bluuebunny/crossref_metadata_2025 huggingface dataset:
ADSORPTION OF Cs ON Si(111)-(7 × 7) SURFACES: SITE PREFERENCE AND THE NEAR-METALLIC STATE OF Cs
Authors: PAPAGEORGOPOULOS A. C. , KAMARATOS M.
Published: April 2003

This study involves the adsorption of Cs on Si (111)-(7 × 7) surfaces at room and elevated temperatures, with increasing coverage of Cs to saturation, in ultrahigh vacuum (UHV) conditions. The techniques of low energy electron diffraction (LEED), Auger electron spectroscopy (AES), thermal desorption spectroscopy (TDS) and work function (WF) measurements were utilized. A WF change at the minimum, found to be Δϕ=-3.2 eV at an approximate 0.23 ML Cs coverage, corresponds to half the saturation coverage. We propose that, at that coverage, the adatom dangling bonds of the Si (111)-(7 × 7) substrate are completely filled. At saturation coverage (0.47 ML), Cs forms a single saturation layer in a near-metallic surface state, where the atomic radius of the Cs adatoms is likely to be 2.2× 10-8 cm. The surface exhibits a high degree of disorder with 0.47 ML of adsorbed Cs, and it is likely that the adsorbate remains in cluster-like domains within the center of the disordered 7×7 unit cells, instead of evenly covering the Si surface. Saturation coverage of Cs on Si (111)-(7 × 7) surfaces exhibits a WF value 0.5 eV less than that of pure metallic Cs. Cesium adatoms form a stronger bond to the Si (111)-(7 × 7) surface than to Ni(100), with a calculated energy of 1.64 eV/atom. The induced surface disorder and strong binding energy are evidence of the strong Cs–Si interaction, which most likely prevents the formation of a purely metallic Cs overlayer.
MORPHOLOGY AND GROWTH MECHANISM OF THE $\{11\bar{2}0\}$ FACE OF Yb:YAl3(BO3)4 CRYSTAL
Authors: ZHAO SHANRONG , WANG JIYANG , SUN DALIANG , HU XIAOBO , LI JING , LIU YAOGANG , WEI JINGQIAN
Published: April 2003

Yb:YAl 3( BO 3)4 (YbYAB) is a self-doubling frequency laser crystal. Based on atomic force microscopy (AFM) observations, a series of growth morphologies formed after different growing times on the smooth [Formula: see text] face are reported in this paper. No two-dimensional nuclei or growth steps have been found on this face after growth of several seconds, or even several minutes. This reflects the fact that at the beginning stage, the growth rate of the [Formula: see text] face is much slower than that of the [Formula: see text] cleavage face of YbYAB crystal (reported in our previous work). The reason is the different properties of nonsaturated bonds on the surfaces between a cleavage face and a natural face. After growth of 50 min, checklike morphologies of a special kind develop on the face. These morphologies result from twin structure. The growth steps with small heights (~ 0.6 nm) cannot cross the two twinned crystal regions, but those with large heights (6–8 nm) can cross by changing the directions at the twin boundaries. We have also observed the rough morphology of the [Formula: see text] face obtained by spontaneous nucleation growth at a high rate. The rough morphology is composed of many small [Formula: see text] faces with the same orientation but very different heights. This reflects the fact that the rough face does not grow by accumulating the growth units irregularly.
SCALING PARAMETERS FOR GOLD AND COPPER CLUSTER GROWTH ON AN ALUMINA SINGLE CRYSTAL SURFACE
Authors: WINKLER C. , CAREW A. , RAVAL R. , LEDIEU J. , McGRATH R.
Published: April 2003

The growth of gold and copper nanoparticles on a γ- Al 2 O 3 single crystal surface has been investigated using LEED and STM. The clusters were grown on the sample by exposing the substrate to a metal vapour. The particle size distributions are determined as a function of the metal vapour dosage and, furthermore, the Volmer–Weber growth mechanism and a semi-log scaling law are deduced from these data.
INVESTIGATION OF THE DEGRADATION MECHANISM OF FIELD-EMITTER ARRAYS
Authors: YUAN JING , LI DE-JIE , DU BING-CHU
Published: April 2003

There are three primary explanations for the degradation mechanism of field-emitter arrays (FEA's): oxidation, sputtering damage and ion implantation. Theoretical analysis and calculation are carried out in this paper to investigate the issue deeply. Adsorption and oxidation of FEA's fit best the experimental phenomenon and are the most reasonable causes for it. The process of adsorption and oxidation is described and directions for further experiments are suggested.
O–Cu(001) II: VLEED QUANTIFICATION OF THE FOUR-STAGECu3O2BONDING KINETICS
Authors: SUN CHANG Q.
Published: April 2003

Further to the previous part [Surf. Rev. Lett.8(3/4), 367 (2001)], this part deals with VLEED numerical quantification of the Cu3O2bond-forming kinetics on the Cu(001) surface. Besides the solution-number certainty that has been ensured, the modeling exercises have enabled the full capacity of VLEED to be explored, revealing that the bond geometry and the elastic potential define the shapes of the VLEED fine-structure features while the inelastic potential contributes to the absolute intensity. VLEED, covering the valence band in energy, is found to be able to collect nondestructive information from the top atomic layer, as the inelastic damping dominates in this region. Except for the bond geometry, dislocation of a single atom in the unit cell produces no feature that can match the VLEED spectral change, indicating the essentiality of the parametrization techniques developed. It is the right premise that it has enabled the four-stage O–Cu(001) reaction kinetics, revealed by VLEED, to be quantified as the evolution of the Cu2to the Cu3O2. In addition, it is revealed that annealing provides disturbance rather than driving force strengthening the bond energy. Therefore, formulation in terms of bond making and its consequence on the behavior of atoms and valence electrons, and the corresponding parametrization, are demonstrated to be able to correctly reflect the real process of reaction and the correlation of the parameters as well as their natural link to the observations using LEED, STM and PES, or equivalent approaches.
EXPERIMENTAL DETERMINATION OF IN VIVO PRESSURE DISTRIBUTION IN BIOLOGIC JOINTS
Authors: Herzog W. , Hasler E. M. , Leonard T. R.
Published: April 2003

The purpose of this communication is to present an idea, and its technical implementation, on how to estimate experimentally in vivo joint contact pressure distributions. The idea is illustrated for the cat patellofemoral joint. For this particular joint, the approach requires muscle force and hindlimb movement measurements during unrestrained locomotion, and the quantification of the joint contact pressures in situ for conditions approximating the in vivo conditions as closely as possible. Although the approach is time-consuming and has its limitations, it is, as far as we know, the first purely experimental approach to determine the in vivo joint contact pressures during normal movement. "Purely experimental" refers to the idea that the required movements, muscle forces and contact pressures are all measured rather than estimated theoretically.
THE EFFECT OF CONTROLLED DYNAMIZATION ON REGENERATE BONE HEALING IN CALLOTASIS
Authors: Choi In Ho , Chung Chin Youb , Cho Tae-Joon , Choi Kyu Won , Choi Jae Bong , Hwang Jae-Kwang
Published: April 2003

We investigated whether controlled dynamization enhanced regenerate bone healing in callotasis of the tibia in 12 adult mongrel dogs. An average of 2 cm (≒ 10%) lengthening was obtained. The left hindlimb was allowed dynamization of 1 mm, 2 mm, and 3 mm in magnitude when 1 cm (≒ 5%) of lengthening was achieved, whereas the right hindlimb was not dynamized and served as a control. Bone mineral density (BMD) of the regenerate bone was measured periodically until nine weeks after the end of distraction. After sacrifice, uniaxial compression testing was performed. Relative BMD ratio and mechanical properties of the regenerate bone were significantly higher in the dynamization group than in the nondynamization group; no significant difference was found among dynamization subgroups, however. We conclude that 1 mm to 3 mm of elastic dynamization accelerates regenerate bone healing in callotasis of the canine tibia.
THE RELIABILITY OF A NEW COMPUTERIZED TECHNIQUE FOR MEASURING EPIPHYSEAL PLATE ZONAL HEIGHT
Authors: Glickman Aaron M. , Hudak Pamela , Yang J. P. , Bowen C. Vaughan A.
Published: April 2003

The objective of this study was to assess the reliability of a new computerized technique for measuring epiphyseal plate zonal height. A fully crossed two factor generalizability experiment in which the effect of observers and time on the reliability of measurements of zonal height within different regions (center and periphery) of the epiphyseal plate was examined. Photomicrographs from both the central and peripheral regions of each of the 30 canine distal ulna epiphyseal plate histological sections were considered; within each region, the proliferative and hypertrophic zones were outlined and, after calibration of the computer program, the zonal height was computed. Irrespective of whether the measures were taken from photomicrographs of the central or the peripheral region of the epiphyseal plate, results indicated higher generalizability coefficients for hypertrophic zone measurements than for those of the proliferative zone in seven of the eight intra-observer and inter-observer calculations. In addition, higher generalizability coefficients were achieved for intra-observer than for inter-observer measurement situations. It was concluded that this is a reliable technique if the sample is measured by one observer and the average of three repeated measurements is used for each specimen.
SERIAL MAGNETIC RESONANCE IMAGING OF ANTERIOR CRUCIATE LIGAMENT GRAFTS AFTER RECONSTRUCTION
Authors: Nakayama Yoshihito , Shirai Yasumasa , Narita Tetsuya , Mori Atsushi , Kobayashi Kaoru , Yoshihara Kiyoshi
Published: April 2003

We investigated the serial changes in MR appearance of anterior cruciate ligament (ACL) grafts after reconstruction, and looked for a correlation between MRI and clinical results. Fifty-four patients underwent serial MRI examinations at 5, 11 and 24 months after arthroscopically-assisted ACL reconstruction. The MR appearance of the graft was categorized into three types depending on the signal intensity and continuity of the ligament: low signal type, intermediate type and high signal type. For the low signal type, a homogeneous low signal band with continuity was visualized over the entire course; for the intermediate type, the signal intensity increased and low signal band was visualized only in part of the graft; and for the high signal type, the graft was not identified through the joint cavity due to markedly increased signal. Forty-three of the 54 patients retained normal low signal type during the first two years of reconstruction. They were classified as Group A. Four of the remaining 11 patients showed intermediate type at five months and altered to high signal type after 12 months. The remaining seven patients showed high signal type at five months and persisted with the same MR type until 24 months. These 11 patients with increased signal intensity were classified as Group B. The mean injured-to-uninjured differences of KT-2000 arthrometer measurements were significantly greater in Group B than that in Group A. Moreover, the percentage of cases with a difference of 5 mm or more was significantly higher in Group B (54.5%) than in Group A (9.3%). It is concluded that the majority of the grafts showed no changes in signal intensity during the first two years of reconstruction. The increase in signal intensity observed in some patients may be a reflection of a deterioration in graft integrity following reconstruction.
MORPHOMETRICAL COMPARISON BETWEEN THE RESECTED SURFACES IN OSTEOARTHRITIC KNEES AND POROUS-COATED ANATOMIC KNEE PROSTHESIS
Authors: Huang Chun-Hsiung , Cheng Cheng-Kung , Liau Jiann-Jong , Lee Ye-Ming
Published: April 2003

In total knee replacement, a good match of the prosthesis to bone is very important. Most knees that require total knee replacement are deformed. However, most of the design parameters of knee prosthesis were based on the normal knee. In this series, the dimensions of the resected surfaces in 77 osteoarthritic knees were measured intraoperatively and compared with the corresponding surfaces of the porous-coated anatomic (PCA) (Howmedica, Rutherford, NJ, USA) knee prosthesis. The results showed that the medial femoral condyle was wider than the lateral femoral condyle (p < 0.05) in the resected surfaces. The intercondylar notch of the resected femur was wider than that of the prosthesis (p < 0.05). In the resected tibial plateau, the ratio of the anteroposterior length to the mediolateral width was larger than that of the prosthesis (p < 0.05). The length and width of the resected patella were greater than those of the implant (p < 0.05). According to the difference in morphometrical parameters between the resected surfaces and the knee prosthesis, we suggest that the dimensions of the resected surfaces of the osteoarthritic knee should be important design parameters in total knee prosthesis.
FINITE ELEMENT ANALYSIS OF THE SPACE CREATED BY SPLIT SPINOUS PROCESSES IN DOUBLE-DOOR LAMINOPLASTY TO OPTIMIZE SHAPE OF AN ARTIFICIAL SPACER
Authors: Hirabayashi Shigeru , Kumano Kiyoshi
Published: April 2003

In double-door laminoplasty, several types of artificial spinous process spacers have been used instead of grafted bone from the iliac crest. However, inadequate contact between the spacer and the spinous process has recently been reported. From the observation during operation, we suspect that the main cause of the inadequate contact is the difference in shape between the spacer and the widened space created by the split spinous processes.

The purpose of this study was to investigate the shape of the widened space by means of a finite element analysis in order to confirm our observation objectively and to provide a shape design of a spacer adapting to the space.

Half-sectioned finite element models of the second cervical (C2) vertebra and the C6 vertebra were made from both the computed tomography (CT) of a clinical case and a plastic model of a cervical spine. The finite element model was designed to have almost the same size and shape as those of the genuine vertebra in the clinical case. Since cancellous bone and soft tissues were thought not to meaningfully influence the rigidity of the model, the model was made of only cortical bone with a thickness of 1.5 mm.

The x-axis was defined as the lateral direction of the vertebral body, the y-axis as the anteroposterior direction of the vertebral body and the z-axis as the craniocaudal direction along the posterior margin of the vertebral body. The boundary conditions were fixed at the inner surface of the half-sectioned vertebral body. A force of 100 N was applied to the inner surface of the half-sectioned spinous process (to the cranial side and the caudal side, 50 N each) in the direction of the x-axis. The lateral deviation of each split spinous process was defined as the degree of deviation in the x-axis direction. The degree of lateral deviation of each split spinous process was analyzed in two types of models with and without making a lateral gutter 4 mm wide along the z-axis direction.

The lateral deviation at the cranial side was larger than that at the caudal side in both the C2 and C6 vertebrae. The difference between the lateral deviation at the cranial side and the caudal side of each vertebra was larger in the type of model with the lateral gutter than in the type of model without it.

It was confirmed that the shape of the widened space is trapezoidal in not only the axial but also frontal sections. In conclusion, the optimal shape of a spacer adapting to the widened space in double-door laminoplasty is trapezoidal in not only the axial but also frontal sections.
SYMPTOMATIC PERINEURIAL CYST IN THE SACRUM
Authors: Inui Kentaro , Nakamura Hiroaki , Yamano Yoshiki
Published: April 2003

We describe here the finding of a huge perineurial cyst which eroded the sacral body. On MRI examination, a huge cyst occupied the space within the sacral spinal canal. On myelography, however, the cyst was not filled with contrast medium immediately after dye injection. Since the patient was disabled by pain, we resected the cyst microscopically. Histological examination revealed neurofibrils in the wall of the cyst. Based on these and myelographic findings, perineurial cyst was diagnosed. Surgical indications for this lesion are still controversial since most are asymptomatic. It is our opinion that if sacral cystic lesions are large enough to erode sacral bone nearly to the retroperitoneal space or sacro-iliac joint, they should be surgically resected using operative microscope.
AGE-DEPENDENT EXPRESSION OF TRANSFORMING GROWTH FACTOR β1 (TGF-β1) AND ITS RECEPTORS, AND AGE-RELATED STIMULATORY EFFECT OF TGF-β1 ON PROTEOGLYCAN SYNTHESIS IN RAT INTERVERTEBRAL DISCS
Authors: Okuda Shin'ya , Nakase Takanobu , Yonenobu Kazuo , Ariga Kenta , Meng Wenxiang , Ochi Takahiro , Yoshikawa Hideki
Published: April 2003

Age-related alterations of gene expression of transforming growth factor β1 (TGF-β1) and its receptors ( T β Rs ) in tissues derived from rat intervertebral discs were assessed together with TGF-β1-dependent proteoglycan synthesis by the cultured disc cells. Disc tissues and cells were individually harvested from two sites of the coccygeal vertebrae, namely the nucleus pulposus (NP) and annulus fibrosus (AF), which are major distinct components of the intervertebral discs. Semi-quantitative RT-PCR analysis indicated that the level of gene expression of TGF-β1/TGF-β1 receptor type I (TβR-I) of NP decreased with age. In AF, the level of TGF-β1/ T β Rs gene expression did not apparently differ with age. Consistent with the RT-PCR results, stimulation of proteoglycan synthesis by TGF-β1 in NP cells decreased with age. Proteoglycan synthesis by AF cells was also stimulated by TGF-β1. However, levels of this stimulation by AF cells were identical. The present findings indicate that the genetic expression of TGF-β1/ T β R -I and TGF-β1-dependent proteoglycan synthesis decreased with age in NP cells, and further suggest that a loss of proteoglycan synthesis with age in the intervertebral disc is at least in part due to the transcriptional down regulation of TGF-β1/ T βR-I and decreased synthetic ability of proteoglycans in response to TGF-β1 by NP cells.
EFFECTS OF APROTININ ON PULMONARY FUNCTIONS IN EXPERIMENTAL FAT EMBOLISM: CHANGES IN ARTERIAL BLOOD GAS LEVELS AND SCINTIGRAPHIC FINDINGS
Authors: Yel Mustafa , Dalgiç Hülya , Taştekin Güngör , Arazi Mehmet , Kutlu Abdurrahman
Published: April 2003

Purpose: To assess the effects of aprotinin on the formation and resolution of fat embolism of the lungs. Methods: The changes in arterial blood gas levels and perfusion scintigraphy were studied by forming experimental standardized fat embolism in rabbits with autogenous fat obtained from their femur medullas. Two groups, each consisting of 14 albino rabbits, were used in this study. Group 1, which received intravenous saline solution, was the control group. Group 2, which received aprotinin, was referred to as the aprotinin group. Autogenous femoral medullary content was used for embolization procedures. Arterial blood gas levels were recorded 72 hours before and 1, 24, 72 hours and 10 days following the embolization procedure. Pulmonary perfusion scintigraphies were performed 72 hours before the embolization procedure and on the first and 72nd hours, and the 10th day. Results: Fat embolism was achieved in all rabbits. Seven rabbits in the control group and one rabbit in the aprotinin group died within an hour after the embolization procedure. According to blood gas levels and perfusion scintigraphic findings, the aprotinin group significantly had less pulmonary fat embolism and recovered faster than the control group, especially during the first 24 hours. There was no significant difference in regression of pulmonary dysfunction between the two groups. Conclusion: The correlation between the blood gas levels and scintigraphic findings suggested that the administration of aprotinin for prophylactic purposes had favorable effects on the development of pulmonary gas exchange disturbance and perfusion defect in fat embolism.
ENDOGENOUS BMP-4 AND BMP-7 GENE EXPRESSION IN CD-1 MOUSE DURING CHONDROGENESIS INDUCED BY BOVINE BONE MORPHOGENETIC PROTEIN IMPLANTATION
Authors: Lu Z. H. , Ulmanen M. , Lindholm T. S. , Jalovaara P. , Hietala O.
Published: April 2003

The osteoinductive activity of bone morphogenetic proteins can be demonstrated by implantation into the muscle pouch in the mouse to induce ectopic cartilage and bone. To study endogenous BMP expression after implantation of 2 mg of native bovine BMP, cDNA clones of the chondroinductive factors BMP-4 and BMP-7 were constructed and used as probes. The investigation concentrated on the early phase of regeneration three and seven days after implantation. Expressions of the endogenous BMP-4 and BMP-7 genes during chondrogenesis was observed. Both BMP-4 and BMP-7 genes were significantly expressed as early as seven days after implantation. The results suggest that ectopic implanted bovine BMP can induce chondrogenesis and that BMP-4/7 participated in this process. This observation could be applied clinically to the repair of damaged cartilage.
THE HARTSHILL HORSESHOE: THE TREATMENT OF CHRONIC PAIN PATIENTS WITH DISCOGENIC PAIN IN THE ABSENCE OF NEURAL COMPRESSION A PROSPECTIVE 2½- TO 3-YEAR REVIEW
Authors: Peckett W. , Hardcastle P. , Sheppherd J. , Sridhar C.
Published: April 2003

Interbody fusion is a well-recognized technique to achieve spinal fusion. The advantage of using tricortical blocks as opposed to the dowel technique is that intervertebral disc height can be restored. Both techniques can be performed either by the anterior or posterior approach.

The traditional tricortical block technique has advantages over using dowels as it is a more stable construct and can restore intervertebral disc height. However, autologous bone graft has an unpredictable behavior causing potential problems of disc space collapse, forward displacement of the graft and donor bone graft site morbidity.

The Hartshill horseshoe was developed to overcome these autograft problems. It is an implant that is placed within the periphery of the intervertebral disc space where the vertebral end plate is strongest to resist compression forces. It has holes that allow screw fixation of the implant to bone to provide immediate stability and a central area for bone graft where the vertebral body is most vascular to allow incorporation of such a graft.

Previous reports on the Hartshill horseshoe have used autograft (single tricortical graft). This prospective study reports the clinical and radiological results of 19 patients who underwent this procedure using xenograft 2½ to 3 years postoperative. The radiological results do not show any evidence of loosening of the screws or implant nor evidence of intervertebral disc space subsidence. It was not possible to assess the exact incidence of spinal fusion.
THE EFFECT OF HYDROGEN PEROXIDE, POVIDONE-IODINE AND RUNNING LOADS ON RAT KNEE JOINT CARTILAGES
Authors: Moon Jeong-Lim , Moon Myung-Sang
Published: April 2003

This study was performed to assess the effect of intra-articularly-injected 3.0% povidone-iodine solution and 2% H2O2on the joint cartilage. Ninety 12-week-old Spraque Dawley rats, weighing 250 g on average, were used; ten were used as controls without any treatment, and 80 were equally divided into four groups for the experiment. In group I, 0.05 ml of normal saline was injected twice into the right knee joints at intervals of one week each, and a running load over a treadmill was added until the animals were sacrificed. In group II, 0.05 ml of 2% H2O2was injected twice into the right knees over the same interval. In group III, 0.05 ml of 2% H2O2was injected twice into the right knees over the same weekly interval, and a running load was added until the knees were sacrificed. In group IV, 0.05 ml of 3.0% povidone-iodine was injected twice into the right knees at one week intervals and a running load was also added until their sacrifice. In each experimental group, five rats were sacrificed at two, four, six and eight weeks after the first intra-articular injection, respectively, and the medial femoral condyles of the joints were taken for histological study of the articular cartilage. After saline injection and running load were applied, stage-I cartilage degeneration was observed at eight weeks after the first saline injection. After H2O2injection only, stage-I cartilage degeneration was observed at four and six weeks, and the changes progressed to Wagenhäuser stage-II degeneration at eight weeks. After H2O2injection and running load were applied, there were no histologic changes by two weeks, but stage-II cartilage degeneration was induced as early as six weeks after the first H2O2injection. After povidone-iodine injection and running load were applied, stage-I cartilage degeration was observed at two weeks, and was maintained up to six weeks. Stage-II degeneration was observed at eight weeks. The matriceal proteoglycan contents was relatively high in comparison with the other groups. Safranin-O stain reduction was observed in groups I, II, III and IV before the histological changes were being observed. From the results, it was found that 3.0% povidone-iodine and 2% H2O2with running loads could induce cartilage damage, and that 3.0% povidone-iodine solution induced more damage to the cartilage than 2% H2O2.
IN VITRO ELUTION OF GENTAMICIN FROM LOCALLY IMPLANTABLE BEADS
Authors: Buranapanitkit Boonsin , Ingviya Natnicha , Lim Apiradee , Geater Alan , Prasongsub Tawil , Kalnauwakul Sineenart
Published: April 2003

Locally implantable antibiotic beads have been approved for their efficacy in treating chronic osteomyelitis. This study aimed to compare the in vitro elution characteristics of commercial antibiotic cement (Septopal®) with those of custom-made gentamicin cement and gentamicin-loaded plaster of Paris. Septopal® had a better inhibitive effect than custom-made gentamicin cement and gentamicin-loaded plaster of Paris for both S. aureus and P. aeruginosa at one month. The elution of gentamicin from Septopal® declined gradually over one month in contrast to those of custom-made gentamicin cement and gentamicin-loaded plaster of Paris, which had a burst effect of elution and showed a small amount of gentamicin after one week. There was a significantly higher total amount of gentamicin eluted from Septopal® than from other types of noncommercially prepared beads. The variability of the inhibitive effect of custom-made gentamicin cement was more pronounced than those of Septopal® and gentamicin-loaded plaster of Paris groups. In conclusion, Septopal® has a better elution characteristic than custom-made gentamicin cement and gentamicin-loaded plaster of Paris in the in vitro study.
MULTIPLE SIMULTANEOUS APPROACH IN LOWER EXTREMITY SPASTICITY SURGERY
Authors: Sayli Ugur , Avci Sinan
Published: April 2003

Lower extremity spasticity in CP interferes with daily living activities, such as ambulation and sitting as well as hygiene. Orthopedic surgery may be needed in the prevention and correction of the deformities and malalignments. Seven girls and nine boys with ages ranging from 7 to 17 years who had at least four surgeries at different levels of their lower extremities in a single stage were presented. Minimum follow-up was two years. The mean number of surgeries performed simultaneously was 6 (4 to 11). The mean operation time was 115 minutes (35 to 225 minutes) and the mean blood loss was 200 ml (100 to 600 ml) during surgery. The hospital stay ranged from two to six days. No complication which may be related to multiple simultaneous surgery was observed. Rehabilitation was begun as soon as the pain permitted. In the postoperative period, the diplegics attended sessions of hippotherapy — therapy by horse riding — in addition to formal therapy modalities. At the latest follow-up postoperatively, all the patients had increase in their level of activities. As a conclusion, whenever needed, simultaneous correction of the lower extremity deformities in spastic CP patients decreases costs and simplifies postoperative rehabilitation without increasing surgical risk for the patients.
RELIABILITY OF A MODIFIED GRADING SCHEME FOR MRI ASSESSMENT OF THORACIC INTERVERTEBRAL DISCS
Authors: Tan Celia I. C. , Song Swithin , Edmondston Stephen J. , Singer Kevin P.
Published: April 2003

The study aimed to investigate the variability in interpreting magnetic resonance imaging (MRI) films for thoracic disc degeneration, using a 5-point MRI disc grading scale and a modified 3-point scale. Forty-six T2-weighted sagittal thoracic MRI films, comprising 18 males and 28 females, aged 7 to 73 years, (mean age =41±16.3 years), were randomly selected from 318 archived cases. Nuclear and anular degeneration, end-plate lesions and osteophytes were graded on the first 30 cases using a modified 3-point grading scale. The next 30 cases were evaluated using the 5-point grading scale. Repeat evaluations for both scales were conducted after a three- to six-month interval. The intra-rater kappa coefficient was higher using the 3-point scale (0.71 to 0.87, p < 0.001) compared to the 5-point scale (0.57 to 0.78, p < 0.001) for the end-plate–disc–end-plate components. The lowest intra-rater reliability was for osteophytes and the highest was for the nucleus. The intra-rater reliability was generally higher in the upper thoracic region compared to the mid and lower thoracic regions.
BIOLOGICAL INTERVENTION BASED ON CELL AND GENE THERAPY TO IMPROVE MUSCLE HEALING AFTER LACERATION
Authors: Lee Chang Woo , Fukushima Kazumasa , Usas Arvydas , Xin Lin , Pelinkovic Dalip , Martinek Vladimir , Somogyi George , Robbins Paul D. , Fu Freddie H. , Huard Johnny
Published: April 2003

Muscle laceration is a challenging problem in traumatology and is common in sports injuries, with functional recovery remaining slow and incomplete. Even though muscles retain their ability to regenerate after injury, muscles' healing process after such injuries has been found to be very slow and often leads to incomplete muscle recovery. Growth factors may have a role in enhancing recovery. Our previous study showed that IGF-1, β-FGF and NGF can improve myoblast proliferation and differentiation in vitro. We then investigated whether the delivery of IGF-1 would improve muscle healing after injuries. We observed that muscle regeneration was enhanced in lacerated muscles treated with IGF-1 protein, which consequently led to an improvement in muscle healing. However, the rapid clearance and short biological half-lives of these proteins may have limited the success of this approach. We then investigated the efficiency of gene therapy based on adenovirus to deliver a stable expression of the growth factor IGF-1. Although a slight improvement in the healing process occurred in the muscle injected with adenovirus (AIGF), the combination of myoblast transplantation and gene therapy with the ex vivo approach further improved the healing process. The injection of normal myoblasts into the injured muscle led to the best improvement of muscle healing at two weeks post-injection. Implantation of normal minced muscle into mdx mice was also capable of improving muscle healing at 2–4 weeks post-implantation. These studies will further our understanding of muscle healing post-injury and help in the development of strategies to promote efficient muscle healing and complete functional recovery after common muscle injuries.
EFFECT OF POVIDONE-IODINE ON THE SYNOVIAL MEMBRANE OF THE KNEE JOINT IN RATS
Authors: Moon Jeong-Lim , Sihn Jang-Cheol , Moon Myung-Sang
Published: April 2003

The effect of two different concentrations of povidone-iodine (PVI) solution, an antiseptic, on joint synovium was investigated. In Group I, 0.05 ml of 10% PVI was used, while in Group II, 0.05 ml of 2.5% of PVI was used. PVI solution was injected twice into both knee joints with one week interval. Ten rats were used as control and 70 rats as experimental.

In the two experimental groups four rats were sacrificed after 6, 12, 24 hours and three day and six rats at the end of the week after the second PVI injection. Synovial reaction was assessed histologically in both groups, based on the pathological parameters.

The results suggest that intra-articular injection of 10% and 2.5% PVI induces synovitis with focal ulceration which gradually subsides, and finally, the synovium becomes normal, though various degrees of subsynovial dense fibrosis complication arise.
ENHANCED SKELETAL MUSCLE HEALING AND REGENERATION BY RAT SKELETAL MUSCLE EXTRACT
Authors: Li M. , Lee K. K. H. , Yu Z. R. , Cai D. Q. , Wong L. M. , Rolf C. , Lee K. M. , Chan K. M.
Published: April 2003

One of the most challenging problems in muscular skeletal trauma is the limited capacity of regeneration of the damaged skeletal muscle fibers after injury and the inevitable replacement by fast growing fibrous tissue compromising function. To date, there is no effective therapeutic measure available in clinical practice. In the present study, red skeletal muscle aqueous extract has been prepared from female adult rats. This muscle extract could strikingly trigger the proliferation and differentiation of myoblasts whose progeny subsequently fuse to preexisting partially damaged muscle fibers to repair the damaged muscle fibers or to form new myotubes to replace the completely damaged muscle fibers during the process of muscle healing and regeneration in vivo. The active myogenic components are probably polypeptides since trypsin or heat treatment could abolish their activity in myogenesis.
VASCULATURE OF REGENERATED MENISCI IN RABBIT KNEES
Authors: Moon Myung-Sang , Woo Young-Kyun , Yeom Gong-Sub
Published: April 2003

Study design: A study comparing the vasculature of the normal and regenerated menisci in rabbits' knees. Objectives: To observe the patterns of the new vessel growth in the regenerating meniscus from its developmental stage to its maturity. Summary of background data: There have been no comparative vascular studies in the normal and regenerated menisci in animals in spite of the well-known previous vascular studies in normal and degenerated menisci in human. Methods: At 3, 4, 6, 10 and 16 weeks after unilateral total meniscectomy in both knees of 25 immature rabbits, aged 6–8 weeks, radiopague blue dye was injected through the abdominal aorta of five rabbits for vascular study before sacrifice, and then the five rabbits were sacrificed at each observation time. A modified Spalteholz clearing technique was employed, and the menisci were examined and photographed under dissecting microscope with reflected light and transillumination. Results: New vessel growth was observed in the regenerating menisci at three weeks after meniscectomy. The blood supply was present in the outer 30–50% of the regenerated meniscus at six weeks postmeniscectomy and then it slightly regressed. The regenerated menisci were smaller in size as compared with normal ones. The anterior and posterior horns were more vascular than the rest of the regenerated menisci. Conclusion: The regenerated medial and lateral menisci had almost the same vascular patterns as those seen in the normal menisci.
THE EFFECTS OF GROWTH FACTORS ON PROLIFERATION AND MATRIX SYNTHESIS OF FIBROBLASTS FROM GOAT MEDIAL COLLATERAL LIGAMENT
Authors: Watanabe Nobuyoshi , Celechovsky Chris , Niyibizi Christopher , Wang James H-C. , Takai Shinro , Woo Savio L-Y.
Published: April 2003

Growth factors have been shown to play a critical role in enhancing tissue healing. In this study, we evaluate the effect of growth factors on cell proliferation and matrix synthesis. Fibroblasts were derived from medial collateral ligaments (MCLs) of goats and grown in culture. Basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF-BB), epidermal growth factor (EGF), and transforming growth factor ( TGF -β1) were used for the treatment of cells. It was found that bFGF, PDGF-BB and EGF significantly increased proliferation of the goat MCL fibroblasts. In addition, among these three growth factors, bFGF, at the concentration of 1.0 ng/ml, had the maximal effect on cell proliferation. Furthermore, both TGF -β1and EGF significantly increased collagen and noncollagenous protein syntheses of goat MCL fibroblasts. The results of this study may be used as baseline data for the application of growth factors to enhance MCL healing in a goat model.
INFLUENCE OF ETHYLENE OXIDE STERILIZATION ON NEW BONE FORMATION INDUCED BY BOVINE BONE MORPHOGENETIC PROTEIN
Authors: Pekkarinen Tarmo , Lindholm T. Sam , Marttinen Aulis , Hietala Oili , Jalovaara Pekka
Published: April 2003

Bone morphogenetic proteins (BMPs) have the capacity to induce and accelerate bone regeneration. Before experimental and clinical settings, BMP must be sterilized. Ethylene oxide (EO) gas sterilizations at different temperatures are commonly used but the effects of that on the osteoinductive capacity of BMP have been the subject of controversy. Here, we investigated the effects of three different EO sterilization methods on the osteoinductivity of partially purified native bovine BMP (bBMP). Gelatin capsules containing 3 mg of bBMP were sterilized as follows: (i) manually inside a dessicator with 12% EO spray (20°C, exposure time 2 h); (ii) with an EO gas sterilizer (Steri-Vac 4XL, temperature 29°C, exposure time 4 h 10 min, ethylene oxide concentration 860 mg/l); (iii) with an EO gas sterilizer (Steri-Vac 5XL, temperature 42°C, exposure time 3 h, ethylene oxide concentration 700 mg/l). The sterilization processes were monitored with samples of Bacillus subtilis (3M, Attest 1264). Osteoinductivity of bBMP was verified by bioassay. After 21 days of implantation of bBMP into the muscle pouches of mice, the animals were killed and new bone formation was measured radiographically and histologically. The EO sterilization techniques used did not significantly decrease the osteoinductive activity of BMP. It is concluded that commercial EO gas equipment sterilization is effective for sterilized BMP and does not decrease the osteoinductive capacity of bovine BMP.
INFECTIONS AND RELATED DISORDERS IN SKELETAL MUSCLE, HEART MUSCLE, CONNECTIVE TISSUES, TENDONS AND LIGAMENTS IN ATHLETES
Authors: Friman Göran , Rolf Christer
Published: April 2003

Elite athletics requires maximum effort by the pursuer, exposing the tendons, ligaments and muscles, including the heart muscle, to intense and frequent mechanical and metabolic demands, which may increase the susceptibility to, and severity of, infections in these tissues. Furthermore, intense and frequent exercise with insufficient resting periods can compromise the immune system. Muscles and tendons are more vulnerable to overuse injuries in the recovery period following various infections. Although the etiology and pathogenesis of a substantial proportion of cases of tendinitis and tendinosis are still largely unknown, gram-positive cocci prevail as the most common etiologies in soft tissue infections. The recent identification of binding sites of staphylococci to intercellular tissue matrix components have opened up the possibility of selectively blocking such binding by prior vaccination. New molecular biological methods, enabling the identification of slow-growing bacteria that are difficult to culture, including Bartonella and Rickettsia, have created the possibility of studying the potential role also of such organisms in soft tissue conditions, including myocarditis. Acute myocarditis remains the most frequent form of myocarditis, commonly emerging in the course of an acute respiratory infection. Since myocarditis episodes are frequently subclinical and self-healing, athletes (and others) should generally be recommended rest during infections, especially during the early phase of the infection.
"OSTEOPOROSIS" IN 2000 AD: QUO VADIS?
Authors: Frost Harold M. , Jee Webster S. S.
Published: April 2003

Here, we suggest that new ideas and knowledge about "osteoporosis" reveal necessary new directions for future work. To explain, by 1999, five studies involving a total of 1827 healthy humans from two to over 80 years of age supported this proposal in the Utah paradigm of skeletal physiology: Momentary muscle strength strongly influences and may dominate control of the biologic mechanisms that determine the postnatal strength of load-bearing bones. That italicized proposal differed so much from former views that before 1999, few people thought it deserved testing in humans. The above five studies did finally test it, and they support it.

If true, its implications would affect many things. In part, they include (A), genetic effects on bone strength and "mass", muscle and "osteoporosis"; (B) the pathogenesis, diagnosis, classification, prevention and management of "osteoporosis"; (C) the things osteoporosis-oriented basic, clinical and pharmaceutical research should study; (D) the absorptiometric methods and animal models used to study the disorder; (E) which research projects would receive preferred funding; (F) and the content of future texts, review articles, classroom lectures and many osteoporosis-oriented meetings.

Many might find some of those implications dubious. While we will respect such doubts, this article describes some of those implications so others can exploit them and/or help to resolve any disagreements they may cause. Because they depend on the Utah paradigm of skeletal physiology, some of its pertinent features must be summarized.
NEUROTROPHIC ARTHROPATHY CAUSED BY SPINAL DISORDERS
Authors: Ueyama Kazumasa , Okada Akihiro , Echigoya Naoki , Yokoyama Toru , Harata Seiko
Published: April 2003

Neurotrophic arthropathy, also called Charcot joint, is caused by various diseases. We came across five cases associated with spinal disorders: two presented with syringomyelia with Chiari malformation, one presented with syringomyelia with arachnoiditis secondary to tuberculous meningitis, one presented with ossification of the posterior longitudinal ligament (OPLL) of the lumber spine, and one presented with spinal dysraphism. Neutrophic joints included two knees, two shoulders and one elbow. All spinal disorders were treated surgically but the Charcot joints were treated with arthrodesis in two knee cases and one shoulder case. Solid fusions of arthrodeses were completely achieved using intramedullary nailing to the knee joints and vascularized fibula graft to the shoulder joint. Pathological joints of the shoulder and elbow that did not undergo joint surgery could not be controlled by spinal surgery. Early diagnosis was important for prevention of trauma or sprains to the weight-bearing joints. MRI of the Charcot joint proved useful in confirming the pathological changes in the early destructive stage, and in determining the extent of surgical removal of it for arthrodesis.
THE EFFECT OF GRADUAL PASSIVE STATIC POSTERIOR COMPRESSION WITH HOOKED RODS ON THE SPINE OF GROWING DOGS
Authors: Moon Myung-Sang , Lee Young-Soo
Published: April 2003

Spinal instrumentations have been practiced frequently for surgical stabilization of unstable segment, correction of the various deformities and maintenance of the correction.

We performed this study to assess the effect of passive posterior static compression immobilization with hooked rods on the growth of spines of immature dogs.

The immobilized bony vertebrae grew less than the nonimmobilized vertebrae above and below, and narrowing of the intervertebral disc spaces in the immobilized segments occurred in all dogs. The A–P diameter of the spinal canal in the immobilized segments increased up to 14% in comparison with the mobilized vertebrae above and below. Degenerative changes and narrowing of the facet joints developed gradually.

From postop 16 weeks onwards, degeneration of the growth plate cartilage of compressed vertebrae developed. These areas of degeneration were sharply demarcated from the remaining normal cartilage layer of the growth plate. The direction of horizontally arranged fibers of annulus fibrosus began to distort and all the fibers of the annulus were vertically arranged completely at the end. The endplate cartilage gradually became thinner, and lastly, the profound degeneration occurred.

Through this study, it was found that growth of the vertebral height, particularly in the posterior part, was suppressed by the growth retardation of the growth plate. The lordosis of the immobilized vertebral segments was caused mostly by disc changes and partly by the corporal growth suppression. It was also found that prolonged posterior instrumented immobilization and compression of the spine ultimately resulted in arthrosis, and that the unequal posterior axial compression of immature spine with static compression rod or rods could induce lordoscoliosis.

In summary, this study clearly demonstrated that instrumented posterior static compression of the growing spine by hooked rods suppressed the posterior spinal growth, while there was less growth suppression on the vertebral body anteriorly. In conclusion, this study provided plausible explanation for the development of the crankshaft phenomenon after posterior static-instrumented compressive stabilization of immature animals with hooked rods.
THE UTILITY OF DIAGNOSING LUMBAR ROTATIONAL INSTABILITY FROM TWIST CT SCANS
Authors: Singer K. P. , Svansson G. , Day R. E. , Breidahl W. H. , Horrex A.
Published: April 2003

The twist CT has been advocated as a useful diagnostic tool for determining lumbar segment instability. According to this test, facet joints showing wide separation on lumbar spine rotation are believed to be pathological. However, no reports have presented the reliability of measuring facet joint separation from clinical twist CT films, nor tested for an association between tendency to separate and anatomical joint orientation.

Forty-five patients, referred for mechanical low back pain, were scanned first in neutral, then right and left trunk twisted positions. Images were video-digitized onto computer for quantitative measurement of facet joint morphology. The induced facet joint separation was contrasted with the neutral scan joint approximation and any difference was expressed in millimeters.

The coefficient of variability (c.v.) of defining right and left transverse plane facet joint orien-tation, and of joint separation, from repeated assessment in ten images was acceptable (c.v. = 2% and 3.5%, respectively). The average joint angle increased from L2–3 to L5–S1 and the mean facet joint separation of 2.6 mm was greatest at the L4–5 level. Forty-three percent of all segments showed little additional separation (<0.2 mm ) when in a rotated posture. In the remainder, a slight relationship existed between facet geometry and separation; joints with wider angles were associated with greater separation than those with a more sagittal configuration (r=0.36, p<0.01).

No conclusive trend was recorded in this patient series for facet joints to separate when the subject adopted an end-range rotated posture. A mild association between physiological separation of facet joints and their morphological angle was determined. This trend alone should not afford confidence in attributing such separation as having pathological significance.