Long-term followup of anterior cruciate ligament reconstruction using freeze-dried fascia lata allografts

We identified 79 patients who underwent arthroscopically assisted intraarticular anterior cruciate ligament reconstruction with freeze-dried fascia lata allografts and an additional lateral extraarticular reconstruction. We were able to contact 62 patients (79%) for follow-up evaluation at an average of 134.5 months. Forty patients (51%) returned for objective evaluation. Lysholm scores at followup averaged 92.3 and Tegner activity scores averaged 5.1. Only four (6%) of the 62 patients contacted reported episodes of full giving way. Thirty (75%) of the 40 patients examined demonstrated 3 mm or less side-to-side difference on KT-1000 arthrometer manual maximum evaluation. Forty-eight (77%) of the 62 patients were participating in sporting activities at final followup. No patient had evidence of graft rejection.

A distinct modulating domain in glucocorticoid receptor monomers in the repression of activity of the transcription factor AP-1

Steroid receptors activate and repress genes. An important class of genes that they repress is controlled by the transcription factor AP-1. The activity of AP-1 is inhibited by the receptor, a mechanism exploited for the therapy of various forms of pathological hyperproliferation in humans. We show here by point mutations in the DNA binding domain and by the choice of steroid ligands that repression of AP-1 activity and transactivation functions of the glucocorticoid receptor (GR) are separable entities. While DNA binding and activation of glucocorticoid-regulated promoters require GR dimerization, we present data that suggest that repression is a function of GR monomers.

Financial modeling/case-mix analysis

The authors describe a case mix system developed by users which goes beyond DRG requirements to respond to management's clinical/financial data needs for marketing, planning, budgeting and financial analysis as well as reimbursement. Lessons learned in development of the system and the clinical/financial base will be helpful to those currently contemplating the implementation of such a system or evaluating available software.