bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed tomography–assisted management of a mandibular dentigerous cyst in a dog with a nasal carcinoma
Authors: Soukup Jason W. , Lawrence Jessica A. , Pinkerton Marie E. , Schwarz Tobias
Published: September 2009

Case Description—A 6-year-old neutered male Boston Terrier was examined to determine the cause of sneezing, bilateral nasal discharge, nasal congestion, lethargy, and coughing of 2 months' duration.

Clinical Findings—An undifferentiated nasal carcinoma was diagnosed. During computed tomography (CT) evaluation of response to tomotherapy radiation treatment, a mandibular dentigerous cyst, associated with an unerupted left mandibular first premolar, was monitored for expansion.

Treatment and Outcome—The dog had a profound response to radiation treatment, and the nasal carcinoma totally resolved. It was determined on the basis of CT that the rate of expansion of the dentigerous cyst was placing the dog at risk for mandibular fracture and loss of vitality to the surrounding teeth. The unerupted left mandibular first premolar and associated dentigerous cyst were surgically removed and submitted for histologic evaluation.

Clinical Relevance—Images obtained during sequential CT evaluations performed after radiation treatment of nasal carcinoma should be examined for evidence of the primary neoplasm as well as to detect unrelated lesions of the orofacial region that can compromise the quality of life. Findings of CT evaluations can be used to determine when and how to initiate treatment for dentigerous cysts in regard to the patient's response to radiation treatment.
Effect of lameness on sow longevity
Authors: Anil Sukumarannair S. , Anil Leena , Deen John
Published: September 2009

Objective—To analyze the association of lameness and performance variables on sow longevity by use of time-to-event analysis.

Design—Cohort study.

Animals—674 sows from a commercial breeding herd.

Procedures—A lameness assessment was performed on each sow. Data on farrowing performance and longevity were collected for the sows during 3 or fewer parities from the database of the herd during 2005 and 2006. The association of risk factors with sow longevity within 350 days after lameness assessment was analyzed via Cox regression analysis. Pigs per day, total production days, and survival at 350 days after lameness evaluation were compared between lame and nonlame sows.

Results—Numbers of preweaning baby pig deaths, stillborn pigs, and mummified pigs were negatively associated with sow longevity within 350 days after lameness assessment. A higher number of pigs born alive and younger parity of sows were protective. Lame sows had a higher risk (1.710 times as high) of removal from the herd within 350 days after lameness assessment. The number of pigs born alive per day, survival of sows at 350 days, and total number of days in the herd were lower in lame sows.

Conclusions and Clinical Relevance—Results of this study indicated significant differences in the survivability of lame and nonlame sows in a commercial herd. Parity and farrowing performance variables were factors influencing sow longevity in this herd. Producers need to minimize sow lameness and remove lame sows from a herd early (when treatment is not an option) to minimize economic loss.
Using the Bi-Masquelet Technique and Reamer-Irrigator-Aspirator for Post-traumatic Foot Reconstruction
Authors: Huffman Lanie K. , Harris John G. , Suk Michael
Published: September 2009

Level of Evidence: V, Expert Opinion
Treatment of a Distal Tibial Osteochondral Lesion with a Synthetic Osteochondral Plug: A Case Report
Authors: Pearce Christopher J. , Lutz Michael J. , Mitchell Adam , Calder James DF
Published: September 2009

Level of Evidence: V, Expert Opinion
In vitro Propagation of Mentha viridis L. from Nodal and Shoot tip Explants
Authors: Raja H. David , Arockiasamy D.I.
Published: September 2009

A simple micropropagation method from nodal and shoot tip explants is reported here for Mentha viridis, an economically important medicinal plant. High frequency of microshoots was obtained from these two explants on MS supplemented with various concentrations of BAP (1.0 - 4.0 mg/l) and Kn (1.0 -4.0 mg/l). Maximum number of shoots was obtained from nodal explants in the medium containing 3.0 mg/l BAP. The root induction was carried out by using IBA and IAA (0.5 - 2.0 mg/l). Among these, high frequency of root proliferation was achieved in the medium containing 1.5 mg/l of IBA. The rooted plantlets were hardened and transferred to the field. The survival rate was 90 - 95% after 25 days. Key words: Micropropagation, Mentha viridis, Node, Shoot tip, Multiple shoots D.O.I. 10.3329/ptcb.v18i1.3243 Plant Tissue Cult. & Biotech. 18(1): 1-6, 2008 (June)
An Improved Protocol for Multiple Shoot Regeneration from Seedlings and Mature Explants of Citrus macroptera Mont.
Authors: Miah Md. Nesawar , Islam Shahina , Hadiuzzaman Syed
Published: September 2009

Efforts have been made to establish a protocol for direct multiple shoot regeneration from both in vitro grown seedlings and mature plants of Citrus macroptera. Both nodal and shoot tip explants taken from in vitro grown seedlings were cultured in MS supplemented with different concentrations of BAP and Kn either singly or in combinations. Both these explants are capable to regenerate and produce in vitro multiple shoots. Maximum number of shoots were obtained from nodal explants in MS supplemented with 1.0 mg/l BAP. BAP alone was found superior to Kn. On the other hand, only nodal explants from mature plants were used and 1.0 mg/1 BAP was also found best suitable for shoot induction and multiplication. Ex vitro rooting in pot soil (mixed with biogas slurry derived from cow-dung) was most successful compared to in vitro rooting in half strength of MS supplemented with different concentrations of NAA and IBA. Key words: In vitro, Shoot regeneration, Citrus macroptera D.O.I. 10.3329/ptcb.v18i1.3246 Plant Tissue Cult. & Biotech. 18(1): 17-24, 2008 (June)
In vitro Clonal Propagtion of Trichosanthes cucumerina L. var. cucumerina
Authors: Devendra N. K. , Rajanna L. , Sheetal C. , Seetharam Y. N.
Published: September 2009

An efficient protocol was established for in vitro shoot multiplication from shoot tip explant of Trichosanthes cucumerina L. var. cucumerina on semisolid MS basal medium supplemented with BA. NAA in the culture medium along with BA promoted higher number of shoot multiplication than BA alone. The rate of shoot multiplication was maximum 12.00 ± 0.70 after four weeks of culture on MS basal medium supplemented with BA 1.0 mg/l + NAA 0.1 mg/l. The elongated shoots rooted within seven - eight days in half strength of MS basal salts supplemented 1.0 mg/l IBA and 3% (w/v) sucrose. About 90% of the rooted plantlets were acclimatized and transferred to the greenhouse and successfully transferred to the field with 80% survival rate. The histological study shows that the organogenesis occurs directly, without callus formation on epidermal and sub epidermal layer of the explants. Adventitious shoots were characterized by the development of shoots apical meristem and leaf primordial. Key words: Trichosanthes cucumerina var. cucumerina, Clonal propagation, Shoot multiplication, Ontogeny D.O.I. 10.3329/ptcb.v18i2.3270 Plant Tissue Cult. & Biotech. 18(2): 103-111, 2008 (December)
In vitro Mass Multiplication with Pure Genetic Identity in Anthurium andreanum Lind.
Authors: Gantait S. , Mandal N. , Bhattacharyya S. , Das P. K.
Published: September 2009

A novel protocol for enhanced in vitro multiple shoot induction was developed for Anthurium andreanum Lind. First shoot bud was induced within a week in MS supplemented with 0.1 mg/l NAA and 0.25 mg/l BAP where maximum six buds from single apical bud explant appeared within next 20 days. For multiple shoot proliferation MS with 0.5 mg/l BAP and 60 mg/l adenine sulphate  (ADS) proved to be best resulting ten  multiple shoots per inoculated shoot bud within 50 days. As many as 11 roots per plantlet were produced in 27 days using MS with 0.5 mg/l IAA and 2 g/l activated charcoal. Autoclaved sand and intermittent water spraying optimized the primary hardening period of 15 days and then earthen pots filled with sand, soil, charcoal and coconut fibre ensured the recovery of 51 well hardened plantlets out of 60 in next 30 days showing 85% success. The  genetic identity of both ex vitro hardened clones and in vitro sustained clones with their mother  ant were tested using 10 ISSR primers, displayed no polymorphism. Key words: Anthurium, In vitro cloning, Multiple shoot, Genetic identity  D.O.I. 10.3329/ptcb.v18i2.3361 Plant Tissue Cult. & Biotech. 18(2): 113-122, 2008 (December)
Optimal 2-Coverage of a Polygonal Region in a Sensor Network
Authors: Abellanas Manuel , Bajuelos Antonio L. , Matos Inês
Published: September 2009

Wireless sensor networks are a relatively new area where technology is developing fast and are used to solve a great diversity of problems that range from museums’ security to wildlife protection. The geometric optimisation problem solved in this paper is aimed at minimising the sensors’ range so that every point on a polygonal region R is within the range of at least two sensors. Moreover, it is also shown how to minimise the sensors’ range to assure the existence of a path within R that stays as close to two sensors as possible.
Minardi, E. Thermodynamics of High Temperature Plasmas. Entropy, 2009, 11, 124-221
Authors: Minardi Ettore
Published: September 2009

I discovered some typographical errors in the paper "Thermodynamics of High Temperature Plasmas" [1] and some points that need clarification. These defects are remedied in this correction. [...]
Self-Rated Health: Inequalities and Potential Determinants
Authors: Alexopoulos Evangelos  C. , Geitona Mary
Published: September 2009

Understanding social inequalities in health is of great importance; it provides the conceptual frame for investigating the social factors that affect health, together with empirical evidence for improving population health. Individual and socioeconomic data, disease related conditions and self rated health (SRH) ratings were collected from a representative sample of 1,000 participants in order to study health inequalities in Greece. 20.8% of men and 37.2% of women reported poor health status. Significant inequalities in SRH were observed. Strong associations of poor SRH with gender, age, insurance coverage and chronic diseases were identified. Social insurance scheme captured partly the effects of educational level, income and residence area in SRH in multivariate analysis. Respondents under chronic treatment and those suffering from cardiovascular, musculoskeletal and neurological/psychiatric disorders exhibited the highest risk of reporting poor SRH. Our findings provide decision-makers with insights into how to manage health inequalities by prioritizing preventive measures and consequently, progress towards the fair distribution of healthcare resources.
Regioselective Alkylation of an Oxonaphthalene-Annelated Pyrrol System
Authors: Spreitzer Helmut , Puschmann Christiane
Published: September 2009

The regioselective alkylation of an oxonaphthalene-annelated pyrrole system is reported. The regioselectivity of alkylation can be controlled by the selection of the solvent.
Synthesis of a [2.2.2] Cryptand Containing Reactive Functional Groups
Authors: Naguib Yousry M. A.
Published: September 2009

The functional group-containing potassium ionophore 195,245-dibromo-4,7,13,16,20,23-hexaoxa-1,10-diaza-19(1,2),24(1,2)-dibenzabicyclo[8.8.6]tetracosaphane has been synthesized.
Pharmacists' Perspectives on Providing Chronic Disease Management Services in the Community — Part I: Current Practice Environment
Authors: Grindrod Kelly A. , Rosenthal Meagen , Lynd Larry , Marra Carlo A. , Bougher David , Wilgosh Chuck , Tsuyuki Ross T.
Published: September 2009

Background:

Several practice models have been developed to support pharmacists in providing chronic disease management. However, most of these models have not been readily accepted by pharmacists, which has led to low uptake and short-term change.

Methods:

Pharmacists were recruited to participate in focus groups held in Alberta and British Columbia. Qualitative methodologies involving a phenomenological approach with content analysis were used to gather and analyze information.

Results:

In total, 36 pharmacists participated in 8 focus groups. Analysis of their discussions revealed 4 main themes: the current practice environment and the need for education about, remuneration for and a plan for the implementation of chronic disease management services. Participants cited several challenges to the provision of this type of care, as experienced in the current practice environment: time constraints; relationships with physicians, patients and employers; limited access to clinical information; and absence of a model for chronic disease management in pharmacy practice. However, these perceptions were not universal, and pharmacists with experience in this area described some of these commonly cited “challenges” (e.g., relationships with physicians) as enablers in their own practices. In addition, staff pharmacists, regional managers and owners often had differing opinions about the key challenges and the role of remuneration.

Conclusion:

Some of the perceived challenges to providing chronic disease management described by staff pharmacists were not consistently supported by employers or those with experience in this practice area. This observation suggests that the greatest challenge to developing a successful model of chronic disease management for pharmacists lies in pharmacists' own perceptions about their relationships with other health care providers and their own role as health care professionals. These issues must be addressed if the practice of pharmacy is to move forward.
Quand la rue fait l'histoire
Authors: Tartakowsky Danielle
Published: September 2009

Résumé Après la défaite de la Commune, la rue a cessé de faire et de défaire les régimes. Les manifestations de rue, demeurées susceptibles de faire histoire au premier chef, en 1934 ou en 1968, tirent du moins leur force de cette histoire antérieure qui les a façonnées. Devenues des vecteurs et des relais d’une histoire dont elles ont capté les vertus émotionnelles ou mobilisatrices, elles s’imposent comme de puissants vecteurs de la mémoire vive, l’occasion d’une brève rencontre entre l’histoire individuelle et l’histoire collective.
Le droit de la rue
Authors: Cassia Paul
Published: September 2009

Résumé Le droit applicable à la rue se caractérise par la recherche d’un équilibre permanent entre l’affirmation de libertés fondamentales, telles celles de circuler ou de stationner, et les restrictions posées à ces libertés à certains usagers de la voie publique, afin de faciliter la circulation ou le stationnement d’autres de ces usagers. Or, ceux-ci sont particulièrement nombreux et divers, qu’il s’agisse par exemple des commerçants, des automobilistes, des piétons ou des propriétaires de chiens, ce qui rend le point d’équilibre entre l’autorisation et l’interdiction fluctuant à la fois dans le temps et dans l’espace. À cette diversité, s’ajoute celle des autorités chargées de réglementer l’occupation, la circulation ou l’utilisation de la voie publique.
Réformer l'État : avec, sans ou contre ses serviteurs ?
Authors: Lulin Élisabeth
Published: September 2009

Résumé Réformer l’État, si l’on veut un changement réel et durable des structures et des comportements influant sur les coûts et la qualité du service public, n’est possible qu’avec l’adhésion des fonctionnaires. Pourtant peu nombreux sont les exemples réussis d’association des fonctionnaires à la réforme. Nous avançons trois hypothèses pour expliquer ce paradoxe. D’une part, la fragmentation extrême du terrain administratif français entre de multiplescorps de fonctionnaires et d’innombrables démembrements de l’État oblige le réformateur à composer avec des intérêts très dispersés et d’autant plus âprement défendus qu’ils sont institutionnalisés ; d’autre part, la pratique actuelle du dialogue avec les agents – ou de ce qui en tient lieu – est un rituel hyper-centralisé, dominé par le face-à-face avec les syndicats et donc fort politisé, au lieu du dialogue décentralisé, passant par une mobilisation des divers échelons d’encadrement, que l’on voit ailleurs ; enfin, la négociation sur la réforme intervient dans un vide, non sur le terreau d’un dialogue managérial au quotidien, et ce faisant cristallise toutes les aspirations et frustrations au lieu de débattre de manière dépassionnée des projets de changement proposés.
La loi du 10 juillet 2000 après le jugement du tunnel du Mont-Blanc
Authors: Fauchon Pierre
Published: September 2009

Résumé Le procès de l’accident du tunnel du Mont-Blanc a donné lieu à un jugement qui répond à certaines des questions posées à propos de la loi du 10 juillet 2000 sur la délinquance non intentionnelle. Des questions nouvelles se posent cependant, en particulier sur la nature des peines encourues, la situation particulière des élus locaux, l’appréciation de la gravité de l’imprudence, le champ de la responsabilité pénale des personnes publiques. Ces questions sont évoquées ici, en correspondance avec le débat ouvert au Sénat dans un colloque le 1 er mars prochain.
Quelles perspectives pour la fonction publique de l'État en France ?
Authors: Richard Jacky
Published: September 2009

Résumé Le statut des fonctionnaires de l’État est condamné à évoluer sous la pression conjuguée des usagers, des contribuables et de l’employeur. Sans renier le principe de la carrière, une nouvelle donne statutaire doit s’imposer pour favoriser la reconnaissance de la réussite des agents sur les nouvelles logiques de réforme de gestion publique inhérente à la lolf , ainsi que sur l’influence grandissante du droit communautaire et sur le droit national. Instituer une véritable Direction des ressources humaines-groupe de l’État permettra, par ailleurs, de coordonner les obligations, aujourd’hui diluées, de l’État employeur. Le dialogue social doit être approfondi pour que les fonctionnaires et leurs représentants soient prêts.
Le retour de la Pologne comme acteur européen
Authors: Beauvois Daniel
Published: September 2009

Résumé L’intégration de la Pologne à l’UE en 2003 est loin de constituer un retour puisque jamais, en fait, les Polonais n’ont quitté la scène européenne. Sont ici rappelées les principales manifestations de cette présence permanente et les attitudes variables du continent à son égard. Exception européenne au xvi e siècle lorsque y apparaît un système politique unique et qu’elle couvre la plus grande surface du continent après la Russie, confetti infime du duché de Varsovie sous Napoléon, phénix redéployant ses ailes et ses griffes sous Pilsudski après 1918, pays fantomatique des décennies communistes après 1945, David de 1980 qui fit s’écrouler le Goliath soviétique, la Pologne a rejoint l’Union européenne en 2003, riche des mille facettes que lui a données l’histoire et de l’énergie qu’ont conférée les épreuves à son peuple.
La Pologne à l'heure américaine
Authors: Rupnik Jacques
Published: September 2009

Résumé De tous les nouveaux membres de l’UE, la Pologne a apporté le soutien le plus explicite à la politique des États-Unis. La crise irakienne a conforté cette image réductrice. L’article examine d’abord les raisons de l’américanophilie polonaise, pour la relativiser dans un second temps : un soutien à la politique étrangère américaine, une convergence avec les États-Unis sur une « politique des valeurs » ne signifient pas adhésion au modèle économique et social « anglo-saxon ». Il est temps de donner une image plus nuancée de la position polonaise, américanophile et européenne, et de nous interroger sur l’évolution de ce pays au-delà de la phase de transition qu’elle a connue entre la chute du système soviétique et son intégration dans l’Union européenne.
La communication médiatique déterminant de l'action publique
Authors: Moutouh Hugues
Published: September 2009

Résumé Depuis quelques années, de nombreuses études critiques dénoncent l’impact considérable qu’auraient les médias dans le fonctionnement quotidien de la démocratie. Sans sous-estimer le rôle déterminant de la communication médiatique sur l’action des gouvernants, il faut éviter toute approche trop simplificatrice aboutissant nécessairement à une lecture univoque de la réalité. Le risque d’une dénaturation progressive de notre système politique par un excès de médiatisation existe indéniablement, mais il ne constituera pas un danger tant que nos gouvernants prendront leurs responsabilités, continueront à vouloir gouverner et à faire de la politique.
More Situations in Which Questions Are Valuable
Authors: Kowalski Karren
Published: September 2009

This column discusses more situations in which questions are valuable.

J Contin Educ Nurs
2009;40(9):393.
Internet Access Produces Misinformed Patients: Managing the Confusion
Authors: Hungerford David S.
Published: September 2009

The Internet has produced a truly phenomenal increase in access to information. This is really only helpful to patients if the information is filtered and appropriate to their specific needs. Too often patients access information about conditions they have self-diagnosed and bring it to the consultation with their physician, who then has to spend time disabusing the patients of the misinformation they have accumulated. Patients also return home from their initial consultation, access the Internet, and come up with all manner of promotional information from companies and even orthopedic practices that they want explained to them by their physician. It is the overwhelming conclusion of orthopedic specialists that this kind of Internet use is actually a burden for them in caring for patients and is not contributing to patient enlightenment. It does not have to be this way, if physicians will do just 2 things: first, create white papers for patients that address common current questions, such as surgical approach or bearing surfaces for implants and why we do what we do. This is a huge time saver and will preempt many questions. Second, develop their own website or select excellent nonprejudicial sites to which they can refer patients. To do less will invite a neverending parade of questions irrelevant to patient welfare.
Periprosthetic Fractures of the Femur
Authors: Cross Michael , Bostrom Mathias
Published: September 2009

Treatment of periprosthetic femur fracture is based on fracture timing, implant stability, fracture pattern, and bone quality. Intraoperative fractures are usually stable; to prevent intraoperative fracture, careful preoperative planning and gentle operative techniques are essential. In managing unstable intraoperative and late postoperative periprosthetic fractures, the surgeon should be know the exact pattern of fracture, prosthesis stability, and bone quality. Loose prostheses should be revised and displaced fractures should be reduced and adequately fixed. These fractures typically occur in the peritrochanteric area, and their treatment is cerclage wiring or cables. Postoperative periprosthetic fractures are usually the result of trauma in the setting of loosening of the prosthesis and/or osteolysis. Periprosthetic femoral fractures are classified using the Vancouver classification, which is based on the location of the fracture, the amount of available proximal bone stock, and the stability of the stem. Correct classification of these fractures is important, as it helps to guide treatment.
Long-term Outcome of Shelf Grafts in Total Hip Arthroplasty for Developmental Hip Dysplasia
Authors: Nousiainen Markku T. , Maury Anthony C. , Alhoulei Ali , Backstein David J. , Gross Allan E.
Published: September 2009

Primary total hip arthroplasty (THA) in patients with osteoarthrosis secondary to developmental hip dysplasia is often complex due to anterolateral acetabular bone deficiency. The use of femoral head (shelf) autograft during the index arthroplasty provides nonimmunogenic, osteoconductive support with the potential for enhanced bone stock should revision surgery be required. Few long-term studies document the outcome of the use of shelf grafts in primary THA or quantify the need for further bone graft at revision surgery.

A retrospective analysis was conducted of a single surgeon's series of 31 THAs performed in 25 patients with developmental hip dysplasia. Postoperative biplanar radiographic analysis was performed at 3 and 6 months and annually thereafter for a mean of 14 years (range, 8–18 years). Grafts were assessed for union, resorption, and displacement. The need for acetabular bone graft at revision surgery was recorded. Bony union was observed in 93% of cases; fibrous union developed in the remaining 7%. There was no graft displacement. In 71% of cases, less than one-third of the graft had resorbed; one-third to one-half had resorbed in the remaining 29% of cases. Of 10 patients revised (all for loosening of the acetabular component), 2 required structural allograft for inadequate bone stock.

Femoral head autograft allows effective acetabular coverage with excellent rates of union, exhibits minimal graft resorption in the long-term, and rarely requires further acetabular allograft in revision surgery.
Shell Retention With a Cemented Acetabular Liner
Authors: Callaghan John J. , Liu Steve S. , Schularick Nathan M.
Published: September 2009

The authors reviewed the indications, technique, and results of cementing an acetabular liner into a well-fixed cementless acetabular shell. Indications for this procedure include a worn acetabular liner in a well-fixed cementless acetabular shell as well as an unstable total hip construct where the shell is secured. To perform such a procedure, an adequate shell diameter is necessary to accept an acetabular liner that will enable 2 mm of cement mantle around it. If the shell has screw holes, there is no need to score the acetabular shell, but otherwise the acetabular shell must be scored to a 1-mm depth in a spiderweb configuration. As for the acetabular liner, it too must be scored to a 1-mm depth in a spiderweb configuration (which enhances torsional stability) as well as a circular configuration to provide optimal lever-out strength. We have evaluated 31 constrained liners and 30 nonconstrained liners with this preparation. The failure rate in the constrained liner series was 6%, and no failures occurred in the nonconstrained series. One dislocation occurred in the nonconstrained series where patients were typically placed in a brace or cast for 6 weeks. This option should be considered in cases with worn-through acetabular liners for unstable configurations when the acetabular shell is well fixed and is of adequate diameter to accept such a construct.
The Role of Impaction Grafting: The When and How
Authors: Haddad Fares S. , Rayan Faizal
Published: September 2009

The challenges of acetabular revision include bone loss and poor bone biology. Favorable 10-year reports exist of uncemented acetabular revision using hemispherical uncemented sockets. In the presence of bone stock deficiency, adjunctive morsellized impaction bone grafting is a recognized means of restoring bone stock. We attempt to restore bone stock with impaction grafting beneath a cementless cup for contained defects, defects that can be rendered contained, and whenever there is capacity for rim fixation.

The technique of bone graft preparation is important. We use a mixture of bone milling and bone chips of various sizes. Morsellized allograft is inserted, packed, and/or reverse reamed into any defects. The reconstruction relies on the ability to gain biological fixation of the component to the underlying host bone. This requires intimate host bone contact and rigid implant stability. The fixation is therefore augmented with screws in all cases.

It is important to achieve host bone contact in a least part of the dome and posterior column. When this is possible, and particularly when there is a good rim fit, we have not found it absolutely necessary to have contact with host bone over >50% of the surface. Stability of primary fixation is a better predictor of outcome than volume of graft or percentage of host bone contact.

The advantages of bone grafting in acetabular reconstruction include the ability to restore bone stock, rebuild a normal hip center and hip biomechanics, and increase bone stock for future revisions.
Stiffness Associated With Total Knee Arthroplasty
Authors: Scott Richard D.
Published: September 2009

Multiple factors may lead to stiffness after total knee arthroplasty (TKA), including patient diagnosis, preoperative range of motion (ROM), prosthetic geometry used, surgical technique, intraoperative ROM after capsular closure, postoperative rehabilitation, and wound healing factors. An ipsilateral arthritic hip can also inhibit postoperative recovery and lead to knee stiffness.

Exposure of the ankylosed knee can be difficult. One must take care to avoid excessive stress on the patellar tendon insertion leading to patellar tendon avulsion. The 2 most common methods to facilitate exposure are a proximal release or a tibial tubercle osteotomy.

When patients fail to achieve satisfactory ROM after TKA, manipulation under anesthesia is considered. It is usually performed approximately 6 weeks postoperatively. The best indicator of each patient's potential is his or her intraoperative flexion against gravity with the capsule closed at the end of the procedure.
Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty Conversion: Assuring a Primary Outcome
Authors: Berend Keith R. , George Joseph , Lombardi Adolph V.
Published: September 2009

Converting unicompartmental knee arthroplasty (UKA) to total knee arthroplasty can be difficult, and specialized techniques are needed. Issues include bone loss, joint-line, sizing, and rotation. Determining the complexity of conversion preoperatively helps predict the need for augmentation, grafting, stems, or constraint. We examined insert thickness, augmentation, stem use, and effect of failure mode on complexity of UKA conversion. Fifty cases (1997–2007) were reviewed: 9 implants (18%) were modular fixed-bearing, 4 (8%) were metal-backed nonmodular fixed-bearing, 8 (16%) were resurfacing onlay, 10 (20%) were all-polyethylene step-cut, and 19 (38%) were mobile bearing designs; 5 knees (10%) failed due to infection, 5 (10%) due to wear and/or instability, 10 (20%) for pain or progression of arthritis, 8 (16%) for tibial fracture or severe subsidence, and 22 (44%) due to loosening of either one or both components. Complexity was evaluated using analysis of variance and chi-squared 2-by-k test (80% power; 95% confidence interval). Insert thickness was no different between implants (
P
=.23) or failure modes (
P
=.27). Stemmed component use was most frequent with nonmodular components (50%), all-polyethylene step-cut implants (44%), and modular fixed-bearing implants (33%;
P
=.40). Stem use was highest in tibial fracture (86%;
P
=.002). Augment use was highest among all-polyethylene step-cut implants (all-polyethylene, 56%; metal-backed, 50%; modular fixed-bearing, 33%;
P
=.01). Augmentation use was highest in fracture (86%) and infection (67%), with a significant difference noted between failure modes (
P
=.003). Failure of nonmodular all-polyethylene step-cut devices was more complex than resurfacing or mobile bearing. Failure mode was predictive of complexity. Reestablishing the joint-line, ligamentous balance, and durable fixation are critical to assuring a primary outcome.
Intermediate Outcomes After Primary Traumatic Anterior Shoulder Dislocation in Skeletally Immature Patients Aged 10 to 13 Years
Authors: Cordischi Keith , Li Xinning , Busconi Brian
Published: September 2009

A paucity of literature exists regarding the outcome of skeletally immature patients who sustain a primary traumatic anterior shoulder dislocation. Most published results focus on adolescents and young adults, using recurrent dislocation/instability as a determinant of outcome, rather than a validated quality of life measurement tool. The purpose of this study is to assess the intermediate term functional outcome after anterior traumatic shoulder dislocation in the skeletally immature patient population. Fourteen patients (age range, 10.9–13.1 years; 14 shoulders) who sustained a primary anterior traumatic unidirectional shoulder dislocation were included. Each patient underwent successful documented closed reduction of the dislocated shoulder and was subsequently treated with initial nonsurgical intervention. All patients were monitored in the clinic routinely, until skeletal maturity was reached. The Western Ontario Shoulder Instability index (WOSI), range of motion, complications, and recurrent dislocations were recorded. The average WOSI score for all patients at the time of injury was 1635 (range, 1550–1690). At final follow-up (mean, 5.6 years), the average WOSI score for all patients was 39.6 (range, 0–195). Subgroup analysis revealed that those treated nonoperatively fared better than their operative counterparts (average final follow-up WOSI score, 9.1 vs 151.7, respectively). Three patients (21.4%) ultimately sustained a recurrent shoulder dislocation that necessitated surgical intervention. Based on the above data, in the pediatric skeletally immature patient who sustained a primary, traumatic, anterior shoulder dislocation, nonoperative treatment results in low shoulder instability recurrence risk and sound functional outcomes.
MRI Measurement of the 2 Bundles of the Normal Anterior Cruciate Ligament
Authors: Cohen Steven B. , Vanbeek Corinne , Starman James S. , Armfield Derek , Irrgang James J. , Fu Freddie H.
Published: September 2009

Anatomical studies have shown that the normal anterior cruciate ligament (ACL) consists of 2 distinct functional bundles: the anteromedial and posterolateral bundles. To date, no study has assessed the magnetic resonance imaging (MRI) appearance of the anteromedial and posterolateral bundles. The purpose of this study was to measure the anteromedial and posterolateral bundles using high-field digital MRI.

Fifty MRIs of the knees of 50 patients were prospectively collected using a 1.5-T magnet. The length and width of each ACL bundle was measured on sagittal and coronal digital MRIs, independently performed by 2 observers blinded to each other's measurements. The average length and width of the anteromedial and posterolateral bundles were determined for all patients. Intraclass correlation coefficients were calculated to determine intertester test–retest reliability. In the sagittal plane, the anteromedial bundle averaged 36.9±2.8 mm in length and 5.1±0.7 mm in width. The posterolateral bundle, by contrast, averaged 20.5±2.4 mm in length and 4.4±0.8 mm in width. In the coronal plane, the width of the anteromedial bundle averaged 4.2±0.8 mm and of the posterolateral bundle averaged 3.7±0.8 mm. Interobserver reliability for length of the ACL in the sagittal plane was 0.85, with a 95% CI of 0.75 to 0.91 for the anteromedial bundle and 0.75 with a 95% CI of 0.60 to 0.85 for the posterolateral bundle.

Providing precise measurement of the ACL anteromedial and posterolateral bundles on MRI may improve the ability to detect damage to 1 or both of the bundles following injury.
Playing [with] multiple roles: Readers, authors, and characters in "Who Is Blaise Zabini?"
Authors: Smith Anne Collins
Published: September 2009

Fans who produce fan works in genres such as fiction, music, and music video take on dual roles in the process, as readers of the original canon and as creators of their own products. These roles—and more—are creatively explored in the Parselmouths' wizard rock composition "Who Is Blaise Zabini?" Like many works of fan fiction, the Parselmouths' songs move beyond a reader's ordinary role, taking on an authorial role to generate new characters and events in the Harry Potter universe. What makes this particular work unusual is that at the same time that they are adopting the roles of authors, and even of participants, the Parselmouths also restrict their own authorial and participatory power, claiming that the Slytherin characters they portray could not perceive their classmate Blaise Zabini until J. K. Rowling provided a complete description of him. To untangle their multiple roles and to recognize the creativity exercised by the Parselmouths in collapsing the boundaries among them, it will be helpful to turn to a theory of audience response that delineates specific roles and that specifies the limitations and the powers inherent in them.
Beneficial Immunomodulation by Streptococcus mutans Anti-P1 Monoclonal Antibodies Is Fc Independent and Correlates with Increased Exposure of a Relevant Target Epitope
Authors: Robinette Rebekah A. , Oli Monika W. , McArthur William P. , Brady L. Jeannine
Published: September 2009

We showed previously that deliberate immunization of BALB/c mice with immune complexes (IC) of the cariogenic bacterium Streptococcus mutans and mAbs against its surface adhesin P1 results in changes in the specificity and isotype of elicited anti-P1 Abs. Depending on the mAb, changes were beneficial, neutral, or detrimental, as measured by the ability of the serum from immunized mice to inhibit bacterial adherence to human salivary agglutinin by a BIAcore surface plasmon resonance assay. The current study further defined changes in the host response that result from immunization with IC containing beneficial mAbs, and evaluated mechanisms by which beneficial immunomodulation could occur in this system. Immunomodulatory effects varied depending upon genetic background, with differing results in C57BL/6 and BALB/c mice. Desirable effects following IC immunization were observed in the absence of activating FcRs in BALB/c Fcer1g transgenic mice. mAb F(ab′)2 mediated desirable changes similar to those observed using intact IgG. Sera from IC-immunized BALB/c mice that were better able to inhibit bacterial adherence demonstrated an increase in Abs able to compete with an adherence-inhibiting anti-P1 mAb, and binding of a beneficial immumomodulatory mAb to S. mutans increased exposure of that epitope. Consistent with a mechanism involving a mAb-mediated structural alteration of P1 on the cell surface, immunization with truncated P1 derivatives lacking segments that contribute to recognition by beneficial immunomodulatory mAbs resulted in an improvement in the ability of elicited serum Abs to inhibit bacterial adherence compared with immunization with the full-length protein.
MS4A4B Is a GITR-Associated Membrane Adapter, Expressed by Regulatory T Cells, Which Modulates T Cell Activation
Authors: Howie Duncan , Nolan Kathleen F. , Daley Stephen , Butterfield Emma , Adams Elizabeth , Garcia-Rueda Hugo , Thompson Claire , Saunders Nigel J. , Cobbold Stephen P. , Tone Yukiko , Tone Masahide , Waldmann Herman
Published: September 2009

In the aftermath of thymic negative selection, natural and adaptive regulatory T cells (Tregs) must acknowledge peripheral, “danger-free” self-Ag to ensure their sustained activity. In this paper, we show that natural and adaptive Tregs or T cells transduced with cDNA for Foxp3, just like Th1 cells, express members of the MS4A family of transmembrane molecules. Naive T cells transduced with MS4A4B become able to respond to lower levels of Ag. Using two family members, MS4A4B and MS4A6B, as baits in a yeast split-ubiquitin Treg library screen, we demonstrate their interaction with each other and with GITR, Orai1, and other surface receptors. Interaction of 4B with GITR augments GITR signaling and T cell IL-2 production in response to triggering with GITR ligand or anti-GITR Abs. This interaction provides a mechanism whereby MS4A family members, through lateral coassociation with costimulatory molecules, may amplify Ag signals. We propose that T cells preoccupied with immune defense use this MS4A family to enhance sensitivity to extrinsic Ag stimulation, ensuring its elimination, while Tregs use these adaptors to allow low level Ag signals to sustain regulatory function.
Aldose Reductase Inhibition Suppresses the Expression of Th2 Cytokines and Airway Inflammation in Ovalbumin-Induced Asthma in Mice
Authors: Yadav Umesh C. S. , Naura Amarjit S. , Aguilera-Aguirre Leopoldo , Ramana Kota V. , Boldogh Istvan , Sur Sanjiv , Boulares Hamid A. , Srivastava Satish K.
Published: September 2009

Airway inflammation induced by reactive oxygen species-mediated activation of redox-sensitive transcription factors is the hallmark of asthma, a prevalent chronic respiratory disease. In various cellular and animal models, we have recently demonstrated that, in response to multiple stimuli, aldose reductase (AR) regulates the inflammatory signals mediated by NF-κB. Because NF-κB-mediated inflammation is a major characteristic of asthma pathogenesis, we have investigated the effect of AR inhibition on NF-κB and various inflammatory markers in cellular and animal models of asthma using primary human small airway epithelial cells and OVA-sensitized/challenged C57BL/6 mice, respectively. We observed that pharmacological inhibition or genetic ablation of AR by small interfering RNA prevented TNF-α- as well as LPS-induced apoptosis; reactive oxygen species generation; synthesis of inflammatory markers IL-6, IL-8, and PGE2; and activation of NF-κB and AP-1 in small airway epithelial cells. In OVA-challenged mice, we observed that administration of an AR inhibitor markedly reduced airway hyperresponsiveness, IgE levels, eisonophils infiltration, and release of Th2 type cytokines in the airway. Our results indicate that AR inhibitors may offer a novel therapeutic approach to treat inflammatory airway diseases such as asthma.
CRTAM Confers Late-Stage Activation of CD8+ T Cells to Regulate Retention within Lymph Node
Authors: Takeuchi Arata , Itoh Yasushi , Takumi Akiko , Ishihara Chitose , Arase Noriko , Yokosuka Tadashi , Koseki Haruhiko , Yamasaki Sho , Takai Yoshimi , Miyoshi Jun , Ogasawara Kazumasa , Saito Takashi
Published: September 2009

In vivo immune response is triggered in the lymph node, where lymphocytes for entry into, retention at, and migration to effector sites are dynamically regulated. The molecular mechanism underlying retention regulation is the key to elucidating in vivo regulation of immune response. In this study, we describe the function of the adhesion molecule class I-restricted T cell-associated molecule (CRTAM) in regulating CD8+ T cell retention within the lymph node and eventually effector function. We previously identified CRTAM as a receptor predominantly expressed on activated CD8+ T cells, and nectin-like molecule-2 (Necl2) as its ligand. In vivo function of CRTAM-Necl2 interaction was analyzed by generating CRTAM−/− mice. CRTAM−/− mice exhibited reduced protective immunity against viral infection and impaired autoimmune diabetes induction in vivo. Although Ag-specific CRTAM−/− CD8+ T cells showed normal CTL functions in vitro, their number in the draining lymph node was reduced. Because CRTAM+ T cells bound efficiently to Necl2-expressing CD8+ dendritic cells (DCs) that reside in T cell area of lymph node, CRTAM may induce retention by binding to CD8+ DCs at the late stage of activation before proliferation. The CRTAM-mediated late interaction with DCs induced retention of activated CD8+ T cells in an Ag-independent fashion, and this possibly resulted in effective CTL development in the draining lymph node.
Furin-Processed Antigens Targeted to the Secretory Route Elicit Functional TAP1−/−CD8+ T Lymphocytes In Vivo
Authors: Medina Francisco , Ramos Manuel , Iborra Salvador , de León Patricia , Rodríguez-Castro Marta , Del Val Margarita
Published: September 2009

Most pathogen-derived peptides recognized by CD8+ CTL are produced by proteasomes and delivered to the endoplasmic reticulum by the TAP transporters associated with Ag processing. Alternative proteases also produce antigenic peptides, but their actual relevance is unclear. There is a need to quantify the contribution of these supplementary pathways in vitro and in vivo. A well-defined TAP-independent secretory route of Ag processing involves the trans-Golgi network protease furin. Quantitation of this route by using OVA constructs encoded by vaccinia viruses indicates that it provides approximately one-third of all surface complexes of peptide and MHC class I molecules. Generation of the epitope carboxyl terminus is a dramatic rate-limiting step, since bypassing it increased efficiency by at least 1000-fold. Notably, the secretory construct activated a similar percentage of Ag-specific CD8+ T cells in wild type as in TAP1-deficient mice, which allow only secretory routes but which have a 10- to 20-fold smaller CD8 compartment. Moreover, these TAP1−/− OVA-specific CD8+ T lymphocytes accomplished elimination of epitope-bearing cells in vivo. The results obtained with this experimental system underscore the potential of secretory pathways of MHC class I Ag presentation to elicit functional CD8+ T lymphocytes in vivo and support the hypothesis that noncytosolic processing mechanisms may compensate in vivo for the lack of proteasome participation in Ag processing in persons genetically deficient in TAP and thus contribute to pathogen control.
Genomic and Functional Uniqueness of the TNF Receptor-Associated Factor Gene Family in Amphioxus, the Basal Chordate
Authors: Yuan Shaochun , Liu Tong , Huang Shengfeng , Wu Tao , Huang Ling , Liu Huiling , Tao Xin , Yang Manyi , Wu Kui , Yu Yanhong , Dong Meiling , Xu Anlong
Published: September 2009

The TNF-associated factor (TRAF) family, the crucial adaptor group in innate immune signaling, increased to 24 in amphioxus, the oldest lineage of the Chordata. To address how these expanded molecules evolved to adapt to the changing TRAF mediated signaling pathways, here we conducted genomic and functional comparisons of four distinct amphioxus TRAF groups with their human counterparts. We showed that lineage-specific duplication and rearrangement were responsible for the expansion of amphioxus TRAF1/2 and 3 lineages, whereas TRAF4 and 6 maintained a relatively stable genome and protein structure. Amphioxus TRAF1/2 and 3 molecules displayed various expression patterns in response to microbial infection, and some of them can attenuate the NF-κB activation mediated by human TRAF2 and 6. Amphioxus TRAF4 presented two unique functions: activation of the NF-κB pathway and involvement in somite formation. Although amphioxus TRAF6 was conserved in activating NF-κB pathway for antibacterial defense, the mechanism was not the same as that observed in humans. In summary, our findings reveal the evolutionary uniqueness of the TRAF family in this basal chordate, and suggest that genomic duplication and functional divergence of the TRAF family are important for the current form of the TRAF-mediated signaling pathways in humans.