Journal of Hand Surgery: European Volume | Year: 2015
Collagenase clostridium histolyticum is the first and only United States Food and Drug Association approved nonsurgical treatment for patients with a palpable Dupuytren's contracture cord. However, the Food and Drug Association has only approved injection of 0.58 mg of this enzyme into one palpable Dupuytren's contracture cord at a time. This review reports on the early outcome of 144 patients treated with the entire bottle of enzyme, approximately 0.78 mg, along with use of a novel slow intracord multi-cord technique. Use of 0.78 mg of enzyme, with the slow intracord multi-cord technique is safe and allows one to inject multiple Dupuytren's contracture cords at one setting. Correction at metacarpophalangeal and proximal interphalangeal joints, taken individually, are comparable with the Collagenase Option for the Reduction of Dupuytren's studies at 43° and 33°, respectively, however due to the multi-cord injection, we achieved 94° average immediate and 76° average final combined metacarpophalangeal and proximal interphalangeal contracture releases per bottle of enzyme. Implementation of the slow intracord multi-cord technique has the potential to improve current treatment for Dupuytren's contracture with resultant significant healthcare savings. © The Author(s) 2014.
Neff J.M.,Neff |
Page D.S.,Bowdoin College |
Landrum P.F.,6829 Earhart Road |
Chapman P.M.,Golder Associates
Marine Pollution Bulletin | Year: 2013
This paper reanalyzes data from an earlier study that used effluents from oiled-gravel columns to assess the toxicity of aqueous fractions of weathered crude oil to Pacific herring embryos and larvae. This reanalysis has implications for future similar investigations, including the observance of two distinct dose-response curves for lethal and sublethal endpoints for different exposures in the same experiment, and the need to consider both potency and slope of dose-response curves for components of a toxicant mixture that shows potentially different toxicity mechanisms/causation. Contrary to conclusions of the original study, the aqueous concentration data cannot support the hypothesis that polycyclic aromatic hydrocarbons (PAHs) were the sole cause of toxicity and that oil toxicity increased with weathering. Confounding issues associated with the oiled gravel columns include changes in the concentration and composition of chemicals in exposure water, which interfere with the production of reliable and reproducible results relevant to the field. © 2012 Elsevier Ltd.
Neff J.M.,Neff |
Page D.S.,Bowdoin College |
Boehm P.D.,Exponent, Inc.
Environmental Toxicology and Chemistry | Year: 2011
We assessed whether sea otters and harlequin ducks in an area of western Prince William Sound, Alaska, USA (PWS), oiled by the 1989 Exxon Valdez oil spill (EVOS), are exposed to polycyclic aromatic hydrocarbons (PAH) from oil residues 20 years after the spill. Spilled oil has persisted in PWS for two decades as surface oil residues (SOR) and subsurface oil residues (SSOR) on the shore. The rare SOR are located primarily on the upper shore as inert, nonhazardous asphaltic deposits, and SSOR are confined to widely scattered locations as small patches under a boulder/cobble veneer, primarily on the middle and upper shore, in forms and locations that preclude physical contact by wildlife and diminish bioavailability. Sea otters and harlequin ducks consume benthic invertebrates that they collect by diving to the bottom in the intertidal and subtidal zones. Sea otters also dig intertidal and subtidal pits in search of clams. The three plausible exposure pathways are through the water, in oil-contaminated prey, or by direct contact with SSOR during foraging. Concentrations of PAH in near-shore water off oiled shores in 2002 to 2005 were at background levels (<0.05ng/L). Median concentrations of PAH in five intertidal prey species on oiled shores in 2002 to 2008 range from 4.0 to 34ng/g dry weight, indistinguishable from background concentrations. Subsurface oil residues are restricted to locations on the shore and substrate types, where large clams do not occur and where sea otters do not dig foraging pits. Therefore, that sea otters and harlequin ducks continue to be exposed to environmentally significant amounts of PAH from EVOS 20 years after the spill is not plausible. Environ. Toxicol. Chem. 2011; 30:659-672. © 2011 SETAC Copyright © 2010 SETAC.
Publishing Research Quarterly | Year: 2013
Germany's acceptance and spread of e-books are typical for a trend-follower. Germans are still reluctant to change their reading habits and strongly support the diversity of small bookshops. Germany's biggest book distributor and wholesaler KNV strongly believes in the future of the printed books and is building the most modern media distribution center in central Germany. KNV is also placing a lot of efforts in supporting small and medium size bookshops and in establishing multi-channel strategies and promoting online and digital sales. After many unsuccessful efforts to establish an e-reading platform in Germany by various organizations, the "Tolino" platform has the potential to grow to a real significance alongside to Amazon and Apple. Therefore, KNV will support its clients to become part of the new alliance, initiated by the major book chains, Bertelsmann and Deutsche Telekom. © 2013 Springer Science+Business Media New York.
Neff J.M.,Neff |
Integrated Environmental Assessment and Management | Year: 2012
An objective of a multiyear monitoring program, sponsored by the US Department of the Interior, Bureau of Ocean Energy Management was to examine temporal and spatial changes in chemical and biological characteristics of the Arctic marine environment resulting from offshore oil exploration and development activities in the development area of the Alaskan Beaufort Sea. To determine if petroleum hydrocarbons from offshore oil operations are entering the Beaufort Sea food web, we measured concentrations of hydrocarbons in tissues of amphipods, Anonyx nugax, sediments, Northstar crude oil, and coastal peat, collected between 1999 and 2006 throughout the development area. Mean concentrations of polycyclic aromatic hydrocarbons (PAH), saturated hydrocarbons (SHC), and sterane and triterpane petroleum biomarkers (StTr) were not significantly different in amphipods near the Northstar oil production facility, before and after it came on line in 2001, and in amphipods from elsewhere in the study area. Forensic analysis of the profiles (relative composition and concentrations) of the 3 hydrocarbon classes revealed that hydrocarbon compositions were different in amphipods, surface sediments where the amphipods were collected, Northstar crude oil, and peat from the deltas of 4 North Slope rivers. Amphipods and sediments contained a mixture of petrogenic, pyrogenic, and biogenic PAH. The SHC in amphipods were dominated by pristane derived from zooplankton, indicating that the SHC were primarily from the amphipod diet of zooplankton detritus. The petroleum biomarker StTr profiles did not resemble those in Northstar crude oil. The forensic analysis revealed that hydrocarbons in amphipod tissues were not from oil production at Northstar. Hydrocarbons in amphipod tissues were primarily from their diet and from river runoff and coastal erosion of natural diagenic and fossil terrestrial materials, including seep oils, kerogens, and peat. Offshore oil and gas exploration and development do not appear to be causing an increase in petroleum hydrocarbon contamination of the Beaufort Sea food web. Integr Environ Assess Manag 2012;8:301-319. © 2011 SETAC.