PurposeThis study examines the effect of component downsizing in a modern total knee arthroplasty (TKA) system on the laxity envelope of the knee throughout flexion.MethodsA robotic testing system was utilized to measure laxity envelopes in the implanted knee by in the anterior–posterior (AP), medial–lateral (ML), internal–external (IE) and varus–valgus (VV) directions. Five fresh-frozen cadavers were tested with a modern cruciate retaining TKA implantation, a 1-mm thinner polyethylene insert and a femoral component 2 mm smaller in the AP dimension.ResultsThe downsized tibial insert was more lax throughout the flexion arc with up to 2.0 mm more laxity in the AP direction at full extension, a 43.8 % increase over the original implantation. A thinner insert consistently increased laxity throughout the arc of flexion in all degrees of freedom. Downsizing the femoral component resulted in 8.5 mm increase in AP laxity at 90°, a 73.9 % increase. In mid-flexion, downsizing the femur produced similar laxity values to the downsized insert in AP, ML, IE and VV directions.ConclusionDownsizing the TKA components had significant effects on laxity throughout flexion. Downsizing a femoral component 2 mm had an equivalent increase in laxity in mid-flexion as downsizing the tibial insert 1 mm. This study quantifies the importance of choosing the appropriate implant component size, having the appropriate size available and the effect of downsizing. The laxity of the implanted knee contributes to how the implant feels to the patient and ultimately the patient’s satisfaction with their new knee.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. The National Institute of Environmental Health Sciences (NIEHS) and Brogan & Partners are collaborating with JSTOR to digitize, preserve and extend access to Environmental Health Perspectives. Tumor promoters are known to induce ODC activity in mouse skin and that this induction can be inhibited by the application of 13-cis-retinoic acid. These two properties of tumor promoters were utilized for screening new tumor promoters in our environment. Two new classes of tumor promoters are presented: indole alkaloids (teleocidin and lyngbyatoxin A) and polyacetates (aplysiatoxin and debromoaplysiatoxin).Teleocidin from streptomyces and lyngbyatoxin A, from the blue-green alga, Lyngbya majuscule, were able to induce ODC activity in mouse skin and showed various biological activities similar to those of TPA. Teleocidin and lyngbyatoxin A are indole alkaloids. Their tumor promoting activities became apparent in the mouse skin through a two-stage carcinogenicity test. The tumor incidence of the group treated with DMBA plus teleocidin was 100% at week 30, which was similar to that of the group given DMBA and TPA. The in vivo carcinogenicity test with lyngbyatoxin A is still underway. The tumor incidence of the group treated with DMBA plus lyngbyatoxin A is 80% at week 21.A second new class of tumor promoter is polyacetate. Aplysiatoxin and debromoaplysiatoxin were isolated from another variety of blue-green alga. Aplysiatoxin and debromoaplysiatoxin induce ODC to the same degree of potency. However, aplysiatoxin induced various membrane effects, such as adhesion of cells and turnover of phospholipid with a similar concentration of TPA, teleocidin and lyngbyatoxin A. On the other hand, debromoaplysiatoxin required an amount almost 100 times greater to achieve the same effects.We are convinced of the possibility that various classes of tumor promoters exist in our environment.
Europe has a rich and diverse cultural heritage that has influenced and created the modern world. Heritage can be both tangible and intangible. Intangible heritage serves to bring people closer to the communities they live in by giving them a sense of identity and continuity. It includes culinary traditions, handicrafts, local arts and rural life. Neglecting the social cohesion of a community that underpins intangible cultural heritage (ICH) efforts puts Europe's cultural heritage at risk. It is imperative that Europe preserves and spreads awareness of its rich and diverse cultural heritage. This multidimensional project seeks to help solve this problem by preserving the most precious and vulnerable aspect of European Culture, which is intangible cultural heritage. This project will serve as a precedent for museums, educational institutions, archives and governments across the globe. This project also adds two additional crucial elements, within the realm of ICH safeguarding, while simultaneously ascertaining employment options and practical skills opportunities for European youth while identifying public-private partnership (PPP) opportunities for investors.
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