Reamed Intramedullary Nailing has an Adverse Effect on Bone Regeneration During the Distraction Phase in Tibial Lengthening.

BACKGROUND: The lengthening over nail (LON) technique has gained popularity because it enables shorter periods of external fixation, prevents deformities during lengthening, and reduces the risk of refracture after removal of the frame compared with the classic Ilizarov method. However, it is not clear if the violation of endosteal blood supply by reamed intramedullary nailing in the LON technique has a negative effect on bone regeneration or a positive effect by compensatory enhancement of periosteal circulation. QUESTIONS/PURPOSES: The purposes of this study were to (1) compare the amount of regenerate bone during the distraction phase between two tibial lengthening techniques, the LON technique and lengthening and then nail (LATN) technique; and (2) compare callus shape at the end of the distraction phase using the classification of Li et al. METHODS: This is a retrospective study comparing two treatment groups. Between September 2011 and June 2013, 120 patients underwent bilateral lower leg lengthening for familial short stature with either the LON or LATN technique, and were considered potentially eligible for inclusion in this retrospective, comparative study. During this same period, LON and LATN techniques were used in other patient populations, but all patients with familial short stature were considered for inclusion in the study. The specific contraindications for LON were diameter of the isthmus of the tibia narrower than 8 mm, length of the tibia shorter than 270 mm, and alignment of the lower extremity in valgus; in patients without these specific contraindications to LON, patients were offered either LATN or LON after counseling regarding the advantages and disadvantages of each procedure. The proposed advantages of LATN were shorter healing index and more stable internal fixation which might lead to earlier full weightbearing, whereas proposed disadvantages were a greater chance for deep infection, more deformity during lengthening, and subsequently longer external fixator period for correction. The groups were comparable in terms of age, sex distribution, smoking history, BMI, distraction rate, and final length gain. A longer period of external fixation was necessary in the LATN group, related to the relative stability of the segment without an intramedullary nail. Patients with tibial lengthening with the LON technique (31 patients, 62 tibiae) were compared with patients who had the LATN technique (89 patients, 178 tibiae) regarding the amount of bone regeneration at the anterior, posterior, medial, and lateral cortices of the lengthened area for each at 4, 8, and 12 weeks postoperatively using a pixel value ratio method. In addition, both groups were compared for callus shape and type at the end of the distraction phase (LON, 3.4 ± 0.06 months; LATN, 4.2 ± 0.05 months). RESULTS: The pixel value ratios of the anterior, posterior, medial, and lateral cortices in the LON and LATN groups were 0.78 ± 0.06 and 0.74 ± 0.05; 0.82 ± 0.08 and 0.76 ± 0.05; 0.75 ± 0.06 and 0.72 ± 0.05; and 0.85 ± 0.06 and 0.82 ± 0.06, respectively at 4 weeks postoperatively(p value > 0.500 for all); 0.75 ± 0.05 and 0.77 ± 0.04; 0.78 ± 0.05 and 0.89 ± 0.04; 0.73 ± 0.05 and 0.82 ± 0.05; and 0.78 ± 0.06 and 0.88 ± 0.03, respectively at 8 weeks postoperatively (p value < 0.001 for the posterior, medial, and lateral cortices); 0.72 ± 0.05 and 0.76 ± 0.03; 0.75 ± 0.07 and 0.89 ± 0.03; 0.71 ± 0.05 and 0.82 ± 0.03; and 0.78 ± 0.06 and 0.91 ± 0.03, respectively at 12 weeks postoperatively (p value < 0.001 for the posterior, medial, and lateral cortices). A greater percentage of tibiae having the generally favored fusiform-shaped callus were seen with the LATN technique (61 of 178 segments) than with the LON technique (four of 62 segments; p < 0.001). There were no tibia showing the inferior concave, lateral, or central-shaped callus with the LATN technique, whereas eight tibiae (eight of 62 segments) showed concave-shaped callus with the LON technique (p < 0.001). CONCLUSIONS: The potentially negative effect on callus regeneration from the concomitant use of reamed intramedullary nailing during the LON technique should not be overlooked. Based on our study, LATN may be a better choice for patients willing to accept the longer period of external fixation. LEVEL OF EVIDENCE: Level III, therapeutic study.

Social networks and physical activity behaviors among cancer survivors: data from the 2005 Health Information National Trends Survey.

The study examined the relation between social networks and physical activity behaviors among cancer survivors. The authors examined 873 cancer survivors (596 women, 277 men) 50 years of age or older who participated in the 2005 Health Information National Trends Survey. Multivariate logistic regression analysis showed that survivors who talked about health with friends/family were more likely to pay attention to new physical activity recommendations (OR = 2.89, CI [1.01, 8.33]). Female survivors were more likely to pay attention to new physical activity recommendations (OR = 2.65, CI [1.55, 4.53]) and more likely to have seen, heard, or read physical activity/exercise and cancer information within the past 12 months (OR = 2.09, CI [1.13, 3.85]) compared with their male counterparts. For male survivors, those who were a member of at least one community organization were more likely to pay attention to new physical activity/exercise recommendations (OR = 5.31, CI [1.32, 21.22]) than the men who were not members. Overall, cancer survivors with a social network (i.e., talking to family/friends about health) were more likely to pay attention to new exercise recommendations compared with those who did not have a social network. Significant differences were also observed by gender with physical activity levels, knowledge, and attitudes. Social networking is an important component in cancer survivorship and further research is needed to encourage social networking strategies that might facilitate in increasing physical activity behaviors among cancer survivors.

Low Serum Vitamin D Is Not Correlated With the Severity of a Rotator Cuff Tear or Retear After Arthroscopic Repair.

BACKGROUND: Despite the essential role of vitamin D in muscle function, the prevalence of vitamin D deficiency has been reported to be very high. Recently, low vitamin D level was found to correlate with fatty degeneration of the rotator cuff tendon in humans and to negatively affect early healing at the rotator cuff repair site in an animal study. However, the effects of vitamin D level on severity of rotator cuff tear and healing after surgical repair have not been documented. PURPOSE: To evaluate (1) the prevalence of vitamin D deficiency among patients who underwent arthroscopic repair for a full-thickness rotator cuff tear, (2) the relationship of vitamin D level with severity of the rotator cuff tear, and (3) surgical outcomes after repair. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A consecutive series of 91 patients (age, 50-65 years) who underwent arthroscopic rotator cuff repair for full-thickness, small-sized to massive tears were evaluated. Preoperative serum vitamin D levels (25-hydroxyvitamin) were analyzed to detect correlations with the features of a preoperative rotator cuff tear as well as postoperative structural and functional outcomes. All patients were followed clinically for a minimum of 1 year. RESULTS: Preoperative vitamin D levels were deficient (<20 ng/mL) in 80 subjects (88%), insufficient (20-30 ng/mL) in 8 subjects (9%), and normal (>30 ng/mL) in 3 subjects (3%). No correlation was found between preoperative tear size (P = .23), extent of retraction (P = .60), degree of fatty infiltration of each cuff muscle (P > .50 each), or the global fatty infiltration index (P = .32). Similarly, no correlations were detected between vitamin D level and postoperative Sugaya type (P = .66) or any of the functional outcome scores (P > .50 each). CONCLUSION: Low serum vitamin D level was not related to tear size, extent of retraction, or the degree of fatty infiltration in cuff muscles. It also had no significant relationships with postoperative structural integrity and functional outcomes after arthroscopic repair. The results suggest that low serum vitamin D level is not a significant risk factor for the severity of rotator cuff tear or poor healing after repair.

Modified suture-bridge technique to prevent a marginal dog-ear deformity improves structural integrity after rotator cuff repair.

BACKGROUND: The arthroscopic suture-bridge technique has proved to provide biomechanically firm fixation of the torn rotator cuff to the tuberosity by increasing the footprint contact area and pressure. However, a marginal dog-ear deformity is encountered not infrequently when this technique is used, impeding full restoration of the torn cuff. PURPOSE: To evaluate the structural and functional outcomes of the use of a modified suture-bridge technique to prevent a marginal dog-ear deformity compared with a conventional suture-bridge method in rotator cuff repair. STUDY DESIGN: Cohort study; Level of evidence 2. METHODS: A consecutive series of 71 patients aged 50 to 65 years who underwent arthroscopic rotator cuff repair for full-thickness medium-sized to massive tears was evaluated. Patients were divided into 2 groups according to repair technique: a conventional suture-bridge technique (34 patients; group A) versus a modified suture-bridge technique to prevent a marginal dog-ear deformity (37 patients; group B). Radiographic evaluations included postoperative cuff integrity using MRI. Functional evaluations included pre- and postoperative range of motion (ROM), pain visual analog scale (VAS), the University of California, Los Angeles (UCLA) shoulder rating scale, the Constant score, and the American Shoulder and Elbow Surgeons (ASES) score. All patients were followed up clinically at a minimum of 1 year. RESULT: When the 2 surgical techniques were compared, postoperative structural integrity by Sugaya classification showed the distribution of types I:II:III:IV:V to be 4:20:2:4:4 in group A and 20:12:4:0:1 in group B. More subjects in group B had a favorable Sugaya type compared with group A (P < .001). The postoperative healed:retear rate was 26:8 in group A and 36:1 in group B, with a significantly lower retear rate in group B (P = .011). However, there were no significant differences in ROM and all functional outcome scores between the 2 groups postoperatively. When surgical techniques were compared across healed (n = 62) and retear (n = 9) groups, significantly fewer modified suture-bridge technique repairs were found in the retear group (P = .03). There were significant differences between healed and retear groups in functional outcome scores, with worse results in the retear group. CONCLUSION: A modified suture-bridge technique to prevent a marginal dog-ear deformity provided better structural outcomes than a conventional suture-bridge technique for medium-sized to massive rotator cuff tears. This technique may ultimately provide better functional outcomes by decreasing the retear rate.

Two quantitative real-time PCR assays for the detection of penaeid shrimp and blue crab, crustacean shellfish allergens.

Food allergen detection methods must be able to specifically detect minute quantities of an allergenic food in a complex food matrix. One technique that can be used is real-time PCR. For the work described here, real-time PCR assays were developed to detect penaeid shrimp and blue crab, crustacean shellfish allergens. The method was tested using shrimp meat and crab meat spiked into several types of foods, including canned soups, deli foods, meat, seafood, and prepared seafood products. Foods were spiked with either shrimp or crab at levels ranging from 0.1 to 106 parts per million (ppm) and analyzed either raw or cooked by a variety of methods. Real-time PCR data were used to generate linear standard curves, and assays were evaluated with respect to linear range and reaction efficiency. Results indicate that both assays performed well in a variety of food types. High reaction efficiencies were achieved across a linear range of 6-8 orders of magnitude. Limits of detection were generally between 0.1 and 1 ppm. Cooking methods used to simulate thermal processing of foods had little effect on assay performance. This work demonstrates that real-time PCR can be a valuable tool in the detection of crustacean shellfish.

Text messaging to motivate walking in older African Americans: a randomized controlled trial.

BACKGROUND: Older minority populations can benefit from increased physical activity, especially walking. Text messaging interventions have the potential to encourage positive changes in health behavior in these groups. PURPOSE: To examine if a 6-week program of motivational text messaging increases physical activity (step count) among older African Americans in an urban setting. DESIGN: RCT pilot study with assignment to motivational text messaging group or a control group. SETTING/PARTICIPANTS: Thirty-six African Americans aged 60-85 years. INTERVENTION: The intervention group received motivational text messages three times a day, 3 days a week, for 6 weeks. Both groups received pedometers and walking manuals to record step counts. The study was conducted and data were analyzed in 2011. MAIN OUTCOME MEASURES: The primary outcome measure was step count. The secondary outcome measure was perceived activity levels assessed by the Leisure Time Exercise Questionnaire (LTEQ). RESULTS: The group who received motivational text messages had greater improvements in step count (+679 vs +398; p<0.05) and perceived activity levels (p<0.05) than the group who did not receive text messages. CONCLUSIONS: Motivational text messaging three times a week for 6 weeks was effective in increasing step count and self-reported leisure time exercise behavior among older African Americans. REGISTRATION: This study is registered at www.clinicaltrials.govNCT01697475.

Vitamin D beliefs and associations with sunburns, sun exposure, and sun protection.

The main objective of this study was to examine certain beliefs about vitamin D and associations with sun exposure, sun protection behaviors, and sunburns. A total of 3,922 lifeguards, pool managers, and parents completed a survey in 2006 about beliefs regarding vitamin D and sun-related behaviors. Multivariate ordinal regression analyses and linear regression analysis were used to examine associations of beliefs and other variables. Results revealed that Non-Caucasian lifeguards and pool managers were less likely to agree that they needed to go out in the sun to get enough vitamin D. Lifeguards and parents who were non-Caucasian were less likely to report that sunlight helped the body to produce vitamin D. A stronger belief about the need to go out in the sun to get enough vitamin D predicted more sun exposure for lifeguards. For parents, a stronger belief that they can get enough vitamin D from foods predicted greater sun protection and a stronger belief that sunlight helps the body produce vitamin D predicted lower sun exposure. This study provides information regarding vitamin D beliefs and their association with certain sun related behaviors across different demographic groups that can inform education efforts about vitamin D and sun protection.

Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial.

OBJECTIVES: To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self-efficacy in older adults who report having a fear of falling. DESIGN: Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice. SETTING: General community. PARTICIPANTS: Ninety-one men and women aged 60 to 92. INTERVENTION: Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session. MEASUREMENTS: Primary outcome measure was the Short Falls Efficacy Scale-International (FES-I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test. RESULTS: GRI participants reported greater improvements on the Short FES-I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music-of-choice group. CONCLUSION: GRI was more effective at increasing falls self-efficacy and self-reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low-cost tool for older adults to improve falls self-efficacy and leisure time exercise behaviors.

The effect of guided relaxation and exercise imagery on self-reported leisure-time exercise behaviors in older adults.

The purpose of this study was to examine the effects of a 6-wk intervention that used guided relaxation and exercise imagery (GREI) to increase self-reported leisure-time exercise behavior among older adults. A total of 93 community-dwelling healthy older adults (age 70.38 ± 8.15 yr, 66 female) were randomly placed in either a placebo control group or an intervention group. The intervention group received instructions to listen to an audio compact disk (CD) containing a GREI program, and the placebo control group received an audio CD that contained 2 relaxation tracks and instructions to listen to music of their choice for 6 wk. Results revealed that listening to a GREI CD for 6 wk significantly increased self-reported leisure-time exercise behaviors (p = .03). Further exploration of GREI and its effects on other psychological variables related to perceived exercise behaviors may substantiate its effectiveness.

Spontaneous multicentric malignant schwannoma in a male Fischer 344 rat.

We describe here a multicentric spontaneous malignant schwannoma obtained from one male F344 rat, and this animal was the subject of a carcinogenicity study for which it was treated with diisodecyl phthalate. The animal of the control group not treated with diisodecyl phthalate showed dyspnea and severe lordosis. On the necropsy, two tan, firm, encapsulated masses were observed in the subcutis of the lumbosacral region and the left inguinal region of the abdominal cavity, respectively; the masses were 25 × 17 × 8 mm and 16 × 14 × 8 mm in size, respectively. Histologically, the tumor consisted of spindle and pleomorphic cells that grew in various patterns, that was, sweeping fascicles and herringbone and local organoid patterns. The pleomorphic neoplastic cells had more than two nuclei. Additionally, the diagnosis of malignant schwannoma was confirmed by the immune reactivity of the tumor cells for S-100 protein.

Associations between chronic community noise exposure and blood pressure at rest and during acute noise and non-noise stressors among urban school children in India.

The present study builds on prior research that has examined the association between children's chronic exposure to community noise and resting blood pressure and blood pressure dysregulation during exposure to acute stressors. A novel contribution of the study is that it examines how chronic noise exposure relates to blood pressure responses during exposure to both noise and non-noise acute stressors. The acute noise stressor was recorded street noise and the non-noise stressor was mental arithmetic. The sample consisted of 189 3rd and 6th grade children (51.9% percent boys; 52.9% 3rd graders) from a noisy (n = 95) or relatively quiet (n = 94) public school in the city of Pune, India. There were no statistically significant differences between chronic noise levels and resting blood pressure levels. However, relative to quiet-school children, noisy-school children had significantly lower increases in blood pressure when exposed to either an acute noise or non-noise stressor. This finding suggests that chronic noise exposure may result in hypo-reactivity to a variety of stressors and not just habituation to noise stressors.

Signal crosstalk between estrogen and peroxisome proliferator-activated receptor alpha on adiposity.

Peroxisome proliferator-activated receptor alpha and estrogen are believed to be involved in metabolic changes leading to obesity. To test this relationship, we divided female wildtype and PPAR alpha-deficient mice fed on a high fat diet into the following groups: mock-operated, ovariectomized (OVX), and E(2)-treated. The visceral white adipose tissue and plasma cholesterol levels were increased significantly in wild type OVX and decreased in the E(2)-treated group, but interestingly not in PPAR alpha-deficient mice. The mRNA levels of lipoprotein lipase in adipose tissue were also increased in only wild type OVX and decreased significantly in E(2)-treated mice. These novel results suggest the possibility of signaling crosstalk between PPAR alpha and E2, causing obesity in vivo.

Gene expression profile by 2,3,7,8-tetrachlorodibenzo-p-dioxin in the liver of wild-type (AhR+/+) and aryl hydrocarbon receptor-deficient (AhR-/-) mice.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is one of the most toxic environmental pollutants that cause various biological effects on mammals. The purpose of our study was to identify the genes involved in hepatotoxicity and hepatocarcinogenesis caused by TCDD. C57BL/6 (AhR+/+, wild type) and B6.129-AhR/J (AhR-/-, knock out) mice were injected i.p. with a single treatment of TCDD at the dose of 100 microg/kg body weight. Relative liver weight was significantly increased at 72 hr after TCDD treatment without an apparent histopathological change in AhR+/+ mice (p<0.05). TCDD treatment also significantly increased activity of serum alanine aminotransferase in AhR-/- mice (p<0.05). The liver was analyzed for gene expression profiles 72 hr later. As compared with AhR-/- mice, the expression of 51 genes (>3-fold) was changed in AhR+/+ mice; 28 genes were induced, while 23 genes were repressed. Most of the genes were associated with chemotaxis, inflammation, carcinogenesis, acute-phase response, immune responses, cell metabolism, cell proliferation, signal transduction, and tumor suppression. This study suggests that the microarray analysis of genes in the liver of AhR+/+ and AhR-/- mice may help to clarify the mechanism of AhR-mediated hepatotoxicity and hepatocarcinogenesis by TCDD.

Effects of fenofibrate on high-fat diet-induced body weight gain and adiposity in female C57BL/6J mice.

Our previous study suggested that fenofibrate affects obesity and lipid metabolism in a sexually dimorphic manner in part through the differential activation of hepatic peroxisome proliferator-activated receptor alpha (PPARalpha) in male and female C57BL/6J mice. To determine whether fenofibrate reduces body weight gain and adiposity in female sham-operated (Sham) and ovariectomized (OVX) C57BL/6J mice, the effects of fenofibrate on not only body weight, white adipose tissue (WAT) mass, and food intake, but also the expression of both leptin and PPARalpha target genes were measured. Compared to their respective low-fat diet-fed controls, both Sham and OVX mice exhibited increases in body weight and WAT mass when fed a high-fat diet. Fenofibrate treatment decreased body weight gain and WAT mass in OVX, but not in Sham mice. Furthermore, fenofibrate increased the mRNA levels of PPARalpha target genes encoding peroxisomal enzymes involved in fatty acid beta-oxidation, and reduced apolipoprotein C-III (apo C-III) mRNA, all of which were expressed at higher levels in OVX compared to Sham mice. However, leptin mRNA levels were found to positively correlate with WAT mass, and food intake was not changed in either OVX or Sham mice following fenofibrate treatment. These results suggest that fenofibrate differentially regulates body weight and adiposity due in part to differences in PPARalpha activation, but not to differences in leptin production, between female OVX and Sham mice.

Combined effect of electron-beam (beta) irradiation and organic acids on shelf life of pork loins during cold storage.

The combined effects of organic acids and irradiation on shelf life of pork loins were examined. Fresh pork loins were sprayed with organic acids (lactic, citric, and acetic) at 2%, packaged aerobically, and irradiated with an electron beam at 1, 2, and 3 kGy. During 14 days of storage, total plate count, coliform number, pH, and thiobarbituric acid-reactive substances were measured. Combinations of organic acid and irradiation were more effective in reducing and maintaining low total plate counts and coliform levels during storage than either treatment alone. Higher lipid oxidations were observed in all combination treatments at 1 day of storage than in the irradiation-only group. However, lower lipid oxidations were the result after 14 days of storage when combination treatments were used with irradiations of 2 and 3 kGy. Combined treatments involving lower irradiation doses than those required for irradiation alone could be used to extend the shelf life of pork loins during postirradiation storage without increasing lipid oxidation.

Phenotype of peroxisome proliferator-activated receptor-alpha(PPARalpha)deficient mice on mixed background fed high fat diet.

Considerable controversy exists in determining the role of peroxisome proliferator-activated receptor-alpha PPARalpha) on obesity. Previous reports demonstrated that PPARalpha is a critical modulator of lipid homeostasis, but the overt, obese phenotypic characterization in the strain of PPAR deficient (PPARalpha-/-) mice is influenced by other factors, including diet and genetics. Therefore, it is necessary to establish the phenotypic characterization of PPARalpha-/- mice prior to the obesity-related study. In this study, we observed phenotype of PPARalpha-/- mice on mixed genetic background (C57BL/6Nx129/Sv) fed a high fat diet for 16 weeks. PPARalpha-/- mice, regardless of sex, raised body growth rate significantly comparing with wild type and showed male-specific fatty change in the liver. They were shown to lack hepatic induction of PPARalpha target genes encoding enzymes for fatty acid beta-oxidation.

Naringenin derivatives as anti-atherogenic agents.

Two classes of naringenin derivatives were evaluated for anti-atherogenic activity. Naringenin 7-O-oleic ester (2) and naringenin 7-O-cetyl ether (3) inhibited the formation of aortic atherosclerotic lesions in high cholesterol-fed rabbits.

Identification of Staphylococcus xylosus isolated from C57BL/6J-Nos2(tm1Lau) mice with dermatitis.

Coagulase negative staphylococci (CNS) are significant pathogens, particularly in medical device related infections and in immunocompromised patients. Five CNS strains were isolated from 5 NOS2 knockout mice with dermatitis. Histologically, granulomatous dermatitis was found in the skin around the ear with epidermal ulceration. Dermal lesions included pustules, necrosis, and accumulations of neutrophils and macrophages. Isolates of the bacterial strains were identified to be Staphylococcus xylosus by the API STAPH kit and 16S-23S intergenic transcribed spacer-PCR. These results demonstrate the potential of this organism to be an opportunistic pathogen in immunocompromised mice.

Helicobacter muricola sp. nov., a novel Helicobacter species isolated from the ceca and feces of Korean wild mouse (Mus musculus molossinus).

A slowly growing microaerophilic Helicobacter strain was isolated from the ceca and fecal pellets of Korean wild mice (Mus musculus molossinus). This bacterial strain possessed a pair of nonsheathed bipolar flagella, was positive for urease, catalase and oxidase, and reduced nitrate to nitrite. It proved susceptible to nalidixic acid and resistant to cephalodine, and did not hydrolyze hippurate. On the basis of phenotypic characteristics and 16S rRNA gene sequence analysis, the isolate represents a new species of the genus Helicobacter, for which the name Helicobacter muricola sp. nov. is proposed; the type strain of the new species is w-06T.