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Papers by William Walsh

Research paper thumbnail of Translating resilience-based management theory to practice for coral bleaching recovery in Hawai'i

Marine Policy, 2019

More frequent and severe coral bleaching events are prompting managers to seek practical interven... more More frequent and severe coral bleaching events are prompting managers to seek practical interventions to promote ecosystem resilience. Although resilience-based management is now well established theoretically, there have been few examples of implementation. In Hawai'i, back-to-back bleaching events in 2014 and 2015 caused significant damage motivating the state to seek guidance on next steps for recovery. Hawai'i is a unique case study in distilling global recommendations to place-based action because of its ecological and social diversity. This study conducted a systematic review of literature using a weighted point system to evaluate and rank twelve potential Hawai'i-specific interventions to promote coral recovery following a bleaching event. Papers were scored based on their ability to achieve their management objective as well as their ability to directly affect coral recovery. A total of 100 papers were included in the review which varied in their scale (multi-site or case study), location (inside or outside of Hawai'i), and type of data collected (theoretical or empirical). Establishing a network of herbivore management areas ranked the highest followed by parrotfish size limits for action that could promote recovery in Hawai'i. Establishing a network of no-take Marine Protected Areas (MPAs) was the intervention with the most literature and ranked third. This method provided a systematic way to compare the effectiveness of management interventions, a system that could be adapted to other regions. This type of evidence-based approach can lead to more fair and transparent decision-making processes, assisting reef managers in navigating the translation of resilience-based management from theory to practice.

Research paper thumbnail of Survival and development of immature stages of four Hawaiian fruit flies (diptera: tephritidae) reared at five constant temperatures

Annals of the Entomological Society of America, 1996

Ann. Entomol. Soc. Am. 89(1): 64-69 (1996) ABSTRACT Development and survival of melon fly,Bactroc... more Ann. Entomol. Soc. Am. 89(1): 64-69 (1996) ABSTRACT Development and survival of melon fly,Bactrocera cucurhitae (Coquillett), ori-ental fruit fly,B. dorsalis (Hendel), B. latifrons (Hendel), and Mediterranean fruit fly,Ceratitis capitata (Wiedemann) eggs, larvae, and ...

Research paper thumbnail of Early Inhaled Nitric Oxide Therapy in Premature Newborns with Respiratory Failure

The safety and efficacy of early, low-dose, prolonged therapy with inhaled nitric oxide in premat... more The safety and efficacy of early, low-dose, prolonged therapy with inhaled nitric oxide in premature newborns with respiratory failure are uncertain. We performed a multicenter, randomized trial involving 793 newborns who were 34 weeks of gestational age or less and had respiratory failure requiring mechanical ventilation. Newborns were randomly assigned to receive either inhaled nitric oxide (5 ppm) or placebo gas for 21 days or until extubation, with stratification according to birth weight (500 to 749 g, 750 to 999 g, or 1000 to 1250 g). The primary efficacy outcome was a composite of death or bronchopulmonary dysplasia at 36 weeks of postmenstrual age. Secondary safety outcomes included severe intracranial hemorrhage, periventricular leukomalacia, and ventriculomegaly. Overall, there was no significant difference in the incidence of death or bronchopulmonary dysplasia between patients receiving inhaled nitric oxide and those receiving placebo (71.6 percent vs. 75.3 percent, P=0.24). However, for infants with a birth weight between 1000 and 1250 g, as compared with placebo, inhaled nitric oxide therapy reduced the incidence of bronchopulmonary dysplasia (29.8 percent vs. 59.6 percent); for the cohort overall, such treatment reduced the combined end point of intracranial hemorrhage, periventricular leukomalacia, or ventriculomegaly (17.5 percent vs. 23.9 percent, P=0.03) and of periventricular leukomalacia alone (5.2 percent vs. 9.0 percent, P=0.048). Inhaled nitric oxide therapy did not increase the incidence of pulmonary hemorrhage or other adverse events. Among premature newborns with respiratory failure, low-dose inhaled nitric oxide did not reduce the overall incidence of bronchopulmonary dysplasia, except among infants with a birth weight of at least 1000 g, but it did reduce the overall risk of brain injury. (ClinicalTrials.gov number, NCT00006401 [ClinicalTrials.gov].).

Research paper thumbnail of Colonization of Newly Planted Coffee Fields: Dominance of Mediterranean Fruit Fly Over Oriental Fruit Fly (Diptera: Tephritidae)

Journal of Economic Entomology, May 31, 1995

... C. capi-tata or B. dorsalis densities (independent variable) was evaluated by regression anal... more ... C. capi-tata or B. dorsalis densities (independent variable) was evaluated by regression analysis of mean ablm-dances (numbers per 100 fmits) per date during each season (SAS Institute 1987). Proportions of ripe (red) and immature (green and yellow) coffee fmits infested by ...

Research paper thumbnail of Animal Study Series in Bioresorbable Technology

As a means to characterize the additional benefits of minimizing soft tissue attachment (STA) to ... more As a means to characterize the additional benefits of minimizing soft tissue attachment (STA) to a bioresorbable sheet following soft tissue repair, an animal study was conducted to focus exclusively on minimizing STA without a soft tissue defect. A large animal (porcine) model was used to evaluate the formation of undesirable STA in a female pelvic surgery model. Through a midline incision using a transperitoneal laparotomy, the bladder and uterus of the porcine were abraded. Two survival periods were used to compare groups with no treatment (control) or treatment with a thin bioresorbable sheet intended to minimize STA. Two bioresorbable sheets were placed within each treatment speci- men: one between the bladder and the abdominal wall, and the second between the bladder and the uterus. After the 4-week and 12-week survival peri- ods, the severity and location of STA to the sheet was assessed using a zero to three-point scale. The resorbable sheet was found to provide an effec- ti...

Research paper thumbnail of Preventing recurrent preterm births and improving maternal infant health via a home visitation system of care: A randomized clinical trial

ABSTRACT Background: High probability of recurrent preterm birth (PTB) with history of prior PTB.... more ABSTRACT Background: High probability of recurrent preterm birth (PTB) with history of prior PTB. Interaction of multiple risk factors and health behaviors may contribute to PTB; some may be amenable to intervention. Home visitation is promising method to deliver evidence based interventions within a system of care (SOC). We evaluated a SOC designed to: 1) reduce preterm births and associated health care costs, and 2) improve the health in pregnant women with a history of a PTB. Methods: Randomized, parallel-group study in regional medical center. Eligibility: >18 years with prior live birth > 20 - < 37 weeks gestation; < 24 weeks gestation at enrollment; spoke and read English; received care at the medical center. All participants (N = 211) received standard prenatal care. Intervention participants (N = 109) also received home visits by certified nurse-midwives guided by protocols for specific risk factors (e.g., depressive symptoms, abuse, smoking). Data collected via multiple methods and sources including intervention fidelity assessments. Results: Average age 27.8 years; mean gestational age at enrollment was 15 weeks. Racial breakdown mirrored local demographics. Most had a partner, high school education, and 62% had Medicaid. No statistically significant group differences were found in gestational age, however differences between groups included: an increase in gestational age compared to prior PTB, and shorter maternal length of stay at delivery. Conclusions: Nurse home visits or contact may limit some risk factors and shorten length of stay at delivery. Study contributes to knowledge about evidence-based interventions targeting risk factors associated with PTB.

Research paper thumbnail of The effect of recombinant equine growth hormone on the biomechanical properties of healing superficial digital flexor tendons in horses

Research paper thumbnail of Elevated Blood Copper/Zinc Ratios in Assaultive Young Males 1 1 First presented as a poster at the 24th annual meeting of the Society of Neuroscience in Miami Beach, Fla., November 18, 1994

Physiol Behav, 1997

Walsh, W.J., H.R. Isaacson, F. Rehman and A. Hall. Elevated blood copper/zinc ratios in assaultiv... more Walsh, W.J., H.R. Isaacson, F. Rehman and A. Hall. Elevated blood copper/zinc ratios in assaultive young males. Physiol Behav 62(2) 327–329, 1997.—In research conducted over the past 20 years, we have observed abnormal trace-metal concentrations, including elevated serum copper and depressed plasma zinc, in blood samples collected from violence-prone individuals. The purpose of the study reported here was to test the validity of our observation that assaultive young males have elevated blood copper/zinc (Cu/Zn) ratios when compared to a control group of young males with no history of assaultive behavior. All male patients between the ages of 3 years and 20 years who made a first visit to the outpatient Pfeiffer Treatment Center in Naperville, Ill., during a two-month period were evaluated. Based on interviews with patients and their families and application of a standardized behavior scale, 135 assaultive young males and 18 controls with no history of assaultive behavior were identified. Blood samples were collected from test subjects and controls and analyzed for serum copper and plasma zinc concentrations by an independent laboratory using atomic absorption methods. The median Cu/Zn ratio for the assaultive subjects was 1.40 compared to 1.02 for controls, a statistically significant difference (t = 5.94; p < 0.01).

Research paper thumbnail of Recombinant equine growth hormone does not affect the in vitro biomechanical properties of equine superficial digital flexor tendon

Research paper thumbnail of Transfer of battery technology developed by the US Department of Energy

Nasa Sti Recon Technical Report N, Aug 1, 1984

This study examines linkages between government and the private sector in battery research and de... more This study examines linkages between government and the private sector in battery research and development, investigates industry's use of advances in battery technology developed with funding from the US Department of Energy (DOE), and explores the appropriate federal role. A major finding is that industry can promptly and effectively translate battery advances with commercial potential into new products, and that aggressive technology transfer activities by DOE are unnecessary. Major US battery companies were found to be highly knowledgeable with respect to DOE program content and technological advances attained. In addition, liberal patent waivers have allowed companies to build proprietary positions, and technology diffusion within the private sector can be rapid and efficient. It appears that DOE can best increase the transfer of technology to industry by simply creating advances with commercial potential at a faster rate. Principal recommendations include: (1) an expanded advisory role for industry; (2) increased programmatic flexibility; (3) greater efforts aimed at quantum advances; and (4) increased technical autonomy for industrial contractors.

Research paper thumbnail of Application of Resorbable Poly(Lactide- co -Glycolide) with Entangled Hyaluronic Acid as an Autograft Extender for Posterolateral Intertransverse Lumbar Fusion in Rabbits

Tissue Engineering Part A, 2011

Research paper thumbnail of Phylogeography, historical demography, and the role of post-settlement ecology in two Hawaiian damselWsh species

Research paper thumbnail of Platelet-Rich Plasma and Bone Defect Healing

Tissue Engineering Part A, 2014

Research paper thumbnail of Generalized additive model and regression

Research paper thumbnail of 136. In Vivo Response to Synthetic Bone Graft Substitutes in a Preclinical Posterolateral Fusion Model

Research paper thumbnail of Evaluating the Effectiveness of a Marine Reserve Network in West Hawai'I to Improve Management of the Aquarium Fishery

Research paper thumbnail of Issues in Scholarly Communications

The Serials Librarian, 2006

SUMMARY The issues surrounding the crisis in scholarly communication are well known to librarians... more SUMMARY The issues surrounding the crisis in scholarly communication are well known to librarians. However, academic faculty and administrators often do not have a similar understanding of these concerns, or what librarians are doing to deal with them. ...

Research paper thumbnail of 363: The predictive value of prenatal bowel dilation in fetuses with gastroschisis

Data Revues 00029378 V204i1ss S0002937810016406, Aug 19, 2011

Research paper thumbnail of Biomechanical assessment of Weber B ankle fractures in a human cadaver model

The Foot, 2002

The effect of fibular displacement and deltoid ligament injury on the contact area and peak intra... more The effect of fibular displacement and deltoid ligament injury on the contact area and peak intra-articular pressure of the tibiotalar joint was examined in nine fresh cadaveric specimens. The contact area and peak intra-articular pressure of the tibiotalar joint were measured using an electronic pressure sensor and pressure-sensitive film in four different positions from 10°dorsiflexion to 20° plantar flexion in 10° increments. The ankles were tested in three stages of progressive joint disruption: •intact ankle joint•isolated Weber type B fibula fracture•Weber type B fibula fracture with deltoid ligament injury.Removal of the lateral malleolus did not have a significant effect on either the contact area or peak intra-articular pressure of the tibiotalar joint. Sectioning the deep deltoid ligament also had no significant effect on these parameters. These results suggest that Weber type B injuries with no damage to the medial side of the joint are amenable to non-operative management.

Research paper thumbnail of In utero Repair of Myelomeningocele: A Comparison of Endoscopy and Hysterotomy

Fetal Diagnosis and Therapy, 2000

To compare endoscopic coverage of myelomeningocele with a maternal split-thickness skin graft in ... more To compare endoscopic coverage of myelomeningocele with a maternal split-thickness skin graft in utero to definitive neurosurgical closure through a hysterotomy. Four fetuses with isolated myelomeningocele underwent endoscopic coverage of the defect with a maternal split-thickness skin graft in a CO(2) environment at 22-24 weeks&#39; gestation. Subsequently, 4 fetuses underwent standard neurosurgical closure of their myelomeningoceles at 28-29 weeks&#39; gestation. The mean operating time for the endoscopic procedures was 297 +/- 69 min. Two fetal losses occurred as a result of chorioamnionitis and placental abruption, respectively. A third baby delivered at 28 weeks&#39; gestation after prolonged disruption of the membranes. The 2 survivors required standard closure of the myelomeningocele after delivery. The mean operating time for the hysterotomy procedures was 125 +/- 8 min. No mortality occurred, and all the infants delivered between 33 and 36 weeks with well-healed myelomeningocele scars. At present, the functional levels of all infants approximate the anatomical levels of the lesions. With current technology, in utero repair of congenital myelomeningocele through a hysterotomy appears to be technically superior to procedures performed endoscopically.

Research paper thumbnail of Translating resilience-based management theory to practice for coral bleaching recovery in Hawai'i

Marine Policy, 2019

More frequent and severe coral bleaching events are prompting managers to seek practical interven... more More frequent and severe coral bleaching events are prompting managers to seek practical interventions to promote ecosystem resilience. Although resilience-based management is now well established theoretically, there have been few examples of implementation. In Hawai'i, back-to-back bleaching events in 2014 and 2015 caused significant damage motivating the state to seek guidance on next steps for recovery. Hawai'i is a unique case study in distilling global recommendations to place-based action because of its ecological and social diversity. This study conducted a systematic review of literature using a weighted point system to evaluate and rank twelve potential Hawai'i-specific interventions to promote coral recovery following a bleaching event. Papers were scored based on their ability to achieve their management objective as well as their ability to directly affect coral recovery. A total of 100 papers were included in the review which varied in their scale (multi-site or case study), location (inside or outside of Hawai'i), and type of data collected (theoretical or empirical). Establishing a network of herbivore management areas ranked the highest followed by parrotfish size limits for action that could promote recovery in Hawai'i. Establishing a network of no-take Marine Protected Areas (MPAs) was the intervention with the most literature and ranked third. This method provided a systematic way to compare the effectiveness of management interventions, a system that could be adapted to other regions. This type of evidence-based approach can lead to more fair and transparent decision-making processes, assisting reef managers in navigating the translation of resilience-based management from theory to practice.

Research paper thumbnail of Survival and development of immature stages of four Hawaiian fruit flies (diptera: tephritidae) reared at five constant temperatures

Annals of the Entomological Society of America, 1996

Ann. Entomol. Soc. Am. 89(1): 64-69 (1996) ABSTRACT Development and survival of melon fly,Bactroc... more Ann. Entomol. Soc. Am. 89(1): 64-69 (1996) ABSTRACT Development and survival of melon fly,Bactrocera cucurhitae (Coquillett), ori-ental fruit fly,B. dorsalis (Hendel), B. latifrons (Hendel), and Mediterranean fruit fly,Ceratitis capitata (Wiedemann) eggs, larvae, and ...

Research paper thumbnail of Early Inhaled Nitric Oxide Therapy in Premature Newborns with Respiratory Failure

The safety and efficacy of early, low-dose, prolonged therapy with inhaled nitric oxide in premat... more The safety and efficacy of early, low-dose, prolonged therapy with inhaled nitric oxide in premature newborns with respiratory failure are uncertain. We performed a multicenter, randomized trial involving 793 newborns who were 34 weeks of gestational age or less and had respiratory failure requiring mechanical ventilation. Newborns were randomly assigned to receive either inhaled nitric oxide (5 ppm) or placebo gas for 21 days or until extubation, with stratification according to birth weight (500 to 749 g, 750 to 999 g, or 1000 to 1250 g). The primary efficacy outcome was a composite of death or bronchopulmonary dysplasia at 36 weeks of postmenstrual age. Secondary safety outcomes included severe intracranial hemorrhage, periventricular leukomalacia, and ventriculomegaly. Overall, there was no significant difference in the incidence of death or bronchopulmonary dysplasia between patients receiving inhaled nitric oxide and those receiving placebo (71.6 percent vs. 75.3 percent, P=0.24). However, for infants with a birth weight between 1000 and 1250 g, as compared with placebo, inhaled nitric oxide therapy reduced the incidence of bronchopulmonary dysplasia (29.8 percent vs. 59.6 percent); for the cohort overall, such treatment reduced the combined end point of intracranial hemorrhage, periventricular leukomalacia, or ventriculomegaly (17.5 percent vs. 23.9 percent, P=0.03) and of periventricular leukomalacia alone (5.2 percent vs. 9.0 percent, P=0.048). Inhaled nitric oxide therapy did not increase the incidence of pulmonary hemorrhage or other adverse events. Among premature newborns with respiratory failure, low-dose inhaled nitric oxide did not reduce the overall incidence of bronchopulmonary dysplasia, except among infants with a birth weight of at least 1000 g, but it did reduce the overall risk of brain injury. (ClinicalTrials.gov number, NCT00006401 [ClinicalTrials.gov].).

Research paper thumbnail of Colonization of Newly Planted Coffee Fields: Dominance of Mediterranean Fruit Fly Over Oriental Fruit Fly (Diptera: Tephritidae)

Journal of Economic Entomology, May 31, 1995

... C. capi-tata or B. dorsalis densities (independent variable) was evaluated by regression anal... more ... C. capi-tata or B. dorsalis densities (independent variable) was evaluated by regression analysis of mean ablm-dances (numbers per 100 fmits) per date during each season (SAS Institute 1987). Proportions of ripe (red) and immature (green and yellow) coffee fmits infested by ...

Research paper thumbnail of Animal Study Series in Bioresorbable Technology

As a means to characterize the additional benefits of minimizing soft tissue attachment (STA) to ... more As a means to characterize the additional benefits of minimizing soft tissue attachment (STA) to a bioresorbable sheet following soft tissue repair, an animal study was conducted to focus exclusively on minimizing STA without a soft tissue defect. A large animal (porcine) model was used to evaluate the formation of undesirable STA in a female pelvic surgery model. Through a midline incision using a transperitoneal laparotomy, the bladder and uterus of the porcine were abraded. Two survival periods were used to compare groups with no treatment (control) or treatment with a thin bioresorbable sheet intended to minimize STA. Two bioresorbable sheets were placed within each treatment speci- men: one between the bladder and the abdominal wall, and the second between the bladder and the uterus. After the 4-week and 12-week survival peri- ods, the severity and location of STA to the sheet was assessed using a zero to three-point scale. The resorbable sheet was found to provide an effec- ti...

Research paper thumbnail of Preventing recurrent preterm births and improving maternal infant health via a home visitation system of care: A randomized clinical trial

ABSTRACT Background: High probability of recurrent preterm birth (PTB) with history of prior PTB.... more ABSTRACT Background: High probability of recurrent preterm birth (PTB) with history of prior PTB. Interaction of multiple risk factors and health behaviors may contribute to PTB; some may be amenable to intervention. Home visitation is promising method to deliver evidence based interventions within a system of care (SOC). We evaluated a SOC designed to: 1) reduce preterm births and associated health care costs, and 2) improve the health in pregnant women with a history of a PTB. Methods: Randomized, parallel-group study in regional medical center. Eligibility: &gt;18 years with prior live birth &gt; 20 - &lt; 37 weeks gestation; &lt; 24 weeks gestation at enrollment; spoke and read English; received care at the medical center. All participants (N = 211) received standard prenatal care. Intervention participants (N = 109) also received home visits by certified nurse-midwives guided by protocols for specific risk factors (e.g., depressive symptoms, abuse, smoking). Data collected via multiple methods and sources including intervention fidelity assessments. Results: Average age 27.8 years; mean gestational age at enrollment was 15 weeks. Racial breakdown mirrored local demographics. Most had a partner, high school education, and 62% had Medicaid. No statistically significant group differences were found in gestational age, however differences between groups included: an increase in gestational age compared to prior PTB, and shorter maternal length of stay at delivery. Conclusions: Nurse home visits or contact may limit some risk factors and shorten length of stay at delivery. Study contributes to knowledge about evidence-based interventions targeting risk factors associated with PTB.

Research paper thumbnail of The effect of recombinant equine growth hormone on the biomechanical properties of healing superficial digital flexor tendons in horses

Research paper thumbnail of Elevated Blood Copper/Zinc Ratios in Assaultive Young Males 1 1 First presented as a poster at the 24th annual meeting of the Society of Neuroscience in Miami Beach, Fla., November 18, 1994

Physiol Behav, 1997

Walsh, W.J., H.R. Isaacson, F. Rehman and A. Hall. Elevated blood copper/zinc ratios in assaultiv... more Walsh, W.J., H.R. Isaacson, F. Rehman and A. Hall. Elevated blood copper/zinc ratios in assaultive young males. Physiol Behav 62(2) 327–329, 1997.—In research conducted over the past 20 years, we have observed abnormal trace-metal concentrations, including elevated serum copper and depressed plasma zinc, in blood samples collected from violence-prone individuals. The purpose of the study reported here was to test the validity of our observation that assaultive young males have elevated blood copper/zinc (Cu/Zn) ratios when compared to a control group of young males with no history of assaultive behavior. All male patients between the ages of 3 years and 20 years who made a first visit to the outpatient Pfeiffer Treatment Center in Naperville, Ill., during a two-month period were evaluated. Based on interviews with patients and their families and application of a standardized behavior scale, 135 assaultive young males and 18 controls with no history of assaultive behavior were identified. Blood samples were collected from test subjects and controls and analyzed for serum copper and plasma zinc concentrations by an independent laboratory using atomic absorption methods. The median Cu/Zn ratio for the assaultive subjects was 1.40 compared to 1.02 for controls, a statistically significant difference (t = 5.94; p < 0.01).

Research paper thumbnail of Recombinant equine growth hormone does not affect the in vitro biomechanical properties of equine superficial digital flexor tendon

Research paper thumbnail of Transfer of battery technology developed by the US Department of Energy

Nasa Sti Recon Technical Report N, Aug 1, 1984

This study examines linkages between government and the private sector in battery research and de... more This study examines linkages between government and the private sector in battery research and development, investigates industry's use of advances in battery technology developed with funding from the US Department of Energy (DOE), and explores the appropriate federal role. A major finding is that industry can promptly and effectively translate battery advances with commercial potential into new products, and that aggressive technology transfer activities by DOE are unnecessary. Major US battery companies were found to be highly knowledgeable with respect to DOE program content and technological advances attained. In addition, liberal patent waivers have allowed companies to build proprietary positions, and technology diffusion within the private sector can be rapid and efficient. It appears that DOE can best increase the transfer of technology to industry by simply creating advances with commercial potential at a faster rate. Principal recommendations include: (1) an expanded advisory role for industry; (2) increased programmatic flexibility; (3) greater efforts aimed at quantum advances; and (4) increased technical autonomy for industrial contractors.

Research paper thumbnail of Application of Resorbable Poly(Lactide- co -Glycolide) with Entangled Hyaluronic Acid as an Autograft Extender for Posterolateral Intertransverse Lumbar Fusion in Rabbits

Tissue Engineering Part A, 2011

Research paper thumbnail of Phylogeography, historical demography, and the role of post-settlement ecology in two Hawaiian damselWsh species

Research paper thumbnail of Platelet-Rich Plasma and Bone Defect Healing

Tissue Engineering Part A, 2014

Research paper thumbnail of Generalized additive model and regression

Research paper thumbnail of 136. In Vivo Response to Synthetic Bone Graft Substitutes in a Preclinical Posterolateral Fusion Model

Research paper thumbnail of Evaluating the Effectiveness of a Marine Reserve Network in West Hawai'I to Improve Management of the Aquarium Fishery

Research paper thumbnail of Issues in Scholarly Communications

The Serials Librarian, 2006

SUMMARY The issues surrounding the crisis in scholarly communication are well known to librarians... more SUMMARY The issues surrounding the crisis in scholarly communication are well known to librarians. However, academic faculty and administrators often do not have a similar understanding of these concerns, or what librarians are doing to deal with them. ...

Research paper thumbnail of 363: The predictive value of prenatal bowel dilation in fetuses with gastroschisis

Data Revues 00029378 V204i1ss S0002937810016406, Aug 19, 2011

Research paper thumbnail of Biomechanical assessment of Weber B ankle fractures in a human cadaver model

The Foot, 2002

The effect of fibular displacement and deltoid ligament injury on the contact area and peak intra... more The effect of fibular displacement and deltoid ligament injury on the contact area and peak intra-articular pressure of the tibiotalar joint was examined in nine fresh cadaveric specimens. The contact area and peak intra-articular pressure of the tibiotalar joint were measured using an electronic pressure sensor and pressure-sensitive film in four different positions from 10°dorsiflexion to 20° plantar flexion in 10° increments. The ankles were tested in three stages of progressive joint disruption: •intact ankle joint•isolated Weber type B fibula fracture•Weber type B fibula fracture with deltoid ligament injury.Removal of the lateral malleolus did not have a significant effect on either the contact area or peak intra-articular pressure of the tibiotalar joint. Sectioning the deep deltoid ligament also had no significant effect on these parameters. These results suggest that Weber type B injuries with no damage to the medial side of the joint are amenable to non-operative management.

Research paper thumbnail of In utero Repair of Myelomeningocele: A Comparison of Endoscopy and Hysterotomy

Fetal Diagnosis and Therapy, 2000

To compare endoscopic coverage of myelomeningocele with a maternal split-thickness skin graft in ... more To compare endoscopic coverage of myelomeningocele with a maternal split-thickness skin graft in utero to definitive neurosurgical closure through a hysterotomy. Four fetuses with isolated myelomeningocele underwent endoscopic coverage of the defect with a maternal split-thickness skin graft in a CO(2) environment at 22-24 weeks&#39; gestation. Subsequently, 4 fetuses underwent standard neurosurgical closure of their myelomeningoceles at 28-29 weeks&#39; gestation. The mean operating time for the endoscopic procedures was 297 +/- 69 min. Two fetal losses occurred as a result of chorioamnionitis and placental abruption, respectively. A third baby delivered at 28 weeks&#39; gestation after prolonged disruption of the membranes. The 2 survivors required standard closure of the myelomeningocele after delivery. The mean operating time for the hysterotomy procedures was 125 +/- 8 min. No mortality occurred, and all the infants delivered between 33 and 36 weeks with well-healed myelomeningocele scars. At present, the functional levels of all infants approximate the anatomical levels of the lesions. With current technology, in utero repair of congenital myelomeningocele through a hysterotomy appears to be technically superior to procedures performed endoscopically.