Effects of banding or burdizzo castration of bulls on neutrophil phagocytosis and respiratory burst, CD62-L expression, and serum interleukin-8 concentration.

The objective was to investigate measures of neutrophil function in response to banding or burdizzo castration of bulls. Thirty-two Holstein-Friesian bulls (14 mo old, 505 +/- 7.8 kg of BW) were assigned to 1 of 4 treatment groups: 1) sham-handled control (CON); 2) banding castration alone (BAND); 3) burdizzo castration alone (BURD); or 4) cortisol infusion (CORT) as a further control group. For each group on d -14, 8 animals (2 animals/treatment) were tied up in tie stalls (day of treatment = d 0). At -2, 2, 6, 12, 24, 48, 72, and 144 h relative to treatment time, blood samples were collected for analyses of neutrophil phagocytosis and respiratory burst, neutrophil CD62-L expression, and serum IL-8 concentration. Leukocyte counts, phagocytosis activity, and CD62-L expression were similar (P > 0.05) among the 4 treatment groups. The BURD castrates had greater burst activity compared with BAND castrates (P = 0.048) and CON (P = 0.01) at 72 h posttreatment. The BURD castrates had a greater percentage of granulocyte positive leukocytes (Gr%; P < 0.01) at 2 h posttreatment compared with CON and CORT bulls. The BURD castrates had greater (P < 0.05) Gr% compared with BAND, CON, and CORT animals at 24, 48, and 72 h posttreatment. The BURD and BAND castrates had greater Gr% (P < 0.05) compared with CORT bulls at 144 h posttreatment. In general, BAND, BURD, and CORT did not affect serum IL-8 concentration. Banding castration, BURD, and CORT did not induce leukocytosis, whereas BURD induced a modest neutrophilia. Neutrophil functioning in terms of phagocytosis and respiratory burst and serum IL-8 concentration were not compromised by BAND, BURD, and CORT. These findings indicate nonsurgical castration is unlikely to induce a severe acute systemic inflammatory response in terms of neutrophil function.

Cartilage anlagen adapt in response to static deformation.

Connective tissue adaptation, including the development of cartilaginous anlagen into bones, is widely believed to be related to dynamic, intermittent load and stress histories. Static stresses, on the other hand, are generally believed deleterious in tissue adaptation. Using serial MRI in a natural human experiment (manipulation and corrective casting of infant clubfoot), we have observed casting produces two effects: (1) the well recognized change in relative positions of the hindfoot anlagen; (2) a newly recognized immediate shape change in the anlagen. These changes seemingly enhance the rate of growth of the anlagen and of the ossific nucleus. The shape change or deformation in the anlagen would occur as a result of alterations in the magnitudes and directions of loading from soft tissue attachments and muscle activity and would necessarily be associated with changes in the stress states within the anlagen and, when present, the ossific nuclei. Given the known role of load and stress history in tissue adaptation, we presume the reduced stress histories influence the enhanced growth rates. These observations contradict some current theories of tissue adaptation since static, rather than dynamic stresses play a crucial role in accelerating the growth and development of anlagen in the infant clubfoot.

Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study.

The senior author's (R.C.) first 25 patients (37 feet) treated with a combination proximal crescentic osteotomy and distal soft-tissue reconstruction made up the patient cohort. All 25 patients were reviewed at a minimum of one year post-op (short-term follow-up) and 20/25 (31/37 feet) were reviewed again at a mean 12.2 years (range 11.4 to 13.0 yrs) post-op (long-term follow-up). This allowed for a comparison of short- and long-term results and led to a long-term follow-up rate of 84% (31/37 feet, mean 12.2 yrs). Clinical, radiographic and patient outcome measures were obtained and compared pre-op and at short- and long-term follow-up. The mean preoperative hallux valgus (HVA) and intermetatarsal angles (IMA) were 37degrees and 16 degrees respectively. The mean HVA correction was 24 degrees and IMA correction 10 degrees at long-term follow-up with no tendency toward recurrence. Sesamoid position and first MTP subluxation was markedly improved postoperatively and the correction was maintained at long-term follow-up. Patients were asked about their satisfaction in terms of pain, appearance and motion. At long-term follow-up, more than 90% of patients were completely satisfied with pain and motion and greater than 80% with their appearance. Ninety-four percent of patients said they would have the operation again. The AOFAS clinical rating scale for the hallux was calculated retrospectively for pre-op and short-term follow-up and prospectively for long-term follow-up. The mean pre-op score was 37/100 (16 to 60) which significantly improved to 92/100 (67 to 100) at both follow-up periods, suggesting no evidence of decrease in outcome over time. Complications included two patients (5%) that were over-corrected into varus (one symptomatic, one asymptomatic), and four patients (11%) that were undercorrected, developing asymptomatic recurrences (>10 degrees increase HVA) at long-term follow-up. In addition, two patients (5%) developed new transfer lesions postoperatively, likely related to technical error (one varus overcorrection, one dorsiflexion malunion). In conclusion, the long-term results, with a mean follow-up of 12.2 years, of the resection realignment procedure for moderate to severe hallux valgus are generally excellent and the complication rate is low and acceptable. Attention to detail, avoiding both undercorrection, which can lead to recurrence, and overcorrection, which can cause symptomatic varus, is essential.

Magnetic resonance imaging study of the congenital clubfoot treated with the Ponseti method.

Little information exists about the degree of efficacy of the several nonoperative treatments, such as manipulation and casting, used in correcting the pathology of the virgin clubfoot deformity. The steps in the correction of the displacements and anomalies of the skeletal components have never been visualized. The method reported to have the best long-term results is that of Ponseti. A magnetic resonance imaging protocol was devised to image the described chondroosseous abnormalities of the virgin clubfoot deformity and to illustrate the changes that occur with the Ponseti method of treatment. Scans were performed at the beginning of, in the middle of, and at the end of treatment. Images obtained with this protocol largely agree with postmortem studies of clubfeet. All of the major chondroosseous pathology could be visualized in vivo. With Ponseti treatment, all the abnormalities seen on the initial scans either improved markedly or corrected completely. Treatment resulted in correction not only of the abnormal relationships of the tarsal bones, but also of the abnormal shapes of the individual tarsal osteochondral anlages, probably because of the changes in growth resulting from the changes in mechanical loading of fast-growing tissues.

Soft tissue anatomy of proximal femoral focal deficiency.

The soft tissue anatomy of Aitken types A, B, C, and D proximal femoral focal deficiency (PFFD) was examined by magnetic resonance imaging (MRI). A characteristic pattern of soft tissue abnormalities is described. All muscles were present, but most were smaller than their normal counterparts. The exception was the obturator externus muscle, which was elongated and remained muscular almost up to its insertion. In type A PFFD, it is straight; in types B, C, and D PFFD, it is L-shaped. The sartorius is hypertrophied.

Extraarticular subtalar arthrodesis: the dowel method.

The technique and results of extraarticular subtalar arthrodesis using the dowel method during the 10-year period between 1976 and 1986 were reviewed retrospectively. Fifty feet in 30 children underwent extraarticular subtalar arthrodesis for valgus deformity for diagnoses including meningomyelocele, idiopathic flatfoot, and cerebral palsy. The aims of the procedure were to correct the deformity, obtain a solid arthrodesis, and improve ambulation by reducing bracing requirements and eliminating pain. Results were excellent in 28 cases (56%), satisfactory in 15 (30%), and unsatisfactory in seven (14%). Intraoperative positioning error and simultaneous perineal tendon lengthening in children with cerebral palsy were the major sources of unsatisfactory results.

Meal frequency and nutritional intake during Ramadan: a pilot study.

A study was carried out to compare the nutritional intake and meal pattern during and after Ramadan. It was found that in a sample group of 15 young Saudis there was a significant increase in caloric, fat, carbohydrate and protein intake. Although there was a significant reduction in meal frequency and the number of meals taken outside the family, a significant increase in body weight was noted during Ramadan.

Comparison of mortality of patients with multiple injuries according to type of fracture treatment--a retrospective age- and injury-matched series.

In a retrospective review of 71 patients with multiple injuries matched for age and severity, 28.5 per cent of those whose fractures were treated conservatively died compared with 4.5 per cent of those whose fractures were fixed. Early stable fixation of fractures is recommended in patients with multiple injuries.