2014 Neer Award Paper: neuromonitoring the Latarjet procedure.

Background: We used intraoperative neuromonitoring to define the stages of the Latarjet procedure during which the nerves are at greatest risk.

Methods: Thirty-four patients with a mean age of 28.4 years were included.

Reverse shoulder arthroplasty as salvage for failed prior arthroplasty in patients 65 years of age or younger.

Background: This study examined outcomes and complications in young patients undergoing revision reverse total shoulder arthroplasty (RTSA) for failed prior total shoulder arthroplasty or hemiarthroplasty and compared them with those of an age-matched cohort undergoing primary RTSA.

Methods: RTSA as a revision for failed shoulder arthroplasty was performed on 36 patients younger than 65 years. Follow-up was available for 32 patients at an average of 55.

Multidisciplinary meetings as an effective clinical intervention.

When used well, multidisciplinary meetings can function in the same way as other clinical interventions to improve communication, efficiency and outcomes. They help break down barriers, manage difficult emotions, and benefit service users and staff. But it is imperative that they are well prepared, well attended, and that the purpose and agenda are agreed.

sdf1 Expression reveals a source of perivascular-derived mesenchymal stem cells in zebrafish.

There is accumulating evidence that mesenchymal stem cells (MSCs) have their origin as perivascular cells (PVCs) in vivo, but precisely identifying them has been a challenge, as they have no single definitive marker and are rare. We have developed a fluorescent transgenic vertebrate model in which PVC can be visualized in vivo based upon sdf1 expression in the zebrafish. Prospective isolation and culture of sdf1(DsRed) PVC demonstrated properties consistent with MSC including prototypical cell surface marker expression; mesodermal differentiation into adipogenic, osteogenic, and chondrogenic lineages; and the ability to support hematopoietic cells.

Glenohumeral Contact Pressure With Simulated Anterior Labral and Osseous Defects in Cadaveric Shoulders Before and After Soft Tissue Repair.

Background: Glenoid rim fractures and erosion can result from traumatic and repeated shoulder dislocations, leading to glenoid bone loss. Traditional instability surgery includes Bankart repair to restore soft tissue anatomy, although a recent trend is to address glenoid bone deficiency when appropriate with a bone block procedure.

Hypothesis/purpose: The purpose of this study was to quantify glenohumeral joint contact pressures as a function of anterior labral detachment, progressive anterior glenoid bone loss, and labral repair.

Can a selective PPARγ modulator improve glycemic control in patients with type 2 diabetes with fewer side effects compared with pioglitazone?

Objective: INT131 besylate is a potent, nonthiazolidinedione, selective peroxisome proliferator-activated receptor γ (PPARγ) modulator (SPPARM) designed to improve glucose metabolism while minimizing the side effects of full PPARγ agonists. This placebo-controlled study compared the efficacy and side effects of INT131 besylate versus 45 mg pioglitazone HCl in subjects with type 2 diabetes (T2D).

Research Design And Methods: This was a 24-week randomized, double-blind, placebo- and active-controlled study of 0.

Complete Fatty infiltration of intact rotator cuffs caused by suprascapular neuropathy.

Suprascapular neuropathy is generally considered to be a diagnosis of exclusion, although it has been described in association with several activities and conditions. To our knowledge, this is the first description of suprascapular neuropathy with complete neurogenic fatty replacement in patients with intact rotator cuff tendons in the absence of traction or compression mechanisms. We present 4 cases of patients who presented with complete fatty infiltration of the supraspinatus (1 patient), infraspinatus (2 patients), and both (1 patient) resulting from suprascapular neuropathy.

Imaging characteristics of lesser tuberosity osteotomy after total shoulder replacement: a study of 220 patients.

Background: The lesser tuberosity osteotomy (LTO) has been gaining popularity as a method of exposing the glenohumeral joint during total shoulder replacement, whereby a small fragment of bone is removed from the lesser tuberosity, thus preserving the subscapularis tendon. To date, no large, randomized studies have reported evaluations of LTO healing and healing rates.

Methods: We reviewed the radiographs and available computed tomography images of 362 patients who underwent a total shoulder arthroplasty by the same surgeon between 2006 and 2012.

Improved intensity-based label-free quantification via proximity-based intensity normalization (PIN).

Researchers are increasingly turning to label-free MS1 intensity-based quantification strategies within HPLC-ESI-MS/MS workflows to reveal biological variation at the molecule level. Unfortunately, HPLC-ESI-MS/MS workflows using these strategies produce results with poor repeatability and reproducibility, primarily due to systematic bias and complex variability. While current global normalization strategies can mitigate systematic bias, they fail when faced with complex variability stemming from transient stochastic events during HPLC-ESI-MS/MS analysis.

Identification by mass spectrometry and immune response analysis of guinea pig cytomegalovirus (GPCMV) pentameric complex proteins GP129, 131 and 133.

Development of a vaccine against congenital infection with human cytomegalovirus (HCMV) is a major public health priority. A potential vaccine target receiving considerable recent attention is the pentameric complex (PC) of HCMV proteins consisting of gL, gH, UL128, UL130, and UL131, since some antibodies against these target proteins are capable of potently neutralizing virus at epithelial and endothelial cell surfaces. Recently, homologous proteins have been described for guinea pig cytomegalovirus (GPCMV), consisting of gH, gL, and the GPCMV proteins GP129, GP131, and GP133.

Management of failed metal-backed glenoid component in patients with bilateral total shoulder arthroplasty.

Total shoulder arthroplasty (TSA) is successful in providing pain relief and functional improvements for patients with shoulder arthritis. Outcomes are directly correlated with implant position and fixation, which ultimately affects wear and longevity. Metal-backed glenoid components were introduced as an alternative to the standard cemented glenoid fixation.

Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States.

Background: Musculoskeletal disorders of the upper extremity are common reasons for patients to seek care and undergo ambulatory surgery. The objective of our study was to assess the overall and age-adjusted utilization rates of rotator cuff repair, shoulder arthroscopy performed for indications other than rotator cuff repair, carpal tunnel release, and wrist arthroscopy performed for indications other than carpal tunnel release in the United States. We also compared demographics, indications, and operating room time for these procedures.

Oxidative damage in MauG: implications for the control of high-valent iron species and radical propagation pathways.

The di-heme enzyme MauG catalyzes the oxidative biosynthesis of a tryptophan tryptophylquinone cofactor on a precursor of the enzyme methylamine dehydrogenase (preMADH). Reaction of H2O2 with the diferric form of MauG, or reaction of O2 with diferrous MauG, forms the catalytic intermediate known as bis-Fe(IV), which acts as the key oxidant during turnover. The site of substrate oxidation is more than 40 Å from the high-spin heme iron where H2O2 initially reacts, and catalysis relies on radical hopping through an interfacial residue, Trp199 of MauG.

Testing the link between community structure and function for ectomycorrhizal fungi involved in a global tripartite symbiosis.

Alnus trees associate with ectomycorrhizal (ECM) fungi and nitrogen-fixing Frankia bacteria and, although their ECM fungal communities are uncommonly host specific and species poor, it is unclear whether the functioning of Alnus ECM fungal symbionts differs from that of other ECM hosts. We used exoenzyme root tip assays and molecular identification to test whether ECM fungi on Alnus rubra differed in their ability to access organic phosphorus (P) and nitrogen (N) when compared with ECM fungi on the non-Frankia host Pseudotsuga menziesii. At the community level, potential acid phosphatase (AP) activity of ECM fungal root tips from A.

Results of the repair of acute rotator cuff tears is not influenced by tear retraction.

Purpose: This study evaluated retraction in the setting of acute rotator cuff tears and determined its effects on patient outcomes and tendon repair integrity.

Materials And Methods: A total of 22 patients had surgery within 6 weeks or less from the time of injury. Fifteen of these patients were prospectively followed at a minimum of 2 years; average 40.

Avoiding miscommunication in acute musculoskeletal trauma cases: use of standardized reporting and classification schemes.

Classification schemes can be a key element of a structured radiology report, providing succinct guidance for clinical decision making. Classification systems delineate the location and morphological characteristics of fractures (diagnosis), may provide a graded measure of severity (prognosis), and ideally guide treatment options. Reports structured in this fashion optimize communication between the physician interpreting the examination and the physician directing the patient's treatment.

Protein expression profile of rat type two alveolar epithelial cells during hyperoxic stress and recovery.

In rodent model systems, the sequential changes in lung morphology resulting from hyperoxic injury are well characterized and are similar to changes in human acute respiratory distress syndrome. In the injured lung, alveolar type two (AT2) epithelial cells play a critical role in restoring the normal alveolar structure. Thus characterizing the changes in AT2 cells will provide insights into the mechanisms underpinning the recovery from lung injury.

Parent and child perceptions of a self-regulated, home-based exercise program for children with cystic fibrosis.

Background: Despite recognized benefits, many children with cystic fibrosis (CF) do not consistently participate in physical activities. There is little empirical literature regarding the feelings and attitudes of children with CF toward exercise programs, parental roles in exercise, or factors influencing exercise experiences during research participation.

Objectives: The aim of this study is to describe the exercise experiences of children with CF and their parents during participation in a 6-month program of self-regulated, home-based exercise.

Complications after arthroscopic revision rotator cuff repair.

Purpose: The purpose of this study was to determine the complication rate of arthroscopic revision rotator cuff repair (ARRCR).

Methods: The retrospective review included 94 patients who underwent ARRCR performed by the 2 senior authors between January 2000 and June 2009 (mean age, 52 years; age range, 44 to 72 years). Sixty-four patients underwent 1 revision rotator cuff repair, 23 patients underwent 2 revisions, and 7 patients underwent 3 or more revisions.

Synchronous breast and colon cancer: factors determining treatment strategy.

A 67-year-old woman presented with synchronous breast and colonic tumours, in the absence of family history. Following multidisciplinary discussion, the patient was started on endocrine therapy for breast cancer. Initial surgical management consisted of right hemicolectomy together with segmental resection of a serosal deposit adherent to the distal ileum, for a moderately differentiated pT4NO caecal carcinoma.

Durability of partial humeral head resurfacing.

Background: Partial humeral head resurfacing arthroplasty uses a stemless device, which conserves bone and restores normal anatomy. We hypothesized that this does not offer a reasonable alternative to full resurfacing or total shoulder arthroplasty.

Methods: We performed a retrospective study of 39 shoulders with focal chondral defects of the humeral head treated with partial resurfacing arthroplasty.

Fertility preservation in young females with non-gynaecologic malignancy: an emerging speciality.

Background: As new treatment and research advances continue to improve the prognosis of cancer patients, oncologists and surgeons are increasingly faced with the issue of fertility protection and preservation. Cancer patients are frequently exposed to gonadotoxic chemotherapy and radiation therapy as a component of their treatment regimens. There are currently various anticipatory techniques available to women who wish to retain future reproductive ability, the most successful of which involves oocyte retrieval followed by in vitro fertilisation and embryo cryopreservation.

Snapshot 3D optical coherence tomography system using image mapping spectrometry.

A snapshot 3-Dimensional Optical Coherence Tomography system was developed using Image Mapping Spectrometry. This system can give depth information (Z) at different spatial positions (XY) within one camera integration time to potentially reduce motion artifact and enhance throughput. The current (x,y,λ) datacube of (85×356×117) provides a 3D visualization of sample with 400 μm depth and 13.

Value-based shoulder surgery: practicing outcomes-driven, cost-conscious care.

Background: Pathology of the shoulder contributes significantly to the increasing burden of musculoskeletal disease. Currently, there exists high variability in the nature and quality of shoulder care, and outcomes and cost reporting are not uniform. Value-based practice aims to simultaneously maximize outcomes and minimize costs for given disease processes.