bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI Appearance of Presumed Self-inflicted Trauma in the Knees of Military Recruits
Authors: Thein Ran , Schweitzer Mark E. , Diprimio Gina , Shabshin Nogah 
Published: May 2012

When knee bone marrow edema is observed on magnetic resonance imaging (MRI), it usually follows a pattern that can be explained by certain etiologies. This article describes a series of unusual knee bone marrow edemas in soldiers presumed to represent self-inflicted trauma.
Ten soldiers (9 men and 1 woman; age range, 19–24 years) underwent knee MRI. None reported recent trauma or stress, and all presented with nonspecific pain or failure to respond to therapy. All showed a similar unusual pattern of bone marrow edema in the medial femoral condyle. Three observers evaluated the location of the bone marrow edema within the medial femoral condyle and its distance from the articular surface, dimensions, overlying soft tissue abnormality, and internal derangements. The edema was always subcortical and located in the middle aspect (n=7) or mid-anterior aspect (n=3) of the medial femoral condyle but was never centered subarticularly. Edema size ranged between 8×10×8 and 32×46×40 mm. Overlying soft tissue abnormalities were common (n=4) and included organizing (n=1) and residual hematoma (n=3). Concomitant MRI abnormalities were seen in 3 patients, usually minor. Eight patients reported longstanding pain with no antecedent trauma, and 2 reported remote trauma. One patient had a negative 4-month follow-up MRI, and another had a negative arthroscopy. Poor correlation existed between MRI findings and the absence of stress and trauma. Soldier chat rooms were found that describe how to induce fractures at this location.
Hemiarthroplasty Versus Reverse Total Shoulder Arthroplasty for Acute Proximal Humerus Fractures in Elderly Patients
Authors: Garrigues Grant E. , Johnston Peter S. , Pepe Matthew D. , Tucker Bradford S. , Ramsey Matthew L. , Austin Luke S. 
Published: May 2012

Proximal humerus fractures are the third most common fracture in elderly patients. Hemiarthroplasty has been the treatment of choice in patients with bone quality and fracture patterns not amenable to open reduction and internal fixation. Reverse total shoulder arthroplasty is a newer option that appears to be less dependent on tuberosity healing than hemiarthroplasty. The authors hypothesized that reverse total shoulder arthroplasty provides improved functional outcomes compared with hemiarthroplasty for fractures in elderly patients.
A retrospective review was performed of all patients treated with arthroplasty for acute proximal humerus fractures in an orthopedic practice using a Current Procedural Terminology code search, patient charts, and radiographs. Validated outcome scores were used to assess satisfaction, function, and general well-being. Twenty-three patients were treated for acute proximal humerus fractures (11 reverse total shoulder arthroplasties and 12 hemiarthroplasties). Three patients were lost to follow-up, and 6 patients were deceased. Mean follow-up was 3.6 years (range, 1.3–8 years). Reverse total shoulder arthroplasty outperformed hemiarthroplasty with regard to forward flexion, American Shoulder and Elbow Society score, University of Pennsylvania shoulder score, and Single Assessment Numerical Evaluation score.
Reverse total shoulder arthroplasty is a reliable option for acute, proximal humerus fractures that are not amenable to closed treatment or reconstruction in elderly patients. Improved functional outcomes when compared with hemiarthroplasty must be balanced against the increased cost and limited life expectancy of patients with this injury.
Anatomical Reconstruction of Reverse Hill-Sachs Lesions Using the Underpinning Technique
Authors: Banerjee Samik , Singh Vinay Kumar , Das Abhishek Kumar , Patel Vipul R. 
Published: May 2012

Posterior glenohumeral joint dislocation is an uncommon injury and is associated with bony and ligamentous disruption. It requires prompt diagnosis and early treatment to prevent acute or recurrent instability and subsequent dysfunction. Reverse Hill-Sachs lesions associated with this injury are challenging to treat, and optimal treatment is controversial. Treatment methods can be divided into those that achieve stability through muscle transfers, osteotomies, or posterior bone-block procedures (glenoid augmentation) and those that restore the sphericity of the humeral head. Joint replacement is often suggested for large head lesions (>50%) considered beyond reconstruction. Restoration of stability, preservation of the proximal humeral anatomy, and salvage of the humeral head sphericity should be the treatment goals in the younger population.
This article describes the surgical technique of elevation of the impressed osteochondral fragment followed by filling the lesion with Allomatrix bone graft putty (Wright Medical Technology, Arlington, Tennessee) in 2 patients. The size of the head lesion was ⩽35%. Underpinning raft screws were used to provide subchondral support and prevent the collapse of the elevated fragment. Postoperatively, the sphericity of the humeral head and glenohumeral stability were restored. No evidence of collapse, osteonecrosis, or osteoarthritis progression was seen at latest follow-up. Functional results were excellent, with a minimum follow-up of 2 years.
This technique is an alternative method of restoring humeral head sphericity in patients with acute posterior glenohumeral joint dislocations with medium (20%–40%) reverse Hill-Sachs lesions.
Zone 2 Flexor Digitorum Profundus and Superficialis Rupture Treated With Single-stage Tendon Reconstruction Using an Active Hunter Rod Implant
Authors: Macknin Jonathan B. , Malone Kevin J. 
Published: May 2012

To our knowledge, no report has been published of a flexor tendon rupture as a result of a closed phalangeal fracture.
A 58-year-old woman with multiple medical comorbidities presented with a closed, apex volar fracture of her long finger proximal phalynx with clinically intact flexor digitorum profundus and superficialis tendons in zone 2 of the flexor tendon sheath. After 5 weeks of nonoperative treatment, the patient reported hearing a pop in her finger, and clinical findings suggested rupture of the flexor digitorum profundus and superficialis tendons. Intraoperatively, the nonreparable attritional rupture was underneath the A2 pulley. A bony prominence in the tendon sheath floor from the healed phalynx fracture made rerupture a concern with a tendon graft. A Hunter Active Tendon Implant (Wright Medical Technology, Inc, Arlington, Tennessee) was used to reconstruct the flexor digitorum profundus tendon to avoid a second procedure. The patient progressed well and had regained a functional arc of active finger range of motion by 2 months postoperatively.
The Hunter Active Tendon Implant provided a suitable alternative to a 2-staged procedure, with the added benefit that a good tendon bed was developed in the event that a second procedure was needed.
Intraspinal Penetrating Stab Injury to the Middle Thoracic Spinal Cord With No Neurologic Deficit
Authors: Li Xinning , Curry Emily J. , Blais Micah , Ma Richard , Sungarian Arno S. 
Published: May 2012

The annual incidence of traumatic spinal cord injury worldwide is estimated to be 35 patients per million. Nonmissile penetrating spinal injuries most commonly occur in the thoracic region, and the majority has neurologic deficits on admission. The management of patients who lack neurologic deficits is controversial due to the risk of neurologic status alteration intraoperatively. However, failure to intervene increases the risk of infection, delayed onset of neurologic deficits, and worsening functional outcome.
A 17-year-old boy presented with an intradural T7-T8 knife penetration injury to the spinal cord with no neurologic deficit. Rapid surgical intervention was critical because the knife was lodged between the 2 hemispheres of the spinal cord. The patient was intubated in the lateral position, transferred to the prone position on a Jackson table, and underwent surgical decompression with laminectomy 1 level above and below the injury site, removal of the knife blade in the original path of trajectory, and repair of the dural tear with a collagen matrix. The patient sustained no neurologic sequelae from the penetrating knife injury. He was able to ambulate at discharge and had no complications. To our knowledge, this is the only report of a patient with intradural spinal cord penetration by a foreign object (knife blade) presenting with a normal neurologic preoperative examination that persisted throughout the course of postoperative care.
Enhanced Depth Imaging Optical Coherence Tomography: Choroidal Thickness and Correlations With Age, Refractive Error, and Axial Length
Authors: Goldenberg Dafna , Moisseiev Elad , Goldstein Michaela , Loewenstein Anat , Barak Adiel 
Published: May 2012

BACKGROUND AND OBJECTIVE:
To evaluate choroidal thickness at five macular locations and assess the correlations between choroidal thickness at these locations with age, refractive error, and axial length.

PATIENTS AND METHODS:
Eighty-four eyes from 42 healthy adult volunteers were included. Enhanced depth imaging by spectral-domain optical coherence tomography was performed, and choroidal thickness was measured at five macular locations: subfoveal and 3 mm nasal, temporal, superior, and inferior. Correlations of choroidal thickness at each location with age, refractive error, and axial length were analyzed.

RESULTS:
Mean choroidal thicknesses at the subfoveal, superior, inferior, temporal, and nasal locations were 293, 308, 264, 263, and 174 μm, respectively. A correlation was found between choroidal thickness, age, refractive error, and axial length at all locations.

CONCLUSION:
Mean subfoveal choroidal thickness in healthy adults is approximately 300 μm. A correlation was found between choroidal thickness and all parameters studied.
Revisiting Autologous Platelets as an Adjuvant in Macular Hole Repair: Chronic Macular Holes Without Prone Positioning
Authors: Kapoor Kapil G. , Khan Adeel N. , Tieu Brian C. , Khurshid Gibran S. 
Published: May 2012

BACKGROUND AND OBJECTIVE:
Chronic macular hole and inability to maintain prone positioning remain poor prognostic markers for successful macular hole closure. The authors revisited the role of autologous platelets as an adjunct to internal limiting membrane (ILM) peeling of chronic macular holes in patients unable to maintain prone positioning.

PATIENTS AND METHODS:

A retrospective case study was conducted on 13 eyes of 13 patients with full-thickness chronic macular hole (> 24 months). Each patient was unable to maintain prone positioning due to medical and physical comorbidities. Each eye was treated with pars plana vitrectomy, ILM peeling, autologous platelets, and C
3
F
8
gas tamponade. No positioning was advised postoperatively. All patients had complete ophthalmic examinations preoperatively and 1 day and 1, 3, and 6 months postoperatively with optical coherence tomography. Outcome measures were anatomic closure based on Tornambe classification, final best-corrected visual acuity, and improvement of quality of vision.

RESULTS:
All 13 patients completed 6 months’ follow-up. Macular hole duration ranged from 2 to 5 years. There was a 100% macular hole closure rate at 1 and 6 months postoperatively. All patients reported subjective improvement in visual acuity as an improvement of an absolute central scotoma. At 6 months postoperatively, 38% of patients reported improved best-corrected visual acuity. There were no recurrences.

CONCLUSION:
Autologous platelets and ILM peeling may function synergistically to enhance chronic macular hole closure in patients unable to maintain prone positioning.
A Switch in Pathogenic Mechanism in Myelin Oligodendrocyte Glycoprotein-Induced Experimental Autoimmune Encephalomyelitis in IFN-γ–Inducible Lysosomal Thiol Reductase-Free Mice
Authors: Bergman Cheryl M. , Marta Cecilia B. , Maric Maja , Pfeiffer Steven E. , Cresswell Peter , Ruddle Nancy H. 
Published: May 2012

Abstract
IFN-γ–inducible lysosomal thiol reductase (GILT) is an enzyme located in the Lamp-2–positive compartments of APC. GILT−/− mice are phenotypically normal, but their T cells exhibit reduced proliferation to several exogenously administered Ags that include cysteine residues and disulfide bonds. We undertook the present studies to determine if GILT−/− mice would process exogenously administered myelin oligodendrocyte glycoprotein (MOG), which contains disulfide bonds, to generate experimental autoimmune encephalomyelitis (EAE) to the endogenous protein. One possibility was that MOG35–55 peptide would induce EAE, but that MOG protein would not. GILT−/− mice were relatively resistant to MOG35–55-induced EAE but slightly more susceptible to rat MOG protein-induced EAE than wild-type (WT) mice. Even though MOG35–55 was immunogenic in GILT−/− mice, GILT APCs could not generate MOG35–55 from MOG protein in vitro, suggesting that the endogenous MOG protein was not processed to the MOG35–55 peptide in vivo. Immunization of GILT−/− mice with rat MOG protein resulted in a switch in pathogenic mechanism from that seen in WT mice; the CNS infiltrate included large numbers of plasma cells; and GILT−/− T cells proliferated to peptides other than MOG35–55. In contrast to WT rat MOG-immunized mice, rat MOG-immunized GILT−/− mice generated Abs that transferred EAE to MOG35–55-primed GILT−/− mice, and these Abs bound to oligodendrocytes. These studies, demonstrating the key role of a processing enzyme in autoimmunity, indicate that subtle phenotypic changes have profound influences on pathogenic mechanisms and are directly applicable to the outbred human population.
Type I IFN Induced by Adenovirus Serotypes 28 and 35 Has Multiple Effects on T Cell Immunogenicity
Authors: Johnson Matthew J. , Petrovas Constantinos , Yamamoto Takuya , Lindsay Ross W. B. , Loré Karin , Gall Jason G. D. , Gostick Emma , Lefebvre François , Cameron Mark J. , Price David A. , Haddad Elias , Sekaly Rafick-Pierre , Seder Robert A. , Koup Richard A. 
Published: May 2012

Abstract
Recombinant adenovirus (rAd) vectors are being investigated as vaccine delivery vehicles in preclinical and clinical studies. rAds constructed from different serotypes differ in receptor usage, tropism, and ability to activate cells, aspects of which likely contribute to their different immunogenicity profiles. In this study, we compared the infectivity and cell stimulatory capacity of recombinant adenovirus serotype 5 (rAd5), recombinant adenovirus serotype 28 (rAd28), and recombinant adenovirus serotype 35 (rAd35) in association with their respective immunogenicity profiles. We found that rAd28 and rAd35 infected and led to the in vitro maturation and activation of both human and mouse dendritic cells more efficiently compared with rAd5. In stark contrast to rAd5, rAd28 and rAd35 induced production of IFN-α and stimulated IFN-related intracellular pathways. However, the in vivo immunogenicity of rAd28 and rAd35 was significantly lower than that of rAd5. Deletion of IFN-α signaling during vaccination with rAd28 and rAd35 vectors increased the magnitude of the insert-specific T cell response to levels induced by vaccination with rAd5 vector. The negative impact of IFN-α signaling on the magnitude of the T cell response could be overcome by increasing the vaccine dose, which was also associated with greater polyfunctionality and a more favorable long-term memory phenotype of the CD8 T cell response in the presence of IFN-α signaling. Taken together, our results demonstrate that rAd-induced IFN-α production has multiple effects on T cell immunogenicity, the understanding of which should be considered in the design of rAd vaccine vectors.
Cutting Edge: Divergent Cell-Specific Functions of MyD88 for Inflammatory Responses and Organ Injury in Septic Peritonitis
Authors: Gais Petra , Reim Daniel , Jusek Gabriela , Rossmann-Bloeck Tanja , Weighardt Heike , Pfeffer Klaus , Altmayr Felicitas , Janssen Klaus-Peter , Holzmann Bernhard 
Published: May 2012

Abstract
Although global MyD88 deficiency attenuates lethal inflammation in sepsis, cell-specific functions of MyD88 remain largely unknown. Using mice with selective expression of MyD88 in myeloid cells (Myd88MYEL), we show that, during polymicrobial septic peritonitis, both myeloid and nonmyeloid cells contribute to systemic inflammation, whereas myeloid cell MyD88 was sufficient to fully establish the peritoneal cytokine response. Importantly, Myd88MYEL mice developed markedly aggravated liver injury that was linked to impaired upregulation of cellular inhibitor of apoptosis protein 2 and an excessive production of TNF-α. Upregulation of inducible cAMP early repressor (ICER), a known transcriptional repressor of the Tnfa gene, was impaired in Myd88MYEL mice. Moreover, Myd88MYEL mice showed enhanced transcription of the Tnfa gene and an excessive production of CCL3, which is also negatively regulated by ICER, but they had normal levels of CXCL1, which is expressed in an ICER-independent manner. Together, these findings suggest a novel protective role for nonmyeloid cell MyD88 in attenuating liver injury during septic peritonitis.
Differential Effects of Denileukin Diftitox IL-2 Immunotoxin on NK and Regulatory T Cells in Nonhuman Primates
Authors: Yamada Yohei , Aoyama Akihiro , Tocco Georges , Boskovic Svjetlan , Nadazdin Ognjenka , Alessandrini Alessandro , Madsen Joren C. , Cosimi A. Benedict , Benichou Gilles , Kawai Tatsuo 
Published: May 2012

Abstract
Denileukin diftitox (DD), a fusion protein comprising IL-2 and diphtheria toxin, was initially expected to enhance antitumor immunity by selectively eliminating regulatory T cells (Tregs) displaying the high-affinity IL-2R (α-β-γ trimers). Although DD was shown to deplete some Tregs in primates, its effects on NK cells (CD16+CD8+NKG2A+CD3−), which constitutively express the intermediate-affinity IL-2R (β-γ dimers) and play a critical role in antitumor immunity, are still unknown. To address this question, cynomolgus monkeys were injected i.v. with two doses of DD (8 or 18 μg/kg). This treatment resulted in a rapid, but short-term, reduction in detectable peripheral blood resting Tregs (CD4+CD45RA+Foxp3+) and a transient increase in the number of activated Tregs (CD4+CD45RA−Foxp3high), followed by their partial depletion (50–60%). In contrast, all NK cells were deleted immediately and durably after DD administration. This difference was not due to a higher binding or internalization of DD by NK cells compared with Tregs. Coadministration of DD with IL-15, which binds to IL-2Rβ-γ, abrogated DD-induced NK cell deletion in vitro and in vivo, whereas it did not affect Treg elimination. Taken together, these results show that DD exerts a potent cytotoxic effect on NK cells, a phenomenon that might impair its antitumoral properties. However, coadministration of IL-15 with DD could alleviate this problem by selectively protecting potentially oncolytic NK cells, while allowing the depletion of immunosuppressive Tregs in cancer patients.
The effects of loperamide, or loperamide plus simethicone, on the distribution of gut water as assessed by MRI in a mannitol model of secretory diarrhoea
Authors: Placidi E. , Marciani L. , Hoad C. L. , Napolitano A. , Garsed K. C. , Pritchard S. E. , Cox E. F. , Costigan C. , Spiller R. C. , Gowland P. A. 
Published: May 2012

SummaryBackgroundLoperamide (LOP) is an anti‐diarrhoeal agent which is thought to act largely by slowing transit with an uncertain effect on the fluid content of the small and large bowel in humans. Adding simethicone (SIM) to LOP improves its efficacy, but the mechanism of interaction is unclear. Novel MRI techniques to assess small bowel water content (SBWC) have shown that mannitol solutions markedly increase SBWC and can be used as a model of diarrhoea.AimWe aimed to use quantitative MRI techniques to compare the actions in the gut of LOP and LOP + SIM in a model of secretory diarrhoea using mannitol.MethodsA total of 18 healthy volunteers ingested capsules containing placebo (PLA) or 12 mg LOP or 12 mg LOP + 125 mg SIM. After 100 min they were given a drink containing 5% mannitol in 350 mL of water. They underwent baseline fasting and postprandial serial MRI scans at 45 min intervals for 4.5 h after ingesting the drink. A range of MRI sequences was acquired to image the gut.ResultsLOP and LOP + SIM significantly accelerated gastric emptying (P < 0.03) and reduced SBWC during the late phase (135–270 min after mannitol ingestion), P < 0.009, while delaying arrival of fluid in the ascending colon (AC). The relaxation time T2 of the contents of the AC was reduced by both drugs (P < 0.0001).ConclusionsLOP and LOP + SIM accelerate gastric emptying, but reduce small bowel water content which may contribute to the delay in oral‐caecal transit and overall anti‐diarrhoeal effect.
Chimeric Antigen Receptor T Cells Shape Myeloid Cell Function within the Tumor Microenvironment through IFN-γ and GM-CSF
Authors: Spear Paul , Barber Amorette , Rynda-Apple Agnieszka , Sentman Charles L. 
Published: May 2012

AbstractThe infiltration of suppressive myeloid cells into the tumor microenvironment restrains anti-tumor immunity. However, cytokines may alter the function of myeloid lineage cells to support tumor rejection, regulating the balance between pro- and anti-tumor immunity. In this study, it is shown that effector cytokines secreted by adoptively transferred T cells expressing a chimeric Ag receptor (CAR) shape the function of myeloid cells to promote endogenous immunity and tumor destruction. Mice bearing the ovarian ID8 tumor were treated with T cells transduced with a chimeric NKG2D receptor. GM-CSF secreted by the adoptively transferred T cells recruited peripheral F4/80loLy-6C+ myeloid cells to the tumor microenvironment in a CCR2-dependent fashion. T cell IFN-γ and GM-CSF activated local, tumor-associated macrophages, decreased expression of regulatory factors, increased IL-12p40 production, and augmented Ag processing and presentation by host macrophages to Ag-specific T cells. In addition, T cell-derived IFN-γ, but not GM-CSF, induced the production of NO by F4/80hi macrophages and enhanced their lysis of tumor cells. The ability of CAR T cell therapy to eliminate tumor was moderately impaired when inducible NO synthase was inhibited and greatly impaired in the absence of peritoneal macrophages after depletion with clodronate encapsulated liposomes. This study demonstrates that the activation of host macrophages by CAR T cell-derived cytokines transformed the tumor microenvironment from immunosuppressive to immunostimulatory and contributed to inhibition of ovarian tumor growth.