A new large pantherine and a sabre-toothed cat (Mammalia, Carnivora, Felidae) from the late Miocene hominoid-bearing Khorat sand pits, Nakhon Ratchasima Province, northeastern Thailand.

We describe two large predators from the hominoid-bearing Khorat sand pits, Nakhon Ratchasima Province, northeastern Thailand: a new genus of pantherine, Pachypanthera n. gen., represented by partial mandible and maxilla and an indeterminate sabre-toothed cat, represented by a fragment of upper canine. The morphological characters of Pachypanthera n. gen., notably the large and powerful canine, the great robustness of the mandibular body, the very deep fossa for the m. masseter, the zigzag HSB enamel pattern, indicate bone-cracking capacities. The genus is unique among Felidae as it has one of the most powerful and robust mandibles ever found. Moreover, it may be the oldest known pantherine, as other Asian pantherines are dated back to the early Pliocene. The taxa we report here are the only carnivorans known from the late Miocene of Thailand. Although the material is rather scarce, it brings new insights to the evolutionary history of Neogene mammals of Southeast Asia, in a geographic place which is partly "terra incognita."

Evolutionary ecology of Miocene hominoid primates in Southeast Asia.

The evolutionary history and palaeoecology of orangutans remains poorly understood until today. The restricted geographic distribution of extant Pongo indicates specific ecological needs. However, it is not clear whether these needs were shared by the great diversity of fossil pongines known from the Miocene to the Pleistocene. Here we show how niche modelling of stable carbon and oxygen isotope data of the carbonate fraction of dental enamel can be used to reconstruct the paleoecology of fossil and modern pongines and associated mammal communities. We focus on Khoratpithecus ayeyarwadyensis, a Late Miocene pongine from Myanmar and the sister clade to extant orangutans, and compare it to its associated mammal fauna and other fossil and extant pongines. The results are consistent with a vertical position high up in the canopy of a forested habitat with purely C3 vegetation for K. ayeyarwadyensis as well as the contemporaneous Sivapithecus. Although their positions in the modelled isotopic niche space look similar to the ecological niche occupied by modern Pongo, a comparison of the modelled niches within the pongine clade revealed possible differences in the use of microhabitats by the Miocene apes.

Longitudinal Cognitive Decline in Patients With Mild Cognitive Impairment or Dementia Due to Alzheimer's Disease.

Sensitive cognitive assessments accurately detect and track cognitive decline in Alzheimer's disease. The Cogstate battery was used to measure cognitive change in cognitively normal participants and in individuals with mild cognitive impairment and mild Alzheimer's disease enrolled in the Australian Imaging, Biomarker and Lifestyle Rate of Change Substudy. Over 18 months, verbal episodic memory performance declined for mild cognitive impairment and mild Alzeheimer's disease groups when compared to cognitively normal participants. Frequent assessments of episodic memory may facilitate early detection of cognitive decline due to Alzheimer's disease.

Battlefield Medicine: Anesthesia and Critical Care in the Combat Zone.

The US Military Joint Trauma System has been developed to mitigate the harsh conditions under which medical providers care for combat casualties and provide continuity of care from the battlefield to US medical centers. We review the components of this system with emphasis on combat trauma care under fire and the role of the anesthesiologist and intensivist in this continuum of care. An important link in the chain of survival is the Air Force Critical Care Aeromedical Transport Team, which provides critical care while transporting casualties from the theater to higher levels of care outside the war zone and home.

Amphipithecine primates are stem anthropoids: cranial and postcranial evidence.

Since their discovery in 1927, the phylogenetic status of the Myanmar amphipithecines has been highly debated. These fossil primates are recognized either as anthropoids or as adapiform strepsirrhines. This uncertainty was largely the consequence of a limited fossil record consisting mostly of jaw fragments but lacking the critical cranial elements that might resolve this debate. We report here cranial remains associated with an ulna from a single individual pertaining to the amphipithecine Ganlea megacanina. In addition to anthropoid-like dentognathic characters, Ganlea displays several ulna and skull features that testify to its anthropoid affinities (e.g. short subvertically oriented lacrimal duct, lacrimal foramen and bone inside the orbit, maxillary contribution to the lower orbital rim, fused metopic suture). By contrast to crown anthropoids, however, Ganlea lacks postorbital closure, confirming that postorbital closure appeared later than many anthropoid dentognathic characters and evolved convergently in extant tarsiers and anthropoids. Thus, amphipithecines must now be recognized as stem anthropoids offering a unique window on the early evolution of cranial and skeletal features in anthropoids, and reinforcing the hypothesis of an origin and early diversification of anthropoids in Asia.

Serum and plasma metabolites associated with postpartum ovulation and pregnancy risks in suckled beef cows subjected to artificial insemination.

Two experiments were conducted to determine relationships of blood metabolite concentrations, BW, BCS, and rump fat depth with postpartum ovulation and pregnancy risks, as well as their utility in predicting those outcomes in suckled beef cows. In experiment 1, plasma glucose collected 10 and 3 d before AI of suckled beef cows at seven locations did not differ between cows that had resumed estrous cycles (ovulated) before AI compared with anovulatory cows, whereas plasma glucose 3 d before AI was greater (P < 0.01) in cows that became pregnant compared with nonpregnant cows. Serum beta-hydroxybutyrate (BHB) tended (P = 0.09) to be less in ovulatory cows compared with anovulatory cows 10 d before AI, but was unrelated to pregnancy status. Receiver-operator derived true-positive (sensitivity) and false-positive (1-specificity) risks were determined for plasma glucose and serum BHB as predictors for postpartum ovulation and pregnancy status. Serum BHB 3 d before AI produced true-positive and false-positive risks of 82% and 37%, respectively, when predicting ovulatory status before AI. Serum BHB 10 d before AI produced a true-positive and false-positive risks of 92% and 25%, respectively, when predicting pregnancy status. In experiment 2, blood was collected weekly for 12 wk from multiparous suckled beef cows to assess blood metabolite concentrations in addition to concurrent weekly assessments of BW, BCS, and rump fat. When blood metabolites and physical measures were normalized to parturition reflecting changes occurring during the first 6 wk after calving, we observed reduced (P < 0.05) concentrations of serum BHB and NEFA, and greater (P < 0.05) rump fat and BCS in cows that ovulated before first AI, whereas reduced (P < 0.05) plasma glucose was characteristic of cows that became pregnant. When blood metabolites and physical measures were normalized to the onset of the AI program reflecting changes during 6 wk before AI, ovulatory cows had increased (P < 0.05) BCS and lower (P < 0.05) NEFA from 3 to 6 wk before the onset of the AI program compared with anovulatory cows. With all predictor variables in regression models, some multiple correlation coefficients (R2) exceeded 50% when predicting postpartum ovulatory status, but those for predicting pregnancy risk were less than 25%. Although measures of BCS and BHB during 6 wk after calving were related to postpartum ovulation risk, rump fat, glucose, BCS, and NEFA were associated with cows that were ovulatory and pregnant.

Two split-time artificial insemination programs in suckled beef cows.

Our objective was to determine which of 2 split-time AI programs applied to suckled beef cows would result in greater pregnancy risk. Suckled beef cows (n = 1,062) at 12 locations in 4 states (CO, KS, MY, and WA) were enrolled. Cows were treated on d -7 with a progesterone insert concurrent with 100 µg GnRH and on d 0 with 25 mg PGF plus removal of the insert. Estrus-detection patches were affixed to cows at insert removal. The study was designed as a completely randomized experiment of 2 treatment combinations. Within location and balanced for parity (primiparous vs. multiparous), cows were assigned randomly to 2 treatment times (55 vs. 65 h after CIDR insert removal) at which time estrus-detection patches were assessed. Estrus was defined to have occurred when an estrus-detection patch was > 50% colored (activated). Cows determined to be in estrus were inseminated at either 55 or 65 h, whereas the residual nonestrous cows in both treatment times received GnRH at 55 or 65 h but were inseminated 20 h later at 75 or 85 h, respectively. Pregnancy outcomes were determined at 36 d after AI and at the end of the breeding season. Thus, pregnancy outcomes of interest were compared between the 55 + 75-h treatment combination and that of the 65+85-h combination. Expression of estrus was greater ( = 0.001) by 65 h after PGF than by 55 h (62.0% vs. 41.9%), respectively, and this proportion was influenced by parity (time x parity interaction; = 0.006). As a result, proportionally more ( < 0.001) cows received the timed AI at 75 than 85 h (59.4% vs. 40.6%). Similar proportions of cows not in estrus by 55 or 65 h were detected in estrus by 75 or 85 h (40.1% vs. 39.3%), respectively. The cumulative proportion of cows in estrus by 75 h was less ( < 0.001) than that by 85 h (66.7% vs. 76.7%), respectively. Pregnancy risks at 36 d differed among treatments, with cows detected in estrus and inseminated at 55 or 65 h having greater pregnancy risks than their time-inseminated herd mates at 75 or 85 h (62.3% vs.49.7%), respectively. Overall pregnancy risk for cows in the 65+85-h treatment combination was greater at 36 d than for cows in the 55 + 75-h treatment combination (61.0% vs. 51.4%), respectively. We conclude that the 65 + 85-h treatment combination produced more pregnancies than the 55 + 75-h combination, but its implementation may be somewhat less convenient in terms of cow handling times.

Gonadotropin-releasing hormone increased pregnancy risk in suckled beef cows not detected in estrus and subjected to a split-time artificial insemination program.

We hypothesized that GnRH would increase pregnancy risk (PR) in a split-time AI program for cows in which estrus was not detected. A total of 1,236 suckled beef cows at 12 locations in 3 states (Colorado, Kansas, and North Dakota) were enrolled. Before applying the fixed-time AI program, BCS was assessed. Cows were treated on d -7 with a progesterone insert concurrent with 100 µg GnRH and on d 0 with 25 mg PGF plus removal of the insert. Estrus-detection patches were affixed to cows at insert removal. Estrus was defined to have occurred when an estrus-detection patch was >50% colored (activated). Cows in estrus by 65 h ( = 758; 61.3% of all cows) were randomly allocated to 2 treatments: 1) 100 µg GnRH and early + GnRH (E+G; = 373) or 2) AI only at 65 h (early - no GnRH [E-G]; = 385). The remaining cows were randomly allocated to 2 treatments: 1) 5(L+G; = 252) or 2) AI only at 84 h (late no GnRH [L-G]; = 226). Pregnancy was determined 35 d after AI via transrectal ultrasound. Pregnancy risk did not differ ( = 0.68) between E+G and E-G cows (61.9 vs. 60.4%, respectively). Conversely, for cows inseminated at 84 h, PR was greater ( = 0.01) in cows that received GnRH (L+G) compared with their herd mates not receiving GnRH (L- G; 41.7 vs. 30.8%, respectively). Of those cows not detected in estrus by 65 h, 42.1% were detected by 84 h, for a total expression of estrus by all cows of 77.6%. Administration of GnRH increased ( < 0.01) PR in cows not detected in estrus by 84 h (+GnRH = 33.4% [ = 146] vs. no GnRH = 15.0% [ = 128]) but had no effect in cows expressing estrus by 84 h (+GnRH = 65.3% [ = 103] vs. no GnRH = 61.7% [ = 97]). Neither estrus expression by 65 or 84 h nor PR was influenced by BCS, parity, or days postpartum at AI. Cows had greater PR when they had been detected in estrus before AI, and PR was improved by administration of GnRH at 65 h after insert removal in cows that were not detected in estrus and inseminated at 84 h.

Using estrus detection patches to optimally time insemination improved pregnancy risk in suckled beef cows enrolled in a fixed-time artificial insemination program.

A multilocation study examined pregnancy risk (PR) after delaying AI in suckled beef cows from 60 to 75 h when estrus had not been detected by 60 h in response to a 7-d CO-Synch + progesterone insert (CIDR) timed AI (TAI) program (d -7: CIDR insert concurrent with an injection of GnRH; d 0: PGF injection and removal of CIDR insert; and GnRH injection at TAI [60 or 75 h after CIDR removal]). A total of 1,611 suckled beef cows at 15 locations in 9 states (CO, IL, KS, MN, MS, MT, ND, SD, and VA) were enrolled. Before applying the fixed-time AI program, BCS was assessed, and blood samples were collected. Estrus was defined to have occurred when an estrus detection patch was >50% colored (activated). Pregnancy was determined 35 d after AI via transrectal ultrasound. Cows ( = 746) detected in estrus by 60 h (46.3%) after CIDR removal were inseminated and treated with GnRH at AI (Control). Remaining nonestrous cows were allocated within location to 3 treatments on the basis of parity and days postpartum: 1) GnRH injection and AI at 60 h (early-early = EE; = 292), 2) GnRH injection at 60 h and AI at 75 h (early-delayed = ED; = 282), or 3) GnRH injection and AI at 75 h (delayed-delayed = DD; = 291). Control cows had a greater ( < 0.01) PR (64.2%) than other treatments (EE = 41.7%, ED = 52.8%, DD = 50.0%). Use of estrus detection patches to delay AI in cows not in estrus by 60 h after CIDR insert removal (ED and DD treatments) increased ( < 0.05) PR to TAI when compared with cows in the EE treatment. More ( < 0.001) cows that showed estrus by 60 h conceived to AI at 60 h than those not showing estrus (64.2% vs. 48.1%). Approximately half (49.2%) of the cows not in estrus by 60 h had activated patches by 75 h, resulting in a greater ( < 0.05) PR than their nonestrous herd mates in the EE (46.1% vs. 34.5%), ED (64.2% vs. 39.2%), and DD (64.8% vs. 31.5%) treatments, respectively. Overall, cows showing estrus by 75 h (72.7%) had greater ( < 0.001) PR to AI (61.3% vs. 37.9%) than cows not showing estrus. Use of estrus detection patches to allow for a delayed AI in cows not in estrus by 60 h after removal of the CIDR insert improved PR to TAI by optimizing the timing of the AI in those cows.

Proteinuria and lipoprotein lipase activity in Miniature Schnauzer dogs with and without hypertriglyceridemia.

Spontaneous hyperlipidemia in rats causes glomerular disease. Idiopathic hypertriglyceridemia (HTG) is prevalent in Miniature Schnauzers, but its relationship with proteinuria is unknown. Decreased activity of major lipid metabolism enzymes, lipoprotein lipase (LPL) and hepatic lipase (HL), may play a role in the cyclic relationship between hyperlipidemia and proteinuria. These enzymes have also not been previously investigated in Miniature Schnauzers. The aims of this study were to determine the relationship between HTG and proteinuria in Miniature Schnauzers and to measure LPL and HL activities in a subset of dogs. Fifty-seven Miniature Schnauzers were recruited (34 with and 23 without HTG). Fasting serum triglyceride concentrations and urine protein-to-creatinine ratios (UPC) were measured in all dogs, and LPL and HL activities were determined in 17 dogs (8 with and 9 without HTG). There was a strong positive correlation between triglyceride concentration and UPC (r = 0.77-0.83, P < 0.001). Proteinuria (UPC ≥ 0.5) was present in 60% of dogs with HTG and absent from all dogs without HTG (P < 0.001). Proteinuric dogs were not azotemic or hypoalbuminemic. Dogs with HTG had a 65% reduction in LPL activity relative to dogs without HTG (P < 0.001); HL activity did not differ. Proteinuria occurs with HTG in Miniature Schnauzers and could be due to lipid-induced glomerular injury. Reduced LPL activity may contribute to the severity of HTG, but further assay validation is required.

Phenotypic relationships between docility and reproduction in Angus heifers.

The objective of this study was to elucidate the phenotypic relationships between docility and first-service AI conception rate in heifers. Data ( = 337) collected from 3 cooperator herds in Kansas at the start of synchronization protocol included exit velocity (EV), chute score (CS), fecal cortisol (FC), and blood serum cortisol (BC). Data were analyzed using logistic regression with 30-d pregnancy rate as the dependent variable. The model included the fixed effect of contemporary group and the covariates FC, BC, EV, CS, BW, and age. Correlation coefficients were calculated between all continuous traits. Pregnancy rate ranged from 34% to 60% between herds. Blood cortisol positively correlated with EV ( = 0.22, < 0.01), negatively correlated with age ( = -0.12, < 0.03), and tended to be negatively correlated with BW ( = -0.10, = 0.09). Exit velocity was positively correlated with CS ( = 0.24, < 0.01) and negatively correlated with BW ( = -0.15, < 0.01) and age ( = -0.12, < 0.03). Chute score negatively correlated with age ( = -0.14, < 0.01), and age and BW were moderately positively correlated ( = 0.42, < 0.01), as expected. Older, heavier animals generally had better temperament, as indicated by lower BC, EV, and CS. The power of our test could detect no significant predictors of 30-d pregnancy for the combined data from all ranches. When the data were divided by ranch, CS ( < 0.03) and BW ( < 0.01) were both significant predictors for 30-d pregnancy for ranch 1. The odds ratio estimate for CS has an inverse relationship with pregnancy, meaning that a 1-unit increase in average CS will reduce the probability of pregnancy at ranch 1 by 48.1%. Weight also has a negative impact on pregnancy because a 1-kg increase in BW will decrease the probability of pregnancy by 2.2%. Fertility is a complex trait that depends on many factors; our data suggest that docility is 1 factor that warrants further investigation.

A double-sided fabrication process for intrafascicular parylene C based electrode arrays.

After the development of a single-sided fabrication process for intrafascicular parylene C based electrode arrays tests showed that an increase in integration density can only be achieved by a double-side process. The process uses 25 µm thick platinum iridium foil, which is thinned down with the laser and sandwiched between two 10 µm thick parylene C layers. Utilizing a picosecond laser (355 nm Nd:YVO4) it was possible to fabricate 40 µm thick electrodes that can be implanted directly in the nerve without relying on additional support layers like chitosan or silk. The fabricated samples feature three 80 µm diameter electrodes on each side and a large ground electrode that is opened to both sides. Impedance mismatches from front to back side as a result of the fabrication process are compensated by electrochemical deposition of nanostructured platinum. This step makes it possible to bring the impedances of the small electrodes down to the range of just a few kΩ at 1 kHz and illustrate the additionally gained surface due to the picosecond laser ablation on the front side electrodes. The safely injectable charge per pulse was found to be 635.75 µC/cm2 for such coated electrodes. Optical investigations show that this fabrication process offers an alternative to established lithographic processes for thin and flexible electrode arrays in neural implants.

A holin and an endopeptidase are essential for chitinolytic protein secretion in Serratia marcescens.

Pathogenic bacteria adapt to their environment and manipulate the biochemistry of hosts by secretion of effector molecules. Serratia marcescens is an opportunistic pathogen associated with healthcare-acquired infections and is a prolific secretor of proteins, including three chitinases (ChiA, ChiB, and ChiC) and a chitin binding protein (Cbp21). In this work, genetic, biochemical, and proteomic approaches identified genes that were required for secretion of all three chitinases and Cbp21. A genetic screen identified a holin-like protein (ChiW) and a putative l-alanyl-d-glutamate endopeptidase (ChiX), and subsequent biochemical analyses established that both were required for nonlytic secretion of the entire chitinolytic machinery, with chitinase secretion being blocked at a late stage in the mutants. In addition, live-cell imaging experiments demonstrated bimodal and coordinated expression of chiX and chiA and revealed that cells expressing chiA remained viable. It is proposed that ChiW and ChiX operate in tandem as components of a protein secretion system used by gram-negative bacteria.

Asian monsoons in a late Eocene greenhouse world.

The strong present-day Asian monsoons are thought to have originated between 25 and 22 million years (Myr) ago, driven by Tibetan-Himalayan uplift. However, the existence of older Asian monsoons and their response to enhanced greenhouse conditions such as those in the Eocene period (55-34 Myr ago) are unknown because of the paucity of well-dated records. Here we show late Eocene climate records revealing marked monsoon-like patterns in rainfall and wind south and north of the Tibetan-Himalayan orogen. This is indicated by low oxygen isotope values with strong seasonality in gastropod shells and mammal teeth from Myanmar, and by aeolian dust deposition in northwest China. Our climate simulations support modern-like Eocene monsoonal rainfall and show that a reinforced hydrological cycle responding to enhanced greenhouse conditions counterbalanced the negative effect of lower Tibetan relief on precipitation. These strong monsoons later weakened with the global shift to icehouse conditions 34 Myr ago.

Altered progesterone concentrations by hormonal manipulations before a fixed-time artificial insemination CO-Synch + CIDR program in suckled beef cows.

We hypothesized that pregnancy outcomes may be improved by inducing luteal regression, ovulation, or both (i.e., altering progesterone status) before initiating a timed-artificial insemination (TAI) program in suckled beef cows. This hypothesis was tested in two experiments in which cows were treated with either PGF2α (PG) or PG + GnRH before initiating a TAI program to increase the proportion of cows starting the program in a theoretical marginal (<1 ng/mL; experiment 1) or elevated (≥1 ng/mL; experiment 2) progesterone environment, respectively. The control was a standard CO-Synch + controlled internal drug release (CIDR) program employed in suckled beef cows (100 µg GnRH intramuscularly [IM] [GnRH-1] and insertion of a progesterone-impregnated intravaginal CIDR insert on study Day -10, 25 mg PG and CIDR insert removal on study Day -3, and 100 µg GnRH IM [GnRH-2] and TAI on study Day 0). In both experiments, blood was collected before each injection for later progesterone analyses. In experiment 1, cows at nine locations (n = 1537) were assigned to either: (1) control or (2) PrePG (same as control with a PG injection on study Day -13). The PrePG cows had larger (P < 0.05) follicles on study Day -10 and more (P < 0.05) ovulated after GnRH-1 compared with control cows (60.6% vs. 36.5%), but pregnancy per TAI was not altered (55.5% vs. 52.2%, respectively). In experiment 2, cows (n = 803) at four locations were assigned to: (1) control or (2) PrePGG (same as control with PG injection on study Day -20 and GnRH injection on study Day -17). Although pregnancy per TAI did not differ between control and PrePGG cows (44.0% vs. 44.4%, respectively), cows with body condition score greater than 5.0 or 77 or more days postpartum at TAI were more (P < 0.05) likely to become pregnant than thinner cows or those with fewer days postpartum. Presynchronized cows in both experiments were more (P < 0.05) likely than controls to have luteolysis after initial PG injections and reduced (P < 0.05) serum progesterone; moreover, treatments altered the proportion of cows and pregnancy per TAI of cows in various progesterone categories before the onset of the TAI protocol. In combined data from both experiments, cows classified as anestrous before the study but with elevated progesterone on Day -10 had increased (P < 0.05) pregnancy outcomes compared with anestrous cows with low progesterone concentrations. Progesterone concentration had no effect on pregnancy outcome of cycling cows. In summary, luteal regression and ovulation were enhanced and progesterone concentrations were altered by presynchronization treatments before the 7-day CO-Synch + CIDR program, but pregnancy per TAI was not improved.

Psychometric evaluation of ADAS-Cog and NTB for measuring drug response.

AIMS: To conduct a psychometric analysis to determine the adequacy of instruments that measure cognition in Alzheimer's disease trials. BACKGROUND: Both the Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and the Neuropsychological Test Battery (NTB) are validated outcome measures for clinical trials in Alzheimer's disease and are approved also for regulatory purposes. However, it is not clear how comparable they are in measuring cognitive function. In fact, many recent trials in Alzheimer's disease patients have failed and it has been questioned if ADAS-Cog still is a sensitive measure. MATERIALS AND METHODS: The present paper examines the psychometric properties of ADAS-Cog and NTB, based on a post hoc analysis of data from a clinical trial (NCT01024660), which was conducted by AstraZeneca, in mild-to-moderate Alzheimer's disease (AD) patients, with a Mini Mental State Examination (MMSE) Total score 16-24. Acceptability, reliability, different types of validity and ability to detect change were assessed using relevant statistical methods. Total scores of both tests, as well as separate domains of both tests, including the Wechsler Memory Scale (WMS), Rey Auditory Verbal Learning Test (RAVLT) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency Condition, were analyzed. RESULTS: Overall, NTB performed well, with acceptable reliability and ability to detect change, while ADAS-Cog had insufficient psychometric properties, including ceiling effects in 8 out of a total of 11 ADAS-Cog items in mild AD patients, as well as low test-retest reliability in some of the items. DISCUSSION: Based on a direct comparison on the same patient sample, we see advantages of the NTB compared with the ADAS-Cog for the evaluation of cognitive function in the population of mild-to-moderate AD patients. The results suggest that not all of ADAS-Cog items are relevant for both mild and moderate AD population. CONCLUSIONS: This validation study demonstrates satisfactory psychometric properties of the NTB, while ADAS-Cog was found to be psychometrically inadequate.

Satisfactory long-term MRI after autologous chondrocyte implantation at the knee.

PURPOSE: Autologous chondrocyte implantation (ACI) to address isolated condylar lesions is supposed to limit degenerative deterioration in neutrally aligned knees. Here, we report long-term results of the first-generation ACI technique with periosteal flap. METHODS: Twelve patients, 29 years old on average, were included on the basis of pre-operative MRI selection of lesions >2 cm2. Cartilage carrots were harvested arthroscopically, then cultured and finally re-implanted within a mean time interval of 12 weeks. Ten-year MRI results were analysed according to a semi-quantitative scale, along with functional assessment based on International Knee Documentation Committee score, Lysholm et al. score and the Tegner et al. activity scale. RESULTS: One patient secondarily required valgus tibial osteotomy with mosaic plasty. Another incurred graft hypertrophy that necessitated arthroscopic peeling. MRI showed that cartilage repair filled more than 50% of the initial defect in 9 patients. Standard radiographs revealed slight narrowing of the joint line. Overall, functional scores improved durably by 50%, although activity level decreased substantially. CONCLUSION: ACI contained degenerative changes within moderate stages while maintaining durable functional improvement. However, in the absence of controls, it was difficult to differentiate between these findings and the spontaneous evolution of non-treated lesions. LEVEL OF EVIDENCE: Case series, Level IV.