Decision making in contemporary shoulder arthroplasty.

Clinical experience with humeral implants has evolved over the past decade, along with a better understanding of shoulder anatomy and function. There is no question that surgeons are getting better at restoring normal anatomic relationships than in preceding decades. Whether or not this impacts implant longevity will only be known with time and further follow-up.

Proximal humeral anatomy in shoulder arthroplasty: Implications for prosthetic design and surgical technique.

Resurfacing arthroplasty of the glenohumeral joint has been established for several decades as a means to restore comfort and function of the shoulder for many afflictions that derange the normal anatomy. Rigorous study of shoulder anatomy in terms relevant to prosthetic geometry, however, did not begin until the 1990s. It has become apparent that normal anatomy is highly variable from individual to individual and that it is aligned somewhat differently than the early modular prosthetic devices.

Evaluation of vinorelbine in persistent or recurrent nonsquamous carcinoma of the cervix: a Gynecologic Oncology Group Study.

Objective: The Gynecologic Oncology Group (GOG) has studied a number of drugs to determine their activity in patients with previously treated squamous and nonsquamous cancer arising in the uterine cervix. A Phase II study with intravenous vinorelbine was initiated for this purpose in patients with Stage IVB, recurrent, or persistent nonsquamous carcinomas who had received one prior chemotherapy or were not eligible for other studies.

Methods: Eligible patients had to have measurable disease, GOG performance status of 0-2 and adequate bone marrow, liver, and renal function.

Environmental tobacco smoke and pregnancy outcome.

Background: Recent reviews conclude that environmental tobacco smoke (ETS) leads to diminished birth weight. However, the threshold and magnitude of that effect is uncertain. We aimed to determine the magnitude and shape of the relations between ETS and various adverse pregnancy outcomes using a highly sensitive biochemical assay.

Choosing abdominal incision and closure techniques: a review.

This review summarizes contemporary concepts of abdominal surgical incision creation and closure. The Ovid computerized database was searched for articles published in English from 1996 to 2003 using keywords pertaining to the specific topic of interest (e.g.

Identification of novel and rare mutations in California Hispanic and African American cystic fibrosis patients.

In ethnic heterogeneous California, complete genetic information is currently lacking to build solid population-based cystic fibrosis (CF) screening programs because a large proportion of mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR/ABCC7) are still unknown, especially in non-Caucasian patients. A total of 402 [46 African American+356 Hispanic] Hispanic and African American patients from California CF patient registry were included in this study. Patients with at least one unidentified mutant allele were asked to donate blood samples for further analysis, first by Genzyme Genetics for a panel of 87 known mutations, followed by temporal temperature gradient gel electrophoresis (TTGE) scanning of the entire coding exons of CFTR gene.

Effects of Tai Chi exercise on physical and mental health of college students.

The purpose of this pilot study is to examine the effects of Tai Chi Quan, a body-mind harmony exercise, on college students' perceptions of their physical and mental health. A three-month intervention of Tai Chi exercise was administered to college students, and multidimensional physical (PHD) and mental (MHD) health scores were assessed using the SF-36v2 health survey questionnaire before and after the intervention. Thirty college students participated in a 1-hour-long Tai Chi exercise intervention twice a week for 3 months.

Unhealthy landscapes: Policy recommendations on land use change and infectious disease emergence.

Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration.

Glenohumeral deformity in children with internal rotation contractures secondary to brachial plexus birth palsy: intraoperative arthrographic classification.

Purpose: To evaluate, with intraoperative arthrography, joint morphology in children undergoing surgical treatment of residual paralysis of the shoulder resulting in brachial plexus birth palsy and to correlate the morphology with the degree of passive external rotation.

Materials And Methods: In 64 children (age range, 7 months to 13 years 6 months), an orthopedic surgeon performed intraoperative arthrography and measured passive external rotation while the patient received a general anesthetic. The orthopedic surgeon and three radiologists reviewed arthrograms and in consensus classified glenohumeral joints in one of four categories: concentric, with the humeral head well centered on the glenoid fossa; flat, with flattening of the posterior glenoid; biconcave, with the humeral head in articulation with the posterior of two concavities, which were in the same plane; and pseudoglenoid, with the humeral head in articulation with the more posterior of two concavities, with retroversion and in a plane different from that of the anterior concavity.

Evaluation of irofulven (MGI-114) in the treatment of recurrent or persistent endometrial carcinoma: A phase II study of the Gynecologic Oncology Group.

Objective: This multi-center phase II trial was conducted by the Gynecologic Oncology Group to evaluate the activity and toxicity of irofulven in patients with previously treated adenocarcinoma of the endometrium.

Methods: Eligible patients had documented recurrent or persistent endometrial carcinoma after receiving definitive locoregional therapy, and were required to have measurable disease, performance status of 0-2, and adequate bone marrow, hepatic and renal functions prior to study entry. Patients were allowed one prior chemotherapy regimen.

Children's ability to access and use health care.

Under new regulations for Medicaid and the State Children's Health Insurance Program (SCHIP), states can extend health insurance to child enrollees' uninsured parents. We compared the extent to which child-only and family coverage (child and parent insured) ensure health care access and use for children in working-poor families. Among these children, 21 percent were uninsured, as were 30 percent of their parents.

Arthroscopic release of shoulder contracture secondary to birth palsy: an early report on findings and surgical technique.

Purpose: Internal rotation contractures are common in children with external rotation weakness secondary to brachial plexus birth palsy. Surgical release of the contracture, with or without latissimus dorsi transfer, is an established treatment through a variety of open methods. This article describes an arthroscopic method of contracture release in this patient population.

Panniculectomy in morbidly obese gynecologic oncology patients.

Background: It is clear that morbid obesity presents a serious risk to women undergoing major intra-abdominal gynecologic surgery. Unfortunately, many gynecologic malignancies and benign conditions are best treated surgically. Thus, the gynecologic surgeon must choose an incision that permits adequate exposure with acceptables rates of complications.

Comparison of arthroscopic findings with magnetic resonance imaging and arthrography in children with glenohumeral deformities secondary to brachial plexus birth palsy.

Background: Characterization of glenohumeral deformities secondary to brachial plexus birth palsy with plain radiography is difficult because the glenohumeral joint does not completely ossify until puberty. The purpose of this study was to compare the findings on magnetic resonance imaging and arthrography with those on arthroscopy to better understand the roles of these methods in the evaluation of glenohumeral development in this condition.

Methods: Eighty-four children who ranged in age from seven months to thirteen years and six months had glenohumeral arthrography while they were under general anesthesia for operative treatment of an internal rotation contracture.

Mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) chemotherapy for gynecological sarcomas.

This report summarizes our experience with the combination of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) for patients with gynecological sarcomas. We reviewed the records of all patients who had received the MAID regimen for a gynecological sarcoma between 1993 and 2000. The MAID regimen was administered intravenously every 4 weeks in the hospital as follows: (1) mesna 1500 mg/m2/day x 4 days; (2) doxorubicin 15 mg/m2/day x 3 days; (3) ifosfamide 1500 mg/m2/day x 3 days; (4) dacarbazine 250 mg/m2/day x 3 days.

Outcomes of endometrial cancer patients undergoing surgery with gynecologic oncology involvement.

Objective: This study was undertaken to compare the outcomes of patients with endometrial cancer who had primary surgery with gynecologic oncology involvement at university or community hospitals.

Methods: The study population consisted of all patients who had primary surgery for endometrial cancer with involvement of the attending physicians of the Division of Gynecologic Oncology. The patients were divided into two groups based on whether their surgery was performed at a university or community hospital.

DeltaNp73, a dominant-negative inhibitor of wild-type p53 and TAp73, is up-regulated in human tumors.

p73 has significant homology to p53. However, tumor-associated up-regulation of p73 and genetic data from human tumors and p73-deficient mice exclude a classical Knudson-type tumor suppressor role. We report that the human TP73 gene generates an NH(2) terminally truncated isoform.

Comparison of tolerance of combination carboplatin and paclitaxel chemotherapy by age in women with ovarian cancer.

Objective: The objective of this study was to compare tolerance of treatment of ovarian cancer patients > or = 70 years to those < or =55.

Materials And Methods: A retrospective review of all data relevant to comparison of clinical course in 31 women > or =70 years (Study Group) and 44 women < or =55 (Control Group), who received primary therapy for ovarian cancer between 1996 and 2001 was performed. The tolerance of the entire treatment plan was then compared using SAS 8.

A randomized controlled trial of a regular diet as the first meal in gynecologic oncology patients undergoing intraabdominal surgery.

Objective: To prospectively evaluate the safety and efficacy of a regular diet as the first meal after intraabdominal surgery in gynecologic oncology patients.

Methods: During a 20-month period, 254 gynecologic oncology patients undergoing intraabdominal surgery were enrolled in a randomized controlled trial of a clear liquid diet compared with a regular diet as the first postoperative meal. All patients received their first meal on the first postoperative day in the absence of nausea, vomiting, or symptomatic abdominal distension.

Does membrane lipid profile explain chilling sensitivity and membrane lipid phase transition of spermatozoa and oocytes?

Ram, fowl and bee spermatozoa, and oocytes of cows and zebrafish were used to study lipid membrane profiles, chilling sensitivity and lipid-phase transitions. The integrity of the membranes was determined by carboxyfluorescein diacetate (CFDA) staining following exposure for 15 minutes to low temperatures. Ram and fowl spermatozoa showed different degrees of loss of membrane integrity.

Chilling sensitivity in zebrafish (Brachydanio rerio) oocytes is related to lipid phase transition.

Oocytes of zebrafish were used to study chilling sensitivity and membrane lipid phase transitions in tropical fish. The oocytes were divided into two groups: small (without yolk, <0.1mm) and large (with yolk, >0.

A randomized controlled trial of early oral analgesia in gynecologic oncology patients undergoing intra-abdominal surgery.

Objective: To evaluate the safety and efficacy of early oral analgesia after intra-abdominal surgery in gynecologic oncology patients.

Methods: Over a 2.5-year period, 227 gynecologic oncology patients undergoing intra-abdominal surgery were enrolled in a randomized controlled trial of early oral versus traditional parenteral analgesia.

Geometric analysis of selected press fit prosthetic systems for proximal humeral replacement.

The ability of a prosthetic system to replicate a wide range of normal anatomy appears dependent in part to its capacity to produce variable prosthetic geometries. Several modern designs have recently been developed in order to provide multiple prosthetic options. The purpose of this study was to compare the geometry of select press fit prosthetic systems in terms of their ability to match normal three-dimensional geometry of the proximal humerus.

Cystic fibrosis screening in newborns: results from existing programs.

Newborn screening for cystic fibrosis (CF) provides early identification and initiation of treatment to infants with this fatal and often misdiagnosed genetic disease. Although reports of health benefits continue to mount from decade-old screening programs in Wisconsin, France, and Australia, newborn screening for CF is still a highly debated topic in genetic policy development. This article summarizes the literature published between May 2000 and April 2001 regarding the health benefits, risks, cost-effectiveness, and programmatic issues of newborn screening for CF.