Given an abstract of a paper, generate a title for this paper such that conveys the key focus of the paper.

Ex Input:
Abstract: The results of forty core-decompression procedures that were performed for ischemic necrosis of the femoral head in thirty-one patients over a four-year period were retrospectively reviewed to ascertain the effectiveness of the procedure. The data did not support the published rates of success of the procedure for Stage-1 and Stage-2 lesions. With a mean length of follow-up of eighteen months, 60 per cent of the hips that had a decompression prior to collapse of the femoral head demonstrated progression of the lesion and were judged to be a failure by clinical or radiographic criteria. Computerized tomographic scans and magnetic resonance imaging proved to be 100 per cent sensitive for diagnosis in preoperative testing; isotopic bone-scanning was less sensitive (80 per cent). Functional intraoperative testing by the method of Ficat did not provide added sensitivity or specificity to the results of the preoperative bone scan. A postoperative or intraoperative fracture occurred in four hips, for an incidence that exceeded any in previously published reports. We concluded that core decompression should be considered a relatively ineffective procedure with significant morbidity.

Ex Output:
Core decompression of the femoral head for osteonecrosis.

Ex Input:
Abstract: The fingernails of twenty-four patients with classical adult (type 1) pityriasis rubra pilaris were examined for changes in nail morphology and a comparison was made with the fingernail morphology of twenty-seven consecutive psoriatic patients with nail changes. Distal yellow-brown discoloration, subungual hyperkeratosis, nail plate thickening, and splinter hemorrhages indicate a diagnosis of type 1 pityriasis rubra pilaris rather than psoriasis, while onycholysis (particularly marginal), salmon patches, small pits, and larger indentations of the nail plate indicate a diagnosis of psoriasis. Histology demonstrated that a nail biopsy would be a useful diagnostic procedure if nails were involved in isolation but provided no additional diagnostic features to those found from biopsy specimens of involved skin in the two conditions. The similarity in nail morphology between the type 1 pityriasis rubra pilaris patients and five patients with chronic erythroderma resulting from Sezary syndrome indicated that these changes may represent a nonspecific reaction pattern that may result from prolonged erythema of the proximal nail bed and matrix. The rough nails (trachyonychia) described in advanced Sezary syndrome were not observed in any of our patients.

Ex Output:
The nails in adult type 1 pityriasis rubra pilaris. A comparison with Sezary syndrome and psoriasis [see comments]

Ex Input:
Abstract: The population of common seal Phoca vitulina in the westernmost part of the Wadden Sea, The Netherlands, has collapsed during the past few decades. Between 1950 and 1975 the population dropped from more than 3,000 to less than 500 animals. Comparative studies of common seal populations from different parts of the Wadden Sea reveal that pup production has declined sharply only in the western (Dutch) part. A comparative toxicological study on the levels of heavy metals and organochlorines in tissues of seals from the western and northern parts of the Wadden Sea shows that only the polychlorinated biphenyl (PCB) levels differ significantly. This is predominantly a result of PCB pollution from the river Rhine, which mainly affects the western (Dutch) part. PCBs are thought to be responsible for the low rate of reproduction in Dutch common seals on the basis of epidemiological and experimental data on the ability of PCBs to interfere with mammalian reproduction. Here I report that reproductive failure in common seals from the Dutch Wadden Sea is related to feeding on fish from that polluted area. This is the first demonstration of a causal relationship between naturally occurring levels of pollutants and a physiological response in marine mammals.

Ex Output:
Reproductive failure in common seals feeding on fish from polluted coastal waters [published erratum appears in Nature 1986 Dec 4-10;324(6096):418]