bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Outcome of Arthroscopic Repair with Concomitant Manipulation in Rotator Cuff Tears with Stiff Shoulder
Authors: Cho Nam Su , Rhee Yong Girl 
Published: June 2008

Background Little has been reported on treatment of rotator cuff tears with shoulder stiffness. Hypothesis Rotator cuff tears with shoulder stiffness will show worse clinical results than will tears without stiffness. Those with stiffness are expected to take longer time in pain reduction and recovery of range of motion. Study Design Case control study; Level of evidence, 3. Methods Among patients who underwent arthroscopic rotator cuff repairs, 15 cases with preoperative shoulder stiffness (group A) and 30 without shoulder stiffness (group B) were enrolled in this study. Preoperative mean forward flexion was 118.3° in group A and 163.4° in group B, whereas external rotation at the side was 34.6° and 55.0°, respectively. The mean follow-up period of group A was 29.8 months (range, 19.5-73.9 months) and 32.4 months (range, 16–0.6 months) in group B. Results The mean visual analog scale during motion at the last follow-up was 0.75 in group A and 0.76 in group B ( P = .942). The mean University of California at Los Angeles score was, respectively, 33.1 and 33.2 points ( P = .561). Forward flexion was 166.7° in group A and 170.2° in group B, whereas external rotation at the side was 48.8° and 53.4°, respectively ( P = .157 and .384, respectively). However, the 2 groups showed a significant difference in forward flexion until 1 year postoperatively as group A recovered more slowly ( P = .021). Both groups showed significant differences in external rotation at the side, internal rotation to the back, and cross-body adduction until 6 weeks postoperatively ( P = .009, P < .001, and P = .026, respectively). Conclusion Pain, range of motion, muscle strength, and function all significantly improved after arthroscopic rotator cuff repair, regardless of the presence of shoulder stiffness. Patients with full-thickness rotator cuff tears and stiffness of the shoulder can be treated with a single surgery and concomitant manipulation with overall good results. Although final outcomes were as good as those in patients without stiffness, the return of range of motion took longer in those patients undergoing manipulation for stiffness of the shoulder.
Sports Participation after Shoulder Replacement Surgery
Authors: McCarty Eric C. , Marx Robert G. , Maerz Deb , Altchek David , Warren Russell F. 
Published: June 2008

Background Return to sports after total hip or knee replacement surgery has been extensively described. However, the return to general sporting activities after shoulder replacement surgery has not been well documented. With improved implant survivorship, patient expectation of function is high. Purpose The purpose of this study was to assess the outcome and ability of patients returning to sports after shoulder replacement surgery. Study Design Case series; Level of evidence, 4. Methods Seventy-five patients (86 shoulder replacements) who participated in sports or recreational activities before surgery were followed for a minimum of 2 years. Their preoperative and postoperative sports participation and level of competition were assessed. The frequency of their activity, modifications in activity, and length of time it took to resume sports participation after the operation were all reviewed. Results The mean age at follow-up was 65.5 years (range, 24-88). The average follow-up was 3.7 years (range, 2-9.4). Sixty-four percent of the patients stated that one of the reasons they had the surgery performed was participation in sports. Thirty-four of 48 of these patients (71 %) demonstrated an improvement in their ability to play their sport and 50% increased their frequency of participation postoperatively. Softball athletes demonstrated the least favorable return; only 2 of 10 patients returned. Swimming, tennis, and golf were the most popular sports; participants in these sports showed the most favorable improvement and actual return. The mean time to partial return to sports was 3.6 months, and 5.8 months to full participation. Conclusion Patients are able to successfully return to sports after shoulder arthroplasty. Many returned with improved performance and increased frequency in participation in a timely manner.
Kinematic Evaluation of the Modified Weaver-Dunn Acromioclavicular Joint Reconstruction
Authors: LaPrade Robert F. , Wickum Daren J. , Griffith Chad J. , Ludewig Paula M. 
Published: June 2008

BackgroundFew reconstructive methods to treat displaced acromioclavicular separations have been evaluated using kinematic data.HypothesisThe modified Weaver-Dunn reconstruction restores intact acromioclavicular joint motion during passive scapular plane abduction.Study DesignControlled laboratory study.MethodsAcromioclavicular joint motion was recorded during passive humeral elevation in 3 states: an intact shoulder, an “injured” state in which the acromioclavicular and coracoclavicular ligaments were transected, and finally in a reconstructed state using a modified Weaver-Dunn reconstruction. Measurements were taken with an electromagnetic motion analysis system attached to rigid pins placed in the clavicle, scapula, humerus, and sternum during passive scapular plane humeral elevation.ResultsTotal translatory motion of the acromioclavicular joint in the cut state was significantly greater than both the intact and reconstructed states in the medial/lateral (intact, 4.3 mm; cut, 7.9 mm; reconstructed, 2.6 mm), anterior/posterior (intact, 4.8 mm; cut, 6.1 mm; reconstructed, 4.9 mm), and superior/inferior (intact, 4.1 mm; cut, 8.0 mm; reconstructed, 4.8 mm) directions. The maximum and minimum positions of the reconstructed state were significantly more anterior and inferior than in the intact state. A significant increase in acromioclavicular axial rotation was also found between the intact and cut state.ConclusionThe modified Weaver-Dunn reconstruction was found to restore motion of the acromioclavicular joint to near-intact values, but created a more anterior and inferior position of the clavicle with respect to the acromion.Clinical RelevanceThese kinematic data support the modified Weaver-Dunn reconstruction as a kinematically sound procedure to treat displaced acromioclavicular joint injuries.
Murine neonates develop vigorous in vivo cytotoxic and Th1/Th2 responses upon exposure to low doses of NIMA-like alloantigens
Authors: Opiela Shannon J. , Levy Robert B. , Adkins Becky 
Published: June 2008

AbstractEarly life exposure to noninherited maternal antigens (NIMAs) may occur via transplacental transfer and/or breast milk. There are indications that early life exposure to NIMAs may lead to lifelong tolerance. However, there is mounting evidence that exposure to NIMAs may also lead to immunologic priming. Understanding how these different responses arise could be critical in transplantation with donor cells expressing NIMAs. We recently reported that murine neonates that received a transplant of low doses of NIMA-like alloantigens develop vigorous memory cytotoxic responses, as assessed by in vitro assays. Here, we demonstrate that robust allospecific cytotoxicity is also manifest in vivo. Importantly, at low doses, NIMA-expressing cells induced the development of in vivo cytotoxicity during the neonatal period. NIMA-exposed neonates also developed vigorous primary and memory allospecific Th1/Th2 responses that exceeded the responses of adults. Overall, we conclude that exposure to low doses of NIMA-like alloantigens induces robust in vivo cytotoxic and Th1/Th2 responses in neonates. These findings suggest that early exposure to low levels of NIMA may lead to long-term immunologic priming of all arms of T-cell adaptive immunity, rather than tolerance.
Antigen-specific T-T interactions regulate CD4 T-cell expansion
Authors: Helft Julie , Jacquet Alexandra , Joncker Nathalie T. , Grandjean Isabelle , Dorothée Guillaume , Kissenpfennig Adrien , Malissen Bernard , Matzinger Polly , Lantz Olivier 
Published: June 2008

AbstractThe regulation of CD4 T-cell numbers during an immune response should take account of the amount of antigen (Ag), the initial frequency of Ag-specific T cells, the mix of naive versus experienced cells, and (ideally) the diversity of the repertoire. Here we describe a novel mechanism of T-cell regulation that potentially deals with all of these parameters. We found that CD4 T cells establish a negative feedback loop by capturing their cognate major histocompatibility class (MHC)/peptide complexes from Ag-presenting cells and presenting them to Ag-experienced CD4 T cells, thereby inhibiting their recruitment into the response while allowing recruitment of naive T cells. The inhibition is Ag specific, begins at day 2 (long before Ag disappearance), and cannot be overcome by providing new Ag-loaded dendritic cells. In this way, CD4 T-cell proliferation is regulated in a functional relationship to the amount of Ag, while allowing naive T cells to generate repertoire variety.
FIP1L1/PDGFRα synergizes with SCF to induce systemic mastocytosis in a murine model of chronic eosinophilic leukemia/hypereosinophilic syndrome
Authors: Yamada Yoshiyuki , Sanchez-Aguilera Abel , Brandt Eric B. , McBride Melissa , Al-Moamen Nabeel J. H. , Finkelman Fred D. , Williams David A. , Cancelas Jose A. , Rothenberg Marc E. 
Published: June 2008

AbstractExpression of the fusion gene FIP1-like 1/platelet-derived growth factor receptor alpha (FIP1L1/PDGFRα, F/P) and dysregulated c-kit tyrosine kinase activity are associated with systemic mastocytosis (SM) and chronic eosinophilic leukemia (CEL)/hypereosinophilic syndrome (HES). We analyzed SM development and pathogenesis in a murine CEL model induced by F/P in hematopoietic stem cells and progenitors (HSCs/Ps) and T-cell overexpression of IL-5 (F/P-positive CEL mice). These mice had more mast cell (MC) infiltration in the bone marrow (BM), spleen, skin, and small intestine than control mice that received a transplant of IL-5 transgenic HSCs/Ps. Moreover, intestinal MC infiltration induced by F/P expression was severely diminished, but not abolished, in mice injected with neutralizing anti–c-kit antibody, suggesting that endogenous stem cell factor (SCF)/c-kit interaction synergizes with F/P expression to induce SM. F/P-expressing BM HSCs/Ps showed proliferation and MC differentiation in vitro in the absence of cytokines. SCF stimulated greater migration of F/P-expressing MCs than mock vector–transduced MCs. F/P-expressing bone marrow–derived mast cells (BMMCs) survived longer than mock vector control BMMCs in cytokine-deprived conditions. The increased proliferation and survival correlated with increased SCF-induced Akt activation. In summary, F/P synergistically promotes MC development, activation, and survival in vivo and in vitro in response to SCF.
Long-term expansion of effector/memory Vδ2− γδ T cells is a specific blood signature of CMV infection
Authors: Pitard Vincent , Roumanes David , Lafarge Xavier , Couzi Lionel , Garrigue Isabelle , Lafon Marie-Edith , Merville Pierre , Moreau Jean-François , Déchanet-Merville Julie 
Published: June 2008

AbstractThe ability of human γδ T cells to develop immunologic memory is still a matter of debate. We previously demonstrated the involvement of Vδ2− γδ T lymphocytes in the response of immunosuppressed organ recipients to cytomegalovirus (CMV). Here, we demonstrate their ability to mount an adaptive immune response to CMV in immunocompetent subjects. Vδ2− γδ T-cell peripheral blood numbers, repertoire restriction, and cytotoxicity against CMV-infected fibroblasts were markedly increased in CMV-seropositive, compared with CMV-seronegative, healthy persons. Whereas Vδ2− γδ T cells were found as naive cells in CMV− patients, they virtually all exhibited the cytotoxic effector/memory phenotype in CMV+ patients, which is also observed in transplanted patients challenged with CMV. This long-term complete remodeling of the Vδ2− γδ T-cell population by CMV predicts their ability to exhibit an adaptive anti-CMV immune response. Consistent with this, we observed that the secondary response to CMV was associated with a faster γδ T-cell expansion and a better resolution of infection than the primary response. In conclusion, the increased level of effector-memory Vδ2− γδ T cells in the peripheral blood is a specific signature of an adaptive immune response to CMV infection of both immunocompetent and immunosuppressed patients.
High plasma levels of soluble P-selectin are predictive of venous thromboembolism in cancer patients: results from the Vienna Cancer and Thrombosis Study (CATS)
Authors: Ay Cihan , Simanek Ralph , Vormittag Rainer , Dunkler Daniela , Alguel Guelay , Koder Silvia , Kornek Gabriela , Marosi Christine , Wagner Oswald , Zielinski Christoph , Pabinger Ingrid 
Published: June 2008

Abstract
Cancer patients are at high risk for venous thromboembolism (VTE). Laboratory parameters with a predictive value for VTE could help stratify patients into high- or low-risk groups. The cell adhesion molecule P-selectin was recently identified as risk factor for VTE. To investigate soluble P-selectin (sP-selectin) in cancer patients as risk predictor for VTE, we performed a prospective cohort study of 687 cancer patients and followed them for a median (IQR) of 415 (221-722) days. Main tumor entities were malignancies of the breast (n = 125), lung (n = 86), gastrointestinal tract (n = 130), pancreas (n = 42), kidney (n = 19), prostate (n = 72), and brain (n = 80); 91 had hematologic malignancies; 42 had other tumors. VTE occurred in 44 (6.4%) patients. In multivariable analysis, elevated sP-selectin (cutoff level, 53.1 ng/mL, 75th percentile of study population) was a statistically significant risk factor for VTE after adjustment for age, sex, surgery, chemotherapy, and radiotherapy (hazard ratio = 2.6, 95% confidence interval, 1.4-4.9, P = .003). The cumulative probability of VTE after 6 months was 11.9% in patients with sP-selectin above and 3.7% in those below the 75th percentile (P = .002). High sP-selectin plasma levels independently predict VTE in cancer patients. Measurement of sP-selectin at diagnosis of cancer could help identify patients at increased risk for VTE.
Iron regulates phosphorylation of Smad1/5/8 and gene expression of Bmp6, Smad7, Id1, and Atoh8 in the mouse liver
Authors: Kautz Léon , Meynard Delphine , Monnier Annabelle , Darnaud Valérie , Bouvet Régis , Wang Rui-Hong , Deng Chiuxia , Vaulont Sophie , Mosser Jean , Coppin Hélène , Roth Marie-Paule 
Published: June 2008

Abstract
Although hepcidin expression was shown to be induced by the BMP/Smad signaling pathway, it is not yet known how iron regulates this pathway and what its exact molecular targets are. We therefore assessed genome-wide liver transcription profiles of mice of 2 genetic backgrounds fed iron-deficient, -balanced, or -enriched diets. Among 1419 transcripts significantly modulated by the dietary iron content, 4 were regulated similarly to the hepcidin genes Hamp1 and Hamp2. They are coding for Bmp6, Smad7, Id1, and Atoh8 all related to the Bmp/Smad pathway. As shown by Western blot analysis, variations in Bmp6 expression induced by the diet iron content have for functional consequence similar changes in Smad1/5/8 phosphorylation that leads to formation of heteromeric complexes with Smad4 and their translocation to the nucleus. Gene expression variations induced by secondary iron deficiency or iron overload were compared with those consecutive to Smad4 and Hamp1 deficiency. Iron overload developed by Smad4- and Hamp1-deficient mice also increased Bmp6 transcription. However, as shown by analysis of mice with liver-specific disruption of Smad4, activation of Smad7, Id1, and Atoh8 transcription by iron requires Smad4. This study points out molecules that appear to play a critical role in the control of systemic iron balance.
Differential effects of donor T-cell cytokines on outcome with continuous bortezomib administration after allogeneic bone marrow transplantation
Authors: Sun Kai , Li Minghui , Sayers Thomas J. , Welniak Lisbeth A. , Murphy William J. 
Published: June 2008

AbstractDissociating graft-versus-tumor (GVT) effect from acute graft-versus-host disease (GVHD) still remains a great challenge in allogeneic bone marrow transplantation (allo-BMT). Bortezomib, a proteasome inhibitor, has shown impressive efficacy as a single agent in patients with hematologic malignancies but can result in toxicity when administered late after allogeneic transplantation in murine models of GVHD. In the current study, the effects of T-cell subsets and their associated cytokines on the efficacy of bortezomib in murine allogeneic BMT were investigated. Increased levels of serum tumor necrosis factor-α (TNFα) and interferon-γ (IFNγ) were observed after allo-BMT and continuous bortezomib administration. Bortezomib-induced GVHD-dependent mortality was preventable by depletion of CD4+ but not CD8+ T cells from the donor graft. The improved survival correlated with markedly reduced serum TNFα but not IFNγ levels. Transfer of Tnf−/− T cells also protected recipients from bortezomib-induced GVHD-dependent toxicity. Importantly, prolonged administration of bortezomib after transplantation of purified CD8+ T cells resulted in enhanced GVT response, which was dependent on donor CD8+ T cell–derived IFNγ. These results indicate that decreased toxicity and increased efficacy of bortezomib in murine allo-BMT can be achieved by removal of CD4+ T cells from the graft or by inhibiting TNFα.
Investigation of the grid and intake-generated tumble on the in-cylinder flow in a compression ignition direct-injection engine
Authors: Micklow G J , Gong W-D 
Published: June 2008

The in-cylinder flow field was numerically investigated for a four-valve per cylinder Caterpillar diesel CAT3401 engine. The computer program used was the KIVA3V code developed by Los Alamos National Laboratory. To assess the effect of modelling assumptions made during the domain discretization, three grid models were developed. The first grid or the ‘complete’ grid was a full 360° mesh with moving valves, intake ports, exhaust ports, and runners. The second grid was a full 360° mesh without moving valves, intake ports, or exhaust ports. The third grid assumed that the in-cylinder flow field was periodic and a 60° mesh was generated to accommodate one of the six centrally located fuel injectors. It also neglected the valves and the intake and exhaust ports. The simplification of the grids is to reduce the massive computational and memory requirements to model these flows. For the complete grid, the computation was initiated when the piston was at the top dead centre location on the intake stroke. For the second and third grids, the computation was initiated after the intake valve had closed. Complex three-dimensional vortical flow structures or tumble is developed during the intake stroke. These structures were clearly shown when the complete grid was used. By comparing the solution of the complete grid with the solutions of the second and third grids, it was seen that important in-cylinder flow information is lost. To overcome this deficiency, a new parameter, namely the initial tumble ratio, was embedded into the standard KIVA3V code by the present authors. When the simplified second grid is used in conjunction with the initial tumble ratio option, an in-cylinder flow pattern similar to that which was computed with the complete grid was obtained. This indicates that the new option significantly improves the accuracy of in-cylinder flow prediction when the moving valves and intake or exhaust ports are not modelled. The effects of the values of the initial turbulence kinetic energy (TKEi) and the initial turbulence length scale (SCLi) were also studied. It is found that the suggested value of TKEi used in KIVA3V is too small to predict the actual turbulence kinetic energy in the cylinder when the second and third grids are used. Therefore, a larger value for TKEi is recommended. The effects of the different grids, the new initial tumble ratio, and the different values of SCLi and TKEi on important flow parameters, such as the swirl ratio, the tumble ratio, and the turbulence kinetic energy are compared in detail in this article.
An optical method for automated roadside detection and counting of vehicle occupants
Authors: Tyrer J R , Lobo L M 
Published: June 2008

The monitoring and control of traffic volume is becoming a constant social, economic, and environmental pressure in the UK and elsewhere, because of landmass and current infrastructure strain under a swelling and increasingly mobile population. The viability of high-occupancy vehicle (HOV) lanes for easing traffic congestion, and hence maximising traffic flow, has been proven in countries worldwide. The USA, Australia, and Canada have had HOV installations for some time, controlling the flux of traffic into their most densely populated areas. Experience in these cases has dictated that it is enforcement which is crucial to the successful implementation of such a traffic policy. To date, all enforcement has been manual, i.e. a police officer counting the occupants in a vehicle as it passes by. Studies have concluded that manual enforcement is typically only 65 per cent accurate and, considering the pressures which one individual is put under in these circumstances, this statistic is not surprising. Lighting and environmental conditions, skin tone, and location of the occupants and the alertness of the officer are all variables affecting the accuracy of manually collected data. Hence there is the need for an autonomous detection system to count the occupancy within a vehicle. This could provide the basis of an enforcement or congestion strategy.
How to Measure the Diagnostic Accuracy of Noninvasive Liver Fibrosis Indices: The Area Under the ROC Curve Revisited
Authors: Lambert Jerome , Halfon Philippe , Penaranda Guillaume , Bedossa Pierre , Cacoub Patrice , Carrat Fabrice 
Published: June 2008

AbstractBackground: The area under the ROC curve (AUC) is widely used to measure the diagnostic accuracy of noninvasive fibrosis indices. However, use of the AUC assumes a binary gold standard, whereas fibrosis staging is based on an ordinal scale and also depends on the distribution of fibrosis stages in the study sample. We explored other fibrosis staging accuracy measures designed for ordinal gold standards, the C-statistic and the Obuchowski measure.Methods: We performed a simulation study to assess the bias in estimating the accuracy measures when the distribution of fibrosis stages in the study sample do not fit the reference distribution in the population to which the indices are applied. We also estimated the type I error of the tests comparing these measures in 2 samples with different distributions of fibrosis stages. We illustrated the practical use of these measures by reanalyzing real data.Results: Compared with the AUC or the C-statistic, the Obuchowski measure showed limited bias when the distribution of fibrosis stages in the study sample differed from the reference distribution. The type I error was strongly inflated with the AUC or the C-statistic but was preserved in the Obuchowski measure. When we compared noninvasive indices on real data, AUC analysis led to discordant results depending on how the fibrosis stages were grouped together. One single conclusion was drawn from the analysis based on the Obuchowski measure.Conclusions: We recommend using the Obuchowski measure for assessing the diagnostic accuracy of noninvasive indices of fibrosis.