Comparison of self-administered University of California, Los Angeles, shoulder score with traditional University of California, Los Angeles, shoulder score completed by clinicians in assessing the outcome of rotator cuff surgery

To determine whether the University of California, Los Angeles (UCLA) shoulder score completed by the patient is comparable to that obtained by the clinician, 110 patients who had undergone either arthroscopic subacromial decompression (ASD) or rotator cuff repair (RCR) completed the UCLA score questionnaire by mail at 2 months (ASD subgroup) or 4 months (RCR subgroup). Patients were then assessed by 2 clinicians in random order. There was a very good level of agreement for the overall UCLA score for the total cohort (N = 100 with complete data) (intraclass correlation coefficient [ICC], 0.910; 95% confidence interval [CI], 0.87 to 0.94) and for ASD (n = 46) (ICC, 0.951; 95% CI, 0.92 to 0.97) and good agreement for RCR (n = 54) (ICC, 0.734; 95% CI, 0.61 to 0.83). Agreement between patient and assessor 1, patient and assessor 2, and assessors 1 and 2 was also very good (with whole-cohort ICCs of 0.875, 0.910, and 0.935, respectively). Bland-Altman plots showed little systematic disagreement and consistently narrow limits of agreement. Patient self-administration of the UCLA shoulder score yields acceptable results.     

Longmire Lecture: My 50 Years at the University of California, Los Angeles

The main concept driving my work has been the humoral theory of immunity to allografts. It led to the development of the microlymphocytotoxicity test, which is used to look for the relevant transplant antigens using alloantisera. Using alloantibodies produced by pregnancies, the HLA system was defined through a series of international histocompatibility workshops. It was then shown that the HLA system was important for matching donors and recipients for bone marrow transplants and organ transplants. More than 6000 HLA-matched kidney transplants from cadaver donors have now been shared in the United States. HLA antigens were found to be of importance in anthropologic and disease susceptibility studies. Currently HLA antibodies are being studied intensively to determine their role in chronic rejection. If it is proven that these antibodies trigger intimal proliferation, occluding arterioles, HLA antibodies will become essential to the monitoring of chronic rejection.     

The Los Angeles experience with laparoscopic cholecystectomy.

Surgeons should be competent in diagnostic laparoscopy before performing laparoscopic cholecystectomy (LC). Well-structured and endorsed courses with experienced faculty are important. Within 12 months, 418 LCs were performed in our hospital. The number of open cholecystectomies decreased to one third of all cholecystectomies performed. Cholangiography was attempted routinely and the duct was successfully cannulated in 90%. Inquiries were made at 6 other hospitals within a 5-mile radius where a total of 220 LCs were performed. The following gray areas need to be addressed: patients with slightly increased liver function tests but no jaundice, and unsuspected stones discovered by cholangiography. New projects are in progress to explore the common bile duct via the cystic duct or directly through the common bile duct with insertion of a T tube. The authors recommend proper training as well as caution and sound judgment before commencing with LC.     

Burn care in Los Angeles, California: LAC+USC experience 1994-2004

The LAC+USC Burn Center has admitted 3118 patients for treatment in the last 10 years. A majority of patients were young adults (1868), with the second largest group being small children (543). The ethnicity of the patients reflects the diverse nature of the population of Los Angeles County. Forty-eight percent of injuries were less than 5% TBSA and approximately 2% were greater than 60% TBSA. Eighty-two percent were accidental injuries. Sixty percent of admitted patients underwent skin grafting. Mortality was negligible in the group with burns over less than 10% of their body and very high (15/19), 79% in the most severely burned group. Further, there was a high correlation between age and mortality. Complications during treatment included: deep venous thrombosis 1% per year; pulmonary emboli in 5 patients; endotracheal tube dislodgment early or self-extubation about 1 month (11.3 per year); 4.5 patients per year who developed acute renal failure; abdominal compartment syndrome developed in 4.7 patients each year; heterotopic ossification was seen in 4 patients (0.4%); 4 patients (0.4%) developed stage II-IV pressure sores; hypothermia was present in 0.8% of patients.     

Historic Landmarks in Clinical Transplantation: Conclusions from the Consensus Conference at the University of California, Los Angeles

The transplantation of organs, cells, and tissues has burgeoned during the last quarter century, with the development of multiple new specialty fields. However, the basic principles that made this possible were established over a three-decade period, beginning during World War II and ending in 1974. At the historical consensus conference held at UCLA in March 1999, 11 early workers in the basic science or clinical practice of transplantation (or both) reached agreement on the most significant contributions of this era that ultimately made transplantation the robust clinical discipline it is today. These discoveries and achievements are summarized here in six tables and annotated with references.     

Gene therapy for prostate cancer at the University of California, Los Angeles: preliminary results and future directions

The treatment options for patients with advanced prostate cancer are limited. Because of recent advances in the understanding of the molecular biology of prostate cancer, the accessibility of the prostate for injection, and the availability of gene promotors that allow tissue-specific expression of therapeutic gene products, gene therapy for prostate cancer has realized significant achievements in recent years. What once belonged to the realm of basic science is now entering the domain of phase II clinical trials. In this review, current results and future directions in prostate gene therapy at the University of California, Los Angeles, are discussed.