bluuebunny/crossref_metadata_2025 huggingface dataset:
EPR Study on Stable Magnesium Complexes of the Phenoxyl Radicals Derived from a Vitamin E Model and Its Deuterated Derivatives
Authors: Nakanishi Ikuo , Matsumoto Shigenobu , Ohkubo Kei , Fukuhara Kiyoshi , Okuda Haruhiro , Inami Keiko , Mochizuki Masataka , Ozawa Toshihiko , Itoh Shinobu , Fukuzumi Shunichi , Ikota Nobuo
Published: September 2004

The phenoxyl radical 1•, generated by the reaction of a vitamin E model, 2,2,5,7,8-pentamethylchroman-6-ol (1H), with 2,2-bis(4-tert-octylphenyl)-1-picrylhydrazyl (DOPPH•), was significantly stabilized by complex formation with Mg2+ in deaerated acetonitrile at 298 K. The assignments of the hyperfine coupling constants (hfc) obtained by computer simulations of the observed EPR spectrum of the Mg2+ complex of 1• (Mg2+–1•), were carried out using three deuterated isotopomers of 1•, i.e., 5-CD3-1•, 7-CD3-1•, and 8-CD3-1•, where a methyl group at the C5, C7, or C8 position is replaced by a CD3 group, respectively. The decreased spin density of the benzene ring in the Mg2+–1• complex indicates that delocalization of the unpaired electron in 1• into Mg2+ by complexation between Mg2+ and 1• results in the enhanced stability of 1• in the presence of Mg2+.
Regional regenerative potential of meniscal cartilage exposed to recombinant insulin-like growth factor-I in vitro
Authors: Tumia N. S. , Johnstone A. J.
Published: September 2004

It is well recognised that meniscal tears situated within the inner, avascular region do not heal. We investigated the potential effect of insulin-like growth factor-I (IGF-I) in promoting regeneration of meniscal tissue in the inner, middle and outer zones of the meniscus. Sheep menisci were harvested and monolayer cell cultures prepared. Various concentrations of IGF-I were used in the presence or absence of 10% fetal calf serum (FCS). We measured the uptake of radioactive thymidine, sulphur, and proline to assess cell proliferation and formation of extracellular matrix (ECM). IGF-I, in the presence or absence of FCS, increased the formation of DNA and ECM in all meniscal zones. However, the response of the cells from the avascular zone was greater than that from the vascular zone. Our findings indicate that fibrochondrocytes cultured from avascular meniscal tissue have the ability to regenerate when exposed to anabolic cytokines such as IGF-I.
Allograft bone in two-stage revision of the hip for infection
Authors: Ammon P. , Stockley I.
Published: September 2004

A two-stage procedure was carried out on 57 patients with confirmed infection in a hip replacement. Allograft bone was used in the second stage. Pathogenic organisms were identified in all patients. In stage 1, the prosthesis was removed together with infected tissue. Antibiotics were added to customised cement beads. Systemic antibiotics were not used. At the second stage, 45 of the patients had either acetabular impaction grafting, femoral impaction grafting or a combination; 12 had a massive allograft.

Eight patients suffered recurrent infection (14%), in six with the original infecting organism. The risk factors for re-infection were multiple previous procedures and highly resistant organisms. We believe that systemic antibiotic therapy should be considered for these patients. Allograft bone is shown to be a useful adjunct in most infected hip replacements with considerable loss of bone stock.
Measurement of bowing of the radius
Authors: Firl M. , Wünsch L.
Published: September 2004

Fractures and plastic deformities of the forearm are common in children. While axial deformities are easily recognised and treated, bowing of the radius may be overlooked. Physiological bowing is essential for full rotation of the forearm. We have used the method of Schemitsch and Richards to estimate the degree of bowing in 100 children who had not suffered a fracture of the forearm.

The site of maximum bowing remained constant at 60.39% of the length of the radius (95% CI 59.65 to 61.14). The value of maximum bowing did not exceed 10% of the total length (mean value 7.21%; 95% CI 7.00 to 7.41). This study provides information that can be useful for the diagnosis of bowing and for the evaluation of post-traumatic deformities.
Expression of vascular endothelial growth factor during healing of the meniscus in a rabbit model
Authors: Becker R. , Pufe T. , Kulow S. , Giessmann N. , Neumann W. , Mentlein R. , Petersen W.
Published: September 2004

Our aim was to investigate vascular endothelial growth factor (VEGF) expression after lacerations of a meniscus in a rabbit model. Specimens of meniscus were examined using immunohistochemistry, enzyme-linked immunoassay and the reverse transcription polymerase chain reaction after one, two, five or ten weeks. In the periphery of the meniscus 90% of the lacerations had healed after five and ten weeks, but no healing was observed in the avascular area. Expression of VEGF protein and VEGF mRNA was found in the meniscus of both the operated and the contralateral sites but both were absent in control rabbits which had not undergone operation. The highest expression of VEGF was found in the avascular area after one week (p < 0.001). It then lessened at both the vascular and avascular areas, but still remained greater in comparison with the control meniscus (p < 0.05). Despite greater expression of VEGF, angiogenesis failed at the inner portion. These findings demonstrated the poor healing response in the avascular area which may not be caused by an intrinsic cellular insufficiency to stimulate angiogenesis.
Monitoring of the sciatic nerve during hamstring lengthening by evoked EMG
Authors: Katz K. , Attias J. , Weigl D. , Cizger A. , Bar-on E.
Published: September 2004

Traction injury to the sciatic nerve can occur during hamstring lengthening. The aim of this study was to monitor the influence of hamstring lengthening on conduction in the sciatic nerve using evoked electromyography (EMG).

Ten children with spastic cerebral palsy underwent bilateral distal hamstring lengthening. Before lengthening, the evoked potential was recorded with the patient prone. During lengthening, it was recorded with the knee flexed to 90°, 60° and 30°, and at the end of lengthening with the hip and knee extended.

In all patients, the amplitude of the evoked EMG gradually decreased with increasing lengthening. The mean decrease with the knee flexed to 60° was 34% (10 to 77), and to 30°, 86% (52 to 98) compared with the pre-lengthening amplitude. On hip extension at the end of the lengthening procedure, the EMG returned to the pre-lengthening level.

Monitoring of the evoked EMG potential of the sciatic nerve during and after hamstring lengthening, may be helpful in preventing traction injury.
Dislocations of the elbow in children
Authors: Rasool M. N.
Published: September 2004

A total of 33 children were treated for acute traumatic dislocation of the elbow between 1994 and 2002; 30 dislocations were posterior and three anterior. Eight children had a pure dislocation and 25 had an associated fracture of the elbow. Two had compound injuries. Two children had injury to the ulnar nerve, one to the radial nerve and one to the median nerve together with injury to the brachial artery. Twenty required open reduction. Complications included pseudarthrosis of the medial epicondyle in one child and loss of flexion and rotation of between 10° and 30° in ten others. Meticulous clinical and radiological assessment is mandatory in children with dislocation of the elbow to exclude associated injuries.

The results were excellent to good in 22 patients, fair in ten and poor in one.
Extrapleural anterolateral decompression in tuberculosis of the dorsal spine
Authors: Jain A. K. , Aggarwal A. , Dhammi I. K. , Aggarwal P. K. , Singh S.
Published: September 2004

We reviewed 64 anterolateral decompressions performed on 63 patients with tuberculosis of the dorsal spine (D1 to L1). The mean age of the patients was 35 years (9 to 73) with no gender preponderance. All patients had severe paraplegia (two cases grade III, 61 cases grade IV). The mean number of vertebral bodies affected was 2.6; the mean pre-treatment kyphosis was 24.8° (7 to 84). An average of 2.9 ribs were removed in the course of 64 procedures. The mean time taken at surgery was 2.45 hours when two ribs were removed and 3.15 hours when three ribs were removed. Twelve patients (19%) showed signs of neurological recovery within seven days, 33 patients (52%) within one month and 12 patients (19%) after two months; but six patients (10%) showed no neurological recovery. Forty patients were followed up for more than two years. In 34 (85%) of these patients there was no significant change in the kyphotic deformity; two patients (5%) showed an increase of more than 20°.
Augmentation of tendon-bone healing by the use of calcium-phosphate cement
Authors: Tien Y.-C. , Chih T.-T. , Lin J.-H. C. , Ju C.-P. , Lin S.-D.
Published: September 2004

The healing of a hamstring graft to bone is the weak link in the reconstruction of a cruciate ligament using this donor material. We therefore investigated the augmentation of healing at the tendon-bone interface using calcium-phosphate cement (CPC).

We performed semitendinosus autograft reconstructions of the anterior cruciate ligament on both knees of 22 New Zealand white rabbits. The interface between the grafted tendon and the bone tunnel for one knee was filled with CPC. Six rabbits were killed at the end of the first and second post-operative weeks in order to evaluate the biomechanical changes. Two rabbits were then killed sequentially at the end of weeks 1, 3, 6, 12 and 24 after operation and tissue removed for serial histological observation.

Histological examination showed that the use of CPC produced early, diffuse and massive bone ingrowth. By contrast, in the non-CPC group of rabbits only a thin layer of new bone was seen. Mechanical pull-out testing at one week showed that the mean maximal tensile strength was 6.505 ± 1.333 N for the CPC group and 2.048 ± 0.950 N for the non-CPC group. At two weeks the values were 11.491 ± 2.865 N and 5.452 ± 3.955 N, respectively.

Our findings indicate that CPC is a potentially promising material in clinical practice as regards its ability to reinforce the fixation of the tendon attachment to bone and to augment the overall effectiveness of tendon healing to bone.
L-shaped caliper for limb length measurement during total hip arthroplasty
Authors: Shiramizu K. , Naito M. , Shitama T. , Nakamura Y. , Shitama H.
Published: September 2004

The existing methods of assessing limb lengthening during total hip arthroplasty (THA) are prone to error because the measurements are not parallel to the limb lengthening axis. In order to address this, we designed a caliper to estimate limb lengthening during THA and evaluated its accuracy compared with our previous device, the straight caliper. Limb lengths were measured in 100 patients. The L-shaped caliper was used in 50 cases and the straight caliper in 50. The correlation between intra-operative and post-operative radiographic measurements was significantly improved using the L-shaped device (p < 0.0001, r = 0.934). This method was extremely accurate in predicting changes in limb length due to surgery.
Long-term disability after neck injury
Authors: Joslin C. C. , Khan S. N. , Bannister G. C.
Published: September 2004

Claims for personal injury after whiplash injury cost the economy of the United Kingdom more than £3 billion per year, yet only very few patients have radiologically demonstrable pathology. Those sustaining fractures of the cervical spine have been subjected to greater force and may reasonably be expected to have worse symptoms than those with whiplash injuries.

Using the neck disability index as the outcome measure, we compared pain and functional disability in four groups of patients who had suffered injury to the cervical spine. After a mean follow-up of 3.5 years, patients who had sustained fractures of the cervical spine had significantly lower levels of pain and disability than those who had received whiplash injuries and were pursuing compensation (p < 0.01), but had similar levels to those whiplash sufferers who had settled litigation or had never sought compensation.

Functional recovery after neck injury was unrelated to the physical insult. The increased morbidity in whiplash patients is likely to be psychological and is associated with litigation.
Pre-operative predictors of the requirement for blood transfusion following total hip replacement
Authors: Aderinto J. , Brenkel I. J.
Published: September 2004

We have reviewed prospective data on 1016 patients who underwent unilateral total hip replacement to establish the pre-operative risk factors associated with peri-operative blood transfusion. Most patients who required transfusion were older and were of lower weight, height, pre-operative haemoglobin level and body mass index than patients who were not transfused.

Multivariate analysis revealed that only the pre-operative haemoglobin level and the patients weight were identified as significant independent factors increasing the need for transfusion (p < 0.001). A haemoglobin level below 12 g/dl was associated with a threefold increase in transfusion requirement.
A spontaneous compartment syndrome in a patient with diabetes
Authors: Jose R. M. , Viswanathan N. , Aldlyami E. , Wilson Y. , Moiemen N. , Thomas R.
Published: September 2004

A compartment syndrome is an orthopaedic emergency which can result from a variety of causes, the most common being trauma. Rarely, it can develop spontaneously and several aetiologies for spontaneous compartment syndrome have been described. We describe a patient with diabetes who developed a spontaneous compartment syndrome. The diagnosis was delayed because of the atypical presentation.
Corrosion of cemented titanium femoral stems
Authors: Thomas S. R. , Shukla D. , Latham P. D.
Published: September 2004

Cemented titanium stems in hip arthroplasty are associated with proximal cement-stem debonding and early failure. This was well publicised with the 3M Capital hip. However, corrosion in this setting has been reported with only one stem design and is less widely accepted.

We present a series of 12 cemented titanium Furlong Straight Stems which required revision at a mean of 78 months for thigh pain. At revision the stems were severely corroded in a pattern which was typical of crevice corrosion. Symptoms were eliminated after revision to an all-stainless steel femoral prosthesis of the same design. We discuss the likely causes for the corrosion. The combination of a titanium stem and cement appears to facilitate crevice corrosion.
Severity of disease and risk of malignant change in hereditary multiple exostoses
Authors: Porter D. E. , Lonie L. , Fraser M. , Dobson-Stone C. , Porter J. R. , Monaco A. P. , Simpson A. H. R. W.
Published: September 2004

We performed a prospective genotype-phenotype study using molecular screening and clinical assessment to compare the severity of disease and the risk of sarcoma in 172 individuals (78 families) with hereditary multiple exostoses. We calculated the severity of disease including stature, number of exostoses, number of surgical procedures that were necessary, deformity and functional parameters and used molecular techniques to identify the genetic mutations in affected individuals. Each arm of the genotype-phenotype study was blind to the outcome of the other. Mutations EXT1 and EXT2 were almost equally common, and were identified in 83% of individuals. Non-parametric statistical tests were used.

There was a wide variation in the severity of disease. Children under ten years of age had fewer exostoses, consistent with the known age-related penetrance of this condition. The severity of the disease did not differ significantly with gender and was very variable within any given family. The sites of mutation affected the severity of disease with patients with EXT1 mutations having a significantly worse condition than those with EXT2 mutations in three of five parameters of severity (stature, deformity and functional parameters). A single sarcoma developed in an EXT2 mutation carrier, compared with seven in EXT1 mutation carriers. There was no evidence that sarcomas arose more commonly in families in whom the disease was more severe.

The sarcoma risk in EXT1 carriers is similar to the risk of breast cancer in an older population subjected to breast-screening, suggesting that a role for regular screening in patients with hereditary multiple exostoses is justifiable.
Vascularised bone graft from the base of the second metacarpal for refractory nonunion of the scaphoid
Authors: Sawaizumi T. , Nanno M. , Nanbu A. , Ito H.
Published: September 2004

A vascularised bone-graft procedure from the base of the second metacarpal was performed in 14 patients with nonunion of the scaphoid. There were 11 men and three women with a mean age of 22 years. In eight patients, who had dorsiflexed intercalated segment instability (DISI), an open wedge was formed at the site of nonunion, and the vascular pedicle was grafted from the volar side. In the six patients without DISI, transplantation was carried out through the same dorsal skin incision.

Complete bony union was obtained in all patients after a mean post-operative period of 10.2 weeks, and DISI was corrected in all affected patients. According to Cooney’s clinical scoring system, the results were excellent in five, good in six, and fair in three patients. Because of its technical simplicity and the limited dissection needed, the procedure should be considered for the primary surgical treatment of patients with nonunion of the scaphoid.
Anterior submuscular transposition of the ulnar nerve
Authors: Bartels R. H. M. A. , Grotenhuis J. A.
Published: September 2004

Outcome studies of revision surgical treatment for recurrent or persistent neuropathy of the ulnar nerve at the elbow are relatively rare and none involves patient self-assessment. In this study of 40 patients (41 elbows), a clear discrepancy is shown between clinical assessment and the patient’s own view. From clinical assessment, 20% of patients had an excellent result, whereas only one (2.5%) patient self-reported a complete cure. More reports using patient self-assessment and validated scores are required.
A correction of windswept deformity by fixator assisted nailing
Authors: Eralp L. , Kocaoglu M. , Çakmak M. , Özden V. Emre
Published: September 2004

We report two cases with windswept deformities of the lower extremities. All deformities were corrected by fixator-assisted intramedullary nailing. At the latest follow-up, the patients had normal alignment, without symptoms and no loss of correction.
Osteochondral autologous transplantation for the treatment of full-thickness articular cartilage defects of the shoulder
Authors: Scheibel M. , Bartl C. , Magosch P. , Lichtenberg S. , Habermeyer P.
Published: September 2004

We performed eight osteochondral autologous transplantations from the knee joint to the shoulder. All patients (six men, two women; mean age 43.1 years) were documented prospectively. In each patient the stage of the osteochondral lesion was Outerbridge grade IV with a mean size of the affected area of 150 mm2. All patients were assessed by using the Constant score for the shoulder and the Lysholm score for the knee. Standard radiographs, magnetic resonance imaging and second-look arthroscopy were used to assess the presence of glenohumeral osteoarthritis and the integrity of the grafts. After a mean of 32.6 months (8 to 47), the mean Constant score increased significantly. Magnetic resonance imaging revealed good osseointegration of the osteochondral plugs and congruent articular cartilage at the transplantation site in all but one patient. Second-look arthroscopy performed in two cases revealed a macroscopically good integration of the autograft with an intact articular surface.

Osteochondral autologous transplantation in the shoulder appears to offer good clinical results for treating full-thickness osteochondral lesions of the glenohumeral joint. However, our study suggests that the development of osteoarthritis and the progression of pre-existing osteoarthritic changes cannot be altered by this technique.
Patient preferences in knee prostheses
Authors: Pritchett J. W.
Published: September 2004

A total of 344 patients underwent bilateral total knee replacement (TKR) using a different prosthesis on each side. Four knee prostheses were used: anterior and posterior cruciate-retaining (ACL-PCL), posterior cruciate-retaining (PCL), medial or lateral pivot (MLP), and posterior cruciate-substituting (PS).

All patients had good or excellent results. The range of movement, relief from pain, alignment, and stability did not vary among any of the prostheses.

Forty-one of 46 patients (89%) preferred the ACL-PCL to the PS knee and 27 of 35 patients (77%) the MLP knee to the PS knee. Of the patients with an ACL-PCL knee on one side and a MLP on the other, an equal number preferred each type. The MLP knee was preferred to the PCL by 34 (79%) patients. PS and PCL knees were preferred equally. Patients with bilateral TKRs preferred retention of both their cruciate ligaments or substitution with a medial or lateral pivot prosthesis.
The association of lumbar spondylolisthesis with collagen IX tryptophan alleles
Authors: Matsui Y. , Mirza S. K. , Wu J.-J. , Carter B. , Bellabarba C. , Shaffrey C. I. , Chapman J. R. , Eyre D. R.
Published: September 2004

Two collagen type IX gene polymorphisms that introduce a tryptophan residue into the protein’s triple-helical domain have been linked to an increased risk of lumbar disc disease. To determine whether a particular subset of symptomatic lumbar disease is specifically associated with these polymorphisms, we performed a prospective case-control study of 107 patients who underwent surgery of the lumbar spine. Patients were assigned to one of five clinical categories (fracture, disc degeneration, disc herniation, spinal stenosis without spondylolisthesis and spinal stenosis with spondylolisthesis) based on history, imaging results, and findings during surgery. Of the 11 tryptophan-positive patients, eight had spinal stenosis with spondylolisthesis and three had disc herniation. The presence of the tryptophan allele was significantly associated with African-American or Asian designation for race (odds ratio 4.61, 95% CI 0.63 to 25.35) and with the diagnosis of spinal stenosis with spondylolisthesis (odds ratio 6.81, 95% CI 1.47 to 41.95).

Our findings indicate that tryptophan polymorphisms predispose carriers to the development of symptomatic spinal stenosis associated with spondylolisthesis which requires surgery.
Delayed internal fixation of fractures of the neck of the femur in young adults
Authors: Upadhyay A. , Jain P. , Mishra P. , Maini L. , Gautum V. K. , Dhaon B. K.
Published: September 2004

We have compared the results and complications after closed and open reduction with internal fixation in young adults with displaced intracapsular fractures (Garden grades III and IV) of the neck of the femur. We also studied the risk factors which influenced nonunion and the development of avascular necrosis (AVN). A total of 102 patients aged between 15 and 50 years was randomised to receive either closed or open reduction. Both groups were compared for age, gender, time to surgery and posterior comminution as well as for union and complications. Using univariate and multivariate analysis the factors influencing nonunion and AVN were assessed.

Of the 102 patients, 92 were available for review. There was no significant difference between the groups in terms of union (p = 0.93) and AVN at two years (p = 0.85). Posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion. The overall incidence of AVN was 16.3% (15 of 92 patients) and it was not influenced by these factors. A delay of more than 48 hours before surgery did not influence the rate of union or the development of AVN when compared with operation within 48 hours of injury.
Seventeen-year survivorship analysis of silastic metacarpophalangeal joint replacement
Authors: Trail I. A. , Martin J. A. , Nuttall D. , Stanley J. K.
Published: September 2004

We reviewed the records and radiographs of 381 patients with rheumatoid arthritis who had undergone silastic metacarpophalangeal joint replacement during the past 17 years. The number of implants was 1336 in the course of 404 operations. Implant failure was defined as either revision or fracture of the implant as seen on radiography. At 17 years, the survivorship was 63%, although on radiographs two-thirds of the implants were seen to be broken. Factors which improved survival included soft-tissue balancing, crossed intrinsic transfer and realignment of the wrist. Surgery to the thumb and proximal interphalangeal joint had a deleterious effect and the use of grommets did not protect the implant from fracture.
Chevron osteotomy in hallux valgus
Authors: Schneider W. , Aigner N. , Pinggera O. , Knahr K.
Published: September 2004

The Chevron osteotomy was described in 1976. There have, however, been only short- to mid-term follow-up reviews, often with small numbers of patients.

We looked at 112 feet (73 patients) with a minimum follow-up of ten years following Chevron osteotomy with a distal soft-tissue procedure. Clinical evaluation was calculated using the hallux score of the American Orthopedic Foot and Ankle Society (AOFAS). For 47 feet (30 patients), the results were compared with those from an interim follow-up of 5.6 years.

The AOFAS-score improved from a pre-operative mean of 46.5 points to a mean of 88.8 points after a mean of 12.7 years. The first metatarsophalangeal (MTP) angle showed a mean pre-operative value of 27.6° and was improved to 14.0°. The first intermetatarsal (IM) angle improved from a pre-operative mean value of 13.8° to 8.7°. The mean pre-operative grade of sesamoid subluxation was 1.7 on a scale from 0 to 3 and improved to 1.2. Measured on a scale from 0 to 3, arthritis of the first MTP joint progressed from a mean of 0.8 to 1.7. Comparing the results in patients younger and older than 50 years, the Chevron osteotomy performed equally in both age groups. Analysing the subgroup of 47 feet with a post-operative follow-up of both 5.6 and 12.7 years, the AOFAS pain and the overall score showed a further improvement between both follow-up evaluations. The MTP angle, first IM angle and sesamoid position remained unchanged. The progression of arthritis of the first MTP joint between 5.6 and 12.7 years post-operatively was statistically significant. Only one patient required a revision procedure due to painful recurrence of the deformity.

Excellent clinical results following Chevron osteotomy not only proved to be consistent, but showed further improvement over a longer follow-up period. The mean radiographic angles were constant without recurrence of the deformity. So far, the statistically significant progression of first MTP joint arthritis has not affected the clinical result, but this needs further observation.
Interspinous bursitis in an athlete
Authors: DePalma M. J. , Slipman C. W. , Siegelman E. , Bayruns T. J. , Bhargava A. , Frey M. E. , Chin K. R.
Published: September 2004

We present a case of L2/3 interspinous bursitis treated with extraspinal injections. No previous investigations have used fluoroscopically guided spinal injections to confirm the clinical relevance of the MRI features of this type of bursae. Autopsy studies have revealed an increased incidence of interspinous lumbar bursal cavities with advancing age. Afflicted patients present with localised, midline lower lumbar pain exacerbated by extension. In young athletes these symptoms can mimic spondylolysis. MRI is useful in detecting soft-tissue injury of the posterior elements.

Fluoroscopically guided diagnostic and therapeutic extraspinal injections can be used for confirmation and treatment of pain from such bursae.
Unicompartmental knee arthroplasty
Authors: Rajasekhar C. , Das S. , Smith A.
Published: September 2004

We report the outcome of 135 knees with anteromedial osteoarthritis in which the Oxford meniscal-bearing unicompartmental arthroplasty was inserted in a district general hospital by a single surgeon. All the knees had an intact anterior cruciate ligament, a correctable varus deformity and the lateral compartment was uninvolved or had only minor osteoarthritis. The mean follow-up was 5.82 years (2 to 12).

Using revision as the end-point, the outcome for every knee was established. Five knees have been revised giving a cumulative rate of survival of the prosthesis at ten years of 94.04% (95% confidence interval 84.0 to 97.8). Knee rating and patient function were assessed using the modified Knee Society scoring system. The mean knee score was 92.2 (51 to 100) and the mean functional score 76.2 (51 to 100).

The survival of the implant is comparable to that reported by the designers of the prosthesis and not significantly different from that for total knee replacement. Unicompartmental knee replacement offers a viable alternative in patients with medial osteoarthritis. Appropriate selection of patients and good surgical technique are the key factors.
Retrieval of a well-functioning extensor mechanism allograft from a total knee arthroplasty
Authors: Burnett R. S. J. , Fornasier V. L. , Haydon C. M. , Wehrli B. M. , Whitewood C. N. , Bourne R. B.
Published: September 2004

We present the histological findings of an extensor mechanism allograft which was used in a total knee arthroplasty two years after implantation. Analysis of the graft was undertaken at four distinct anatomical levels and it was found to be incorporated into host tissue at each level. A wedge of fibrinoid necrosis, probably related to impingement of the graft on the tibial polyethylene insert, was seen. Impingement may play a role in the injury and necrosis of an allograft and may be one mode of failure in an extensor mechanism allograft.
Multiple congenital brachymetatarsia
Authors: Kim J. S. , Baek G. H. , Chung M. S. , Yoon P. W.
Published: September 2004

We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results.

Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants.
Stable elastic intramedullary nailing for fractures of the femur in children
Authors: Metaizeau J.-P.
Published: September 2004

Fractures of the femur are the most incapacitating fractures in children. Conservative treatment necessitates a long stay in hospital for traction and subsequent immobilisation in an uncomfortable cast. This treatment is not well tolerated, especially in adolescents. Moreover, near the end of growth, accurate reduction is necessary, as malunion is no longer correctable by growth. Stable elastic intramedullary nailing uses two flexible nails which are introduced percutaneously either through the lower metaphysis or the subtrochanteric area. This technique does not disturb the healing of the fracture. The elasticity of the device allows slight movement at the fracture site which favours union. Reduction and stabilisation are adequate and the operative risk is very low. A cast is not required, functional recovery is rapid and the patient is allowed to walk with crutches after seven to ten days according to the type of fracture. This technique is very efficient in adolescents and can be used after the age of seven years when conservative treatment is unsuccessful.
New Products, Sales Promotions, and Firm Value: The Case of the Automobile Industry
Authors: Pauwels Koen , Silva-Risso Jorge , Srinivasan Shuba , Hanssens Dominique M.
Published: September 2004

Year after year, managers strive to improve financial performance and firm value through marketing actions such as new product introductions and promotional incentives. This study investigates the short- and long-term impact of such marketing actions on financial metrics, including top-line, bottom-line, and stock market performance. The authors apply multivariate time-series models to the automobile industry, in which both new product introductions and promotional incentives are considered important performance drivers. Notably, whereas both marketing actions increase top-line firm performance, their long-term effects strongly differ for the bottom line. First, new product introductions increase long-term financial performance and firm value, but promotions do not. Second, investor reaction to new product introduction grows over time, indicating that useful information unfolds in the first two months after product launch. Third, product entry in a new market yields the highest top-line, bottom-line, and stock market benefits. Managers may use these results to justify new product efforts and to weigh short- and long-term consequences of promotional incentives.
Comparison of cardiac troponin T and I in healthy men and in aortic valve replacement
Authors: Gurr Eberhard , Leitz Knut
Published: September 2004

Troponins are of outstanding importance for the diagnosis of myocardial infarction. Cardiac troponin T (cTnT) and the various cardiac troponin I (cTnI) assays differ with respect to method comparison, diagnostic sensitivity and diagnostic specificity. To understand the differences in the diagnostic behavior of troponin assays, AccuTnI and Elecsys Troponin STAT were used in a group of healthy men and in the follow-up of patients with aortic valve replacement (AVR). Within the healthy subjects AccuTnI was able to differentiate two subgroups from each other, whereas the cTnT concentrations of all subjects were below the detection limit. In AVR patients, cTnT and cTnI correlated sufficiently, if the postoperative periods were taken into consideration. There was a rapid increase in cTnI within 24 h. In contrast, a broad peak was evident for cTnT between 48 and 120 h. The results emphasize more the differences in the release of cTnI and cTnT from the cytoplasm and the thin filaments of the cardiomyocytes than the modifications of the troponins circulating in the blood.
ARH missense polymorphisms and plasma cholesterol levels
Authors: Hubacek Jaroslav A. , Hyatt Tommy
Published: September 2004

Mutations in a putative low-density lipoprotein (LDL) receptor adaptor protein called
Genetic and immunological analyses of patients with increased serum butyrylcholinesterase activity and its C5 variant form
Authors: Akizuki Setsuko , Ohnishi Akihiro , Kotani Kazuo , Sudo Kayoko
Published: September 2004

Recent evidence has denied genetic abnormality as a mechanism of the C5 variant of butyrylcholinesterase (BChE) and proposed the binding of an unknown protein with the C4 component. The present study aimed to evaluate whether the coding sequences and nontranslated sequences of the
Polymorphisms in the P-selectin (CD62P) and P-selectin glycoprotein ligand-1 (PSGL-1) genes and coronary heart disease
Authors: Bugert Peter , Vosberg Marion , Entelmann Mathias , Jahn Jürgen , Katus Hugo A. , Klüter Harald
Published: September 2004

P-selectin and its ligand, PSGL-1, are cell adhesion molecules that facilitate interaction of platelets, leukocytes and endothelial cells. Polymorphisms of these genes have been reported to be associated with coronary heart disease (CHD). In the present study, we characterized the entire coding regions of
Odd-numbered long-chain fatty acids in erythrocyte phospholipids as long-term follow-up parameter in propionic acidemia
Authors: Meissner Thomas , Leichsenring Michael , Mayatepek Ertan
Published: September 2004

Odd-numbered long-chain fatty acids (OLCFAs) increase in total erythrocyte lipids or plasma in patients with propionic acidemia and have been proposed as a useful parameter of metabolic control. However, up to now no parameter for long-term metabolic control has been available for this disorder. In contrast to previous investigations, we investigated OLCFAs with particular reference to differences for two phospholipid fractions of erythrocyte lipids. The phosphatidylethanolamine (PE) fraction of erythrocyte lipids has a slow turnover rate and might reflect the metabolic propionyl-CoA burden over a period of some weeks. Distinct increases in OLCFA of up to 200% in the phosphatidylcholine fraction were observed after episodes of metabolic decompensation and maximum OLCFA levels were found 3 weeks after the onset of a crisis. As a sign of poor metabolic control, OLCFA levels in PE steadily increased after recurrent episodes of decompensation, but not in clinically stable patients. However, in one patient with clinically good metabolic control, OLCFAs continually increased after the second year of life for an as yet unknown reason. In conclusion, data from this study indicate the usefulness of OLCFA analysis in the PE fraction of erythrocyte lipids, in particular with regard to the need for such a parameter for evidence-based improvement of management strategies in propionic acidemia.
Simplified method for the diameter sizing of serum low-density lipoprotein using polyacrylamide gradient gel electrophoresis
Authors: Tsukamoto Hideko , Takei Izumi , Ishii Keiko , Watanabe Kiyoaki
Published: September 2004

The appearance of small, dense, low-density lipoprotein in serum has been demonstrated to be associated with increased risk of coronary artery disease. The molecular diameter of low-density lipoprotein is usually measured on the basis of mobility differences on polyacrylamide gel electrophoresis. However, since mobility assessed by this method is seriously affected by the increased levels of serum free fatty acids associated with hypertriglyceridemia, we used polyacrylamide gradient gel electrophoresis to eliminate the interference by fatty acids and devised a simple, precise method of polyacrylamide gradient gel electrophoresis to measure the diameter of small, dense, low-density lipoproteins in serum. We used apoferritin and thyroglobulin, which have a molecular diameter of 12.2 nm and 17.0 nm, respectively, and standard low-density lipoprotein particles having a diameter of 25.7 and 27.0 nm as calibrators, estimated by measurement of negative staining of electron microscopy. We also included apoferritin as an internal standard for polyacrylamide gradient gel electrophoresis. The only stain used was Coomassie brilliant blue, and it was used for lipoprotein staining. When we used low-density lipoprotein of 25.73 nm in diameter as a quality control specimen, the coefficient of variation of the size measurements obtained by our method was less than 1.2%. The new method markedly improved the laboratory procedure for measuring the diameter of low-density lipoproteins.
In vitro inhibition of fibrinolysis by apolipoprotein(a) and lipoprotein(a) is size- and concentration-dependent
Authors: Knapp Jean-Pierre , Herrmann Wolfgang
Published: September 2004

Lipoprotein(a) (Lp(a)) is considered an independent risk factor for atherosclerotic heart and circulatory diseases. The unique, polymorphic character of Lp(a) is based on its apolipoprotein(a) (apo(a)), which has remarkable structural analogies with plasminogen, an important protein for fibrinolysis. The formation of plasmin from plasminogen is a fundamental step in the dissolution of fibrin. Repression of this step may lead to a deceleration of fibrinolysis.

It has been suggested that Lp(a) has antifibrinolytic properties through apo(a) and that the apo(a)-size polymorphism has a distinct influence on the prothrombotic properties of Lp(a). However, the results on this topic are controversial. Therefore we used a standardized in vitro fibrinolysis model to provide further information on the influence of Lp(a) on plasmin formation. Monitoring the time-course of plasmin formation, we investigated the inhibition of plasmin formation through dependence on Lp(a), respectively, free apo(a) concentration. Furthermore, we investigated the influence of three Lp(a)/apo(a) phenotypes (

Adding varying amounts of Lp(a) to our model, we observed that the rate of plasmin formation was inversely related to the Lp(a) concentration. At 0.1 µmol/l

Comparing the antifibrinolytic influence of different apo(a) phenotypes we found that the reduction of plasmin generation advanced with the size of apo(a). At 0.1 µmol/l Lp(a) the reduction of the plasmin formation increased in the order

Summarizing these results, our study indicates a distinct interrelation of Lp(a)/apo(a) phenotype and concentration with the formation of plasmin. From the antifibrinolytic Lp(a)/apo(a) effect in vitro it may be hypothesized that Lp(a)/apo(a) also has an inhibitory influence on in vivo fibrinolysis.
Evaluation of a shorter methionine loading test
Authors: De Jonge Robert , Griffioen Pieter H. , van Zelst Bertrand , Montserrate Brouns R. , Visser Willy , Lindemans Jan
Published: September 2004

We validated whether a shorter methionine loading test is as accurate as the original 6-h test in identifying hyperhomocysteinemic patients and investigated determinants of fasting and post-load homocysteine concentration. Plasma homocysteine was determined in EDTA-blood from women with a history of preeclampsia (n=106) after 12 h fasting and 3 and 6 h after an oral methionine load (0.1 g/kg body weight). The 677C > T polymorphism in the methylenetetrahydrofolate reductase (
Homocysteine, vitamin B12 and folate in vascular dementia and in Alzheimer disease
Authors: Malaguarnera Mariano , Ferri Raffaele , Bella Rita , Alagona Giovanna , Carnemolla Anna , Pennisi Giovanni
Published: September 2004

The association between elevated plasma levels of homocysteine (Hcy) and nutritional status has been shown in Alzheimer disease (AD) patients and also in vascular dementia (VaD). Moreover, a previous study provided evidence that the relation between a high Hcy level and low vitamin B

Increased levels of Hcy associated with low vitamin B
The clinical impact of screening for gestational diabetes
Authors: Schytte Tine , Jørgensen Lone G. M. , Brandslund Ivan , Petersen Per Hyltoft , Andersen Bent
Published: September 2004

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance during pregnancy. In Denmark the health service offers selective screening for GDM, i.e., admission to an oral glucose tolerance test (OGTT) after pre-screening with interview for clinical risk factors for GDM, two capillary fasting blood glucose (cFBG) measurements and a urine test for glucosuria. The aim of the present study was to investigate the power of the pre-screening to identify GDM and the screening to predict adverse clinical outcome.

A retrospective investigation of pregnant women undergoing screening during 1998 at Vejle County Hospital, Denmark was undertaken. The two most frequent pre-screening criteria for OGTT were body-mass index (BMI) ≥ 27 kg/m

The frequency of complicated delivery was similar in GDM (58%) compared to non-GDM (56%). The best predictor of complicated delivery was a BMI with OR=1.50 (95% CI: 0.87 to 2.60) for BMI ≥ 27 kg/m

Screening cFBG of 4.1 mmol/l was unable to predict GDM and adverse outcome. Glucosuria was too rare to be effective as a screening tool. Pre-screening did not identify GDM. The best predictor of complicated delivery was a high BMI. The best predictor of foetal adverse outcome was cBG
Comparison between creatinine and pregnanediol adjustments in the retrospective analysis of urinary hormone profiles during the human menstrual cycle
Authors: Miro Fernando , Coley John , Gani Mohamed M. , Perry Paul W. , Talbot Duncan , Aspinall Laurence J.
Published: September 2004

Measurement of reproductive hormones in urine is a practical way of obtaining large amounts of information; however, there is still controversy on how to overcome problems derived from volume fluctuations between samples. Creatinine adjustment is a widely accepted solution, however, it introduces an extra cost, and large studies involving multiple sequential determinations would benefit from more economical solutions.

We determined the value of creatinine adjustment, and compared it with a mathematical method that uses the smoothed profile of pregnanediol (PdG) as a reference to adjust other hormonal markers. To do this, we investigated the effects on three major urinary reproductive hormonal markers (luteinizing hormone (LH), estrone 3-glucuronide (E1G) and PdG) in 17 complete menstrual cycles. Detection of the day of LH peak did not differ between raw and adjusted data. Creatinine adjustment reduced variation in pre-ovulatory E1G levels between individuals, though the effect was negligible within individuals. No significant differences were found regarding post-ovulatory PdG rise. Although creatinine adjustment significantly reduces variability, producing smoother profiles, an equivalent degree of smoothness is obtained using the PdG adjustment.

We conclude that under the current technology, for the retrospective study of urinary hormonal profiles in the human menstrual cycle, PdG adjustment is a valid alternative to creatinine.
The measurement of complexed prostate-specific antigen has a better performance than total prostate-specific antigen
Authors: Herrmann Wolfgang , Stöckle Michael , Sand-Hill Marga , Hübner Ulrich , Herrmann Markus , Obeid Rima , Wullich Bernd , Loch Tillmann , Geisel Jürgen
Published: September 2004

The aim of this study was to compare the diagnostic utility of complexed prostate-specific antigen (cPSA) with total PSA (tPSA) in screening for prostate cancer. Serum concentrations of tPSA and cPSA were measured in 4479 adult men during the prostate cancer screening program in the Saarland region (Germany). The percentage of men with c/tPSA ratio above the cut-off value of 0.75 increased with increasing tPSA intervals: tPSA 0–0.9 µg/l, 4.4%; 1.0–1.9 µg/l, 24.3%; 2.0–2.9 µg/l, 43.9%; 3.0–3.9 µg/l, 50.4%; and 4.0–20 µg/l, 60.2%. The commonly accepted tPSA cut-off value of 3.9 µg/l matched to the 93rd percentile of the overall population (corresponding cPSA value, 2.9 µg/l). A total of 202 men out of 313 with increased cPSA had increased c/tPSA ratio (cut-off ≥ 0.75) vs. 186 out of 312 men with increased tPSA. Thus, an additional 16 men at high risk for prostate cancer were selected only if cPSA was utilised as a first line parameter. Our data show that, compared to tPSA, cPSA measurement will always detect more high-risk patients, independent of the cut-off levels utilised for cPSA, tPSA and c/tPSA ratio. cPSA is more effective than tPSA in selecting subjects with an elevated c/tPSA ratio who are at high risk of prostate cancer. Thus, cPSA might be seen as the superior first-line parameter in screening for prostate cancer. Using lower cut-off values for tPSA or cPSA than the commonly accepted values seems reasonable for screening purposes.
Effect of prolonged physical exercise on urinary proANP1-30 and proANP31-67
Authors: Cappellin Enrico , De Palo Elio F. , Gatti Rosalba , Soldà Giuseppe , Woloszczuk Wolfgang , Spinella Paolo
Published: September 2004

Dynamic exercise strongly affects atrial natriuretic peptides (ANP), in particular the mature bioactive αANP and the proANP fragments, namely proANP