Drug Misuse by Athletes : What the GP Needs to Know

Gerrard, David Medical Publications Korea 1996 Medical Progress Vol.18 No.10

Comparing Outcomes of Tumor Prosthesis Revision and Locking Plate Fixation in Supracondylar Femoral Periprosthetic Fractures

Gerrard Gan, MRCS,Yee Hong Teo,Ernest Beng Kee Kwek 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.2

Background: Periprosthetic fractures around a total knee replacement (TKR) can be complex and difficult to manage, requiring the surgical expertise of the trauma and arthroplasty surgeon. There are a number of treatment modalities available, each with their own merits and limitations. As data on tumor prosthesis revision in periprosthetic fractures is sparse, this study aims to evaluate the results of revision using a tumor prosthesis and compare them with those of fixation using a locking plate in periprosthetic fractures after TKR. Methods: This is a retrospective study of 15 patients who underwent either tumor prosthesis revision (n = 7) or locking plate fixation (n = 8) for supracondylar femoral periprosthetic fractures in our hospital from 2009 and 2014. The mean follow-up time for these patients was 44 months. This study’s main outcome measures were pain relief, return to premorbid ambulatory function, and complications. Results: The revision and fixation groups saw five versus three patients achieve pain relief (71.4% vs. 37.5%, p = 0.315), and two versus four patients return to their premorbid ambulatory function (28.6% vs. 50%, p = 0.608) at the follow-up, respectively. The mean time to weight-bearing in the revision group and fixation group was 2.9 days and 18.9 weeks, respectively (p = 0.001). There were eight complications seen in the revision group with none requiring reoperation; there were five complications seen in the fixation group, and two required reoperation. Conclusions: The results of revision TKR using a tumor prosthesis were comparable to those of fixation using a locking plate in periprosthetic fractures after TKR. Tumor prosthesis revision may be considered as a viable alternative to locking plate fixation when indicated.

Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

Adam Daniel Gerrard,Charalambos P. Charalambous 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.4

Purpose: A meta­analysis was performed to assess the outcomes following surgical intervention for medial knee plica.Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient­reported postoperative scores of “good” and “excellent”. Meta­analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta­analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8–91.4). In those cases that had non­surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1–87).Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first­line treatment or when symptoms have not responded to non­surgical interventions.Level of Evidence: IV

The Economic Implications of China's Open Door Policy to the Asia-Pacific Economies

John Paolo Rosales Rivera,Kurt Gerrard Tiu See 한국관세학회 2009 한국관세학회 학술대회 Vol.2009 No.11

Genetic Analysis of Cholesterol Transport Disorders

Lee,Mi Hye,Dean,Michael,Shulenin,Sergey,Gerrard,Bemard,Allikmets,Rando,Remaley,Allen,Santamarlna Fojo,Silvia,Brewer,Bryan,Lu,Kang Mo,Patel,Shallesh 한국지질학회 2001 韓國脂質學會誌 Vol.11 No.3

Porcine satellite cells are restricted to a phenotype resembling their muscle origin

Zhu, H.,Park, S.,Scheffler, J. M.,Kuang, S.,Grant, A. L.,Gerrard, D. E. American Society of Animal Science 2013 Journal of animal science Vol.91 No.10

<P>Muscles in most domestic animals differ in function and growth potential based largely on muscle fiber type composition. Though much is known about satellite cells (SC), information is limited regarding how populations of SC differ with muscle fiber type, especially in pigs. Therefore, the objective of this study was to isolate and culture SC from red (RST) and white (WST) portions of the semitendinosus muscle of neonatal and adult pigs and determine their capacity to proliferate, differentiate, and express various myosin heavy chain (MyHC) isoforms in vitro. Porcine satellite cells were isolated from RST and WST muscles of 6-wk-old and adult (>6-mo-old) pigs and cultured under standard conditions. Muscle from neonatal pigs yielded nearly 10 times more (<I>P</I> < 0.001) presumptive satellite cells as those from adult pigs, with fusion percentages close to 60% for the former. The RST yielded more (<I>P</I> < 0.001) SC per gram muscle compared to WST, 8.1 ± 0.2 × 10<SUP>4</SUP> cells versus 6.7 ± 0.1 × 10<SUP>4</SUP> cells/gram muscle in young pigs, and 9.7 ± 0.4 × 10<SUP>3</SUP> cells versus 5.5 ± 0.4 × 10<SUP>3</SUP> cells/gram muscle in adult pigs, respectively. Likewise, satellite cells from RST proliferated faster (<I>P</I> < 0.001) than those from WST across both ages, as indicated by a shorter cell doubling time, 18.6 ± 0.8 h versus 21.3 ± 0.9 h in young pigs, and 23.2 ± 0.7 h versus 26.7 ± 0.9 h in adult pigs, respectively. As a result of shorter times to confluence, satellite cells from RST also formed myotubes earlier than those SC originating from WST. Once induced, however, SC from WST differentiated and fused faster (<I>P</I> < 0.05) as evidenced by fusion percentage within the first 24 h, 41.6% versus 34.3%, respectively; but reached similar ultimate fusion percentages similar to WST by 48 h. Over 90% of MyHC expressed in maximally fused SC cultures from both RST and WST was restricted to the embryonic isoform. Type IIX MyHC mRNA was not detected in any culture. Myotube cultures from RST expressed more (<I>P</I> < 0.01) Type I MyHC isoform mRNA than those from WST, whereas those cultures from WST expressed more (<I>P</I> < 0.05) Type II (including Types IIA and IIB) MyHC transcripts. These data show SC cultures from porcine fast and slow muscles express MyHC profiles largely reflective of their muscle of origin and suggest satellite cells are partially restricted to a particular muscle phenotype in which they are juxtapositioned. Understanding the molecular nature of these intrinsic control mechanisms may lead to improved strategies for augmenting meat animal growth or muscle regeneration.</P>

A Tobacco Cessation Intervention with Rural, Medically Underserved, Blue-collar Employees: A Quasiexperimental Study

Stewart, Telisa,Formica, Margaret K.,Adachi-Mejia, Anna M.,Wang, Dongliang,Gerrard, Meg Occupational Safety and Health Research Institute 2016 Safety and health at work Vol.7 No.4

Background: The aim of this study was to increase knowledge regarding the dangers associated with tobacco use, and decrease secondhand smoke exposure and tobacco use behaviors with an antitobacco messaging campaign among rural, medically underserved, blue-collar workers. Methods: A quasiexperimental study was conducted with employees at two worksites. One worksite received the intervention, which consisted of nine different antitobacco messages. Baseline and follow-up surveys were conducted at each worksite to assess change in knowledge and behavior; the data were compared across the two worksites. Results: Two hundred twenty-two and 243 participants completed baseline and follow-up surveys at the intervention and comparison sites, respectively. A statistically significant difference was seen over time between the worksites on knowledge of the dangers of tobacco (p < 0.0001); the mean knowledge score increased at the intervention site, but remained unchanged at the comparison site. In general, non-smokers at both worksites appeared to try to decrease exposure to secondhand smoke over the follow-up period. Repeated measures analysis indicated that there were no differences in motivation to quit (p = 0.81), interest in quitting (p = 0.40), thinking about quitting (p = 0.53), or several tobacco-use behaviors over time among smokers at the intervention and comparison worksites. There were slight increases over time in the proportion of smokers who do not allow smoking in their homes/vehicles at the intervention worksite, although not statistically significant. Conclusion: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.

A Tobacco Cessation Intervention with Rural, Medically Underserved, Blue-collar Employees: A Quasiexperimental Study

Telisa Stewart,Margaret K. Formica,Anna M. Adachi-Mejia,Dongliang Wang,Meg Gerrard 한국산업안전보건공단 산업안전보건연구원 2016 Safety and health at work Vol.7 No.4

Background: The aim of this study was to increase knowledge regarding the dangers associated with tobacco use, and decrease secondhand smoke exposure and tobacco use behaviors with an antitobacco messaging campaign among rural, medically underserved, blue-collar workers. Methods: A quasiexperimental study was conducted with employees at two worksites. One worksite received the intervention, which consisted of nine different antitobacco messages. Baseline and followup surveys were conducted at each worksite to assess change in knowledge and behavior; the data were compared across the two worksites. Results: Two hundred twenty-two and 243 participants completed baseline and follow-up surveys at the intervention and comparison sites, respectively. A statistically significant difference was seen over time between the worksites on knowledge of the dangers of tobacco (p < 0.0001); the mean knowledge score increased at the intervention site, but remained unchanged at the comparison site. In general, nonsmokers at both worksites appeared to try to decrease exposure to secondhand smoke over the followup period. Repeated measures analysis indicated that there were no differences in motivation to quit (p = 0.81), interest in quitting (p = 0.40), thinking about quitting (p = 0.53), or several tobacco-use behaviors over time among smokers at the intervention and comparison worksites. There were slight increases over time in the proportion of smokers who do not allow smoking in their homes/vehicles at the intervention worksite, although not statistically significant. Conclusion: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.

Fiber hypertrophy and increased oxidative capacity can occur simultaneously in pig glycolytic skeletal muscle

Scheffler, T. L.,Scheffler, J. M.,Park, S.,Kasten, S. C.,Wu, Y.,McMillan, R. P.,Hulver, M. W.,Frisard, M. I.,Gerrard, D. E. American Physiological Society 2014 American journal of physiology. Cell physiology Vol.306 No.4

<P>An inverse relationship between skeletal muscle fiber cross-sectional area (CSA) and oxidative capacity suggests that muscle fibers hypertrophy at the expense of oxidative capacity. Therefore, our objective was to utilize pigs possessing mutations associated with increased oxidative capacity [AMP-activated protein kinase (AMPKγ<SUB>3</SUB><SUP>R200Q</SUP>)] or fiber hypertrophy [ryanodine receptor 1 (RyR1<SUP>R615C</SUP>)] to determine if these events occur in parallel. Longissimus muscle was collected from wild-type (control), AMPKγ<SUB>3</SUB><SUP>R200Q</SUP>, RyR1<SUP>R615C</SUP>, and AMPKγ<SUB>3</SUB><SUP>R200Q</SUP>-RyR1<SUP>R615C</SUP> pigs. Regardless of AMPK genotype, RyR<SUP>R615C</SUP> increased fiber CSA by 35%. In contrast, AMPKγ<SUB>3</SUB><SUP>R200Q</SUP> pig muscle exhibited greater citrate synthase and β-hydroxyacyl CoA dehydrogenase activity. Isolated mitochondria from AMPKγ<SUB>3</SUB><SUP>R200Q</SUP> muscle had greater maximal, ADP-stimulated oxygen consumption rate. Additionally, AMPKγ<SUB>3</SUB><SUP>R200Q</SUP> muscle contained more (∼50%) of the mitochondrial proteins succinate dehydrogenase and cytochrome <I>c</I> oxidase and more mitochondrial DNA. Surprisingly, RyR1<SUP>R615C</SUP> increased mitochondrial proteins and DNA, but this was not associated with improved oxidative capacity, suggesting that altered energy metabolism in RyR1<SUP>R615C</SUP> muscle influences mitochondrial proliferation and protein turnover. Thus pigs that possess both AMPKγ3<SUP>R200Q</SUP> and RyR<SUP>R615C</SUP> exhibit increased muscle fiber CSA as well as greater oxidative capacity. Together, our findings support the notion that hypertrophy and enhanced oxidative capacity can occur simultaneously in skeletal muscle and suggest that the signaling mechanisms controlling these events are independently regulated.</P>