bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lengthening of fourth brachymetatarsia by three different surgical techniques
Authors: Lee W.-C. , Yoo J. H. , Moon J.-S. 
Published: October 2009

We carried out a retrospective study to assess the clinical results of lengthening the fourth metatarsal in brachymetatarsia in 153 feet of 106 patients (100 female, six males) using three different surgical techniques. In one group lengthening was performed by one-stage intercalary bone grafting secured by an intramedullary Kirschner-wire (45 feet, 35 patients). In the second group lengthening was obtained gradually using a mini-external fixator after performing an osteotomy with a saw (59 feet, 39 patients) and in the third group lengthening was achieved in a gradual manner using a mini-external fixator after undertaking an osteotomy using osteotome through pre-drilled holes (49 feet, 32 patients). The mean age of the patients was 26.3 years (13 to 48). Pre-operatively, the fourth ray of the bone-graft group was longer than that of other two groups (p < 0.000). The clinical outcome was compared in the three groups. The mean follow-up was 22 months (7 to 55). At final follow-up, the mean lengthening in the bone-graft group was 13.9 mm (3.5 to 23.0, 27.1%) which was less than that obtained in the saw group with a mean of 17.8 mm (7.0 to 33.0, 29.9%) and in the pre-drilled osteotome group with a mean of 16.8 mm (6.5 to 28.0, 29.4%, p = 0.001). However, the mean time required for retention of the fixation in the bone-graft group was the shortest of the three groups. Patients were dissatisfied with the result for five feet (11.1%) in the bone-graft group, eight (13.6%) in the saw group and none in the pre-drilled osteotomy group (p < 0.000). The saw group included eight feet with failure of bone formation after surgery. Additional operations were performed in 20 feet because of stiffness (n = 7, all groups), failure of bone formation (n = 4, saw group), skin maceration (n = 4, bone-graft group), malunion (n = 4, bone-graft and saw groups) and breakage of the external fixator (n = 1, saw group). We conclude that the gradual lengthening by distraction osteogenesis after osteotomy using an osteotome produces the most reliable results for the treatment of fourth brachymetatarsia.
Potential risk of thermal damage to cervical nerve roots by a high-speed drill
Authors: Hosono N. , Miwa T. , Mukai Y. , Takenaka S. , Makino T. , Fuji T. 
Published: October 2009

Using the transverse processes of fresh porcine lumbar spines as an experimental model we evaluated the heat generated by a rotating burr of a high-speed drill in cutting the bone. The temperature at the drilled site reached 174°C with a diamond burr and 77°C with a steel burr. With water irrigation at a flow rate of 540 ml/hr an effective reduction in the temperature was achieved whereas irrigation with water at 180 ml/hr was much less effective. There was a significant negative correlation between the thickness of the residual bone and the temperature measured at its undersurface adjacent to the drilling site (p < 0.001). Our data suggest that tissues neighbouring the drilled bone, especially nerve roots, can be damaged by the heat generated from the tip of a high-speed drill. Nerve-root palsy, one of the most common complications of cervical spinal surgery, may be caused by thermal damage to nerve roots arising in this manner.
Mid- to long-term results of irradiated allograft in acetabular reconstruction
Authors: Emms N. W. , Buckley S. C. , Stockley I. , Hamer A. J. , Kerry R. M. 
Published: October 2009

Between 1990 and 2000, 123 hips in 110 patients were reconstructed for aseptic loosening using impaction bone grafting with frozen, irradiated, morsellised femoral heads and cemented acetabular components. This series was reported previously at a mean follow-up of five years. We have extended this follow-up and now describe the outcome of 86 hips in 74 patients at a mean of ten years. There have been 19 revisions, comprising nine for infection, seven for aseptic loosening and three for dislocation. In surviving acetabular reconstructions, union of the graft had occurred in 64 of 67 hips (95.5%). Survival analysis for all indications at ten years was 83.3% (95% confidence interval (CI) 68 to 89) and 71.3% (95% CI 58 to 84) at 15 years. Acetabular reconstruction using irradiated allograft and a cemented acetabular component is an effective method of reconstruction, providing results in the medium- to long-term comparable with those of reported series where non-irradiated freshly-frozen bone was used.
An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component
Authors: Corten K. , Vanrykel F. , Bellemans J. , Frederix P. Reynders , Simon J.-P. , Broos P. L. O. 
Published: October 2009

The use of plate-and-cable constructs to treat periprosthetic fractures around a well-fixed femoral component in total hip replacements has been reported to have high rates of failure. Our aim was to evaluate the results of a surgical treatment algorithm to use these lateral constructs reliably in Vancouver type-B1 and type-C fractures. The joint was dislocated and the stability of the femoral component was meticulously evaluated in 45 type-B1 fractures. This led to the identification of nine (20%) unstable components. The fracture was considered to be suitable for single plate-and-cable fixation by a direct reduction technique if the integrity of the medial cortex could be restored. Union was achieved in 29 of 30 fractures (97%) at a mean of 6.4 months (3 to 30) in 29 type-B1 and five type-C fractures. Three patients developed an infection and one construct failed. Using this algorithm plate-and-cable constructs can be used safely, but indirect reduction with minimal soft-tissue damage could lead to shorter times to union and lower rates of complications.
Impact of late surgical intervention on heterotopic ossification of the hip after traumatic neurological injury
Authors: Genet F. , Marmorat J.-L. , Lautridou C. , Schnitzler A. , Mailhan L. , Denormandie P. 
Published: October 2009

Heterotopic ossification (HO) of the hip after injury to the central nervous system can lead to joint ankylosis. Surgery is usually delayed to avoid recurrence, even if the functional status is affected. We report a consecutive series of patients with HO of the hip after injury to the central nervous system who required surgery in a single, specialised tertiary referral unit. As was usual practice, they all underwent CT to determine the location of the HO and to evaluate the density of the femoral head and articular surface. The outcome of surgery was correlated with the pre-, peri- and post-operative findings. In all, 183 hips (143 patients) were included of which 70 were ankylosed. A total of 25 peri-operative fractures of the femoral neck occurred, all of which arose in patients with ankylosed hips and were associated with intra-articular lesions in 18 and severe osteopenia of the femoral head in seven. All the intra-articular lesions were predicted by CT and strongly associated with post-operative complications. The loss of the range of movement before ankylosis is a more important factor than the maturity of the HO in deciding the timing of surgery. Early surgical intervention minimises the development of intra-articular pathology, osteoporosis and the resultant complications without increasing the risk of recurrence of HO.
Two extension block Kirschner wire technique for mallet finger fractures
Authors: Lee Y. H. , Kim J. Y. , Chung M. S. , Baek G. H. , Gong H. S. , Lee S. K. 
Published: October 2009

We treated 32 displaced mallet finger fractures by a two extension block Kirschner-wire technique. The clinical and radiological outcomes were evaluated at a mean follow-up of 49 months (25 to 84). The mean joint surface involvement was 38.4% (33% to 50%) and 18 patients (56%) had accompanying joint subluxation. All 32 fractures united with a mean time to union of 6.2 weeks (5.1 to 8.2). Congruent joint surfaces and anatomical reduction were seen in all cases. The mean flexion of the distal interphalangeal joints was 83.1° (75° to 90°) and the mean extension loss was 0.9° (0° to 7°). No digit had a prominent dorsal bump or a recurrent mallet deformity. We believe that this technique, when properly applied, produces satisfactory results both clinically and radiologically.
Total knee replacement with rotational proximal tibial osteotomy for osteoarthritis with severe external tibial torsion and patellar instability
Authors: Ramaswamy R. , Kosashvili Y. , Cameron H. U. , Cameron J. C. 
Published: October 2009

The management of osteoarthritis of the knee associated with patellar instability secondary to external tibial torsion > 45° is challenging. Patellofemoral biomechanics in these patients cannot be achieved by intra-articular correction using standard techniques of total knee replacement. We reviewed seven patients (eight knees) with recurrent patellar dislocation and one with bilateral irreducible lateral dislocation who had undergone simultaneous total knee replacement and internal tibial derotational osteotomy. All had osteoarthritis and severe external tibial torsion. The mean follow-up was for 47.2 months (24 to 120). The mean objective and functional Knee Society scores improved significantly (p = 0.0001) from 29.7 and 41.5 pre-operatively to 71.4 and 73.5 post-operatively, respectively. In all patients the osteotomies healed and patellar stability was restored. Excessive external tibial torsion should be identified and corrected in patients with osteoarthritis and patellar instability. Simultaneous internal rotation osteotomy of the tibia and total knee replacement is a technically demanding but effective treatment for such patients.
Gas adsorption applications of porous metal–organic frameworks
Authors: Ma Shengqian 
Published: October 2009

Abstract
Porous metal–organic frameworks (MOFs) represent a new type of functional materials and have recently become a hot research field due to their great potential in various applications. In this review, recent progress of gas adsorption applications of porous MOFs, mainly including hydrogen storage, methane storage, and selective gas adsorption will be briefly summarized.
Histological Course of Nonalcoholic Fatty Liver Disease in Japanese Patients
Authors: Hamaguchi Erika , Takamura Toshinari , Sakurai Masaru , Mizukoshi Eishiro , Zen Yoh , Takeshita Yumie , Kurita Seiichiro , Arai Kuniaki , Yamashita Tatsuya , Sasaki Motoko , Nakanuma Yasuni , Kaneko Shuichi 
Published: October 2009

OBJECTIVE
The goal of this study was to examine whether metabolic abnormalities are responsible for the histological changes observed in Japanese patients with nonalcoholic fatty liver disease (NAFLD) who have undergone serial liver biopsies.

RESEARCH DESIGN AND METHODS
In total, 39 patients had undergone consecutive liver biopsies. Changes in their clinical data were analyzed, and biopsy specimens were scored histologically for stage.

RESULTS
The median follow-up time was 2.4 years (range 1.0–8.5). Liver fibrosis had improved in 12 patients (30.7%), progressed in 11 patients (28.2%), and remained unchanged in 16 patients (41%). In a Cox proportional hazard model, decrease in A1C and use of insulin were associated with improvement of liver fibrosis independent of age, sex, and BMI. However, ΔA1C was more strongly associated with the improvement of liver fibrosis than use of insulin after adjustment for each other (χ2; 7.97 vs. 4.58, respectively).

CONCLUSIONS
Tight glycemic control may prevent histological progression in Japanese patients with NAFLD.
Proinflammatory Modulation of the Surface and Cytokine Phenotype of Monocytes in Patients With Acute Charcot Foot
Authors: Uccioli Luigi , Sinistro Anna , Almerighi Cristiana , Ciaprini Chiara , Cavazza Antonella , Giurato Laura , Ruotolo Valeria , Spasaro Francesca , Vainieri Erika , Rocchi Giovanni , Bergamini Alberto 
Published: October 2009

OBJECTIVEDespite increased information on the importance of an inappropriate inflammatory response in the acute Charcot process, there has been no previous attempt to define the specific pathways that mediate its pathogenesis. Here, the role played by monocytes was analyzed.RESEARCH DESIGN AND METHODSThe immune phenotype of peripheral monocytes was studied by fluorescence-activated cell sorter analysis comparing patients with acute Charcot (n = 10) in both the active and recovered phase, diabetic patients with neuropathy (with or without osteomyelitis), and normal control subjects.RESULTSWhen compared with diabetic control subjects and healthy subjects, monocytes from acute Charcot patients showed a proinflammatory immune phenotype characterized by increased production of proinflammatory cytokines, reduced secretion of anti-inflammatory cytokines, increased expression of surface costimulatory molecules, and increased resistance to serum withdrawal-induced apoptosis. In addition, the pattern of circulating cytokines confirmed activation of proinflammatory cytokines. No modulation of the monocyte phenotype was documented in diabetic control subjects and healthy subjects, thus indicating that the proinflammatory alterations of monocytes are specific and causative of acute Charcot.CONCLUSIONSTogether, these data provide evidence for the role of proinflammatory changes in the immune phenotype of monocytes in the pathogenesis of acute Charcot. These alterations may explain the abnormally intense and prolonged inflammatory response that characterizes this disorder and may represent a potential therapeutic target for specific pharmacological interventions.
Hormonal and Metabolic Factors Associated With Variations in Insulin Sensitivity in Human Pregnancy
Authors: McIntyre H. David , Chang Allan M. , Callaway Leonie K. , Cowley David M. , Dyer Alan R. , Radaelli Tatjana , Farrell Kristen A. , Huston-Presley Larraine , Amini Saeid B. , Kirwan John P. , Catalano Patrick M. ,   for the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group
Published: October 2009

OBJECTIVE
The objective of this study was to determine maternal hormonal and metabolic factors associated with insulin sensitivity in human pregnancy.

RESEARCH DESIGN AND METHODS
This was a prospective observational cross-sectional study of 180 normal pregnant women, using samples collected at the time of a blinded oral glucose tolerance test (OGTT) between 24 and 32 weeks' gestation as an ancillary to the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. The study was conducted at two public university teaching hospitals, Cleveland, Ohio, and Brisbane, Australia. Fasting maternal serum cholesterol, triglycerides, free fatty acids, insulin, leptin, tumor necrosis factor-α, placental growth hormone (PGH), insulin-like growth factors (IGFs) 1 and 2, and insulin-like growth factor binding proteins (IGFBPs) 1 and 3 were assayed. Correlation and multiple regression analyses were used to determine factors associated with maternal insulin sensitivity (IS) estimated using both OGTT-derived (ISOGTT) and fasting (using the homeostasis model assessment [HOMA]; ISHOMA) insulin and glucose concentrations.

RESULTS
Insulin sensitivity correlated (r = x and y for ISOGTT and ISHOMA, respectively) with fasting maternal serum leptin (−0.44 and −0.52), IGFBP1 (0.42 and 0.39), and triglycerides (−0.31 and −0.27). These factors were significantly associated with insulin sensitivity in multiple regression analyses (adjusted R2 0.44 for ISOGTT and ISHOMA). These variables explained more than 40% of the variance in estimates of insulin sensitivity.

CONCLUSIONS
Maternal hormonal and metabolic factors related to the placenta, adipose tissue, and the growth hormone axis are associated with the variation in insulin sensitivity seen during normal human pregnancy.
Performance Characteristics of the New Definition of Diabetes
Authors: Lorenzo Carlos , Haffner Steven M. 
Published: October 2009

OBJECTIVE
A1C ≥6.5% has been recently proposed as the defining criterion for diabetes. However, performance characteristics of this definition have not been described.

RESEARCH DESIGN AND METHODS
In the Insulin Resistance Atherosclerosis Study, we compared new to previous definitions of diabetes: 1999 World Health Organization (DM1999WHO) and 2003 American Diabetes Association based on fasting glucose alone (DMFPG126).

RESULTS
Participants with A1C ≥6.5%, DM1999WHO, and DMFPG126 were 44 (5.2%), 132 (15.4%), and 61 (7.1%), respectively. In individuals with DM1999WHO, mean, median, and interquartile range of A1C were 6.3, 5.9, and 5.5–6.6%, respectively; in individuals with DMFPG126, mean, median, and interquartile range of A1C were 7.0, 6.6, and 6.0–7.1%.

CONCLUSIONS
A1C ≥6.5% identifies fewer individuals than DM1999WHO or DMFPG126. Studies are needed to determine that A1C ≥6.5% compromises neither blood pressure and lipid management in early diabetes nor the implementation of lifestyle interventions for diabetes prevention.
Resource Optimization of Mobile Intelligent System with heart MPLS network
Authors: Oubaha Jawad , Habbani Ahmed , Elkoutbi Mohammed 
Published: October 2009

In this paper, we introduce the original Mobile Intelligent System (MIS) in embeded FPGA architecture. This node will allow the construction of autonomous mobile network units which can move in unknowns, inaccessible or hostile environnement for human being, in order to collect data by various sensors and transmits them by routing to a unit of distant process.
In the sake of improving the performance of transmission, we propose a global schema of QoS management using DiffServ/MPLS backbones. We provide an evaluation of several scenarios for combining QoS IP networks with MIS access network. We conclude with a study on interoperability between QoS patterns in access and backbone networks.
Discrete Domains of MARCH1 Mediate Its Localization, Functional Interactions, and Posttranscriptional Control of Expression
Authors: Jabbour Maurice , Campbell Erin M. , Fares Hanna , Lybarger Lonnie 
Published: October 2009

Abstract
Within APCs, ubiquitination regulates the trafficking of immune modulators such as MHC class II and CD86 (B7.2) molecules. MARCH1 (membrane-associated RING-CH), a newly identified ubiquitin E3 ligase expressed in APCs, ubiquitinates MHC class II, thereby reducing its surface expression. Following LPS-induced maturation of dendritic cells, MARCH1 mRNA is down-regulated and MHC class II is redistributed to the cell surface from endosomal compartments. Here, we show that MARCH1 expression is also regulated at the posttranscriptional level. In primary dendritic cell and APC cell lines of murine origin, MARCH1 had a half-life of &lt;30 min. MARCH1 degradation appears to occur partly in lysosomes, since inhibiting lysosomal activity stabilized MARCH1. Similar stabilization was observed when MARCH1-expressing cells were treated with cysteine protease inhibitors. Mutational analyses of MARCH1 defined discrete domains required for destabilization, proper localization, and functional interaction with substrates. Taken together, these data suggest that MARCH1 expression is regulated at a posttranscriptional level by trafficking within the endolysosomal pathway where MARCH1 is proteolyzed. The short half-life of MARCH1 permits very rapid changes in the levels of the protein in response to changes in the mRNA, resulting in efficient induction of Ag presentation once APCs receive maturational signals.
Anxiety levels in mothers of children with specific learning disability
Authors: Karande S , Kumbhare N , Kulkarni M , Shah N 
Published: October 2009

Background:
Parents of children with specific learning disability (SpLD) undergo stress in coping with their child's condition.

Aim:
To measure the levels of anxiety and find out the cause of anxiety in mothers of children with SpLD at time of diagnosis.

Settings and Design:
Prospective rating-scale and interview-based study conducted in our clinic.

Materials and Methods:
One hundred mothers of children (70 boys, 30 girls) with SpLD were interviewed using the Hamilton anxiety rating scale (HAM-A) and a semi-structured questionnaire. Detailed clinical and demographic data of mothers were noted.

Statistical Analysis:
Chi-square test or unpaired student's t-test was applied wherever applicable.

Results:
The mean age of mothers was 40.14 years (±SD 4.94, range 25.07-54.0), 73% belonged to upper or upper middle socioeconomic strata of society, 67% were graduates or postgraduates, 58% were full-time home-makers, and 33% lived in joint families. Levels of anxiety were absent in 24%, mild in 75%, and moderate in 1% of mothers. Their mean total anxiety score was 5.65 (±SD 4.75, range 0-21), mean psychic anxiety score was 3.92 (±SD 3.11, range 0-13), and mean somatic anxiety score was 1.76 (±SD 2.05, range 0-10). Their common worries were related to child's poor school performance (95%), child's future (90%), child's behavior (51%), and visits to our clinic (31%).

Conclusion:
Most mothers of children with SpLD have already developed mild anxiety levels by the time this hidden disability is diagnosed. These anxieties should be addressed by counseling to ensure optimum rehabilitation of these children.
Prevalence of RET/PTC expression in papillary thyroid carcinoma and its correlation with prognostic factors in a north Indian population
Authors: Mishra A , Agrawal V , Krishnani N , Mishra SK 
Published: October 2009

Context:
The prevalence of Rearranged during Transfection/Papillary Thyroid Carcinoma (RET/PTC) rearrangement in papillary thyroid carcinoma (PTC) varies in different geographic regions and its prognostic significance remains unclear.

Aim:
The aim of this study was to recognize the prevalence of RET/PTC expression in PTC from the endemically iodine-deficient region in Northern India and to correlate the expression with the clinicopathologic prognostic factors.

Settings and Design:
Retrospective. Archival tissue used.

Materials and Methods:
Immunohistochemistry was performed to look for activated RET protein expression in 50 cases of PTC. No patient had any history of prior irradiation. Statistical Analysis Used : Chi-square method, Student t test, and binary regression method. A P value of <. 05 was considered significant for all the tests.

Results:
The prevalence of RET expression was 44%. Twenty-six (52%) cases showed RET immunoreactivity in histiocytes. Immunoreactivity was the highest in the classic variant of PTC (47.5%), followed by tumors with poorly differentiated areas (25%) and follicular variant (16.7%). RET expression was more prevalent in young patients (45.5 vs. 35.3%), females (43.3 vs. 40.0%), small tumors (33.3 vs. 26.7%), multicentric tumors (36.8 vs. 33.3%), tumors with extrathyroidal invasion (38.9 vs. 32.4%), and regional lymphadenopathy (55.2 vs. 22.2%), while it was less in cases with distant metastases (20 vs. 43.9%). There was no significant correlation of immunoreactivity with any prognostic factor. However, when the cases having immunoreactivity within histiocytes (n=26) and histiocytes + tumor tissue (n=28) were considered, then the expression was significantly more in cases with lymphadenopathy (P values=.009, in both instances). However, the exact clinical significance of RET/PTC positive histiocytes remained unexplained.

Conclusions:
Prevalence of RET/PTC in our study was consistent with the reported prevalence from other geographic areas. There was no significant correlation with the clinicopathologic factors. However, uniform techniques of detection and large international collaborative studies could clear the uncertainties regarding the prognostic importance of RET/PTC.