MRI-based navigated cryosurgery of extra-abdominal desmoid tumors using skin fiducial markers: a case series of 15 cases.

Background: Precision surgery is becoming increasingly important in the field of Orthopaedic Oncology. Image-guided percutaneous cryosurgery (CRA) has emerged as a valid treatment modality for extra-abdominal desmoid tumors (EDTs). To date, most CRA procedures use CT-based guidance which fails to properly characterize tumor segments.

Reliability of Cone Beam Weightbearing Computed Tomography Analysis of Total Ankle Arthroplasty Positioning and Comparison to Weightbearing X-Ray Measurements.

Background: The current reference standard for postoperative evaluation of total ankle arthroplasty (TAA) positioning, weightbearing radiography (WBXR), is subject to technical bias. Weightbearing cone beam computed tomography (WBCT) enables visualization of the foot's complex 3-dimensional (3D) structure under standing load. To date, no WBCT-based system for TAA positioning has been validated.

Axial rotation analysis in total ankle arthroplasty using weight-bearing computer tomography and three-dimensional modeling.

Background: Post-operative alignment is the most critical indicator for a successful total ankle arthroplasty (TAA). Total ankle malrotation is associated with an increased risk for polyethylene wear and medial gutter pain. Currently, there is no consensus on the correct way to measure the alignment of the tibial and talar component rotations in the axial plane.

Classification of the Os Calcis Subtalar Morphology in Symptomatic Flexible Pediatric Pes Planus Deformity Using Weightbearing CT and Distance Mapping.

Background: The etiology of symptomatic pediatric pes planus (PP) deformity is unclear. Reduced os calcis subtalar joint (OCST) anterior facet morphology has been suggested to result in less support to the talar head and a higher propensity to develop PP deformity. Weightbearing computed tomography (WBCT) and distance mapping (DM) offer new opportunities to investigate PP deformity in general and the OCST specifically.

Inhospital Complications and Costs of Simultaneous Bilateral Total Knee Arthroplasty: The Case for Selection and Potential Cost Savings.

Background: Published comparisons between bilateral and unilateral total knee arthroplasties (TKAs) remain biased, as most patients undergoing bilateral TKA are prescreened and healthier than average patients having unilateral procedures. Our objectives were to compare postoperative complications and resource utilization of patients having simultaneous bilateral TKAs with similar patients having unilateral procedures.

Methods: The Nationwide Inpatient Sample (NIS) database was used to identify patients undergoing primary elective TKA from 2002 to 2011.

Increased Morbidity With Diagnosis and Treatment of Pulmonary Embolism After Total Joint Arthroplasty: A Matched Control Analysis of 30,000 Patients.

Background: Currently, the risks associated with the diagnosis of pulmonary embolism (PE) and subsequent treatment are not well known. The purpose of our study is to quantify the specific in-hospital complications and resource utilization of patients with PE following total joint arthroplasty when compared to a matched cohort.

Methods: The Nationwide Inpatient Sample database was used to identify patients undergoing primary hip and knee arthroplasty from January 1993 to December 2008.

Clinical Assessment and Treatment Options for Posterior Hip Pain.

Diagnosis and treatment of posterior hip pain has increased due to advancements in clinical, anatomical, biomechanical, and related pathological understandings of the hip. Due to its complexity and close anatomical relationship with many osseous, neurovascular, and musculotendinous structures, posterior hip pain must be appropriately categorized based on its origin. Therefore, it is crucial that clinicians are able to determine whether patient complaints are of extra-articular or intra-articular nature so that they can implement the optimal treatment plan.

Magnetic Resonance Imaging Is Not Reliable in Classifying Anterior Inferior Iliac Spine Morphology Compared to 3-Dimensional Computerized Tomography.

Purpose: The purpose of this study is to determine the reliability of standard magnetic resonance imaging (MRI) evaluation of AIIS morphology compared with three-dimensional (3D) computerized tomography (CT) (reference standard).

Methods: Sixty hips in 30 patients met the inclusion criteria. The images were reviewed and classified by two fellowship-trained orthopedic surgeons.

Cryo-surgery for symptomatic extra-abdominal desmoids. A proof of concept study.

Background And Objective: Extra abdominal desmoid tumors are rare, highly aggressive, and invasive benign soft tissue tumors. Current treatment modalities show high levels of recurrence and comorbidities. Cryo-surgery as an alternative was subsequently investigated.

Transcriptional mechanisms link epithelial plasticity to adhesion and differentiation of epidermal progenitor cells.

During epithelial tissue morphogenesis, developmental progenitor cells undergo dynamic adhesive and cytoskeletal remodeling to trigger proliferation and migration. Transcriptional mechanisms that restrict such a mild form of epithelial plasticity to maintain lineage-restricted differentiation in committed epithelial tissues are poorly understood. Here, we report that simultaneous ablation of transcriptional repressor-encoding Ovol1 and Ovol2 results in expansion and blocked terminal differentiation of embryonic epidermal progenitor cells.

Numerical Methods for Two-Dimensional Stem Cell Tissue Growth.

Growth of developing and regenerative biological tissues of different cell types is usually driven by stem cells and their local environment. Here, we present a computational framework for continuum tissue growth models consisting of stem cells, cell lineages, and diffusive molecules that regulate proliferation and differentiation through feedback. To deal with the moving boundaries of the models in both open geometries and closed geometries (through polar coordinates) in two dimensions, we transform the dynamic domains and governing equations to fixed domains, followed by solving for the transformation functions to track the interface explicitly.

Stem cell niche structure as an inherent cause of undulating epithelial morphologies.

The spatial organization of stem cells into a niche is a key factor for growth and continual tissue renewal during development, sustenance, and regeneration. Stratified epithelia serve as a great context to study the spatial aspects of the stem cell niche and cell lineages by organizing into layers of different cell types. Several types of stratified epithelia develop morphologies with advantageous, protruding structures where stem cells reside, such as rete pegs and palisades of Vogt.

Operator Splitting Implicit Integration Factor Methods for Stiff Reaction-Diffusion-Advection Systems.

For reaction-diffusion-advection equations, the stiffness from the reaction and diffusion terms often requires very restricted time step size, while the nonlinear advection term may lead to a sharp gradient in localized spatial regions. It is challenging to design numerical methods that can efficiently handle both difficulties. For reaction-diffusion systems with both stiff reaction and diffusion terms, implicit integration factor (IIF) method and its higher dimensional analog compact IIF (cIIF) serve as an efficient class of time-stepping methods, and their second order version is linearly unconditionally stable.

Neonatal assessment of babies conceived by in vitro fertilization.

Problem: Neonatal outcome of in vitro fertilization (IVF) pregnancies has been described by different authors, but several issues have yet to be resolved. The aim of the present study was to evaluate neonates conceived in vitro and to direct special attention to neonatal morbidity and prevalence of minor abnormalities. The information that has been accumulated so far is scant.

Pregnancy outcome in renal allograft recipients in Israel.

The literature contains reports of 2,309 pregnancies in some 1,600 women who have undergone renal transplantation. Certain pre-pregnancy factors, especially hypertension, renal graft dysfunction and short interval between transplant and pregnancy, appear to increase the neonatal risks. We describe the outcome of 42 pregnancies in 27 allograft recipients at Beilinson Medical Center in Israel during the last 8 years.

The management of dermoid cysts--a comparative study of laparoscopy and laparotomy.

The aim of our study was to compare laparoscopy with laparotomy for the removal of ovarian dermoid cysts. Thirty-eight women with benign ovarian dermoid cyst were allocated for either laparoscopy (18 patients) or laparotomy (20 patients). The two groups were compared for operative and hospitalization times and postoperative course.

Augmentation of low ovarian response to superovulation before in vitro fertilization following priming with contraceptive pills.

Poor ovarian response to superovulation treatment is observed in a certain group of patients, the so-called 'low responders'. Despite the evolution of sophisticated controlled ovarian hyperstimulation (COH) regimens prior to the in vitro fertilization (IVF), the ideal stimulation protocol for the low responder has yet to be formulated. The objective of this study was to assess the effect of oral contraceptive pills (OCP), administered before the initiation of superovulation, on ovarian response and IVF treatment results in patients with previous 'low response' to exogenous gonadotropin stimulation.

Perinatal complications following gestational diabetes mellitus how 'sweet' is ill?

Objective: We tested the effect of patient compliance, fasting plasma glucose on oral glucose tolerance test, maternal body constitution, and the method of treatment (diet versus insulin) on the perinatal outcome of patients with gestational diabetes mellitus.

Study Design: A prospective population-based study compared the perinatal outcome of patients with gestational diabetes mellitus (n = 470) (diabetic with regard to the parameters specified above) and a contemporaneous control group (nondiabetic, n = 250).

Results: The diabetic and control groups were matched in demographic characteristics.

Microalbuminuria in early pregnancy in normal and high-risk patients.

The albumin excretion rate (AER) is elevated in normal pregnant women in the third trimester of pregnancy, compared to the second and first trimesters, and to the non-pregnant state. The effect of early pregnancy on AER values was tested in normal and high-risk pregnant patients using radioimmunoassay. All pregnant patients demonstrated significantly higher AER values as compared to non-pregnant women, and the results were in correlation with higher urinary creatinine clearance values.

Microalbuminuria as an early marker of severity in hypertensive pregnant women.

The value of microalbuminuria in predicting hypertensive complications in pregnant patients at high risk was tested in a prospective trial. A total of 276 patients were studied (142 in the study group vs 134 controls). Albumin was measured in 8-h overnight urine collection throughout pregnancy using radioimmunoassay technique.

Microalbuminuria as an early predictor of hypertensive complications in pregnant women at high risk.

The value of microalbuminuria in predicting hypertensive complications in pregnant patients at high risk was tested in a prospective trial. A secondary aim was to compare the urinary albumin excretion rate between high risk hypertensive pregnant patients (study group) and pregnant patients at high risk of other complications, normal pregnant subjects, and nonpregnant subjects. Over the last 5 years, 276 patients were studied (142 in the study group v 134 controls).

Viscosity and refractive index of follicular fluid in relation to in vitro fertilization.

Purpose: To set the standard values of follicular fluid viscosity and refractive index, and to investigate a possible relationship between these physiological parameters and the outcome of in vitro fertilization treatment.

Design And Results: 128 samples of follicular fluid were collected from 40 in vitro fertilization patients. Viscosity determinations (centipoise; mean +/- SD) for shear rates of 23, 46, 115, and 230 were 2.

Intranasal nafarelin versus buserelin (short protocol) for controlled ovarian hyperstimulation before in vitro fertilization: a prospective clinical trial.

The aim of this study was to compare the effect of nafarelin acetate with that of buserelin acetate nasal spray, when administered in a 'short' protocol, as an adjunct to human menopausal gonadotropin (hMG) for controlled ovarian hyperstimulation before in vitro fertilization (IVF). Twenty-two IVF subjects were randomly recruited. Each underwent two consecutive treatment cycles; one with buserelin (900 micrograms/day) and another with nafarelin (400 micrograms/day).

The impact of GnRH agonist and menotropin therapy on lipoprotein metabolism.

Two groups of women, 48 undergoing controlled ovarian hyperstimulation for in vitro fertilization (IVF) treatment with a gonadotropin-releasing hormone (GnRH) analog and human menopausal gonadotropin daily and a group of 15 treated with a GnRH analog using the 'luteal phase protocol' before the hyperstimulation for IVF, took part in a prospective randomized study at the IVF Unit of the Beilinson Medical Center, Israel. The aim was to evaluate the changes in lipid metabolism occurring in the course of a standard controlled ovarian hyperstimulation protocol during IVF treatment cycles by measuring serum lipid levels before and after treatment. In the former group, in parallel with the 17 beta-estradiol increase, the cholesterol and low-density lipoprotein-cholesterol levels dropped and the high-density lipoprotein-cholesterol levels increased significantly.