Traumatic anterior cruciate ligament tear and its implications on meniscal degradation: a preliminary novel lapine osteoarthritis model.

Background: Injury patterns of the meniscus following impact trauma resulting in anterior cruciate ligament (ACL) rupture are not well understood. This study explored the spatial and temporal distribution of meniscal tears in a novel in vivo lapine model.

Methods: Skeletally mature Flemish Giant rabbits were subjected to either tibiofemoral impaction resulting in ACL rupture or surgical ACL transection.

Intratumoral immune cell infiltrates, FoxP3, and indoleamine 2,3-dioxygenase in patients with melanoma undergoing CTLA4 blockade.

Purpose: CTL-associated antigen 4 (CTLA4)-blocking monoclonal antibodies induce long-term regression of metastatic melanoma in some patients, but the exact mechanism is unknown. In this study, biopsies of selected accessible tumor lesions from patients treated with tremelimumab were examined to further elucidate the mechanism of its antitumor activity.

Experimental Design: Fifteen tumor biopsies from 7 patients who had been treated with tremelimumab (CP-675,206) were collected.

CXCR2 and RET single nucleotide polymorphisms in pancreatic cancer.

Enhanced angiogenesis and perineural invasion are markers of poor prognosis in patients with pancreatic cancer. Systemic therapies for pancreatic cancer have been largely ineffective, and thus improved, targeted therapies are needed. Single nucleotide polymorphisms (SNP) are DNA sequence variations that result in vast diversity of disease susceptibility and response to disease.

Constitutive modeling of skeletal muscle tissue with an explicit strain-energy function.

While much work has previously been done in the modeling of skeletal muscle, no model has, to date, been developed that describes the mechanical behavior with an explicit strain-energy function associated with the active response of skeletal muscle tissue. A model is presented herein that has been developed to accommodate this design consideration using a robust dynamical approach. The model shows excellent agreement with a previously published model of both the active and passive length-tension properties of skeletal muscle.

Obesity and dysrhythmias.

In the United States, obesity has reached epidemic proportions. Results from the 2003-2004 National Health and Nutrition Examination Survey estimated that 66% of US adults are either overweight (body mass index [BMI] 25-30 kg/m(2)) or obese (BMI>30 kg/m(2)) as defined by the BMI cutoffs established by the World Health Organization. In the 1970s, only 15% of the US population between the ages of 20 and 74 years was categorized as obese.

How are tris(triazolyl)borate ligands electronically different from tris(pyrazolyl)borate ligands? A study of (Ttz(tBu,Me))CuCO [Ttz(tBu,Me) = tris(3-t-butyl-5-methyl-1,2,4-triazolyl)borate].

(Ttz(tBu,Me))CuCO [Ttz(tBu,Me) = tris(3-t-butyl-5-methyl-1,2,4-triazolyl)borate] was prepared and fully characterized to test whether the Ttz(tBu,Me) ligand, which is sterically similar to Tp(tBu,Me) is electronically different; Ttz(tBu,Me) is a weaker electron donor and (Ttz(tBu,Me))CuCO is water stable and has a propensity to form hydrogen bonds.

Early versus delayed hormonal therapy for prostate specific antigen only recurrence of prostate cancer after radical prostatectomy.

Purpose: Hormonal therapy (HT) is the current mainstay of systemic treatment for prostate specific antigen (PSA) only recurrence (PSAR), however, there is virtually no published literature comparing HT to observation in the clinical setting. The goal of this study was to examine the Department of Defense Center for Prostate Disease Research observational database to compare clinical outcomes in men who experienced PSAR after radical prostatectomy by early versus delayed use of HT and by a risk stratified approach.

Materials And Methods: Of 5,382 men in the database who underwent primary radical prostatectomy (RP), 4,967 patients were treated in the PSA-era between 1988 and December 2002.

A quantitative study of the microstructure and biochemistry of the medial meniscal horn attachments.

Little quantitative data is available on the structure of meniscal attachments. Therefore, as an aid to designing meniscal replacements as well as a possible explanation for mechanical behavior, this study was designed to further the knowledge of the microstructure and biochemistry of native meniscal attachments. Bovine medial meniscal attachments (the external ligamentous portion as well as the transition zones at the bony insertion) were removed and prepared for microstructural evaluation.

Sensitive ultrasonic detection of dystrophic skeletal muscle in patients with duchenne muscular dystrophy using an entropy-based signal receiver.

The dystrophinopathies comprise a group of X-linked genetic diseases that feature dystrophin deficiency. Duchenne and Becker muscular dystrophy are characterized by progressive weakness and wasting of skeletal, smooth, and/or cardiac muscle. Duchenne muscular dystrophy (DMD) is the most severe dystrophinopathy, with an incidence of 1:3500 male births.

Failure properties and strain distribution analysis of meniscal attachments.

The menisci are frequently injured due to both degeneration and traumatic tearing. It has been suggested that the success of a meniscal replacement is dependent on several factors, one of which is the secure fixation and firm attachment of the replacement to the tibial plateau. Therefore, the objectives of the current study were to (1) determine the failure properties of the meniscal horn attachments, and (2) determine the strain distribution over their surfaces.

Proteoglycan breakdown of meniscal explants following dynamic compression using a novel bioreactor.

Motivated by our interest in examining meniscal mechanotransduction processes, we report on the validation of a new tissue engineering bioreactor. This paper describes the design and performance capabilities of a tissue engineering bioreactor for cyclic compression of meniscal explants. We showed that the system maintains a tissue culture environment equivalent to that provided by conventional incubators and that its strain output was uniform and reproducible.

Collagenase and surgical disease.

Collagen types I, II, and III are the most abundant extracellular matrix (ECM) proteins. Collagenase is a member of the matrix metalloproteinase (MMP) family of enzymes, and is the principal enzyme involved with collagen degradation. Cellular-ECM interactions are vitally important to tissue structure and function.

Consumer-driven health care: lessons from the first five years.

Lessons learned from the past five years' growth of the consumer-driven health movement bodes well for its longevity in the marketplace. The authors of this article review the results achieved by early adopters of consumer-driven health initiatives and the success strategies they've used in the areas of plan design, pricing, integration with wellness initiatives, communication and vendor selection. They conclude with a case example of how a transportation service company experienced substantial consumer-driven health plan enrollment and achieved a significant number of the key predictive success steps along the way.

New algorithm for selecting meniscal allografts that best match the size and shape of the damaged meniscus.

Procedures used by tissue banks in selecting meniscal allografts that will best restore normal contact pressure at the time of surgical implantation into a recipient's knee should be improved. Our objective was to develop regression equations that use dimensions measured from magnetic resonance (MR) images of the contralateral knee to predict values of important meniscal parameters of the injured knee. Another objective was to incorporate these equations into an algorithm for selecting allografts that best match the size and shape of the damaged meniscus (either medial or lateral).

3D finite element model of meniscectomy: changes in joint contact behavior.

The goal of this study is to quantify changes in knee joint contact behavior following varying degrees of the medial partial meniscectomy. A previously validated 3D finite element model was used to simulate 11 different meniscectomies. The accompanying changes in the contact pressure on the superior surface of the menisci and tibial plateau were quantified as was the axial strain in the menisci and articular cartilage.

Long-term mortality in patients with pauses in ventricular electrical activity.

Background: The long-term significance of ventricular pauses of > or =3.0 seconds observed on Holter monitor is unclear, as previously conducted retrospective studies have been poorly controlled. We compared the prognosis of patients with pauses > or =3.

Intramural hematoma of the descending thoracic aorta.

Aortic intramural hematoma (AIH) is part of the acute aortic syndrome together with aortic dissection and penetrating aortic ulcer. AIH represents up to 12% of acute aortic syndrome cases and has a clinical presentation indistinguishable from that of classic aortic dissection. A patient with AIH is presented and the diagnostic, prognostic and therapeutic implications of the disease are discussed.

Characterizing sterol defect suppressors uncovers a novel transcriptional signaling pathway regulating zymosterol biosynthesis.

erg26-1ts cells harbor defects in the 4alpha-carboxysterol-C3 dehydrogenase activity necessary for conversion of 4,4-dimethylzymosterol to zymosterol. Mutant cells accumulate toxic 4-carboxysterols and are inviable at high temperature. A genetic screen aimed at cloning recessive mutations remediating the temperature sensitive growth defect has resulted in the isolation of four complementation groups, ets1-4 (erg26-1ts temperature sensitive suppressor).

Symptomatic expansile vertebral hemangioma causing conus medullaris compression.

Objective: To present a case of symptomatic, expansile L1 vertebral hemangioma.

Clinical Features: A 46-year-old man presented with progressive neurologic changes and insidious onset of low back pain.

Intervention And Outcome: After a trial of 3 visits of conservative chiropractic care, no improvement was noted.

Left atrial tachycardia originating from the mitral annulus-aorta junction.

Background: At the mitral annulus-aorta (MA-Ao) junction, the left atrium is continuous through the subaortic curtain with the musculature of the anterior mitral leaflet. Under experimental conditions, this region can generate abnormal electrical activity. In patients with left atrial tachycardia, we investigated whether this region could be the source of this arrhythmia.

External beam radiation therapy after radical prostatectomy: efficacy and impact on urinary continence.

Introduction And Objectives: The efficacy of adjuvant and salvage external beam radiation (AXRT+SXRT) for prostate cancer after radical prostatectomy (RP) has been debated because of the inability to rule out systemic occult metastasis, uncertainty that radiation eradicates residual local disease and the potential of exacerbating impotency and incontinence. To characterize the effectiveness and treatment morbidity a retrospective review was performed.

Methods: In all, 38 patients received AXRT and 91 received SXRT.

Early versus delayed hormonal therapy for prostate specific antigen only recurrence of prostate cancer after radical prostatectomy.

Purpose: Hormonal therapy (HT) is the current mainstay of systemic treatment for prostate specific antigen (PSA) only recurrence (PSAR), however, there is virtually no published literature comparing HT to observation in the clinical setting. The goal of this study was to examine the Department of Defense Center for Prostate Disease Research observational database to compare clinical outcomes in men who experienced PSAR after radical prostatectomy by early versus delayed use of HT and by a risk stratified approach.

Materials And Methods: Of 5382 men in the database who underwent primary radical prostatectomy (RP), 4967 patients were treated in the PSA-era between 1988 and December 2002.

Watchful waiting and factors predictive of secondary treatment of localized prostate cancer.

Purpose: Watchful waiting remains an important treatment option for some patients with localized prostate cancer. We defined the demographic, clinical and outcome features of men selecting watchful waiting as an initial treatment strategy, and determined factors predictive of eventual progression to secondary treatment.

Materials And Methods: Of 8390 patients diagnosed with prostate cancer from 1990 to 2001 in the Department of Defense Center for Prostate Disease Research Database, 1158 patients chose watchful waiting as initial treatment.

Factors associated with blood loss during radical prostatectomy for localized prostate cancer in the prostate-specific antigen (PSA)-era: an overview of the Department of Defense (DOD) Center for Prostate Disease Research (CPDR) national database.

Radical Prostatectomy (RP) has been traditionally associated with significant operative blood loss and high risk of transfusion. However, over the last few years, centers of excellence have reported less bleeding and transfusion. To verify and document changes in the epidemiology of bleeding and transfusion of men electing RP, we undertook an analysis of such cases in the Department of Defense (DoD) Center for Prostate Disease Research (CPDR) Multicenter Research Database.

Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy.

Purpose: To determine if obesity is associated with higher prostate specific antigen recurrence rates after radical prostatectomy (RP), and to explore racial differences in body mass index (BMI) as a potential explanation for the disparity in outcome between black and white men.

Patients And Methods: A retrospective, multi-institutional pooled analysis of 3,162 men undergoing RP was conducted at nine US military medical centers between 1987 and 2002. Patients were initially categorized as obese (BMI > or = 30 kg/m(2)), overweight (BMI 25 to 30 kg/m(2)), or normal (BMI < or = 25 kg/m(2)).