Search

In this talk I want to focus on three issues. The first is the relationship between globalization and the nation state. The second is the relationship between the nation states […]

A number of interrelated changes in the five years since the Cold War ended have had a negative impact on Third World oil producers. First, the continuing stagnation of the [...]

Now I'd like to turn to the energy and oil industries. On the demand side, as always, a serious recession like the present one means stagnant demand for energy and [...]

What I shall do today is first to give a very brief report on the Rio conference, which I attended as a correspondent for Monthly Review and the Bulletin of [...]

This is an important work which deserves careful reading by progressive people in both the developed and underdeveloped world. Barry Commoner, trained as a biologist and currently the Director of [...]

OIL AND THE PERSIAN GULF CRISIS It is well known by now that the CIA directed the overthrow of the Mossadeq government in Iran after it dared to nationalize the [...]

Orthopaedic surgery is characterized by surgical tasks that are physical, repetitive and require some degree of stamina from the surgeon. Occupational injuries are alarmingly common in orthopaedic surgery with two-thirds of all surgeons reporting a work-related musculoskeletal (MSK) injury during their career. One of the leading causes of the high level of MSK injuries among orthopaedic surgeon is lack of ergonomics of the operating room. Implementing an ergonomic process has been shown to be effective in reducing the risk of developing MSK disorders in other high-risk industries. We reviewed well-established and effective ergonomic guidelines from the industrial workplace and determined the pertinent principles that could be transferred to the operating room to help reduce the number and severity of common orthopaedic work-related MSK injuries.

Introduction: The high dislocation rate following revision total hip arthroplasty (THA) has been shown to be significantly reduced by closing the posterior capsule and by the use of large diameter femoral heads. The relative importance of each of these strategies on the rate of dislocation remains unknown. We undertook a study to determine if increasing femoral head diameter, in addition to posterior capsular closure would influence the dislocation rate following revision THA.Methods: We retrospectively reviewed 144 patients who underwent a revision THA. We included all patients who underwent revision THA with closure of the posterior capsule and who had at least a 2-year minimum follow-up. 48 patients had a 28-mm femoral head, 47 had a 32-mm head and 49 patients had a 36-mm femoral head.Results: At a minimum follow-up of 2 years, there were 3 dislocations. There were no dislocations in the 28-mm group (0%), 2 in the 32-mm group (4%) and 1 in the 36-mm group (2%). Head size alone was not found to significantly decrease the risk of dislocation (28-mm versus 32-mm p =0.12; 28-mm versus 36-mm p =0.27; 32-mm versus 36-mm p =0.40).Conclusion: Both large diameter heads and careful attention to surgical technique with posterior capsular closure can decrease the historically high dislocation rate after revision THA when utilising the posterolateral approach. Capsular closure outweighs the effect of femoral head diameter in preventing dislocation following revision THA through a posterolateral approach.

While academic students of international trade theory have been concentrating on exports and imports of products, another type of international activity, direct foreign investment by multinational corporations, has been increasing at a dramatic rate. The major oil companies, as always, are even more heavily involved in overseas operations. Much has been written about the promise held out by the multinational corporation for the progress of less developed countries. Few writers, however, examine the perils or costs to the host country that might be associated with these benefits. These can be seen as possible threats to its political, cultural or economic sovereignty, as well as to its long-run economic development.

In recent years economists of all political persuasions have tended to depreciate the threat of cyclical instability in the U.S. economy. The basic danger to the U.S. economy is the one ever present in any capitalist economy-the possibility that monetary conditions will get out of line with physical production and consumption needs. Credit capitalism is really the highest and purest form of capitalism. For one thing, nothing tangible is produced, so that there are few labor problems. Second, credit capitalism has the potential to be automatically self-perpetuating, in that interest on the debt continually adds to the amount of debt outstanding.

The article presents news on various topics from around the world. After a brief cooling-off period following the gold and dollar crises of last March, the international monetary pot is once again boiling partly because of the pressure front between the stable, non-inflationary West German economy and the crisis-racked inflationary French economy. In another development according to former U.S. President Richard M. Nixon, leaderless, indecisive Democratic Party is the last thing he wants in the 91st Congress. He knows that a disorganized, ineffective opposition, with a mandate to control the U.S. House of Representatives but no muscle to do so, would make governing the country exceedingly difficult.

The United States and continental Europe are engaged in a titanic subsurface economic struggle, primarily over the role of U.S. investment in Europe. The outcome may determine whether Europe can survive as an independent entity. Respective roles of gold and the dollar in the world economy are at the focus of this struggle. Mechanics of the struggle are such that its resolution may be determined in the end, not by nations involved but by individual speculators on both sides of the Atlantic, with potentially disastrous consequences for all.

No one can deny that the past ten years have witnessed great changes in the international oil industry. A decade ago, the seven largest international oil companies--Exxon, Shell, British Petroleum, [...]

In a recent MONTHLY REVIEW article ('New Light on Dependency and Dependent Development,' January 1983) Arthur MacEwan noted that while 'Marxists have often argued that economic development would not take [...]

Articular cartilage degeneration in osteoarthritis (OA) involves type II collagen degradation and chondrocyte differentiation (hypertrophy). Because these changes resemble growth plate remodeling, we hypothesized that collagen degradation may be inhibitable by growth factors known to suppress growth plate hypertrophy, namely transforming growth factor (TGF)-β2, fibroblast growth factor (FGF)-2, and insulin. Full-depth explants of human OA knee articular cartilage from arthroplasty were cultured with TGF-β2, FGF-2, and insulin in combination (growth factors) or individually. In cultured explants from five OA patients, collagenase-mediated type II collagen cleavage was significantly down-regulated by combined growth factors as measured by enzyme-linked immunosorbent assay. Individually, FGF-2 and insulin failed to inhibit collagen cleavage in some OA explants whereas TGF-β2 reduced collagen cleavage in these 5 explants and in 19 additional explants. Moreover, TGF-β2 effectively suppressed cleavage at low concentrations. Together or individually these growth factors did not inhibit glycosaminoglycan (primarily aggrecan) degradation while TGF-β2 occasionally did. Semiquantitative reverse transcriptase-polymerase chain reaction of articular cartilage from six OA patients revealed that TGF-β2 suppressed expression of matrix metalloproteinase-13and matrix metalloproteinase-9, early (PTHrP) and late (COL10A1) differentiation-related genes, and proinflammatory cytokines (interleukin-1β, tumor necrosis factor-α). In contrast, TGF-β2 up-regulated PGES-1expression and prostaglandin E2release. These observations show that TGF-β2 can suppress collagen resorption and chondrocyte differentiation in OA cartilage and that this may be mediated by prostaglandin E2. Therefore TGF-β2 could provide therapeutic control of type II collagen degeneration in OA.

To determine the predictors of outcome in patients with osteoarthritis 2 years after receiving total hip or knee replacement. A prospective cohort study of 222 osteoarthritis patients undergoing total hip or knee replacement in Boston and Montreal was done. Their postoperative outcomes at 6 months were previously reported. This followup reports on the outcomes after 2 years among the 165 patients (74%) who remained. The subjects were divided into 2 groups according to the median value of their preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score. The Short Form 36-item physical function subscale and the WOMAC pain and function subscale scores were collected at baseline and at 3, 6, and 24 months postoperatively. Clinical outcomes were analyzed at 2 years, using descriptive and multiple regression analyses. Improvements in pain and function at 2 years were similar to those observed at 6 months. Those subjects with the worst function and pain at the time of surgery (baseline) had comparatively worse function 2 years after surgery. In this comparison, the poor outcomes observed at 6 months following total joint replacement in patients with worse baseline functional status persisted after 2 years. Although there are no validated indications for when a patient should optimally have total joint replacement, these data suggest that timing of surgery may be more important than previously realized and, specifically, that performing surgery earlier in the course of functional decline may be associated with better outcome.

To determine the sites of cleavage and denaturation of type II collagen (CII) by collagenase(s) in healthy and osteoarthritic (OA) human articular cartilage and their relationship to the distribution of matrix metalloproteinase 1 (MMP-1) and MMP-13. Single (per subject) full-depth specimens from femoral condylar cartilage were isolated from articulating surfaces at autopsy from 8 subjects without arthritis and during arthroplasty from 10 patients with OA. Fixed frozen sections of cartilage were examined by immunoperoxidase localization, using antibodies to the collagenase-generated cleavage site in CII, to an intrachain epitope recognized only in denatured CII, and to MMP-1 and MMP-13 (proenzyme, activated enzyme, or enzyme/inhibitor complex). Staining for collagen cleavage, denaturation, and both MMPs was weak to moderate and was frequently observed in pericellular sites in cartilage from younger, nonarthritic subjects. In specimens from older subjects, this staining was often more widespread and of greater intensity. Similar staining was usually, but not always, seen for all antibodies. In OA cartilage, staining was often stronger and more intense than that in normal cartilage from older subjects, and the distribution of staining was often similar for the different antibodies. Pericellular staining in the deep zone was frequently more pronounced in arthritic cartilage and extended to territorial and sometimes interterritorial sites. In very degenerate specimens, staining was distributed throughout most of the cartilage matrix. These observations provide evidence for the presence of limited cleavage and denaturation of CII restricted to mainly pericellular and superficial sites in cartilage from younger, healthy subjects, where MMP-1 and MMP-13 are also selectively localized. Collagen degradation is more extensive and often more pronounced in cartilage from older, nonarthritic subjects. Characteristic changes in early OA are similar to those seen with aging in cartilage from older, healthy subjects, with collagen damage and collagenases concentrated closer to the articular surface. There was usually a close correspondence between the cleavage and denaturation of CII and the sites at which these collagenases were detected, suggesting that both MMPs are involved in the physiology and pathology. There was no evidence that the damage to CII is ordinarily initiated in sites other than at and near the articular surface and around chondrocytes.

We evaluated 59 hips that underwent a primary total hip arthroplasty using an S-ROM modular femoral component at a mean follow-up of 101 months (range, 72-145 months). All cases showed radiographic evidence of bone ingrowth, and there were no femoral revisions for aseptic loosening. The Harris hip score improved from a mean of 40 preoperatively to 89 at final follow-up. Some degree of proximal femoral disuse atrophy from stress shielding occurred in 46 hips (78%), and some degree of femoral osteolysis occurred in 25 hips (42%). Only additional follow-up will reveal whether there is a consequence of both types of proximal femoral bone loss.

To examine whether type II collagen cleavage by collagenase and loss of proteoglycan are excessive in human osteoarthritic (OA) articular cartilage compared with nonarthritic articular cartilage, and whether this can be inhibited by a selective synthetic inhibitor that spares collagenase 1 (matrix metalloproteinase 1 [MMP-1]). Articular cartilage samples were obtained during surgery from 11 patients with OA and at autopsy from 5 adults without arthritis. The articular cartilage samples were cultured in serum-free medium. A collagenase-generated neoepitope, which reflects cleavage of type II collagen, and proteoglycan glycosaminoglycan (GAG), which predominantly reflects aggrecan release, were assayed in culture media. In addition, cultures were performed using either of 2 synthetic MMP inhibitors, both of which inhibited collagenase 2 (MMP-8) and collagenase 3 (MMP-13), but one of which spared collagenase 1. Cultures were also biolabeled with ³H-proline in the presence and absence of these inhibitors to measure collagen synthesis (as tritiated hydroxyproline) and incorporation in articular cartilage. As a group, cleavage of type II collagen by collagenase was significantly increased in OA cartilage samples. In contrast, proteoglycan (GAG) release was not increased. This release of a collagenase-generated epitope was inhibited by both MMP inhibitors in 2 of 5 nonarthritic samples and in 9 of 11 OA cartilage samples. The inhibitor that spared collagenase 1 was generally more effective and inhibited release from 4 of 5 nonarthritic cartilage samples and the same OA cartilage samples. Group analyses revealed that the inhibition of collagenase neoepitope release by both inhibitors was significant in the OA patient cartilage, but not in the nonarthritic cartilage. Proteoglycan loss was unaffected by either inhibitor. Newly synthesized collagen (predominantly, type II) exhibited increased incorporation in OA cartilage, but only in the presence of the inhibitor that arrested collagenase 1 activity. These results further indicate that the digestion of type II collagen by collagenase is selectively increased in OA cartilage, and that this can be inhibited in the majority of cases by a synthetic inhibitor that can inhibit collagenases 2 and 3, but not collagenase 1. The results also suggest that in OA, newly synthesized collagen is digested, but in a different manner than that of resident molecules. Proteoglycan release was not increased in OA cartilage and was unaffected by these inhibitors. Inhibitors of this kind may be of value in preventing damage to type II collagen in human arthritic articular cartilage.

To determine whether patients with knee or hip osteoarthritis (OA) who have worse physical function preoperatively achieve a postoperative status that is similar to that of patients with better preoperative function. This study surveyed an observational cohort of 379 consecutive patients with definite OA who were without other inflammatory joint diseases and were undergoing either total hip or knee replacement in a US (Boston) and a Canadian (Montreal) referral center. Questionnaires on health status (the Short Form 36 and Western Ontario and McMaster Universities Osteoarthritis Index) were administered preoperatively and at 3 and 6 months postoperatively. Physical function and pain due to OA were deemed the most significant outcomes to study. Two hundred twenty-two patients returned their questionnaires. Patients in the 2 centers were comparable in age, sex, time to surgery, and proportion of hip/knee surgery. The Boston group had more education, lower comorbidity, and more cemented knee prostheses. Patients undergoing hip or knee replacement in Montreal had lower preoperative physical function and more pain than their Boston counterparts. In patients with lower preoperative physical function, function and pain were not improved postoperatively to the level achieved by those with higher preoperative function. This was most striking in patients undergoing total knee replacement. Surgery performed later in the natural history of functional decline due to OA of the knee, and possibly of the hip, results in worse postoperative functional status.

Twenty-five patients with symptomatic uncemented total hip components were studied with contrast arthrography prior to surgical exploration. All but one had uncemented femoral stems and 16 had an uncemented acetabular component. As judged by the findings at surgery, on the femoral side the sensitivity, specificity, and accuracy of arthrography were 57%, 60%, and 58% respectively. There was a relatively high incidence of both false positives (17%) and false negatives (25%). On the acetabular side sensitivity, specificity, and accuracy were 29%, 89%, and 62.5%. False negatives were common (31%), while there was only one false positive. The results in this small series show that arthrography has distinct limitations in identifying the fixation status of uncemented total hip components.

Purpose: The dosimetry of hip irradiation for the prevention of heterotopic bone formation following arthroplasty is complicated by the use of custom shielding in the treatment portal, and the fact that irradiation is usually required during a 48 hour period following surgery. Both the machine output and depth dose factors of the resulting fields are modified by the presence of the shielding blocks. A simplified dosimetric approach, based on correction factors for both the output and depth dose as a function of field geometry is presented for various megavoltage energy beams.

The Standard Oil Co. of New Jersey, which had openly expressed interest in bidding for South Vietnamese offshore oil concessions, has made a reportedly significant oil find in Malaysian waters bordering the South Vietnamese tracts. But, assuming an inevitable degree of uncertainty until drilling actually begins, the overriding operational question facing the big American oil companies is the probability of finding oil and warding off competitors in the event the oil is found out. The foundation for the incredible profits of the five huge American companies which along with Royal Dutch Shell and British Petroleum Co. PLC dominate the international oil industry, is their ownership of enormous quantities of low cost crude oil all over the world, and particularly in the Middle East, North Africa and Venezuela.

The intra-helical cleavage of type II collagen by proteases, including collagenases and cathepsin K, is increased with aging and osteoarthritis (OA) in cartilage as determined by immunochemical assays. The distinct sites of collagen cleavage generated by collagenases and cathepsin K in healthy and OA human femoral condylar cartilages were identified and compared.

OBJECTIVE: To determine whether the provision of single lens distance glasses to older wearers of multifocal glasses reduces falls. Design Parallel randomised controlled trial stratified by recruitment site and source of referral, with 13 months’ follow-up and outcome assessors blinded to group allocation. Setting Community recruitment and treatment room assessments in Sydney and Illawarra regions of NSW, Australia. Participants 606 regular wearers of multifocal glasses (mean age 80 (SD 7) years). Inclusion criteria included increased risk of falls (fall in previous year or timed up and go test >15 seconds) and outdoor use of multifocal glasses at least three times a week. Interventions Provision of single lens distance glasses with recommendations for wearing them for walking and outdoor activities compared with usual care. MAIN OUTCOME MEASURES: Number of falls and injuries resulting from falls during follow-up. RESULTS: Single lens glasses were provided to 275 (90%) of the 305 intervention group participants within two months; 162 (54%) of the intervention group reported satisfactory use of distance glasses for walking and outdoor activities for at least 7/12 months after dispensing. In the 299 intervention and 298 control participants available to follow-up, the intervention resulted in an 8% reduction in falls (incidence rate ratio 0.92, 95% confidence interval 0.73 to 1.16). Pre-planned sub-group analyses showed that the intervention was effective in significantly reducing all falls (incidence rate ratio 0.60, 0.42 to 0.87), outside falls, and injurious falls in people who regularly took part in outside activities. A significant increase in outside falls occurred in people in the intervention group who took part in little outside activity. CONCLUSIONS: With appropriate counselling, provision of single lens glasses for older wearers of multifocal glasses who take part in regular outdoor activities is an effective falls prevention strategy. The intervention may be harmful, however, in multifocal glasses wearers with low levels of outdoor activity. Trial registration Clinical trials NCT00350855.

A letter to the editor is presented "Concerned Citizens Must Get Active to Avert Catastrophe," by Philip Symons in the December 2009/January 2010.