Good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years

Background When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice. Patients and methods We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) between 1994 and 2001. We used the ilio-inguinal (I-I) approach in 32 hips and a modified Smith-Petersen (S-P) approach in 4. The patients were followed for mean 4 (1.5-8) years. In 1 patient with coxa valga, a varus femoral osteotomy was performed 1 year after PAO. 2 hips, in which we used the modified S-P approach, necessitated a capsulotomy. Results The median Merle d'Aubigne score increased from 13 points preoperatively to 16 points postoperatively. This improvement in terms of pain, motion and ambulation was accompanied by spatial reorientation and correction. The lateral center edge angle of Wiberg (CE) improved from an average of 7° to 28°. The anterior center edge angle of Lequesne (FP) improved from an average of 18° to 28°. The acetabular index angle (AC) improved from an average of 22° to 10°. Major complications included 1 partial lesion of the sciatic nerve, 1 malunion and 1 combined nonunion of the pubic and ischiatic osteotomy. 2 patients underwent subsequent total hip replacement (THR) for progressive osteoarthrosis with pain. Interpretation We found good radiographic correction of deformities, improvement of hip function and pain relief with an acceptable complication rate. With appropriate patient selection, this procedure is the most physiological treatment of symptomatic hip dysplasia in young adults. In addition to relieving symptoms, it may prevent and postpone the development of secondary osteoarthrosis

Unsupervised Contact Learning for Humanoid Estimation and Control

This work presents a method for contact state estimation using fuzzy clustering to learn contact probability for full, six-dimensional humanoid contacts. The data required for training is solely from proprioceptive sensors - endeffector contact wrench sensors and inertial measurement units (IMUs) - and the method is completely unsupervised. The resulting cluster means are used to efficiently compute the probability of contact in each of the six endeffector degrees of freedom (DoFs) independently. This clustering-based contact probability estimator is validated in a kinematics-based base state estimator in a simulation environment with realistic added sensor noise for locomotion over rough, low-friction terrain on which the robot is subject to foot slip and rotation. The proposed base state estimator which utilizes these six DoF contact probability estimates is shown to perform considerably better than that which determines kinematic contact constraints purely based on measured normal force.Comment: Submitted to the IEEE International Conference on Robotics and Automation (ICRA) 201

Пойкилодермия пигментная сетчатая Сиватта: клинический случай

КОЖНЫЕ БОЛЕЗНИМЕЛАНОЗСиватта пойкилодерми

The Initial Conditions of Clustered Star Formation III. The Deuterium Fractionation of the Ophiuchus B2 Core

We present N2D+ 3-2 (IRAM) and H2D+ 1_11 - 1_10 and N2H+ 4-3 (JCMT) maps of the small cluster-forming Ophiuchus B2 core in the nearby Ophiuchus molecular cloud. In conjunction with previously published N2H+ 1-0 observations, the N2D+ data reveal the deuterium fractionation in the high density gas across Oph B2. The average deuterium fractionation R_D = N(N2D+)/N(N2H+) ~ 0.03 over Oph B2, with several small scale R_D peaks and a maximum R_D = 0.1. The mean R_D is consistent with previous results in isolated starless and protostellar cores. The column density distributions of both H2D+ and N2D+ show no correlation with total H2 column density. We find, however, an anticorrelation in deuterium fractionation with proximity to the embedded protostars in Oph B2 to distances >= 0.04 pc. Destruction mechanisms for deuterated molecules require gas temperatures greater than those previously determined through NH3 observations of Oph B2 to proceed. We present temperatures calculated for the dense core gas through the equating of non-thermal line widths for molecules (i.e., N2D+ and H2D+) expected to trace the same core regions, but the observed complex line structures in B2 preclude finding a reasonable result in many locations. This method may, however, work well in isolated cores with less complicated velocity structures. Finally, we use R_D and the H2D+ column density across Oph B2 to set a lower limit on the ionization fraction across the core, finding a mean x_e, lim >= few x 10^{-8}. Our results show that care must be taken when using deuterated species as a probe of the physical conditions of dense gas in star-forming regions.Comment: ApJ accepte

Effects on osteoclast and osteoblast activities in cultured mouse calvarial bones by synovial fluids from patients with a loose joint prosthesis and from osteoarthritis patients

Aseptic loosening of a joint prosthesis is associated with remodelling of bone tissue in the vicinity of the prosthesis. In the present study, we investigated the effects of synovial fluid (SF) from patients with a loose prosthetic component and periprosthetic osteolysis on osteoclast and osteoblast activities in vitro and made comparisons with the effects of SF from patients with osteoarthritis (OA). Bone resorption was assessed by the release of calcium 45 ((45)Ca) from cultured calvariae. The mRNA expression in calvarial bones of molecules known to be involved in osteoclast and osteoblast differentiation was assessed using semi-quantitative reverse transcription-polymerase chain reaction (PCR) and real-time PCR. SFs from patients with a loose joint prosthesis and patients with OA, but not SFs from healthy subjects, significantly enhanced (45)Ca release, effects associated with increased mRNA expression of calcitonin receptor and tartrate-resistant acid phosphatase. The mRNA expression of receptor activator of nuclear factor-kappa-B ligand (rankl) and osteoprotegerin (opg) was enhanced by SFs from both patient categories. The mRNA expressions of nfat2 (nuclear factor of activated T cells 2) and oscar (osteoclast-associated receptor) were enhanced only by SFs from patients with OA, whereas the mRNA expressions of dap12 (DNAX-activating protein 12) and fcrγ (Fc receptor common gamma subunit) were not affected by either of the two SF types. Bone resorption induced by SFs was inhibited by addition of OPG. Antibodies neutralising interleukin (IL)-1α, IL-1β, soluble IL-6 receptor, IL-17, or tumour necrosis factor-α, when added to individual SFs, only occasionally decreased the bone-resorbing activity. The mRNA expression of alkaline phosphatase and osteocalcin was increased by SFs from patients with OA, whereas only osteocalcin mRNA was increased by SFs from patients with a loose prosthesis. Our findings demonstrate the presence of a factor (or factors) stimulating both osteoclast and osteoblast activities in SFs from patients with a loose joint prosthesis and periprosthetic osteolysis as well as in SFs from patients with OA. SF-induced bone resorption was dependent on activation of the RANKL/RANK/OPG pathway. The bone-resorbing activity could not be attributed solely to any of the known pro-inflammatory cytokines, well known to stimulate bone resorption, or to RANKL or prostaglandin E(2 )in SFs. The data indicate that SFs from patients with a loose prosthesis or with OA stimulate bone resorption and that SFs from patients with OA are more prone to enhance bone formation

Variability in synovial inflammation in rheumatoid arthritis investigated by microarray technology

In recent years microarray technology has been used increasingly to acquire knowledge about the pathogenic processes involved in rheumatoid arthritis. The present study investigated variations in gene expression in synovial tissues within and between patients with rheumatoid arthritis. This was done by applying microarray technology on multiple synovial biopsies obtained from the same knee joints. In this way the relative levels of intra-patient and inter-patient variation could be assessed. The biopsies were obtained from 13 different patients: 7 by orthopedic surgery and 6 by rheumatic arthroscopy. The data show that levels of heterogeneity varied substantially between the biopsies, because the number of genes found to be differentially expressed between pairs of biopsies from the same knee ranged from 6 to 2,133. Both arthroscopic and orthopedic biopsies were examined, allowing us to compare the two sampling methods. We found that the average number of differentially expressed genes between biopsies from the same patient was about three times larger in orthopedic than in arthroscopic biopsies. Using a parallel analysis of the tissues by immunohistochemistry, we also identified orthopedic biopsies that were unsuitable for gene expression analysis of synovial inflammation due to sampling of non-inflamed parts of the tissue. Removing these biopsies reduced the average number of differentially expressed genes between the orthopedic biopsies from 455 to 171, in comparison with 143 for the arthroscopic biopsies. Hierarchical clustering analysis showed that the remaining orthopedic and arthroscopic biopsies had gene expression signatures that were unique for each patient, apparently reflecting patient variation rather than tissue heterogeneity. Subsets of genes found to vary between biopsies were investigated for overrepresentation of biological processes by using gene ontology. This revealed representative 'themes' likely to vary between synovial biopsies affected by inflammatory disease

Outflows in rho Ophiuchi as Seen with the Spitzer Infrared Array Camera

Using the IRAC images from the Spitzer c2d program, we have made a survey of mid-infrared outflows in the rho Ophiuchi molecular cloud. Extended objects that have prominent emission in IRAC channel 2 (4.5 micron) compared to IRAC channel 1 (3.6 micron) and stand out as green objects in the three-color images (3.6 micron in blue, 4.5 micron in green, 8.0 micron in red) are identified as mid-infrared outflows. As a result, we detected 13 new outflows in the rho Ophiuchi molecular cloud that have not been previously observed in optical or near-infrared. In addition, at the positions of previously observed HH objects or near-infrared emission, we detected 31 mid-infrared outflows, among which seven correspond to previously observed HH objects and 30 to near-infrared emission. Most of the mid-infrared outflows detected in the rho Ophiuchi cloud are concentrated in the L1688 dense core region. In combination with the survey results for Young Stellar Objects (YSOs) and millimeter and sub-millimeter sources, the distribution of mid-infrared outflows in the rho Ophiuchi molecular complex hints a propagation of star formation in the cloud in the direction from the northwest to the southeast as suggested by previous studies of the region.Comment: 23 pages and 43 figure

Modeling water emission from low-mass protostellar envelopes

Within low-mass star formation, water vapor plays a key role in the chemistry and energy balance of the circumstellar material. The Herschel Space Observatory will open up the possibility to observe water lines originating from a wide range of excitation energies.Our aim is to simulate the emission of rotational water lines from envelopes characteristic of embedded low-mass protostars. A large number of parameters that influence the water line emission are explored: luminosity, density,density slope and water abundances.Both dust and water emission are modelled using full radiative transfer in spherical symmetry. The temperature profile is calculated for a given density profile. The H2O level populations and emission profiles are in turn computed with a non-LTE line code. The results are analyzed to determine the diagnostic value of different lines, and are compared with existing observations. Lines can be categorized in: (i) optically thick lines, including ground-state lines, mostly sensitive to the cold outer part; (ii) highly excited (E_u>200-250 K) optically thin lines sensitive to the abundance in the hot inner part; and (iii) lines which vary from optically thick to thin depending on the abundances. Dust influences the emission of water significantly by becoming optically thick at the higher frequencies, and by pumping optically thin lines. A good physical model of a source, including a correct treatment of dust, is a prerequisite to infer the water abundance structure and possible jumps at the evaporation temperature from observations. The inner warm (T>100 K) envelope can be probed byhighly-excited lines, while a combination of excited and spectrally resolved ground state lines probes the outer envelope. Observations of H218O lines, although weak, provide even stronger constraints on abundances.Comment: 17 pages with an online appendix of 6 pages. Accepted by A&A. Several figures are too large for astro-ph. These can be downloaded from http://www.strw.leidenuniv.nl/~kempen/water.ph

Chemical characterization of secondary organic aerosol at a rural site in the southeastern US: insights from simultaneous high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS) and FIGAERO chemical ionization mass spectrometer (CIMS) measurements

The formation and evolution of secondary organic aerosol (SOA) were investigated at Yorkville, GA, in late summer (mid-August to mid-October 2016). The organic aerosol (OA) composition was measured using two online mass spectrometry instruments, the high-resolution time-of-flight aerosol mass spectrometer (AMS) and the Filter Inlet for Gases and AEROsols coupled to a high-resolution time-of-flight iodide-adduct chemical ionization mass spectrometer (FIGAERO-CIMS). Through analysis of speciated organics data from FIGAERO-CIMS and factorization analysis of data obtained from both instruments, we observed notable SOA formation from isoprene and monoterpenes during both day and night. Specifically, in addition to isoprene epoxydiol (IEPOX) uptake, we identified isoprene SOA formation from non-IEPOX pathways and isoprene organic nitrate formation via photooxidation in the presence of NO_x and nitrate radical oxidation. Monoterpenes were found to be the most important SOA precursors at night. We observed significant contributions from highly oxidized acid-like compounds to the aged OA factor from FIGAERO-CIMS. Taken together, our results showed that FIGAERO-CIMS measurements are highly complementary to the extensively used AMS factorization analysis, and together they provide more comprehensive insights into OA sources and composition