Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents.

Objectives: Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period.

Methods: Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011.

Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis.

Introduction: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs).

In vitro-analysis of kinematics and intradiscal pressures in cervical arthroplasty versus fusion--A biomechanical study in a sheep model with two semi-constrained prosthesis.

Background: As an alternative technique to arthrodesis of the cervical spine, total disc replacement (TDR) has increasingly been used with the aim of restoration of the physiological function of the treated and adjacent motions segments. The purpose of this experimental study was to analyze the kinematics of the target level as well as of the adjacent segments, and to measure the pressures in the proximal and distal disc after arthrodesis as well as after arthroplasty with two different semi-constrained types of prosthesis.

Methods: Twelve cadaveric ovine cervical spines underwent polysegmental (C2-5) multidirectional flexibility testing with a sensor-guided industrial serial robot.

Effectiveness of safety vests in pediatric horseback riding.

Background: Despite the benefit of safety vests to the reduction of torso injuries in children and adolescents is unclear, its' use is recommended. The aim of the present study is to determine the effectiveness of safety vests actually used in pediatric equestrian activities.

Patients And Method: In this case-control-study, we analyzed the accidents of 92 riders aged 18 or younger who fell off a horse onto his/her torso during a period of 18 months.

The discovery of the benzhydroxamate MEK inhibitors CI-1040 and PD 0325901.

A novel series of benzhydroxamate esters derived from their precursor anthranilic acids have been prepared and have been identified as potent MEK inhibitors. 2-(2-Chloro-4-iodo-phenylamino)-N-cyclopropylmethoxy-3,4-difluoro-benzamide, CI-1040, was the first MEK inhibitor to demonstrate in vivo activity in preclinical animal models and subsequently became the first MEK inhibitor to enter clinical trial. CI-1040 suffered however from poor exposure due to its poor solubility and rapid clearance, and as a result, development of the compound was terminated.

2-Alkylamino- and alkoxy-substituted 2-amino-1,3,4-oxadiazoles-O-Alkyl benzohydroxamate esters replacements retain the desired inhibition and selectivity against MEK (MAP ERK kinase).

This paper reports a second generation MEK inhibitor. The previously reported potent and efficacious MEK inhibitor, PD-184352 (CI-1040), contains an integral hydroxamate moiety. This compound suffered from less than ideal solubility and metabolic stability.

4-anilino-5-carboxamido-2-pyridone derivatives as noncompetitive inhibitors of mitogen-activated protein kinase kinase.

A new series of MEK1 inhibitors, the 4-anilino-5-carboxamido-2-pyridones, were designed and synthesized using a combination of medicinal chemistry, computational chemistry, and structural elucidation. The effect of variation in the carboxamide side chain, substitution on the pyridone nitrogen, and replacement of the 4'-iodide were all investigated. This study afforded several compounds which were either equipotent or more potent than the clinical candidate CI-1040 (1) in an isolated enzyme assay, as well as murine colon carcinoma (C26) cells, as measured by suppression of phosphorylated ERK substrate.

Follow-up costs up to 5 years after conventional treatments in patients with cartilage lesions of the knee.

In this retrospective cross-sectional study, we contacted patients who had been diagnosed with (and, if necessary, treated for) knee cartilage defects by arthroscopy at one of seven treatment centres in Germany between 1997 and 2001. In early 2003, patients completed a questionnaire on the health care resources they had used since the time of the arthroscopy. Based on this information, we determined follow-up costs.

Evaluation of the learning curves associated with uncemented primary total hip arthroplasty depending on the experience of the surgeon.

The aim of the paper is to prove and to portray the learning curve in total hip arthroplasty. This prospective study included 168 patients who were operated on by three surgeons, all demonstrating different degrees of experience in performing total hip arthroplasty. Perioperative complications and postoperative radiographs were analysed.

Primary stability of anterior lumbar stabilization: interdependence of implant type and endplate retention or removal.

This is a comparative in vitro biomechanical study of the primary stability of an anterior lumbar interbody stabilization. The objective was to compare the stability of a interbody stabilizing titanium cage with and without the retention of the bordering vertebral endplates, as well as to compare the titanium cage with a tricalcium phosphate block when the endplates are removed. An adequate blood supply is critical for interbody fusion, which suggests surgical treatment of the bordering endplates.

Comparative biomechanical testing of anterior and posterior stabilization procedures.

Study Design: This is a comparative in vitro biomechanical study in a calf lumbar spine model.

Objectives: The objective was to compare the primary stability of an anterior instrumentation, an intercorporal cage in combination with an anterior instrumentation, and a posterior instrumentation for monosegmental spondylodesis.

Summary Of Background Data: Spondylodesis can be achieved through a posterior lumbar fusion, posterior lumbar intercorporal fusion, or an anterior lumbar intercorporal fusion.

[Obesity and low back pain--biology, biomechanics and epidemiology].

Aim of the following paper is to describe the impact of obesity on low back pain. The mature disc is one of the most sparsely cellular tissues in the body, water content and concentration of proteoglycan decreases with increasing age. Both, static compressive loading and increased pressures, may result in damage of the integrity of the disc like tears of the anulus, followed by mechanical compression or chemical damage of the nerve roots.

Shoulder arthrodesis: indications, technique, results, and complications.

Complications after shoulder arthrodesis are frequent. Through results and comparisons with the literature, the presented article analyzes the correlation of complications with the specific operative techniques, indications, and postoperative treatment. Between 1964 and 2001, a total of 43 cases of shoulder arthrodesis (13 screw and 30 plate arthrodeses) were performed and then analyzed after a mean of 6.

Risk evaluation of thermal injury to the cervical spine during intradiscal laser application in vitro.

Objective: We aimed to investigate temperature distribution during laser and its possible thermal damage to the neurovascular structures.

Background Data: Percutaneous laser disc decompression (PLDD) is now being performed as a minimally invasive intradiscal technique for the operative therapy of non-sequestered herniated cervical discs. As yet, no experimental basic research has been reported with regard to temperature rise and distribution in the cervical region during laser radiation.

Structures of human MAP kinase kinase 1 (MEK1) and MEK2 describe novel noncompetitive kinase inhibition.

MEK1 and MEK2 are closely related, dual-specificity tyrosine/threonine protein kinases found in the Ras/Raf/MEK/ERK mitogen-activated protein kinase (MAPK) signaling pathway. Approximately 30% of all human cancers have a constitutively activated MAPK pathway, and constitutive activation of MEK1 results in cellular transformation. Here we present the X-ray structures of human MEK1 and MEK2, each determined as a ternary complex with MgATP and an inhibitor to a resolution of 2.

Reconstructive operations for the upper limb after brachial plexus palsy.

Limited function due to paralysis following brachial plexus lesions can be improved by secondary operations of the bony and soft tissue. Between April 1994 and December 2000, 109 patients suffering from arm-plexus lesions underwent a total of 144 reconstructive operations guided by our concept of integrated therapy. The average age at the time of surgery was 32 years (range: 15-59).

[Biomechanical testing of different ventral fixation devices on the bovine lumbar spine].

Aim: The primary stability of ventral fixation systems has been improved over the past years and special implants supporting minimally invasive procedures have been developed. The aim of this study was to analyze the primary stability of several of these implants.

Methods: Thirty (30) lumbar segments from 5 to 7-month-old calves were harvested and tested on a pure moment apparatus (PMA) as well as a modified materials testing machine (MTS) according to the European standard recommendations of Wilke et al.

Long-term outcome following high tibial osteotomy with tension bend principle.

Background: High tibial osteotomy has been successfully performed on patients with varus gonarthrosis for many years now. The prospective study presented here serves to verify the long-term outcome of this procedure.

Methods: A supratuberous high tibial osteotomy was carried out on 100 patients with varus gonarthrosis.

Osteotomy of the humerus to improve external rotation in nine patients with brachial plexus palsy.

Malfunction of the infraspinatus muscle and teres minor muscle illustrate the typical clinical picture in patients with brachial plexus palsy. The arm hangs down in an inwardly rotated position and elbow flexion is hindered by striking of the lower arm against the thorax. Between 1995 and 2000, we have done external rotational osteotomy of the humerus for nine patients with brachial plexus palsy.

[Corrective bone operations for treatment of deformities caused by obstetrical brachial plexus palsy].

In an adult, a marked deformity of the upper arm and forearm with loss of function of the limb due to obstetrical brachial plexus palsy has been corrected. An external rotational osteotomy of the humerus and radioulnar arthrodesis resulted in an improved function.

[MRI in spondylitis and spondylodiscitis].

Magnetic resonance imaging (MRI) is highly sensitive and specific for the diagnosis of spondylitis and in that respect is superior to other radiologic methods. Its excellent morphological resolution allows early recognition of pathologies and spread of the spondylitis. Affected vertebral bodies and discs reveal typical alterations in T1- and T2-weighted images; post-gadolinium images are necessary to improve specificity.

[Characteristics of the learning curve in total hip endoprosthesis exemplified by the BiContact prosthesis].

Aim: Total hip arthroplasty is a common operation but there are few data describing the learning curve of this operation. The aim of the presented study is to prove and describe the learning curve in total hip arthroplasty.

Method: Between 1991 and 1993, 168 patients were included in this prospective study, operated by three surgeons having different experiences in operating total hip arthroplasty.

[Possibilities and limits of conservative therapy of spondylitis and spondylodiscitis].

Background And Aim Of The Study: For many years the treatment of spondylitis and spondylodiscitis has been discussed controversially. The aim of this study is to report on objective and subjective mid-term results of therapy of spondylitis and to present a differentiated concept of treatment.

Methods: Between 1988 and 1996, 58 patients were treated with spondylitis or spondylodiscitis.