Polarized epithelia play crucial roles as barriers to the outside environment and enable the formation of specialized compartments for organs to carry out essential functions. Barrier functions are mediated by cellular junctions that line the lateral plasma membrane between cells, principally tight junctions in vertebrates and septate junctions (SJs) KEY WORDS: Septate junction, Epithelia, Innate immunity INTRODUCTIONPolarized epithelia play crucial roles as barriers to the outside world and in providing distinct compartments for organs to carry out essential metabolic functions in all metazoans. These functions require a physiologically tight epithelium to provide a barrier to the flow of small molecules between the apical and basal sides of the epithelium. This paracellular barrier is established and maintained by tight junctions (TJs) in the epithelia of vertebrate organisms, and by septate junctions (SJs) in invertebrate organisms. TJs localize

Drug therapy of AHFS may include diuretics, vasodilators, morphine, ACE inhibitors, digoxin, inotropes, and vasopressin antagonists. Clinical practice guidelines for patients with AHFS provide a useful mechanism to incorporate available evidence and standards of practice into patient care.

BACKGROUND The purpose of our study was to perform a large cross-sectional study aimed at determining the postnatal growth pattern of the clavicle from birth to 18 years of age. METHODS We analyzed digital chest radiographs of a convenience sample of 961 individuals between birth and 18 years of age. Malrotated radiographs were excluded. Right and left clavicle lengths were measured in millimeters from the most lateral ossified border to the most medial ossified border of each clavicle. Study subjects were divided into 19 subgroups with the first group being labeled “birth to 11 months of age” followed by 1 year olds, 2 year olds, etc. Subjects were also grouped by gender. There was a minimum of 25 subjects in each group. RESULTS At 18 years of age the mean±SD clavicle length for females was 149±12 mm and for males it was 161±11 mm. Although a statistically significant difference (p=0.049) was noted between the length of right and left clavicles it was not clinically significant (0.036 mm). A steady growth rate was noted for both genders from birth to age 12 years (8.4 mm per yr). Above age 12 there were significant differences in the growth of the clavicles of girls (2.6 mm per yr) versus boys (5.4 mm per yr) (p<0.001). Our data suggest that females achieve 80% of their clavicle length by 9 years of age and boys by 12 years of age. CONCLUSION This cross-sectional study establishes that relatively little clavicle growth (20%) remains for girls beyond age 9 years and for boys beyond 12 years. The length of one clavicle may be properly judged by comparing it to the contralateral clavicle. CLINICAL RELEVANCE Remodeling of clavicle shaft fractures is currently believed to be proportional to growth remaining. Our study questions the capacity of the clavicle to re-establish normal length beyond the age thresholds we have identified.

The docking plus technique allows greater stiffness and a higher moment to failure immediately after reconstruction and describes a way to maintain constant graft tension during fixation, resulting in a biomechanically stronger UCL reconstruction.