bluuebunny/crossref_metadata_2025_split huggingface dataset:
An in Vitro Analysis of an Anatomical Medial Knee Reconstruction
Authors: Coobs Benjamin R. , Wijdicks Coen A. , Armitage Bryan M. , Spiridonov Stanislav I. , Westerhaus Benjamin D. , Johansen Steinar , Engebretsen Lars , LaPrade Robert F. 
Published: December 2009

Background An anatomical medial knee reconstruction has not been described in the literature. Hypothesis Knee stability and ligamentous load distribution would be restored to the native state with an anatomical medial knee reconstruction. Study Design Controlled laboratory study. Methods Ten nonpaired cadaveric knees were tested in the intact, superficial medial collateral ligament and posterior oblique ligament—sectioned, and anatomically reconstructed states. Each knee was tested at 0°, 20°, 30°, 60°, and 90° of knee flexion with a 10-N·m valgus load, 5-N·m external and internal rotation torques, and 88-N anterior and posterior drawer loads. A 6 degrees of freedom electromagnetic motion tracking system measured angulation and displacement changes of the tibia with respect to the femur. Buckle transducers measured the loads on the intact and reconstructed proximal and distal divisions of the superficial medial collateral ligament and the posterior oblique ligament. Results A significant increase was found in valgus angulation and external rotation after sectioning the medial knee structures at all tested knee flexion angles. This was restored after an anatomical medial knee reconstruction. The authors also found a significant increase in internal rotation at 0°, 20°, 30°, and 60° of knee flexion after sectioning the medial knee structures, which was restored after the reconstruction. A significant increase in anterior translation was observed after sectioning the medial knee structures at 20°, 30°, 60°, and 90° of knee flexion. This increase in anterior translation was restored following the reconstruction at 20° and 30° of knee flexion, but was not restored at 60° and 90°. A small, but significant, increase in posterior translation was found after sectioning the medial knee structures at 0° and 30° of knee flexion, but this was not restored after the reconstruction. Overall, there were no clinically important differences in observed load on the ligaments when comparing the intact with the reconstructed states for valgus, external and internal rotation, and anterior and posterior drawer loads. Conclusion An anatomical medial knee reconstruction restores near-normal stability to a knee with a complete superficial medial collateral ligament and posterior oblique ligament injury, while avoiding overconstraint of the reconstructed ligament grafts. Clinical Significance This anatomical medial knee reconstruction technique provides native stability and ligament load distribution in patients with chronic or severe acute medial knee injuries.
Comparative Kinematic Evaluation of All-Inside Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Tsai Andrew G. , Wijdicks Coen A. , Walsh Michael P. , LaPrade Robert F. 
Published: December 2009

Background The efficacy of single-bundle versus double-bundle ACL reconstruction in improving knee stability has been widely discussed. The biomechanics of all-inside double-bundle ACL reconstructions have not been evaluated. Hypothesis An anatomic all-inside double-bundle ACL reconstruction will more effectively restore native knee kinematics in vitro, especially rotational stability, when compared with an all-inside single-bundle ACL reconstruction. Study Design Controlled laboratory study. Methods Seven pairs of fresh-frozen cadaveric human knees were used. Knees were tested using 88 N of force for anterior and posterior drawers, 5 N·m internal and external rotation moments, 10 N·m valgus and varus moments, and coupled 5 N·m internal rotation and 10 N·m valgus moments to simulate a pivot shift at 0°, 20°, 30°, 60°, and 90° of knee flexion. Motion of the knee in response to external loading was measured with a Polhemus electromagnetic tracking system. Knees were first tested in the intact state, with either the anteromedial or posterolateral bundle cut, and then with both bundles cut. Subsequently, 7 single-bundle and 7 double-bundle all-inside ACL reconstructions were performed. Results Both single- and double-bundle all-inside ACL reconstructions restored knee kinematics for posterior drawer, varus/valgus rotation, and internal/external rotation motions. After single-bundle all-inside ACL reconstruction, anterior translation during the simulated pivot-shift test was significantly higher compared with the intact state at 20°, 30°, and 60° of flexion. There was no significant difference between the double-bundle all-inside ACL reconstruction and the intact knee during a simulated pivot shift. Conclusion We found that an all-inside double-bundle ACL reconstruction demonstrated significant improvement in restoring normal rotational knee motion during simulated pivot-shift testing compared with single-bundle ACL reconstructions in vitro, with no significant differences in other knee loading conditions. Clinical Relevance All-inside double-bundle ACL reconstruction may provide advantages over single-bundle ACL reconstruction for rotational knee stability.
Correlation of Valgus Stress Radiographs with Medial Knee Ligament Injuries
Authors: LaPrade Robert F. , Bernhardson Andrew S. , Griffith Chad J. , Macalena Jeffrey A. , Wijdicks Coen A. 
Published: December 2009

Background The amount of medial compartment opening for medial knee injuries determined by valgus stress radiography has not been well documented. The purpose of this study was to develop clinical guidelines for diagnosing medial knee injuries using valgus stress radiography. Hypothesis Measurements of medial compartment gapping can accurately differentiate between normal and injured medial structure knees on valgus stress radiographs. Study Design Controlled laboratory study. Methods Valgus stress radiographs were obtained on 18 adult lower extremities using 10-N·m and clinician-applied valgus loads at 0° and 20° of flexion to intact knees and after sequential sectioning of the superficial medial collateral ligament proximally and distally, the meniscofemoral and meniscotibial portions of the deep medial collateral ligament, the posterior oblique ligament, and the cruciate ligaments. Three independent observers of different experience levels measured all of the radiographs during 2 separate occasions to determine intraobserver repeatability and interobserver reproducibility. Results Compared with the intact knee, significant medial joint gapping increases of 1.7 mm and 3.2 mm were produced at 0° and 20° of flexion, respectively, by a clinician-applied load on an isolated grade III superficial medial collateral ligament simulated injury. A complete medial knee injury yielded gapping increases of 6.5 mm and 9.8 mm at 0° and 20°, respectively, for a clinician-applied load. Intraobserver repeatability and interobserver reproducibility intraclass correlation coefficients were .99 and .98, respectively. Conclusion Valgus stress radiographs accurately and reliably measure medial compartment gapping but cannot definitively differentiate between meniscofemoral- and meniscotibial-based injuries. A grade III medial collateral ligament injury should be suspected with greater than 3.2 mm of medial compartment gapping compared to the contralateral knee at 20° of flexion, and this injury will also result in gapping in full extension. Clinical Significance Valgus stress radiographs provide objective and reproducible measurements of medial compartment gapping, which should prove useful for definitive diagnosis, management, and postoperative follow-up of patients with medial knee injuries.
Effect of Posteroinferior Capsule Tightness on Contact Pressure and Area beneath the Coracoacromial Arch during Pitching Motion
Authors: Muraki Takayuki , Yamamoto Nobuyuki , Zhao Kristin D. , Sperling John W. , Steinmann Scott P. , Cofield Robert H. , An Kai-Nan 
Published: December 2009

Background Tightness of the posteroinferior capsule is assumed to be the cause of internal rotation loss in baseball pitchers. Although the relationship between posterior capsule and subacromial impingement has been recognized, this relationship during the baseball-pitching motion is unclear. Hypothesis Contact pressure during baseball-pitching motion increases with posterior capsule tightness. Study Design Controlled laboratory study. Methods Eight fresh-frozen shoulders were used. The peak contact pressure and area on the coracoacromial arch were measured on a custom-designed shoulder experimental device capable of 6 degrees of freedom motion. Simultaneously, the sites of peak pressure on the coracoacromial arch and humerus were observed from various angles. The posteroinferior capsule tightness was simulated by plicating the capsule in the region from 6 to 8 o'clock. The static testing positions correlated to the early cocking, late cocking, acceleration, deceleration, and follow-through phases of the pitching motion. Results The peak contact pressure during the follow-through phase (0.63 ± 0.50 MPa) significantly increased with posteroinferior capsule tightness (1.00 ± 0.65 MPa) (P = .014). Additionally, the contact area on the coracoacromial ligament during the follow-through phase (0.98 ± 0.67 cm2) significantly increased with posteroinferior capsule tightness (1.47 ± 0.91 cm 2) (P < .001). The site of the peak contact pressure did not change between the 2 conditions. Conclusion Our findings demonstrate that posteroinferior capsule tightness leads to higher contact pressure under the subacromial arch and increased contact area, particularly on the coracoacromial ligament during the follow-through phase. Clinical Relevance This tightness may affect risk of injury of the rotator cuff and its surrounding tissues by increasing subacromial contact during pitching.
Reconstruction of the Medial Patellofemoral Ligament for Treatment of Patellofemoral Instability: A Systematic Review
Authors: Buckens Constantinus F. M. , Saris Daniël B. F. 
Published: December 2009

Background Growing awareness of the biomechanical contribution of the medial patellofemoral ligament has led to an upsurge in the publication of techniques and trials dealing with reconstructive techniques, warranting a review that includes the most recent evidence. Study Design Systematic review. Methods The authors undertook a systematic electronic search and rigorous screening process to find and identify published evidence describing the outcomes of medial patellofemoral ligament reconstruction. Results Fourteen trials were included for analysis. Although they showed generally excellent outcomes for medial patellofemoral ligament reconstruction modalities, there were several recurring weaknesses. Most were small case series, many had limited follow-up, and a majority employed other adjunctive techniques besides medial patellofemoral ligament reconstruction, making it difficult to distinguish the determining factors in their outcomes. Conclusion There is limited but growing evidence that a medial patellofemoral ligament—based surgical approach to patellofemoral instability leads to excellent functional outcomes.
Prophylactic antivirals may be helpful in prevention of varicella-zoster virus reactivation in myeloma, but are they safe?
Authors: Dasanu Constantin A , Alexandrescu Doru T 
Published: December 2009

Purpose. Retrospective analysis of two recent multiple myeloma (MM) clinical trials suggested that the use of bortezomib may be associated with an increased incidence of herpes zoster infections. Therefore, prophylactic use of antivirals has been advocated by some authors. This article explores the potential risks and pitfalls linked to routine acyclovir prophylaxis in bortezomib-treated MM. Summary. Use of antivirals can be associated with important nephro- and neurotoxicity. The nephrotoxicity induced by MM itself and its supportive therapies, superimposed to aging and inherent immunosuppression in myeloma, makes the development of renal impairment even more likely. On the other hand, sensory neuropathy is known to occur both during myeloma progression and in the setting of bortezomib therapy. Furthermore, preexisting nephropathy in MM patients can contribute to the occurrence of serious neurologic toxicity with acyclovir. Conclusions. Long-term acyclovir prophylaxis in MM patients treated with bortezomib may cause severe renal and neurological toxicity. Prevention of these complications can be achieved through either withholding of the antivirals or a very close monitoring of both neurologic status and renal function in this patient population. This highlights the importance of both clinician’s and pharmacist’s involvement in optimization of myeloma patient care.
Dose-rounding of adjuvant chemotherapy for breast cancer: an audit of toxicity
Authors: Jenkins Peter , Wallis Richard 
Published: December 2009

Purpose. Dose-rounding of chemotherapy is increasingly being used in oncology departments to improve the efficiency of outpatient clinics. There is, however, no published data on the effect of this strategy on drug toxicity. Methods. We have analysed acute chemotherapy side effects in a cohort of 662 consecutive patients receiving adjuvant FEC (5-fluorouracil, epirubicin, cyclophosphamide) for breast cancer. A dose-rounding algorithm was used to deliver drug doses that were within 5% of the standard dose based on body surface area. Results. Patients receiving a rounded dose of chemotherapy that was higher than that calculated from their body surface area were not at increased risk of acute haematological or non-haematological toxicity. Conclusions. Dose-rounding of adjuvant FEC within the range ±5% is not associated with any difference in acute chemotherapy side effects. Longer term follow-up is required to determine whether patients receiving rounded doses below that calculated from their body surface area are at increased risk of relapse.
Reducing workplace cytotoxic surface contamination using a closed-system drug transfer device
Authors: Siderov Jim , Kirsa Sue , McLauchlan Robert 
Published: December 2009

Background. The potential for staff exposure to antineoplastic agents exists in the workplace despite current recommended safe handling procedures. Reliance on cytotoxic drug safety cabinets (CDSC) to provide total protection from exposure to hazardous drugs is insufficient. Preventing workplace contamination is the best strategy to minimise exposure. PhaSeal® is a commercially available system for ensuring the leak-free transfer of hazardous drugs, fitting both the NIOSH and ISOPP definitions of a closed system. To date, there have been no published studies examining the use of a closed system drug transfer device (PhaSeal®) under Australian conditions. The purpose of this study is to determine the impact of a closed system drug transfer device on cytotoxic surface contamination in the cytotoxic preparation areas of two Australian metropolitan public hospitals. Method. This was a pre- and post-intervention study in which chemical contamination was tested at baseline then at five and 12 months after the introduction of the a closed system drug transfer device. Cyclophosphamide was used as a surrogate marker for all cytotoxic drugs. Surface wipe sampling was performed at specified sites within the cytotoxic suite using a standardized technique. Commercial products of cyclophosphamide were also sampled. Results. After five months, contamination was reduced in 13 of the 22 sites sampled (59%), with four of these samples showing undetectable levels of contamination. Two other site samples (9%) remained unchanged. The total contamination of surfaces tested was reduced by 24%. After five months hospital 1 withdrew from the study. After 12 months, surface contamination was reduced in 75% of sample sites. The total contamination of surfaces tested was reduced by 68%. The wipes of the external surface of commercial products detected cyclophosphamide contamination. Conclusion. When used inside a CDSC, the closed system drug transfer device PhaSeal® further reduces surface contamination, in some instances to undetectable levels.
Review: Discordant findings in color-coded duplex-sonography and magnetic resonance angiography in symptomatic internal carotid artery stenosis: implications for diagnostic work-up and early intervention
Authors: Eyding Jens , Krogias Christos , Seemann Marcus , Gold Ralf , Mumme Achim 
Published: December 2009

Background: Magnetic resonance angiography (MRA) is supposed to be the new ’gold standard’ in the diagnosis of atherosclerotic disease of the extracranial arteries. Methods: A case report is presented on a patient in whom discordant findings of the status of the left internal carotid artery (ICA) were identified in color-coded duplex-sonography and MRA. Results: Left ICA stenosis was suspected in duplex-sonography, yet not confirmed in contrast-enhanced (CE) MRA reconstruction. Diagnosis was confirmed after surgery and in subsequent analysis of the original CE-MRI data. Conclusions: The analysis of source images must not be missed in MRA examinations. Conventional duplex-sonography may be superior in the estimation of the embolic potential of vascular lesions. Advanced CE techniques may therefore be adequate tools in differentiating patients eligible for carotid endarterectomy (CEA) or carotid stenting, avoiding the risk of peri-interventional iatrogenic complications. It should urgently be further improved and validated.
Characteristics of Drug and Dietary Supplement Inquiries by College Athletes
Authors: Ambrose Peter J. , Tsourounis Candy , Olander Rachel , Uryasz Frank 
Published: December 2009

Background: In the United States, the National Center for Drug Free Sport manages the drug-testing programs for athletes of the National Collegiate Athletic Association (NCAA). Through its Resource Exchange Center (REC), Drug Free Sport supports athletic staff and athletes with information regarding drugs and dietary supplements. Purpose: To characterize the types of drug-related and dietary supplement–related inquiries submitted to Drug Free Sport through the REC. Study Design: Cross-sectional study. Methods: All inquiries submitted to the REC for the period of September 1, 2005, through June 30, 2006, were reviewed. The data were categorized by the method of inquiry submission; the name of the substance in question; the sex, sport, and NCAA division of the athlete involved; the nature of the inquiry; and the response provided by the REC regarding the NCAA’s status of the substance in question. Results: Pseudoephedrine, acetaminophen/hydrocodone, and albuterol were the most commonly self-searched medications; stimulants accounted for the majority of banned medications. Dietary supplements accounted for 80% of all inquiries submitted to the REC via the Banned Drug Inquiry Form. Among all dietary supplements, creatine was the most commonly inquired. Banned substances accounted for 29% of all inquiries. Conclusions: There were more than 10 000 inquiries regarding the status of medications, dietary supplements, and other substances for NCAA athletes during the 2005–2006 academic year. It is helpful for athletes to have resources that help them navigate banned-substance lists and so avoid the inadvertent use of banned substances. Clinical Relevance: Educating athletes regarding the stimulant content of various dietary supplements and addressing the lack of clinical trials to support stated claims and safety appear critical.
Association of high-level MCL-1 expression with in vitro and in vivo prednisone resistance in MLL-rearranged infant acute lymphoblastic leukemia
Authors: Stam Ronald W. , Den Boer Monique L. , Schneider Pauline , de Boer Jasper , Hagelstein Jill , Valsecchi Maria G. , de Lorenzo Paola , Sallan Stephen E. , Brady Hugh J. M. , Armstrong Scott A. , Pieters Rob 
Published: December 2009

Abstract
MLL-rearranged acute lymphoblastic leukemia (ALL) represents an unfavorable type of leukemia that often is highly resistant to glucocorticoids such as prednisone and dexamethasone. Because response to prednisone largely determines clinical outcome of pediatric patients with ALL, overcoming resistance to this drug may be an important step toward improving prognosis. Here, we show how gene expression profiling identifies high-level MCL-1 expression to be associated with prednisolone resistance in MLL-rearranged infant ALL, as well as in more favorable types of childhood ALL. To validate this observation, we determined MCL-1 expression with quantitative reverse transcription–polymerase chain reaction in a cohort of MLL-rearranged infant ALL and pediatric noninfant ALL samples and confirmed that high-level MCL-1 expression is associated with prednisolone resistance in vitro. In addition, MCL-1 expression appeared to be significantly higher in MLL-rearranged infant patients who showed a poor response to prednisone in vivo compared with prednisone good responders. Finally, down-regulation of MCL-1 in prednisolone-resistant MLL-rearranged leukemia cells by RNA interference, to some extent, led to prednisolone sensitization. Collectively, our findings suggest a potential role for MCL-1 in glucocorticoid resistance in MLL-rearranged infant ALL, but at the same time strongly imply that high-level MCL-1 expression is not the sole mechanism providing resistance to these drugs.
Short-term inhibition of p53 combined with keratinocyte growth factor improves thymic epithelial cell recovery and enhances T-cell reconstitution after murine bone marrow transplantation
Authors: Kelly Ryan M. , Goren Emily M. , Taylor Patricia A. , Mueller Scott N. , Stefanski Heather E. , Osborn Mark J. , Scott Hamish S. , Komarova Elena A. , Gudkov Andrei V. , Holländer Georg A. , Blazar Bruce R. 
Published: December 2009

AbstractMyeloablative conditioning before bone marrow transplantation (BMT) results in thymic epithelial cell (TEC) injury, T-cell immune deficiency, and susceptibility to opportunistic infections. Conditioning regimen–induced TEC damage directly contributes to slow thymopoietic recovery after BMT. Keratinocyte growth factor (KGF) is a TEC mitogen that stimulates proliferation and, when given before conditioning, reduces TEC injury. Some TEC subsets are refractory to KGF and functional T-cell responses are not fully restored in KGF-treated BM transplant recipients. Therefore, we investigated whether the addition of a pharmacologic inhibitor, PFT-β, to transiently inhibit p53 during radiotherapy could spare TECs from radiation-induced damage in congenic and allogeneic BMTs. Combined before BMT KGF + PFT-β administration additively restored numbers of cortical and medullary TECs and improved thymic function after BMT, resulting in higher numbers of donor-derived, naive peripheral CD4+ and CD8+ T cells. Radiation conditioning caused a loss of T-cell zone fibroblastic reticular cells (FRCs) and CCL21 expression in lymphoid stroma. KGF + PFT-β treatment restored both FRC and CCL21 expression, findings that correlated with improved T-cell reconstitution and an enhanced immune response against Listeria monocytogenes infection. Thus, transient p53 inhibition combined with KGF represents a novel and potentially translatable approach to promote rapid and durable thymic and peripheral T-cell recovery after BMT.