bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of a Norvancomycin-Loaded, PDLLA-Coated Plate in Preventing Early Infection of Rabbit Tibia Fracture
Authors: Fei Jun , Yu Hong-Jun , Pan Chang-Jiang , Zhao Chang-Hong , Zhou Yong-Gang , Wang Yan 
Published: May 2010

Despite improvements in surgical techniques and implant designs in orthopedic surgery, implantation-associated infections are still a challenging problem for surgeons. The goal of this study was to evaluate the efficacy of a norvancomycin-loaded, PDLLA-coated stainless steel plate vs an uncoated stainless steel plate in a rabbit model (n=50). The norvancomycin was delivered from a biodegradable poly(D,L-lactide) (PDLLA) coating of a stainless steel plate. Intraoperatively, rabbit tibia fractures were contaminated withStaphylococcus aureus(105 colony forming units) after plate implantation. The implants were either uncoated or coated with PDLLA and norvancomycin. In vivo drug release profiles showed that the norvancomycin release rate was decreased by increasing the time. The norvancomycin concentration in the tissue around the plate was higher than the minimum inhibitory concentration on the 14th day after implantation surgery. The animals were followed up for 28 days. Radiographic examinations were performed, and C-reactive protein and erythrocyte sedimentation rate were determined.Infection was evaluated by histological, microbiological, and radiological analysis. Eight of 25 rabbits (32%) implanted with the norvancomycin-loaded, PDLLA-coated plates were infected. Twenty-three of 25 rabbits (92%) implanted with the uncoated plates were infected (P<.05). The norvancomycin-loaded, PDLLA-coated plate may be used to treat open fractures to reduce the incidence of early infection.
Acetabular Osteochondroplasty and Simultaneous Reorientation: Background and Validation of Concept
Authors: Anderson Lucas A. , Crofoot Carmen D. , Erickson Jill , Morton David A. , Peters Christopher L. 
Published: May 2010

Most hips with femoroacetabular impingement (FAI) have combinations of femoral and acetabular abnormalities, including acetabular deficiency in some cases. Other impinging hips have large acetabular hyaline cartilage lesions that, when treated by resection, lead to acetabular deficiency and the need for a subsequent reorientation to improve coverage. Ideally, large cartilage lesions could be identified preoperatively and treated with 1 procedure. Therefore, a single operative approach that allows for both femoral and acetabular osteochondroplasty where needed, as well as simultaneous acetabular reorientation, is advantageous.
We hypothesized that the addition of traction and dry arthroscopy via the Smith-Petersen approach at the time of periacetabular osteotomy could allow for the diagnosis and treatment of intra-articular labral and hyaline cartilage lesions and simultaneous acetabular reorientation. To validate this concept, we performed the procedure on cadaveric hips and subsequently treated a series of patients successfully (4 hips with limited anterior debridement and dry arthroscopy and 1 hip with a simultaneous periacetabular osteotomy). There were no intra- or postoperative complications in the series of 5 hips.
The addition of traction and dry arthroscopy can permit the diagnosis and treatment of intra-articular lesions in reorienting periacetabular osteotomy. This enables the surgeon to address both acetabular cartilage and labral lesions, as well as idealizing acetabular orientation and coverage in 1 setting with less morbidity.
Biomechanical Verification That PCL Reconstruction Is Unnecessary in the Muscle-Stabilized Knee
Authors: Sohn David H. , Balasubramanian Sriram , Demetropoulos Constantine , Yang King , Guettler Joseph , Jurist Kenneth A. 
Published: May 2010

Treatment of isolated posterior cruciate ligament (PCL) injuries is controversial. This is due in part to the discrepancy between clinical and biomechanical studies in the literature. Clinically, isolated PCL injuries are treated nonoperatively, and patients do well as long as they have adequate quadriceps function. Biomechanically, however, PCL injuries have been shown in cadavers to lead to altered kinematics and increased contact pressures. These studies, however, did not simulate weight-bearing muscle forces, which can compensate for the PCL deficiency.
We sought to study the biomechanical effects of PCL deficiency and reconstruction in a cadaveric knee, but with reproduction of the muscle-stabilizing effects of the quadriceps and hamstring muscles. We used a novel 6 degrees of freedom testing system to simulate a muscle-stabilized cadaveric knee and recorded both kinematics and contact pressure data. Four conditions were tested: normal, PCL-deficient, and PCL single- and double-bundle reconstructed states.
We found that with muscle stabilization, there were no significant changes in kinematics or contact pressures in the knee between any of these conditions. This corroborates clinical findings and verifies that PCL reconstruction is unnecessary in the muscle-stabilized knee.
Surgery Is Not Always Necessary in Intraosseous Lipoma
Authors: Bagatur A. Erdem , Yalcinkaya Merter , Dogan Ahmet , Gur Semih , Mumcuoglu Erhan , Albayrak Mehmet 
Published: May 2010

Intraosseous lipoma is the rarest primary bone tumor, is usually asymptomatic, and is often discovered incidentally during unrelated investigations. Lipomas usually undergo varying degrees of involution, with necrosis, cyst formation, and calcification. Careful radiological–pathological correlation is required to avoid misinterpretation.
This study describes 12 intraosseous lipomas in 11 patients (6 men, 5 women; mean age, 36 years [range, 25–50 years]; mean follow-up, 5 years [range, 2–11 years]). The lesions were located in the calcaneus in 7 patients (bilaterally in 1 patient), the tibia in 2, the femur in 1, and the ilium in 1. All lesions were asymptomatic and discovered incidentally except in 4 patients (5 lesions). Curettage and bone grafting were performed after biopsy in 4 lesions; and in 1 patient, curettage, bone grafting, and reconstructive surgery were performed after pathologic fracture. The remaining 7 patients were followed up conservatively.
Although definite diagnosis of an intraosseous lesion is possible only by histopathologic examination, computed tomography and magnetic resonance imaging findings of intraosseous lipoma are typical, and most patients' symptoms are relieved by conservative means. For this reason, we believe that in patients with no signs of an impending pathologic fracture or suspicion of malignancy, clinical and radiological follow-up is sufficient. However, since intraosseous lipoma is an uncommon bone tumor, physicians should be familiar with the radiological features of this lesion for the correct diagnosis.
Congenital Dislocation of the Knee in a 16-Year-Old Girl
Authors: Kazemi Seyyed Morteza , Abbasian Mohammad Reza , Hosseinzadeh Hamid Reza Seyyed , Zanganeh Ramin Farhang , Eajazi Alireza , Besheli Laleh Daftari 
Published: May 2010

Congenital dislocation of the knee ranges from hyperextension of the knee to translation of the femur on the tibia. Treatment options include bracing, splinting, manipulation and casting, and surgery.
A 16-year-old girl presented with an inability to walk, stand upright, or bend her knees. She exhibited deformity of both lower extremities. She had deformed knees from birth, and they had been put in a cast for 2 months. No other therapeutic measures were taken. The patient walked on her abnormally hyperextended knees and could hyper-extend the knees to 150° recurvatum. She was diagnosed with a grade III congenital dislocation of the knee, and a flexion-shortening osteotomy at the distal femur above the trochlear level was performed on her knees in 2 sessions. Postoperatively, range of motion changed from hyperextention to 80° flexion. A femoral supracondylar osteotomy was also performed 2 years later, and as a result, a 15° flexion and 15° valgus were added to the limb. The patient is now able to stand and walk without a knee brace and has 90° passive and 80° active knee flexion on both sides.
Congenital dislocation of the knee is a rare congenital disorder. The results of treatment are favorable if started before age 3 months, or sometimes before age 2 years, but there is no effective treatment for older, neglected cases; therefore, we believe this case report demonstrates a novel surgical approach.
Visual Demands in Elementary School
Authors: Langford Amy , Hug Timothy 
Published: May 2010

Purpose:
To evaluate the visual demands on elementary school students for both distance and near learning tasks. This information may be useful for prescribing glasses or amblyopia treatments such as occlusion therapy.

Methods:
Classrooms for kindergarten to 5th grade were visited with consent from the school principal. Measurements of the vertical size of distance and near letters and the distances from the board to student desks were taken. A near visual working distance of 16 inches was assumed. The Snellen equivalent size of these target letters was calculated.

Results:
Average visual acuity demands in these classrooms at distance ranged from 20/100 to 20/300 for children in grades kindergarten to 2 and from 20/60 to 20/100 for grades 3 to 5. The average near demand ranged from 20/100 to 20/500 for all grades at 16 inches.

Conclusion:
Children with moderate to severe amblyopia may be able to visually perform in some classroom settings while undergoing occlusion therapy. Children with mild to moderate distance refractive errors may be able to perform in classroom activities without correction. A larger multi-school study may be indicated to provide more statistically significant data because visual demands may vary among different schools and school districts throughout the country.

[J Pediatr Ophthalmol Strabismus 2010;47:152–156.]
Conformance With Preferred Practice Patterns in Caring for Children With Esotropia
Authors: Gupta Preeya K. , Freedman Sharon F. , Lee Paul P. 
Published: May 2010

Educational Objectives

1.
To familiarize clinicians with the preferred practice patterns as they relate to patients with esotropia.

2.
To highlight the summary benchmarks within the preferred practice patterns for esotropia.

3.
To highlight areas of potential deficiency among compliance with the preferred practice patterns.

Purpose:
To evaluate documentation of the initial evaluation in patients with esotropia, with respect to history, physical examination, care management, and patient education, for the presence of key elements as defined in the American Academy of Ophthalmology's Summary Benchmarks for Preferred Practice Patterns.

Methods:
Two hundred charts of patients seen at the Pediatrics Service at the Duke Eye Center for an initial diagnosis of esotropia were reviewed relative to both the 2002 (all patients) and 2007 (for those seen in 2007) Preferred Practice Patterns benchmarks for esotropia. Documentation of key elements as defined in the Preferred Practice Patterns was recorded.

Results:
The average total score was 85.8% for all evaluations. On average, 63.6% of the initial history key elements, 99.6% of the initial physical examination key elements, and 94.2% of the care management and patient education key elements were documented. For evaluations performed in 2007 and scored according to the 2007 Preferred Practice Patterns, scores were similar, except that the physical examination subset score average decreased to 90.3% and the family history documentation score increased to 45.5%.

Conclusion:
In an academic practice, the process quality of care for strabismus often conforms well to professional practice patterns. However, there are opportunities for improvement in the documentation of key history elements. Additional data are needed from other practice settings and for other conditions to assess the quality of eye care for children.

[J Pediatr Ophthalmol Strabismus 2010;47:145–149.]
Infantile Aphakic Glaucoma: A Proposed Etiologic Role of IL-4 and VEGF
Authors: Michael Inbal , Walton David S. , Levenberg Shulamit 
Published: May 2010

Purpose:
To identify the factors secreted by lens epithelial cells (LECs) responsible for the altered trabecular meshwork (TM) cells and to compare their effect on monocultured TM cells with that of TM cells co-cultured with LECs.

Methods:
Such factors were isolated using cytokine antibody array membranes, and their effect on TM cells was assessed by analyzing changes in morphology and gene expression. In addition, inhibition of the isolated factors was performed in the co-culture model by adding specific antibodies to the cell culture media.

Results:
Transforming growth factor beta-2, interleukin-4 (IL-4), and vascular endothelial growth factor (VEGF) are presented as candidate cytokines responsible for the observed changes in LEC-TM co-cultures. Culturing TM cells in the presence of VEGF and IL-4 triggered alterations closely reflecting those observed in the LEC-TM co-culture model, where their inhibition significantly hindered the alteration of the TM cells.

Conclusion:
These findings suggest a possible explanation for the development of infantile aphakic glaucoma, based on residual LECs secreting IL-4 and VEGF after removal of congenital cataract, which then alter trabecular meshwork cell morphology and gene expression.
Night Driving Simulation in a Randomized Prospective Comparison of Visian Toric Implantable Collamer Lens and Conventional PRK for Moderate to High Myopic Astigmatism
Authors: Schallhorn Steven , Tanzer David , Sanders Donald R. , Sanders Monica , Brown Mitch , Kaupp Sandor E. 
Published: May 2010

PURPOSE:
To compare changes in simulated night driving performance after Visian Toric Implantable Collamer Lens (TICL; STAAR Surgical) implantation and photorefractive keratectomy (PRK) for the correction of moderate to high myopic astigmatism.

METHODS:
This prospective, randomized study consisted of 43 eyes implanted with the TICL (20 bilateral cases) and 45 eyes receiving conventional PRK (VISX Star S3 excimer laser) with mitomycin C (22 bilateral cases) for moderate to high myopia (−6.00 to −20.00 diopters[D] sphere) measured at the spectacle plane and 1.00 to 4.00 D of astigmatism. As a substudy, 27 eyes of 14 TICL patients and 41 eyes of 21 PRK patients underwent a simulated night driving test. The detection and identification distances of road signs and hazards with the Night Driving Simulator (Vision Sciences Research Corp) were measured with and without a glare source before and 6 months after each procedure.

RESULTS:
No significant difference was noted in the pre- to postoperative Night Driving Simulator in detection distances with and without the glare source between the TICL and PRK groups. The differences in identification distances without glare were significantly better for business and traffic road signs and pedestrian hazards in the TICL group relative to the PRK group whereas with glare, only the pedestrian hazards were significantly better. A clinically relevant change of Night Driving Simulator performance (>0.5 seconds change in ability to identify tasks postoperatively) was significantly better in the TICL group (with and without glare) for all identification tasks.

CONCLUSIONS:

The TICL performed better than conventional PRK in the pre- to postoperative Night Driving Simulator testing with and without a glare source present. [
J Refract Surg
. 2010;26:321–326.]
Changes in Higher Order Wavefront Aberrations After Contact Lens Corneal Refractive Therapy and LASIK Surgery
Authors: Goldstone Robert N. , Yildiz Elvin H. , Fan Vincent C. , Asbell Penny A. 
Published: May 2010

PURPOSE:
To compare ocular higher order aberrations induced by corneal refractive therapy (CRT, Paragon Vision) to those produced by LASIK for patients with comparable levels of myopia.

METHODS:
A retrospective chart review of 11 patients who used CRT lenses and 12 patients who underwent LASIK for correction of low to moderate myopia was performed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and optical higher order aberrations were recorded before and 1 month after treatment for each patient.

RESULTS:

The CRT group consisted of 11 patients (4 men, 7 women) with a mean age of 29.1±5.2 years (range: 23 to 40 years), and the LASIK group consisted of 12 patients (3 men, 9 women) with a mean age of 39.2±12.0 years (range: 23 to 60 years). Manifest refraction decreased statistically significantly from −2.81±1.05 diopters (D) at baseline to −0.77±0.64 D following CRT treatment at 1 month (
P
<.0001) and from −3.11±1.21 D at baseline to −0.43±0.27 D at 1 month after LASIK (
P
<.0001). Both CRT and LASIK exhibited no significant changes in total higher order aberrations for 4-mm pupils but induced statistically significant increases in total higher order aberrations for 6-mm pupils. Corneal refractive therapy and LASIK both exhibited statistically similar factors of change for total higher order aberrations and coma-like higher order aberrations for 6-mm pupils. Corneal refractive therapy demonstrated a statistically significant greater factor of increase in spherical-like higher order aberrations for 6-mm pupils (
P
=.01).

CONCLUSIONS:

Contact lens corneal refractive therapy and LASIK can effectively correct myopia, but both increase higher order aberrations for 6-mm pupils to a similar degree. However, spherical-like aberrations were statistically significantly greater after CRT than after LASIK. [
J Refract Surg
. 2010;26:348–355.]
Dark-Adapted Pupil Diameter as a Function of Age Measured with the NeurOptics Pupillometer
Authors: Bradley Jay C. , Bentley Karl C. , Mughal Aleem I. , Bodhireddy Hari , Brown Sandra M. 
Published: May 2010

Purpose:
To measure the dark-adapted pupil diameter of normal research participants in their second through ninth decades of life using the NeurOptics pupillometer (Neuroptics Inc).

Methods:
Individuals aged 18 to 80 years with no history of eye disease or injury, intraocular surgery, or use of systemic antihistamines or opiates were recruited. After 2 minutes of adaptation at 1 lux illumination, the right dark-adapted pupil diameter was measured using the NeurOptics pupillometer, with accommodation controlled by distance fixation. The NeurOptics pupillometer reported a mean dark-adapted pupil diameter and a standard deviation of the mean, which were analyzed as a function of age-decade.

Results:
Two-hundred sixty-three individuals participated. For participants aged 18 to 19 years (n=6), the mean dark-adapted pupil diameter was 6.85 mm (range: 5.6 to 7.5 mm); 20 to 29 years (n=66), 7.33 mm (range: 5.7 to 8.8 mm); 30 to 39 years (n=50), 6.64 mm (range: 5.3 to 8.7 mm); 40 to 49 years (n=51), 6.15 mm (range: 4.5 to 8.2 mm); 50 to 59 years (n=50), 5.77 mm (range: 4.4 to 7.2 mm); 60 to 69 years (n=30), 5.58 mm (range: 3.5 to 7.5 mm); 70 to 79 years (n=6), 5.17 mm (range: 4.6 to 6.0 mm); and 80 years (n=4), 4.85 mm (range: 4.1 to 5.3 mm). These values were consistent with studies using infrared photography. The standard deviation was >0.1 mm in 10 (3.8%) participants, all of whom were younger than 55 years.

Conclusions:
The dark-adapted pupil diameter is an important clinical variable when planning refractive surgery. Surgeons can compare a patient’s dark-adapted pupil diameter with the results of this population study to identify outlier measurements, which may be erroneous, and repeat testing prior to surgery.
Atorvastatin for Diabetic Macular Edema in Patients With Diabetes Mellitus and Elevated Serum Cholesterol
Authors: Panagiotoglou Theonitsa D. , Ganotakis Emmanuel S. , Kymionis George D. , Moschandreas Joanna A. , Fanti Garufalia N. , Charisis Spyridon K. , Malliaraki Niki E. , Tsilimbaris Miltiadis K. 
Published: May 2010

BACKGROUND AND OBJECTIVE:
To determine the efficacy of atorvastatin in reducing hard exudates and diabetic macular edema.

PATIENTS AND METHODS:
An uncontrolled clinical case series included 18 eyes with diabetic maculopathy and an elevated baseline lipid profile. All patients were treated with atorvastatin. Ophthalmologic evaluation, including fundus photography and fluorescein angiography, was performed at presentation and repeated at 3, 6, and 12 months. Hard exudates, hemorrhages, and fluorescein leakage at 12 months were evaluated and compared with baseline findings.

RESULTS:

Eighteen subjects with diabetic maculopathy received atorvastatin, and a significant decrease in total cholesterol and low-density lipoprotein cholesterol was seen (
P
< .05). Hard exudates and fluorescein leakage were decreased. No evidence of an association between change in hemorrhage status and treatment was found.

CONCLUSION:
Oral atorvastatin therapy in patients with diabetes mellitus and dyslipidemia seems to reduce the severity of hard exudates and fluorescein leakage in diabetic maculopathy and could be useful as an adjuvant therapy in the management of diabetic macular edema.

[Ophthalmic Surg Lasers Imaging 2010;41:316–322.]
Intravitreal Bevacizumab for the Treatment of Refractory Diabetic Macular Edema
Authors: Mehta Sachin , Blinder Kevin J. , Shah Gaurav K. , Kymes S. M. , Schlief Shelley L. , Grand M. Gilbert 
Published: May 2010

BACKGROUND AND OBJECTIVE:
To report the effect of intravitreal bevacizumab on visual acuity and central retinal thickness (CRT) in refractory diabetic macular edema.

PATIENTS AND METHODS:
Records of 60 eyes of 54 consecutive patients who underwent intravitreal bevacizumab therapy for refractory diabetic macular edema were reviewed. All eyes received intravitreal bevacizumab 1.25 mg/0.05 mL, and 36 eyes underwent pretreatment and post-treatment optical coherence tomography. Mean follow-up was 7.4 months.

RESULTS:

Pretreatment mean visual acuity plus or minus standard deviation was 0.71 ± 0.28 logarithm of the minimum angle of resolution (LogMAR) Snellen letters. At final follow-up, mean visual acuity had improved to 0.66 ± 0.30 LogMAR (
P
= .0543). Mean baseline CRT was 440 ± 106 µm, and follow-up mean CRT was 386 ± 129 µm (
P
= .008). Vitrectomized eyes had worse visual acuity and CRT outcomes (
P
= .002 and
P
= .028, respectively) compared with nonvitrectomized eyes.

CONCLUSION:
Intravitreal bevacizumab may provide a functional and anatomic benefit in eyes with persistent diabetic macular edema despite previous treatments.

[Ophthalmic Surg Lasers Imaging 2010;41:323–329.]
Orbicularis Oculi Myo-osseous Fixation: A New Treatment for Benign Essential Blepharospasm and Blepharospasm Associated With Diffuse Facial Dystonia (Meige Syndrome)
Authors: Borodic Gary E. 
Published: May 2010

BACKGROUND AND OBJECTIVE:
This article describes a novel surgical procedure, myo-osseous fixation, as an adjunct therapy for patients with reduced or poor response to repeated botulinum toxin injections for essential blepharospasm and Meige syndrome.

PATIENTS AND METHODS:
The small-incision, rapidly healing, rapidly performed technique uses self-drilling titanium screws tightly engaged with a compression wrench. The screws fixate the periorbital orbicularis oculi muscle to bone, creating mechanical resistance to outer portions of the orbicularis muscle involved in debilitating involuntary contractions.

RESULTS:
Eleven of the treated 12 patients experienced immediate improvement in function. Each responding patient noted enhanced effect of subsequent botulinum toxin injections at previously ineffective doses. The benefit was substantial and sustained for 6 months in 9 of 12 patients. Decreased brow depression during forced closure, forced frown, and brow elevation at rest was apparent in all patients postoperatively. Although the brow elevation effect was reduced after 6 months, reduced brow depression during forced closure still was easily demonstrated in most patients. Complications included a nodular bump over the brow, more commonly found when large titanium screws were used, transient headache, and easily removed dislodged screw.

CONCLUSION:
Initial data suggest that this procedure appears safe, well tolerated, and useful in the treatment of patients with essential blepharospasm and Meige syndrome responding poorly to botulinum toxin therapy.

[Ophthalmic Surg Lasers Imaging 2010;41:360–369.]