138 research outputs found
Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?
<p>Abstract</p> <p>Background</p> <p>The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already denervated and subsequently reinnervated muscles as motors. This study aimed to compare the outcomes of tendon transfers for residual shoulder dysfunction in patients who had undergone early nerve surgery to the outcomes in patients who had not.</p> <p>Methods</p> <p>A total of 91 patients with obstetric paralysis-related shoulder abduction and external rotation deficits who underwent a modified Hoffer transfer of the latissimus dorsi/teres major to the greater tubercle of the humerus tendon between 2002 and 2009 were retrospectively analysed. The patients who had undergone neural surgery during infancy were compared to those who had not in terms of their preoperative and postoperative shoulder abduction and external rotation active ranges of motion.</p> <p>Results</p> <p>In the early surgery groups, only the postoperative external rotation angles showed statistically significant differences (25 degrees and 75 degrees for total and upper type palsies, respectively). Within the palliative surgery-only groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. The significant differences between the early surgery groups and the palliative surgery groups with total palsy during the preoperative period diminished postoperatively (p < 0.05 and p > 0.05, respectively) for abduction but not for external rotation. Within the upper type palsy groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles.</p> <p>Conclusions</p> <p>In this study, it was found that in patients with total paralysis, satisfactory shoulder abduction values can be achieved with tendon transfers regardless of a previous history of neural surgery even if the preoperative values differ.</p
Does preoperative abduction value affect functional outcome of combined muscle transfer and release procedures in obstetrical palsy patients with shoulder involvement?
COMPANIONS TO APOGEE STARS. I. A MILKY WAY-SPANNING CATALOG OF STELLAR AND SUBSTELLAR COMPANION CANDIDATES AND THEIR DIVERSE HOSTS
In its three years of operation, the Sloan Digital Sky Survey Apache Point Observatory Galactic Evolution Experiment (APOGEE-1) observed >14,000 stars with enough epochs over a sufficient temporal baseline for the fitting of Keplerian orbits. We present the custom orbit-fitting pipeline used to create this catalog, which includes novel quality metrics that account for the phase and velocity coverage of a fitted Keplerian orbit. With a typical radial velocity precision of similar to 100-200 m s(-1), APOGEE can probe systems with small separation companions down to a few Jupiter masses. Here we present initial results from a catalog of 382 of the most compelling stellar and substellar companion candidates detected by APOGEE, which orbit a variety of host stars in diverse Galactic environments. Of these, 376 have no previously known small separation companion. The distribution of companion candidates in this catalog shows evidence for an extremely truncated brown dwarf (BD) desert with a paucity of BD companions only for systems with a 10M(Jup). Finally, we find all types of companions are ubiquitous throughout the Galactic disk with candidate planetary-mass and BD companions to distances of similar to 6 and similar to 16 kpc, respectively
Portal vein embolization with n-butyl-cyanoacrylate through an ipsilateral approach before major hepatectomy: single center analysis of 50 consecutive patients
The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014
AIM: The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing. METHODS: Prospective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014. CONCLUSIONS: We applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma
Two-stage hepatectomy (R0) with portal vein ligation—towards curing patients with extended bilobular colorectal liver metastases
PIK3CA dependence and sensitivity to therapeutic targeting in urothelial carcinoma
Background
Many urothelial carcinomas (UC) contain activating PIK3CA mutations. In telomerase-immortalized normal urothelial cells (TERT-NHUC), ectopic expression of mutant PIK3CA induces PI3K pathway activation, cell proliferation and cell migration. However, it is not clear whether advanced UC tumors are PIK3CA-dependent and whether PI3K pathway inhibition is a good therapeutic option in such cases.
Methods
We used retrovirus-mediated delivery of shRNA to knock down mutant PIK3CA in UC cell lines and assessed effects on pathway activation, cell proliferation, migration and tumorigenicity. The effect of the class I PI3K inhibitor GDC-0941 was assessed in a panel of UC cell lines with a range of known molecular alterations in the PI3K pathway.
Results
Specific knockdown of PIK3CA inhibited proliferation, migration, anchorage-independent growth and in vivo tumor growth of cells with PIK3CA mutations. Sensitivity to GDC-0941 was dependent on hotspot PIK3CA mutation status. Cells with rare PIK3CA mutations and co-occurring TSC1 or PTEN mutations were less sensitive. Furthermore, downstream PI3K pathway alterations in TSC1 or PTEN or co-occurring AKT1 and RAS gene mutations were associated with GDC-0941 resistance.
Conclusions
Mutant PIK3CA is a potent oncogenic driver in many UC cell lines and may represent a valuable therapeutic target in advanced bladder cancer
Shedding Light on the Galaxy Luminosity Function
From as early as the 1930s, astronomers have tried to quantify the
statistical nature of the evolution and large-scale structure of galaxies by
studying their luminosity distribution as a function of redshift - known as the
galaxy luminosity function (LF). Accurately constructing the LF remains a
popular and yet tricky pursuit in modern observational cosmology where the
presence of observational selection effects due to e.g. detection thresholds in
apparent magnitude, colour, surface brightness or some combination thereof can
render any given galaxy survey incomplete and thus introduce bias into the LF.
Over the last seventy years there have been numerous sophisticated
statistical approaches devised to tackle these issues; all have advantages --
but not one is perfect. This review takes a broad historical look at the key
statistical tools that have been developed over this period, discussing their
relative merits and highlighting any significant extensions and modifications.
In addition, the more generalised methods that have emerged within the last few
years are examined. These methods propose a more rigorous statistical framework
within which to determine the LF compared to some of the more traditional
methods. I also look at how photometric redshift estimations are being
incorporated into the LF methodology as well as considering the construction of
bivariate LFs. Finally, I review the ongoing development of completeness
estimators which test some of the fundamental assumptions going into LF
estimators and can be powerful probes of any residual systematic effects
inherent magnitude-redshift data.Comment: 95 pages, 23 figures, 3 tables. Now published in The Astronomy &
Astrophysics Review. This version: bring in line with A&AR format
requirements, also minor typo corrections made, additional citations and
higher rez images adde
Evidence for a distinct neuro-immune signature in rats that develop behavioural disability after nerve injury
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