Surgical Treatment of Pediatric Scoliosis: Historical Origins and Review of Current Techniques.

The treatment of scoliosis has been explored and debated in medicine since the first recorded texts. Scoliosis treatment has shifted over time from external modalities, such as traction and bracing, to internal stabilization techniques that leverage surgical advances. Surgical fixation constructs can generally be separated into two different modalities: dynamic vs. static constructs. For skeletally immature individuals with progressive deformities, surgical options range from traditional or magnetically controlled growing rods to vertebral body staples or tethering. For individuals who have reached skeletal maturity, many devices have been developed that provide static length constructs. Understanding the surgical options available is critical for the appropriate management of this varied patient population. With this article, we sought to provide a summary of past and present techniques and devices used in the treatment of scoliosis.

The Role of Glomerular Epithelial Injury in Kidney Function Decline in Patients With Diabetic Kidney Disease in the TRIDENT Cohort.

INTRODUCTION: Although diabetic kidney disease (DKD) is responsible for more than half of all chronic and end-stage kidney disease (ESKD), the association of light (LM) and electron microscopic (EM) structural changes with clinical parameters and prognosis in DKD is incompletely understood. METHODS: This is an interim analysis of 62 patients diagnosed with biopsy-confirmed DKD from the multicenter TRIDENT (Transformative Research in Diabetic Nephropathy) study. Twelve LM and 8 EM descriptors, representing changes in glomeruli, tubulointerstitium, and vasculature were analyzed for their relationship with clinical measures of renal function. Patients were followed every 6 months. RESULTS: Multivariable linear regression analysis revealed that estimated glomerular filtration rate (eGFR) upon enrollment correlated the best with interstitial fibrosis. On the other hand, the rate of kidney function decline (eGFR slope) correlated the most with glomerular lesions including global glomerulosclerosis and mesangiolysis. Unbiased clustering analysis based on histopathologic data identified 3 subgroups. The first cluster, encompassing subjects with the mildest histologic lesions, had the most preserved kidney function. The second and third clusters had similar degrees of kidney dysfunction and structural damage, but differed in the degree of glomerular epithelial cell and podocyte injury (podocytopathy DKD subtype). Cox proportional hazard analysis showed that subjects in cluster 2 had the highest risk to reach ESKD (hazard ratio: 17.89; 95% confidence interval: 2.13-149.79). Glomerular epithelial hyperplasia and interstitial fibrosis were significant predictors of ESKD in the multivariate model. CONCLUSION: The study highlights the association between fibrosis and kidney function and identifies the role of glomerular epithelial changes and kidney function decline.

Correlation of single leg vertical jump, single leg hop for distance, and single leg hop for time.

OBJECTIVES: To determine the correlation among three functional tests: single leg vertical jump (SLVJ), single leg hop for distance (SLHD), and single leg hop for time (SLHT). DESIGN: Prospective correlational investigation. SETTING: University research laboratory. PARTICIPANTS: Forty healthy men (n = 19) and women (n = 21) between the ages of 18 and 30 (23.9 ± 2.0 years). MAIN OUTCOME MEASURES: SLVJ was measured using the Vertec. SLHD was measured using a standard tape measure. SLHT was measured over a 10-m course using a standard stopwatch. RESULTS: The strongest correlation was between SLHT and SLHD, -0.89 and -0.89 for dominant and non-dominant lower extremities (LE), respectively. The weakest pairwise correlation was between SLVJ and SLHT, -0.71 and -0.63 for dominant and non-dominant LE, respectively. The correlation between SLVJ and SLHD was 0.74 and 0.71 for dominant and non-dominant LE, respectively. CONCLUSION: There is a strong correlation between SLHT and SLHD, suggesting that each test measures similar constructs of function, while the modest correlation between SLVJ and SLHT suggest these two tests do not measure the same functional components, and could be paired as outcome measures for the clinical assessment of lower extremity function.

Synthesis, characterization, and reactivity of the stable iron carbonyl complex [Fe(CO)(N4Py)](ClO4)2: photoactivated carbon monoxide release, growth inhibitory activity, and peptide ligation.

Photoactivated carbon monoxide (CO) release by the iron carbonyl complex [Fe(II)(CO)(N4Py)](ClO(4))(2) (1) is described. Compound 1 is a low-spin ferrous complex that is highly stable and soluble in aerobic aqueous solutions. CO release was studied by the substitution of MeCN for CO, which displays saturation kinetics, and by the transfer of CO to deoxymyoglobin, which is slow in the dark but fast upon irradiation with UV light (365 nm). Compound 1 is active against PC-3 prostate cancer cells and shows potent photoinduced cytotoxicity. In addition, the iron carbonyl complex was attached to a short peptide toward the goal of tissue or cell-specific delivery.

Iron-binding and mobilization from ferritin by polypyridyl ligands.

Polypyridyl ligands were investigated for their ability to bind and mobilize iron(ii) from ferritin in aqueous solution. Association constants with iron(ii) (pFe(II)) were determined for the pentadentate ligands N4Py (pFe(II) = 14.4) and Bn-TPEN (pFe(II) = 13.7) using a competition method with the hexadentate ligand TPEN (pFe(II) = 14.6, 0.1 M KNO(3)). Ferrous complexes were formed using the polypyridyl ligands and ferritin as the sole iron source in the presence of reductant. The observed rates of iron mobilization from ferritin were dependent on reductant and were higher in the presence of ascorbate than dithiothreitol. TPEN, N4Py and Bn-TPEN demonstrated comparable and in some cases faster rates and higher levels of iron mobilization when compared to the iron(ii) chelator 1,10-phenanthroline, particularly at low concentrations of chelator.