Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty

Objectives

Because there have been no standard methods to determine pre-operatively the thickness of resection of the proximal tibia in unicompartmental knee arthroplasty (UKA), information about the relationship between the change of limb alignment and the joint line elevation would be useful for pre-operative planning. The purpose of this study was to clarify the correlation between the change of limb alignment and the change of joint line height at the medial compartment after UKA.

Methods

A consecutive series of 42 medial UKAs was reviewed retrospectively. These patients were assessed radiographically both pre- and post-operatively with standing anteroposterior radiographs. The thickness of bone resection at the proximal tibia and the distal femur was measured radiographically. The relationship between the change of femorotibial angle (δFTA) and the change of joint line height, was analysed.

Results

The mean pre- and post-operative FTA was 180.5° (172.2° to 184.8°) and 175.0° (168.5° to 178.9°), respectively. The mean δFTA was 5.5° (2.3° to 10.1°). The joint line elevation of the tibia (JLET) was 4.4 mm (2.1 to 7.8). The δFTA was correlated with the JLET (correlation coefficient 0.494, p = 0.0009).

Conclusions

This study indicated that there is a significant correlation between the change of limb alignment and joint line elevation. This observation suggests that it is possible to know the requirement of elevation of the joint line to obtain the desired correction of limb alignment, and to predict the requirement of bone resection of the proximal tibia pre-operatively. Cite this article: Bone Joint Res 2015;4:128–133

Nerve injury induces the expression of syndecan-1 heparan sulfate proteoglycan in primary sensory neurons

Heparan sulfate proteoglycans (HSPGs) have important functions in development of the central nervous system; however, their functions in nerve injury are not yet fully understood. We previously reported the expression of syndecan-1, a type of HSPG, in cranial motor neurons after nerve injury, suggesting the importance of syndecan-1 in the pathology of motor nerve injury. In this study, we examined the expression of syndecan-1, a type of HSPG, in primary sensory neurons after nerve injury in mice. Sciatic nerve axotomy strongly induced the expression of syndecan-1 in a subpopulation of injured dorsal root ganglion (DRG) neurons, which were small in size and had CGRP- or isolectin B4-positive fibers. Syndecan-1 was also distributed in the dorsal horn of the spinal cord ipsilateral to the axotomy, and located on the membrane of axons in lamina II of the dorsal horn. Not only sciatic nerve axotomy, infraorbital nerve axotomy also induced the expression of syndecan-1 in trigeminal ganglion neurons. Moreover, syndecan-1 knockdown in cultured DRG neurons induced a shorter neurite extension. These results suggest that syndecan-1 expression in injured primary sensory neurons may have functional roles in nerve regeneration and synaptic plasticity, resulting in the development of neuropathic pain.

Fibrosing cholestatic hepatitis developing within one month after living donor liver transplantation for chronic hepatitis C-related cirrhosis: a case report

Fibrosing cholestatic hepatitis (FCH) is a life-threatening consequence of hepatitis C virus (HCV) infection occurring in a small minority of liver transplantation (LT) recipients. We herein report a case of early-onset FCH after living donor LT in a 47-year-old woman with HCV-related cirrhosis. The patient underwent balloon-occluded retrograde transvenous obliteration of a splenorenal shunt to treat an impaired portal flow on the sixth postoperative day (POD 6) and a bypass operation for hepatic artery thrombosis on POD 12. Thereafter, the serum bilirubin levels increased gradually; however, computed tomography revealed no evidence of biliary stricture. The serum HCV-RNA level on POD 27 was >7.8 log IU/mL. Histopathology of a needle graft biopsy performed on POD 28 revealed FCH with extensive portal fibrosis accompanied by mild inflammation, hepatocyte ballooning, and ductular proliferation with cholestasis. The patient received combination therapy with pegylated interferon, ribavirin, and double-filtration plasmapheresis for the treatment of early-onset FCH. Both the recipient and the donor carried the major genotype single nucleotide polymorphism (TT) at rs8099917 near the interleukin-28B gene. Furthermore, the HCV genotype was treatment-sensitive 2a. Nonetheless, the recipient died of hepatic failure on POD 211. Thus far, few cases of FCH occurring within 1 month after LT have been reported. In addition, the early onset of FCH may be an adverse prognostic factor.

Cleavage pattern and development of isolated D blastomeres in bivalves

Although bivalves develop through spiral cleavage patterns, similar to other lophotrochozoans, the cleavage pattern of D lineage blastomeres is unique, since 2d shows four rounds of stereotypic unequal cleavage before bilateral cleavage of the largest derivative of 2d: 2d(1121) . This unique modification of spiral cleavage is directly associated with the characteristic morphology of bivalves, namely, bilaterally separated shell plates, because the bilateral shell plates are thought to be derived from the bilateral derivatives of 2d(1121) . In this report, to determine whether the unique cleavage pattern of bivalves is regulated depending on the interaction with other cells or by cell autonomous mechanisms, we performed cell isolation experiments and observed subsequent cleavage patterns of isolated blastomeres. When focusing on the largest derivatives of D blastomeres, 8% of isolated D blastomeres followed the cleavage pattern of normal development up to bilateral cleavage. Importantly, the remainder of the partial embryos ended cleavage before that stage, and none of the isolated blastomeres showed abnormal cleavage patterns. We also examined the development of isolated blastomeres and found that isolated D blastomeres could develop shell plates, whereas larvae developed from AB blastomeres never had shell plates. Based on these observations, we concluded that D blastomeres control their unique cleavage pattern through intrinsic mechanisms and develop shell glands autonomously without any cell-cell interaction with other lineages.

Formation of a Transfer Product from Stevioside by the Cultures of Actinomycete

An Actinomycete, strain K-128, which was isolated from soil, formed a transfer product when the strain was cultured in a medium containing both stevioside and curdlan. The transfer product in culture broth was separated by DIAION HP-20 column and TOYOPEARL HW-40F column chromatographies. From structural studies, the transfer product was identified as C13-O-beta-6(2)-beta-glucosylsophorosyl-C19-O-beta-glucopyranosyl steviol. This product was the first to be obtained by a culture of an Actinomycete.

Adjunct antibiotic combination therapy for steroid-refractory or -dependent ulcerative colitis: an open-label multicentre study

BACKGROUND

We previously demonstrated that antibiotic combination therapy is effective for induction and maintenance of ulcerative colitis (UC) remission.

AIM

To assess whether antibiotic combination therapy is effective for active UC refractory to or dependent on steroids in a multicentre, open-label trial.

METHODS

We enrolled 30 patients with steroid-refractory and 64 with steroid-dependent active UC. These patients received three-times-daily by mouth amoxicillin 500 mg, tetracycline 500 mg and metronidazole 250 mg, for two weeks, as well as conventional treatment. Symptom assessment and colonoscopic evaluation were performed before enrolment and at 3 and 12 months after treatment completion. Clinical response was defined as a Lichtiger symptom score decrease in ≥3 points and clinical remission as a score ≤4.

RESULTS

Nineteen of the 30 steroid-refractory (63.3%) and 47 of the 64 steroid-dependent (73.4%) patients showed a clinical response within 2 weeks. At 3 and 12 months, 60% and 66.6% of steroid-refractory patients, and 56.3% and 51.6% of steroid-dependent patients, respectively, achieved clinical remission. In the steroid-dependent group, 39 of the 64 patients (60.9%) were able to stop steroid therapy and remained in remission for 3 months. Three (10%) steroid-refractory and four (6.3%) steroid-dependent patients underwent colectomy.

CONCLUSIONS

This multicentre, long-term follow-up study suggests 2 week antibiotic combination therapy to be effective and safe in patients with active UC refractory to or dependent on steroids.

Evaluation of genetic introgression from domesticated pigs into the Ryukyu wild boar population on Iriomote Island in Japan

We evaluated genetic introgression from domesticated pigs into the Ryukyu wild boar (RWB) population on Iriomote Island based on their genetic structure and diversity. We used a combination of mitochondrial DNA D-loop region (596 bp) polymorphisms and 23 microsatellite markers. RWBs (n = 130) were collected from 18 locations on Iriomote Island and compared with 66 reference samples of European and Asian domestic pigs. We identified six distinct haplotypes, involving 22 single nucleotide polymorphisms (including one insertion) in the RWB population. The phylogenetic tree had two branches: the RWB group and domestic lineage. Fourteen of 130 RWBs (10.8%) belonged to the European domestic lineage, including 11 RWBs from the Panari Islands, northwest of Iriomote Main Island (IMI). The heterozygosity values, total number of alleles, number of effective alleles and polymorphism information content of the RWB groups were lower than those of the European domestic groups. The RWB population on IMI had a lower heterozygous deficiency index (FIS = 0.059) than did the other populations, which indicates that this population was more inbred. There was a large genetic distance (FST = 0.560) between RWBs on IMI and the Meishan populations. Structure analysis using the 23 microsatellite markers revealed that 16 RWBs had an admixture pattern between RWB and domesticated pig breeds. These results suggest that gene flow may have occurred from domestic pigs to RWBs and demonstrate that there was low genetic variation in the IMI population.

Effects of extracellular DNA from Candida albicans and pneumonia-related pathogens on Candida biofilm formation and hyphal transformation

AIMS

The aim of this study was to investigate the effects of genomic DNA purified from Candida albicans and pneumonia-related pathogens, Pseudomonas aeruginosa and Staphylococcus aureus, on in vitro biofilm formation and morphological change of 3 Candida species (C. albicans, C. glabrata, and C. tropicalis).

METHODS AND RESULTS

Biofilm formation was evaluated by the crystal violet assay and colony-forming unit counts. Morphological characteristics of biofilms were evaluated by scanning electron microscopy and fluorescence microscopy. Addition of DNA at a low concentration (<1·0 μg ml(-1)) significantly increased biofilm mass of all three Candida species. In contrast, the addition of DNA at a high concentration (10 μg ml(-1)) decreased the biofilm mass. Interestingly, the formation of hyphae in a dense network of yeast cells was observed in C. albicans biofilms exposed to a low concentration of DNA (<1·0 μg ml(-1)).

CONCLUSIONS

These findings demonstrated that extracellular DNA (eDNA) plays a crucial role in Candida biofilm formation and suggested that eDNA may induce the morphological transition from yeast to hyphal growth form during C. albicans biofilm development.

SIGNIFICANCE AND IMPACT OF THE STUDY

A novel therapy targeting eDNA may be applicable for Candida infection to decrease biofilm formation and hyphal formation.

Eating frequency in relation to body mass index and waist circumference in British adults

BACKGROUND

Inconsistent associations between eating frequency (EF) and adiposity may be mainly due to measurement errors of EF.

OBJECTIVE

This cross-sectional study examined the association of EF with body mass index (BMI) and waist circumference (WC), by focusing on the confounding of energy misreporting and the effect of exclusion of underreporters (URs).

DESIGN

Dietary intake was assessed using a 7-day weighed dietary record in 1487 British adults aged 19-64 years. EF was calculated based on all eating occasions (EF(all)), after excluding those providing no energy (EF(energy)), and after excluding those providing <210 kJ of energy (EF(⩾210 kJ)). Energy misreporting was assessed as reported energy intake divided by estimated energy requirement (EI:EER).

RESULTS

The mean values (1st and 99th percentiles) of EF(all), EF(energy) and EF(⩾210 kJ) were, respectively, 7.8 (3.1, 15.3), 7.2 (2.9, 12.7), and 5.6 (2.3, 10.7) times/day in men and 7.6 (3.0, 13.9), 6.7 (2.7, 12.1), and 4.8 (1.9, 9.1) times/day in women. In the univariate analyses of the entire male population, EF(⩾210 kJ), but not EF(all) and EF(energy), was inversely associated with BMI and WC. After full adjustment (including EI:EER), all three measures of EF were positively associated with BMI and WC. In the univariate analyses of the entire female population, all three measures of EF were inversely associated with BMI and WC. After full adjustment, EF(⩾210 kJ) was positively associated with BMI and WC while EF(all) and EF(energy) showed null associations. When URs (EI:EER <0.665) were excluded, the multivariate analyses showed that EF(all) and EF(energy) were positively associated with BMI in men while EF(⩾210 kJ) was positively associated with BMI and WC in both sexes.

CONCLUSIONS

We showed positive associations of EF with BMI and WC. Adjustment for EI:EER and the exclusion of URs, as well as definitions of EF, radically affected the results of the analysis.