bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Fibroblast Survival in Freeze-Dried Irradiated Platelets, Fresh Concentrated Platelets, or Foetal Bovine Serum
Authors: Ruangchainikom Monchai , Waikakul Saranatra , Wongkajornsilp Adisak , Chongkolwatana Viroje 
Published: October 2016

Purpose. To compare the survival of human fibroblasts in freeze-dried irradiated platelets, fresh concentrated platelets, or foetal bovine serum. Methods. 3, 10, 30, and 100 μg protein/ml of freeze-dried irradiated platelets or fresh concentrated platelets, or 5%, 15%, and 50% of foetal bovine serum were each added to the culture medium with human fibroblasts. Controls had no growth factors or serum added. The initial number of fibroblasts was 5000 per well plate. After 72 hours of incubation, the number of living fibroblasts was measured using the MTT (dimethylthiazol diphenyl tetrazolium bromide) assay. Inter- and intra-group differences were compared. Results. After 72 hours of incubation, the number of living fibroblasts was highest in wells with foetal bovine serum, followed by fresh concentrated platelets, freeze-dried irradiated platelets, and controls. Inter-group differences between the controls and each of the other groups were significant. Intra-group differences were significant for all subgroups with fresh concentrated platelets (except 30 vs 100 μg) and foetal bovine serum. Conclusion. Freeze-dried irradiated platelets contain enough growth factor activity for fibroblast survival and may be used to promote wound healing.
Laminar Fractures as a Severity Marker in Burst Fractures of the Thoracolumbar Spine
Authors: Tisot Rodrigo A , Avanzi Osmar 
Published: October 2016

Purpose. To assess the correlation between the presence of lamina fractures, narrowing of the spinal canal, and the severity of injury. Methods. Records of 146 men and 44 women aged 13 to 84 (mean, 39) years diagnosed with burst fractures of the thoracolumbar spine were retrospectively reviewed. The laminar fractures and narrowing of the spinal canal were measured using computed tomography. The severity of injury was determined using the Injury Severity Score (ISS) and the New Injury Severity Score (NISS). The ISS and NISS of patients with and without laminar fractures were compared. The sensitivity and specificity of ISS, NISS, and narrowing of the spinal canal in association with laminar fractures were also compared. Results. 92 (48%) of the patients had laminar fractures. The mean narrowing of the spinal canal was more severe in patients with laminar fractures than those without (47% vs 28%, p<0.001). Patients with laminar fractures had a significantly higher mean ISS (17 vs 12, p<0.001) and NISS (19 vs 13, p<0.001). Narrowing of the spinal canal is more sensitive and specific than the ISS and NISS when correlating laminar fractures. Conclusion. In patients with burst fractures of the thoracolumbar spine, the presence of laminar fractures indicates a more severe injury.
Laminoplasty after Anterior Spinal Fusion for Cervical Spondylotic Myelopathy
Authors: Pang Chun-Hong , Leung Hon-Bong , Yen Chi-Hung 
Published: October 2016

Purpose. To review outcomes of laminoplasty after anterior spinal fusion (ASF) in 8 patients with cervical spondylotic myelopathy (CSM). Methods. Records of 3 men and 5 women aged 49 to 80 (mean, 60) years who underwent laminoplasty after ASF for CSM were reviewed. Before and after ASF and laminoplasty, the causes of CSM, mechanical instability, the Pavlov Torg ratio, the numbers of levels of stenosis, myelomalacia, ASF, and laminoplasty, the modified Japanese Orthopaedic Association (JOA) score, and the Hirabayashi recovery rate were recorded in all the patients. Results. After ASF, the mean modified JOA score improved to 9.6 from 8.3 (p=0.05), with a mean Hirabayashi recovery rate of 12.5% at the 12-month follow-up. However, it deteriorated to 9 after a mean of 25 (range, 3–54) months follow-up. Indications for a secondary laminoplasty included inadequate decompression (n=5), progression of prolapsed discs (n=4), osteophytes (n=3), ossification of the posterior longitudinal ligament (n=1), and hypertrophy of the ligamentum flavum (n=4). The mean interval between ASF and laminoplasty was 30 (range, 14–55) months. The mean number of levels of laminoplasty was 4.5 (range, 4–5). After laminoplasty, all patients had adequate spinal decompression with no cord compromise, neck pain or stiffness, despite the signal change remaining the same. Two patients improved, 2 deteriorated, and 4 remained unchanged with respect to walking status. The mean modified JOA scores improved to 9.7 from 9 (p=0.38); the mean Hirabayashi recovery rate was −1.5%. All patients had persistent myelomalacia, which was not reflected in the improved modified JOA score. Conclusions. Initial surgery (such as ASF) is more effective in relieving cord compromise and myelopathy. Inadequate decompression and progression of disease may necessitate secondary laminoplasty, which conferred additional benefits that 5 of our 8 patients enjoyed despite persistence of myelomalacia.
Outcome of Osteoplastic Laminotomy for Excision of Spinal Cord Tumours
Authors: Matsumoto Yoshihiro , Harimaya Katsumi , Doi Toshio , Maeda Takeshi , Iwamoto Yukihide 
Published: October 2016

Purpose. To evaluate the outcome of osteoplastic laminotomy after excision of primary tumours of the thoracolumbar and lumbar spine. Methods. Records of 10 male and 11 female consecutive patients aged 15 to 57 (mean, 37) years who underwent osteoplastic laminotomy for excision of spinal cord tumours in the thoracolumbar (n=13) and lumbar (n=8) spine were reviewed. After tumour resection, the removed posterior elements were reattached to the superior and inferior processes using anchoring sutures. Pre- and postoperative functional status was retrospectively graded according to the modified McCormick scale. Spinal deformities were classified as sagittal and coronal malalignment, segmental instability, and spondylolisthesis. Results. The mean follow-up duration was 43 (range, 12–108) months. The mean number of laminae excised was 1.3 (range, 1–4). At the final follow-up, the modified McCormick scale score improved in 16 patients, remained unchanged in 4, and deteriorated in one. No patient developed any severe complication, recurrence, spondylolisthesis, or aseptic necrosis of grafted laminae. In 2 patients their spinal deformities became worse: one had segmental instability of 17° at L3–4 secondary to non-union of the L3 lamina; the other (with type-I neurofibromatosis and dystrophic deformity) underwent fusion for severe low back pain and lumbar kyphosis and progressive rotational dislocation, despite union of the grafted L2 lamina. Conclusions. Osteoplastic laminotomy preserves the structures that could be important for spinal stability and may reduce the risk of deformities. Anterior strut grafting and posterior fusion may be necessary in neurofibromatosis patients with dystrophic deformities.
Surgical Outcome of Soft Tissue Sarcomas of the Adductor Compartment
Authors: Rudiger Hannes A , Ngan Samuel YK , Choong Peter FM 
Published: October 2016

Purpose. To review outcomes and complications of 25 consecutive patients with soft tissue sarcomas in the adductor compartment. Methods. Records of 11 men and 14 women aged 20 to 83 (mean, 56) years who underwent resection for soft tissue sarcomas in the adductor compartment were reviewed. Two of the patients had undergone inadequate resection of the tumour elsewhere. No patient had metastases. 20 and 2 patients underwent neo-adjuvant and postoperative radiotherapy, respectively. The interval between radiotherapy and surgery was at least 3 weeks. No neo-adjuvant chemotherapy was given. 24 patients underwent limb salvage surgery and one had external hemipelvectomy. 21 patients had direct wound closure; in 4 a microsurgical free flap was used. Results. The overall survival rate was 81% and 72% at 3 and 5 years, respectively, and remained unchanged until the end of follow-up. Four patients died from pulmonary metastases and one died from liver metastases. One patient had local recurrence, and 7 (26%) developed major complications. Five patients underwent revision surgery. Conclusion. Good survival and local control rates can be achieved in patients with soft tissue sarcomas in the adductor compartment using limb salvage and radiotherapy.
Combined Preoperative Autologous Blood Donation and Intra-Operative Cell Salvage for Hip Surgery
Authors: Kubota Reiko , Nozawa Masahiko , Matsuda Keiji , Maezawa Katsuhiko , Kim Sung-Gon , Maeda Kouichi , Ikegami Takashi , Hayashi Kentarou , Nagayama Masataka , Kaneko Haruka 
Published: October 2016

Purpose. To review records of 161 consecutive hip surgery patients for whom preoperative autologous blood donation (PABD) was used in combination with intra-operative cell salvage (ICS). Methods. 114 women and 14 men aged 41 to 86 (mean, 64) years underwent 135 primary total hip arthroplasties (THAs), whereas 19 women and 7 men aged 16 to 52 (mean, 35) years underwent 26 rotational acetabular osteotomies (RAOs). Two or 3 weeks before the operation, patients deposited one unit (400 ml) of blood weekly, so long as their haemoglobin levels exceeded 110 g/1 (if they had osteoarthritis) or 100 g/1 (if they had rheumatoid arthritis). Patients were given oral ferrous sulphate, lactated Ringer's solution, and recombinant human erythropoietin. 800 and 1200 ml of blood were deposited for patients undergoing THA and RAO, respectively. Intra-operatively, ICS was carried out using a continuous autotransfusion system. The blood from ICS was transfused first, and then the blood from PABD was transfused during the latter half of the operation. Results. By combining PABD and ICS, homologous blood transfusion was avoided in all patients, even in those with unexpected massive bleeding during surgery. In 3 patients, one unit of deposited autologous blood was discarded, because they showed no sign of anaemia. The mean total blood loss was almost 1.5 times higher in RAO than in THA patients (1095 vs 1550 ml). In the THA and RAO patients respectively, the mean amount of ICS was 181 and 210 ml, whereas the mean total blood transfusion volume was 975 and 1394 ml. No complications (including infection) related to autologous blood transfusion were observed during PABD, the surgery or the postoperative period. Conclusion. Homologous blood transfusion was avoided with the use of PABD and ICS. Preoperative donation of 800 and 1200 ml of blood (combined with ICS) seemed optimal, as only 3 units of blood were discarded.
Terrible Triad of the Elbow
Authors: Seijas Roberto , Ares-Rodriguez Oscar , Orellana Adolfo , Albareda Daniel , Collado Diego , Llusa Manel 
Published: October 2016

Purpose. To review epidemiological characteristics and treatment outcomes of the terrible triad of the elbow. Methods. Records of 18 cases of the terrible triad of the elbow occurring in 8 women and 8 men aged 17 to 77 (mean, 45) years were reviewed. The epidemiology and various treatment approaches and functional outcomes were recorded. The mean follow-up period was 13.6 (range, 4–38) months. The injury mechanisms included simple falls (n=12), falls from a low height (n=2), traffic accidents (n=2), and sports accidents (n=2). Radial head fractures and the coronoid apophysis fractures were classified. Results. There were 10 type-III and 8 type-II radial head fractures, 9 type-I and 9 type-II coronoid apophysis fractures, and all humeroulnar dislocations were posterior. The mean duration of immobilisation was 25.5 (range, 17–38) days. After rehabilitation, the mean range of motion of the elbow improved to 130° flexion (24% recovery), 18° extension (35% recovery), 73° supination (142% recovery), and 85° pronation (25% recovery). The greatest gain in range of motion occurred within 3 to 4 months. Complications included heterotopic ossification (n=4), blocked pronation and supination (n=4), transient ulnar nerve injury (n=2), Essex-Lopresti lesion (n=2), unnoticed dislocation (n=3), and rapidly progressive arthrosis (n=1). Conclusion. Although our patients had better recovery of range of motion than those reported in other studies, the terrible triad of the elbow can lead to joint instability, osteoarthritis, arthrosis, and joint stiffness, and may resort to total elbow arthroplasty in some cases.
Early Adolescent Nutritional Rickets
Authors: Agarwal Anil , Gulati Divesh 
Published: October 2016

Purpose. To evaluate early adolescents with nutritional rickets and their responses to treatment. Methods. 203 adolescents (aged 10 to 13 years) presenting with clinical features of lower-limb deformity, carpopedal spasm, joint swelling, a significant limp, or non-traumatic joint pain were screened for nutritional rickets. Multi-specialty examinations were performed. Family size, number of earning members, number and gender of children, preference for vegetarian food, composition of the meals, and the amount of milk consumed in a day were recorded. Radiographs of wrists, knees, ankles, and pelvis, as well as serum calcium, phosphate, and alkaline phosphatase levels were evaluated. The diagnosis of nutritional rickets was made based on a combination of clinical, radiological, and biochemical criteria, and confirmed by the responses to treatment. Children with nutritional rickets were treated by a single large intramuscular dose of vitamin D (600 000 IU) along with oral calcium and supplementary vitamin D as well as advice on diet and sunlight exposure. Results. 40 females and 11 males were diagnosed as having nutritional rickets. 65% presented with bilateral knee pain with aggravation at night, 37% presented with lower-limb deformity, 24% had joint swelling especially at the wrist and ankle, 6% had a significant limp and walked with an antalgic gait secondary to pathological fractures. No patient reported carpo-pedal spasm. All patients had rachitic changes on radiographs in some but not all bones (100% in the ulna, 45% in the radius, 37% in the upper tibia, 37% in the lower fibula and 22% in the lower tibia). Three patients had pathological fractures. 55% had hypocalcaemia, 41% had hypophosphataemia and 100% had raised serum alkaline phosphatase levels. The mean time for biochemical resolution was 12 (range, 3–24) weeks. For radiological resolution it was 5 (range, 2–6) months, with the lower end of ulna being last to resolve. Conclusions. Radiographs of the lower end of ulna and serum alkaline phosphatase levels can be used as a screening and monitoring tool for nutritional rickets in early adolescents. There may be a high prevalence of subclinical vitamin-D deficiency in our adolescent population.
Curve Length, Curve Form, and Location of Lower-End Vertebra as a Means of Identifying the Type of Scoliosis
Authors: Abul-Kasim Kasim , Ohlin Acke 
Published: October 2016

Purpose. To determine if the curve length, curve form, and location of the lower-end vertebra can identify the type of scoliosis. Methods. Standing posteroanterior and lateral radiographs of 78 women and 27 men with scoliosis aged 8 to 32 years were retrospectively analysed. Parameters measured were (1) the curve length (the number of vertebrae in the main curve), (2) the curve form (C-form, inverted C-form, or S-form), (3) the curve apex (the vertebral body at the apex of each curve), (4) the site of the scoliosis (thoracic, thoracolumbar, or lumbar), and (5) the location of the lower-end vertebra. Results. Only 3 (4%) of 77 patients with idiopathic scoliosis had a curve length of >8 vertebrae, compared with 19 (90%) of 21 patients with neuromuscular/neuropathic scoliosis (p<0.001, Fisher's exact test). 14 (18%) of the patients with idiopathic scoliosis had an S-form curve, compared with none in those with neuromuscular/neuropathic or congenital/osteogenic scoliosis (p=0.035, Fisher's exact test). No patient with idiopathic scoliosis had the lower-end vertebra located at L5, compared with 8 (38%) patients with neuromuscular scoliosis (p<0.001, Fisher's exact test). The criteria for neuromuscular/neuropathic scoliosis (a curve length of >8 vertebrae, a C-form or inverted C-form curve, and a lower-end vertebra located at L4 or L5) had 81% specificity, 76% sensitivity, 100% positive and 93% negative predictive values. Conclusion. These criteria may help identify patients with neuromuscular/neuropathic scoliosis for further investigation by magnetic resonance imaging or computed tomography before they undergo corrective surgery.
Impact of Preoperative Function on Early Postoperative Outcome after Total Hip Arthroplasty
Authors: Johansson Henning R , Bergschmidt Philipp , Skripitz Ralf , Finze Susanne , Bader Rainer , Mittelmeier Wolfram 
Published: October 2016

Purpose. To investigate the impact of preoperative functional status on early postoperative outcomes after total hip arthroplasty (THA). Methods. 39 men and 36 women aged 50 to 76 years who underwent cementless THA for osteoarthritis were followed up for at least 2 years. Patients were evaluated pre- and post-operatively (at 6, 12, and 24 months) using the Harris Hip Score (HHS), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Patients were classified into 3 groups based on their preoperative HHS (poor, <45; intermediate, 45–55; good, >55). Differences between and within groups were compared. Results. Patients with a poor preoperative HHS had worse early postoperative outcomes in terms of HHS, SF-36, and WOMAC. Postoperative pain and function correlated with preoperative HHS, but postoperative range of motion and deformity did not. Conclusion. Poor preoperative function may affect recovery unfavourably and lead to prolonged pain. Earlier THA in the course of functional decline may associate with better outcomes.
Initial Symptoms and Delayed Diagnosis of Osteosarcoma around the Knee Joint
Authors: Pan Kok Long , Chan Wai Hoong , Chia Yin Yin 
Published: October 2016

Purpose. To identify initial symptoms of osteosarcoma around the knee joint. Methods. Records of 19 men and 11 women aged 9 to 34 (mean, 17) years with osteosarcoma around the knee joint were reviewed. Each patient was interviewed (for a mean of 1.5 hours), and a detailed history of symptom onset recorded. Results. In all patients, the first symptom was pain, which was more pronounced on weight bearing in 16 (53%) of them and was worse at night in 11 (37%). Swelling was noticed in 28 patients (a mean of 7 weeks after pain onset). 16 (53%) of the patients had a history of minor trauma around the time of symptom onset. 20 (67%) of the patients had a limp, in 9 of whom it was not associated with pain on weight bearing; only 2 (7%) had a pathological fracture. The mean interval from the onset of symptoms (pain) to presentation was 10 (range, 0–49) weeks. The mean interval from presentation to radiography was 3 (range, 0–20) weeks; in 8 patients this interval exceeded 3 weeks despite a noticeable swelling. The mean interval from radiography to referral to our hospital was 2 (range, 0–14) weeks. Together with the 2 weeks for diagnostic workup and biopsy, the mean total delay was 17 (range, 4–55) weeks. Conclusion. Physicians should be aware of the symptoms of osteosarcoma and promptly refer patients to tumour centres, especially adolescents, those who present with pain that may be worse at night and on weight bearing, and those in whom a swelling and/or a limp is evident.
Radiological and Histological Analysis of Synthetic Bone Grafts in Recurring Giant Cell Tumour of Bone: A Retrospective Study
Authors: Hattori Hiroyuki , Matsuoka Hiroaki , Yamamoto Kengo 
Published: October 2016

Purpose. To review the radiology and histology of synthetic bone grafts resected from patients with recurrent giant cell tumour (GCT) of bone. Methods. 22 patients underwent curettage and grafting for GCT of bone using autogenous cancellous bone mixed with apatite-wollastonite-containing glass ceramic (AWGC), hydroxyapatite (HA), or a mixture of HA and tricalcium phosphate (TCP). Patients were followed up every 3 to 6 months. Three men and 3 women aged 20 to 33 (mean, 27) years developed local recurrence. The mean interval from surgery to recurrence was 35 (range, 12–89) months. Specimens containing the recurring GCT of bone and the surrounding synthetic bone and new bone were evaluated. Results. No complication related to the use of the synthetic bone (such as toxicity, fracture or deformity) occurred. The synthetic bone incorporated well into the surrounding host bone, but was not completely absorbed. HA was more bioactive than AWGC in human bone. HA/TCP were more bioresorbable and osteoconductive in human bone than HA or AWGC. In most areas of AWGC grafts, intervening layers of fibrous connective tissue were seen between the granules and the bone. In most areas of HA grafts, the granules were completely surrounded by viable bone, with bone ingrowth into the pores of the granules, as well as venules and fibrous tissue ingrowth in the pores of portions of the grafts. Conclusion. A mixture of synthetic bone and autogenous cancellous bone is safe and useful for grafting after curettage for GCT of bone.
Mortality after Vertebral Fractures in a Japanese Population
Authors: Ikeda Yuzo , Sudo Akihiro , Yamada Tomomi , Uchida Atsumasa 
Published: October 2016

Purpose. To assess the association between vertebral fractures and mortality. Methods. 419 women and 210 men aged 60 to 98 (mean, 73) years participated in an osteoporosis screening exercise. Patient age, gender, comorbidity, lumbar pain, smoking, and alcohol consumption were recorded, as were the number of vertebral fractures and bone mineral density. Vertebral fractures were evaluated using lateral radiographs and quantitative morphometry. Anterior, central, and posterior vertebral heights were measured; vertebral fractures were defined as a decrease of ≥20% in any of these heights. Results. 131 (21%) of the participants had vertebral fractures. At the 10-year follow-up, 121 (19%) of the participants (55 men and 66 women) had died; 43 of them had vertebral fractures and 78 did not. The respective 10-year survival rates for participants with and without vertebral fractures were 69% and 86% (p<0.0001). The survival rate was lower in those with greater number of vertebral fractures (76% for those with one or 2 fractures and 50% for those with ≥3 fractures). Multiple regression analysis showed that advanced age (p<0.0001), male gender (p=0.003), and presence of vertebral fractures (p=0.013) correlated significantly with survival. Conclusion. The presence and number of vertebral fractures were associated with mortality. Prevention of vertebral fractures may be important for improving the prognosis of patients with osteoporosis.