Complications of Elbow Arthroscopy in a Community-Based Practice.

PURPOSE: The purpose of this study was to report the complications of elbow arthroscopy in a large community practice with multiple surgeons and to analyze potential risk factors for these complications. METHODS: Patient demographic information, surgical variables, surgeon variables, and complications were retrospectively reviewed for all elbow arthroscopies performed within the health network from 2006 to 2014. Inclusion criteria included patients of any age undergoing a primary and revision elbow arthroscopy, which may have been performed in conjunction with other procedures. Exclusion criteria included incorrectly coded procedures where arthroscopy was not performed and no postoperative follow-up. Statistical calculations were performed using a binary logistic regression analysis to fit a logistic regression model. RESULTS: 560 consecutive elbow arthroscopies in 528 patients performed between 2006 and 2014, by 42 surgeons at 14 facilities, were reviewed. 113 procedures were performed in pediatric patients under the age of 18. The average age was 38.6 years (range: 5-88). There were 444 males. The average length of follow-up was 375.8 days (2 to 2,739 days). Overall, heterotopic ossification occurred in 14 of 560 cases (2.5%) (all males), and 20 of 560 (3.5%) cases developed transient nerve palsies (8 ulnar, 8 radial, 1 median, 3 medial antebrachial cutaneous). There were 3 (0.5%) deep and 11 (2%) superficial infections. There were no vascular injuries, compartment syndrome, deep vein thrombosis, or pulmonary embolism. Elevated blood sugar was a significantly higher risk for infection (odds ratio [OR] 4.11, 95% confidence interval [CI] 1.337 to 12.645; P = .0136). Previous elbow surgery (OR 3.57, 95% CI 1.440 to 8.938; P = .006) and female sex (OR 4.05; 95% CI 1.642 to 9.970; P = .002) had a significantly higher risk for nerve injury. Relative to pediatric patients, there were higher odds in adults for nerve injury, infection, and heterotopic ossification, but none reached significance. CONCLUSIONS: Elbow arthroscopy is a safe procedure with low complication rates. Diabetes is a risk factor for infection. Prior surgery and female sex are risk factors for nerve injury. LEVEL OF EVIDENCE: Case series, level 4.

Effects of Dietary Energy Levels on the Physiological Parameters and Reproductive Performance of Gestating Gilts.

This experiment was conducted to investigate the effects of dietary energy levels on the physiological parameters and reproductive performance of gestating first parity sows. A total of 52 F1 gilts (Yorkshire×Landrace) were allocated to 4 dietary treatments using a completely randomized design. Each treatment contained diets with 3,100, 3,200, 3,300, or 3,400 kcal of metabolizable energy (ME)/kg, and the daily energy intake of the gestating gilts in each treatment were 6,200, 6,400, 6,600, and 6,800 kcal of ME, respectively. During gestation, the body weight (p = 0.04) and weight gain (p = 0.01) of gilts linearly increased with increasing dietary energy levels. Backfat thickness was not affected at d110 of gestation by dietary treatments, but increased linearly (p = 0.05) from breeding to d 110 of gestation. There were no significant differences on the litter size or litter birth weight. During lactation, the voluntary feed intake of sows tended to decrease when the dietary energy levels increased (p = 0.08). No difference was observed in backfat thickness of the sows within treatments; increasing energy levels linearly decreased the body weight of sows (p<0.05) at d 21 of lactation and body weight gain during lactation (p<0.01). No significant differences were observed in the chemical compositions of colostrum and milk. Therefore, these results indicated that high-energy diets influenced the bodyweight and backfat thickness of sows during gestation and lactation. NRC (2012) suggested that the energy requirement of the gestation gilt should be between 6,678 and 7,932 kcal of ME/d. Similarly, our results suggested that 3,100 kcal of ME/kg is not enough to maintain the reproductive performance for gilts during gestation with 2 kg feed daily. Gilts in the treatment 3,400 kcal of ME/kg have a higher weaning number of piglets, but bodyweight and backfat loss were higher than other treatments during lactation. But bodyweight and backfat loss were higher than other treatments during lactation. Consequently, an adequate energy requirement of gestating gilts is 6,400 kcal of ME/d.

Tone-language speakers show hemispheric specialization and differential cortical processing of contour and interval cues for pitch.

Electrophysiological studies demonstrate that the neural coding of pitch is modulated by language experience and the linguistic relevance of the auditory input; both rightward and leftward asymmetries have been observed in the hemispheric specialization for pitch. In music, pitch is encoded using two primary features: contour (patterns of rises and falls) and interval (frequency separation between tones) cues. Recent evoked potential studies demonstrate that these "global" (contour) and "local" (interval) aspects of pitch are processed automatically (but bilaterally) in trained musicians. Here, we examined whether alternate forms of pitch expertise, namely, tone-language experience (i.e., Chinese), influence the early detection of contour and intervallic deviations within ongoing pitch sequences. Neuroelectric mismatch negativity (MMN) potentials were recorded in Chinese speakers and English-speaking nonmusicians in response to continuous pitch sequences with occasional global or local deviations in the ongoing melodic stream. This paradigm allowed us to explore potential cross-language differences in the hemispheric weighting for contour and interval processing of pitch. Chinese speakers showed differential pitch encoding between hemispheres not observed in English listeners; Chinese MMNs revealed a rightward bias for contour processing but a leftward hemispheric laterality for interval processing. In contrast, no asymmetries were observed in the English group. Collectively, our findings suggest tone-language experience sensitizes auditory brain mechanisms for the detection of subtle global/local pitch changes in the ongoing auditory stream and exaggerates functional asymmetries in pitch processing between cerebral hemispheres.

Validation of AJCC TNM staging for breast tumors diagnosed before 2004 in cancer registries.

PURPOSE: American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N), and Metastatic (M) staging is commonly used in clinical practice for treatment decisions, yet before 2004, Surveillance Epidemiology and End Results (SEER)-affiliated cancer registries did not routinely include TNM staging defined by AJCC criteria, reporting instead SEER Summary Staging. METHODS: We developed and validated an algorithm to determine AJCC TNM staging from Extent of Disease information for 17,133 female breast cancer cases diagnosed from 1988 to 2003 in the cancer registries of Kaiser Permanente Northern and Southern California. Test characteristics (percent agreement, Cohen's kappa, sensitivity, specificity) were calculated to compare derived TNM with gold-standard TNM available in the registry. RESULTS: Agreement for TNM variables was excellent (range 0.91-1.00 for percent agreement and Cohen's kappa). The sensitivity and specificity, respectively, of the algorithm for AJCC TNM Version 6 staging were as follows: Stage 0 (0.99, 1.00), Stage I (0.97, 0.98), Stage II (0.91, 0.96), Stage III (0.69, 0.99), and Stage IV (0.92, 1.00). Stage III had lower sensitivity due to reclassification of supraclavicular lymph node positivity from M1 (Stage IV) to N3 (Stage IIIC) in AJCC Version 6. CONCLUSIONS: Derived AJCC staging for breast tumors diagnosed before 2004 is feasible and accurate using cancer registry data.

The growth pattern and fuel life cycle analysis of the electricity consumption of Hong Kong.

As the consumption of electricity increases, air pollutants from power generation increase. In metropolitans such as Hong Kong and other Asian cities, the surge of electricity consumption has been phenomenal over the past decades. This paper presents a historical review about electricity consumption, population, and change in economic structure in Hong Kong. It is hypothesized that the growth of electricity consumption and change in gross domestic product can be modeled by 4-parameter logistic functions. The accuracy of the functions was assessed by Pearson's correlation coefficient, mean absolute percent error, and root mean squared percent error. The paper also applies the life cycle approach to determine carbon dioxide, methane, nitrous oxide, sulfur dioxide, and nitrogen oxide emissions for the electricity consumption of Hong Kong. Monte Carlo simulations were applied to determine the confidence intervals of pollutant emissions. The implications of importing more nuclear power are discussed.

Hyperleptinaemia and hypoadiponectinaemia are associated with gallstone disease.

BACKGROUND: Gallstone disease has been regarded as an obesity-related disease. Therefore, we hypothesized that leptin and adiponectin, mainly produced by adipose tissue, may play roles in gallstone disease. PATIENTS AND METHODS: The RIA method was used to analyze serum leptin and adiponectin levels of 90 gallstone patients and 91 healthy subjects. RESULTS: Our results showed that BMI, fasting glucose, serum AST and ALT, and leptin were significantly increased in the gallstone patients as compared with the healthy subjects (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.013, respectively). Intriguingly, serum adiponectin was the only variable to be significantly decreased in the gallstone patients (P = 0.002). Furthermore, serum AST, leptin, and adiponectin were significantly associated with gallstone disease (P < 0.001, P = 0.021, and P = 0.006, respectively). Overweight (BMI >or= 25 kg m(-2)), but not normal-weight, gallstone patients had an increased serum leptin and a decreased serum adiponectin level as compared with matched healthy subjects (P < 0.001 and P = 0.024, respectively). In addition, serum leptin was positively correlated with BMI and serum cholesterol, while serum adiponectin was inversely correlated with serum triglyceride in the gallstone patients. CONCLUSIONS: Our study indicated that hyperleptinaemia and hypoadiponectinaemia might be involved in the occurrence of gallstone disease. However, the causal relationship of hyperleptinaemia and hypoadiponectinaemia with gallstone disease might require further investigation.

Recursive time-varying filter banks for subband image coding.

Filter banks, subband/wavelets, and multiresolution decompositions that employ recursive filters have been considered previously and are recognized for their efficiency in partitioning the frequency spectrum. This paper presents an analysis of a new infinite impulse response (IIR) filter bank in which these computationally efficient filters may be changed adaptively in response to the input. The new filter bank framework is presented and discussed in the context of subband image coding. In the absence of quantization errors, exact reconstruction can be achieved. By the proper choice of an adaptation scheme, it is shown that recursive linear time-varying (LTV) filter banks can yield improvement over conventional ones.

One Herbert double-threaded compression screw fixation of displaced type II odontoid fractures.

Surgical treatment of type II odontoid fractures (OFs) has usually entailed C1-2 arthrodesis rather than fracture fixation. An alternative treatment of direct screw fixation is used to treat the fractures for preservation of atlantoaxial rotation. Type II OFs that cannot be completely reduced by close means are generally believed to be a contraindication for anterior screw fixation. Seven patients (group I) with displaced type II OFs that could be completely reduced were treated with fracture fixation by one 4.5-mm double-threaded compression screw and five patients (group II) with displaced type II OFs that could only be partially reduced were treated with fracture fixation by one 3.0-mm double-threaded compression screw. All patients had a minimum of 1-year follow-up. No major complications occurred. No loss of reduction occurred in group I patients. Group II patients had an average loss of reduction of 0.8 mm anterior displacement and 5 degrees anterior angulation. The overall rate of fracture union was 100%, and fracture resolution averaged 4.1 months. Ten patients had a normal range of cervical rotation, and there was no difference in preservation of cervical rotation between the two groups. Our results suggest that close reduction and compressive osteosynthesis by one double-threaded compression screw is an optimal method of treatment for displaced type II OFs that can be completely reduced and for some cases that can only be partially reduced. A 100% rate of fracture union and preservation of cervical rotation are the major advantages of this method. However, significant complications have been reported by other investigators. (ABSTRACT TRUNCATED AT 250 WORDS)

Specific high-affinity binding of fatty acids to epidermal cytosolic proteins.

Cytosol from rat, mouse, and human skin or rat epidermis was incubated with [3H]arachidonic acid, [14C]retinoic acid, [14C]oleic acid, [3H]leukotriene A4, [3H]prostaglandin E2 (PGE2) or [3H] 15-hydroxyeicosatetraenoic acid (15-HETE), and protein-bound ligands were separated using Lipidex-1000 at 4 degrees C to assess the binding specificity. The binding of oleic acid and arachidonic acid with rat epidermal cytosol was rapid, saturable, and reversible. Binding of oleic acid was competed out with the simultaneous addition of other ligands and found to be in the following order: arachidonic acid greater than oleic acid greater than linoleic acid greater than lauric acid greater than leukotriene A4 greater than 15-HETE = PGE1 greater than PGE2 = PGF2. Scatchard analysis of the binding with arachidonic acid, oleic acid, and retinoic acid revealed high-affinity binding sites with the dissociation constant in the nM range. SDS-PAGE analysis of the oleic acid-bound epidermal cytosolic protein(s) revealed maximum binding at the 14.5 kDa region. The presence of the fatty acid-binding protein in epidermal cytosol and its binding to fatty acids and retinoic acid may be of significance both in the trafficking and the metabolism of fatty acids and retinoids across the skin.

Sex steroid content and metabolism in Trichostrongylus colubriformis (Nematoda).

Testosterone, progesterone and cholesterol were found in mixed sexes of the nematode Trichostrongylus colubriformis from goats, according to thin-layer, gas-liquid and high-performance liquid chromatography. The structure of these steroids was confirmed by proton nuclear magnetic resonance and mass spectroscopy. Melting points of the worms' steroids were similar to authentic standards of the steroids. Estradiol was not detected in worms from either goat sex. Cholesterol was about 0.08% of the worms' dry weight in helminths from either sex of host. Testosterone was 0.02% of the dry weight when worms were taken from male goats, but only 0.005% from female goats. Progesterone was not detected in worms from male goats, but was 0.005% of the dry weight of helminths from female hosts. Incubation of a worm preparation with tritiated steroids showed that progesterone was converted to 17-alpha-hydroxyprogesterone, based on retention during radioactive thin-layer and gas-liquid chromatography, and co-crystallization. Testosterone, cholesterol and 17-beta-estradiol were not metabolized.