Computer-assisted hip resurfacing surgery using the acrobot navigation system.

The authors have previously reported on the laboratory development of the Acrobot Navigation System for accurate computer-assisted hip resurfacing surgery. This paper describes the findings of using the system in the clinical setting and including the improvements that have been made to expedite the procedure. The aim of the present system is to allow accurate planning of the procedure and precise placement of the prosthesis in accordance with the plan, with a zero intraoperative time penalty in comparison to the standard non-navigated technique.

Comparison of longitudinal leukocyte gene expression after burn injury or trauma-hemorrhage in mice.

A primary objective of the large collaborative project entitled "Inflammation and the Host Response to Injury" was to identify leukocyte genes that are differentially expressed after two different types of injury in mouse models and to test the hypothesis that both forms of injury would induce similar changes in gene expression. We report here the genes that are expressed in white blood cells (WBCs) and in splenocytes at 2 h, 1 day, 3 days, and 7 days after burn and sham injury or trauma-hemorrhage (T-H) and sham T-H. Affymetrix Mouse Genome 430 2.

Transcriptional profiles of human epithelial cells in response to heat: computational evidence for novel heat shock proteins.

We hypothesized that broad-scale expression profiling would provide insight into the regulatory pathways that control gene expression in response to stress and potentially identify novel heat-responsive genes. HEp2 cells, a human malignant epithelial cell line, were heated at 37 degrees C to 43 degrees C for 60 min to gauge the heat shock response, using as a proxy inducible Hsp70 quantified by Western blot analysis. Based on these results, microarray experiments were conducted at 37 degrees C, 40 degrees C, 41 degrees C, 42 degrees C, and 43 degrees C.

A prospective randomized controlled trial of anterior compared with posterior stabilization for unilateral facet injuries of the cervical spine.

Object: Unilateral facet injuries can be treated with either anterior or posterior fixation techniques with reportedly good outcomes. The two approaches have not been directly compared, however, and consensus is lacking as to which is the optimal method. The primary objective of this study was to determine whether acute postoperative morbidity differed between anteriorly and posteriorly treated patients with unilateral facet injuries.

Navigation reduces the learning curve in resurfacing total hip arthroplasty.

Hip resurfacing is a novel technique with a substantial learning curve resulting in poor outcomes for many patients. We asked whether navigation would influence this learning curve and accuracy of implantation. Twenty medical students earning their degree in surgical technology participated in a randomized trial.

Co-crystal structure guided array synthesis of PPARgamma inverse agonists.

PPARgamma-activating thiazolidinediones and carboxylic acids such as farglitazar exert their anti-diabetic effects in part in PPARgamma rich adipose. Both pro- and anti-adipogenic PPARgamma ligands promote glucose and lipid lowering in animal models of diabetes. Herein, we disclose representatives of an array of 160 farglitazar analogues with atypical inverse agonism of PPARgamma in mature adipocytes.

Robotic clinical trials of uni-condylar arthroplasty.

A randomised clinical trial has been completed for uni-condylar arthroplasty. The trial, under the auspices of the UK MHRA, comprised 15 knees of patients undergoing conventional surgery, and 13 knees of patients who had robotic surgery using the Acrobot hands-on robotic system. The results of the trial were checked by comparing post-op CT scans with pre-op CT-based plans, and show a significant improvement in accuracy using the robot.

The transverse pelvic plane: a new and practical reference frame for hip arthroplasty.

Acetabular orientation is a crucial part of the planning and performance of hip arthroplasty. Currently, most surgeons use the anterior pelvic plane (APP) to orient themselves when navigating the acetabulum, despite the fact that the anterior superior iliac spine (ASIS) of the unaffected side is not accessible in the lateral position. We have identified another plane, the transverse pelvic plane (TPP), relying on both posterior superior iliac spines and the ASIS of the affected side.

The synthesis and enzymic hydrolysis of (E)-2-[2,3-2H2]propenyl glucosinolate: confirmation of the rearrangement of the thiohydroximate moiety.

(E)-2-[2,3-2H2]propenyl glucosinolate was synthesised starting from (E)-[3,4-2H2]but-3-en-1-ol, which was produced by reduction of but-3-yn-1-ol with deuterium gas in the presence of Lindlar's catalyst. The synthesis of (E)-2-[2,3-2H2]propenyl glucosinolate was completed via the nitro intermediate to form the basic desulphoglucosinolate skeleton. The (E)-2-[2,3-2H2]propenyl glucosinolate was fully characterised and deuterium NMR spectroscopy used to examine the rearrangement of the thiohydroximate to the isothiocyanate and thiocyanate.

The murine plasma protein response to polymicrobial intra-abdominal sepsis.

Protein biomarkers in the peripheral blood could potentially be used as early indicators of sepsis and a means to stratify patients for clinical trials. Although individual molecular markers have been proposed for sepsis, none has clinical utility. The global changes in plasma proteins over the clinical course of sepsis have not been characterized using proteomic methods.

Robotic control in knee joint replacement surgery.

A brief history of robotic systems in knee arthroplasty is provided. The place of autonomous robots is then discussed and compared to more recent 'hands-on' robotic systems that can be more cost effective. The case is made for robotic systems to have a clear justification, with improved benefits compared to those from cheaper navigation systems.

Baldness and the androgen receptor: the AR polyglycine repeat polymorphism does not confer susceptibility to androgenetic alopecia.

Androgenetic alopecia, or male pattern baldness, is a complex condition with a strong heritable component. In 2001, we published the first significant evidence of a genetic association between baldness and a synonymous coding SNP (rs6152) in the androgen receptor gene, AR. Recently, this finding was replicated in three independent studies, confirming an important role for AR in the baldness phenotype.

Surviving sepsis: bcl-2 overexpression modulates splenocyte transcriptional responses in vivo.

We hypothesized that spleen microarray gene expression profiles analyzed with contemporary pathway analysis software would provide molecular pathways of interest and target genes that might help explain the effect of bcl-2 on improving survival during sepsis. Two mouse models of sepsis, cecal ligation and puncture and tracheal instillation of Pseudomonas aeruginosa, were tested in both wild-type mice and mice that overexpress bcl-2. Whole spleens were obtained 6 h after septic injury.

Observation of muon neutrino disappearance with the MINOS detectors in the NuMI neutrino beam.

This Letter reports results from the MINOS experiment based on its initial exposure to neutrinos from the Fermilab NuMI beam. The rates and energy spectra of charged current nu(mu) interactions are compared in two detectors located along the beam axis at distances of 1 and 735 km. With 1.

Preoperative planning and intraoperative guidance for accurate computer-assisted minimally invasive hip resurfacing surgery.

Hip resurfacing is an alternative to total hip replacement (THR) and is particularly suitable for the younger, more active patient. However, it is a more demanding procedure. This paper describes a system that enables the surgeon to plan the surgery preoperatively with optimally sized and placed components, and then transfer this plan to an intraoperative system that registers computer models to the real patient and tracks surgical tools, allowing the surgeon to ensure that the bone is resected correctly and that the components are fitted in accordance with the plan.

Thermography and thermometry in the assessment of diabetic neuropathic foot: a case for furthering the role of thermal techniques.

There are currently 3 established techniques employed routinely to determine the risk of foot ulceration in the patient with diabetes mellitus. These are the assessment of circulation, neuropathy, and foot pressure. These assessments are widely used clinically as well as in the research domain with an aim to prevent the onset of foot ulceration.

Molecular diagnostics in sepsis: from bedside to bench.

Background: Based on recent in vitro data, we tested the hypothesis that microarray expression profiles can be used to diagnose sepsis, distinguishing in vivo between sterile and infectious causes of systemic inflammation.

Study Design: Exploratory studies were conducted using spleens from septic patients and from mice with abdominal sepsis. Seven patients with sepsis after injury were identified retrospectively and compared with six injured patients.

Very low-dose computed tomography for planning and outcome measurement in knee replacement. The imperial knee protocol.

Surgeons need to be able to measure angles and distances in three dimensions in the planning and assessment of knee replacement. Computed tomography (CT) offers the accuracy needed but involves greater radiation exposure to patients than traditional long-leg standing radiographs, which give very little information outside the plane of the image. There is considerable variation in CT radiation doses between research centres, scanning protocols and individual scanners, and ethics committees are rightly demanding more consistency in this area.

Cell-specific expression and pathway analyses reveal alterations in trauma-related human T cell and monocyte pathways.

Monitoring genome-wide, cell-specific responses to human disease, although challenging, holds great promise for the future of medicine. Patients with injuries severe enough to develop multiple organ dysfunction syndrome have multiple immune derangements, including T cell apoptosis and anergy combined with depressed monocyte antigen presentation. Genome-wide expression analysis of highly enriched circulating leukocyte subpopulations, combined with cell-specific pathway analyses, offers an opportunity to discover leukocyte regulatory networks in critically injured patients.

RecQ helicases: lessons from model organisms.

RecQ DNA helicases function during DNA replication and are essential for the maintenance of genome stability. There is increasing evidence that spontaneous genomic instability occurs primarily during DNA replication, and that proteins involved in the S-phase checkpoint are a principal defence against such instability. Cells that lack functional RecQ helicases exhibit phenotypes consistent with an inability to fully resume replication fork progress after encountering DNA damage or fork arrest.

Splenic CD4+ T cells have a distinct transcriptional response six hours after the onset of sepsis.

Background: In animal and human autopsy studies of sepsis, CD4+ splenocytes either undergo apoptosis or are polarized to the Th2 effector subtype. In mice, these changes occur within 24 hours of the onset of sepsis. Preventing the loss of CD4+ T cells and the Th2-polarization of CD4+ T cells provides a significant survival advantage in mouse models of sepsis.

Stability of pesticides on solid-phase extraction disks after incubation at various temperatures and for various time intervals: interlaboratory study.

An interlaboratory study was conducted at 8 locations to assess the stability of pesticides on solid-phase extraction (SPE) disks after incubation at various temperatures and for various time intervals. Deionized water fortified with selected pesticides was extracted by using 2 types of SPE filtration disks (Empore C18 and Speedisk C18XF), and after extraction, the disks were incubated at 3 temperatures (25, 40, and 55 degrees C) and for 2 time intervals (4 and 14 days). Deionized water was fortified with atrazine, carbofuran, and chlorpyrifos by all participating laboratories.

An optimized whole blood method for flow cytometric measurement of ZAP-70 protein expression in chronic lymphocytic leukemia.

Background: ZAP-70 protein expression has been proposed as a marker for immunoglobulin heavy chain mutational status, which some studies have correlated with disease course in B-cell chronic lymphocytic leukemia (CLL). Studies published to date measuring levels of expression of ZAP-70 intracellular protein using flow cytometry have demonstrated poor performance, as defined by the difference in signal in known positive and negative lymphocyte populations.

Methods: A recently published method (Chow S, Hedley DW, Grom P, Magari R, Jacobberger JW, Shankey TV, Cytometry A 2005;67:4-17) to measure intracellular phospho-epitopes was optimized using a design of experiments (DOE) approach to provide the best separation of ZAP-70 expression in positive T- or NK-cells as compared to negative B-cells in peripheral blood samples.

Improving blood pressure control through provider education, provider alerts, and patient education: a cluster randomized trial.

Background: Inadequate blood pressure control is a persistent gap in quality care.

Objective: To evaluate provider and patient interventions to improve blood pressure control.

Design: Cluster randomized, controlled trial.