bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Plate Osteosynthesis for Metastatic Pathologic Humeral Fractures
Authors: Choo Suk Kyu , Woo Sung Jong , Oh Hyoung Keun 
Published: January 2012

Because patients with metastatic bone disease may survive only 3 to 12 months, the goal of surgery for pathologic fractures is to attain rigid and durable internal fixation and immediate postoperative use of the upper extremity. Surgical options such as intramedullary nailing, plating, and insertion of prosthesis usually reinforced with bone cement have been proposed for pathological humeral fractures. We describe a 42-year-old man with a pathologic distal humeral fracture. The fracture location and lack of distal bone stock precluded the use of intramedullary nails. We performed minimally invasive plating by using a locking plate for bridging and stabilization of fracture.
Minimally invasive plate osteosynthesis of the humeral shaft was developed to allow anterior plate and screw stabilization involving less soft tissue disruption and to theoretically improve healing rates and reduce complications, such as infection and iatrogenic radial nerve palsy. Plain radiographs showed stable consolidation of the fracture without screw loosening at the 7-month follow-up. Elbow range of motion was 120°, and the arm was stable without pain. Minimally invasive plate using a locking plate can provide stable fixation and allow early arm mobilization without protection and decrease the risk of operation-related complications, making it a useful surgical alternative in the treatment of pathologic humeral fractures.
Pseudoseptic Arthritis of the Shoulder Following Pneumococcal Vaccination
Authors: Floyd Mark W. , Boyce Brandon M. , Castellan Robert M. , McDonough E. Barry 
Published: January 2012

Pseudoseptic arthritis is primarily described in rheumatoid arthritis and other systemic inflammatory conditions. To our knowledge, only 1 case report of pseudoseptic arthritis associated with intra-articular injection of a pneumococcal polyvalent vaccine (PPV) has been published. Here, a second case is presented in which a patient presented with swelling, pain, and erythema of the affected shoulder.
A 59-year-old woman presented to the emergency department with a 3-day history of severe pain and decreased mobility of her left shoulder after receiving a PPV vaccination. Her clinical and laboratory workup was suspicious for septic arthritis; however, magnetic resonance imaging of the affected shoulder with and without contrast showed only a partial thickness tear of the rotator cuff, fluid in the subacromial/subdeltoid bursa, and subcutaneous edema without evidence of an abscess. Based on the clinical and laboratory data, she underwent arthroscopic debridement. There was inflammatory tissue throughout the shoulder but no obvious purulent material. She did well postoperatively with a supervised range of motion rehabilitation protocol. Her cultures remained negative. At 12 weeks, she was discharged from follow-up. We suspect that the vaccination was inadvertently injected into the glenohumeral joint directly through the rotator cuff given the lack of a full-thickness tear and the patient’s thin body habitus, which could explain her aseptic inflammatory arthritis.
Intraosseous Tophus Deposits in the Os Trigonum
Authors: Ercin Ersin , Gamsizkan Mehmet , Avsar Serdar 
Published: January 2012

High levels of uric acid cause accumulation of monosodium urate crystals. This formation of masses is called tophus. Intraosseous tophus deposits are rare, even for patients with gout. We report an unusual case of intraosseous tophus deposits in the os trigonum. The patient presented with ankle pain with no previous history of gout. On examination, tenderness on the posterior aspect of his ankle and limitation of plantarflexion was noted. Laboratory values were normal, except for an elevated serum uric acid value. Radiographs of the right ankle showed the presence of a large os trigonum with osteosclerotic changes, whereas magnetic resonance imaging showed intraosseous tophus deposits in the os trigonum. Conservative therapy failed, and the patient was admitted for an endoscopic resection of the os trigonum.
Intraosseous chalky crystals were detected during endoscopic resection of the os trigonum. The histological diagnosis was tophaceous gout. The underlying pathological mechanism of intraosseous tophi is uncertain. Penetration of urate crystals from the joint due to hyperuricemia may be the mechanism of deposition in this patient.
When a patient with hyperuricemia presents with posterior ankle impingement symptoms, intraosseous tophus deposits should be included in the differential diagnosis. Posterior endoscopic excision may be an option for treating intraosseous lesions of the os trigonum because of good visualization, satisfactory excision, and rapid recovery time.
Fracture of the Alumina-bearing Couple Delta Ceramic Liner
Authors: Taheriazam Afshin , Mohajer Mohammad Azizbaig , Aboulghasemian Mansoour , Hajipour Babak 
Published: January 2012

The fracture rate of third-generation ceramic liners is greatly reduced compared with first- and second-generation liners because of improvements in the design and manufacturing process. Fractures of the alumina-bearing couple are rare for the same reason.
This article describes a case of a fracture of an alumina-bearing couple delta ceramic liner without trauma history that was treated with ceramic-on-polyethylene revision total hip arthroplasty. A 57-year-old man was admitted to the hip ward because of an alumina-bearing couple delta ceramic liner fracture. He underwent hip replacement by anterior approach 18 months previously in the same center because of left hip primary osteoarthritis. He received a 54×36-mm modular press-fit cup ceramic alumina-bearing couple delta insert. Probable causes of such fractures are manufacture production failure and edge loading based on cup inclination, but in our patient, inacceptable range of motion, failure of the locking mechanism during implantation insertion, or cracking were possible causes of fracture.
Although the fracture rate of third-generation alumina-bearing couples is low, we believe that it may not be possible to eliminate the actual risk of alumina head fracture. Patients should be informed about the potential for this complication before receiving an alumina-bearing couple.
Effect of Basic Fibroblast Growth Factor on Corneal Epithelial Healing After Photorefractive Keratectomy
Authors: Meduri Alessandro , Aragona Pasquale , Grenga Pier L. , Roszkowska Anna M. 
Published: January 2012

PURPOSE:
To evaluate the effect of basic fibroblast growth factor (bFGF) eye drops on corneal epithelial healing after photorefractive keratectomy (PRK).

METHODS:
One hundred patients treated with PRK for myopia were enrolled in this prospective, randomized study. Fifty patients were treated postoperatively with standard topical therapy and bFGF eye drops and 50 patients, used as controls, received standard postoperative therapy plus placebo (saline drops). Postoperatively, patients were examined daily until the epithelium healed. The velocity of resurfacing was recorded. Corneal clarity, visual acuity, and refraction were evaluated during the 3-month postoperative period.

RESULTS:

Complete epithelial healing was observed starting at postoperative day 3 in 46% of eyes in the bFGF group and 14% of eyes in the control group. At day 4, 98% and 72% of eyes in the bFGF and control groups, respectively, had healed. Five days after PRK, 100% of eyes treated with bFGF and 92% of control eyes achieved complete epithelial healing. In the control group, 98% of eyes healed at day 6 and all eyes completed healing at day 7. The difference in healing time was statistically significant (
P
<.001). No statistically significant differences were noted for haze prevalence, uncorrected distance visual acuity, and spherical equivalent refraction after treatment between groups (
P
>.05). No side or toxic effects were reported during the study.

CONCLUSIONS:
Basic fibroblast growth factor accelerates epithelial healing after PRK and could be used as additional treatment in circumstances of delayed healing.
Improved Keratoconus Detection by Ocular Response Analyzer Testing After Consideration of Corneal Thickness as a Confounding Factor
Authors: Galletti Jeremías Gastón , Pförtner Tomás , Bonthoux Fernando Fuentes 
Published: January 2012

PURPOSE:
To compare corneal hysteresis (CH) and corneal resistance factor (CRF) between normal eyes and eyes with keratoconus correcting for the effect of central corneal thickness (CCT) and to estimate keratoconus detection sensitivity and specificity of these parameters.

METHODS:
Observational case series of 102 normal eyes (control group) and 77 eyes with keratoconus (keratoconus group). Examination included corneal topography, tomography, and biomechanical testing with the Ocular Response Analyzer (Reichert Technologies). The confounding effect of CCT was controlled by stratification (20-μm CCT intervals) and linear transformation. Receiver operating characteristic curves were used to identify optimal CH and CRF cutoff points for keratoconus detection. Main outcome measures were CCT, CH, CRF, and diagnostic performance of CH and CRF.

RESULTS:

Corneal hysteresis and CRF were positively correlated to CCT in both groups. In the control versus keratoconus group, CH was 9.79±1.51 vs 8.49±1.48 (
P
<.0001) and CRF was 9.55±1.64 vs 7.24±1.43 (
P
<.0001), respectively. Only CRF remained significantly lower in eyes with keratoconus after CCT stratification in 20-μm intervals, and keratoconus grade influenced CH and CRF. Transformed CH and CRF data confirmed these results. Sensitivity and specificity of CRF cutoff points ranged between 83% and 94% and 69% and 83%, respectively. True positive rate for CRF in eyes with keratoconus with normal topography was 84%.

CONCLUSIONS:
Corneal resistance factor was better than CH for detecting keratoconic corneas once the effect of CCT on ORA measurements was considered, even for topographically unaffected fellow eyes of patients with keratoconus. The CCT-corrected CRF cutoff values and transformed indices may be of clinical use.
A High-Resolution 3D Ultrasonic System for Rapid Evaluation of the Anterior and Posterior Segment
Authors: Peyman Gholam A. , Ingram Charles P. , Montilla Leonardo G. , Witte Russell S. 
Published: January 2012

BACKGROUND AND OBJECTIVE:Traditional ultrasound imaging systems for ophthalmology employ slow, mechanical scanning of a single-element ultrasound transducer. The goal was to demonstrate rapid examination of the anterior and posterior segment with a three-dimensional (3D) commercial ultrasound system incorporating high-resolution linear probe arrays.MATERIALS AND METHODS:The 3D images of the porcine eye were generated in approximately 10 seconds by scanning one of two commercial linear arrays (25- and 50-MHz). Healthy enucleated pig eyes were compared with those with induced injury or placement of a foreign material (eg, metal). Rapid, volumetric imaging was also demonstrated in one human eye in vivo.RESULTS:The 50-MHz probe provided exquisite volumetric images of the anterior segment at a depth up to 15 mm and axial resolution of 30 μm. The 25-MHz probe provided a larger field of view (lateral X depth: 20 × 30 mm), sufficient for capturing the entire anterior and posterior segments of the pig eye, at a resolution of 60 μm. A 50-MHz scan through the human eyelid illustrated detailed structures of the Meibomian glands, cilia, cornea, and anterior segment back to the posterior capsule.CONCLUSION:The 3D system with its high-frequency ultrasound arrays, fast data acquisition, and volume rendering capability shows promise for investigating anterior and posterior structures of the eye.
Molecular Methods to Measure Intestinal Bacteria: A Review
Authors: Agriculture G Douglas Inglis , Thomas Matthew C , Thomas Dallas K , Kalmokoff Martin L , Brooks Stephen P J , Selinger L Brent 
Published: January 2012

Abstract
The intestine is an exceptionally rich ecosystem encompassing a complex interaction among microorganisms, influenced by host factors, ingested food, and liquid. Characterizing the intestinal microbiota is currently an active area of research. Various molecular-based methods are available to characterize the intestinal microbiota, but all methods possess relative strengths, as well as salient weaknesses. It is important that researchers are cognizant of the limitations of these methods, and that they take the appropriate steps to mitigate weaknesses. Here, we discuss methodologies used to monitor intestinal bacteria including: (i) traditional clone libraries; (ii) direct sequencing using next-generation parallel sequencing technology; (iii) denaturing gradient gel electrophoresis and temperature gradient gel electrophoresis; (iv) terminal restriction fragment length polymorphism analysis; (v) fluorescent in situ hybridization; and (vi) quantitative PCR. In addition, we also discuss experimental design, sample collection and storage, DNA extraction, gene targets, PCR bias, and methods to reduce PCR bias.
Bacteria, Colonic Fermentation, and Gastrointestinal Health
Authors: Macfarlane George T , Macfarlane Sandra 
Published: January 2012

Abstract
The colonic microbiota plays an important role in human digestive physiology and makes a significant contribution to homeostasis in the large bowel. The microbiome probably comprises thousands of different bacterial species. The principal metabolic activities of colonic microorganisms are associated with carbohydrate and protein digestion. Nutrients of dietary and host origin support the growth of intestinal organisms. Short-chain fatty acids (SCFAs), predominantly acetate, propionate, and butyrate, are the principal metabolites generated during the catabolism of carbohydrates and proteins. In contrast, protein digestion yields a greater diversity of end products, including SCFAs, amines, phenols, indoles, thiols, CO2, H2, and H2S, many of which have toxic properties. The majority of SCFAs are absorbed from the gut and metabolized in various body tissues, making a relatively small but significant contribution to the body's daily energy requirements. Carbohydrate fermentation is, for the most part, a beneficial process in the large gut, because the growth of saccharolytic bacteria stimulates their requirements for toxic products associated with putrefaction, for incorporation into cellular proteins, thereby protecting the host. However, as digestive materials move along the gut, carbohydrates become depleted, which may be linked to the increased prevalence of colonic disease in the distal bowel.
Probiotic and Prebiotic Applications for Vaginal Health
Authors: Reid Gregor 
Published: January 2012

Abstract
Infections of the urogenital tract in women are extremely common, and there is no evidence of a reduction in incidence. Treatment and preventive strategies have been relatively unchanged for 50 years. The concept of using probiotic lactobacilli or prebiotics that stimulate the growth of protective organisms emerged in the mid-1980s and has led to several strains being tested successfully in women. With the advent of genomic profiling of the healthy vaginal microbiota, an improved understanding of metabolic systems within lactobacilli, and the ability to deliver products in food and supplement forms, the future should see new ways for women to restore and maintain their vaginal health, without the side effects of pharmaceutical agents. Indeed, studies indicate that probiotics can be taken in conjunction with the antibiotics and antifungal agents used to eradicate infections. In the future, probiotics and prebiotics will represent an important adjunct to pharmaceutical and other approaches used to care for feminine health.
Predictors of Response to Targeted Therapy in Renal Cell Carcinoma
Authors: Eisengart Laurie J. , MacVicar Gary R. , Yang Ximing J. 
Published: January 2012

Context.—The prognosis for patients with metastatic renal cell carcinoma is poor, with an average 5-year survival of approximately 10%. Use of traditional cytokine therapy, specifically high-dose interleukin 2, is limited by significant toxicity. Better understanding of the molecular pathogenesis of renal cell carcinoma has led to the development of targeted therapies to inhibit specific cellular pathways leading to tumorigenesis. These drugs provide improved survival with a more favorable toxicity profile. There is ongoing investigation of markers that predict response of an individual patient to different targeted therapies.Objective.—To explain the molecular basis for vascular endothelial growth factor inhibitor (antiangiogenic) and mammalian target of rapamycin inhibitor therapies for renal cell carcinoma, summarize the clinical trials demonstrating the effectiveness of these drugs, and describe the biomarkers shown to correlate with outcome in patients treated with targeted therapy.Data Sources.—All included sources are from peer-reviewed journals in PubMed (US National Library of Medicine).Conclusion.—Emerging evidence shows promise that biomarkers will be useful for predicting an individual patient's response to targeted therapy, leading to a more personalized approach to treating renal cell carcinoma.
Battle in the Amazon: Arapaima versus Piranha
Authors: Meyers M. A. , Lin Y. S. , Olevsky E. A. , Chen P.‐Y. 
Published: January 2012

AbstractThe scales of theArapaimas, a large freshwater fish (up to 200 kg), are a superb example of a natural material that has evolved to provide protection against predators. TheArapaimaslives primarily in Amazon basin lakes that become infested with piranhas as the dry season advances and is covered with scales having up to 10 cm length. They have a collagen interior with a highly mineralized external layer. The collagen fibers form a cross‐lamellar arrangement which produces a laminate composite. The internal collagenous layer provides the flexibility to the scales, which can undergo significant elastic deformation prior to failure, providing considerable toughness. The mineralized exterior provides the required protection against predation. The flexibility of the biomineral is enabled by two factors: (i) a corrugated configuration in which the tensile strains are minimized; (ii) a graded composition. We propose herein that the structure of the scales, a composite consisting of a mineralized external layer with surface corrugations and an internal flexible collagenous foundation, can serve as inspiration for the design of flexible composites having a hard ceramic surface. The piranha (Serrasalminae) is one of the principal predators in seasonal lakes, in which fish get trapped. Its teeth form triangular arrays creating a guillotine action that is highly effective in slicing through muscle. The bite force is calculated for a piranha with a mass of 1 kg from estimated maximum force values applied by three muscle groups connecting the jaw to the mandible: it is ≈20 N. Mechanical tests on the scales and teeth demonstrate that the cutting and puncturing ability of the piranha teeth cannot penetrate theArapaimasscales.
Design Principle of Conjugated Polyelectrolytes to Make Them Water‐Soluble and Highly Emissive
Authors: Lee Kangwon , Kim Hyong‐Jun , Kim Jinsang 
Published: January 2012

AbstractThe correlation between the molecular design of a conjugated polyelectrolyte (CPE) and its aggregated structure and the emissive properties in water is systematically investigated by means of UV–vis spectrometry, fluorescence spectroscopy, and scanning/transmission electron microscopy. Five different and rationally designed CPEs having carboxylic acid side chains are synthesized. All five conjugated polyelectrolytes are seemingly completely soluble in water in visual observation. However, their quantum yields are dramatically different, changing from 0.45 to 51.4%. Morphological analysis by electron microscopy combined with fluorescence spectrophotometry reveals that the CPEs form self‐assembled aggregates at the nanoscale depending on the nature of their side chains. The feature of the self‐assembled aggregates directly determines the emissive property of the CPEs. The nature and the length of the spacer between the carboxylic acid group and the CPE backbone have a strong influence on the quantum yield of the CPEs. Our study demonstrates that bulky and hydrophilic side chains and spacers are required to achieve complete water‐solubility and high quantum yield of CPEs in water, providing an important molecular design principle to develop functional CPEs.
Beyond the patient: The broader impact of genetic discrimination among individuals at risk of Huntington disease
Authors: Bombard Yvonne , Palin JoAnne , Friedman Jan M. , Veenstra Gerry , Creighton Susan , Bottorff Joan L. , Hayden Michael R. ,   The Canadian Respond‐HD Collaborative Research Group
Published: January 2012

AbstractWe aimed to address gaps in current understanding of the scope and impact of discrimination, by examining a cohort of individuals at‐risk for Huntington disease (HD), to describe the prevalence of concern for oneself and one's family in multiple domains; strategies used to mitigate discrimination; and the extent to which concerns relate to experiences. We conducted a cross‐sectional survey of 293 individuals at‐risk for HD (80% response rate); 167 respondents were genetically tested and 66 were not. Fear of discrimination was widespread (86%), particularly in the insurance, family and social settings. Approximately half of concerned individuals experienced discrimination (40–62%, depending on genetic status). Concern was associated with “keeping quiet” about one's risk of HD or “taking action to avoid” discrimination. Importantly, concern was highly distressing for some respondents (21% for oneself; 32% for relatives). Overall, concerned respondents with high education levels, who discovered their family history at a younger age, and those who were mutation‐positive were more likely to report experiences of discrimination than others who were concerned. Concerns were rarely attributed to genetic test results alone. Concern about genetic discrimination is frequent among individuals at‐risk of HD and spans many settings. It influences behavioral patterns and can result in high levels of self‐rated distress, highlighting the need for practice and policy interventions. © 2012 Wiley Periodicals, Inc.