Total Knee Arthroplasty (TKA) has become a well-established treatment modality for surgical correction of knee disorders and pain generated by arthritis and other disorders such as trauma. Today a ...patient can expect to rely on his new knee to serve him with comfort for a fair number of years if not his entire life. TKA has taken on a predicated level of confidence and certain trends have developed over the years. Success has increased demand and the health care system is challenged to meet current and growing demand for surgery In fact, the epidemiological studies have predicted that hips will grow only a little whereas knees are projected to have a 6-fold increase - see Kutz AAOS Scientific Exhibit 2006. Surgical techniques are specializing into specific indications or camps for specialized product features. Uni-compartmental, Bi-compartmental, Total Knee with and without replacement of the patella, along with Patella-femoral replacement are some of the product classifications now available. The near future is now with articular focal defect replacement. New materials and techniques will open this area to increased indications as the sport-medicine surgeon finds his way into this growing surgical market.
A flow-past nose-only inhalation system was used for the co-exposure of mice to carbon black aerosols (CBA) and sulfur dioxide (SO
2) at varying relative humidities (RH). The conversion of SO
2 to ...sulfate (SO
4
−2) on the CBA, at a fixed aerosol concentration, was dependent on RH and SO
2 concentration. The effect of the aerosol-gas mixture on alveolar macrophage (AM) phagocytosis was assessed three days following exposure for 4 h. Exposure to 10 mg/m
3 CBA alone at low RH (10%) and high RH (85%), to 10 ppm SO
2 alone at both RH, and to the mixture at low RH had no effect on AM phagocytosis. In contrast, AM phagocytosis was significantly suppressed following co-exposure at 85%. RH, the only circumstance in which significant chemisorption of the gas by the aerosol and oxidation to SO
4
−2 occurred. The results suggest that fine carbon particles can be an effective vector for the delivery of toxic amounts of SO
4
−2 to the periphery of the lung.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
This study reviewed 52 revision hip arthroplasties in which calcar cortical deficiencies were addressed by implantation of a cemented, modern-design head and neck replacement femoral prosthesis. Mean ...clinical follow-up was 38 months. Radiographic follow-up beyond 22 months was available for 34 patients (mean: 35.8 months). Mean Mayo clinical hip score (maximum: 80) improved from 28.2 preoperatively to 55.2 at last follow-up. No femoral component was revised for aseptic loosening. However, radiographic analysis demonstrated one prosthesis was probably loose and two were possibly loose. A 92.7% Kaplan-Meier 5-year implant survival rate free from radiographic loosening was projected. This type of prosthesis has yielded good clinical results and excellent early survival.
Thirty-one children with postoperative coarctation of the aorta underwent maximal graded bicycle ergometry using an electronically braked ergometer and the James protocol; 18 also underwent ...expiratory gas measurement using a mass spectrometer. Twenty-two age- and gender-matched normal subjects were used as a control group. The mean age at operation was 41 months and the mean age at evaluation was 134 months (mean follow-up interval 93 months). The original surgical repair was subclavian flap repair in 8 patients, end to end anastomosis in 21, patch aortoptasty in 1 patient and tubular graft in 1.
Patients exercised until exhaustion and maximal exercise variables were obtained. The maximal voluntary peak heart rate was 183 beats/min (94.6 of predicted value), indicating excellent effort. Mean power was 111% of predicted value and, when measured, maximal oxygen consumption was 89% of predicted value with an anaerobic threshold at 63 ± 3.5% of exercise time. The observed work variables were not different from values in the control group and were not affected by the type of repair. The mean peak systolic blood pressure was 152 ± 7.6 mm Hg versus 147 ± 5.7 mm Hg in the control group (p = NS). Patients who had associated intracardiac lesions had significantly lower maximal oxygen consumption (85 ± 3% vs. 98 ± 4% of predicted value).
The results suggest that adequate cardiopulmonary function, normal or above average work capacity and normal exercise systolic blood pressure can be obtained in children with satisfactory repair of coarctation of the aorta performed before school age.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
A flow-past nose-only inhalation system is described for the coexposure of animals to carbon black aerosols (CBA) and sulfur dioxide (SO2) at varying relative humidities (RH). The conversion ...of (SO2 to sulfate (SO42-) on the CBA, at a fixed aerosol concentration, was dependent on RH and SO2 concentration. The effect of the aerosol-gas mixture on alveolar macrophage (AM) phagocytosis was assessed 3 days following nose-only exposure of mice for 4 h. Exposure to 10 mg/m3 CBA alone at low RH (10%) and high RH (85%), to 10 ppm SO2 alone at both RH, and to the mixture at low RH had no effect on AM phagocytosis. In contrast, AM phagocytosis was significantly suppressed following coexposure at 85% RH, the only circumstance in which significant chemisorption of the gas and oxidation to SO42- occurred. The results suggest that fine carbon particles are an effective vector for the delivery of toxic amounts of SO42- to the periphery of the lung under conditions of elevated RH.
Work in our laboratory has revealed autonomic and/or behavioral sensitivity of mice, rats, and a domestic fowl to extremely-low-frequency (ELF) or nominally static magnetic (B) fields at flux ...densities between 250 and 1700 microT (rms). To extend our work, an automated exposure and data-acquisition system was used with the technique of conditional suppression to assess behavioral sensitivity to time-varying B fields. Each of five rats was exposed aperiodically to a B field during 3 min warning periods that terminated in a brief electric shock. The difference between rates of lever pressing during B-field warning periods and rates during immediately antecedent, 3 min control periods was analyzed at frequencies of 7, 16, 30, 60, and 65.1 Hz. To produce equivalent induced voltages in the rat at each frequency, graded flux densities were established that ranged from 1900 microT at 7 Hz to 200 microT at 65.1 Hz. Analysis of differences in lever-pressing rates revealed that in a given session of testing the rats would increasingly suppress responding when exposed to a B field, but this trend was independent of frequency. This experiment provides evidence of behavioral sensitivity by a mammal to an ELF magnetic field.
Complex left ventricular outflow tract obstruction after operation for subaortic stenosis or with hypoplastic aortic anulus remains a challenge for pediatric cardiac surgeons. We have recently ...applied a new technique of extended aortic root replacement using a cryopreserved aortic allograft to treat two patients who had previously been operated on for subaortic stenosis and a third who had aortic stenosis with a hypoplastic aortic anulus. This new procedure combines the concept of aortoventriculoplasty with aortic root replacement and coronary artery reimplantation. The valved aortic homograft is used in place of an aortic valve prosthesis and the attached anterior mitral leaflet augments the interventricular septum to relieve the subvalvular left ventricular outflow tract obstruction. The coronary ostia are then reimplanted into the allograft and an anastomosis between the distal graft and the ascending aorta is completed. Allograft aortic tissue is then used to patch the right ventricular outflow tract. One patient had aortic stenosis with annular hypoplasia and did well after extended root replacement. Two patients had previous operations for subaortic stenosis before undergoing extended aortic root replacement. One required mediastinal exploration and drainage at 2 weeks for Serratia marcescens mediastinitis and bacteremia, but uncomplicated recovery followed. The other patient had complete heart block for 2 days, but normal sinus rhythm resumed and convalescence was benign. This modified technique with the aortic allograft was very helpful in treating these difficult problems, and the lack of mortality, limited morbidity, and good functional results are encouraging.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Peer-led, teacher-led, and expert-led interventions were conducted in six Vermont schools in order to test the effectiveness of each approach as a smoking deterrent on seventh grade students. Results ...are discussed. (Author/MT)
PDF
