A coupled stochastic/deterministic model to estimate the evolution of the risk of water contamination by pesticides across Canada.

Periodic assessments of the risk of water contamination by pesticides help decision makers improve the sustainability of agricultural management practices. In Canada, when evaluating the risk of water contamination by pesticides, 2 main constraints arise. First, because the area of interest is large, a pesticide transport model with low computational running time is mandatory. Second, some relevant input data for simulations are not known, and most are known only at coarse scale. This study aims to develop a robust methodology to estimate the evolution of the risk of water contamination by pesticides across Canada. To circumvent the 2 aforementioned issues, we constructed a stochastic model and coupled it to the 1-dimensional pesticide fate model Pesticide Root Zone Model (PRZM). To account for input data uncertainty, the stochastic model uses a Monte Carlo approach to generate several pesticide application scenarios and to randomly select PRZM parameter values. One hundred different scenarios were simulated for each of over 2000 regions (Soil Landscapes of Canada [SLC] polygons) for the years 1981 and 2006. Overall, the results indicated that in those regions in which the risk increased from 1981 to 2006, the increase in risk was mainly attributable to the increased area treated by pesticides or an increase in the number of days with runoff. More specifically, this work identifies the areas at higher risk, where further analyses with finer-scale input data should be performed. The model is specific for Canadian data, but the framework could be adapted for other large countries.

Knee arthrodesis with the Wichita Fusion Nail: an outcome comparison.

UNLABELLED: The Wichita Fusion Nail (WFN) is a knee arthrodesis stabilization system that employs compression via an intramedullary rod. It was designed for use in the salvage of the irretrievably failed total knee arthroplasty and other severe knee pathologies. Questionnaires covering the fusion success rate, fusion time, and complication rate were obtained from 33 surgeons who were among the first to use the device. Data from these questionnaires were analyzed to determine if the rate of successful fusion was close to 100%, which was the primary hypothesis of this study. The average time required to achieve fusion and the rate of complications were also calculated and compared to similar results available in the literature. The results for 44 selected patients were included and it was determined that all achieved fusion for a success rate of 100%. This compared favorably with reported success rates in the range of 54% to 96%. The average fusion time was 15.5 weeks. Complications included: six delayed unions, three deep infections, and two periimplant fractures for a major complications rate of 20.4%. Both the fusion times and complication rate compared favorably with other reported results. Surgeons using the device for the first time had outcomes equal to those of more experienced users. Our results demonstrated that a rate of successful arthrodesis close to 100% could be consistently achieved with the WFN. Overall, the WFN facilitated an improved outcome for a previously difficult procedure. LEVEL OF EVIDENCE: Therapeutic study, level IV (case series). See the Guidelines for Authors for a complete description of level of evidence.

Acoustic startle, conditioned startle potentiation and the effects of 8-OH-DPAT and buspirone in rats selectively bred for differences in 8-OH-DPAT-induced hypothermia.

HDS and LDS rats are the result of selective breeding for differences in the hypothermic effects of the 5-hydroxytryptamine-1A (5-HT1A) agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT); HDS (high DPAT sensitivity) rats exhibit a much greater hypothermic response than do LDS (low DPAT sensitivity) rats. It is possible that this genetically-based difference in sensitivity to the hypothermic effects of the 5-HT1A agonist is associated with a change in other behaviours modulated by 5-HT neurotransmission. The present study examined the acoustic startle response, the classically conditioned enhancement of startle, and the effects of 8-OH-DPAT and buspirone treatments on these measures, in HDS and LDS rats. On four test sessions, HDS and LDS rats were exposed to 20 acoustic startle stimuli (115 dB; 40 ms in duration). For each test session, 10 trials were presented in the dark (Noise Alone trials) and 10 were presented at the end of a 3500 ms presentation of a 15 W signal light (Light + Noise trials). LDS rats exhibited greater startle amplitude than did HDS rats on Noise Alone trials. Initially, there was no difference in startle amplitude on the Light + Noise versus Noise Alone trials in either LDS or HDS rats. By the end of the first test session, however, and continuing throughout the remainder of the four test sessions, startle amplitude on the Light + Noise trials was significantly greater than in the Noise Alone trials. The magnitude of this startle-potentiated startle (SPS) effect did not differ in HDS versus LDS rats. SPS testing was continued for three additional sessions; in these sessions the effects of acute treatment with the 8-OH-DPAT (125 microg/kg, subcutaneously (s.c.)), the novel anxiolytic buspirone (4 mg/kg, intraperitoneally (i.p.)) or vehicle (distilled water) were determined. Both 8-OH-DPAT and buspirone treatment increased baseline (Noise Alone) startle amplitude in LDS rats but not in HDS rats. With respect to the conditioned enhancement of startle, buspirone reduced the SPS effect in both HDS and LDS rats, whereas 8-OH-DPAT did not change the conditioned enhancement effect in either rat line. These findings suggest that the selective breeding for differences in 8-OH-DPAT-induced hypothermia has resulted in changes in other behaviours and also changes in the response to 5-HT1A agonist treatment. Moreover, these findings are consistent with the hypotheses that: (a) 5-HT1A agonist actions underlie the buspirone-induced and 8-OH-DPAT-induced increases in Noise Alone startle amplitude; whereas (b) the buspirone-induced reduction in potentiated startle is not the result of 5-HT1A agonist actions of this compound.

Conflict behavior and the effects of 8-OHDPAT treatment in rats selectively bred for differential 5-HT(1A)-induced hypothermia.

The high DPAT sensitivity (HDS) and low DPAT sensitivity (LDS) rat lines are the result of selective breeding for differences in the hypothermic response to acute treatment with the 5-HT(1A) receptor agonist 8-hydroxydipropylaminotetralin (8-OHDPAT). The HDS rats exhibit a much greater hypothermic response than do the LDS rats. The present study examined conflict anxiety-like behavior and the effects of acute challenges with 8-OHDPAT and phenobarbital (PhB) on conflict behavior in HDS and LDS rats. Water-restricted (24-h deprivation) HDS and LDS rats were trained to drink from a tube that was occasionally electrified. The 5-s bouts of drinking tube electrification occurred on a fixed interval (FI) 30-s schedule and were signaled by the presence of a tone. Under this schedule, responding is suppressed approximately 10-fold during the tone-on periods compared to the no-tone periods. After two weeks of training in this repeated measures drink suppression conflict paradigm, the effects of acute challenges with 8-OHDPAT (30-500 microg/kg, SC, +10 min) or PhB (20 mg/kg, IP, +10 min) were determined. In control (i.e. , non-drug) conflict test sessions, rats of the HDS line accepted significantly fewer shocks than did rats of the LDS line. Acute treatment with 8-OHDPAT resulted in a modest increase in punished responding (maximum increase: +30-40 shocks/session) in both lines at doses of 60 and 125 microg/kg. Higher doses produced significant general behavioral disruption and substantial reductions in water intake (unpunished responding) in both HDS and LDS rats. Neither the increase in shocks received nor the decrease in water intake produced by these 8-OHDPAT challenges differed between HDS and LDS rats. In both lines, acute PhB treatment resulted in a more dramatic increase in punished responding than did 8-OHDPAT (+55-65 shocks/session) and an increase in water intake. The effects of PhB also did not differ between HDS and LDS rats. These data suggest that the HDS and LDS rats exhibit differences in baseline anxiety-like behavior in the conflict task, but do not differ in their response to acute challenges with PhB or 8-OHDPAT.

Construct stiffness of different fixation methods for supracondylar femoral fractures above total knee prostheses.

Supracondylar fracture of the femur after total knee arthroplasty has an estimated frequency of 0.6%-2.5% among total knee recipients and presents an extremely difficult problem when encountered. The goal of this study is to determine the most stable method of fixation of these supracondylar fractures among currently available devices. Synthetic composite femurs with properties similar to human bone were used, and identical, unstable supracondylar fractures were created in each. Osteotomized specimens were placed into four groups of five. Each group was then tested with one of four devices: the Green-Seligson-Henry (GSH) intramedullary nail, AO 95 degrees blade plate, dynamic condylar screw and sideplate, and condylar buttress plate. After stabilization with the different types of fixation, the constructs were tested individually for bending stiffness in four modes: flexion, extension, varus, and valgus bending. The stiffest fixation was determined in each of the four bending planes. Resistance to all tested directions was greatest for the condylar screw and sideplate construct. Resistance to flexion (stiffness = 30.96 N/mm), extension (stiffness = 36.36 N/mm), varus (stiffness = 35.46 N/mm), and valgus forces (stiffness = 32.26 N/mm) was highest in the group fixed with the dynamic condylar screw. This may be due to the purchase gained by the large lag screw into the distal femur, or it may be the result of the total rigidity of the implant. Although the femoral samples used in this study do not duplicate the typical osteopenic bone encountered at the site of a total knee arthroplasty, they do allow direct comparison of the fixation devices by removing the variability associated with cadaveric bone samples.

Negative pressure intrusion cementing technique for total knee arthroplasty.

Negative pressure intrusion (NPI) is an alternative cementing technique for the tibial baseplate of total knee arthroplasty that uses a suction cannula in the proximal tibia to remove excess fluids and fat before cementing. This technique was compared with standard third-generation positive pressure intrusion (PPI) techniques in an in vitro implantation and analysis of 6 pairs of cadaveric tibiae. Six matched pairs of fresh frozen tibiae were prepared by cutting the tibial surfaces, standard cleaning and surface drying, then performing PPI and NPI on 1 of each pair. No objective differences were noted on radiographs or direct cement depth measurement analysis. Scanning electron micrograph evaluation revealed that the PPI specimens had consistently more voids in the cement-bone composite, and the NPI specimens had consistently narrower empty spaces between bone and cement, resulting in tighter fill in NPI specimens. NPI was shown to enhance characteristics known to improve tensile and shear strength in cement-bone composites.

The nutritional adequacy of mineral content of formulas.

The nutritional adequacy of infant formulas is a subject with which all pediatricians need to be familiar. Unfortunately, we are still learning what is nutritionally adequate and what is excessive for some minerals in infants. Pediatricians must be aware of the parameters that are used when such recommendations are made. Although this brief does not contain an analysis of each individual formula, the commercial infant formulas currently in use provide an adequate intake of the minerals through the first 6 months of life. Thereafter, supplementation with solid foods is suggested.

Effect of bone block removal and patellar prosthesis on stresses in the human patella.

Thermoelastic stress analysis was used to examine stresses on the anterior surface of patellae after patellar bone block excision for autogenous graft anterior cruciate ligament reconstruction. Complications of anterior cruciate ligament injury often lead to degenerative changes in the knee that can require total knee joint replacement. It was hypothesized that stresses in a bone block-compromised patella may be increased even further by insertion of a patellar prosthesis. All patellae were first tested intact and then were retested after a sequence of surgical modifications including patellar prosthesis implantation, tapered bone block excision, square bone block excision, and both shapes of excised bone blocks with a patellar prosthesis in place. Stresses in patellae with bone blocks excised were significantly greater than stresses in intact patellae. The anterior surface stress pattern in the loaded patella was significantly altered by excision of a bone block. There were no significant differences between maximum stress in patellae with tapered and square bone blocks excised. A finite element analysis showed that excision of a larger trapezoid-shaped bone block greatly increased maximum stress levels. Insertion of a patellar prosthesis did not significantly alter stress patterns or maximum stress levels in the patella.

Orthopedic injuries from the Andover, Kansas, tornado.

Devastating tornados struck the state of Kansas on Friday, April 26, 1991. Twenty lives were lost and many people were injured. Property damage was extensive. Overall, the outcome of those admitted to the various hospitals was good, with few orthopedic-related complications. The low complication rate can be attributed to thorough open wound management and suspicion and recognition of other potential orthopedic complications such as compartment syndrome.

External fixation of unstable Malgaigne fractures: the comparative mechanical performance of a new configuration.

An external fixator has been designed that is rigid enough to eliminate the need for skeletal traction in patients with unstable pelvic-ring fractures. This Wichita frame is similar to the Pittsburgh frame but is stiffened by the use of locked crossbars connecting the side triangles. The frame was tested in cadaveric specimens by techniques previously reported. In addition, finite-element modeling of the various frame designs was performed to ensure that the frame configuration was optimal and to supplement in vitro test results. Multiple variables that can influence frame failure loads were examined.

A histopathologic study of late aseptic loosening of cemented total hip prostheses.

Eighteen patients being treated for revision total hip arthroplasty for aseptic loosening an average of 9.5 years after primary cemented hip arthroplasty were studied. The patients were found to have been symptomatic an average of one year before revision. Review of the roentgenograms at the time of revision revealed that most patients had moderate to severe loosening of the prostheses by Charnley's criteria. These findings were confirmed at surgery. Study of the tissue surrounding the prostheses suggests that the prominent particles were methylmethacrylate "pearls" caused by cement fragmentation. These particles were surrounded by histiocytes that were actively synthesizing and releasing protein. Cement fragmentation and not polyethylene wear may be the major cause of late aseptic loosening of cemented hip prostheses.

A comparison of epidural and non-epidural anesthesia and analgesia in total hip or knee arthroplasty patients.

This retrospective study explores a number of variables encountered with the use of either epidural or non-epidural anesthesia and analgesia. Postoperative mobility, amount of narcotic used, incidence of blood transfusion, length of stay, and presence of urinary retention, pruritus, nausea and vomiting, or respiratory depression were compared in a group of 101 consecutive patients scheduled for total hip or knee arthroplasty. Fifty-two patients received epidural anesthesia and analgesia; the remaining 49 received non-epidural anesthesia, followed by standard IM/IV postoperative analgesia. Epidural patients required significantly less narcotic than the non-epidural group. There were significantly fewer blood transfusions in the epidural group; however, epidural patients had significantly increased incidence of urinary retention and pruritus. The use of epidural anesthesia and analgesia for total hip and knee arthroplasty patients has definite merit, but is most safely administered in a monitored, skilled nursing unit.

Purification and characterization of a novel extracellular esterase from pathogenic Streptomyces scabies that is inducible by zinc.

Native polyacrylamide gels of extracellular proteins produced by several Streptomyces isolates grown with suberin were assayed in situ for esterase activity. Two pathogenic isolates of Streptomyces scabies from different geographical regions were found to produce a similar esterase activity that was not produced by nonpathogenic strains. After treatment with EDTA, suberin no longer induced esterase production. Expression was restored when EDTA-treated suberin was supplemented with zinc. The optimal concentration of zinc required for esterase production was 2 microM. This esterase was purified from one of the pathogenic isolates and characterized. The enzyme was 38,000 daltons when determined by gel filtration on Sephadex G-100 and 36,000 daltons when determined by denaturing polyacrylamide gel electrophoresis. The esterase showed maximal activity in sodium phosphate buffer above pH 8.0, was stable to temperatures of up to 60 degrees C, and had an apparent Km of 125 microM p-nitrophenyl butyrate.

A comparison of the structure of small blood vessels in normal, denervated and dystrophic human muscle.

A light- and electron-microscopic study of the small arterial vessels and capillaries in muscle from 20 patients with Duchenne muscular dystrophy failed to adduce any direct morphological evidence that the necrobiotic muscle lesions in this disease are produced by muscle ischaemia. However the electron-microscopic studies showed that the basement membrane width in 3 out of 4 cases of Duchenne dystrophy so studied was significantly less than that or normal control material. In further case of Duchenne dystrophy, selected for study because some vessels in the biopsy muscle were surrounded by small round cell infilitrates, the basement membrane width was significantly greater than that in the normal control material. In the single case of spinal muscular atrophy studied, the basement membrane width was also significantly less than the control measurements. The possible relationship of these observations to the "ischaemic" theory of the pathogenesis of muscular dystrophy is discussed.