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This study was designed to itemize and analyze the classification of fracture types and their corresponding outcomes in an attempt to provide a better understanding of the current treatment methods. Two PubMed searches were performed using the words "periprosthetic distal femur fracture" and "periprosthetic supracondylar femur fracture" in studies that were published in the previous 10 years (2004-2014). Data from 41 articlesthat met the general inclusion criteria, were collected and categorized into fracture type and treatment method groupings. Healing outcome and complications were the two parameters used to analyze the data. Treatment techniques were grouped in the following categories: locking plate, non-locking plate, intramedullary nail/rod, screw, blade plate, cerclage wires, allograft, external fixation, revision arthroplasty, non-operative, and other. Classification systems by Lewis and Rorabeck, the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA), Su et al., Neer et al., Kim et al., Backstein et al., and the Societe Francaise de Chirurgie Orthopedique et Traumatologique were reported. In total 448 fractures were identified, of which Rorabeck type II was the most common fracture studied. The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). The most frequent complications associated with periprosthetic distal femur fractures included non/mal/delayed union and the need for revision. Locking plates used to treat Rorabeck type II fractures had a complication rate of 35% and those treated with intramedullary nailing had a higher complication rate of 53%. In conclusion, the most frequent type of periprosthetic distal femur fracture after total knee arthroplasty was Rorabeck type II. The most common treatments for these types of fractures are locked plating and intramedullary nailing, with similar healing rates of 87% and 84%, respectively. However, the complication rate for locked plating was lower than for intramedullary nailing.

This study investigated the effect of in vivo low-dose acetylsalicylic acid (ASA, aspirin) on human platelet aggregation induced in vitro by Porphyromonas gingivalis cells. Blood was collected from volunteers (n = 20), half of whom ingested 81 mg of aspirin 24 hours before donating blood. Low-dose aspirin inhibited P. gingivalis cell-induced platelet aggregation and produced an inverse correlation of inhibition to number of cells. At the higher concentration of cells used in this in vitro assay, aspirin inhibition was significant (P = 0.001); however, partial platelet activation was observed. The significance of partial platelet activation is discussed in this article, as is the relevance of platelet aggregation to the putative link between inflammatory periodontal disease and cardiovascular disease.

We discuss the design and implementation of an active object-oriented database built upon Gemstone, and an associated debugger. We concentrate upon the issue of visibility of ‘wrapping’ code, explaining why it is desirable for users of our system to be able to access and debug the code in both its ‘raw’ form and with the wrapping code hidden.

We discuss the implementation of GOAD (Gemstone Object-oriented Active Database), an active object-oriented database built on top of GemStone. This system has been developed with the specific aim of supporting interface tools for the creation and maintenance of rule bases, and we give particular attention to explaining how GOAD is designed to meet this aim. We show how objects, classes and metaclasses can support a three level event model which integrates with the underlying system in an ‘open’ manner. Moreover, by providing a uniform interface to these different objects, we are providing support for the implementation of more generic tools. We discuss the design of the system and how we gather inherited rules at run-time in an efficient manner. We explain the problems that arise as a result of our desired mode of implementation and how they were circumvented. Finally we discuss our future work and specifically how we plan to implement tools for the easier creation of rule bases.