Is an operation always needed for pediatric triplane fractures? Preliminary results.

We compared the outcomes of nonoperative and operative treatments of triplane fractures. Thirty-three patients with triplane fractures were treated conservatively (n=19) or surgically (n=14). Bone union and postoperative complications were radiographically examined. The mean American Orthopedic Foot and Ankle Society scores were 100 (nonoperative group) and 98.1 (operative group) (P=0.304). The modified Weber protocol scores were excellent in both groups. One patient in each group showed a leg-length discrepancy of more than 10 mm at the last follow-up. According to our preliminary data, it appears that nonoperative treatment of triplane fracture may have comparable clinical and radiographic results to operative treatment. However, further studies are needed to corroborate our findings.

Deficiency of inducible nitric oxide synthase attenuates immobilization-induced skeletal muscle atrophy in mice.

The present study examined the effects of inducible nitric oxide synthase (iNOS) deficiency on skeletal muscle atrophy in single leg-immobilized iNOS knockout (KO) and wild-type (WT) mice. The left leg was immobilized for 1 wk, and the right leg was used as the control. Muscle weight and contraction-stimulated glucose uptake were reduced by immobilization in WT mice, which was accompanied with increased iNOS expression in skeletal muscle. Deficiency of iNOS attenuated muscle weight loss and the reduction in contraction-stimulated glucose uptake by immobilization. Phosphorylation of Akt, mTOR, and p70S6K was reduced to a similar extent by immobilization in both WT and iNOS KO mice. Immobilization decreased FoxO1 phosphorylation and increased mRNA and protein levels of MuRF1 and atrogin-1 in WT mice, which were attenuated in iNOS KO mice. Aconitase and superoxide dismutase activities were reduced by immobilization in WT mice, and deficiency of iNOS normalized these enzyme activities. Increased nitrotyrosine and carbonylated protein levels by immobilization in WT mice were reversed in iNOS KO mice. Phosphorylation of ERK and p38 was increased by immobilization in WT mice, which was reduced in iNOS KO mice. Immobilization-induced muscle atrophy was also attenuated by an iNOS-specific inhibitor N(6)-(1-iminoethyl)-l-lysine, and this finding was accompanied by increased FoxO1 phosphorylation and reduced MuRF1 and atrogin-1 levels. These results suggest that deficiency of iNOS attenuates immobilization-induced skeletal muscle atrophy through reduced oxidative stress, and iNOS-induced oxidative stress may be required for immobilization-induced skeletal muscle atrophy.

Epidemiology and demographics of slipped capital femoral epiphysis in Korea: a multicenter study by the Korean Pediatric Orthopedic Society.

BACKGROUND: In 1979, slipped capital femoral epiphysis (SCFE) was rarely reported in Korea, although it is the most common hip disorder of adolescence in Western nations. However, because the number of reported cases of SCFE in Korea has increased a great deal since then, we performed a nationwide survey to ascertain its epidemiology and demographics in Korea. METHODS: We reviewed the discharge databases for the period between January 1989 and December 2003 from 19 university hospitals across Korea. Recorded data included age at onset, sex, past medical history, height, weight, and type of slippage. We compared those data with national census data. The incidence data are reported as cases per 100,000 children between the ages of 10 and 14 years. RESULTS: Data for 231 patients (175 boys and 56 girls) were included in our survey. The average age at onset was 12 years 10 months in boys and 12 years in girls. The average annual incidence was estimated to be at least 0.499 for boys and 0.142 for girls for every 100,000 children between the ages of 10 and 14 years, which was lower than that of Western nations and Japan. The incidence showed a pattern of increments across each period. The mean body mass index was significantly higher in Korean patients with SCFE than in the population of the same age group without it. CONCLUSIONS: The incidence of SCFE in preadolescents in Korea has increased markedly since 1979, which may be related to increasing rates of obesity. LEVEL OF EVIDENCE: Therapeutic, level 4.

Designed strength identification of concrete by ultrasonic signal processing based on artificial intelligence techniques.

This paper presents a pattern recognition method to identify the designed strength of concrete by evidence accumulation based on artificial intelligence techniques with multiple feature parameters. Concrete specimens in this experiment, which were designed to have the strengths of 180, 210, 240, 300, and 400 kg/cm2, respectively, have been considered. Variance, zero-crossing, mean frequency, autoregressive (AR) model coefficients, and linear cepstrum coefficients are extracted as feature parameters from ultrasonic signals of concretes. Pattern recognition is carried out through the evidence accumulation procedure using the distances measured with reference parameters. A fuzzy mapping function is introduced to transform the distance for the application of the evidence accumulation method. Results are presented to support the feasibility of the suggested approach for concrete pattern identification.