive lucent line around the acetabular component and six had progressive lucent lines around the femoral component. A total of 18 femoral components (8%) had migrated into varus and those with lucent lines present migrated a mean of 3.8° (1.02° to 6.54°) more than the rest. Superolateral notching of the femoral neck and reactive sclerosis at the tip of the peg of the femoral component were associated with the presence of lucent lines (chi-squared test, p < 0.05), but not with migration of the femoral component, and are of unknown significance.

Our results with the Birmingham hip resurfacing continue to be satisfactory at a mean follow-up of five years.
Non-invasive interactive neurostimulation in the post-operative recovery of patients with a trochanteric fracture of the femur
Authors: Gorodetskyi I. G. , Gorodnichenko A. I. , Tursin P. S. , Reshetnyak V. K. , Uskov O. N.
Published: November 2007

We undertook a trial on 60 patients with AO 31A2 fractures of the hip who were randomised after stabilisation of the fracture into two equal groups, one of which received post-operative treatment using a non-invasive interactive neurostimulation device and the other with a sham device. All other aspects of their rehabilitation were the same. The treatment was continued for ten days after operation.

Outcome measurements included the use of a visual analogue scale for pain, the brief pain inventory and Ketorolac for post-operative control of pain, and an overall assessment of outcome by the surgeon. There were significantly better results for the patients receiving treatment by active electrical stimulation (repeated measures analysis of variance, p < 0.001). The findings of this pilot trial justify a larger study to determine if these results are more generally applicable.
Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques
Authors: Koslowsky T. C. , Mader K. , Dargel J. , Koebke J. , Hellmich M. , Pennig D.
Published: November 2007

We have evaluated four different fixation techniques for the reconstruction of a standard Mason type-III fracture of the radial head in a sawbone model. The outcome measurements were the quality of the reduction, and stability.

A total of 96 fractures was created. Six surgeons were involved in the study and each reconstructed 16 fractures with 1.6 mm fine-threaded wires (Fragment Fixation System (FFS)), T-miniplates, 2 mm miniscrews and 2 mm Kirschner (K-) wires; four fractures being allocated to each method using a standard reconstruction procedure.

The quality of the reduction was measured after definitive fixation. Biomechanical testing was performed using a transverse plane shear load in two directions to the implants (parallel and perpendicular) with respect to ultimate failure load and displacement at 50 N.

A significantly better quality of reduction was achieved using the FFS wires (Tukey’s post hoc tests, p < 0.001) than with the other devices with a mean step in the articular surface and the radial neck of 1.04 mm (sd 0.96) for the FFS, 4.25 mm (sd 1.29) for the miniplates, 2.21 mm (sd 1.06) for the miniscrews and 2.54 mm (sd 0.98) for the K-wires. The quality of reduction was similar for K-wires and miniscrews, but poor for miniplates.

The ultimate failure load was similar for the FFS wires (parallel, 196.8 N (sd 46.8), perpendicular, 212.5 N (sd 25.6)), miniscrews (parallel, 211.8 N (sd 47.9), perpendicular, 208.0 N (sd 65.9)) and K-wires (parallel, 200.4 N (sd 54.5), perpendicular, 165.2 N (sd 37.9)), but significantly worse (Tukey’s post hoc tests, p < 0.001) for the miniplates (parallel, 101.6 N (sd 43.1), perpendicular, 122.7 N (sd 40.7)). There was a significant difference in the displacement at 50 N for the miniplate (parallel, 4.8 mm (sd 2.8), perpendicular, 4.8 mm (sd 1.7)) vs FFS (parallel, 2.1 mm (sd 0.8), perpendicular, 1.9 mm (sd 0.7)), miniscrews (parallel, 1.8 mm (sd 0.5), perpendicular, 2.3 mm (sd 0.8)) and K-wires (parallel, 2.2 mm (sd 1.8), perpendicular, 2.4 mm (sd 0.7; Tukey’s post hoc tests, p < 0.001)).

The fixation of a standard Mason type-III fracture in a sawbone model using the FFS system provides a better quality of reduction than that when using conventional techniques. There was a significantly better stability using FFS implants, miniscrews and K-wires than when using miniplates.
The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion
Authors: Aono H. , Ohwada T. , Kaneko N. , Fuji T. , Iwasaki M.
Published: November 2007

Inflammatory markers such as the C-reactive protein (CRP), white blood cell count and body temperature are easy to measure and are used as indicators of infection. The way in which they change in the early post-operative period after instrumented spinal surgery has not been reported in any depth.

We measured these markers pre-operatively and at one, four, seven and 14 days postoperatively in 143 patients who had undergone an instrumented posterior lumbar interbody fusion.

The CRP proved to be the only sensitive marker and had returned to its normal level in 48% of patients after 14 days. The CRP on day 7 was never higher than that on day 4. Age, gender, body temperature, operating time and blood loss were not related to the CRP level. A high CRP does not in itself suggest infection, but any increase after four days may presage infection.
A comparison of the penetration rate of two polyethylene acetabular liners of different levels of cross-linking
Authors: Triclot P. , Grosjean G. , El Masri F. , Courpied J. P. , Hamadouche M.
Published: November 2007

We carried out a prospective randomised study designed to compare the penetration rate of acetabular polyethylene inserts of identical design but different levels of cross-linking at a minimum of four years follow-up. A total of 102 patients (102 hips) were randomised to receive either highly cross-linked Durasul, or contemporary Sulene polyethylene inserts at total hip replacement. A single blinded observer used the Martell system to assess penetration of the femoral head. At a mean follow-up of 4.9 years (4.2 to 6.1) the mean femoral head penetration rate was 0.025 mm/year (sd 0.128) in the Durasul group compared with 0.106 mm/year (sd 0.109) in the Sulene group (Mann-Whitney test, p = 0.0027). The mean volumetric penetration rate was 29.24 mm3/year (sd 44.08) in the Durasul group compared with 53.32 mm3/year (sd 48.68) in the Sulene group. The yearly volumetric penetration rate was 55% lower in the Durasul group (Mann-Whitney test, p = 0.0058). Longer term results are needed to investigate whether less osteolysis will occur.
The biological and physiological effects of intramedullary reaming
Authors: Pape H.-C. , Giannoudis P.
Published: November 2007

This paper summarises the current knowledge on the effects of medullary reaming of long-bone fractures. Following a review of intramedullary vascular physiology, the consequences for vascularity, the autograft effects, the generation of heat, and fat embolism are outlined. Also, alternative reaming techniques are described.
Endoprosthetic replacement of the distal humerus following resection of bone tumours
Authors: Hanna S. A. , David L. A. , Aston W. J. S. , Gikas P. D. , Blunn G. W. , Cannon S. R. , Briggs T. W. R.
Published: November 2007

Between 1988 and 2006, 18 patients had a custom-made endoprosthetic replacement of the distal humerus for bone tumours at our institution. There were 11 primary malignant neoplasms, six secondary deposits, and one benign aggressive tumour. The mean follow-up was for 4.4 years (1 to 18.2). Complications occurred in nine patients and included aseptic loosening in three (16.6%), local recurrence in two (11%), infection in two (11%), neuropraxia of the radial nerve in one (5.5%) and a peri-prosthetic fracture in one (5.5%). Excision was inadequate in four patients (22%), all of which developed local recurrence and/or metastases. There were seven deaths from the primary disease after a mean of 2.3 years (1 to 5), one of whom had an above-elbow amputation for local recurrence seven months before death. The remaining six had satisfactory elbow function at their last follow-up. The 11 living patients were evaluated using the Musculoskeletal Tumour Society and Toronto Extremity Salvage scoring systems. The mean scores achieved were 76% (67% to 87%) and 73% (59% to 79%), respectively. Overall, 17 of 18 patients had significant improvement in the degree of their pain following operation.

Custom-made endoprosthetic reconstruction of the elbow for bone tumours is a viable treatment in carefully selected patients. It maintains satisfactory function and provides good pain relief.
Total knee replacement for osteoarthritis of the knee with congenital dislocation of the patella
Authors: Kumagi M. , Ikeda S. , Uchida K. , Ono T. , Tsumara H.
Published: November 2007

We carried out three total knee replacements with proximal realignment in two patients with severe osteoarthritis of the knee and congenital dislocation of the patella. During the operation, the femur and the tibia were cut according to the recommendations of the manufacturer of the implant. The femoral component was placed in external rotation and the centre of the tibial component aligned in relation to the tibial tuberosity with regard to rotation and translation. After making the bone cuts, the iliotibial tract was detached from Gerdy’s tubercle, the popliteus tendon divided, and the biceps femoris tendon elongated by Z-plasty. After the trial implants were positioned, a proximal re-alignment procedure was performed. One knee had deep infection. There was one dislocated patella which was repositioned, and walking ability was improved in all knees. We believe that the rotational alignment of a prosthesis is as important as the soft-tissue surgery.
Payment by results and coding practice in the National Health Service
Authors: Jameson S. , Reed M. R.
Published: November 2007

This paper considers the new financial infrastructure of the National Health Service and provides a resource for orthopaedic surgeons. We describe the importance of accurate documentation and data collection for National Health Service hospital Trust finances and league tables, and support our discussion with examples drawn from our local audit work.
Predictors of quality of life outcomes after revision total hip replacement
Authors: Biring G. S. , Masri B. A. , Greidanus N. V. , Duncan C. P. , Garbuz D. S.
Published: November 2007

A prospective cohort of 222 patients who underwent revision hip replacement between April 2001 and March 2004 was evaluated to determine predictors of function, pain and activity level between one and two years post-operatively, and to define quality of life outcomes using validated patient reported outcome tools. Predictive models were developed and proportional odds regression analyses were performed to identify factors that predict quality of life outcomes at one and two years post-operatively. The dependent outcome variables were the Western Ontario and McMaster Osteoarthritis Index (WOMAC) function and pain scores, and University of California Los Angeles activity scores. The independent variables included patient demographics, operative factors, and objective quality of life parameters, including pre-operative WOMAC, and the Short Form-12 mental component score.

There was a significant improvement (t-test, p < 0.001) in all patient quality of life scores. In the predictive model, factors predictive of improved function (original regression analyses, p < 0.05) included a higher pre-operative WOMAC function score (p < 0.001), age between 60 and 70 years (p < 0.037), male gender (p = 0.017), lower Charnley class (p < 0.001) and aseptic loosening being the indication for revision (p < 0.003). Using the WOMAC pain score as an outcome variable, factors predictive of improvement included the pre-operative WOMAC function score (p = 0.001), age between 60 and 70 years (p = 0.004), male gender (p = 0.005), lower Charnley class (p = 0.001) and no previous revision procedure (p = 0.023). The pre-operative WOMAC function score (p = 0.001), the indication for the operation (p = 0.007), and the operating surgeon (p = 0.008) were significant predictors of the activity assessment at follow-up.

Predictors of quality of life outcomes after revision hip replacement were established. Although some patient-specific and surgery-specific variables were important, age, gender, Charnley class and pre-operative WOMAC function score had the most robust associations with outcome.
Isolated tuberculosis of the patellar tendon
Authors: Franceschi F. , Longo U. G. , Ruzzini L. , Denaro V.
Published: November 2007

Among the variety of differential diagnoses for chronic patellar tendinopathy, isolated tuberculosis is extremely rare. We report such a case, without any evident primary contiguous or distant focus, in a 31-year-old immunocompetent male.
Repair in the central nervous system
Authors: FitzGerald J. , Fawcett J.
Published: November 2007

The subject of central nervous system damage includes a wide variety of problems, from the slow selective ‘picking off’ of characteristic sub-populations of neurons typical of neurodegenerative diseases, to the wholesale destruction of areas of brain and spinal cord seen in traumatic injury and stroke. Experimental repair strategies are diverse and the type of pathology dictates which approach will be appropriate. Damage may be to grey matter (loss of neurons), white matter (cutting of axons, leaving neurons otherwise intact, at least initially) or both. This review will consider four possible forms of treatment for repair of the human central nervous system.
A 15-year follow-up study of 4606 primary total knee replacements
Authors: Roberts V. I. , Esler C. N. A. , Harper W. M.
Published: November 2007

This is a 15-year follow-up observational study of 4390 patients with 4606 primary total knee replacements (TKRs) implanted in the Trent health region between 1990 and 1992. The operations were performed in 21 hospitals, including both district general and teaching hospitals, with 77 different surgeons as named consultant.

The main objective was to analyse the survival of the patients and of the prostheses, and to evaluate what impact different variables have on survival. In addition, the 1480 patients (33.7%) (1556 TKRs) alive at 15 years following operation were sent a self-administered questionnaire which examined their level of satisfaction, of pain, and their quality of life at 15 years. Completed responses were received from 912 TKRs (58.6%).

Three survival curves were constructed: a best-case scenario based on the patients entered into the life tables, another included failures not reported in the revision database, and a third worst-case scenario based on all patients lost to follow-up presumed to have had a failed primary TKR. In the best-case scenario survival at 15 years was 92.2%, and in the worst-case scenario was 81.1%. Survival was significantly increased in women and older patients (Mantel-Cox log-rank test, p < 0.005 and p < 0.001, respectively).

Revision as a result of infection was required in 40 TKRs (18.8%) representing 0.87% of the original cohort.

The limited information available from the questionnaire indicated that satisfaction was less frequent among men, patients with osteoarthritis and those who required revision (chi-squared test, p < 0.05, p < 0.05 and p < 0.0001, respectively). With regard to pain, older patients, females and patients who still had their primary replacement in place at 15 years, reported the least pain (chi-squared test for trends, p < 0.0005, p < 0.005 and p < 0.0001, respectively). The reported quality of life was not affected by any variable.
High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement
Authors: Han H. S. , Kang S.-B. , Yoon K. S.
Published: November 2007

We have examined the results obtained with 72 NexGen legacy posterior stabilised-flex fixed total knee replacements in 47 patients implanted by a single surgeon between March 2003 and September 2004.

Aseptic loosening of the femoral component was found in 27 (38%) of the replacements at a mean follow-up of 32 months (30 to 48) and 15 knees (21%) required revision at a mean of 23 months (11 to 45). We compared the radiologically-loose and revised knees with those which had remained well-fixed to identify the factors which had contributed to this high rate of aseptic loosening.

Post-operatively, the mean maximum flexion was 136° (110° to 140°) in the loosened group and 125° (95° to 140°) in the well-fixed group (independent t-test, p = 0.022). Squatting, kneeling, or sitting cross-legged could be achieved by 23 (85%) of the loosened knees, but only 22 (49%) of the well-fixed knees (chi-squared test, p = 0.001). The loosened femoral components were found to migrate into a more flexed position, but no migration was detected in the well-fixed group.

These implants allowed a high degree of flexion, but showed a marked rate of early loosening of the femoral component, which was associated with weight-bearing in maximum flexion.
Callus formation during healing of the repaired tendon-bone junction
Authors: Hibino N. , Hamada Y. , Sairyo K. , Yukata K. , Sano T. , Yasui N.
Published: November 2007

This study was undertaken to elucidate the mechanism of biological repair at the tendon-bone junction in a rat model. The stump of the toe flexor tendon was sutured to a drilled hole in the tibia (tendon suture group, n = 23) to investigate healing of the tendon-bone junction both radiologically and histologically. Radiological and histological findings were compared with those observed in a sham control group where the bone alone was drilled (n = 19). The biomechanical strength of the repaired junction was confirmed by pull-out testing six weeks after surgery in four rats in the tendon suture group. Callus formation was observed at the site of repair in the tendon suture group, whereas in the sham group callus formation was minimal. During the pull-out test, the repaired tendon-bone junction did not fail because the musculotendinous junction always disrupted first.

In order to understand the factors that influenced callus formation at the site of repair, four further groups were evaluated. The nature of the sutured tendon itself was investigated by analysing healing of a tendon stump after necrosis had been induced with liquid nitrogen in 16 cases. A proximal suture group (n = 16) and a partial tenotomy group (n = 16) were prepared to investigate the effects of biomechanical loading on the site of repair. Finally, a group where the periosteum had been excised at the site of repair (n = 16) was examined to study the role of the periosteum. These four groups showed less callus formation radiologically and histologically than did the tendon suture group.

In conclusion, the sutured tendon-bone junction healed and achieved mechanical strength at six weeks after suturing, showing good local callus formation. The viability of the tendon stump, mechanical loading and intact periosteum were all found to be important factors for better callus formation at a repaired tendon-bone junction.
Longitudinal Changes in BMD and Bone Geometry in a Population-Based Study
Authors: Lauretani Fulvio , Bandinelli Stefania , Griswold Michael E , Maggio Marcello , Semba Richard , Guralnik Jack M , Ferrucci Luigi
Published: November 2007

We prospectively examined vBMD and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up. Periosteal apposition occurred both in men and women. Endocortical resorption causes bone loss in older women despite periosteal apposition.

Introduction: To address the hypothesis that age-related changes in BMD and bone geometry may be different in men and women, we prospectively examined volumetric BMD (vBMD) and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up.

Materials and Methods: Three hundred forty-five men and 464 women 21–102 yr of age from the InCHIANTI study, a population-based study in Tuscany, Italy, were included. Tibial QCT bone parameters were measured at enrollment (1998–2000) and at 3- (2001–2003) and 6-yr (2004–2006) follow-ups.

Results: Periosteal apposition occurred both in men and women. The annual rate of bone periosteal apposition was higher in younger than in older men, whereas in women, the rate of apposition was homogenous across age groups. The age-related medullary expansion, expression of endocortical resorption, was significantly higher in women compared with men. In women, but not in men, accelerated endocortical resorption not sufficiently balanced by periosteal apposition caused accelerated loss in cortical bone mass. The cross-sectional moment of inertia decreased progressively over the life span in both sexes.

Conclusions: Endocortical resorption causes bone loss in older women despite periosteal apposition. Obtaining a balance between endocortical resorption and periosteal apposition should be the target for interventions aimed to decrease bone loss and prevent osteoporosis in older women.