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Full-thickness massive irreparable rotator cuff tears present a demanding challenge for the surgeon. The subacromial balloon spacer is a novel biodegradable implant used to treat massive, irreparable rotator cuff tears. There have, however, been several isolated reports of balloon migration. This Technical Note describes ultrasound-assisted balloon deflation followed by arthroscopic removal of a symptomatic dislodged balloon. [Display omitted] [ABSTRACT FROM AUTHOR]

Operative fixation for acute displaced midshaft clavicle fractures provides improved functional outcomes and patient satisfaction over nonoperative treatment. Although open reduction and plate fixation is most commonly used, intramedullary fixation produces similar patient outcomes with fewer symptomatic hardware or scar complications. The purpose of this Technical Note is to detail a straightforward and cost-efficient method of intramedullary clavicle fracture fixation using a headless cannulated screw. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: The toxigenic marine flagellate Prymnesium parvum was first recorded in Lake Texoma, OK-TX, USA, an impoundment of the Red and Washita Rivers, following a massive fish kill in January 2004. Results of a 4.5-year monitoring program, spanning five bloom periods, revealed that Prymnesium abundances in the lake were temporally and spatially variable—densities were higher in winter, near-shore, and in Red River-associated sampling sites; the largest blooms were in Lebanon Pool, a large backwater basin often disconnected from the main reservoir. Prymnesium blooms appeared to have been fueled by high nutrient concentrations, and winter-spring densities were positively correlated with chlorophyll a, conductivity, total phosphorus, total nitrogen, and microzooplankton biomass, and negatively correlated with molar total nitrogen:total phosphorus and cladoceran and total crustacean zooplankton biomass. Comparison of Prymnesium densities with hydrological data suggested that Prymnesium blooms in Lebanon Pool were highest when the pool was disconnected from the main reservoir; no bloom occurred in the winter of 2004–2005, the only year since the 2003–2004 invasion in which Lebanon Pool and Lake Texoma were connected during the winter months. [ABSTRACT FROM AUTHOR]

Abstract: Within the last two decades, Prymnesium parvum (golden algae) has rapidly spread into inland waterways across the southern portion of North America and this organism has now appeared in more northerly distributed watersheds. In its wake, golden algae blooms have left an alarming trail of ecological devastation, namely massive fish kills, which are threatening the economic and recreational value of freshwater systems throughout the United States. To further understand the nature of this emerging crisis, our group investigated the chemical nature of the toxin(s) produced by P. parvum. We approached the problem using a two-pronged strategy that included analyzing both laboratory-grown golden algae and field-collected samples of P. parvum. Our results demonstrate that there is a striking difference in the toxin profiles for these two systems. An assemblage of potently ichthyotoxic fatty acids consisting primarily of stearidonic acid was identified in P. parvum cultures. While the concentration of the fatty acids alone was sufficient to account for the rapid-onset ichthyotoxic properties of cultured P. parvum, we also detected a second type of highly labile ichthyotoxic substance(s) in laboratory-grown golden algae that remains uncharacterized. In contrast, the amounts of stearidonic acid and its related congeners present in samples from recent bloom and fish kill sites fell well below the limits necessary to induce acute toxicity in fish. However, a highly labile ichthyotoxic substance, which is similar to the one found in laboratory-grown P. parvum cultures, was also detected. We propose that the uncharacterized labile metabolite produced by P. parvum is responsible for golden algae''s devastating fish killing effects. Moreover, we have determined that the biologically-relevant ichthyotoxins produced by P. parvum are not the prymnesins as is widely believed. Our results suggest that further intensive efforts will be required to chemically define P. parvum''s ichthyotoxins under natural bloom conditions. [Copyright &y& Elsevier]