All-polyethylene versus metal-backed and stemmed tibial components in cemented total hip arthroplasty.
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Bone Cements↗
Biomedical subjects
J A Rodriguez
Publications and source records attributed to J A Rodriguez.
Plasma membrane ganglioside sialidase regulates axonal growth and regeneration in hippocampal neurons in culture.
It has been long recognized that the ganglioside GM1 plays a role in axonal growth and neuronal differentiation. However, the involvement of plasma membrane GM1 has been difficult to elucidate. This is possible now thanks to the recent cloning of plasma membrane ganglioside sialidase (PMGS), the enzyme responsible for the localized hydrolysis of oligosialogangliosides into GM1. In this work we show that PMGS mRNA and protein levels are high at early developmental stages of the hippocampus and low in adulthood both in vivo and in vitro. We also demonstrate that inhibition of PMGS activity blocks axonal elongation, whereas the increase in PMGS activity dramatically enhances axon growth and accelerates the polarization of cytoskeletal proteins. Finally, we show that axotomy close to the cell body in PMGS overexpressing neurons results in the regrowth of the original axon instead of randomly, as is the case in control neurons. In all, these results imply that PMGS activity through the modulation of GM1 surface levels is an important component of the machinery controlling axonal growth. We hypothesize that increasing PMGS activity in the adult nervous system may be useful to improve regeneration after nerve damage.
Aging↗
Laparoscopic versus open fundoplication in infants.
BACKGROUND: Laparoscopic esophagogastric fundoplication is an effective treatment for severe gastroesophageal reflux disease (GERD), although its role in the very young is still largely undetermined. We review our surgical outcome in infants with severe GERD, comparing laparoscopic (LNF) with open (ONF) Nissen fundoplication. METHODS: This study reviewed 55 consecutive Nissen fundoplications performed for GERD on infants less than 1 year old at our institution between January 1996 and June 2000. The follow-up period for LNF averaged 14.2 months (range, 3.3-42 months), as compared with 16.5 months (range, 1-37.1 months) for ONF (p was not significant, t-test). Surgical outcome was compared in terms of the following parameters: average operative time, times to initiation and completion of feeding schedule, postoperative complications, and recurrence rates. RESULTS: For the study, 53 infants were divided into two groups: LNF (n = 39; 73.6%) and ONF (n = 14; 26.4%). The average operating time for LNF was 120 +/- 24 min (range, 60-195 min), as compared with 91 +/- 21 min (range, 60-135 min) for ONF (p < 0.05, t-test). Time to initiation of postoperative feeding schedule was 1.3 +/- 0.3 days for LNF, as compared with 3 +/- 0.9 days for ONF (p < 0.05, t-test). Full feedings were reached in 1.7 +/- 0.6 days for LNF, as compared with 1.3 +/- 0.9 for ONF (p was not significant, t-test). During the short-term follow-up period, recurrent reflux developed in 2/14 ONF patients (14.3%) as compared with 1/39 LNF patients (2.6%) (p < 0.05). CONCLUSIONS: We conclude that in addition to sparing infants the morbidity of celiotomy, laparoscopic Nissen fundoplication had a surgical outcome comparable to that of traditional open fundoplication in infants with severe GERD. Importantly, resumption of goal nutritional regimens was equally efficient in both groups.
Child, Preschool↗
Chemistry of NO2 on oxide surfaces: formation of NO3 on TiO2(110) and NO2<-->O vacancy interactions.
Synchrotron-based high-resolution photoemission, X-ray absorption near-edge spectroscopy, and first-principles density functional (DF) slab calculations were used to study the interaction of NO(2) with a TiO(2)(110) single crystal and powders of titania. The main product of the adsorption of NO(2) on TiO(2)(110) is surface nitrate with a small amount of chemisorbed NO(2). A similar result is obtained after the reaction of NO(2) with polycrystalline powders of TiO(2) or other oxide powders. This trend, however, does not imply that the metal centers of the oxides are unreactive toward NO(2). An unexpected mechanism is seen for the formation of NO(3). Photoemission data and DF calculations indicate that the surface nitrate forms through the disproportionation of NO(2) on Ti sites (2NO(2,ads) --> NO(3,ads) + NO(gas)) rather than direct adsorption of NO(2) on O centers of titania. Complex interactions take place between NO(2) and O vacancies of TiO(2)(110). Electronic states associated with O vacancies play a predominant role in the bonding and surface chemistry of NO(2). The adsorbed NO(2), on its part, affects the thermochemical stability of O vacancies, facilitating their migration from the bulk to the surface of titania. The behavior of the NO(2)/titania system illustrates the importance of surface and subsurface defects when using an oxide for trapping or destroying NO(x)() species in the prevention of environmental pollution (DeNOx operations).
Environmental Pollutants↗
Prevalence of upper respiratory symptoms in patients with symptomatic gastroesophageal reflux disease.
UNLABELLED: This study evaluated the prevalence of upper respiratory symptoms (URS) among patients with symptomatic gastroesophageal reflux disease (GERD). Seventy-four subjects with heartburn completed a URS questionnaire before dual-probe, 24-h esophageal pH monitoring. The URS questionnaire was also completed by 74 normal volunteers without previous or current symptoms of GERD. Esophageal pH monitoring results were classified as normal, distal, or proximal and distal gastroesophageal reflux using standardized criteria. Mean URS scores (+/- SD) were 8.31 +/- 3.98 in the 52 subjects with GERD and 4.57 +/- 3.57 in the 22 subjects with negative pH probe studies, p = 0.02. Subjects with negative pH probe studies and normal volunteers scored similarly on the URS questionnaire. Reflux episodes/24 h correlated with URS scores, r = 0.47, p = 0.0001. Seventy-five percent of subjects with upper reflux, 68% of subjects with lower reflux, 36% of subjects with normal esophageal pH studies, and 9% of normal volunteers reported laryngeal symptoms for at least 5 d/mo. Sixty-nine percent of subjects with upper reflux, 50% of subjects with lower reflux, 31% of subjects with normal pH studies, and 14% of normal volunteers reported nasal symptoms for at least 5 d/mo. URS are frequent among subjects with GERD. KEYWORDS: rhinitis; upper airway; gastroesophageal reflux
Adult↗
Vitamins C and E attenuate plasminogen activator inhibitor-1 (PAI-1) expression in a hypercholesterolemic porcine model of angioplasty.
BACKGROUND: The plasminogen activator inhibitor-1 (PAI-1), which modulates fibrinolysis and cell migration, may influence proteolysis and neointimal formation in the arterial wall contributing to restenosis after vascular injury. Antioxidants have been proposed as inhibiting multiple proatherogenic events. We explore the effect of vitamins C and E on PAI-1 expression in an experimental model of angioplasty in hypercholesterolemic pigs. METHODS AND RESULTS: A total of 44 Yucatan minipigs were divided into three diet groups: a normal-cholesterol (NC), a high-cholesterol (HC), and a high-cholesterol plus vitamins C+E (HCV) group. Balloon injury was induced in the right internal iliac artery 4 weeks after initiation of either dietary regimen, and plasma and tissue samples were taken at different time periods to measure PAI-1 activity and vascular inhibitor expression. The cholesterol-rich diet induced an increased in vascular PAI-1 expression in the intima, media and adventitia which was markedly reduced in the HCV group. After injury, severe structural changes were observed in NC and HC animals associated with increased systemic PAI-1 activity (P<0.001) and local PAI-1 expression being more intense in HC group. Vitamins C and E significantly reduced plasma PAI-1 activity (P=0.018) and attenuated the inhibitor expression as compared with HC. CONCLUSIONS: This experimental study in a porcine model of hypercholesterolemia demonstrates that vitamins C and E reduce local and systemic PAI-1 induced after angioplasty as well as the hypercholesterolemia-induced vascular PAI-1.
Analysis of Variance↗
Comparative metabolism of albendazole and albendazole sulphoxide by different helminth parasites.
Albendazole (ABZ) is a broad-spectrum benzimidazole anthelmintic widely used in human and veterinary medicine. The aim of the current work was to characterise the sulphoxidative metabolism of ABZ, and the sulphoreduction of ABZ sulphoxide (ABZSO), by microsomal (Ms) and cytosolic (Cyt) fractions of three different helminth species: Fasciola hepatica, Moniezia expansa and Ascaris suum. After the incubation assays, parasite material was analysed by HPLC to characterise the metabolic product formed. Both the Ms and Cyt fractions of the three parasites studied were able to oxidise ABZ into ABZSO in a non-enantioselective fashion. Oxidation of ABZ was greater in the Ms fraction of the trematode (50%) than in both cestode (19%) and nematode (14%) parasites. Only the incubation of ABZSO with both subcellular fractions of M. expansa generated ABZ as a metabolic product. The results obtained here indicate that helminths have the capacity to biotransform benzimidazole compounds; however, this metabolic activity differs qualitatively and quantitatively among helminth species.
Albendazole↗
Synthesis, antimycobacterial activities and cytotoxicity on V79 of 3-[4'-Y-(1,1'-biphenyl)-4-yl]-N,N-dimethyl-3-(4-X-phenyl)-2-propen-1-amine derivatives.
The derivatives of 3-(4'-bromo-[1,1'-biphenyl]-4-yl)-3-(4-X-phenyl)-N,N-dimethyl-2-propen-1-amine (5a-m) were synthesised through a Friedel-Crafts acylation followed by Wittig reaction. The effects of the compounds on standard strains of Mycobacterium sp. (ATCC) and M. tuberculosis isolated from clinical specimens were evaluated. Also the toxicity was determined on V79 cells line using neutral red uptake (NRU), nucleic acid content (NAC) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction to measure the cellular viability.
Alkenes↗
Continuous oral cytarabine ocfosfate with interferon-alpha-2b for patients with newly diagnosed chronic myeloid leukaemia: a pilot study.
Recombinant(R) interferon alpha (r-IFN-alpha) has been shown to be an effective drug for chronic myeloid leukaemia (CML). However, higher response rates can be achieved using cytarabine along with r-IFN-alpha. YNK01 is a derivative of cytosine arabinoside for oral administration. So far, the only published experience with continuous YNK01 was in advanced CML (10 cases). We have performed a pilot study to evaluate the efficacy and toxicity of the combined therapy r-IFN-alpha and daily oral YNK01 in patients with newly diagnosed Ph+ CML. Ten previously untreated patients were included in the study. Among those patients evaluable for cytogenetic response, 87% (seven out of eight) reached a major cytogenetic response with four reaching complete cytogenetic response (50%). The most significant side-effects were gastrointestinal. Macrocytic anaemia was observed in three patients. In conclusion, continuous oral administration of YNK01 in combination with IFN-alpha is safe and can result in high-cytogenetic response rates.
Adolescent↗
A ruptured abdominal aortic aneurysm repaired with a bifurcated unibody endoluminal graft.
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Aged↗
Posterior cruciate-sacrificing versus posterior cruciate-substituting total knee arthroplasty: a study of clinical and functional outcomes in matched patients.
Since the introduction of the Total Condylar Prosthesis (TCP) in 1974, concomitant improvements in surgical technique and prosthetic design have occurred. The individual effects of each of these variables have not been investigated, however. This study evaluates 2 different knee designs using the same operative technique by a single surgeon. All primary total knee arthroplasties performed between 1986 and 1989 were entered into a database of 2 cohorts, TCP and Press Fit Condylar (PFC) knees, matched for age, gender, body weight, and diagnosis. Follow-up data within 12 months of each other were used, evaluating patients clinically and using a self-administered questionnaire. In each cohort, 74 knees were matched by these criteria. Follow-up time was 4.04 and 4.45 years for the TCP and PFC cohorts. Range of motion averaged 107 degrees and 112 degrees for the TCP and PFC cohorts. This difference was statistically significant. Total knee score and functional score improved significantly. Anterior knee pain was present in 9 TCP and 3 PFC knees. Lateral release was performed in 30 TCP and 18 PFC knees. The PFC showed an advantage in ROM, stair function, anterior knee pain, and use of lateral release. Both designs showed comparable pain relief and walking ability.
Adult↗
Correction of limb-length inequality during total hip arthroplasty.
Although several methods of intraoperative limb-length measurements have been described, their success in predicting the limb-length correction is not well documented. A new technique of measuring intraoperative limb lengthening using a vertical Steinmann pin at the infracotyloid groove of the acetabulum was studied in 100 consecutive primary total hip arthroplasties. Correlation of the predicted intraoperative correction was done with the postoperative radiographic measurements. Preoperative limb-length inequality ranged from -24 mm (short) to +2 mm (long) (mean, -4.2 mm). Intraoperative measurement of lengthening ranged from 0 to 15 mm (mean, 5.9 mm). Radiographic measurements of postoperative radiographs showed lengthening ranging from 0 to 17 mm (mean, 7.4 mm). There was significant correlation between the 2 values (r =.84). Postoperative limb-length inequality ranged from -7 mm to +8 mm (mean, 1.9 mm). None of the patients had to use shoe lifts for equalization of limb lengths.
Acetabulum↗
Metal-backed and all-polyethylene tibial components in total knee replacement.
One hundred seventy-five patients with 243 consecutive primary Press Fit Condylar cruciate-substituting total knee replacements were evaluated at a mean of 5.5 years. One hundred thirteen knees had modular metal-backed tibial components and 130 had all-polyethylene tibial components. The mean knee score and functional score for the patients with unrevised components was not significantly different. The incidence of osteolysis and synovitis was higher in patients in the modular metal-backed tibia group (5%; five patients, six knees). No patients in the all-polyethylene tibia group had osteolysis or synovitis. Five revision operations were necessary: four for osteolytic defects and one for synovitis, all in patients in the modular metal-backed tibia group. All of the retrieved polyethylene inserts had evident backside wear. The best case rate of survival of the all-polyethylene tibial components was 96%+/-0.8% at 7 years and for the modular metal-backed components it was 75%+/-10% at 7 years. Metal backing and modularity were added to the Press Fit Condylar total knee replacement design to improve fixation durability. However, the superiority of the modular metal-backed implants remains in question.
Adolescent↗
Total condylar knee replacement: a 20-year followup study.
Between 1976 and 1979, 220 total knee replacements were done on 164 patients using the Total Condylar Knee replacement. The diagnosis was rheumatoid arthritis in 111 knees and osteoarthritis in 109 knees. Patients with 157 knees are known to have died as of December 1998, leaving 63 knees in patients who are still alive. Twelve patients with 18 knees were lost to followup. The average 20-year followup data (range, 18-22 years) are presented for 45 knees in 30 patients using Knee Society evaluations. The average Knee Society clinical score for the surviving patients was 88 points, and the average functional score was 58 points. The radiographic followup averaged 19 years. The average overall alignment was 3 degrees valgus. Femoral lucencies were present in 17 of 40 adequate lateral views, most commonly about the anterior and posterior surfaces. Two femoral components were loose. Twenty-two tibial components had radiolucencies; four radiolucencies were circumferential. The remaining 41 knees retained a well-fixed cemented central peg despite proximal interface lucencies. From the group of 220 knees, 14 revisions have been done at an average of 11.4 years postoperative. Two knee replacements were revised for isolated tibial loosening, whereas one knee replacement had isolated femoral loosening. Three knee replacements were revised for loosening of both components, and one was revised for isolated patellar loosening. Four patients had sepsis develop; three of these four patients were treated with two-stage revision, and one underwent fusion. Three patients were treated for supracondylar fractures. The Total Condylar Knee replacement maintains excellent durability at 20-years followup.
Adult↗
Clinical and radiographic evaluation of the Harris-Galante cup: incidence of wear and osteolysis at 7 to 9 years follow-up.
A retrospective evaluation of the clinical and radiographic results of the Harris-Galante acetabular cups was performed in 112 patients with 127 total hip arthroplasties. Patients with 14 hips had died, and patients with 20 hips were lost to follow-up. A total of 82 patients with 93 hips was available for follow-up. There were 67 men and 45 women. The mean follow-up was 87 months (range, 48-113 months). There were a total of 9 revisions: 2 for recurrent dislocations, 1 for a loose cup, and 6 for wear and osteolysis. Radiographic evaluation demonstrated that 22 (24%) hips had periacetabular osteolysis, and 16 of these 22 (73%) were associated with the screws. Twenty-two hips (23%) demonstrated osteolytic lesions around the femoral stem. Mean femoral head displacement was of 1.00 mm (range, 0.40-4.5 mm) with a rate of 0.16 mm/yr (range, 0.05-0.44 mm/yr). The Harris-Galante socket has maintained a low implant failure rate at intermediate term, even in these young patients. As follow-up increases, wear of the polyethylene and periprosthetic osteolysis may become growing concerns.
Arthroplasty, Replacement, Hip↗
Laparoscopic excision of a rare type II choledochal cyst: case report and review of the literature.
Although once considered rare, choledochal cysts now are extensively reported on and have an official anatomic classification. The authors report a case of a 4-year-old girl whom on routine abdominal ultrasound as follow-up for vesicoureteral reflux was found to have a choledochal cyst. Follow-up hepatobiliary scan together with the ultrasound findings was consistent with a rare type II choledochal cyst. On laparoscopy, a type II choledochal cyst was confirmed on dissection and amenable to laparoscopic excision. Intraoperative cholangiogram after excision showed normal remaining biliary anatomy. The patient was discharged the following day without delayed complications on follow-up visits. This report suggests a role for laparoscopic surgery in the definitive management of selected cases of choledochal cystic disease. (Included is relevant radiological documentation, illustration of technique, and review of the literature.)
Child, Preschool↗
The function of permanent vascular access.
BACKGROUND: Complications arising from vascular access (VA) are major causes of morbidity in patients on renal replacement therapy (RRT). They contribute to frustration of health care providers and to high medical cost. To prevent failures in the future it will be helpful to identify the factors that are related to VA malfunction. METHODS: In a retrospective analysis we analysed the types, duration and primary rate of patency of 1033 permanent vascular accesses in 544 consecutive patients established during a 13-year period in a tertiary care hospital. Patient characteristics, incidence, and risk factors related to VA failure were registered. In addition, VA outcomes in patients who started haemodialysis with a catheter and in whom initial VA failure occurred were analysed separately. RESULTS: Forty-five per cent of patients required a central catheter at the start of HD, but 92% of them were being dialysed with an a-v fistula at the last observation. The total number of complications was 0.24 episodes per patient per year at risk and the rate of thrombosis 0.1. A total of 52% of patients were dialysed throughout the observation period with their initial a-v fistula; 9.3% had more than three episodes of VA failure. The radiocephalic a-v fistula was the VA with the best median duration, exceeding 7 years, but also the type that had the highest initial failure rate, i.e. 25% of patients and 13% of the events. The brachiocephalic a-v fistula was the second most frequent type of VA, with a median duration of function of 3.6 years, in contrast to the humerobasilic a-v fistula, which exceeded 5 years. Average patency of the different types of grafts did not exceed 1 year, with the exception of the autologous saphenous graft with a median duration of function of 1.4 years. Patients with glomerulonephritis had the best function rates for their VA, the median exceeding the duration of the study, whereas in half of the diabetic patients it was less than 1 year. The duration of patency of the VA was twice in patients below age 65 years and in elderly males compared to elderly females. Patients who started HD with a catheter, as well as those with initial VA failure, had a higher rate of VA failure in the subsequent course on RRT. CONCLUSION: The radiocephalic and the humerobasilic a-v fistulae are the two types of VA with the longest duration of function, although a high rate of initial failure is seen with the radiocephalic a-v fistula. Age, female gender, presence of diabetic nephropathy, start of dialysis with a catheter, and failure to wait for initial maturation of the VA are risk factors, and account for the majority of VA failures during RRT.
Aged↗
Liver sulphoxidative metabolism of albendazole in rat: enantioselectivity and effect of methimazole.
The aim of the present work was to evaluate the effects of methimazole (MTZ) on the enantioselective sulphoxidation of albendazole (ABZ) by rat liver microsomes and tissue slices. Albendazole sulphoxide (ABZSO) was the metabolite recovered after the incubation with ABZ in both liver preparations. MTZ significantly reduced ABZSO production both in microsomes and slices. ABZSO production decreased as a function of MTZ concentration. The sulphoxidation reaction performed by rat liver explants in the presence of MTZ was 65% lower than that observed in controls. The reduction in the production of ABZSO in the presence of MTZ was mainly due to a lower production of (+) ABZSO. The results reported further contribute to the understanding of the enantioselective metabolism of ABZ. In addition, the work presented provides information on the comparison of two different liver tissue preparations for the evaluation of xenobiotic metabolism.
Albendazole↗